Changes in serum TG levels during pregnancy and their association with postpartum hypertriglyceridemia: a population-based prospective cohort study

Abstract Background Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Methods A total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves. Results There was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM. Conclusions Gestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.

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Is Indoor Air Pollution From Different Fuel Types Associated With the Anemia Status of Pregnant Women in Ethiopia?

Journal of Primary Care & Community Health ◽

10.1177/21501327211034374 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110343

Author(s):

Sewitemariam Desalegn Andarge ◽

Abriham Sheferaw Areba ◽

Robel Hussen Kabthymer ◽

Miheret Tesfu Legesse ◽

Girum Gebremeskel Kanno

Keyword(s):

Air Pollution ◽

Logistic Regression ◽

Pregnant Women ◽

Indoor Air ◽

Pregnancy Outcomes ◽

Indoor Air Pollution ◽

Adverse Pregnancy Outcomes ◽

Outcome Variable ◽

Multivariable Logistic Regression Analysis ◽

Adverse Pregnancy

Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.

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Variation of Efficacy of Filtering Face Pieces Respirators over Time in a Dental Setting: A Pilot Study

Dentistry Journal ◽

10.3390/dj9040036 ◽

2021 ◽

Vol 9 (4) ◽

pp. 36

Author(s):

Vittorio Checchi ◽

Marco Montevecchi ◽

Luigi Checchi

Keyword(s):

Fixed Effects ◽

Random Effect ◽

Wilcoxon Test ◽

Linear Mixed Effect Model ◽

Clinical Activity ◽

Time Data ◽

Paired Data ◽

Mixed Effect ◽

Protective Function ◽

Over Time

Since aerosol continuously persists in dental settings, where different procedures and patients come in succession, the use of oronasal masks is highly recommended. Among them, respirators known as Filtering Face Pieces (FFP) show a protective superiority compared to surgical masks. Even concerning respirators classified as non-reusable, it is not known how many hours of use are necessary to compromise their filtering capacity. The aim of this study is to investigate the variations of filtering capacity of an FFP2 respirator over time, in order to safely optimize the timing of its use. Five respirators were worn by the same operator during clinical activity for different usage times (8, 16, 24, 32, 40 h), and one respirator was kept unused. All respirators underwent a bacterial filtration efficacy (BFE) test. T-test for paired data with Bootstrap technique and Wilcoxon test for paired data compared BFE values of the five tested FFP2s respectively at each time, and the areas with the corresponding values of the control respirator (FFp2-F). A generalized linear mixed effect model (GLM) was applied considering type of respirator and time as fixed effects and intercept as random effect. No significant statistical differences were present in the BFE of each time. Data obtained by the present study highlight the important ability of FFP2s to maintain their BFE over time, suggesting a long lasting protective function.

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Dynamic hematological changes in patients undergoing distal pancreatectomy with or without splenectomy: a population-based cohort study

10.21203/rs.3.rs-51696/v1 ◽

2020 ◽

Author(s):

Ming Cui ◽

Jing-Kai Liu ◽

Bang Zheng ◽

Qiao-Fei Liu ◽

Lu Zhang ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Hematological Parameters ◽

Population Based ◽

Linear Mixed Effect Model ◽

Mixed Effect ◽

Spleen Preserving ◽

Effect Model ◽

Vessel Preservation ◽

Splenic Vessel Preservation ◽

Hematological Changes

Abstract Background: The clinical outcomes of distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) patients have been generally investigated. However, postoperative hematological changes after distal pancreatectomy with or without splenectomy are poorly understood. Methods: Information from patients undergoing distal pancreatectomy (DP) between January 2014 and June 2019 at a single institution was reviewed. A linear mixed-effect model was used to compare dynamic hematological changes between different groups. Results: In total, 302 patients who underwent DP were enrolled. In the long term, most postoperative hematological parameters remained significantly higher than preoperative levels in the DPS group, while postoperative lymphocyte, monocyte, basophil, and platelet levels returned to preoperative levels in the SPDP group. All postoperative hematological parameters except for red blood cell count and serum hemoglobulin level were significantly higher in the DPS group than in the SPDP group. There were no significant differences in hematological changes between the splenic vessel preservation (SVP) and Warshaw technique (WT) groups. Conclusions: Postoperative hematological changes were significantly different between the DPS and SPDP groups. Compared to DPS, SPDP reduced abnormal hematological changes caused by splenectomy. SVP and WT were comparable in terms of postoperative hematological changes.

