Factors Influencing Quality of Life during the First Trimester of Pregnancy: A Prospective Cohort Study

Introduction: Pregnancy, delivery and postpartum periods are associated with fast changesleading to decreased self-confidence, anxiety, stress or even maternal depression impairing theirquality of life (QOL). Although considered important, QOL of women during pregnancy is poorlyunderstood. The aim of our study was to assess factors influencing QOL during first trimester ofpregnancy. The secondary goal of our study was to evaluate whether QOL during first trimester ofpregnancy is associated with newborn weight. Materials and methods: A prospective cohort studywas performed including pregnant women during the first trimester visit. Our questionnaireconsisted of the SF-36 QOL questionnaire, Wexner fecal incontinence scale, and other additionalinformation. The SF-36 questionnaire mental (MCS) and physical (PCS) health scores were used inorder to evaluate QOL of women during first trimester of pregnancy. Two multiple logisticregression models were created in order to determine independent variables that influence the QOL.Results: 440 pregnant women were included in the study. The two main domains that were used inthe study were MCS and PCS, their medians were 50.0 (25.0; 50.0) and 50.1 (39.4; 59.0) pointsrespectively. From the two logistic regression models we determined several independent factorsthat influence QOL of women during the first trimester of pregnancy. Additionally, we determinedthat women who reported worse QOL tended to give birth to newborns large for their gestationalage. Conclusions: We found several significant variables that influence QOL of women during thefirst trimester of pregnancy. We also found that that lower MCS and PCS scores during the firsttrimester are associated with newborns large for gestational age.

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Red Blood Cells in The First Trimester and The Risk of Gestational Diabetes: A Prospective Cohort Study

10.21203/rs.3.rs-156418/v1 ◽

2021 ◽

Author(s):

Jiajing Jia ◽

Ying Yang ◽

Minjin Zhang ◽

Li Lin ◽

Yequn Chen ◽

...

Keyword(s):

Cohort Study ◽

Gestational Diabetes ◽

Blood Cell ◽

Pregnant Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Hematological Parameters ◽

First Trimester ◽

Logistic Regression Models ◽

Increased Risk

Abstract Background: This research aimed to assess the potential association of gestational diabetes (GDM) with early trimester hematological parameters including hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC), and platelet count (PLT) through a prospective cohort study.Methods: The prospective cohort included pregnant women subjected to prenatal examination at Shantou and Beijing hospitals in China from March 2014 to December 2015. Data were collected since the first perinatal visit in obstetrics clinics, and then participants were followed up at 24, 32, 36 gestational weeks and the time of delivery, respectively. Multivariable adjusted logistic regression models were conducted to estimate odds ratio (OR) and its corresponding 95% confidence interval (95% CI).Results: A total of 1004 pregnant women with singletons, less than 12 gestational weeks, and without history of chronic disease were eligible for analysis. The incidence of GDM was 18.82%, and the mean age was 29.50 ± 3.84 years. Total of 187 (18.63%) women who had abnormal RBC level and 222 (22.11%) had abnormal Hb in the first trimester of pregnancy. After multivariable adjustment, each unit increment in numeric RBC or Hb was associated with 177% and 4% increased risk for GDM. The risk for GDM was significantly increased with higher RBC (OR: 2.00 for RBC>4.55×1012 /L) and Hb (OR: 2.14 for Hb>139 g/L) levels in the first trimester.Conclusions: Elevated RBC and Hb in the first trimester are associated with increasing risk of GDM. Further evidence are warranted to confirm these possible causal relationships.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003–2012

Nutrients ◽

10.3390/nu13030795 ◽

2021 ◽

Vol 13 (3) ◽

pp. 795

Author(s):

Mary M. Murphy ◽

Kelly A. Higgins ◽

Xiaoyu Bi ◽

Leila M. Barraj

Keyword(s):

Pregnant Women ◽

Protein Intake ◽

First Trimester ◽

The United States ◽

Limited Information ◽

Health And Nutrition ◽

Animal Source ◽

Usual Intake ◽

First Trimester Of Pregnancy ◽

Using Data

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.

