scholarly journals Role of pregravid body mass and its gestational increase in development of various variants of preeclampsia

2020 ◽  
pp. 11-15
Author(s):  
K. B. Pokusaeva ◽  
A. S. Krivenko ◽  
N. Yu. Katkova ◽  
V. N. Pokusaeva ◽  
A. S. Vakhrushin
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Fat Mass ◽  
Early Onset ◽  
Late Onset ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Increased Risk ◽  
Negative Effect ◽  
Early Onset Preeclampsia

Aim. To evaluate the effects of maternal pre-pregnancy body weight and excessive gestational weight gain (GWG) on the risk of different subtypes of preeclampsia (PE).Methods. A cohort study of 289 pregnant women: 41 with early-onset (less than 34 weeks) preeclampsia (EPE), 76 with late-onset (more than 34 weeks) preeclampsia (LPE) and 172 normotensive women (control). Associations between anthropometric indicators (pre-pregnancy BMI, GWG, fat mass in the 1st, 2nd, 3rd trimesters, on the 2–3rd day after birth) and risk of PE and its subtypes were evaluated.Results. Pre-pregnancy body weight (r = 0.36; р = 0.000) and BMI (r = 0.38; р = 0.000) moderately increased risk of PE. GWG had independent risk of developing PE (r = 0.46; р = 0.000). Women with excessive GWG had an increased risk of PE in normal BMI (RR = 2.2; р = 0.019), in overweigh (RR = 2.7; р = 0.028), in obese (ОР = 5.2; р = 0.000). The risk of developing preeclampsia increased in normal weight with GWG more than 500 g per week in the 2nd trimester (р = 0.000) and more than 400 g per week in the 3d trimester (р = 0.000), total GWG more than 16.5 kg increased risk of preeclampsia in 3.4-fold (ОР = 3.4; р = 0.001). Overweight and obesity had an increased risk of late-onset preeclampsia (RR = 4.9; р = 0.000). No association was found for early-onset preeclampsia (p > 0.050). Gestational metabolic disorders were independent risk of LPE: weekly GWG and the per cent of fat mass in normal weight pregnant women with LPE were significantly higher compared to the women with EPE and control. The per cent of fat mass in the 1st trimester in PPE (23.90 ± 4.40 %) exceeded control (20.50 ± 4.30 %; р = 0.003) and EPE (21.20 ± 3.65 %; р = 0.008) groups. Differences were aggravated during pregnancy (р < 0.050).Conclusions. Pre-pregnancy overweight and obesity, excessive GWG and gain of fatty mass were an independent risk of developing PE with synergistic negative effect. Pre-pregnancy and gestational lipid dismetabolism were associated with LPE. Our results suggested that no correlation between pre-pregnancy BMI, GWG, fatty mass and risk of EPE.

Is overweight/obesity a risk factor for atopic allergic disease in prepubertal children? A case–control study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Aysel Vehapoglu ◽  
Zeynep Ebru Cakın ◽  
Feyza Ustabas Kahraman ◽  
Mustafa Atilla Nursoy ◽  
Ali Toprak
Keyword(s):  
Body Weight ◽  
Allergic Disease ◽  
Weight Status ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
University Hospital ◽  
Healthy Children ◽  
Prepubertal Children ◽  
Body Weight Status ◽  
Increased Risk

Abstract Objectives It is unclear whether body weight status (underweight/normal weight/overweight/obese) is associated with allergic disease. Our objective was to investigate the relationship between body weight status (body mass index; BMI) and atopic allergic disease in prepubertal children, and to compare children with atopic allergic diseases with non atopic healthy children. Methods A prospective cross sectional study of 707 prepubertal children aged 3–10 years was performed; the participants were 278 atopic children with physician-diagnosed allergic disease (allergic rhinitis and asthma) (serum total IgE level >100 kU/l and eosinophilia >4%, or positivity to at least one allergen in skin test) and 429 non atopic healthy age- and sex-matched controls. Data were collected between December 2019 and November 2020 at the Pediatric General and Pediatric Allergy Outpatient Clinics of Bezmialem Vakıf University Hospital. Results Underweight was observed in 11.6% of all participants (10.8% of atopic children, 12.2% of healthy controls), and obesity in 14.9% of all participants (18.0% of atopic children, 12.8% of controls). Obese (OR 1.71; 95% CI: 1.08–2.71, p=0.021), and overweight status (OR 1.62; 95% CI: 1.06–2.50, p=0.026) were associated with an increased risk of atopic allergic disease compared to normal weight in pre-pubertal children. This association did not differ by gender. There was no relationship between underweight status and atopic allergic disease (OR 1.03; 95% CI: 0.63–1.68, p=0.894). Conclusions Overweight and obesity were associated with an increased risk of atopic allergic disease compared to normal weight among middle-income and high-income pre pubertal children living in Istanbul.

