scholarly journals Adolescent Pregnancy’s Ongoing Effects on the Depression and Anxiety Scores in Subsequent Pregnancy

Author(s):  
Esengul Turkyilmaz ◽  
Selma Tural Hesapcioglu

<p><strong>Objective:</strong> Child/adolescent 'marriages' and following pregnancies have adverse effects both on the child and adolescent mother.<br />The aim of this study is to detect whether the adult pregnant women who have previous adolescent pregnancy more susceptible to the depression and anxiety than current adolescent pregnants and the adult pregnant women who have no adolescent pregnancy history. </p><p><strong>Study Design:</strong> This cross sectional study evaluated a total of 163 pregnant women who attended to our antenatal clinic. Subjects aged between 16 and 43 years including both adolescent and adult pregnant women were divided into three groups. These groups are current adolescent pregnant women (Group I), adult pregnant women who have adolescent pregnancy history (Group II), adult pregnant women who have no adolescent pregnancy history (Group III). Three groups were compared in terms of the pregnancy status, socio-demographic variables and depression-anxiety scores.</p><p><strong>Result:</strong> In the current study the highest depression and anxiety scores were observed in Group II [depression scores’ median (IQR) values respectively 5 (8.5) points for Group I, 12.5 (8.5) for Group II, 9 (12) for Group III (p&lt;0.001 between Group I and Group II for BDI comparison). Anxiety scores’ median (IQR) values respectively 19.5 (15.5) for group II, 9 (15.5) for group I, 14 (15.25) for Group III (p=0.005 between Group I and Group II for BAI comparison). </p><p><strong>Conclusion:</strong> Marriage and pregnancy at an early age are considered as risk factors for psychiatric morbidity in the next pregnancy. Therefore, women with a history of teenage pregnancy should be carefully monitored for depression and anxiety symptoms.</p>

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 715-715
Author(s):  
Rupert M. Bauersachs ◽  
Joachim Dudenhausen ◽  
Andree Faridi ◽  
Thorsten Fischer ◽  
Samson Fung ◽  
...  

Abstract Women with a history of VTE, thrombophilia or both are at increased risk for VTE during pregnancy, but the optimal management strategy, and the need for thromboprophylaxis is not well defined in clinical guidelines because of limited trial data. The EThIG (Efficacy of Thromboprophylaxis as an Intervention during Gravidity) is a multicenter trial that prospectively enrolled 810 pregnant women at risk of VTE. Women were assigned to one of 3 management strategies: Low risk group I (including women with prior secondary VTE, or asymptomatic thrombophilia) with “watchful waiting” management, and dalteparin prophylaxis postpartum (50–100 IU/kg), or earlier if additional risk factors occurred; high risk group II (e.g. idiopathic VTE or symptomatic thrombophilia) receiving 50–100 IU/kg dalteparin; and very high-risk group III (e.g. acute VTE, prior long-term OAC, symptomatic AT-deficiency or antiphospholipid syndrome), receiving 100–200 IU/kg dalteparin. Primary efficacy outcome measure was symptomatic VTE, main safety outcome measures were haemorrhages, osteoporosis, thromboctopenia and pregnancy outcome. Results (mean ± SD / 95% CI): 810 women (age 30.8±5.4 years, weight 73.6±16.1kg) were enrolled, 28 % in group I, 58 % in II and 14% in III, including 66 women with acute VTE. 60.1% had prior VTE, 75.4% had thrombophilia (42.1 % FV-Leiden, 2.1 % homozygous, 9.5 % FII G20210A, 4.1% PC-, 1 % AT-deficiency; 17.4 % APS). 35.8 % had previous miscarriage, still birth or physical malformation. Comorbid conditions included lupus erythematosus, liver transplantation, ventricular septum defect, paraplegia, hepatitis C, nephrotic syndrome, asthma, chronic haemolytic anaemia, thalassaemia, osteoporosis and thrombocytopaenia. Median treatment initiation was at 17.0 weeks, at 24.0 weeks in group I, 14.5 weeks in group II and 16.0 weeks for group III. Mean daily dose was 66.2 ± 22.5 IU per kg (group I), 76.8 ± 24.1 IU per kg (group II) and 120.0 ± 49.1 IU per kg (group III). Objectively confirmed, symptomatic VTE occurred in 5 of 810 women (0.6%;0.2–1.5%). The rate of serious bleeding was 3.0% (1.9–4.4%), 0.9% (0.3–1.8%) occurred in the antepartum period, 2.1% (1.3–3.4%) peri-partum;1.1% (0.5–2.2%) was possibly heparin-related. There was no evidence of heparin-induced thrombocytopenia, and one case of osteoporosis (fracture of the saccygous bone during delivery). There were 94.4% successful pregnancies, 40 foetuses (4.9%; 3.6–6.7%) were lost due to miscarriage, 7 due to elective termination. Risk-stratified heparin prophylaxis was associated with a low incidence of symptomatic venous thromboembolism and few clinically important adverse events. Antepartum heparin prophylaxis is warranted in pregnant women with prior idiopathic thrombosis or symptomatic thrombophilia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eissa Khalifa ◽  
Alaa El-Sateh ◽  
Mohamed Zeeneldin ◽  
Ahmed M. Abdelghany ◽  
Mahmoud Hosni ◽  
...  

