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Marin M, Annunziato KM, Tompach MC, Liang W, Zahn SM, Li S, Doherty J, Lee J, Clark JM, Park Y, Timme-Laragy AR. Maternal PFOS exposure affects offspring development in Nrf2-dependent and independent ways in zebrafish (Danio rerio). AQUATIC TOXICOLOGY (AMSTERDAM, NETHERLANDS) 2024; 271:106923. [PMID: 38669778 DOI: 10.1016/j.aquatox.2024.106923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/29/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Perfluorooctanesulfonic acid (PFOS) is a ubiquitous legacy environmental contaminant detected broadly in human samples and water supplies. PFOS can cross the placenta and has been detected in cord blood and breastmilk samples, underscoring the importance of understanding the impacts of maternal PFOS exposure during early development. This study aimed to investigate the effects of a preconception exposure to PFOS on developmental endpoints in offspring, as well as examine the role of the transcription factor Nuclear factor erythroid-2-related factor (Nrf2a) in mediating these effects. This transcription factor regulates the expression of several genes that protect cells against oxidative stress including during embryonic development. Adult female zebrafish were exposed to 0.02, 0.08 or 0.14 mg/L PFOS for 1 week (duration of one cycle of oocyte maturation) and then paired with unexposed males from Nrf2a mutant or wildtype strains. Embryos were collected for two weeks or until completion of 5 breeding events. PFOS was maternally transferred to offspring independent of genotype throughout all breeding events in a dose-dependent manner, ranging from 2.77 to 23.72 ng/embryo in Nrf2a wildtype and 2.40 to 15.80 ng/embryo in Nrf2a mutants. Although embryo viability at collection was not impacted by maternal PFOS exposure, developmental effects related to nutrient uptake, growth and pancreatic β-cell morphology were observed and differed based on genotype. Triglyceride levels were increased in Nrf2a wildtype eggs from the highest PFOS group. In Nrf2a wildtype larvae there was a decrease in yolk sac uptake while in Nrf2a mutants there was an increase. Additionally, there was a significant decrease in pancreatic β-cell (islet) area in wildtype larvae from the 0.14 mg/L PFOS accompanied by an increase in the prevalence of abnormal islet morphologies compared to controls. Abnormal morphology was also observed in the 0.02 and 0.08 mg/L PFOS groups. Interestingly, in Nrf2a mutants there was a significant increase in the pancreatic β-cell area in the 0.02 and 0.08 mg/L PFOS groups and no changes in the prevalence of abnormal islet morphologies. These results suggest that the regulation of processes like nutrient consumption, growth and pancreatic β-cell development are at least partially modulated by the presence of a functional Nrf2a transcriptomic response. Overall, preconception exposure to environmental pollutants, such as PFOS, may impact the maturing oocyte and cause subtle changes that can ultimately impact offspring health and development.
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Affiliation(s)
- Marjorie Marin
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA; Biotechnology Training Program, University of Massachusetts, Amherst, MA, USA
| | - Kate M Annunziato
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Madeline C Tompach
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA; Biotechnology Training Program, University of Massachusetts, Amherst, MA, USA; Molecular and Cellular Biology Graduate Program, University of Massachusetts, Amherst, MA, USA
| | - Wenle Liang
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Sarah M Zahn
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Sida Li
- Department of Food Science, University of Massachusetts, Amherst, MA, USA
| | - Jeffery Doherty
- Department of Veterinary and Animal Science, University of Massachusetts, Amherst, MA, USA
| | - Jonghwa Lee
- Department of Veterinary and Animal Science, University of Massachusetts, Amherst, MA, USA
| | - John M Clark
- Department of Veterinary and Animal Science, University of Massachusetts, Amherst, MA, USA
| | - Yeonhwa Park
- Department of Food Science, University of Massachusetts, Amherst, MA, USA
| | - Alicia R Timme-Laragy
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA; Molecular and Cellular Biology Graduate Program, University of Massachusetts, Amherst, MA, USA.
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Berhane A, Belachew T. Determinants of neural tube defects among women who gave birth in hospitals in Eastern Ethiopia: evidence from a matched case control study. BMC Womens Health 2023; 23:662. [PMID: 38071290 PMCID: PMC10710723 DOI: 10.1186/s12905-023-02796-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Neural tube defects (NTDs) are severe birth defects caused by nutritional, genetic or environmental factors. Because NTDs continue to have a significant health and economic impact on children and community at large, it is crucial to investigate potential risk factors in order to develop novel approaches to NTDs prevention. Determinants for the development of NTDs differ by country, region as well as within the country. The objective of this study was to identify the determinants of NTDs among newborns delivered in three hospitals found in eastern Ethiopia. METHODS A hospital-based matched case-control study was conducted among 138 cases and 138 control women who delivered in three teaching hospitals in Eastern Ethiopia in 2021. Data were collected using a structured and pre-tested interviewer-administered questionnaire. Cases were mothers who delivered a neonate with any type of NTDs regardless of gestational age or fetal viability, whereas controls were mothers who delivered an apparently healthy newborn. Chi-square was used to assess the significant difference between the two groups. Conditional logistic regression model was used to generate adjusted odds ratio with its corresponding 95% confidence intervals and compare the two groups. RESULTS Anencephaly (51.4%) and spinal bifida (34.1%) were the most frequently observed NTDs. None of study participants took preconception folic acid supplementation. Being a non-formal mothers (AOR = 0.34, 95% CI: 0.12-0.92, P = 0.034), rural residence, (AOR = 3.4, 95% CI: 1.18-9.78, P = 0.023), history of spontaneous abortion (AOR = 2.95, 95% CI: 1.15-7.55, P = 0.023), having severe anemia (AOR = 3.4, 95% CI: 1.17-9.87, P = 0.024), history of fever or cold (AOR = 2.75; 95% CI: 1.05-7.15, P = 0.038), and an exposure to various agro-chemicals (AOR = 3.39, 95% CI: 1.11-10.3, P = 0.032) were independent determinants of NTDs. CONCLUSION AND RECOMMENDATION In this study, NTDs were associated to several determinant factors in the area, including residential area, history of spontaneous abortion, severe anemia, fever/cold, antibiotic use before or during early pregnancy, and exposure to agrochemicals. Addressing the identified determinants is critical in averting the incidence of NTDs in the study area. Moreover, more research is needed to investigate women's dietary practices as well as the practice of preconception folic acid supplementation for pregnant women in Ethiopia's current health care system.
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Affiliation(s)
- Anteneh Berhane
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Meaton I, Karouni F, Gillies J, Kapaya H. "Smoking during pregnancy - Perinatal outcomes, financial implications, and tobacco treatment services". Prev Med Rep 2023; 36:102451. [PMID: 37822980 PMCID: PMC10563039 DOI: 10.1016/j.pmedr.2023.102451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
Objective Smoking in pregnancy is the leading modifiable risk factor for poor pregnancy outcomes. A sample population from United Lincolnshire Hospital NHS Trust (ULHT), with the highest prevalence of smoking at the time of delivery (SATOD) in England from April 2020 to March 2021 was studied. The project mapped the journey of women who smoked during pregnancy until birth and compared with a non-smoking cohort. In addition, it explored the options for possible changes to the current tobacco treatment service and importance of catering to the population demographics. Methods Data was analysed using Chi-squared or Mann Whitney and student T-test for categorical and continuous variables respectively. A p-value of < 0.05 was considered statistically significant. Results All women who smoked during pregnancy were referred to the stop smoking service. However, only 34.9 % accessed the service. Smoking mothers were younger (P = 0.001), had more complex obstetric history (P = 0.044), required increased fetal surveillance (P=<0.001), delivered at an earlier gestation (P = 0.033), and had babies with lower birth-weight (P=<0.001) compared to non-smokers. In addition, women who smoked demonstrated a downward trend in breast feeding their babies at birth and on discharge (P=<0.001 and P=<0.001 respectively). Conclusions Findings from the study informed a successful business case for improvements to the current tobacco treatment service and the development of in-house maternity model for pregnant smokers at ULHT.
