Adipsin of the Alternative Complement Pathway Is a Potential Predictor for Preeclampsia in Early Pregnancy

ObjectiveThe concentrations of complement proteins (adipsin, C3a, and C5a) and soluble endoglin (sENG) in the plasma were measured in this study, and their value as early-pregnancy predictors and potential diagnostic marker of preeclampsia was assessed, respectively.Experimental DesignPlasma samples were obtained from healthy and preeclampsia pregnant women before delivery for a cross-sectional study. Plasma samples were collected from healthy and preeclampsia pregnant women throughout pregnancy and postpartum for a follow-up study. Enzyme-linked immunosorbent assays were used to detect plasma levels of several complement proteins (adipsin, C3a, and C5a) and sENG.ResultsThe plasma levels of adipsin, C5a, and sENG were significantly increased before delivery in pregnant women with preeclampsia. During pregnancy, the plasma adipsin, C5a, and sENG levels were increased from the third trimester in healthy pregnant women; plasma adipsin levels remained stable after delivery, while C3a levels increased in the second trimester and remained stable afterward. Furthermore, levels of adipsin, C5a, and sENG were higher in preeclampsia patients at different stages of pregnancy; the C3a level presents a similar change and no difference was found in the third trimester. In the first trimester, receiver-operating curve (ROC) curve analysis showed that adipsin (AUC, 0.83 ± 0.06, P=0.001) and sENG (AUC, 0.74 ± 0.09, P=0.021) presented high value as predictors of early pregnancy.ConclusionsAdipsin is likely a novel plasma biomarker to monitor the increased risk of preeclampsia in early pregnancy. Moreover, the increased plasma levels of adipsin, C5a, and sENG before delivery may be associated with preeclampsia.

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Cognitive–behavioral therapy-based intervention to treat symptoms of anxiety in pregnancy in a prenatal clinic using non-specialist providers in Pakistan: design of a randomised trial

BMJ Open ◽

10.1136/bmjopen-2020-037590 ◽

2020 ◽

Vol 10 (4) ◽

pp. e037590 ◽

Cited By ~ 1

Author(s):

Pamela J Surkan ◽

Syed Usman Hamdani ◽

Zill-e Huma ◽

Huma Nazir ◽

Najia Atif ◽

...

Keyword(s):

Mental Health ◽

Cognitive Behavioral Therapy ◽

Pregnant Women ◽

Early Pregnancy ◽

Low Income ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Relaxation Techniques ◽

Third Trimester ◽

The Third

IntroductionPrenatal anxiety is a prevalent condition that is harmful for women and a strong predictor of postpartum depression. This trial assesses an intervention initiated in early pregnancy to mid pregnancy among women with clinical or subclinical symptoms of anxiety in Pakistan.Methods and analysisHappy Mother, Healthy Baby(HMHB) is a phase three, two-arm, single-blind, individual randomised clinical trial conducted in the outpatient department of Holy Family Hospital, a large public tertiary care facility affiliated with Rawalpindi Medical University (RMU). Pregnant women (enrolled at ≤22 weeks of gestation) receive six individual HMHB sessions based on cognitive–behavioral therapy (CBT) and relaxation techniques that are administered by non-specialist providers and tailored to address anxiety symptoms. Two to six booster sessions are given between the fifth consecutive weekly core session and the sixth core session that occurs in the third trimester. Apart from baseline data, data are collected in the third trimester, at birth and at 6-weeks postpartum. Primary outcomes include diagnoses of postpartum common mental disorders. Secondary outcomes include symptoms of anxiety and of depression, and birth outcomes including small-for-gestational age, low birth weight and preterm birth. An economic analysis will determine the cost effectiveness of the intervention.EthicsEthics approval was obtained from the Johns Hopkins Bloomberg School of Health Institutional Review Board (Baltimore, USA), the Human Development Research Foundation Ethics Committee (Islamabad, Pakistan), the RMU Institutional Research Forum (Rawalpindi, Pakistan) and the National Institute of Mental Health-appointed Global Mental Health Data Safety and Monitoring Board.DisseminationResults from this trial will build evidence for the efficacy of a CBT-based intervention for pregnant women delivered by non-specialised providers. Identification of an evidence-based intervention for anxiety starting in early pregnancy to mid pregnancy may be transferable for use and scale-up in other low-income and middle-income countries.Trial registration numberNCT03880032.