Abstract Background This study aims to detect the effects of increased BMI on labor outcomes in primigravida pregnant women. Methods A cross-sectional study involved 600 full-term singleton primigravida pregnant women who presented in the active phase of labor to the labor ward. They were divided according to BMI into three equals groups; women with normal BMI (group I), overweight women (group II), and women with class I obesity (group III). Results We found that high BMI was associated with a significantly increased risk of Caesarean section (C.S.) (13% in group I, 18% in group II and 40% in group III). Women with higher BMI and delivered vaginally had a significantly prolonged first and second stage of labor, consequently increased the need for oxytocin augmentation as well as the oxytocin dose. Regarding the maternal and fetal outcomes, there are significantly increased risks of postpartum sepsis, perineal tears, wound infection, as well as significantly increased birth weight and longer neonatal stay in the neonatal unit (NNU). Conclusion Obese primigravida pregnant women were at higher risk of suboptimal outcomes. Besides, prolonged first and second stages of labor and the incidence of C.S. have also been increased.


2000 ◽  
Vol 38 (11) ◽  
pp. 3967-3970 ◽  
Author(s):  
Yasuhiro Suzuki ◽  
Raymund Ramirez ◽  
Cindy Press ◽  
Shuli Li ◽  
Stephen Parmley ◽  
...  

We examined the efficiency of detection of immunoglobulin M (IgM) antibodies to a 35-kDa antigen (P35) of Toxoplasma gondiifor serodiagnosis of acute infection in pregnant women. A double-sandwich enzyme-linked immunosorbent assay (ELISA) with recombinant P35 antigen (P35-IgM-ELISA) was used for this purpose. On the basis of the clinical history and the combination of results from the toxoplasma serological profile (Sabin-Feldman dye test, conventional IgM and IgA ELISAs, and the differential agglutination test), the patients were classified into three groups: group I, status suggestive of recently acquired infection; group II, status suggestive of infection acquired in the distant past; group III, status suggestive of persisting IgM antibodies. Eighteen (90.0%) of 20 serum samples from group I patients were positive by the P35-IgM-ELISA, whereas none of the 33 serum samples from group II patients were positive. Only 4 (25.0%) of 16 serum samples from group III patients were positive by the P35-IgM-ELISA, whereas all these serum samples were positive by the conventional IgM ELISA. These results indicate that demonstration of IgM antibodies against P35 by the P35-IgM-ELISA is more specific for the acute stage of the infection than demonstration of IgM antibodies by the ELISA that uses a whole-lysate antigen preparation. Studies with sera obtained from four pregnant women who seroconverted (IgG and IgM antibodies) during pregnancy revealed that two of them became negative by the P35-IgM-ELISA between 4 and 6 months after seroconversion, whereas the conventional IgM ELISA titers remained highly positive. The P35-IgM-ELISA appears to be useful for differentiating recently acquired infection from those acquired in the distant past in pregnant women.


2018 ◽  
Vol 4 (2) ◽  
pp. 00060-2017 ◽  
Author(s):  
Mikhail P. Kostinov ◽  
Alexander P. Cherdantsev ◽  
Nelli K. Akhmatova ◽  
Daria A. Praulova ◽  
Aristitsa M. Kostinova ◽  
...  