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Affiliation(s)
- I. Meaton
- Foundation Year Doctor, Frimley Health NHS Foundation Trust, United Kingdom
| | - F. Karouni
- Research Support Officer, Queen's Medical Centre, Nottingham University Hospitals, Nottingham NG7 2UH, United Kingdom
| | - J. Gillies
- PGDiP Public Health, Tobacco Control Programme Manager, Office for Health Improvement and Disparities, Department of Health and Social Care, United Kingdom
| | - H. Kapaya
- SFHEA, Consultant Obstetrician Nottingham University Hospitals NHS Trust, United Kingdom
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Din HN, Strong D, Singh-Carlson S, Corliss HL, Hartman SJ, Madanat H, Su HI. The effect of changing pregnancy intentions on preconception health behaviors: a prospective cohort study. J Cancer Surviv 2023; 17:1660-1668. [PMID: 36289184 PMCID: PMC10539193 DOI: 10.1007/s11764-022-01281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Pregnancy intentions are associated with preconception health behaviors but are understudied among female adolescent and young adult (AYA) cancer survivors. Preconception health is critical for survivors because they face unique risks to fertility and pregnancy from late effects of cancer treatments. This study prospectively assessed the effect of pregnancy intention on physical activity (PA) and smoking behaviors among female AYA survivors. METHODS A cohort of 1049 female AYA survivors were recruited between 2013 and 2017. Participants were 18-39 years and had completed primary cancer treatment. Longitudinal mixed effects analysis was conducted on participants who completed at least 2 of 4 questionnaires over 1.5 years. Two measures were used to capture multiple dimensions of pregnancy intention. The pregnancy intention score (PIS) captured wanting and planning dimensions and represented a scaled response of low to high intention. The trying dimension captured urgent intention and ranged from not trying, ambivalent (neither attempting nor avoiding pregnancy), and trying now. Intention change was assessed between each consecutive time points. Final analysis was conducted with multiple imputations. RESULTS Survivors with increased intention measured by trying was associated with increased PA over time (adjusted B [95%CI]: 0.3 [0.01, 0.5]) compared to survivors with no changes or decreased trying intention. PIS was not significantly associated with preconception behaviors. No measure of intention was associated with smoking behavior. CONCLUSIONS Increasingly urgent pregnancy intention (trying dimension) was associated with higher preconception PA. IMPLICATIONS FOR CANCER SURVIVORS Screening for immediate intentions can identify AYA survivors in need of early preconception health promotion.
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Affiliation(s)
- Hena Naz Din
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
| | - David Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr., La Jolla, CA, 92037, USA
| | - Savitri Singh-Carlson
- School of Nursing, San Diego State University, 5500 Campanile Mall, San Diego, CA, 92182, USA
| | - Heather L Corliss
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Center for Research On Sexuality and Sexual Health, Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr., La Jolla, CA, 92037, USA
| | - Hala Madanat
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Division of Research & Innovation, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA
| | - H Irene Su
- Division of Reproductive Endocrinology and Infertility, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
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Chang YC, Lin YT, Jung CR, Chen KW, Hwang BF. Maternal exposure to fine particulate matter and congenital heart defects during preconception and pregnancy period: A cohort-based case-control study in the Taiwan maternal and child health database. ENVIRONMENTAL RESEARCH 2023; 231:116154. [PMID: 37187309 DOI: 10.1016/j.envres.2023.116154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/21/2023] [Accepted: 05/13/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few studies have explored the association between maternal exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and congenital heart defects occurring before and during pregnancy. We aimed to investigate the association and the critical time windows between the maternal exposure to PM2.5 and congenital heart defects. METHOD We conducted a cohort-based case-control study of 507,960 participants obtained from the Taiwan Maternal and Child Health Database between 2004 and 2015. We applied satellite-based spatiotemporal models with 1-km resolution to calculate the average PM2.5 concentration during preconception and the specific periods of pregnancy. We also performed conditional logistic regression with distributed lag non-linear models (DLNMs) to assess the effects of weekly average PM2.5 on both congenital heart defects and their isolated subtypes, as well as the concentration-response relationships. RESULTS In DLNMs, exposure to PM2.5 (per 10 μg/m3) during weeks 7-12 before conception and weeks 3-9 after conception was associated with congenital heart defects. The strongest association at 12 weeks before conception (odds ratio [OR] = 1.026, 95% confidence intervals [CI]: 1.012-1.040) and 7 weeks after conception (OR = 1.024, 95% CI: 1.012-1.036) for every 10 μg/m3 increase in PM2.5 concentration. In modification analysis, strongest associations were observed for low SES. CONCLUSIONS Our study revealed that exposure to ambient PM2.5 raises the risk of congenital heart defects, particularly among individuals with lower socioeconomic status. Moreover, our findings suggest that preconception exposure to PM2.5 may be a crucial period for the development of congenital heart defects.
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Affiliation(s)
- Ya-Chu Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Yu-Ting Lin
- Big Data Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.
| | - Chau-Ren Jung
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Japan Environment and Children's Study Programme Office, Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba, Japan
| | - Ke-Wei Chen
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Poix S, Elmusharaf K. Investigating the pathways from preconception care to preventing maternal, perinatal and child mortality: A scoping review and causal loop diagram. Prev Med Rep 2023; 34:102274. [PMID: 37387730 PMCID: PMC10302151 DOI: 10.1016/j.pmedr.2023.102274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 07/01/2023] Open
Abstract
In recent years, there has been a growing recognition that developing preconception care provides an opportunity to significantly reduce maternal and child mortality and morbidity. This involves targeting multiple risk factors through a large array of medical, behavioural and social interventions. In this study, we created a Causal Loop Diagram (CLD) to describe several pathways by which a set of preconception interventions may lead to women's improved health and better pregnancy outcomes. The CLD was informed by a scoping review of meta-analyses. It summarises evidence on the outcomes and interventions related to eight preconception risk factors. The authors reviewed literature from two databases (PubMed and Embase) and used the framework developed by Arksey and O'Malley. The CLD includes 29 constructs categorised into five different levels (mortality, causes of death, preconception risk factors, intermediate factors, interventions or policies). The model indicates interconnections between five sub-systems and highlights the role of preventing early and rapidly repeated pregnancies, as well as optimising women's nutritional status in the preconception period. It also shows the prevention of preterm birth as a privileged route for lowering child mortality and morbidity. The CLD demonstrates the potential benefits of strategies that address multiple preconception risk factors simultaneously and can be used as a tool to promote the integration of preconception care into efforts to prevent maternal and child mortality. With further improvements, this model could serve as a basis for future research on the costs and benefits of preconception care.
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Affiliation(s)
- Sébastien Poix
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Khalifa Elmusharaf
- Applied Health Research, University of Birmingham Dubai, Dubai, United Arab Emirates
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Sommer P, Sciacca V, Anselmino M, Tilz R, Bourier F, Lehrmann H, Bulava A. Practical guidance to reduce radiation exposure in electrophysiology applying ultra low-dose protocols: a European Heart Rhythm Association review. Europace 2023; 25:euad191. [PMID: 37410906 PMCID: PMC10365833 DOI: 10.1093/europace/euad191] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
Interventional electrophysiology offers a great variety of treatment options to patients suffering from symptomatic cardiac arrhythmia. Catheter ablation of supraventricular and ventricular tachycardia has globally evolved a cornerstone in modern arrhythmia management. Complex interventional electrophysiological procedures engaging multiple ablation tools have been developed over the past decades. Fluoroscopy enabled interventional electrophysiologist throughout the years to gain profound knowledge on intracardiac anatomy and catheter movement inside the cardiac cavities and hence develop specific ablation approaches. However, the application of X-ray technologies imposes serious health risks to patients and operators. To reduce the use of fluoroscopy during interventional electrophysiological procedures to the possibly lowest degree and to establish an optimal protection of patients and operators in cases of fluoroscopy is the main goal of modern radiation management. The present manuscript gives an overview of possible strategies of fluoroscopy reduction and specific radiation protection strategies.
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Affiliation(s)
- Philipp Sommer
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Georgstr. 11, Bad Oeynhausen 32545, Germany
| | - Vanessa Sciacca
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Georgstr. 11, Bad Oeynhausen 32545, Germany
| | - Matteo Anselmino
- Division of Cardiology, Department of Medical Sciences, ‘Citta della Salute e della Scienza di Torino’ Hospital, University of Turin, Torino, Italy
| | - Roland Tilz
- University Heart Center Lübeck, Department of Rhythmology, University Hospital Schleswig-Holstein, Luebeck, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Felix Bourier
- Department of Electrophysiology, German Heart Center, Technical University, Munich, Germany
| | - Heiko Lehrmann
- Department of Cardiology and Angiology (Campus Bad Krozingen), University Hospital Freiburg, Bad Krozingen, Germany
| | - Alan Bulava
- Department of Cardiology, Ceske Budejovice Hospital and Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
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Hristova-Atanasova E, Iskrov G, Raycheva R, Mandova V, Stefanov R. Preconception-Health-Related Attitudes of Bulgarian Women of Reproductive Age. Healthcare (Basel) 2023; 11:healthcare11070989. [PMID: 37046916 PMCID: PMC10094175 DOI: 10.3390/healthcare11070989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Preconception care (PC) is relatively new area of practice. While the volume and quality of PC activities depend on local settings, the awareness of women is critical for the successful promotion of PC services. The aim of this study was to examine the preconception-health-related attitudes and experiences of Bulgarian women of reproductive age. A qualitative study conducted among 20 women aged 18 to 49 years was performed between May and July 2022. Two focus groups were used with mixed samples of nulligravida, pregnant, and postpartum women. The participants thought that the Internet and their obstetrician-gynecologist were the only places where they could learn about getting pregnant. Only two of them discussed their PC plans with their physicians. Women pointed out that general practitioners (GPs) need to be more proactive in promoting PC. All respondents outlined the need for a web-based educational platform that could serve as a primary source of health information for future families. The role and functions of GPs in the continuum of PC should be reconsidered. We recommend targeted educational measures for all stakeholders, including women and GPs. In this regard, an easily accessible, knowledge-based web platform could enhance Bulgarian women’s awareness and perceptions of PC.
