scholarly journals Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

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 ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Multivariate Logistic Regression Analysis ◽  
Brazilian Amazon ◽  
First Trimester ◽  
Inflammatory Factors ◽  
Anthropometric Measures ◽  
First Trimester Of Pregnancy ◽  
Adverse Pregnancy ◽  
Angiopoietin 2

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.

scholarly journals High starchy food intake may increase the risk of adverse pregnancy outcomes: a nested case-control study in the Shaanxi province of Northwestern China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Liyan Huang ◽  
Li Shang ◽  
Wenfang Yang ◽  
Danyang Li ◽  
Cuifang Qi ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Pregnancy Outcomes ◽  
Case Control Study ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Starchy Food ◽  
First Trimester Of Pregnancy ◽  
Adverse Pregnancy ◽  
Nested Case Control ◽  
Control Study

Abstract Background There was a wider disparity in the diet characterization among most studies on diet and pregnancy outcomes in different countries, and the research in northern China is limited. Therefore, the purpose of the present study that was conducted in northwest China was to understand the dietary characteristics of periconceptional women and to explore the relationship between and specific dietary patterns with adverse pregnancy outcomes. Methods A nested case-control study was conducted from October 2017 to November 2018 in Shaanxi, China. Based on a prospective cohort of 368 women who were pregnant or prepared for pregnancy, 63 participants who developed the outcomes of gestational hypertension, gestational diabetes, preterm birth, low birth weight, and birth defects were included in the case group. A total of 237 healthy pregnant women were included during the same period in the control group. Dietary intake was assessed using a validated food frequency questionnaire for the three months before pregnancy and the first trimester. Information on delivery details and antenatal pregnancy complications was obtained from the hospital maternity records. Dietary patterns were derived using factor analysis. Stratified analysis was performed on the overall, single and multiple adverse pregnancy outcomes categories. Adjustment was made for sociodemographic characteristics and nutritional supplement status. Results Six major dietary patterns were identified. The ‘starchy’ dietary pattern, composed of high intake in noodle and flour products and/or rice and its products, was associated with the odds of developing of adverse pregnancy outcomes (OR: 2.324, 95% CI: 1.293–4.178). This risk remained significant following adjustment for potential confounders of maternal demographic characteristics and nutritional status (aOR: 2.337, 95% CI:1.253–4.331). Strong association were found during the first trimester of pregnancy, but showed no association during the three months before pregnancy (aOR:1.473, 95% CI: 0.682–3.234). Conclusions High starchy food intake was associated with adverse pregnancy outcomes, particularly during the first trimester of pregnancy. Health education focusing on periconceptional dietary patterns could be a practical strategy for preventing adverse pregnancy outcomes.

scholarly journals Angiopoietin 1 and 2 serum concentrations in first trimester of pregnancy as biomarkers of adverse pregnancy outcomes

2014 ◽  
Vol 210 (4) ◽  
pp. 345.e1-345.e9 ◽  
Author(s):  
Francisco J. Schneuer ◽  
Christine L. Roberts ◽  
Anthony W. Ashton ◽  
Cyrille Guilbert ◽  
Vitomir Tasevski ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Serum Concentrations ◽  
First Trimester Of Pregnancy ◽  
Adverse Pregnancy ◽  
Angiopoietin 1

scholarly journals Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study

2021 ◽  
Author(s):  
Xiaomei Zhang ◽  
Ning Yuan ◽  
Jianbin Sun ◽  
Xin Zhao ◽  
Jing Du ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Iodine Deficiency ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Single Center ◽  
Iodine Level ◽  
Adverse Pregnancy ◽  
Beijing China

AbstractIodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658–8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465–6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539–5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb (Pnon-linear < 0.05). Iodine deficiency during the first trimester is a risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405

scholarly journals How does subchorionic hematoma in the first trimester affect pregnancy outcomes?

