scholarly journals Maternal serum selenium as a predictor of preeclampsia

Author(s):  
Vismaya Kaveri ◽  
Manjula S. K. ◽  
Sheela C. N. ◽  
Anura Kurpad ◽  
Pratibha Dwarkanath

Background: Preeclampsia (PE) is a hypertension disorder condition occurring in 7-10% of all pregnancies. Preeclampsia if unidentified and left untreated is associated with poor maternal and fetal adverse outcomes. The objective of the present study was to characterize maternal serum selenium levels as a predictor of preeclampsia and to correlate dietary selenium intake with serum selenium levels in first trimester of pregnancyMethods: A retrospective case-control study of 107 pregnant women was conducted over 1.5 years at St. John’s Medical College Hospital. On screening for inclusion criteria, at baseline, information on maternal socio-demography, anthropometry, dietary intake and clinical examination was collected. A venous blood sample at baseline and 2nd or 3rdtrimester of pregnancy was collected for estimation of selenium concentrations. Blood pressure was measured at baseline and followed up during pregnancy to select cases and controls. Pregnant women were termed ‘cases’ based on NHBPEP (National High Blood Pressure Education Program) classification and subsequent 22 women with normal blood pressure controlled for age were termed as ‘controls.Results: No statistically significant differences were observed for baseline characteristics, biochemical parameters and blood pressure at recruitment among cases and controls. Cases had significant lower levels of energy (P=0.032) and micronutrients like zinc (P=0.027), selenium (P=0.022), magnesium (P=0.047) at first trimester. The serum selenium levels were significantly higher in cases as compared to the controls (69.2±13.7 vs. 59.6±12.9; P=0.021) at baseline.Conclusions: Our findings suggest that serum selenium levels may not be an independent predictor of preeclampsia. Assessment of other micronutrients, oxidative stress markers and other complementary elements may be useful in predicting preeclampsia.

Author(s):  
Shilpi Singh ◽  
Pushpa Singh

Background: Serum pregnancy-associated plasma protein-A (PAPP-A) levels fluctuate in continuation with the pregnancy and thus become an important standalone marker in monitoring the adverse outcomes that may occur in pregnancy.Methods: A prospective observational study was conducted in the department of obstetrics and gynaecology. A total of 240 pregnant women in their first trimester were included in the study. Serum PAPP-A levels were measured at 11-13+6week of gestation and were evaluated with respect to the feto-maternal outcome. The data was entered in MS excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.Results: The mean age of the study population was 27 years. Among the maternal pregnancy parameters, PIH, pre-term labor and Emergency LSCS were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, P<0.05. All the fetal outcome measures: IUGR, IUD, low birth weight, SGA babies, prematurity and NICU admissions, were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, p <0.05.Conclusions: Serum PAPP-A in the early pregnancy showed significant correlation with feto-maternal outcome. Thus, it has the potential to be used as a prognostic factor and in the management of adverse outcomes by increasing surveillance for pregnant women with high-risk factors.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2012
Author(s):  
Lisa Daneels ◽  
Dries S. Martens ◽  
Soumia Arredouani ◽  
Jaak Billen ◽  
Gudrun Koppen ◽  
...  

Nutrition is important during pregnancy for offspring health. Gestational vitamin D intake may prevent several adverse outcomes and might have an influence on offspring telomere length (TL). In this study, we want to assess the association between maternal vitamin D intake during pregnancy and newborn TL, as reflected by cord blood TL. We studied mother–child pairs enrolled in the Maternal Nutrition and Offspring’s Epigenome (MANOE) cohort, Leuven, Belgium. To calculate the dietary vitamin D intake, 108 women were asked to keep track of their diet using the seven-day estimated diet record (EDR) method. TL was assessed in 108 cord blood using a quantitative real-time PCR method. In each trimester of pregnancy, maternal serum 25-hydroxyvitamin D (25-OHD) concentration was measured. We observed a positive association (β = 0.009, p-value = 0.036) between newborn average relative TL and maternal vitamin D intake (diet + supplement) during the first trimester. In contrast, we found no association between average relative TL of the newborn and mean maternal serum 25-OHD concentrations during pregnancy. To conclude, vitamin D intake (diet + supplements), specifically during the first trimester of pregnancy, is an important factor associated with TL at birth.


2020 ◽  
Author(s):  
AYSE OZBAN

Abstract Objective: This study aims to determine whether it is possible to predict preeclampsia by comparing postpartum results and test results of the pregnant women diagnosed with preeclampsia, whose first and/or second trimester screening tests were accessible, and to demonstrate the predictability of severity and week of onset.Background: 204 patients underwent renal transplantation in our center and 84 of them were female. Five of our patients (one of them had two births) gave birth to a total of 6 pregnancies.Method: 135 patients were diagnosed with preeclampsia and their first and/or second trimester screening tests were accessible, and 366 control participants gave birth to a healthy baby between 37-41 weeks after standard follow-up period for pregnancy and their screening tests were also accessible.Results: The study results show that the first trimester maternal serum PAPP-A level is significantly low in preeclamptic pregnant women, and that the second trimester maternal serum AFP and hCG levels are significantly high and uE3 levels are significantly low The results also suggest that the first and second trimester Down syndrome biochemical markers can be used in preeclampsia screening.Conclusion: Among these markers, uE3 is the parameter which affects the possibility of preeclampsia the most. However, the first and second trimester Down syndrome biochemical markers are not effective in predicting the severity and onset week of preeclampsia.