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Carter T, Schoenaker D, Adams J, Steel A. Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies. BMC Public Health 2023; 23:509. [PMID: 36927694 PMCID: PMC10022288 DOI: 10.1186/s12889-023-15335-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes. METHODS Medline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012-2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle-Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables. RESULTS This review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight. CONCLUSION The current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.
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Affiliation(s)
- Tristan Carter
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia.
| | - Danielle Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia
| | - Amie Steel
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia
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Crowe HM, Wesselink AK, Wise LA, Jick SS, Rothman KJ, Mikkelsen EM, Sørensen HT, Hatch EE. Pre-pregnancy migraine diagnosis, medication use, and spontaneous abortion: a prospective cohort study. J Headache Pain 2022; 23:162. [PMID: 36539705 PMCID: PMC9764528 DOI: 10.1186/s10194-022-01533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Migraine is common among females of reproductive age (estimated prevalence:17-24%) and may be associated with reproductive health through underlying central nervous system excitability, autoimmune conditions, and autonomic dysfunction. We evaluated the extent to which pre-pregnancy migraine diagnosis and medication use are associated with risk of spontaneous abortion (SAB). METHODS We analyzed data from a preconception study of pregnancy planners (2013-2021). Eligible participants self-identified as female, were aged 21-45 years, resided in the USA or Canada, and conceived during follow-up (n = 7890). Participants completed baseline and bimonthly follow-up questionnaires for up to 12 months or until a reported pregnancy, whichever occurred first. Pregnant participants then completed questionnaires during early (~ 8-9 weeks) and late (~ 32 weeks) gestation. We defined migraineurs as participants who reported a migraine diagnosis or use of a medication to treat migraine. Preconception questionnaires elicited migraine medication use during the past 4 weeks, and SAB on follow-up and pregnancy questionnaires. We used Cox regression models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations among preconception migraine, migraine medication use, and SAB, controlling for potential demographic, medical, and lifestyle confounders. RESULTS Nineteen percent of study pregnancies ended in SAB. History of migraine before conception was not appreciably associated with SAB risk (HR = 1.03, 95% CI: 0.91-1.06). Use of any migraine medication was associated with a modest increase in SAB risk overall (HR = 1.14, 95% CI: 0.96-1.36). We observed the greatest increase in risk among those taking migraine medications daily (HR = 1.38, 95% CI: 0.81-2.35) and those taking prescription migraine prophylaxis (HR = 1.43, 95% CI: 0.72-2.84) or combination analgesic and caffeine medications (HR = 1.42, 95% CI: 0.99-2.04). CONCLUSIONS Migraine medication use patterns suggesting greater underlying migraine severity were associated with increased risk of SAB. This research adds to the limited information available on the reproductive effects of migraine.
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Affiliation(s)
- Holly M. Crowe
- grid.189504.10000 0004 1936 7558Harvard T.H. Chan School of Public Health, Department of Epidemiology, 677 Huntington Avenue, Boston, MA 02115 USA ,grid.189504.10000 0004 1936 7558Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, Boston, MA 02118 USA
| | - Amelia K. Wesselink
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, Boston, MA 02118 USA
| | - Lauren A. Wise
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, Boston, MA 02118 USA
| | - Susan S. Jick
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, Boston, MA 02118 USA
| | - Kenneth J. Rothman
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, Boston, MA 02118 USA
| | - Ellen M. Mikkelsen
- grid.7048.b0000 0001 1956 2722Aarhus University, Department of Clinical Epidemiology, Olof Palmes Allé 43-45, DK-8200 Aarhus N, Denmark
| | - Henrik T. Sørensen
- grid.7048.b0000 0001 1956 2722Aarhus University, Department of Clinical Epidemiology, Olof Palmes Allé 43-45, DK-8200 Aarhus N, Denmark
| | - Elizabeth E. Hatch
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, Boston, MA 02118 USA
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11
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Partap U, Chowdhury R, Taneja S, Bhandari N, De Costa A, Bahl R, Fawzi W. Preconception and periconception interventions to prevent low birth weight, small for gestational age and preterm birth: a systematic review and meta-analysis. BMJ Glob Health 2022; 7:bmjgh-2021-007537. [PMID: 35948345 PMCID: PMC9379503 DOI: 10.1136/bmjgh-2021-007537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background Low birth weight (LBW), including preterm birth (PTB) and small for gestational age (SGA), contributes a significant global health burden. We aimed to summarise current evidence on the effect of preconception and periconception interventions on LBW, SGA and PTB. Methods In this systematic review and meta-analysis, we searched PubMed, Embase, Cochrane Library and WHO Global Index Medicus for randomised controlled trials and quasi-experimental studies published by 28 November 2020, which assessed interventions delivered in preconception and periconception or preconception and pregnancy. Primary outcomes were LBW, SGA and PTB. Studies were categorised by intervention type and delivery during preconception and periconception or during preconception and pregnancy. Estimates were pooled using fixed-effects or random-effects restricted maximum likelihood method meta-analyses. Quality of evidence for primary outcomes was assessed using the Grades of Recommendations, Assessment, Development and Evaluation approach. Results We included 58 studies. Twenty-eight studies examined nutrition interventions (primarily micronutrient or food supplementation). Thirty studies (including one reporting a nutrition intervention) provided health interventions (general preconception health, early adverse pregnancy outcome prevention, non-communicable disease and infectious disease prevention and management). One study assessed a social intervention (reproductive planning). Studies varied in terms of specific interventions, including delivery across preconception or pregnancy, resulting in few studies for any single comparison. Overall, the evidence was generally very uncertain regarding the impact of any intervention on LBW, SGA and PTB. Additionally, preconception and periconception nutritional supplementation containing folic acid was associated with reduced risk of birth defects (10 studies, N=3 13 312, risk ratio: 0.37 (95% CI: 0.24 to 0.55), I2: 74.33%). Conclusion We found a paucity of evidence regarding the impact of preconception and periconception interventions on LBW, SGA and PTB. Further research on a wider range of interventions is required to clearly ascertain their potential effectiveness. Trial registration number This review was prospectively registered with PROSPERO (CRD42020220915).
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Affiliation(s)
- Uttara Partap
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ayesha De Costa
- Department of Maternal, Newborn, Child and Adolescent Health, and Ageing, World Health Organization, Geneva, Switzerland
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health, and Ageing, World Health Organization, Geneva, Switzerland
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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12
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Doke PP, Gothankar JS, Chutke AP, Palkar SH, Patil AV, Pore PD, Bhuyan KK, Karnataki MV, Deshpande AV, Shrotri AN, Narula APS. Prevalence of preconception risk factors for adverse pregnancy outcome among women from tribal and non-tribal blocks in Nashik district, India: a cross-sectional study. Reprod Health 2022; 19:166. [PMID: 35897076 PMCID: PMC9327168 DOI: 10.1186/s12978-022-01473-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although critical, the preconception phase in women's lives is comparatively ignored. The presence of some risk factors during this phase adversely affects the wellbeing of the woman and the pregnancy outcome. The study objectives were to measure the prevalence of various known risk factors for adverse pregnancy outcome in the preconception period of women and their comparison between blocks. METHODS This was a community-based cross-sectional study in two tribal and two non-tribal blocks each in Nasik district, Maharashtra, India. The study included married women desiring to conceive within 1 year. Trained Accredited Social Health Activists (field level health worker) collected information from women using a validated interview schedule through house-to-house visits and obtained women's anthropometric measurements in a standard manner. The study assessed the presence of 12 documented risk factors. RESULTS The study enlisted 7875 women desiring pregnancy soon. The mean age of women was 23.19 (± 3.71) years, and 16% of them were adolescents. Women's illiteracy was higher in tribal areas than non-tribal (p < 0.001). About two-thirds of women have at least one risk factor, and 40.0% have a single risk factor. The most common risk factor observed was no formal education (44.35%). The prevalence of selected risk factors was significantly higher among women from tribal areas. The mean BMI of women was 19.73 (± 3.51), and a higher proportion (40.5%) of women from tribal areas had BMI < 18.5. Despite being of high parity status (≥ 4), about 7.7% of women from the tribal area and 3% from non-tribal desired pregnancy. Tobacco and alcohol consumption was higher among tribal women. The majority of women consumed meals with family members or husbands. Protein and calorie intake of about 1.4% of women was less than 50% of the recommended daily allowance; however, most of them perceived to have abundant food. CONCLUSIONS Health risks, namely younger age, illiteracy, high parity, consumption of tobacco, low protein, and calorie intake, were quite prevalent, and the risks were significantly more among women from tribal areas. "Continuum of care" must comprise preconception care inclusive of Behavioral Change Communication, particularly for easily modifiable risk factors and specially for tribal women.