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The determinant of National Vitamin A supplementation in Ethiopia: A Multilevel Logistic Regression Analysis

10.21203/rs.3.rs-17477/v1 ◽

2020 ◽

Author(s):

Mohammed M. Oumer ◽

Zelalem Mengestu ◽

Sewbesew Yitayih ◽

Malede Mequanent ◽

Ayenew Molla

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Vitamin A ◽

Low Income ◽

Associated Factors ◽

Vitamin A Deficiency ◽

Public Health Problem ◽

Linear Mixed Effect Model ◽

Mixed Effect ◽

Vitamin A Supplementation

Abstract Background: Vitamin A deficiency is a public health problem in many low-income countries including Ethiopia. Globally, the prevalence of vitamin A deficiency is estimated to be 190 million among children under-five age causing one up to two million deaths annually.Its periodic supply is a major intervention program to reduce the morbidity, mortality, and blindness among the children in Ethiopia. Objective: The aim of this study was to determine associated factors of national vitamin A supplementationamong children aged 6-59 monthsusing the 2016 Ethiopian Demographic and Health Survey Data. Methods: A population based cross-sectional study design wasperformed to determine factors associated with the vitamin A supplyamong children aged between 6 and 59 monthswithin the last six months before the start of the survey. A univariateanalysis, bivariate analysis, binary logistic regression, and generalized linear mixed effect model were appliedto analyze the data. Results: After adjusting for covariates; the odds of taking vitamin A supply were 1.3 times, 1.7 times, and 1.8 times higher among the women who had two, three, and four and above antenatal care visits, respectively. The mothers’ employment status, health cheek up after their delivery,and theirhealth facility delivery were positively influence the uptake of the vitamin A capsule. In addition,women residing in the communities with high proportion of the media exposure[AOR (Adjusted Odds Ratio) = 1.17 (95%CI: 1.00, 1.37)]were positively associated with the receipt of vitamin A capsule.Random effects indicated that the variation on the uptake of vitamin A supplementation between the communities was statistically significant in all stage of the models. Conclusions: The individual and community level characteristics had a significant influence on the uptake of vitamin A supplementation. Therefore, these factors should be considered in policy formulation and programming in order to improve the coverage of vitamin A supplementation in Ethiopia. Keywords: Vitamin A supply, associated factors, multilevellogistic regression analysis, Ethiopia

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Pregnancy outcomes with Primary Sjogren's syndrome among Chinese women: a retrospective cohort study

10.21203/rs.2.14389/v1 ◽

2019 ◽

Author(s):

Jinfeng Xu ◽

Daijuan Chen ◽

Yuan Tian ◽

Bing Peng

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Pregnant Women ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Primary Sjögren’S Syndrome ◽

Odds Ratios ◽

Primary Sjogren’S Syndrome ◽

Adverse Pregnancy

Abstract Background Data on pregnancy outcomes in Primary Sjogren's syndrome (pSS) women are scarce, and results have been conﬂicting. The aim of our study is to analyze the adverse pregnancy outcome in patients with pSS. Methods This was a retrospective cohort study conducted at a tertiary medical center located in Chengdu, Sichuan, China, from May 2013 to November 2018. The relevant medical records of all pregnant women were retrospectively reviewed. Logistic regression analyses were performed to compute crude odds ratios (crude OR) with 95% confidence intervals (CI) for maternal and fetal outcomes. Adjusted odds ratios (aOR) were estimated by logistic regression adjusted for confounders. Results Women with pSS had a significantly higher incidence of pre-eclampsia (aOR 11.49, 95% CI 1.65-79.98), PPROM (aOR 5.09, 95% CI 1.14-22.63). Compared to general population, pregnant women with pSS were at increased risks of fetal loss (aOR 15.06, 95%CI 1.19 to 191.11), and a higher risk of fetal growth restriction (aOR 15.69, 95%CI 1.61 to 153.33), preterm birth (aOR 5.52, 95%CI 1.83 to 16.65), a cesarean section (aOR 6.53, 95%CI 3.18 to 13.42) and a neonatal intensive care unit admission (aOR 12.86, 95%CI 1.88 to 87.82) after adjusting for confounding factors. The rate of congenital heart block in the pSS group was 4.7%. Conclusions Pregnant women with pSS were at increased risk of having adverse pregnancy outcomes. Women with pSS require prenatal counseling to explain the risks involved and well control of pSS condition before conception and a close antenatal monitoring should be performed by both rheumatologists and obstetricians.

