scholarly journals A Prenatal DHA Test to Help Identify Women at Increased Risk for Early Preterm Birth: A Proposal

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1933 ◽  
Author(s):  
Kristina Jackson ◽  
William Harris
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Clinical Utility ◽  
Fish Intake ◽  
Blood Levels ◽  
Omega 3 ◽  
Childbearing Age ◽  
Increased Risk ◽  
The Us ◽  
Early Preterm Birth

Fish intake and docosahexaenoic acid (DHA), a nutrient found in fish, have been favorably linked to several pregnancy outcomes. The risk of early preterm birth (ePT, <34 weeks gestation) is associated with low fish intake and DHA blood levels and can be reduced by supplemental DHA. Here, we summarize the evidence linking blood DHA levels with risk for ePT birth, and based on the available studies, propose that women who are pregnant or trying to become pregnant aim for a red blood cell (RBC) DHA value of at least 5% (of total RBC fatty acids). In the US, ~70% of women of childbearing age are likely below this cut-point, and dietary intake data suggest that this group, including pregnant women, consumes ~60 mg/day DHA and that >90% of this group do not take an omega-3 supplement. Since the recommendations for women to consume fish and to take a 200 mg DHA supplement during pregnancy are not being heeded generally, there is a need to motivate practitioners and pregnant women to attend to these recommendations. Having an objective prenatal blood DHA test could provide such motivation. More research is needed to test the clinical utility of this proposed target prenatal DHA level.

scholarly journals Perinatal Outcomes in HIV Positive Pregnant Women with Concomitant Sexually Transmitted Infections

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Erin Burnett ◽  
Tammy L. Loucks ◽  
Michael Lindsay
Keyword(s):  
Preterm Birth ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Hiv Positive ◽  
City Hospital ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk

Objective. To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs) are at increased risk of adverse perinatal and neonatal outcomes.Methods. We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB), postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders.Results. HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR) 2.11, 95% confidence interval [CI] 1.12–3.97). After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01–3.78).Conclusions. HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.

scholarly journals Pregnancy outcomes in women with immunoglobulin A nephropathy: a nationwide population-based cohort study

2021 ◽  
Author(s):  
Simon Jarrick ◽  
Sigrid Lundberg ◽  
Olof Stephansson ◽  
Adina Symreng ◽  
Matteo Bottai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Immunoglobulin A ◽  
Reference Population ◽  
Immunoglobulin A Nephropathy ◽  
Childbearing Age ◽  
Increased Risk

Abstract Background Immunoglobulin A nephropathy (IgAN) incidence peaks in childbearing age. Data on pregnancy outcomes in women with IgAN are limited. Methods We performed a register-based cohort study in a nationwide cohort of women with biopsy-verified IgAN in Sweden, comparing 327 pregnancies in 208 women with biopsy-verified IgAN and 1060 pregnancies in a matched reference population of 622 women without IgAN, with secondary comparisons with sisters to IgAN women. Adverse pregnancy outcomes, identified by way of the Swedish Medical Birth Register, were compared through multivariable logistic regression and presented as adjusted odds ratios (aORs). Main outcome was preterm birth (< 37 weeks). Secondary outcomes were preeclampsia, small for gestational age (SGA), low 5-min Apgar score (< 7), fetal or infant loss, cesarean section, and gestational diabetes. Results We found that IgAN was associated with an increased risk of preterm birth (13.1% vs 5.6%; aOR = 2.69; 95% confidence interval [CI] = 1.52–4.77), preeclampsia (13.8% vs 4.2%; aOR = 4.29; 95%CI = 2.42–7.62), SGA birth (16.0% vs 11.1%; aOR = 1.84; 95%CI = 1.17–2.88), and cesarean section (23.9% vs 16.2%; aOR = 1.74, 95%CI = 1.14–2.65). Absolute risks were low for intrauterine (0.6%) or neonatal (0%) death and for low 5-min Apgar score (1.5%), and did not differ from the reference population. Sibling comparisons suggested increased risks of preterm birth, preeclampsia, and SGA in IgAN, but not of cesarean section. Conclusion We conclude that although most women with IgAN will have a favorable pregnancy outcome, they are at higher risk of preterm birth, preeclampsia and SGA. Intensified supervision during pregnancy is warranted.

scholarly journals Schistosomiasis among pregnant women in Njombe-Penja health district, Cameroon