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Affiliation(s)
- Prakash Prabhakarrao Doke
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, 411043, India
| | - Jayashree Sachin Gothankar
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, 411043, India.
| | - Amruta Paresh Chutke
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, 411043, India
| | - Sonali Hemant Palkar
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, 411043, India
| | - Archana Vasantrao Patil
- State Family Welfare Bureau, Department of Public Health, Government of Maharashtra, Pune, 411001, India
| | - Prasad Dnyandeo Pore
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, 411043, India
| | | | | | | | - Aparna Nishikant Shrotri
- State Family Welfare Bureau, Department of Public Health, Government of Maharashtra, Pune, 411001, India
| | - Arvinder Pal Singh Narula
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, 411043, India
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13
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Planning is not equivalent to preparing, how Dutch women perceive their pregnancy planning in relation to preconceptional lifestyle behaviour change - a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:577. [PMID: 35854217 PMCID: PMC9295368 DOI: 10.1186/s12884-022-04843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Unhealthy prenatal lifestyle behaviours are associated with adverse pregnancy outcomes, but little is known about what motivates women to comply with preconceptional lifestyle recommendations or consciously plan their pregnancy. Therefore, the objective of this study is to explore the associations between preconceptional lifestyle behaviours, health beliefs and pregnancy planning among Dutch pregnant women. Methods In this cross-sectional study based on the data of the APROPOS-II study, 1,077 low-risk pregnant women were eligible for inclusion. Preconception lifestyle behaviours and actively preparing for pregnancy were assessed in relation to planned pregnancies (based on the London Measure of Unplanned Pregnancies) and health beliefs (14 statements). The following preconceptional lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester of pregnancy: fruit intake, vegetable intake, caffeine intake, (second-hand)smoking, alcohol intake, folic acid supplement use and exercise. Data were analysed using multivariate logistic regression analyses. Results A total of 921 (85.5%) women in our cohort had a planned pregnancy. However, of these women, 640 (69.5%) adequately used folic acid supplements and 465 (50.5%) women consumed alcohol at any point during pregnancy. Of the women considering themselves ‘healthy enough and not needing preconception care’, 48 (9.1%) women had an adequate vegetable intake, 294 (55.6%) women consumed alcohol at any point during pregnancy and 161 (30.4%) women were either over-or underweight. Conclusion Despite consciously planning their pregnancy, most women did not adhere to preconceptional lifestyle behaviour recommendations. Women’s health beliefs and overestimation of their health status seem to interfere with actively planning and preparing for pregnancy. Findings from our study may encourage the development of prospective health-promoting interventions that focus on health beliefs and actively preparing for pregnancy, to improve preconceptional lifestyle behaviours, thereby optimizing the health of future generations. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04843-4.
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14
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Caut C, Schoenaker D, McIntyre E, Vilcins D, Gavine A, Steel A. Relationships between Women's and Men's Modifiable Preconception Risks and Health Behaviors and Maternal and Offspring Health Outcomes: An Umbrella Review. Semin Reprod Med 2022; 40:170-183. [PMID: 35830867 DOI: 10.1055/s-0042-1744257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Parental health before conception effects maternal and offspring health outcomes. Preconception care provides healthcare to prospective parents addressing modifiable preconception risks and health behaviors. This umbrella review aimed to consolidate evidence on women's and men's modifiable preconception risks or health behaviors associated with maternal and offspring health outcomes. MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, and PsycINFO were searched from March 4, 2010, to March 4, 2020. Eligible studies were systematic reviews or meta-analyses of observational studies examining associations between modifiable preconception risks or health behaviors and maternal and offspring health outcomes. Screening, data extraction, and methodological quality assessment (AMSTAR 2) occurred independently by two reviewers. Degree of overlap was examined. Findings were summarized for evidence synthesis. Twenty-seven systematic reviews were included. Modifiable preconception risks and health behaviors were identified across categories: body composition (e.g., overweight, obesity), lifestyle behaviors (e.g., caffeine, smoking), nutrition (e.g., micronutrients), environmental exposures (e.g., radiation), and birth spacing (e.g., short interpregnancy intervals). Outcomes associated with exposures affected embryo (e.g., embryonic growth), maternal (e.g., gestational diabetes mellitus), fetal/neonate (e.g., preterm birth), and child (e.g., neurocognitive disorders) health. For real-world practice and policy relevance, evidence-based indicators for preconception care should include body composition, lifestyle, nutrition, environmental, and birth spacing.
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Affiliation(s)
| | - Danielle Schoenaker
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Erica McIntyre
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.,Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
| | - Dwan Vilcins
- Children's Health Environmental Program (CHEP), Child Health Research Centre, University of Queensland, South Brisbane, Australia
| | - Anna Gavine
- School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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15
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Cot S, Durand D, Daniel S, Paris S, Millot I, Binquet C. [Not Available]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2022; 34:71-85. [PMID: 36102094 DOI: 10.3917/spub.221.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The environment and living conditions of parents during the "first 1000 days" period influence the short- and long-term health trajectories of children. Professionals following pregnancies play an important role in advising future parents to adopt health-promoting behaviors. It appeared necessary to describe the prevention messages transmitted by professionals early in pregnancy. OBJECTIVES To identify the prevention messages systematically delivered during the first trimester of pregnancy and determine the degree of priority that professionals (midwives, obstetricians, general practitioners) of Bourgogne-Franche-Comté give to them. RESULTS Prevention messages on infectious risk were addressed by 96.5% of respondents, and those on risk behaviors and addictions by 93.7%. Dietary balance and sports activities (78.5%), as well as risks in the daily life (47.1%) were less delivered. The messages that professionals declared to be delivered systematically to pregnant women during the first trimester were generally those that they considered to be priorities. There were some differences depending on the professional. Regarding information media, the majority of respondents did not use any. They agreed on the importance of a paper-based information medium and wished to be able to rely on a digital medium (62.6%). CONCLUSION The co-construction of support that meets the needs of both women and professionals and that is validated by health authorities would contribute to better consideration and promotion of health-promoting behaviors by parents, by promoting empowerment of women and couples from the beginning of pregnancy.
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16
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Huang C, Wu D, Khan FA, Wang Y, Xu J, Luo C, Zhang K, Sun F, Huo L. Zinc oxide nanoparticle causes toxicity to the development of mouse oocyte and early embryo. Toxicol Lett 2022; 358:48-58. [DOI: 10.1016/j.toxlet.2022.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/31/2021] [Accepted: 01/18/2022] [Indexed: 12/24/2022]
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17
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Suresh S, Abozaid A, Tsang B, Gerlai R. Exposure of parents to alcohol alters behavior of offspring in zebrafish. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110143. [PMID: 33096155 DOI: 10.1016/j.pnpbp.2020.110143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/12/2020] [Accepted: 10/14/2020] [Indexed: 12/22/2022]
Abstract
Alcoholism and alcohol abuse represent a significant medical and societal problem, and have been thoroughly investigated in humans as well as using animal models. A less well understood aspect of alcohol related disorders is the possible effect of this drug on offspring whose parents were exposed prior to conception. The zebrafish has been successfully employed in alcohol research, however, the effect of exposing the parents to alcohol before fertilization of the eggs on offspring has not been demonstrated in this species. In this proof of concept study, we attempt to address this hiatus. We exposed both adult male and female zebrafish to 0.0% (control) or 0.5% (vol/vol) alcohol chronically for 7 days, subsequently bred the fish within their respective treatment group, collected the fertilized eggs, allowed them to develop, and tested the behavior of free-swimming offspring at their age of 7-9 days post-fertilization. We conducted the analysis in two genetically distinct quasi-inbred strains of zebrafish, AB and TL. Although gross morphology and general activity of the fish appeared unaffected, we found significant behavioral alterations in offspring of alcohol exposed parents compared to offspring of control parents in both strains. These alterations included robustly increased duration and reduced frequency of immobility, increased turn angle, and increased intra-individual variance of turn angle in offspring of alcohol exposed parents in both strains. The mechanisms underlying these behavioral effects or whether the effects are due to exposure of the father, the mother, or both to alcohol are unknown. Nevertheless, our results now set the stage for future studies with zebrafish that will address these questions.