scholarly journals Altered Maternal Serum Matrix Metalloproteinases MMP-2, MMP-3, MMP-9, and MMP-13 in Severe Early- and Late-Onset Preeclampsia

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Marzena Laskowska
Keyword(s):  
Matrix Metalloproteinases ◽  
Pregnant Women ◽  
Immunosorbent Assay ◽  
Early Onset ◽  
Late Onset ◽  
Maternal Serum ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Control Subjects ◽  
Early Onset Preeclampsia

Objective. The aim of this study was to determine whether maternal serum matrix metalloproteinases 2, 3, 9, and 13 levels differ in early- and late-onset preeclampsia and uncomplicated pregnancies. Patients and Methods. The study was carried out in 125 pregnant women (29 with early-onset preeclampsia; 31 preeclamptic patients with late-onset preeclampsia; and 65 healthy pregnant controls). Levels of MMP-2, MMP-3, MMP-9, and MMP-13 were measured in the maternal serum using an enzyme-linked immunosorbent assay. Results. Maternal serum MMP-2 levels in both the groups of preeclamptic women were significantly higher than those in the controls. Levels of MMP-3 were significantly higher in preeclamptic patients with early-onset disease; however, the MMP-3 levels in patients with late-onset preeclampsia were similar to those observed in the control subjects. MMP-9 levels were lower whereas the levels of MMP-13 were higher in both preeclamptic groups of pregnant women than in the healthy controls, but these differences were statistically insignificant. Conclusions. One important finding of the present study was that MMP-3 appears to be involved solely in early-onset preeclampsia, but not in late-onset preeclampsia. Higher levels of MMP-2 and MMP-13 and lower levels of MMP-9 seem to be related to both early- and late-onset severe preeclampsia.

scholarly journals Are There Differences in the Anthropometric, Hemodynamic, Hematologic, and Biochemical Profiles between Late- and Early-Onset Preeclampsia?

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Márcia Aires Rodrigues de Freitas ◽  
Alice Vieira da Costa ◽  
Luciana Alves de Medeiros ◽  
Mario da Silva Garrote Filho ◽  
Angélica Lemos Debs Diniz ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Doppler Ultrasonography ◽  
Late Onset ◽  
Tertiary Hospital ◽  
Hemodynamic Changes ◽  
Osmotic Stability ◽  
Biochemical Profiles ◽  
Early Onset Preeclampsia ◽  
Transversal Study

Preeclampsia (PE) is classified as early-onset PE (EOPE) and late-onset PE (LOPE) when present before or after 34 weeks of gestation, respectively. This transversal study aimed to investigate the differences and possible associations existing in the anthropometric, hemodynamic, hematologic, and biochemical profiles of late- and early-onset preeclampsia. The study included 65 volunteers admitted to a tertiary hospital in Brazil: 29 normotensive and 36 with preeclampsia (13 with EOPE and 23 with LOPE). Pregnant women with LOPE presented greater weight gain and borderline increase in body mass index at the end of gestation in relation to the other groups, which is compatible with the metabolic origin, associated with obesity, attributed to this form of the disease. Pregnant women with EOPE presented a borderline reduction in the number of erythrocytes and a significant decrease in the number of platelets, in addition to a significant increase in reticulocytes, serum iron, and ferritin when compared to normotensive pregnant women and pregnant women with LOPE. A significant increase in osmotic stability of erythrocytes was observed in the EOPE group in relation to other groups. Hemodynamic analysis by Doppler ultrasonography of the ophthalmic artery showed that both groups of pregnant women with PE presented alterations compatible with the occurrence of hyperflow in the orbital territory. These hemodynamic changes were associated with changes in hematimetric indices.

scholarly journals Elecsys® and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable?