2019 ◽  
Vol 13 (12) ◽  
pp. 1150-1158
Author(s):  
Calvin Tonga ◽  
Charlie Ngo Bayoi ◽  
Flore Chanceline Tchanga ◽  
Jacqueline Félicité Yengue ◽  
Godlove Bunda Wepnje ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Statistical Significance ◽  
Haemoglobin Concentration ◽  
Epidemiological Data ◽  
Blood Levels ◽  
Childbearing Age ◽  
Significance Level ◽  
Younger Women ◽  
Factors Associated ◽  
Antenatal Consultation

Introduction: Schistosomiasis is a neglected tropical disease with endemic foci in Cameroon. Epidemiological data on schistosomiasis in pregnancy are scarce in the country. This study describes the prevalence, diversity and factors associated with schistosomiasis in pregnant women in Njombe-Penja where schistosomiasis was first reported in 1968. Methodology: Two hundred and eighty-two (282) pregnant women were enrolled at first antenatal consultation between April and December 2016. A questionnaire was used to document socio-economic and obstetric information. Stool and terminal urine samples were collected and analysed using Kato-Katz/Formol-Ether concentration techniques and centrifugation methods respectively. Haemoglobin concentration was measured from finger prick blood, using an URIT®-12 electronic haemoglobinometer. Bivariate and logistic regression were used for statistical analyses with Epi-Info version 7.2.1.0. Statistical significance level was set at 0.05. Results: The overall prevalence of schistosomiasis was 31.91%. Schistosoma guineensis, S. haematobium and S. mansoni infections were found in 0.35% (n = 1), 4.96% (n = 14) and 28.01% (n = 79) of participants, respectively. Co-infection with two species of Schistosoma was found in 4.44% of these women. The prevalence of this disease was significantly higher in younger women (≤ 20 years old) and among residents of Njombe. All S. haematobium infected women were anemic and infection was associated with significantly lower haemoglobin levels (p = 0.02). Conclusion: The prevalence of schistosomiasis is high among pregnant women in Njombe-Penja, with some adverse effects on blood levels. Three Schistosoma species were found. Female of childbearing age should be considered for mass drug administration.

scholarly journals Schistosomiasis among pregnant women in the Njombe-Penja health district, Littoral region of Cameroon: A cross sectional study

2019 ◽  
Author(s):  
Calvin Tonga ◽  
Charlie Ngo Bayoi ◽  
Flore Chanceline Tchanga ◽  
Jacqueline Félicité Yengue ◽  
Godlove Bunda Wepnje ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Haemoglobin Concentration ◽  
Epidemiological Data ◽  
Adverse Pregnancy Outcomes ◽  
Health District ◽  
Blood Levels ◽  
Childbearing Age ◽  
Adverse Pregnancy ◽  
In Pregnancy

AbstractBackgroundSchistosomiasis is a Neglected Tropical Disease with endemic foci in Cameroon. Epidemiological data on schistosomiasis in pregnancy are scarce in the country. This study is about schistosomiasis among pregnant women in the Njombe-Penja health district, where schistosomiasis was reported since 1969.MethodologyOverall, 282 pregnant women were enrolled upon informed consent at first antenatal consultation. A questionnaire was administered to document socio-economic and obstetric information. Stool and terminal urine samples were collected and analysed using the Kato-Katz/formol-ether concentration techniques and centrifugation method respectively. Haemoglobin concentration was measured with finger prick blood, using a URIT-12® electronic haemoglobinometer.Principal findingsThe overall prevalence of schistosomiasis was 31.91%. Schistosoma guineensis, S. haematobium and S. mansoni infections were found in 0.35%, 04.96% and 28.01% of participants respectively. Co-infection with 2 species of Schistosoma was found in 04.44% of these women. The prevalence of schistosomiasis was significantly higher in younger women (≤20) and among residents of Njombe. All S. haematobium infected women were anemic and infection was associated with significantly lower haemoglobin levels (p=0.02).ConclusionThe prevalence of schistosomiasis is high in pregnant women of the Njombe-Penja health district, with possible adverse pregnancy outcomes. Female of childbearing age should be considered for mass drug administration.Author summaryPregnant women are known to be more vulnerable to infectious diseases and in their case, at least two lives are at risk. Although schistosomiasis remains a major public health issue in Cameroon, epidemiological data on schistosomiasis in pregnancy are scarce. These data are of high interest for informed decision-making. We examined stools and urines from 282 women of the Njombe-Penja Health district and measured their blood levels. Overall, 31.91% of women were infected, mostly younger ones and those living in the town of Njombe. Three species of Schistosoma parasite were identified. Women having urinary schistosomiasis had lower blood levels. These results show that the prevalence of schistosomiasis is high in pregnant women of Njombe. Also, because of the anemia it induces, the disease can lead to adverse pregnancy outcomes on the woman and her foetus. Treating female of childbearing age would cure the disease and prevent adverse outcomes.