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Affiliation(s)
| | - Amira Abozaid
- Department of Cell & System Biology, University of Toronto, Canada
| | - Benjamin Tsang
- Department of Psychology, University of Toronto Mississauga, Canada
| | - Robert Gerlai
- Department of Psychology, University of Toronto Mississauga, Canada; Department of Cell & System Biology, University of Toronto, Canada.
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18
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Lv F, Fan G, Wan Y, Chen Y, Ni Y, Huang J, Xu D, Zhang W, Wang H. Intrauterine endogenous high glucocorticoids program ovarian dysfunction in female offspring secondary to prenatal caffeine exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 789:147691. [PMID: 34082199 DOI: 10.1016/j.scitotenv.2021.147691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/27/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
Ovarian dysfunction has an intrauterine origin, and prenatal caffeine exposure (PCE) could lead to abnormal follicle counts in offspring after birth. However, the effect of PCE on offspring ovarian function and its mechanism of intrauterine programming have not been reported thus far. In this study, pregnant Wistar rats were intragastrically administered caffeine (30 and 120 mg/kg·d) at gestational days 9-20 (GD9-20). Certain tests were performed on the blood, ovaries and hypothalamus of female offspring at different time points. PCE female offspring had ovarian dysfunction in adulthood compared with the control. Further results showed that in utero ovarian morphological development and estradiol synthesis were inhibited but rapidly increased during puberty in the PCE group. The histone 3 lysine 27 acetylation (H3K27ac) level of the insulin-like growth factor 1 (IGF1) promoter region and its expression were decreased in the ovary, which was due to exposure to high levels of fetal blood corticosterone, and the H3K27ac level of IGF1 and its expression shifted to increase after birth with a decrease in serum corticosterone levels. Chronic stress led to increased serum corticosterone levels in adult offspring, whereas ovarian morphological development, the H3K27ac level of IGF1 and its expression, and estradiol synthesis were significantly inhibited. Moreover, the activity of the hypothalamic-pituitary-ovarian (HPO) axis was increased in the early postnatal period of PCE offspring, and chronic stress reversed these changes. In the KGN cell line, it was found that cortisol could promote the translocation of the glucocorticoid receptor (GR) into the nucleus and upregulate histone deacetylase 10 (HDAC10) to inhibit the H3K27ac level of IGF1 and its expression and estradiol synthesis. In summary, PCE is associated with ovarian dysfunction in female adult offspring, and the potential mechanism is related to intrauterine high glucocorticoid exposure by activating the GR and recruiting HDAC10 to affect ovarian glucocorticoid-IGF1 axis programming and to inhibit estradiol synthesis.
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Affiliation(s)
- Feng Lv
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Guanlan Fan
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Yang Wan
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Yunxi Chen
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Yuan Ni
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Jing Huang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Dan Xu
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Wei Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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19
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Caffeine use during pregnancy: prevalence of use and newborn consequences in a cohort of French pregnant women. Eur Arch Psychiatry Clin Neurosci 2021; 271:941-950. [PMID: 32086556 DOI: 10.1007/s00406-020-01105-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
Abstract
Many pregnant women, in the world, drink caffeine-containing beverages. Maternal caffeine consumption during pregnancy may have adverse effects on foetus but results are conflicting. Our goals were to estimate the prevalence of caffeine use in a cohort of French pregnant women using maternal self-reports and to evaluate the association between caffeine consumption during pregnancy and delivery and newborn characteristics. All pregnant women who gave birth in a large French urban area during a limited period of time were included (in total 724 mothers were included). Coffee, tea or cola consumption as well as pregnancy and neonate characteristics were analysed. The mean consumption of caffeine per day slightly decreased from the first to the third trimester of pregnancy: 587 caffeine users, with a consumption of caffeine of 59.2 ± 61.5 mg/day during the first trimester as compared to 577 consumers (54.3 ± 55.4 mg/day) during the third trimester, respectively. A significant decrease of neonates' birth length was observed when mothers were using at least 100 mg/day (or two cups) of caffeine during the second and third trimesters but this difference was no longer significant after adjustment on potential confounding factors such as tobacco use. The potential existence of other confounders (e.g. poorer dietary habits or other lifestyle variables) that might also be associated with reduced birth length, may not be excluded. Caffeine use during pregnancy was associated with reduced birth length but this effect was no longer significant after adjustment on potential confounding variables.
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20
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Maas VYF, Poels M, Lamain-de Ruiter M, Kwee A, Bekker MN, Franx A, Koster MPH. Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes. BMC Pregnancy Childbirth 2021; 21:492. [PMID: 34233654 PMCID: PMC8265143 DOI: 10.1186/s12884-021-03935-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background While the potential adverse outcomes of prenatal exposure to unhealthy lifestyle are widely evidenced, little is known about these exposures in the periconception period. We investigated the associations between lifestyle behaviours and adverse pregnancy outcomes with a unique distinction between preconceptional- and prenatal lifestyle behaviours. Methods A secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first trimester lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between 2012 and 2014 and analysed using multivariate logistic regression. Results Women who are overweight, and especially obese, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95 % Confidence Interval (CI) 1.31–1.99) and aOR 2.85 (95 %CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally continued smoking attained higher odds for SGA (aOR 1.91 (95 %CI 1.05–1.15)) compared to the reference group, but these odds decreased when women prenatally quit smoking (aOR 1.14 (95 %CI 0.59–2.21)). Women who did not use folic acid supplements tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95 %CI 0.97–1.69)), while women who prenatally started folic acid supplements did not (aOR 1.01 (95 %CI 0.82–1.25)). Conclusions Our results indicate that smoking cessation, having a normal body mass index (BMI) and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03935-x.
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Affiliation(s)
- Veronique Y F Maas
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Marjolein Poels
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.,Research Agency Care2Research, Mattenbiesstraat 133, 1087GC, Amsterdam, the Netherlands
| | | | - Anneke Kwee
- Department of Obstetrics and Gynaecology, Division Woman and Baby, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, the Netherlands
| | - Mireille N Bekker
- Department of Obstetrics and Gynaecology, Division Woman and Baby, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, the Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Maria P H Koster
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
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21
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Du L, La X, Zhu L, Jiang H, Xu B, Chen A, Li M. Utilization of preconception care and its impacts on health behavior changes among expectant couples in Shanghai, China. BMC Pregnancy Childbirth 2021; 21:491. [PMID: 34233653 PMCID: PMC8262048 DOI: 10.1186/s12884-021-03940-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners. METHODS A cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception. RESULTS Of the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45-4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48-5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03-4.39, P = 0.041] before conception. CONCLUSIONS Utilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.
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Affiliation(s)
- Li Du
- Shanghai Center for Women and Children's Health, 339 Luding Road, Putuo District, Shanghai, 200062, China
| | - Xuena La
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China
- Shanghai Municipal Center for Disease Control and Prevention, No.1380 West Zhongshan Road, Shanghai, 200336, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, 339 Luding Road, Putuo District, Shanghai, 200062, China.
| | - Hong Jiang
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Biao Xu
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China
| | - An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA Institute), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, FI-02150, Espoo, Finland
| | - Mu Li
- School of Public Health, China Studies Centre, University of Sydney, Room 313, Edward Ford Building, Sydney, 2006, Australia
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Rovira-Vizcaíno NE, Sáez-Padilla J, Romero-Márquez JM, Merino-Godoy MDLÁ. Preconception Care for Men and Women during the Pandemic, an Intervention Proposal. Healthcare (Basel) 2021; 9:healthcare9070816. [PMID: 34203317 PMCID: PMC8304192 DOI: 10.3390/healthcare9070816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic and its measures resulted in limited outdoor activities, reduced group meetings, etc., leading to unhealthy habits. Several studies showed how certain unhealthy habits can lead to serious consequences for both men and women, as well as affect future offspring. (1) Background: Therefore, we present a community intervention at the preconception stage to avoid future risks. The purpose of this intervention is to change lifestyles and beliefs about the health of men and women in the preconception period; (2) Methods: For the design of the intervention, a bibliographic search was performed both in English and Spanish in the main databases of health sciences and nursing (Cochrane, PubMed, Web of Science, CINAHL, LILACS, Dialnet), using descriptors in MeSH health for sciences; (3) Results: We proposed that a variety of lifestyles be analyzed, including aspects such as physical activity, nutrition, etc. In addition, stress management should be emphasized through a relaxation workshop, where three different techniques be proposed to reduce anxiety levels in stressful situations; (4) Conclusions: Due to the limited scientific results of interventions carried out in the preconception period simultaneously with men and women, more community interventions that address this topic are needed to assess the impact of these actions on the health of the population.