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Maternal Serum EG-VEGF as A First Trimester Predictor of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

10.21203/rs.3.rs-156363/v1 ◽

2021 ◽

Author(s):

Shiyu Zeng ◽

Ling Yu ◽

Yiling Ding ◽

Mengyuan Yang

Keyword(s):

Cohort Study ◽

Growth Factor ◽

Prediction Model ◽

Pregnant Women ◽

Predictive Value ◽

Prospective Cohort ◽

First Trimester ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Sensitivity Specificity

Abstract Background This study aims to explore whether plasma endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in the first trimester can be used as a predictor of hypertensive disorders of pregnancy (HDP), and compare it with placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to evaluate its prediction of HDP value. Methods This is a prospective cohort study that records the medical history of the pregnant women included in the study at 11–13 weeks’ gestation, and analyzes serum biochemical markers including EG-VEGF, PIGF, sFlt-1 and sFlt-1/PIGF. The predictive values of these tests were determined. We used the receiver operating characteristic (ROC) curve to find the optimal cut-off value for each biomarker and compare the operating characteristics (sensitivity, specificity). Logistic regression analysis was used to create a prediction model for HDP based on maternal characteristics and maternal biochemistry. Results Data were obtained from 205 pregnant women. 17 cases were diagnosed with HDP, the incidence rate was 8.2% (17/205). Women who developed HDP had a significantly higher body mass index (BMI) and mean arterial pressure (MAP). Serum EG-VEGF levels in the first trimester are significantly higher in pregnant women with HDP. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of serum EG-VEGF levels more than 227.83 pg/ml for predicting HDP were 43%, 93%, 86% and 62%, respectively. We established a prediction model in the first trimester include maternal BMI, MAP, and EG-VEGF, with an AUC of 0.8861 (95%CI: 0.7905–0.9818), which is better than using EG-VEGF alone (AUC: 0.66). Conclusion This study demonstrated that serum EG-VEGF is a promising biomarker for predicting HDP in the first trimester. It has better predictive performance compared with the currently used biomarkers like PIGF and sFlt-1. Combining maternal clinical characteristics and biochemical tests at 11–13 weeks can effectively identify women at high risk of HDP.

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AYURVEDIC MANAGEMENT OF GARBHINI CHARDI (Emesis Gravidarum) WITH CHATURJATA CHOORNA (CHATURJATA POWDER) - A PILOT STUDY

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj0308072020 ◽

2020 ◽

Vol 8 (9) ◽

pp. 4317-4323

Author(s):

Priyanka 1 ◽

Shreyes. S ◽

Yogitha Bali M.R

Keyword(s):

Pilot Study ◽

Pregnant Women ◽

First Trimester ◽

Nausea And Vomiting ◽

Morning Sickness ◽

Excessive Salivation ◽

First Trimester Of Pregnancy ◽

Rice Water ◽

Single Blind

Background: During pregnancy many demands are made by growing fetus, to meet these requirements maternal system has to undergo certain changes. Garbhinichardi (Emesis Gravidarum) is one among them and this has been termed as Gruhita Garbha Lakshanas (Immediate signs of conception) in Ayurvedic clas-sics. Approximately 80 % of pregnant women experience excessive salivation, nausea and vomiting during pregnancy, commonly known as “morning sickness”, which is seen frequently throughout the day. Design: This is single blind pilot study. 30 patients with complaints of Garbhinichardi (Emesis Gravidarum) in first trimester were included in this study. Patients were given Chaturjatachurna (Chatutjata powder)for a peri-od of 2 weeks in dose of 3gms thrice a day after meal with Anupana (Adjuvant) as Madhu (honey) of 5ml mixed with Tandulodaka (Raw rice water) Results: This pilot study showed statistically significant changes with Chaturjatachurna in reducing the complaints of pregnant women such as nausea (p<0.001), vomiting (p<0.001) and Aruchi (Anorexia) (p<0.001) in their first trimester of pregnancy. Conclusion: Chaturjata-churna was effective in the management of Garbhini Chardi (Emesis Gravidarum) and other symptoms in the first trimester of pregnancy.