2021 ◽  
Author(s):  
Taner Günay ◽  
Oğuz Yardımcı
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Placental Abruption ◽  
First Trimester ◽  
Early Pregnancy Loss ◽  
Adverse Pregnancy

IntroductionSubchorionic hematoma (SCH) in pregnancy has been associated with increased risk of adverse pregnancy outcomes. We aimed to investigate the association of SCH with adverse pregnancy outcomes in pregnant women in relation to size of hematoma and control subjects.Material and methodsThis study included 178 pregnant women with sonographically detected SCH in the 1st trimester, and 350 pregnant controls without SCH. Data on maternal age, smoking status, gestational week at diagnosis, location of SCH, medications before diagnosis, gestational week at delivery, delivery route and pregnancy outcomes (first trimester vaginal bleeding, pre-eclampsia, gestational diabetes, intrauterine growth restriction (IUGR), placental abruption, preterm delivery < 37 weeks, early pregnancy loss and intrauterine death) were retrieved retrospectively from hospital records. Pregnant women with SCH were divided into 3 groups according to the size of hematoma including small SCH (SCH-I group, n = 47), medium- size SCH (SCH-II group, n = 110) and large SCH (SCH-III group, n = 21) groups.ResultsSubchorionic hematoma was associated with significantly lower gestational age at delivery (p < 0.001) and higher rate of first trimester bleeding (p < 0.001) compared with the control group, regardless of the size of the hematoma. Placental abruption (p = 0.002) and early pregnancy loss (p < 0.001) were significantly more common in SCH-II and -III groups than in the control group. SCH-III group was associated with a significantly higher rate of < 37 gestational weeks at delivery (p < 0.001), first trimester vaginal bleeding (p < 0.001), early pregnancy loss (p < 0.001), IUGR (p = 0.003) and preterm delivery (p < 0.001) compared to both lesser size hematoma and control groups.ConclusionsIn conclusion, our findings suggest that large SCH might indicate an increased risk of adverse pregnancy outcomes such as 1st trimester vaginal bleeding, early pregnancy loss, IUGR, placental abruption or preterm delivery. These findings are important to guide the patients with SCH for detailed clinical evaluation.

scholarly journals Zika Virus Infection in a Cohort of Pregnant Women with Exanthematic Disease in Manaus, Brazilian Amazon

2020 ◽  
Author(s):  
Elijane de Fátima Redivo ◽  
Camila Helena Bôtto Menezes ◽  
Márcia da Costa Castilho ◽  
Marianna Facchinetti Brock ◽  
Evela da Silva Magno ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Zika Virus ◽  
Descriptive Analysis ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Rt Pcr ◽  
Zikv Infection ◽  
Adverse Pregnancy ◽  
In Pregnancy

The epidemic transmission of Zika virus (ZIKV) in Brazil has been identified as a cause of microcephaly and other neurological malformations in babies of ZIKV-infected women. This study provides a descriptive analysis, since the onset of symptoms to the delivery, of a cohort who were registered as having ZIKV infection in pregnancy, from November 2015 to December 2016. Suspected cases were registered at a referral center for infectious and tropical diseases in Manaus, in the Brazilian Amazonian region. A total of 834 women with suspected ZIKV in pregnancy were included, of whom 91.4% had confirmed pregnancy. Reverse-transcriptase polymerase chain reaction (RT-PCR) confirmed ZIKV infection in 42.2% of the cohort. In 35.2% of the cohort, ZIKV was the sole infection identified. Severe adverse pregnancy outcomes (abortion, stillbirth, or microcephaly) were observed in both RT-PCR ZIKV-positive (4.96%) and ZIKV-negative (2.15%) cases. Women with suspected ZIKV infection were much more likely to have adverse pregnancy outcomes if they were symptomatic during the first trimester of pregnancy (odds ratio 10.5; 95% confidence interval 4.0&ndash;27.0; p&lt;0.001). Among pregnant women with suspected ZIKV infection, the occurrence of symptoms in the first trimester is associated with an especially high risk of severe adverse pregnancy outcomes.

scholarly journals First-Trimester Fasting Hyperglycemia without Gestational Diabetes Mellitus is not Associated with Adverse Pregnancy Outcomes:A Prospective Cohort Study in China

2020 ◽  
Author(s):  
Zhiheng Guo ◽  
Yanhong Shan ◽  
Caifeng Xiu ◽  
Yi Yang ◽  
Shu Zheng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Prospective Cohort ◽  
First Trimester ◽  
Adverse Pregnancy