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The Global Network Maternal Newborn Health Registry: a multi-country, community-based registry of pregnancy outcomes

Reproductive Health ◽

10.1186/s12978-020-01020-8 ◽

2020 ◽

Vol 17 (S2) ◽

Cited By ~ 1

Author(s):

Elizabeth M. McClure ◽

Ana L. Garces ◽

Patricia L. Hibberd ◽

Janet L. Moore ◽

Shivaprasad S. Goudar ◽

...

Keyword(s):

Health Care ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Newborn Health ◽

Population Based ◽

Global Network ◽

Resource Limited ◽

Health Registry ◽

Population Based Registry ◽

Over Time

Abstract Background The Global Network for Women's and Children’s Health Research (Global Network) conducts clinical trials in resource-limited countries through partnerships among U.S. investigators, international investigators based in in low and middle-income countries (LMICs) and a central data coordinating center. The Global Network’s objectives include evaluating low-cost, sustainable interventions to improve women’s and children’s health in LMICs. Accurate reporting of births, stillbirths, neonatal deaths, maternal mortality, and measures of obstetric and neonatal care is critical to determine strategies for improving pregnancy outcomes. In response to this need, the Global Network developed the Maternal Newborn Health Registry (MNHR), a prospective, population-based registry of pregnant women, fetuses and neonates receiving care in defined catchment areas at the Global Network sites. This publication describes the MNHR, including participating sites, data management and quality and changes over time. Methods Pregnant women who reside in or receive healthcare in select communities are enrolled in the MNHR of the Global Network. For each woman and her offspring, sociodemographic, health care, and the major outcomes through 42-days post-delivery are recorded. Study visits occur at enrollment during pregnancy, at delivery and at 42 days postpartum. Results From 2010 through 2018, the Global Network MNHR sites were located in Guatemala, Belagavi and Nagpur, India, Pakistan, Democratic Republic of Congo, Kenya, and Zambia. During this period at these sites, 579,140 pregnant women were consented and enrolled in the MNHR, nearly 99% of all eligible women. Delivery data were collected for 99% of enrolled women and 42-day follow-up data for 99% of those delivered. In this supplement, the trends over time and assessment of differences across geographic regions are analyzed in a series of 18 manuscripts utilizing the MNHR data. Conclusions Improving maternal, fetal and newborn health in countries with poor outcomes requires an understanding of the characteristics of the population, quality of health care and outcomes. Because the worst pregnancy outcomes typically occur in countries with limited health registration systems and vital records, alternative registration systems may prove to be highly valuable in providing data. The MNHR, an international, multicenter, population-based registry, assesses pregnancy outcomes over time in support of efforts to develop improved perinatal healthcare in resource-limited areas. Trial Registration The Maternal Newborn Health Registry is registered at Clinicaltrials.gov (ID# NCT01073475). Registered February 23, 2019. https://clinicaltrials.gov/ct2/show/NCT01073475

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Comparison of Various Obesity-Related Indices for Identification of Metabolic Syndrome: A Population-Based Study from Taiwan Biobank

Diagnostics ◽

10.3390/diagnostics10121081 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1081

Author(s):

Tai-Hua Chiu ◽

Ya-Chin Huang ◽

Hsuan Chiu ◽

Pei-Yu Wu ◽

Hsin-Ying Clair Chiou ◽

...