2019 ◽  
Vol 57 (9) ◽  
pp. 1339-1348 ◽  
Author(s):  
Holger Stepan ◽  
Martin Hund ◽  
Peter Dilba ◽  
Johanna Sillman ◽  
Dietmar Schlembach
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Late Onset ◽  
Correlation Coefficients ◽  
Serum Samples ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio ◽  
Control Study

Abstract Background For pregnant women with suspected preeclampsia, the soluble fms-like tyrosine-kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio is a biomarker to aid diagnosis. We performed method comparisons between Elecsys® and Kryptor sFlt-1 and PlGF immunoassays and assessed the diagnostic performance for preeclampsia. Methods Serum samples from a case-control study involving 113 pregnant women with preeclampsia/elevated liver enzymes and low platelet count (HELLP) and 270 controls were analyzed. sFlt-1 and PlGF were measured using Roche Elecsys® and BRAHMS Kryptor sFlt-1/PlGF immunoassays. The sFlt-1/PlGF ratios were calculated, and Passing-Bablok regression/Bland-Altman plots were performed. Gestation-specific cut-offs, ≤33 and ≥85/≥110, were assessed. Results Mean (±2 standard deviation [SD]) differences between the Elecsys® and Kryptor values were: sFlt-1, 173.13 pg/mL (6237.66, −5891.40); PlGF, −102.71 pg/mL (186.06, −391.48); and sFlt-1/PlGF, 151.74 (1085.11, −781.63). The Elecsys® and Kryptor immunoassays showed high correlation: Pearson’s correlation coefficients were 0.913 (sFlt-1) and 0.945 (PlGF). Slopes were 1.06 (sFlt-1) and 0.79 (PlGF), resulting in ~20% lower values for Kryptor PlGF. Sensitivities and specificities using the sFlt-1/PlGF ≥85 cut-off for early-onset preeclampsia (20 + 0 to 33 + 6 weeks) were 88.1%/100.0% (Elecsys®) and 90.5%/96.2% (Kryptor), respectively, and using the ≥110 cut-off for late-onset preeclampsia (≥34 + 0 weeks) were 51.3%/96.5% (Elecsys®) and 78.9%/90.1% (Kryptor), respectively. Using Elecsys® and Kryptor sFlt-1/PlGF, 0% and 3.8% of women, respectively, were falsely ruled-in for early-onset, and 3.5% and 9.9%, respectively, for late-onset preeclampsia. Conclusions Despite high correlation between the Elecsys® and Kryptor immunoassays, we observed significant differences between sFlt-1/PlGF and PlGF results. Therefore, sFlt-1/PlGF cut-offs validated for Elecsys® immunoassays are not transferable to Kryptor immunoassays.

scholarly journals Circadian misalignment measured by social jetlag from early to late pregnancy and its association with nutritional status: a longitudinal study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Cristina Tibiletti Balieiro ◽  
Cristiana Araújo Gontijo ◽  
Luisa Pereira Marot ◽  
Gabriela Pereira Teixeira ◽  
Walid Makin Fahmy ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Absolute Difference ◽  
Third Trimester ◽  
Circadian Misalignment ◽  
The Third ◽  
Social Jetlag ◽  
Increased Risk

AbstractA mismatch between circadian and social clocks leads to a circadian misalignment, which has been widely measured by social jetlag (SJL). There are several studies measuring SJL, but it has not been studied in pregnant women. Therefore, this study aimed to identify the occurrence of SJL throughout pregnancy and to verify whether there is an effect of pre-pregnancy body mass index (BMI) on SJL throughout pregnancy. The baseline of the present study was conducted with 205 1st trimester pregnant women of whom 100 were followed in their 2nd and 3rd trimester. SJL was calculated based on the absolute difference between mid-sleep time on workdays versus work-free days. The pre-pregnancy BMI and current BMI (kg/m2) were calculated. Linear regression and Generalised Estimating Equation (GEE) adjusted for confounders were used to determine the association between SJL and the gestational trimesters (time), and anthropometric variables. Most of the pregnant women (54.5%) presented SJL > 1 h in the first gestational trimester. We also found an isolated effect of the gestation trimester on the SJL mean. In this sense, pregnant women had a decrease in SJL from the second to the third trimester (1.33 ± 0.08 versus 1.12 ± 0.07, respectively; p = 0.012). GEE analyzes showed that pregnant women of a normal weight showed a decrease in SJL from the second to the third trimester (1.29 ± 0.11 and 0.93 ± 0.08, respectively, p = 0.032), but this was not found in the other groups of nutritional status (underweight, overweight and obesity). In addition, a positive association between SJL and pre-gestational BMI in the third trimester (β = 0.200, p = 0.046) was found. SJL is quite prevalent during the gestational period and excessive BMI both before and during pregnancy is associated with an increased risk of having SJL > 1 h in the third and second trimesters, respectively. In addition, pregnant women of normal weight—but not underweight or overweight—had decreased SJL from the second to the third trimester.