Abstract Background Gestational diabetes mellitus (GDM) is a common pregnancy-induced metabolic complication worldwide. At present, a variety of strategies for diagnosis and management of GDM have been recommended. Our aim is to investigate the clinical features and pregnancy outcomes among women in whom a first-trimester fasting glucose value (≥ 5.10 mmol/L but < 7.0 mmol/L) was detected and a 2-h 75-g oral glucose tolerance test (OGTT) between 24–28 weeks was negative.Methods This is a prospective cohort study of women who registered and delivered between June 2016 and November 2019 at First Hospital, Jilin University. Pregnant women who met the inclusion criteria were categorized as normal first-trimester fasting plasma glucose(FPG)(< 5.10 mmol/L) and first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L).Outcomes included weeks at time of delivery, neonatal birth weight, Apgar score at 1 min, Apgar score at 5 min, prevalence of macrosomia, hypertensive disorders of pregnancy ,primary cesarean delivery, preterm delivery ,premature rupture of membranes and sillbirth or neonatal death were compared after women who developed gestational diabetes mellitus (GDM) were excluded.Results In our population of 2124 eligible subjects, pregnant women with first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L) constituted 20.8% of the total study population and accounted for 27.6% of subsequent GDM diagnosis. The other 1683 had a normal first-trimester FPG (< 5.1 mmol/L), accounting for 11.6% of all subsequent GDM diagnosis (p < 0.01).After excluding women with a diagnosis of GDM between 24 and 28 weeks of gestation, we observed no significant difference between groups for adverse maternal and prenatal outcomes.Conclusion More than two thirds of first-trimester fasting hyperglycemia pregnant women will have a normal OGTT performed at 24–28 week and of these women whom in no increased risk of adverse pregnancy outcomes have been identified.

scholarly journals Composition of Vaginal Microflora in Relation to Vaginal pH and Wet Mount Diagnostic Tests in the First Trimester of Pregnancy

2014 ◽  
Vol 67 (6) ◽  
pp. 478-484
Author(s):  
Jana Žodžika ◽  
Dace Rezeberga ◽  
Gilbert Donders ◽  
Natālija Vedmedovska ◽  
Olga Vasina ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Multivariate Logistic Regression Analysis ◽  
First Trimester ◽  
Antenatal Visit ◽  
Cross Sectional ◽  
E Coli ◽  
Vaginal Microflora ◽  
Wet Mount ◽  
Vaginal Ph ◽  
First Trimester Of Pregnancy

Abstract The aim of the study was to determine the relations between vaginal culture results, elevated vaginal pH and abnormal vaginal microflora observed in microscopy, during the first trimester of pregnancy. A cross-sectional, observational study of 100 women receiving antenatal care in five outpatient clinics was carried out in Rîga from March 2010 until April 2011. Pregnant women at the first antenatal visit were submitted to a vaginal specimen collection for pH measurement, wet mount and cultures. Fifty pregnant women with vaginal pH 4.5 and 50 subsequent pregnant women with vaginal pH less than 4.5 were included. 96% of women with increased pH and 86% of women with normal vaginal pH showed positive cultures. Increased vaginal pH was significantly associated with M. hominis (P < 0.001), U. urealyticum (P = 0.017) and E. coli (P = 0.018). Abnormal vaginal microflora patterns showed similar associations with culture findings. Multivariate logistic regression analysis showed the highest risk of abnormal vaginal microflora associated with M. hominis (OR 14.4, 95% CI 1.6–124.4, P = 0.015) and E. coli (OR 8.5, 95% CI 1.6–45.9, P = 0.013). Increased vaginal pH and abnormal vaginal microflora pattern in wet mounts was associated with M. hominis and E. coli in vaginal cultures.

scholarly journals Perceived Barriers to Exercise in the First Trimester of Pregnancy

2018 ◽  
Vol 27 (4) ◽  
pp. 198-206 ◽  
Author(s):  
Terin T. Sytsma ◽  
Kate P. Zimmerman ◽  
Jennifer B. Manning ◽  
Sarah M. Jenkins ◽  
Nancy C. Nelson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Regular Physical Activity ◽  
Perceived Barriers ◽  
Barriers To Exercise ◽  
First Trimester Of Pregnancy

Regular physical activity has been shown to improve pregnancy outcomes. We sought to identify barriers to exercise during the first trimester of pregnancy. Five hundred forty-nine pregnant women in their first trimester rated barriers to exercise on a scale of 1 (not a barrier) to 5 (a huge barrier) and recorded physical activity (minutes/week). Women were placed into one of three classifications, nonexercisers (zero exercise), infrequent exercisers (<150 minutes/week), or exercisers (≥150 minutes/week). The greatest barriers (mean) were nausea/fatigue (3.0) and lack of time (2.6). Exercisers reported significantly lower barrier levels. Nausea/fatigue was a greater barrier for nonexercisers compared to exercisers (3.6 vs 2.8, p < .001). Focusing education and interventions on these barriers may help pregnant women achieve healthy exercise levels.

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