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Affiliation(s)
| | - Jesús Sáez-Padilla
- Integrated Didactics Department, University of Huelva, 21071 Huelva, Spain
- Correspondence:
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Veteran-Reported Receipt of Prepregnancy Care: Data from the Examining Contraceptive Use and Unmet Need (ECUUN) Study. Matern Child Health J 2021; 25:1254-1264. [PMID: 33929654 DOI: 10.1007/s10995-021-03131-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To identify the prevalence of women Veterans reporting receipt of counseling about health optimization prior to pregnancy, topics most frequently discussed, and factors associated with receipt of this care. METHODS We analyzed data from a nationally representative, cross-sectional telephone survey of women Veterans (n = 2302) ages 18-45 who used VA for primary care in the previous year. Our sample included women who were (1) currently pregnant or trying to become pregnant, (2) not currently trying but planning for pregnancy in the future, or (3) unsure of pregnancy intention. Multivariable logistic regression was used to examine adjusted associations of patient- and provider-level factors with receipt of any counseling about health optimization prior to pregnancy (prepregnancy counseling) and with counseling on specific topics. RESULTS Among 512 women who were considering or unsure about pregnancy, fewer than half (49%) reported receiving any prepregnancy counseling from a VA provider in the past year. For those who did, the most frequently discussed topics included healthy weight (29%), medication safety (27%), smoking (27%), and folic acid use before pregnancy (27%). Factors positively associated with receipt of prepregnancy counseling include history of mental health conditions (aOR = 1.96, 95% CI: 1.28, 3.00) and receipt of primary care within a dedicated women's health clinic (aOR = 2.07, 95% CI: 1.35, 3.18), whereas factors negatively associated include far-future and unsure pregnancy intentions (aOR = 0.35, 95% CI: 0.17, 0.71 and aOR = 0.33, 95% CI: 0.16, 0.70, respectively). CONCLUSIONS FOR PRACTICE Routine assessment of pregnancy preferences in primary care could identify individuals to whom counseling about health optimization prior to pregnancy can be offered to promote patient-centered family planning care.
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Fetene MT, Teji K, Assefa N, Bayih WA, Tsehaye G, Hailemeskel HS. Magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of eastern Ethiopia. BMC Psychiatry 2021; 21:96. [PMID: 33588806 PMCID: PMC7885430 DOI: 10.1186/s12888-021-03078-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 01/31/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Use of substances like alcohol, tobacco and khat during pregnancy can bring miscarriage, prematurity, neurodevelopmental problems, sudden infant death syndrome and others. There are limited studies on the magnitude and associated factors of substance use among pregnant women in Eastern Ethiopia. Therefore, the aim of this study was to assess the magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of Easttern Ethiopia, 2019. METHOD Hospital based cross-sectional study was employed on 510 pregnant women attending ANC at public hospitals of Eastern Ethiopia (Jigjiga, Dire Dawa and Harar towns). Data were collected from the study participants that were selected using systematic sampling method from each public hospital. The data were collected through interviewer administered structured questionnaire. Binary logistic regressions with 95% confidence interval were used to determine the degree of association between covariates and outcome variable. Multicollinearity between independent variables by using the standard error was checked. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests. RESULTS Out of 526 participants, a total of 510 study participants were involved in this study thereby making a response rate of 96.9%. In this study, the magnitude of substance use among pregnant women attending ANC was 26.5% (95% CI: 22.7, 30.6%). Among the overall pregnant mothers, 100 (19.6%) chewed khat, 48 (9.4%) drank alcohol, 12 (2.4%) used tobacco products and 28(20.7%) were dual substance users. Pre pregnancy substance use (AOR = 27.25, CI: 14.107-52.66), partner substance use (AOR = 3.704 CI: 1.839-7.464), family substance use (AOR = 3.447 CI: 1.69-7.031) and the amount of monthly household income (AOR = 3.397, 95% CI: 1.316-8.766) were found to be statistically significant and positively associated with substance use during pregnancy. CONCLUSION The magnitude of antenatal substance use in the study area was 26.5%. Pre- pregnancy substance use, partner substance use, monthly house hold income and family substance use were found to be positively associated with substance use during pregnancy. Therefore, health education which is inclusive of child bearing age women with their partner and family may be helpful to decrease antenatal substance use during pregnancy.
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Affiliation(s)
| | - Kedir Teji
- School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
| | | | - Genet Tsehaye
- College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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25
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La X, Wang W, Zhang M, Liang L. Definition and Multiple Factors of Recurrent Spontaneous Abortion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1300:231-257. [PMID: 33523437 DOI: 10.1007/978-981-33-4187-6_11] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Recurrent spontaneous abortion (RSA) is usually defined as three or more spontaneous abortions prior to 20-28 weeks gestation. RSA affects approximately 2-5% of all women of childbearing age, and it brings tremendous psychological and psychiatric trauma to the women and also results in economic burden. The causes could be female age, anatomical and chromosomal abnormalities, genetic, endocrinological, placental anomalies, infection, smoking and alcohol consumption, psychological factor, exposure to environmental factors such as heavy metal, environment pollution, and radiation.
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Affiliation(s)
- Xiaolin La
- Reproductive Medicine Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
| | - Wenjuan Wang
- Reproductive Medical Center, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, P.R. China
| | - Meng Zhang
- Reproductive Medicine Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Li Liang
- Reproductive Medical Center, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, P.R. China
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26
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Najafi ML, Zarei M, Gohari A, Haghighi L, Heydari H, Miri M. Preconception air pollution exposure and glucose tolerance in healthy pregnant women in a middle-income country. Environ Health 2020; 19:131. [PMID: 33298083 PMCID: PMC7727159 DOI: 10.1186/s12940-020-00682-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/01/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Preconception exposure to air pollution has been associated with glucose tolerance during pregnancy. However, the evidence in low and middle-income countries (LMICs) is under debate yet. Therefore, this study aimed to assess the relationship between exposure to ambient particulate matter (PM) and traffic indicators with glucose tolerance in healthy pregnant women in Sabzevar, Iran (2019). METHODS Two-hundred and fifty healthy pregnant women with singleton pregnancies and 24-26 weeks of gestations participated in our study. Land use regression (LUR) models were applied to estimate the annual mean of PM1, PM2.5 and PM10 at the residential address. Traffic indicators, including proximity of women to major roads as well as total streets length in 100, 300 and 500 m buffers around the home were calculated using the street map of Sabzevar. The oral glucose tolerance test (OGTT) was used to assess glucose tolerance during pregnancy. Multiple linear regression adjusted for relevant covariates was used to estimate the association of fasting blood glucose (FBG), 1-h and 2-h post-load glucose with PMs and traffic indicators. RESULTS Exposure to PM1, PM2.5 and PM10 was significantly associated with higher FBG concentration. Higher total streets length in a 100 m buffer was associated with higher FBG and 1-h glucose concentrations. An interquartile range (IQR) increase in proximity to major roads was associated with a decrease of - 3.29 mg/dL (95% confidence interval (CI): - 4.35, - 2.23, P-value < 0.01) in FBG level and - 3.65 mg/dL (95% CI, - 7.01, - 0.28, P-value = 0.03) decrease in 1-h post-load glucose. CONCLUSION We found that higher preconception exposure to air pollution was associated with higher FBG and 1-h glucose concentrations during pregnancy.
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Affiliation(s)
- Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Zarei
- Department of Physical Education and Sport Science, Faculty of Human Science, University of Neyshabur, Neyshabur, Iran
| | - Ali Gohari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Leyla Haghighi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Hafez Heydari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Mohammad Miri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, PO Box 319, Sabzevar, Iran.
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27
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Chronopoulou E, Raperport C, Serhal P, Saab W, Seshadri S. Preconception tests at advanced maternal age. Best Pract Res Clin Obstet Gynaecol 2020; 70:28-50. [PMID: 33358154 DOI: 10.1016/j.bpobgyn.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
Pregnancies at an advanced reproductive age are increasingly common. However, the safety of pregnancy remains a concern as maternal age is a recognized independent factor for various obstetric complications. Also, age is a risk factor for most systematic health problems and older women are more likely to enter into pregnancy with pre-existing conditions. At the moment there is no separate, structured guidance on preconception tests at advanced maternal age. However, the preconceptual period offers an ideal window to recognize and address underlying health issues, social issues and harmful lifestyle behaviours in order to optimize maternal health ultimately reducing infertility, perinatal morbidity and mortality. Preconception tests should be clinically relevant aiming to identify risk factors and address them to predict and prevent infertility and pregnancy complications. The importance of preconception care is magnified for women of advanced age for whom the risks are higher and the potential benefits greater.
