Peculiarities of hormonal balance and metabolic profile in pregnant women with different obesity types

2020 ◽  
pp. 67-72
Author(s):  
К. Tyshko ◽  
◽  
О. Gnatko ◽  

Maternal obesity has become one of the main factors influencing obstetric and perinatal outcomes. Obesity in pregnant women increases the risk of complications during pregnancy, childbirth and the postpartum period. The newborns of obese women also have higher rates of perinatal morbidity and an increased risk of long-term health problems. The objective: to learn hormonal and metabolic peculiarities in pregnant women with different obesity types during full-term pregnancy. Materials and methods. We examined 61 pregnant women with android type and 57 pregnant women with gynoid type of obesity at 39.6–40.6 weeks of gestation and 57 pregnant women without obesity and overweight. The concentration of estradiol, free estriol, insulin, placental lactogen, free testosterone, cortisol, dehydroepialdosterone sulfate (DHEA sulfate), and serum progesterone by enzyme-linked immunosorbent method and glucose rate by glucose-oxydase method were determined. The HOMA index was determined. Results. In pregnant women with gynoid obesity type, the level of progesterone was 41.15 (34.6–48) ng/ml, with android type – 35.7 (32.6–40.6) ng/ml and with physiological body weight 35.4 (33.2–40) ng/ml (p<0.05). While determining the concentration of placental lactogen in three groups there were no significant differences. There was a decrease (p<0,05) in the level of free estriol in groups of pregnant women with android and gynoid type of obesity in comparison with the control group, respectively 13.9 (13.1–14.9) ng/ml, 13.6 (12, 4–15.4) ng/ml and 14.7 (13.6–15.8) ng/ml. The concentration of estradiol in second group was 24 925.3 (20 206.6–30 400.5) pg/ml, which is 1.2 times (p<0.05) higher as in the control group and 1.4 times higher as in first group. In pregnant women with android-type obesity, estradiol levels were 1.2 times lower (p<0.05) compared with the control group. The concentration of cortisol in pregnant women with android type was 812.1 (599–1235.15) nmol/l, which is 2.7 times higher (p<0.05) compared to the women with gynoid type of obesity and 1.5 times higher (p<0.05) than in the control group. In pregnant women with gynoid type of obesity, 1.7 times lower (p<0.05) cortisol levels were observed in comparison with control group. The level of free testosterone was 2.4 (1.7–3.1) nmol/l in pregnant women of first group, what was higher (p<0.05) than in second group and in control group, respectively 1 (0.8–1.5) nmol/l and 1.9 (1.6–2.3) nmol/l. Pregnant women in group 1 had 2.4 times higher (p<0.05) testosterone levels compared to group 2 and 1.2 times higher (p<0.05) than in control group. In women with android type, the concentration of DHEA sulfate was 2.4 times higher (p<0.05) than in pregnant women with gynoid type and 2.1 times higher (p<0.05) compared with the control group. Pregnant women with android type of obesity have a significantly higher (p<0.05) serum insulin concentration of 67 (40–94.5) μIU / ml compared to women with gynoid type of obesity 33.3 (25.6–43) μIU/ml. When determining the glucose concentration no significant difference between three groups was found. The HOMA index in pregnant women with android type of obesity was 2.1 times higher than in pregnant women with gynoid type and 2.3 times higher than in control group (p<0.05). Conclusions. The results of a study indicate that the type of distribution of adipose tissue is important during pregnancy and childbirth because the hormonal and metabolic activity of adipose tissue in android and gynoid obesity types are different. Keywords: android type of obesity, pregnancy, gynoid type of obesity, hormonal balance, metabolic profile.