Author(s):  
Rajeev Gandham ◽  
CD Dayanand ◽  
SR Sheela

Introduction: Pre-eclampsia is a pregnancy specific disorder, characterised by the onset of hypertension and proteinuria. Pre-eclampsia is the leading cause of maternal, perinatal morbidity and mortality. The exact cause of pre-eclampsia is not known clearly and needs to be explored. Aim: To evaluate the maternal serum apelin 13 levels among pre-eclampsia and healthy pregnant women and also, to find the association between apelin 13 and blood pressure. Materials and Methods: A case-control study was conducted between Department of Biochemistry and Department of Obstetrics and Gynaecology, RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India. After approval from the Institutional Ethics Committee and written informed consent from study subjects, a total of 270 pregnant women were recruited for this study. Among them, 135 pre-eclamptic women were considered as cases and 135 normotensive healthy pregnant women served as controls. According to the pre-eclampsia severity, cases were grouped into mild (n=47) and severe pre-eclampsia (n=88). Blood samples were collected from all the study subjects and was analysed for apelin 13 by Enzyme Linked Immunosorbent Assay (ELISA) method. Maternal and foetal adverse outcomes were recorded. Results were expressed as mean±Standard Deviation (SD). Categorical variables were expressed in percentages. Spearman’s correlation was applied and p<0.05 was considered significant. Results: The mean gestational age was 36.66±3.69 weeks which was, significantly low in pre-eclamptic women compared with healthy pregnant women. BMI (26.94±3.81 kg/m2), systolic (157.82±15.14 mmHg), diastolic (101.68±11.02 mmHg) and Mean Arterial Pressure (MAP) (120.20±11.12 mmHg), pulse rate (88.14±5.82 bpm), Aspartate Transaminase (AST) (25.25±12.49 IU/L) and Alanine Transaminase (ALT) (19.01±10.95 IU/L) were significantly increased in pre-eclamptic women when compared with control group. Mean maternal serum apelin 13 (341.44±218.63 pg/mL) concentrations were significantly lower in pre-eclampsia compared with healthy pregnant women. Maternal serum apelin 13 concentrations were negatively correlated with Systolic Blood Pressure (SBP) (r = -0.196), Diastolic Blood Pressure (DBP) (r = -0.172) and MAP (r =-0.204). Adverse maternal outcomes such as epigastric pain 75 (55.55%), oedema 62 (45.92%) and persistent headache 35 (25.92%) were higher in pre-eclamptic group. Additionally, adverse foetal outcomes were more in pre-eclamptic cases including significantly decreased birth weight (2.40±0.65), babies requiring Neonatal Intensive Care Unit (NICU) admission were 54 (40%), preterm birth (≤37 wks) in 50 (37.03%), Respiratory Distress Syndrome (RDS) 31 (22.96%), Small for Gestational Age (SGA) in 4 (2.96%) and Intra Uterine Death (IUD) in 11 (8.14%) babies. Conclusion: It was concluded from the present study that there was low maternal serum apelin 13 concentrations in pre-eclampsia and had negative correlation with blood pressure, suggesting its potential role in the pathophysiology of pre-eclampsia.


PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0238263
Author(s):  
Stephen Chijioke Eze ◽  
Nathan Azubuike Ododo ◽  
Emmanuel Onyebuchi Ugwu ◽  
Joseph Tochukwu Enebe ◽  
Onyema Athanatius Onyegbule ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Rafael Aporta Rodriguez ◽  
Mariola García Montero ◽  
Jose Pablo Lorente Aporta ◽  
Carolina Gallego Luque ◽  
Alfonso Chacón Mayor ◽  
...  

Iron deficiency and iron deficiency anemia during pregnancy call for safe treatment options that raise maternal hemoglobin levels and counterbalance iron demand and blood volume expansion while minimizing risks for the growing fetus. This retrospective study describes experience with intravenous ferric carboxymaltose given to pregnant women in a tertiary hospital in Spain. In a 5-year period, 95 pregnant women who had pretreatment hemoglobin <10 g/dL and at least one time of ferric carboxymaltose administration during pregnancy were included. Main outcome measures were week of pregnancy at iron administration, Hb levels before and after treatment, neonatal 5-minute Apgar scores, and birth weight. The majority received one dose of ferric carboxymaltose (1000 mg iron) during advanced pregnancy (median 31 weeks; interquartile range [IQR]: 27; 37 weeks) with minor to no adverse outcomes. Overall, median Hb increased from 8.5 g/dL (8.1; 8.9 g/dL) before treatment to 11.0 g/dL (9.9; 11.7 g/dL) after treatment. Normal Apgar scores were observed in all 97 infants (median birth weights 3560 g, 3270, and 3798 g). Four women received ferric carboxymaltose in the first trimester and twenty-eight during the second trimester without adverse outcomes for mother or child. These cases add to the evidence that ferric carboxymaltose administration during pregnancy is effective and safe.