Characteristics of markers of metabolic syndrome and features of the course of early gestation in pregnant women with the threat of miscarriage, depending on the body weight of the pregnant woman

2017 ◽  
pp. 69-76
Author(s):  
Yu.M. Duka ◽  
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Diagnostic Algorithm ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
The Body ◽  
Clinical Group ◽  
Perinatal Complications ◽  
Early Gestation ◽  
Perinatal Center

The article gives a scientific and practical justification for the expansion of the diagnostic algorithm in pregnant women with the threat of miscarriage, taking into account the woman’s phenotype. The objective: was to study the basic patterns of the formation and disruption of the reproductive system in pregnant women with overweight and obesity and to evaluate possible criteria for the formation of endocrine and metabolic disorders for the timely diagnosis and prevention of perinatal complications in pregnant women, depending on their phenotype. Materials and methods. Clinical groups comprised 175 pregnant women of different body weight (120 women with overweight and obesity, who were observed from a small gestation period on the basis of the department of fetal medicine and the pathology of early pregnancy of the communal institution «Dnepropetrovsk Regional Perinatal Center with a hospital» in the city of Dnepr (I clinical group) and 55 pregnant women with normal body weight (II clinical group – comparison group)). Results. The dependence of the detection of menstrual cycle disorders in women with overweight and obesity is 1.5 times more often than in women with normal weight. The course of early gestation was analyzed. The necessity of lipid and carbohydrate profile estimation in these patients is substantiated. Authentic criteria of violations of carbohydrate metabolism are specified. Сonclusion. It is necessary to move from the assessment of the effects of obesity to the «Body Mass Index-Oriented Approach» to the assessment based on the «complicity approach». This will make it possible to individualize therapeutic tactics in pregnant women depending on their phenotype and reduce the incidence of gestational complications and perinatal losses. Key words: phenotype, pregnancy, loss of pregnancy, obesity, phenotype, carbohydrate profile, lipid profile, hormonal characteristics.

scholarly journals Morphofunctional and motor characteristics of Baikal region’s students (Russia) with overweight

2019 ◽  
Vol 23 (1) ◽  
pp. 4-13
Author(s):  
M.M. Kolokoltsev ◽  
S.S. Iermakov
Keyword(s):  
Body Weight ◽  
Physical Fitness ◽  
Fat Mass ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Motor Action ◽  
Component Structure ◽  
Normal Body ◽  
Normal Body Weight ◽  
Males And Females

Purpose : to study the morphofunctional and motor characteristics of the organism of students with overweight and obesity. To compare these data with data of students with normal weight. Participants : it was examined students (females - n=1937; males - n=1302) of 17-21 year-olds. (Baikal region, Russia). It was performed an anthropometrical and physiometric examination of students. It was determined the content of muscle and fat mass in the component structure of a body. It was determined the motor qualities of students. Results : the indicators of anthropometrical and physiometric characteristics, results of motor action tests, the content of muscle and fat mass in a body of students with overweight and obesity are lower in comparison with the indicators of females and males with normal body weight (р<0.05). The integral criterion of physical fitness of students with overweight and obesity is lower in comparison with students with normal body weight (р<0.05). It is defined the direct dependence between the decrease in the level of physical fitness and increase in body weight of males and females. It was obtained data concerning interrelation of anthropometrical and functional characteristics with motor qualities of males and females with different body weight. Conclusions : Results of the research allow correcting physical training classes of youth. Such classes are focused on the differentiated decrease in fat mass content and increase in muscle mass in the component structure of students' bodies.