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Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District-Malawi

Reproductive Health ◽

10.1186/s12978-018-0605-5 ◽

2018 ◽

Vol 15 (1) ◽

Cited By ~ 7

Author(s):

Chancy S. Chimatiro ◽

Precious Hajison ◽

Effie Chipeta ◽

Adamson S. Muula

Keyword(s):

Pregnant Women ◽

First Trimester ◽

Antenatal Clinic ◽

First Trimester Of Pregnancy

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Obstetrical and Neonatal Outcomes in Pregnant Women with Serum Thyroid-Stimulating Hormone (TSH) Levels >2.0 mU/Lvs.Those with TSH <2.0 in the First Trimester of Pregnancy

10.1210/endo-meetings.2011.part2.or6.or15-4 ◽

2011 ◽

pp. OR15-4-OR15-4

Author(s):

Shweta Achit ◽

Tapasya Dhar ◽

Kumkum Awasthi ◽

Bharti Uppal ◽

Jubbin Jagan Jacob

Keyword(s):

Pregnant Women ◽

First Trimester ◽

Thyroid Stimulating Hormone ◽

Neonatal Outcomes ◽

First Trimester Of Pregnancy ◽

Tsh Levels ◽

Stimulating Hormone

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Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009390 ◽

2021 ◽

Vol 15 (4) ◽

pp. e0009390

Author(s):

Jamille Gregório Dombrowski ◽

André Barateiro ◽

Erika Paula Machado Peixoto ◽

André Boler Cláudio da Silva Barros ◽

Rodrigo Medeiros de Souza ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Multivariate Logistic Regression Analysis ◽

Brazilian Amazon ◽

First Trimester ◽

Inflammatory Factors ◽

Anthropometric Measures ◽

First Trimester Of Pregnancy ◽

Adverse Pregnancy ◽

Angiopoietin 2

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.

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Gestational metabolic syndrome and neonatal anthropometric indices: a prospective cohort study

British Journal of Midwifery ◽

10.12968/bjom.2021.29.7.386 ◽

2021 ◽

Vol 29 (7) ◽

pp. 386-391

Author(s):

Zeinab Hatamian ◽

Lida Moghaddam-Banaem ◽

Samira Mokhlesi ◽

Marzieh Saei Ghare Naz

Keyword(s):

Metabolic Syndrome ◽

Cohort Study ◽

Birth Weight ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Linear Regression Analysis ◽

First Trimester ◽

P Value ◽

Anthropometric Parameters ◽

First Trimester Of Pregnancy

Background and aim There is limited knowledge about the effect of maternal metabolic syndrome (MetS) on the anthropometric parameters of newborns. Therefore, the authors aimed to evaluate the association between MetS in the first trimester of pregnancy with weight and height of the newborn. Methods This prospective cohort study was conducted on 455 pregnant women in Tehran during their first trimester of pregnancy. MetS was defined as the coexistence of three or more of the following criteria: fasting blood sugar (FBS) level ≥92 mg/dl, blood pressure ≥130.85 mm/hg, triglyceride ≥150 mg/dl, high density lipoprotein ≤50 mg/dl, and body mass index (BMI) ≥30 kg/m2. All participants were followed up to childbirth. After birth, the baby's weight and height data were collected from the birth certificate. Results Linear regression analysis showed FBS (ß: 0.100, p-value: 0.038), BMI (ß: 0.139, p-value: 0.004), and MetS (ß: -0.122, p-value: 0.015) were significantly associated with birth weight but no statistically significant results were found for birth height. Conclusion MetS and some of its components in pregnancy can affect birth weight of neonates.

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