2021 ◽  
Vol 5 (1) ◽  
pp. 42
Author(s):  
Shinta Wurdiana Rhomadona ◽  
Dianita Primihastuti

As gestational age increases, the quality of sleep can decrease. It was reported that about 60% of late trimester pregnant women experience fatigue and> 75% experience sleep disturbances. However, these complaints are often ignored, even though it can lead to an increased risk of gestational hypertension, diabetes, prematurity, and postpartum depression. Sleep disturbances can also cause depression and stress that affects the fetus. Mild stress causes an increase in fetal heart rate which, if left untreated, will make the baby hyperactive. Meanwhile, the consequences are depression and babies who are born have less time to sleep deeply. Efforts to overcome this sleep disorder are yoga and lavender aromatherapy inhalation. Purpose: Therefore, the researchers estimated that the application of a combination of prenatal gentle yoga and lavender aromatherapy would be more effective in affecting the quality of sleep in pregnant women, so it is hoped that it can reduce sleep disturbances in third trimester pregnant women. Results: There is a significant effect of the combination of prenatal gentle yoga and inhalation of lavender aromatherapy in improving sleep quality in the treatment group with a value of α = 0.011 or α <0.05. There was a significant difference in the quality of sleep in the group compared to the control group with a value of α = 0.004 or α <0.05. Conclusion: By practicing prenatal gentle yoga and regular inhalation of lavender aromatherapy, it will be able to improve sleep patterns without using sleeping pills which wil


Author(s):  
KÜBRA DOĞAN ◽  
mehmet senes ◽  
ANARA KARACA ◽  
DAMLA KAYALP ◽  
SEYFULLAH KAN ◽  
...  

ABSTRACT Background: Obesity and overweight are significant public health problems due to higher risk for coronary artery disease (CAD). It is very important to determine new predictive markers to identify the CAD risk in obese and overweight. To this aim, we analyzed HDL-C subclass and their paraoxonase-1 (PON-1) activity in obese, overweight and normal weight subjects. Method: 71 newly diagnosed obese, 40 overweight and 30 healthy subjects as a control group were enrolled the study. Serum lipids levels were determined with enzymatic colorimetric method. PON-1 activities and HDL-3 levels were determined by spectrophotometric methods. Non-HDL3-C concentrations were calculated with the subtraction of HDL3-C from total HDL-C. Results: The mean serum levels of total HDL-C, HDL3-C, Non-HDL3-C -C and ApoA1 were higher in control group than obese and overweight groups. There were a statistically significant difference between obese and control group in terms of Lp(a), hsCRP and HOMA index. Higher total PON-1, non-HDL3 PON-1 and HDL3 PON-1 activities were found in the control group compared to obese and overweight groups. Total HDL was weakly negative correlated with the HOMA index, BMI and waist circumference. There was a weak negative correlation between non-HDL3-C and waist circumstance. Conclusion: Abnormal HDL-subgroups pattern and decreased PON-1 activities causes increased risk for CVD in obese and overweight individuals. Therefore determination of HDL subgroups and their PON-1 activity improves risk prediction compared with measuring total HDL-C levels and its PON-1 activity alone. Body weight and insulin resistance appear to have a role in the decreased HDL-C levels and PON-1activity in obese.


2007 ◽  
Vol 64 (4) ◽  
pp. 231-234 ◽  
Author(s):  
Aleksandar Cetkovic ◽  
Marina Djurovic

Background/Aim. Pregestational diabetes mellitus (PGDM) represents glucose intolerance that begins before pregnancy and is followed by the increased risk of neonatal and maternal complications. The aim of this study was to establish neonatal outcome in pregnancies with pregestational diabetes mellitus and the factors that had influence on it. Methods. This study included 27 pregnant women with insulin-dependant PGDM hospitalized during 2004 in the Institute for Obstretics and Gynecology, Clinical Center of Serbia, Belgrade. The control group consisted of 2 292 healthy pregnant women presented to the Institute within 2004. Results. Twenty-three (85%) infants of the women with PGDM had complications in comparison with 356 (15.5%) infants of the women in the control group, that was statistically significant difference (p < 0.001). Macrosomia was present in 8 (29.6%) and birth injuries in 6 (22.2%) infants of women with PGDM that was statistically significant difference (p < 0.001) in comparisom with the women in the control group who had 194 (8.5%) infants with macrosomia and 156 (6.8%) infants with birth injuries. The women with PGDM had 3 (11.1%) neonatal deaths and 3 (11.1%) infants were born with congenital malformations in comparison with the women in the control group without these complications. We established statisticaly significant correlation (p < 0.001) between glicoregulation before and during pregnancy in the women with PGDM and neonatal outcome. Conclusion. The incidence of neonatal morbidity and mortality in the women with PGDM was significantely more frequent as compared with the normal population. Achieving optimal maternal glucose levels in women with PGDM both preconceptionally and during pregnancy is associated with significant reduction of neonatal complications.