Keyword(s):

Metabolic Syndrome ◽

Logistic Regression ◽

Predictive Performance ◽

Roc Curves ◽

Shape Index ◽

Population Based ◽

Volume Index ◽

Visceral Adiposity Index ◽

Adiposity Index ◽

Tyg Index

This study aimed to evaluate the performance of 11 obesity-related indices, including body mass index (BMI), waist circumference, waist-to-height ratio, waist–hip ratio, a body shape index, abdominal volume index, body adiposity index, body roundness index, conicity index, visceral adiposity index (VAI), and triglyceride glucose (TyG) index, in identifying metabolic syndrome (MetS) in adults. The information of 5000 participants was obtained from the Taiwan Biobank. Logistic regression analyses were performed to determine the associations between MetS and obesity-related indices with odds ratio (ORs). The predictive performance of the indices to identify MetS was compared using receiver operating characteristic (ROC) curves and areas under curves (AUCs). Multivariate-adjusted logistic regression showed that the ORs for MetS increased across the quartiles of each index. ROC curves analysis demonstrated that TyG index had the greatest AUC in men (AUC = 0.850) and women (AUC = 0.890). Furthermore, VAI had the greatest AUC in men (AUC = 0.867) and women (AUC = 0.925) aged 30−50 years, while TyG index had the greatest AUC in men (AUC = 0.849) and women (AUC = 0.854) aged 51−70 years. Among the studied obesity-related indices, TyG index and VAI exhibited the best performance for identifying MetS in adults. TyG index and VAI may be the relevant indices to assess MetS in clinical practice.

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Burden, risk factors and outcomes associated with gestational diabetes in a population-based cohort of pregnant women from North India

BMC Pregnancy and Childbirth ◽

10.1186/s12884-022-04389-5 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Stuti Bahl ◽

Neeta Dhabhai ◽

Sunita Taneja ◽

Pratima Mittal ◽

Rupali Dewan ◽

...

Keyword(s):

Risk Factors ◽

Clinical Trial ◽

Caesarean Section ◽

Gestational Diabetes ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Population Based ◽

Adverse Pregnancy Outcomes ◽

Oral Glucose ◽

Adverse Pregnancy

Abstract Background The burden of gestational diabetes mellitus (GDM) appears to be increasing in India and may be related to the double burden of malnutrition. The population-based incidence and risk factors of GDM, particularly in lower socio-economic populations, are not known. We conducted analyses on data from a population-based cohort of pregnant women in South Delhi, India, to determine the incidence of GDM, its risk factors and association with adverse pregnancy outcomes (stillbirth, preterm birth, large for gestational age babies) and need for caesarean section. Methods We analyzed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), an individually randomized factorial design trial. An oral glucose tolerance test (OGTT) was performed at the time of confirmation of pregnancy, and for those who had a normal test (≤140 mg), it was repeated at 24–28 and at 34–36 weeks. Logistic regression was performed to ascertain risk factors associated with GDM. Risk ratios (RR) were calculated to find association between GDM and adverse pregnancy outcomes and need for caesarean section. Results 19.2% (95% CI: 17.6 to 20.9) pregnant women who had at least one OGTT were diagnosed to have GDM. Women who had prediabetes at the time of confirmation of pregnancy had a significantly higher risk of developing GDM (RR 2.08, 95%CI 1.45 to 2.97). Other risk factors independently associated with GDM were woman’s age (adjusted OR (AOR) 1.10, 95% CI 1.06 to 1.15) and BMI (AOR 1.04, 95% CI 1.01 to 1.07). Higher maternal height was found to be protective factor for GDM (AOR 0.98, 95% CI 0.96 to 1.00). Women with GDM, received appropriate treatment did not have an increase in adverse outcomes and no increased need for caesarean section Conclusions A substantial proportion of pregnant women from a low to mid socio-economic population in Delhi had GDM, with older age, higher BMI and pre-diabetes as important risk factors. These findings highlight the need for interventions for prevention and provision of appropriate management of GDM in antenatal programmes. Clinical trial registration Clinical Trial Registry – India, #CTRI/2017/06/008908 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies).

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Burden, Risk Factors and Outcomes Associated with Gestational Diabetes in A Population-Based Cohort of Pregnant Women from North India

10.21203/rs.3.rs-654299/v1 ◽

2021 ◽

Author(s):

Stuti Bahl ◽

Neeta Dhabhai ◽

Sunita Taneja ◽

Pratima Mittal ◽

Rupali Dewan ◽

...