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The Maternal Cytokine and Chemokine Profile of Naturally Conceived Gestations Is Mainly Preserved duringIn VitroFertilization and Egg Donation Pregnancies

Journal of Immunology Research ◽

10.1155/2015/128616 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Alicia Martínez-Varea ◽

Begoña Pellicer ◽

Vicente Serra ◽

David Hervás-Marín ◽

Alicia Martínez-Romero ◽

...

Keyword(s):

Pregnant Women ◽

Transforming Growth Factor Beta ◽

Plasma Levels ◽

Transforming Growth Factor ◽

Egg Donation ◽

Third Trimester ◽

Necrosis Factor Alpha ◽

Prospective Longitudinal Study ◽

The Third ◽

Prospective Longitudinal

This prospective longitudinal study aimed at comparing maternal immune response among naturally conceived (NC;n=25),in vitrofertilization (IVF;n=25), and egg donation (ED;n=25) pregnancies. The main outcome measures were, firstly, to follow up plasma levels of interleukin (IL) 1beta, IL2, IL4, IL5, IL6, IL8, IL10, IL17, interferon gamma, tumor necrosis factor-alpha (TNFα), transforming growth factor-beta (TGFβ), regulated upon activation normal T-cell expressed and secreted (RANTES), stromal cell-derived factor 1 alpha (SDF1α), and decidual granulocyte-macrophage colony-stimulating factor (GM-CSF) during the three trimesters of pregnancy during the three trimesters of pregnancy; secondly, to evaluate if the cytokine and chemokine pattern of ED pregnant women differs from that of those with autologous oocytes and, thirdly, to assess if women with preeclampsia show different cytokine and chemokine profile throughout pregnancy versus women with uneventful pregnancies. Pregnant women in the three study groups displayed similar cytokine and chemokine pattern throughout pregnancy. The levels of all quantified cytokines and chemokines, except RANTES, TNFα, IL8, TGFβ, and SDF1α, rose in the second trimester compared with the first, and these higher values remained in the third trimester. ED pregnancies showed lower SDF1αlevels in the third trimester compared with NC and IVF pregnancies. Patients who developed preeclampsia displayed higher SDF1αplasma levels in the third trimester.

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

Scientific Reports ◽

10.1038/s41598-021-97946-5 ◽

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.

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Serum vitamin D3 levels in pregnant women with preeclampsia at third trimester of pregnancy

Baghdad Journal of Biochemistry and Applied Biological Sciences ◽

10.47419/bjbabs.v2i03.42 ◽

2021 ◽

Vol 2 (03) ◽

pp. 131-137

Author(s):

Anas Sadek ◽

Rayah Baban ◽

May Al-Habib ◽

Enas Khazaali

Keyword(s):

Pregnant Women ◽

Vitamin D3 ◽

Case Control Study ◽

Serum Vitamin ◽

Third Trimester ◽

The Third ◽

Increased Risk ◽

Significant Difference ◽

Vitamin D3 Deficiency ◽

Control Study

Background: Preeclampsia (PE) is a pregnancy-specific condition, characterized by high blood pressure and proteinuria after 20 weeks of gestation. One of the hypotheses concerning the etiology of PE is vitamin D3 deficiency during pregnancy. Vitamin D3 is especially important during pregnancy as low maternal vitamin D3 stores may contribute to problems like low birth weight as well as an increased risk of maternal comorbidities. Objectives: To evaluate serum vitamin D3 levels and how they can be affected by the severity of PE at the third trimester of pregnancy. Methods: This case-control study included a total of 71 pregnant women at the third trimester of pregnancy (41 with PE and 30 without PE as controls). Vitamin D3 serum level was measured by enzyme-linked immune-sorbent assay (ELISA). Results: The study’s findings showed no significant difference in serum vitamin D3 level (p>0.05) between controls (14.41±1.41ng/ml) and PE patients (14.32±1.00). As well, subgroup analysis revealed non-considerable changes between mild PE cases (15.92±1.73 ng/ml) and severe ones (13.07±1.09 ng/ml). Conclusions: PE and its severity may have no significant effect on serum vitamin D3 levels of pregnant women at the third trimester of pregnancy.