2019 ◽  
pp. 50-54
Author(s):  
V.O. Golyanovskiy ◽  
◽  
Ye.O. Didyk ◽  

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Farokh Saljughi ◽  
Mitra Savabi-Esfahani ◽  
Shahnaz Kohan ◽  
Soheila Ehsanpour

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.


2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.


2020 ◽  
pp. 105477382098491
Author(s):  
Hülya Türkmen ◽  
Serap Çetinkaya ◽  
Hafize Kiliç ◽  
Emine Apay ◽  
Devrim Karamüftüoğlu ◽  
...  

This randomized controlled experimental study was conducted with an intervention group ( n = 61) and a control group ( n = 63) consisting of primipara pregnant women. The pregnant women in the intervention group were asked to focus their attention on Maryam’s flower opening its leaf buds and imagine the labor’s progress during the course of their labor. The VAS was administered to each group at specific times (at 4–5 cm, 6–7 cm, 8–9 cm cervical dilatation) to determine their level of labor pain. A statistically significant difference was found between the groups’ mean pain scores at 4–5 cm, 6–7 cm, and 8–9 cm cervical dilatation ( p < .05). The labor duration of the pregnant women in the intervention group was significantly shorter than that of the pregnant women in the control group ( p = .017). The physical comfort level of the intervention group was significantly higher than that of the control group at 8–9 cm cervical dilatation ( p = .039).


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tria Astika Endah Permatasari ◽  
Fauza Rizqiya ◽  
Walliyana Kusumaningati ◽  
Inne Indraaryani Suryaalamsah ◽  
Zahrofa Hermiwahyoeni

Abstract Background Almost one-third of children under 5 years old in Indonesia suffer from stunting. Stunting can be prevented optimally during pregnancy as the initial phase of the first 1000 days of life. This study aims to determine the effect of nutrition and reproductive health education of pregnant women in Bogor Regency, Indonesia. Methods A quasi-experimental study was conducted among 194 pregnant women from August to November 2019. The pregnant women were randomly selected from four different villages in Bogor Regency. The intervention group (n = 97) received 2 h of nutrition and reproductive health education in small groups (four or five mothers per group) every 2 weeks for 3 consecutive months. This interactive education was given by facilitators using techniques such as lectures, role-playing, simulation, and games. The control group (n = 97) received regular health care services. A structured questionnaire was applied to collect data consisting of maternal characteristics, nutritional and reproductive health knowledge, attitudes, and practices in the intervention and control groups. Data were analysed using t-test and chi-square analysis. Results Pregnant women in the intervention group indicated a significant increase in knowledge, attitudes, and practices regarding nutrition and reproductive health after receiving education. The pre-test and post-test mean scores in the intervention group were 55.1 and 83.1 for overall knowledge, 40.2 and 49.0 for attitudes, and 36.2 and 40.2 for practices, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for these three variables. There was a significant difference (P < 0.001) in the post-test mean between the intervention group and the control group, but the difference was not significant (P > 0.05) in the pre-test. Conclusion Providing nutrition and reproductive health education through small groups with interactive methods improves the knowledge, attitudes, and practices of pregnant women. This intervention has the potential to be replicated and developed for large-scale implementation by optimising collaboration between government, non-governmental organizations, and maternal and child health service providers.