scholarly journals Mean arterial blood pressure: potential predictive tool for preeclampsia in a cohort of healthy nulliparous pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jussara Mayrink ◽  
◽  
Renato T. Souza ◽  
Francisco E. Feitosa ◽  
Edilberto A. Rocha Filho ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Early Onset ◽  
Late Onset ◽  
Roc Curves ◽  
Predictive Tool ◽  
Arterial Blood ◽  
Early Onset Preeclampsia

Abstract Background Prediction of preeclampsia is a challenge to overcome. The vast majority of prospective studies in large general obstetric populations have failed in the purpose of obtain a useful and effective model of prediction, sometimes based on complex tools unavaible in areas where the incidence of preeclampsia is the highest. The goal of this study was to assess mean arterial blood pressure (MAP) levels at 19–21, 27–29 and 37–39 weeks of gestation and performance of screening by MAP for the prediction of preeclampsia in a Brazilian cohort of healthy nulliparous pregnant women. Methods This was a cohort approach to a secondary analysis of the Preterm SAMBA study. Mean arterial blood pressure was evaluated at three different time periods during pregnancy. Groups with early-onset preeclampsia, late-onset preeclampsia and normotension were compared. Increments in mean arterial blood pressure between 20 and 27 weeks and 20 and 37 weeks of gestation were also calculated for the three groups studied. The accuracy of mean arterial blood pressure in the prediction of preeclampsia was determined by ROC curves. Results Of the 1373 participants enrolled, complete data were available for 1165. The incidence of preeclampsia was 7.5%. Women with early-onset preeclampsia had higher mean arterial blood pressure levels at 20 weeks of gestation, compared to the normotensive group. Women with late-onset preeclampsia had higher mean arterial blood pressure levels at 37 weeks of gestation, than the normotensive groups and higher increases in this marker between 20 and 37 weeks of gestation. Based on ROC curves, the predictive performance of mean arterial blood pressure was higher at 37 weeks of gestation, with an area under the curve of 0.771. Conclusion As an isolated marker for the prediction of preeclampsia, the performance of mean arterial blood pressure was low in a healthy nulliparous pregnant women group. Considering that early-onset preeclampsia cases had higher mean arterial blood pressure levels at 20 weeks of gestation, future studies with larger cohorts that combine multiple markers are needed for the development of a preeclampsia prediction model.

scholarly journals Life-course trajectories of weight and their impact on the incidence of type 2 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Diego Yacamán-Méndez ◽  
Ylva Trolle-Lagerros ◽  
Minhao Zhou ◽  
Antonio Monteiro Ponce de Leon ◽  
Hrafnhildur Gudjonsdottir ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Life Course ◽  
Risk Ratio ◽  
Absolute Risk ◽  
Early Adulthood ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Increased Risk ◽  
Incident Cases

AbstractAlthough exposure to overweight and obesity at different ages is associated to a higher risk of type 2 diabetes, the effect of different patterns of exposure through life remains unclear. We aimed to characterize life-course trajectories of weight categories and estimate their impact on the incidence of type 2 diabetes. We categorized the weight of 7203 participants as lean, normal or overweight at five time-points from ages 7–55 using retrospective data. Participants were followed for an average of 19 years for the development of type 2 diabetes. We used latent class analysis to describe distinctive trajectories and estimated the risk ratio, absolute risk difference and population attributable fraction (PAF) associated to different trajectories using Poisson regression. We found five distinctive life-course trajectories. Using the stable-normal weight trajectory as reference, the stable overweight, lean increasing weight, overweight from early adulthood and overweight from late adulthood trajectories were associated to higher risk of type 2 diabetes. The estimated risk ratios and absolute risk differences were statistically significant for all trajectories, except for the risk ratio of the lean increasing trajectory group among men. Of the 981 incident cases of type 2 diabetes, 47.4% among women and 42.9% among men were attributable to exposure to any life-course trajectory different from stable normal weight. Most of the risk was attributable to trajectories including overweight or obesity at any point of life (36.8% of the cases among women and 36.7% among men). The overweight from early adulthood trajectory had the highest impact (PAF: 23.2% for woman and 28.5% for men). We described five distinctive life-course trajectories of weight that were associated to increased risk of type 2 diabetes over 19 years of follow-up. The variability of the effect of exposure to overweight and obesity on the risk of developing type 2 diabetes was largely explained by exposure to the different life-course trajectories of weight.

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