The use of drugs in the first trimester of pregnancy: pharmacoepidemiologic study

2015 ◽  
Vol 21 (31) ◽  
pp. 45-47
Author(s):  
Арчегова ◽  
E. Archegova ◽  
Болиева ◽  
Laura Bolieva

The article presents the results of pharmacoepidemiological study the main goal of which was to analyze the real practice of drugs prescription to the pregnant women during the first trimester of pregnancy in hospitals of North Ossetia-Alania. A retrospective descriptive study based on medical records of patients (n=284) admitted to hospitals in 2012 was performed. According to the obtained data the main problems were: high frequency of prescribing drugs in pregnancy; great number of drugs prescribed to every pregnant women at the same time; high percent of drugs, when the reliable information of safety is lacking during the pregnancy.

2018 ◽  
pp. 14-18
Author(s):  
V.V. Kaminskyi ◽  
◽  
O.I. Zhdanovich ◽  
T.V. Kolomiychenko ◽  
A.D. Derkach ◽  
...  

The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.


Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 601
Author(s):  
Houyu Zhao ◽  
Mei Zhang ◽  
Jiaming Bian ◽  
Siyan Zhan

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.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 795
Author(s):  
Mary M. Murphy ◽  
Kelly A. Higgins ◽  
Xiaoyu Bi ◽  
Leila M. Barraj

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.


2020 ◽  
Vol 8 (9) ◽  
pp. 4317-4323
Author(s):  
Priyanka 1 ◽  
Shreyes. S ◽  
Yogitha Bali M.R

Background: During pregnancy many demands are made by growing fetus, to meet these requirements maternal system has to undergo certain changes. Garbhinichardi (Emesis Gravidarum) is one among them and this has been termed as Gruhita Garbha Lakshanas (Immediate signs of conception) in Ayurvedic clas-sics. Approximately 80 % of pregnant women experience excessive salivation, nausea and vomiting during pregnancy, commonly known as “morning sickness”, which is seen frequently throughout the day. Design: This is single blind pilot study. 30 patients with complaints of Garbhinichardi (Emesis Gravidarum) in first trimester were included in this study. Patients were given Chaturjatachurna (Chatutjata powder)for a peri-od of 2 weeks in dose of 3gms thrice a day after meal with Anupana (Adjuvant) as Madhu (honey) of 5ml mixed with Tandulodaka (Raw rice water) Results: This pilot study showed statistically significant changes with Chaturjatachurna in reducing the complaints of pregnant women such as nausea (p<0.001), vomiting (p<0.001) and Aruchi (Anorexia) (p<0.001) in their first trimester of pregnancy. Conclusion: Chaturjata-churna was effective in the management of Garbhini Chardi (Emesis Gravidarum) and other symptoms in the first trimester of pregnancy.


2021 ◽  
Vol 15 (4) ◽  
pp. e0009390
Author(s):  
Jamille Gregório Dombrowski ◽  
André Barateiro ◽  
Erika Paula Machado Peixoto ◽  
André Boler Cláudio da Silva Barros ◽  
Rodrigo Medeiros de Souza ◽  
...  

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.


Author(s):  
Thais de Pontes Ellery ◽  
Helena de Carvalho Sampaio ◽  
Antônio Carioca ◽  
Bruna da Costa Silva ◽  
Júlio Alves ◽  
...  

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Hsiao-Ling Wang ◽  
Tzu-Chi Lee ◽  
Shih-Hsien Kuo ◽  
Fan-Hao Chou ◽  
Li-Li Chen ◽  
...  

The purpose of this study was to explore correlations among constitution, stress, and discomfort symptoms during the first trimester of pregnancy. We adopted a descriptive and correlational research design and collected data from 261 pregnant women during their first trimester in southern Taiwan using structured questionnaires. Results showed that (1) stress was significantly and positively correlated with Yang-Xu, Yin-Xu, and Tan-Shi-Yu-Zhi constitutions, respectively; (2) Yin-Xu and Tan-Shi-Yu-Zhi constitutions had significant correlations with all symptoms of discomfort, while Yang-Xu had significant correlations with all symptoms of discomfort except for “running nose”; (3) Tan-Shi-Yu-Zhi constitution and stress were two indicators for “fatigue”; Tan-Shi-Yu-Zhi was the indicator for “nausea”; Yang-Xu and Yin-Xu were indicators for “frequent urination.” Our findings also indicate that stress level affects constitutional changes and that stress and constitutional change affect the incidence of discomfort. This research can help healthcare professionals observe these discomforts and provide individualized care for pregnant women, to nurture pregnant women into neutral-type constitution, minimize their levels of discomfort, and promote the health of the fetus and the mother.


2020 ◽  
Vol 16 ◽  
pp. 174550652094939
Author(s):  
Sharath Chandra Guntuku ◽  
Jessica S Gaulton ◽  
Emily K Seltzer ◽  
David A Asch ◽  
Sindhu K Srinivas ◽  
...  

We sought to evaluate whether there was variability in language used on social media across different time points of pregnancy (before, during, and after pregnancy, as well as by trimester and parity). Consenting patients shared access to their individual Facebook posts and electronic medical records. Random forest models trained on Facebook posts could differentiate first trimester of pregnancy from 3 months before pregnancy (F1 score = .63) and from a random 3-month time period (F1 score = .64). Posts during pregnancy were more likely to include themes about family (β = .22), food craving (β = .14), and date/times (β = .13), while posts 3 months prior to pregnancy included themes about social life (β = .30), sleep (β = .31), and curse words (β = .27), and 3 months post-pregnancy included themes of gratitude (β = .17), health appointments (β = .21), and religiosity (β = .18). Users who were pregnant for the first time were more likely to post about lack of sleep (β = .15), activities of daily living (β = .09), and communication (β = .08) compared with those who were pregnant after having a child who posted about others’ birthdays (β = .16) and life events (.12). A better understanding about social media timelines can provide insight into lifestyle choices that are specific to pregnancy.


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