2021 ◽  
Vol 7 (3) ◽  
pp. 233
Author(s):  
Philipp Foessleitner ◽  
Herbert Kiss ◽  
Julia Deinsberger ◽  
Julia Ott ◽  
Lorenz Zierhut ◽  
...  

Pregnant women have an increased risk of vulvovaginal candidosis. Recurrent candidosis is under debate as a contributor to preterm birth, and vertical transmission may cause diaper dermatitis and oral thrush in the newborn. Apart from cultural methods, the gold standard for diagnosing candidosis is Gram staining, which is time-consuming and requires laboratory facilities. The objective of this prospective study was to validate a point-of-care vaginal yeast detection assay (SavvyCheckÔ Vaginal Yeast Test) and to evaluate it in asymptomatic pregnant women. We enrolled 200 participants, 100 of whom had vulvovaginal candidosis according to Gram stain (study group) and 100 were healthy pregnant controls (control group). Of these, 22 participants (11%) had invalid test results. The point-of-care test of the remaining 85 and 93 study participants in the study and control groups, respectively, showed a sensitivity of 94.1%, specificity of 98.9%, positive predictive value of 90.3%, and negative predictive value of 99.4% when compared with Gram stain. In conclusion, we found a high correlation between the SavvyCheckÔ Vaginal Yeast Test and Gram-stained smears during pregnancy. This suggests a potential role of this point-of-care test as a screening tool for asymptomatic pregnant women in early gestation.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Jafaripour ◽  
Z Aryanian ◽  
S Hosseinzadeh ◽  
R Pourkia ◽  
MM Ansari Ramandi ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Lichen planus (LP) which is a chronic inflammatory disease can cause impaired atrial electromechanical coupling, leading to increased risk of atrial fibrillation. Purpose The present study aimed to evaluate atrial electromechanical coupling in LP patients by using electrocardiography (ECG) and echocardiography. Methods Forty-six LP patients were investigated in this cross-sectional case-control study. The control group comprised healthy individuals selected in age and gender-matched manner. Echocardiography and ECG were done for all patients to show inter and intra-atrial electromechanical delays and P wave dispersion respectively. The electromechanical delays were calculated by using the difference between the delays from the onset of the P wave on ECG to the onset of A wave on tissue Doppler recordings of the different areas. Results The baseline characteristics of the case and control group were similar and did not differ significantly. The P wave dispersion was 45.63 ± 3.48 milliseconds in the LP group in comparison to 36.56 ± 2.87 milliseconds in the control group (p &lt; 0.001). As shown in the table, the intra and inter-atrial electromechanical delays were also significantly prolonged in LP patients when compared to the control group (p &lt; 0.001). There was no significant difference between the left and right ventricular systolic function and diastolic function of the two groups. Conclusion The results of the study indicate the presence of significant impaired atrial electromechanical coupling in patients with LP confirmed by both electrocardiographic and echocardiographic tools. Electromechanical delays Case N = 46 (mean ± SD) Control N = 46 (mean ± SD) P value Septal - PA (msec) 59.71 ± 13.24 44.39 ± 11.07 0.002 Lateral - PA (msec) 55.71 ± 13.26 48.89 ± 11.21 0.009 Tricuspid - PA (msec) 52.37 ± 13.12 43.28 ± 10.58 0.002 Inter-atrial delay (msec) (lateral PA−RV PA) 8.47 ± 1.62 6.37 ± 1.36 &lt;0.001 Intra-atrial delay (msec) (LA) [lateral PA−septal PA] 4.80 ± 1.48 3.83 ± 0.82 &lt;0.001 Intra-atrial delay (msec) (RA) [septal PA−RV PA] 3.91 ± 0.96 2.02 ± 0.71 &lt;0.001 PA Delay from the onset of the P wave on ECG to the onset of A wave on tissue Doppler, N: number, SD: Standard Deviation, LA: Left Atrium, RA: Right Atrium, RV: Right Ventricle


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