A Comparative Study on Serum Levels of Iron, Magnesium, Calcium and Phosphorus during First & Second Trimesters of Pregnancy at a Tertiary Referral Hospital in South India

2021 ◽  
Vol 8 (29) ◽  
pp. 2609-2614
Author(s):  
Pradeep Kumar M ◽  
Mayadevi Brahmanandan ◽  
Dini S.B
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Serum Levels ◽  
First Trimester ◽  
Second Trimester ◽  
Mean Values ◽  
Calcium And Phosphorus ◽  
In Pregnancy

BACKGROUND Multiple micronutrient deficiencies commonly coexist in pregnancy and may play a role in the pathogenesis of many high-risk events in pregnancy. Mineral estimation during the first and second trimester may help in the identification of high-risk pregnancies predisposed to pre-eclampsia, preterm birth or low birth weight. Body mass index (BMI) is an independent risk factor influencing the serum levels of micronutrients like iron, calcium, phosphorous and magnesium. The purpose of this study was to compare the serum levels of iron, magnesium, calcium and phosphorus during first & second trimesters of pregnancy and their correlation with body mass index and adverse pregnancy outcomes. METHODS This was a longitudinal descriptive study, done over a period of twelve months, from April 2017 to March 2018. 94 low risk pregnant women were selected in the first trimester, and they were followed up for the entire duration of pregnancy. 2 ml of blood is collected at first and second trimester and analysed for the serum levels of iron (µg/dl), magnesium (mg/dl), calcium (mg/dl) and inorganic phosphorus (mg/dl). Mean values of these elements were noted and BMI was measured. Patients were followed up to observe the pregnancy outcome, especially development of hypertension, preterm birth and low birth weight. The data were subjected to suitable statistical analyses. P value less than 0.05 is considered as statistically significant. RESULTS Mean values of Ca, Mg, inorganic P and Fe were 9.3 mg/dl ± 0.52, 1.79 mg/dl ± 0.28, 3.59 mg/dl ± 0.54 and 83.7 µg/dl ± 25.36 respectively in first trimester and 8.9 mg/dl ± 0.47, 1.62 mg/dl ± 0.16, 3.17 mg/dl ± 0.44 and 76.17 µg/dl ± 21. 69 respectively in the second trimester. Hypocalcaemia was noted in 12.7 % and 38.3 % in the first and second trimester respectively. Hypomagnesaemia was seen in 51.1 % and 80.9 % in the first and second trimester respectively. Hypophosphatemia was seen in 3.2 % and 14.8 % in the first and second trimester respectively. These findings were statistically significant. There was no significant change in the iron levels in the present study. 19.1 % were underweight. 56.4 % had normal BMI. 19.2 % were overweight. 5.3 % were obese. CONCLUSIONS There is no correlation between serum values of trace elements and the BMI of study subjects. Even though significant hypocalcaemia, hypophosphatemia and hypomagnesaemia was noted in second trimester compared to first, there was no predisposition to the development of adverse outcomes like pre-eclampsia, preterm birth or low birth weight. This may be the effect of dietary and pharmacological supplementation during pregnancy. KEYWORDS Micronutrients, Pregnancy Complications, Calcium, Phosphorus, Magnesium, Iron

scholarly journals Investigation of Metronidazole Use during Pregnancy and Adverse Birth Outcomes

2012 ◽  
Vol 56 (9) ◽  
pp. 4800-4805 ◽  
Author(s):  
Catherine A. Koss ◽  
Dana C. Baras ◽  
Sandra D. Lane ◽  
Richard Aubry ◽  
Michele Marcus ◽  
...  
Keyword(s):  
New York ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Congenital Anomalies ◽  
New York State ◽  
Multivariable Analysis ◽  
Preterm Births ◽  
First Trimester ◽  
First Trimester Of Pregnancy

ABSTRACTTo assess whether treatment with metronidazole during pregnancy is associated with preterm birth, low birth weight, or major congenital anomalies, we conducted chart reviews and an analysis of electronic data from a cohort of women delivering at an urban New York State hospital. Of 2,829 singleton/mother pairs, 922 (32.6%) mothers were treated with metronidazole for clinical indications, 348 (12.3%) during the first trimester of pregnancy and 553 (19.5%) in the second or third trimester. There were 333 (11.8%) preterm births, 262 (9.3%) infants of low birth weight, and 52 infants (1.8%) with congenital anomalies. In multivariable analysis, no association was found between metronidazole treatment and preterm birth (odds ratio [OR], 1.02 [95% confidence interval [CI], 0.80 to 1.32]), low birth weight (OR, 1.05 [95% CI, 0.77 to 1.43]), or treatment in the first trimester and congenital anomalies (OR, 0.86 [0.30 to 2.45]). We found no association between metronidazole treatment during the first or later trimesters of pregnancy and preterm birth, low birth weight, or congenital anomalies.

scholarly journals Relation of Hemoglobin Measured at Different Times in Pregnancy to Preterm Birth and Low Birth Weight in Shanghai, China

1998 ◽  
Vol 148 (10) ◽  
pp. 998-1006 ◽  
Author(s):  
L.-M. Zhou ◽  
W.-W. Yang ◽  
J.-Z. Hua ◽  
C.-Q. Deng ◽  
X. Tao ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
In Pregnancy

scholarly journals Warning of Immortal Time Bias When Studying Drug Safety in Pregnancy: Application to Late Use of Antibiotics and Preterm Delivery