2012 ◽  
Vol 72 (12) ◽  
pp. 1995-2001 ◽  
Author(s):  
Florentien D O de Steenwinkel ◽  
Anita C S Hokken-Koelega ◽  
Yaël A de Man ◽  
Y B de Rijke ◽  
Maria A J de Ridder ◽  
...  

BackgroundHigh rheumatoid arthritis (RA) disease activity during pregnancy is associated with a lower birth weight. Active RA is characterised by high circulating levels of cytokines, which can mediate placental growth and remodelling.ObjectivesTo assess the influence of maternal serum cytokine levels on birth weight in RA pregnancy.MethodsThis study is embedded in the PARA Study, a prospective study on RA and pregnancy. In the present study, 161 pregnant women with RA and 32 healthy pregnant women were studied. The main outcome measures were birth weight SD score (birth weight SDS) in relation to maternal serum levels of interleukin-10 (IL-10), interleukin-6 (IL-6) and tumour necrosis factor-α (TNFα) at three different time points: preconception and during the first and third trimester. Single-nucleotide polymorphisms (SNPs) in the corresponding cytokine genes were also studied.ResultsDuring the first trimester, IL-10 was detectable in 16% of patients with RA, IL-6 in 71%, and TNFα in all patients with RA. Mean birth weight SDS of children born to mothers with RA was higher when IL-10 level was high compared with low (difference=0.75; p=0.04), and lower when IL-6 was high compared with low (difference=0.50; p<0.01) in the first trimester. No correlation was seen at the other time points studied or with TNFα. Cytokine levels were not related to their corresponding SNPs.ConclusionsMaternal IL-10 and IL-6 levels are associated with fetal growth in RA. In the first trimester, high IL-10 levels are associated with higher birth weight SDS, and high IL-6 levels are associated with lower birth weight SDS, even after correction for disease activity.


Author(s):  
Renji S. R. ◽  
Sujatha Thankappan Lekshmi ◽  
Nirmala Chellamma

Background: Number of pregnant women with preexisting diabetes is increasing. Hence the detection and management of diabetes from the beginning of pregnancy itself will help to improve the fetal and maternal outcome. Aim of the study was to determine the prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center and to study the associated factors.Methods: This was a cross sectional study conducted in SAT hospital, Government Medical College, Trivandrum, Kerala, India for one year. HbA1C was the test used to diagnose diabetes. 400 women attending the OP in their first trimester were selected after informed consent. Socio demographic factors assessed by a structured questionnaire.  Blood samples were taken for HbA1C. Diagnosis of diabetes was made at levels of HbA1C ≥6.5%. Statistical tests used were mean, standard deviation, chi-square and odds ratio.Results: Prevalence of pre-gestational diabetes was 3.8%.in our study. Main associations were age more than 25 years, body mass index, family history of diabetes, history of intra uterine death, gestational diabetes in previous pregnancy, candidiasis and thyroid disease.Conclusions: Screening of all pregnant women in first trimester itself for diabetes will help in early detection of pre-gestational diabetes, so that anticipation of adverse outcomes and proper management can be done in such cases.


Author(s):  
Hymavathi K. ◽  
Sandhya Rani Davuluru ◽  
Sameera Shaik ◽  
Sahithi Kaviti

Background: This study was conducted to evaluate the efficacy of different biochemical and biophysical markers in the early weeks of gestation as screening tools for early prediction of preeclampsia.Methods: This hospital-based prospective observational study conducted on 52 pregnant women, at less than 13 weeks of gestation were recruited. Maternal serum inhibin A and USG uterine artery PI levels were analyzed among the pregnant women who subsequently developed PE and compare with those who did not develop PE. Methods used for the detection of markers were: chemiluminescence immunoassay (CLIA) for serum inhibin A levels, and uterine artery Doppler velocimetry was done by PHILIPS HD11XE transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer.Results: The present study revealed a significant rise of inhibin A in preeclamptic women when compared to normotensive women (p<0.0001). The mean levels of 1st and 2nd trimester uterine artery PI significantly high in women who subsequently developed PE when compared to those who did not develop preeclampsia (p<0.0001). Study results showed a strong association between gestational age at delivery and neonatal outcome (neonatal birth weight and APGAR) with preeclampsia. The maternal serum inhibin A, and uterine artery PI found to have good sensitivity and specificity for early prediction of PE.Conclusions: Study concluded that the women who are prone to develop PE subsequently, had high levels of MAP, UAPI, inhibin A. In our setting, MAP, UAPI, inhibin A, appeared to be better screening modalities. Combination of the biochemical markers with the biophysical markers, demographic characteristics, and other novel markers will establish the effective screening models for early prediction of PE. Early identification of high-risk cases will offer an opportunity for prophylactic therapy, such as Low- dose Aspirin in selected groups of high-risk women screened in the first trimester, thus improving the maternal and perinatal outcome.


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