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GAMBARAN KLINIS GINGIVA PADA IBU HAMIL DI PUSKESMAS BAHU KECAMATAN MALALAYANG

e-GIGI ◽

10.35790/eg.3.2.2015.8878 ◽

2015 ◽

Vol 3 (2) ◽

Author(s):

Lucyana S. Angwirawan ◽

Shane H. R. Ticoalu ◽

Krista V. Siagian

Keyword(s):

Oral Cavity ◽

Pregnant Women ◽

Clinical Picture ◽

Research Result ◽

General Purpose ◽

Third Trimester ◽

Cross Sectional ◽

The Third ◽

Increased Risk ◽

Age Category

Abstract: Pregnancy is a very unique phase on every women marked with complex physiologic changes that can affect the healthiness of the oral cavity. The increased risk of mouth disease on pregnant women can be affected by the surge of estrogen and progesterone that marked by swelling and inflammation on the teeth. The General purpose of this research is to identify the clinical conception of the gingiva on pregnant women on Puskesmas Bahu in Malalayang residency. This research is tend to be observational descriptive with the cross-sectional approach. Population of this research is all the pregnant women that made a visit to Puskesmas Bahu in the period of January to February 2015 with 60 samples. The research on pregnant women can be divided with the scoring of gingiva clinical conception which is 0 for normal and 1 for abnormal on the color, size, contour, consistency and texture of the gingiva. The research result shows that the clinical picture of the gingiva on pregnant women are generally experience changes the texture of the gingiva (75%), followed by the gingiva consistency (73%), contour of the gingiva (58%), color of the gingiva (48%) and the size of the gingiva(43%). On the age category, the highest value of the percentage present on age 36 to 45 years old especially the changes on the texture of the gingiva (86%). On the category of age of the pregnancy, the highest value of the percentage present on the third trimester especially the changes of the the gingival consistency (86%).Keywords: clinical picture of gingiva, pregnant womenAbstrak: Kehamilan ialah masa yang sangat unik pada setiap wanita yang ditandai dengan perubahan fisiologis secara kompleks, sehingga dapat memengaruhi kesehatan rongga mulut. Peningkatan resiko terjadinya penyakit mulut pada wanita hamil dapat disebabkan oleh peningkatan hormon estrogen dan progesteron yang biasanya ditandai dengan pembengkakan dan peradangan pada gingiva. Tujuan dari penelitian ini ialah untuk mengetahui gambaran klinis gingiva pada ibu hamil di Puskesmas Bahu Kecamatan Malalayang. Penelitian ini bersifat deskriptif observasional dengan pendekatan cross sectional. Populasi dalam penelitian ini ialah seluruh ibu hamil yang dating berkunjung ke Puskesmas Bahu Kecamatan Malalayang pada bulan Januari – Februari tahun 2015 dengan jumlah sampel sebanyak 60 sampel. Penelitian pada ibu hamil dapat dibedakan dengan pembagian skor gambaran klinis gingiva yaitu normal sama dengan 0 dan tidak normal sama dengan 1 pada warna gingiva, besar gingiva, kontur gingiva, konsistensi gingiva dan tektur gingiva. Hasil dari penelitian ini menunjukkan bahwa gambaran klinis gingiva pada ibu hamil kebanyakkan mengalami perubahan pada tekstur gingiva (75%), diikuti berurut-turut konsistensi gingiva (73%), kontur gingiva (58%), warna gingiva (48%) dan besar gingiva (43%). Pada kategori umur presentase terbesar terdapat pada umur 36-45 tahun khususnya perubahan pada tekstur gingiva (86%). Pada kategori usia kehamilan presentase terbesar terdapat pada trimester ke – III khususnya perubahan pada konsistensi gingiva (86%).Kata kunci: gambaran klinis gingiva, ibu hamil

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The Relationship between Gestational Weight Gain and Postpartum Depression in Normal and Overweight Pregnant Women

Journal of Pregnancy ◽

10.1155/2018/9315320 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Fatemeh Dayan ◽

Nahid Javadifar ◽

Mitra Tadayon ◽

Amal Saki Malehi ◽

Hosein Komeili Sani

Keyword(s):