2020 ◽  
Vol 17 (18) ◽  
pp. 6465
Author(s):  
Giovanni Corrao ◽  
Federico Rea ◽  
Matteo Franchi ◽  
Benedetta Beccalli ◽  
Anna Locatelli ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Apgar Score ◽  
Time Varying ◽  
Immortal Time Bias ◽  
Increased Risk ◽  
In Pregnancy

This study aimed to illustrate and account for immortal time bias in pregnancy observational investigations, using the relationship between late use of antibiotics and risk of preterm birth as an example. We conducted a population-based cohort study including 549,082 deliveries between 2007 and 2017 in Lombardy, Italy. We evaluated the risk of preterm births, low birth weight, small for gestational age, and low Apgar score associated with antibiotic dispensing during the third trimester of pregnancy. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of the outcomes, considering the use of antibiotics as time-fixed (with biased classification of exposure person-time) and time-varying (with proper classification of exposure person-time) exposure. There were 23,638 (4.3%) premature deliveries. There was no association between time-fixed exposure to antibiotics and preterm delivery (adjusted HR 0.96; 95% CI 0.92 to 1.01) but an increased risk of preterm birth when time-varying exposure to antibiotics was considered (1.27; 1.21 to 1.34). The same trend was found for low birth weight and low Apgar score. Immortal time bias is a common and sneaky trap in observational studies involving exposure in late pregnancy. This bias could be easily avoided with suitable design and analysis.

scholarly journals Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m3811
Author(s):  
Matthew Francis Chersich ◽  
Minh Duc Pham ◽  
Ashtyn Areal ◽  
Marjan Mosalam Haghighi ◽  
Albert Manyuchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Random Effects ◽  
High Temperatures ◽  
Meta Analysis ◽  
Middle Income ◽  
Statistical Heterogeneity ◽  
In Pregnancy

Abstract Objective To assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth. Design Systematic review and random effects meta-analysis. Data sources Medline and Web of Science searched up to September 2018, updated in August 2019. Eligibility criteria for selecting studies Clinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths. Results 14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings. Conclusions Although summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health. Systematic review registration PROSPERO CRD 42019140136 and CRD 42018118113.

scholarly journals A meta-analysis of the relationship between antidepressant use in pregnancy and the risk of preterm birth and low birth weight

2014 ◽  
Vol 36 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Hsiang Huang ◽  
Shane Coleman ◽  
Jeffrey A. Bridge ◽  
Kimberly Yonkers ◽  
Wayne Katon
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Meta Analysis ◽  
Antidepressant Use ◽  
The Relationship ◽  
In Pregnancy

scholarly journals Effects of maternal smoking on body size and proportions at birth: a register-based cohort study of 1.4 million births

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e033465 ◽  
Author(s):  
Isabell Rumrich ◽  
Kirsi Vähäkangas ◽  
Matti Viluksela ◽  
Mika Gissler ◽  
Hanna de Ruyter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Body Size ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Head Circumference ◽  
Maternal Smoking ◽  
First Trimester ◽  
Body Proportions ◽  
High Head

ObjectivesThe aim of our work was to analyse the effect of maternal smoking on body size and body proportions of newborns when the mother had smoked only during the first trimester, in comparison with continued smoking after the first trimester. Furthermore, we have evaluated how growth restriction associated with maternal smoking contributes to changes in body proportions.DesignRegister-based cohort studySettingMaternal Exposure (MATEX) cohort identified from the Finnish Medical Birth Register.ParticipantsSingleton births without congenital anomalies and missing data (1.38 million) from 1 January 1991 to 31 December 2016.MethodsLogistic regression was used to quantify the effect of maternal smoking, stratified by the maternal smoking status.Outcome measuresBody proportions indicated by low brain-to-body ratio (defined as <10th percentile); high ponderal index and high head-to-length ratio (defined as >90th percentile); small body size for gestational age at birth (defined as weight, length or head circumference <10th percentile) and preterm birth (<37 weeks) and low birth weight (2500 g).ResultsContinued smoking after the first trimester was associated with high ponderal index (OR 1.26, 95% CI 1.23 to 1.28), low brain-to-body ratio (1.11, 1.07–1.15) and high head-to-length ratio (1.22, 1.19–1.26), corresponding with absolute risks of 22%, 10% and 19%, respectively). The effects were slightly lower when smoking had been quit during the first trimester. Similar effects were seen for the body size variables and low birth weight. Preterm birth was not associated with smoking only during first trimester.ConclusionsMaternal smoking, independent of smoking duration during pregnancy, was associated with abnormal body proportions resulting from larger reduction of length and head circumference in comparison to weight. The effects of having quit smoking during the first trimester and having continued smoking after the first trimester were similar, suggesting the importance of early pregnancy as a sensitive exposure window.

scholarly journals Quantifying Low Birth Weight, Preterm Birth and Small-for-Gestational-Age Effects of Malaria in Pregnancy: A Population Cohort Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (7) ◽  
pp. e100247 ◽  
Author(s):  
Marcus J. Rijken ◽  
Alysha M. De Livera ◽  
Sue J. Lee ◽  
Machteld E. Boel ◽  
Suthatsana Rungwilailaekhiri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Age Effects ◽  
Malaria In Pregnancy ◽  
Population Cohort ◽  
In Pregnancy
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