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Affiliation(s)
- Elpiniki Chronopoulou
- Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK.
| | - Claudia Raperport
- Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK
| | - Paul Serhal
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| | - Wael Saab
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| | - Srividya Seshadri
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
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Patient Screenings for Preconception Health Interventions at a Community Pharmacy. PHARMACY 2020; 8:pharmacy8040181. [PMID: 33027982 PMCID: PMC7712468 DOI: 10.3390/pharmacy8040181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022] Open
Abstract
Preconception health refers to health before pregnancy and involves addressing risk factors that can negatively impact either a patient or future pregnancy. Pharmacists can play an essential role in screening for and managing patients’ risk factors to optimize pregnancy outcomes. The primary objective of this study is to determine whether preconception health screenings in community pharmacy settings identify opportunities for preconception health services, particularly pharmacy-based interventions. The secondary objectives are to describe the preconception health status of community pharmacy patients and their interest in receiving preconception care services by a clinical pharmacist in a community pharmacy setting. Two independent pharmacies conducted a pilot project where people were invited to complete a health screening form that evaluated their preconception health. Participants received a personalized health report with an invitation to meet with the clinical pharmacist for services related to identified opportunities, such as contraception and immunizations. Retrospective analysis was conducted for data collected from 43 women during the patient screening effort in three community pharmacy settings (two independent community pharmacy locations and one neighborhood pharmacy outreach event). Nearly all participants (n = 42, 98%) had at least one opportunity identified to receive preconception care services, with the majority related to their alcohol use (60%). A majority of participants (56%) indicated an interest in learning more about preconception services offered at the pharmacy, but only 19% wanted to schedule an appointment with a pharmacist. Thus, there is an apparent need and opportunity for utilization of preconception health services at the pharmacy.
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29
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Sundaram L, Rathnavelu V, Venugopal DC, Narasimhan M, Sabesan M, Swetha S. Prevalence of Common Clinically Manifested Developmental Anomalies of the Oral Cavity Among Adults - An Epidemiological Study in a South Indian Population. Cureus 2020; 12:e9961. [PMID: 32983665 PMCID: PMC7510503 DOI: 10.7759/cureus.9961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Developmental anomalies are malformation which arises due to the disturbances during the development of the organs. Although there have been many studies that have described the prevalence of these anomalies in the oral cavity, none have specified the prevalence of clinically manifested anomalies and their distribution between gender. Materials and methods In this study, 500 patients aged 18 to 50 years were screened for clinically manifested developmental anomalies. These were then divided based on age, sex, and jaws, which were then analyzed using a chi-square test and tabulated. Results We detected anomalies in 12.2% of the study population. Supernumerary teeth were the most prevalent anomaly detected (4.25%). The frequency of developmental anomalies was higher in men (57.1%). Conclusions Supernumerary teeth were the most widely recognized anomaly. Other anomalies identified were related to the shape and size of teeth. These anomalies can lead to severe orofacial problems. Therefore, proper care of these anomalies should be taken.
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Affiliation(s)
- Lokesh Sundaram
- Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Vidhya Rathnavelu
- Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Divyambika C Venugopal
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Malathi Narasimhan
- Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Mythili Sabesan
- Oral Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Swarna Swetha
- Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Bala R, Singh V, Rajender S, Singh K. Environment, Lifestyle, and Female Infertility. Reprod Sci 2020; 28:617-638. [DOI: 10.1007/s43032-020-00279-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/24/2020] [Indexed: 01/01/2023]
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Caffeine, alcohol, khat, and tobacco use during pregnancy in Butajira, South Central Ethiopia. PLoS One 2020; 15:e0232712. [PMID: 32384102 PMCID: PMC7209255 DOI: 10.1371/journal.pone.0232712] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/20/2020] [Indexed: 01/19/2023] Open
Abstract
Background The use of excessive caffeine and consumption of alcohol, cigarette, and khat during pregnancy can result in adverse health effects on the fetus. The World Health Organization (WHO) recommends a daily caffeine intake not exceeding 300 mg. Likewise, pregnant women are recommended to avoid alcohol, khat and tobacco use. However, the prevalence’s of the use of substances among pregnant women were not well studied in developing countries such as Ethiopia. Therefore, the study aimed to estimate the prevalence of caffeine and alcohol consumption, khat chewing, and tobacco use during pregnancy and identify key factors associated with excess caffeine consumption. Methods We conducted a community based cross-sectional study and used a random sampling technique to recruit 352 pregnant women. We adapted a questionnaire from Caffeine Consumption Questionnaire-Revised (CCQ-R), Alcohol Use Disorder Identification Test (AUDIT), Global Adult Tobacco Survey (GATS), and Ethiopian Demographic Health Survey 2016 for caffeine, alcohol consumption, tobacco use, and khat chewing assessment, respectively. We conducted non-consecutive two days 24-hour recall to determine the habitual intake of caffeine from caffeinated beverages and foods. Prevalence with 95% confidence interval was estimated for excess caffeine intake per day, alcohol consumption, khat chewing, and passive tobacco smoking. We ran a multivariable binary logistic regression model to identify factors associated with excess caffeine intake. Results Almost all pregnant women (98.2%) consumed caffeine as estimated using the 2 days 24-hour average. The median daily caffeine intake was 170.5 mg and ranged from 0.00 mg to 549.8 mg per day. In addition, 17.6% (95% CI: 13.9%, 22.0%) of them had a daily caffeine consumption of 300 mg and above exceeding the WHO recommended daily caffeine intake during pregnancy. The prevalence of alcohol consumption and Khat chewing were 10.0% (95% CI: 7.2%, 13.7%) and 35.8% (95% CI: 30.8, 41.0%) respectively. None of the pregnant women were active tobacco smokers. However, 23.2% (95% CI: 19.0, 28.0%) were passive tobacco smokers. We found that pregnant women in the richest wealth quintile (AOR = 3.66; 95% CI: 1.13, 11.88), and the first trimester of pregnancy (AOR = 4.04; 95% CI: 1.26, 13.05) had higher odds of consuming excessive caffeine. Conclusions The study showed a considerable magnitude of substance use among pregnant women in the study area. Given this findings, we recommend, programs and services focusing on pregnant women to consider addressing substance use.
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Mello S, Stifano S, Tan AS, Sanders-Jackson A, Bigman CA. Gendered Conceptions of Preconception Health: A Thematic Analysis of Men's and Women's Beliefs about Responsibility for Preconception Health Behavior. JOURNAL OF HEALTH COMMUNICATION 2020; 25:374-384. [PMID: 32602417 DOI: 10.1080/10810730.2020.1775728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Preconception health (PCH) focuses on taking steps before a pregnancy to safeguard the health of the woman and future baby. Although recommendations to improve PCH target all people of reproductive age, research shows most interventions and messages focus primarily on women, which may contribute to existing normative beliefs that women are more responsible for protecting children's health. In this study, we explore society's gendered expectations of responsibility for engaging in recommended PCH behaviors (i.e., avoiding smoking, drinking, and environmental toxins). An applied thematic analysis of online survey responses from U.S. men and women (N = 573) identified five main themes and related subthemes: body and health, shared responsibility, choice and moral obligation, gender stereotypes, and doubt and uncertainty. Both men and women frequently referenced biological connections between prospective parents and offspring as justification for PCH behaviors. When challenging PCH recommendations, respondents mentioned excessive control of women and men's secondary role in reproduction. Overall, gender stereotypes were more commonly expressed in relation to men yet reflected both traditional and contemporary male roles (i.e., as supporters, co-parents). When judging personal responsibility, women commonly viewed PCH behaviors as the 'duty of a good mother'. Implications for PCH communication research and practice are discussed.
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Affiliation(s)
- Susan Mello
- Communication Studies Department, Northeastern University , Boston, MA, USA
| | - Sara Stifano
- Department of Communication, University of Connecticut , Storrs, CT, USA
| | - Andy Sl Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research , Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Ashley Sanders-Jackson
- Department of Advertising and Public Relations, Michigan State University , East Lansing, MI, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign , Urbana, IL, USA
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Kim HW, Kim DH, Lee HY, Lee YJ, Ahn HY. Adult Perceptions of Healthy Pregnancy: A Focus-Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2460. [PMID: 32260300 PMCID: PMC7178235 DOI: 10.3390/ijerph17072460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/28/2020] [Accepted: 03/31/2020] [Indexed: 11/27/2022]
Abstract
The fastest aging society with the lowest fertility rate can be buffered by support for healthy pregnancies using sociocultural approaches. We aimed to address adult perceptions of a healthy pregnancy and explored their needs and concerns about childbirth across the lifespan. We conducted a qualitative study using content analysis to investigate general perceptions of a healthy pregnancy after focus-group interviews with adult men and women. We interviewed 60 participants in nine group sessions of 5 to 8 people per group. Three major themes emerged that affect healthy pregnancies: Taking responsibility for a prepared pregnancy, factors that interfere with a healthy pregnancy, and improving strategies for a healthy pregnancy. For the first theme, the two main concerns were financial and parenthood preparation. Factors interfering with a healthy pregnancy had direct and indirect causes, considering personal, social, and cultural changes. Strategies for a healthy pregnancy included family and workplace support, systematic education, and governmental support for financial preparation and health screening. Participants averred that various kinds of support (financial, healthcare, and career) are needed for a healthy pregnancy and childbirth. This public awareness could promote better decisions toward healthy pregnancy with more sociocultural approaches in the various settings of home, school, and the workplace.