scholarly journals Old and new adventures with fatty acids and their oxylipins: The road towards personalised clinical nutrition

OCL ◽  
2021 ◽  
Vol 28 ◽  
pp. 49
Author(s):  
Robert Gibson
Keyword(s):  
Fatty Acids ◽  
Preterm Birth ◽  
Cognitive Development ◽  
Preterm Infants ◽  
Dietary Fats ◽  
World Health ◽  
Blood Levels ◽  
Omega 3 Fatty Acids ◽  
Omega 3

After paying homage to the work of E. Chevreul, Prof. Robert Gibson went on in a lighthearted way to find similarities in the way they both approached their respective fields of research, as well as their way of life. Prof. Robert Gibson, who was awarded the 2021 Chevreul Medal, reported that “his huge delight was to witness the massive growth of lipid research and to have played a role in elucidating the role of dietary fats in the health of mothers and their babies”. Prof. Gibson highlighted some of the major results he collected from Australian clinical studies conducted on the role of omega-3 fatty acids on the health outcomes of mothers and their infants. He first discussed the role of fish oil on visual acuity of babies and demonstrated that infant formulas supplying more than 1% of linolenic acid (ALA) seemed adequate to ensure optimal visual and cognitive development of term infants. However, in preterm infants, whether there is a specific need for DHA above the benefit provided by ALA, still needs to be clarified. He reported a small beneficial impact on the cognitive development of preterm infants receiving DHA enriched breast milk of their mothers (1% of total fatty acids). He then discussed data from his large randomised clinical trials conducted on pregnant women receiving a DHA dietary treatment (800 mg/d DHA) or placebo, that suggested that DHA may decrease the risk of preterm birth (DOMInO trial, 2400 women). This effect was confirmed in the ORIP trial (5400 women) which found that preterm birth could be prevented by a DHA supplement treatment mainly in women with a singleton pregnancy who had a low omega-3 status in the first trimester. In the last part of his review, Robert Gibson described the use of a new low cost, rapid and efficient method to monitor changes in blood levels of omega-3 fatty acids with clinical outcomes: the Dried Blood Spots (DBS) technology. The validation of this technique has been demonstrated in large trials like N3RO and ORIP involving large cohorts of women, which could not have been obtained easily by classical analysis of lipids. He went on to point out that free fatty acids (generally not explored despite their importance in many metabolic disorders) and oxylipins, are both stable and easily identified when they are preserved in a dry state on a paper matrix (DBS), thus opening new fields of research. To conclude, the major impact of Prof. Robert Gibson’s work was identifying and overcoming one of the causes of early preterm birth (omega-3 deficiency), developing a tool to rapidly assess omega-3 status (the DBS technique) that together is close to being implemented into the world health system.

scholarly journals Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks

2022 ◽  
Vol 14 (1) ◽  
pp. 62-74
Author(s):  
Amber N. Edinoff ◽  
Niroshan Sathivadivel ◽  
Shawn E. McNeil ◽  
Austin I. Ly ◽  
Jaeyeon Kweon ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Antipsychotic Drugs ◽  
Congenital Abnormalities ◽  
Childbearing Age ◽  
Risks And Benefits ◽  
Increased Risk ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Potential Risks

Pregnant women constitute a vulnerable population, with 25.3% of pregnant women classified as suffering from a psychiatric disorder. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have on pregnant women and their developing fetus. However, the induction of pharmacological treatment during pregnancy may pose significant risks to the developing fetus. Antipsychotics are typically introduced when the nonpharmacologic approaches fail to produce desired effects or when the risks outweigh the benefits from continuing without treatment or the risks from exposing the fetus to medication. Early studies of pregnant women with schizophrenia showed an increase in perinatal malformations and deaths among their newborns. Similar to schizophrenia, women with bipolar disorder have an increased risk of relapse in antepartum and postpartum periods. It is known that antipsychotic medications can readily cross the placenta, and exposure to antipsychotic medication during pregnancy is associated with potential teratogenicity. Potential risks associated with antipsychotic use in pregnant women include congenital abnormalities, preterm birth, and metabolic disturbance, which could potentially lead to abnormal fetal growth. The complex decision-making process for treating psychosis in pregnant women must evaluate the risks and benefits of antipsychotic drugs.