Pregnancy is a condition of modulated immune suppression, so this group of patients has increased risk of infectious diseases.Trivalent subunit vaccines, unadjusted Agrippal S1 (group I) and immunoadjuvant Grippol Plus (group II), containing 5 μg of actual influenza virus strains, were administered respectively to 37 and 42 women in the second and third trimester of physiological pregnancy.The administration of subunit influenza vaccines was accompanied by the development of local reactions in no more than 10% of patients, compared with 4.9% of the 41 pregnant women in the placebo group (group III). Systemic reactions were of a general somatic nature, did not differ between vaccinated and placebo groups, and were not associated with vaccination. Physiological births in groups I, II and III were 94.6%, 92.9% and 85.4%, respectively, and the birth rates of children without pathologies were 91.9%, 90.5% and 80.5%, respectively, and were comparable between groups. Vaccination stimulated the production of protective antibodies against influenza virus strains in 64.8–94.5% of patients after immunisation with an unadjusted vaccine and in 72.5–90.0% of patients after the administration of an immunoadjuvant vaccine. After 9 months, antibody levels were recorded in 51.3–72.9% in group I and 54.2–74.2% in group II. Immunisation against influenza in pregnant women provided a high level of seroprotection and seroconversion. Nevertheless, the level of seroprotection against the influenza strain A(H3N2, Victoria) was slightly lower in the group immunised with an unadjusted vaccine compared to those vaccinated with the immunoadjuvant vaccine.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Hulya Ozdemir ◽  
Ipek Akman ◽  
Senay Coskun ◽  
Utku Demirel ◽  
Serap Turan ◽  
...  

Aim.To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants.Methods.Women with hypothyroidism and having anti-thyroglobulin (ATG) and anti-thyroid peroxidase (anti-TPO) antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III.Results.Pregnant women with autoimmune hypothyroidism (group I) had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU) admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8%) in group II had thyroid-stimulating hormone (TSH) levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4). Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5%) had TSH levels above >20 mIU/mL at the 1st postnatal week.Conclusion.Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction.


Author(s):  
L.E. Tumanova ◽  
◽  
E.V. Kolomiets ◽  

Purpose — to study the indicators of quality of life in pregnant women with a history of different types of infertility. Materials and methods. The study of quality of life indicators was carried out in 127 women aged 20 to 49 years, 97 of whom had a history of infertility of various origins and 30 pregnant women who had it. The distribution of pregnant women into groups was based on the factor of infertility: Group I — 35 pregnant women with a history of endocrine infertility, Group II — 37 pregnant women with a history of inflammatory infertility, Group III — 25 pregnant women with a history of combined infertility of inflammatory genesis with endocrine, Group IV (control) — 30 healthy pregnant women who did not have a history of infertility. The method of assessing quality of life was the WHOQOL-BREF Short Questionnaire. Results. The indicators of quality of life and general health, according to the subjective assessment of the patients, were the lowest in group III — 2.5±0.10 points and 2.1±0.05 points. In group I patients, the score was 3.1±0.15 points and 3.2±0.20 points and in group II — 3.2±0.10 points and 3.3±0.07 points, respectively. It should be noted that the most positive assessment of these indicators took place in the control group of pregnant women — 5.0±0.3 points. Thus, the physical functioning was assessed by the patients of group III at 16.7±1.1 points, and self+perception — at 20.5±1.6 points. A patient of groups I and II with a history of infertility assessed these indicators — 18.2±1.3 points; 23.4±1.5 points and 19.5±1.4 points; 22.6±1.6 points, respectively. The women in the control group had higher scores — 24.7±1.8 points; 25.7±1.7 points. Microsocial support in groups I, II, III was assessed 8.2±0.3 points; 9.3±0.5 points; 7.7±0.2 points, but in the control group — 13.7±0.1 points. The indicators of social well+being were 22.4±1.8 points; 23.5±1.9 points; 20.6±1.5 in groups I, II, III, and in the control group — 36.4±2.1 points. Conclusions. In women who became pregnant after long-term treatment of infertility in anamnesis, there was a significant deterioration in quality of life indicators compared with healthy women, which is explained by the high incidence of obstetric complications in them. Determination of quality of life indicators in women with a history of infertility is an integral part of monitoring during pregnancy, which allows adequate assessment and timely correction of physical, social and psycho-emotional functions in the interests of the mother and the fetus. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: short WHO questionnaire, quality of life assessment, pregnancy after infertility.


Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.


1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.


2015 ◽  
Vol 18 (3) ◽  
pp. 098
Author(s):  
Cem Arıtürk ◽  
Serpil Ustalar Özgen ◽  
Behiç Danışan ◽  
Hasan Karabulut ◽  
Fevzi Toraman

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>


2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


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