Weight Gain ◽

Postpartum Depression ◽

Pregnant Women ◽

Health Care Providers ◽

First Trimester ◽

Care Providers ◽

Third Trimester ◽

The Third ◽

Pregnancy And Postpartum ◽

The Relationship

Objective. To investigate the relationship between weight gain in pregnancy and postpartum depression (PPD) in normal and overweight pregnant women. Methods. The participants of this prospective cohort study were 223 healthy pregnant women with the first trimester body mass index (BMI) between 18.5 and 30 and the gestational age of 10-14 weeks and depressed women were excluded with Beck questionnaire in the first trimester. The evaluation included weight gain at the end of the second and third trimesters and the screening of PPD in 6-8 weeks after delivery by Edinburgh scale. Results. 49 participants were excluded from the study and data from 174 people were analyzed. 32.2% of mothers were scored above 12 in the Edinburgh scale. The only variable associated with depression was the third trimester weight gain (OR 1.17, 95%CI 1.04-1.32). Conclusion. In addition to considering other risk factors for postpartum depression, health care providers should consider the higher probability of PPD in prepregnancy normal and overweight women who have excessive weight gain especially in the third trimester of pregnancy.

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Unlikely SARS-CoV-2 Transmission During Vaginal Delivery

Reproductive Sciences ◽

10.1007/s43032-021-00681-5 ◽

2021 ◽

Author(s):

Claudio Fenizia ◽

Irma Saulle ◽

Maria Di Giminiani ◽

Claudia Vanetti ◽

Daria Trabattoni ◽

...

Keyword(s):

Pregnant Women ◽

Plasma Samples ◽

Third Trimester ◽

Virus Particles ◽

Viral Loads ◽

The Third ◽

Vaginal Secretions ◽

Rectal Swabs ◽

Risk Of Progression ◽

Blood Specimens

AbstractPregnant women display a higher risk of progression to disease and higher viral loads during infections due to their more permissive, tolerogenic immune system. However, only few studies have focused on SARS-CoV-2 intrapartum vertical transmission via vaginal secretions or faeces. The aim of this study was to investigate the presence of the virus in vaginal, rectal and blood specimens from pregnant women characterized by different COVID-19 disease severity. We enrolled 56 SARS-CoV-2-positive pregnant women, of which 46 (82%) were in the third trimester of pregnancy, 6 (10%) in the second and 4 (7%) in the first. QPCR was performed to detect the virus in vaginal and rectal swabs and in plasma samples. SARS-CoV-2 was detected in 27% of rectal swabs of pregnant women in the third trimester, while no virus particles were detected in vaginal swabs of the same patients. Furthermore, only 4% plasma samples tested positive to SARS-CoV-2. No virus was detected in newborn’s nasopharyngeal swabs. Despite the low number of subjects enrolled, our data suggest that, while theoretically possible, intrapartum vaginal or orofecal SARS-CoV-2 transmission seems to be unlikely.

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Features of the course and treatment of glaucoma during pregnancy

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-3-178-184 ◽

2020 ◽

Vol 98 (3) ◽

pp. 178-184

Author(s):

T. V. Chernyakova ◽

A. Yu. Brezhnev ◽

I. R. Gazizova ◽

A. V. Kuroyedov ◽

A. V. Seleznev

Keyword(s):

Pregnant Women ◽

Laser Treatment ◽

Progressive Disease ◽

Clinical Course ◽

The Other ◽

Third Trimester ◽

The Third ◽

Chronic Progressive Disease ◽

Hypotensive Therapy ◽

Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

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A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03755-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nader Salari ◽

Niloofar Darvishi ◽

Behnam Khaledi-Paveh ◽

Aliakbar Vaisi-Raygani ◽

Rostam Jalali ◽

...

Keyword(s):

Pregnant Women ◽

Sleep Disorders ◽

Sleep Disturbances ◽

Meta Analysis ◽

Physical And Mental Health ◽

Third Trimester ◽

Cross Sectional ◽

The Third ◽

Physical Problems ◽

Meta Regression Analysis

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.

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The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽

10.1093/rheumatology/keab372 ◽

2021 ◽

Author(s):

Rugina I Neuman ◽

Hieronymus T W Smeele ◽

A H Jan Danser ◽

Radboud J E M Dolhain ◽

Willy Visser

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Disease Activity ◽

Pregnant Women ◽

Gestational Age ◽

Third Trimester ◽

Low Disease Activity ◽

The Third ◽

Observational Prospective Cohort Study ◽

Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio > 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

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