scholarly journals PREGNANCY RELATED PLASMA PROTEIN–A AND PREMATURE BIRTH

2021 ◽  
Vol 19 (2) ◽  
pp. 172-177
Author(s):  
Iv. Todorov ◽  
N. Tododrov ◽  
M. Angelova ◽  
K. Peeva
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Plasma Protein ◽  
Premature Birth ◽  
Chromosomal Abnormalities ◽  
Placenta Previa ◽  
Protein A ◽  
Preterm Births ◽  
Sonographic Examination ◽  
Increased Risk

Introduction: Children born prematurely are at higher risk of mortality, morbidity, and impaired motor and cognitive development in childhood than prematurely born babies. Aim: To establish the relationship between the corresponding levels of pregnancy-related plasma protein-A (PAPP-A) and the frequency of premature birth. Materials and methods: The study is prospective. The data was collected through monitoring patients through a questionnaire and sonographic examination at 11-13 gestational weeks. The study excluded all known risk factors for preterm birth, such as previous preterm births, pregnant women with gestational diabetes, preeclampsia, hypertension, placenta previa, hydramnion, multiple pregnancies, smoking, structural and chromosomal abnormalities of the fetus and planned preterm birth. The data from the measured values of PAPP-A and the frequency of premature birth in 636 pregnant women were analyzed. Conclusions: PAPP-A levels are a statistically significant factor for preterm birth. It is expected with a 95% probability in the population with PAPP-A values below 0,515 that the cases with premature birth will be from 7 to 14 times more. Pregnant women with PAPP-A level less than 10th per cent are significantly associated with an increased risk of preterm birth.

scholarly journals Maternal risk factors associated with preterm birth after IVF/ICSI

2021 ◽  
Author(s):  
Jian Li ◽  
Jinhua Shen ◽  
Xiaoli Zhang ◽  
Yangqin Peng ◽  
Qin Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Multivariate Logistic Regression Analysis ◽  
Maternal Risk ◽  
Increased Risk ◽  
Gestational Week ◽  
Independent Risk Factors ◽  
Early Preterm Birth

Abstract In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).is associated with an increased risk of preterm (33rd - 37th gestational week), and early preterm birth (20th - 32nd gestational week). The underlying general and procedure related risk factors are not well understood so far. 4,328 infertile women undergoing IVF/ICSI were entered into this study. The study population was divided into three groups: a) early preterm birth group (n=66), b) preterm birth group (n=675 ) and c) full-term birth group (n=3653). Odds for preterm birth were calculated by stepwise multivariate logistic regression analysis. We identified seven independent risk factors for preterm birth and four independent risk factors for early preterm birth. Older (>39) or younger (<25) maternal age (OR:1.504, 95%CI: 1.108-2.042,P=0.009; OR: 2.125, 95%CI: 1.049-4.304,P=0.036, respectively), multiple pregnancy (OR: 9.780, 95%CI: 8.014-11.935,P<0.001; OR: 8.588, 95%CI: 4.866-15.157,P<0.001, respectively), placenta previa (OR: 14.954, 95%CI: 8.053-27.767,P<0.001; OR: 16.479, 95%CI: 4.381-61.976,P<0.001, respectively), and embryo reduction (OR: 3.547, 95%CI: 1.736-7.249,P=0.001; OR: 7.145, 95%CI: 1.990-25.663,P=0.003, respectively) were associated with preterm birth and early preterm birth, whereas gestational hypertension (OR: 2.494, 95%CI: 1.770-3.514,P<0.001), elevated triglycerides (OR: 1.120, 95%CI: 1.011-1.240,P=0.030) and shorter activated partial thromboplastin time (OR: 0.967, 95%CI: 0.949-0.985,P<0.001) were associated only with preterm birth. In conclusion, preterm and early preterm birth risk factors in patients undergoing assisted IVF/ICSI are in general similar to those in natural pregnancy. The lack of some associations in the early preterm group was most likely due to the lower number of early preterm birth cases. Only embryo reduction represents an IVF/ICSI specific risk factor.

Sign in / Sign up

Export Citation Format

Share Document