Keyword(s):

Risk Factors ◽

Clinical Trial ◽

Caesarean Section ◽

Gestational Diabetes ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Population Based ◽

Adverse Pregnancy Outcomes ◽

Oral Glucose ◽

Adverse Pregnancy

Abstract Background: The burden of gestational diabetes mellitus (GDM) appears to be increasing in India and may be related to the double burden of malnutrition. The population-based incidence and risk factors of GDM, particularly in lower socio-economic populations, are not known. We conducted analyses on data from a population-based cohort of pregnant women in South Delhi, India, to determine the incidence of GDM, its risk factors and association with adverse pregnancy outcomes (stillbirth, preterm birth, large for gestational age babies) and need for caesarean section. Methods: We analyzed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), an individually randomized factorial design trial. An oral glucose tolerance test (OGTT) was performed at the time of confirmation of pregnancy, and for those who had a normal test (≤140 mg), it was repeated at 24-28 and at 34-36 weeks. Logistic regression was performed to ascertain risk factors associated with GDM. Risk ratios (RR) were calculated to find association between GDM and adverse pregnancy outcomes and need for caesarean section. Results: 19.2% (95% CI: 17.6 to 20.9) pregnant women who had at least one OGTT were diagnosed to have GDM. Women who had prediabetes at the time of confirmation of pregnancy had a significantly higher risk of developing GDM (RR 2.08, 95%CI 1.45 to 2.97). Other risk factors independently associated with GDM were woman’s age (adjusted OR (AOR) 1.10, 95% CI 1.06 to 1.15) and BMI (AOR 1.04, 95% CI 1.01 to 1.07). Higher maternal height was found to be protective factor for GDM (AOR 0.98, 95% CI 0.96 to 1.00). Women with GDM, received appropriate treatment did not have an increase in adverse outcomes. However, GDM increased the need for caesarean section (RR 1.17, 95% CI 1.01 to 1.36).Conclusions: A substantial proportion of pregnant women from a low to mid socio-economic population in Delhi had GDM, with older age, higher BMI and pre-diabetes as important risk factors. These findings highlight the need for interventions for prevention and provision of appropriate management of GDM in antenatal programmes.Clinical Trial registration: Clinical Trial Registry – India, #CTRI/2017/06/008908 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies)

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Patterns of contraceptive use among Australian women of reproductive age with chronic disease: a prospective cohort study

10.22541/au.163934441.16631258/v1 ◽

2021 ◽

Author(s):

Melissa Harris ◽

Nicholas Egan ◽

Peta Forder ◽

Deborah Bateson ◽

Deborah Loxton

Keyword(s):

Cohort Study ◽

Chronic Disease ◽

Contraceptive Use ◽

Population Data ◽

Population Based ◽

Reproductive Age ◽

National Guidelines ◽

Mixed Effect ◽

Transition Analysis ◽

Over Time

Objective: Examine patterns of contraceptive use among reproductive age women, with and without chronic disease, and investigate factors which influence contraceptive use over time. Design: Population-based cohort study Setting and population: Data from 8,030 women from the Australian Longitudinal Study on Women’s Health. Main outcome measures: Contraceptive patterns identified using latent transition analysis. Methods: Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results: Women with chronic disease used contraception at similar rates to women without chronic disease however contraceptive non-use increased over the observation period (13.6% vs 12.7% in 2018 when aged 40-45 years). When specific contraceptive use patterns were examined over time, differences were found for women with autoinflammatory diseases only. Compared to women without chronic disease using the pill and condoms, women with autoinflammatory disease had increased odds of using condom and natural methods (OR=1.20, 95% CI=1.00, 1.44), and sterilisation and other methods (OR=1.61, 95% CI=1.08, 2.39) or no contraception (OR=1.32, 95% CI=1.04, 1.66), compared to women without chronic disease using short-acting methods and condoms. Conclusion: Potential gaps in the provision of appropriate contraceptive access and care exist for women with chronic disease, particularly those diagnosed with autoinflammatory conditions. Development of national guidelines as well as a clear coordinated contraceptive strategy from adolescence through to the mid reproductive years and perimenopause encouraging regular contraceptive review during care management to increase support for, and agency among, women with chronic disease is required.

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