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Affiliation(s)
- Hae Won Kim
- Seoul National University, College of Nursing, Research Institute of Nursing Science, Seoul 03080, Korea;
| | - Duck Hee Kim
- College of Nursing, Woosuk University, Jeollabuk-do 55338, Korea;
| | - Hyang Yuol Lee
- College of Nursing, The Catholic University of Korea, Seoul 06591, Korea
| | - Young Jin Lee
- College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Hye Young Ahn
- College of Nursing, Eulji University, Daejeon 34824, Korea;
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Antiapolipoprotein A-1 Autoantibody Positivity Is Associated with Threatened Abortion. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9309121. [PMID: 32219148 PMCID: PMC7081016 DOI: 10.1155/2020/9309121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/08/2020] [Indexed: 11/17/2022]
Abstract
Background Autoantibodies against apolipoprotein A-1 (anti-ApoA-1 IgG) were demonstrated to be associated with cardiovascular outcomes in several inflammatory diseases. As balanced inflammation is critical for uncomplicated pregnancy, we aimed to investigate the prevalence of anti-ApoA-1 IgG and anti-c-terminal ApoA-1 autoantibodies (Ac-terAA1 IgG) in a cohort of pregnant women and their potential relationship with threatened abortion (TA). Methods Between 2012 and 2014, 371 consecutive outpatient pregnant women were included in this study and followed until delivery. Anti-ApoA-1 and anti-Ac-terAA1 IgG were measured by ELISA technique on serum samples collected between the 24th and 26th week of pregnancy. Associations with TA were tested using linear regression analysis and C-statistics. Results Median age was 34 with a prevalence of the Caucasian ethnicity (90.5%). TA occurred in 10 women (2.7%). C-statistics indicated that anti-ApoA-1 and anti-Ac-terAA1 IgG levels upon study inclusion were predictive of TA (0.73, 95% confidence interval [CI] 0.69-0.78, p < 0.001 and 0.76, 95% CI 0.71-0.80, p < 0.001 and 0.76, 95% CI 0.71-0.80, p < 0.001 and 0.76, 95% CI 0.71-0.80, p < 0.001 and 0.76, 95% CI 0.71-0.80, Conclusion Anti-ApoA-1 and anti-Ac-terAA1 IgG are independently associated with TA during pregnancy with an appealing NPV. The causal biological mechanisms underlying this association as well as the possible clinical relevance of these findings require further investigations.
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Barišić A, Kolak M, Peterlin A, Tul N, Gašparović Krpina M, Ostojić S, Peterlin B, Pereza N. DNMT3B rs1569686 and rs2424913 gene polymorphisms are associated with positive family history of preterm birth and smoking status. Croat Med J 2020; 61:8-17. [PMID: 32118373 PMCID: PMC7063552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/20/2019] [Indexed: 12/17/2023] Open
Abstract
AIM To evaluate the association between spontaneous preterm birth (SPTB) and DNA methyltransferase (DNMT)1, 3A, 3B, and 3L gene polymorphisms, and their contribution to the clinical characteristics of women with SPTB and their newborns. METHODS This case-control study, conducted in 2018, enrolled 162 women with SPTB and 162 women with term delivery. DNMT1 rs2228611, DNMT3A rs1550117, DNMT3B rs1569686, DNMT3B rs2424913, and DNMT3L rs2070565 single nucleotide polymorphisms were genotyped using polymerase chain reaction and restriction fragment length polymorphism methods. The clinical characteristics included in the analysis were family history of preterm birth, maternal smoking, maternal age, gestational week at delivery, and fetal birth weight. RESULTS DNMT gene polymorphisms were not significantly associated with SPTB. DNMT3B rs1569686 and rs2424913 minor alleles (T) were significantly more frequent in women with familial PTB than in women with non-familial PTB, increasing the odds for familial PTB 3.30 and 3.54 times under dominant genetic models. They were also significantly more frequent in women with SPTB who smoked before pregnancy, reaching the most significant association under additive genetic models (odds ratio 6.86, 95% confidence interval 2.25-20.86, P<0.001; odds ratio 3.77, 95% confidence interval 1.36-10.52, P=0.011, respectively). CONCLUSIONS DNMT3B rs1569686 and rs2424913 gene polymorphisms might be associated with positive family history of PTB and smoking status.
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Affiliation(s)
| | | | | | | | | | | | | | - Nina Pereza
- Nina Pereza, Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, B. Branchetta 20, 51000 Rijeka, Croatia,
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Brussé IA, Kluivers ACM, Zambrano MD, Shetler K, Miller EC. Neuro-obstetrics: A multidisciplinary approach to care of women with neurologic disease. HANDBOOK OF CLINICAL NEUROLOGY 2020; 171:143-160. [PMID: 32736747 DOI: 10.1016/b978-0-444-64239-4.00007-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The term "neuro-obstetrics" refers to a multidisciplinary approach to the care of pregnant women with neurologic comorbidities, both preconceptionally and throughout pregnancy. General preconception care should be offered to all women, including women with neurologic disease. Women with neurologic comorbidities should also be offered specialist preconception care by an obstetrician who consults with a neurologist, anesthesiologist, and if indicated clinical geneticist and/or other specialists. In women with neurologic comorbidities, neurologic sequelae may influence the course of the pregnancy and delivery. Also, pregnancy may influence the severity of the neurologic condition, depending on the type of disease. Physiologic adaptations during pregnancy and altered pharmacokinetics may cause altered blood serum levels of drugs, leading to decreased or increased drug effects. When administering drugs to a woman who wishes to conceive, it is important to consider possible teratogenic effects and possible secretion in breast milk. Tailoring medication regimens should be considered, preferably preconceptionally. In this chapter, we review general principles of neuro-obstetric care, as well as some specific considerations for neurologists, obstetricians, and anesthesiologists caring for pregnant women with common neurologic conditions.
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Affiliation(s)
- Ingrid A Brussé
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Anna C M Kluivers
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maria D Zambrano
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Kara Shetler
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Eliza C Miller
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, United States
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Lowe SA. Ionizing radiation for maternal medical indications. Prenat Diagn 2019; 40:1150-1155. [PMID: 31697844 DOI: 10.1002/pd.5592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/23/2019] [Accepted: 10/11/2019] [Indexed: 12/21/2022]
Abstract
Ionizing radiation should be considered an avoidable exposure although all pregnant women receive some radiation from their environment. The potential effect of ionizing radiation on the fetus is determined by the dose and the timing of the exposure with growing interest in the potential risks of transgenerational effects of radiation as an epigenetic phenomenon. High dosage exposure is very unlikely in routine situations such as occupational, diagnostic, or therapeutic exposures. Individual diagnostic radiation procedures (fetal dosage <50 mGy), are not associated with any increase in lethality (miscarriage or stillbirth), genetic damage, teratogenicity, growth impairment, mental retardation, or sterility. More recent modeling has suggested that a 10 mGy fetal dose is associated with an excess risk of childhood cancer risk as low as 1 in 4545, well below historical estimates.When the mother's condition necessitates diagnostic radiation it is necessary to balance the risks of the procedure with the benefits to be gained. As almost all diagnostic imaging involves doses below the 50 mGy threshold, clinically indicated investigations should not be withheld because of concerns regarding fetal radiation exposure. Even radiotherapy directed away from the abdomen or pelvis may be considered during pregnancy, if the benefits outweigh the risks and no suitable alternative is available.
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Affiliation(s)
- Sandra A Lowe
- Royal Hospital for Women, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, Australia
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Kedzior SG, Bianco-Miotto T, Breen J, Diener KR, Donnelley M, Dunning KR, Penno MA, Schjenken JE, Sharkey DJ, Hodyl NA, Fullston T, Gardiner M, Brown HM, Rumbold AR. It takes a community to conceive: an analysis of the scope, nature and accuracy of online sources of health information for couples trying to conceive. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2019; 9:48-63. [PMID: 32021914 PMCID: PMC6994282 DOI: 10.1016/j.rbms.2019.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/16/2019] [Accepted: 08/05/2019] [Indexed: 05/25/2023]
Abstract
This study examined the nature and accuracy of information available across online platforms for couples trying to conceive. A consumer simulation-based investigation of English websites and social media (Facebook, Twitter, Instagram) was undertaken using common search terms identified in a pilot study. Claims about fertility and pregnancy health were then extracted from the results and analysed thematically. The accuracy of each claim was assessed independently by six fertility and conception experts, rated on a scale of 1 (not factual) to 4 (highly factual), with scores collated to produce a median rating. Claims with a median score < 3 were classified as inaccurate. The use of the terms 'trying to conceive' and '#TTC' were common identifiers on online platforms. Claims were extracted predominantly from websites (n = 89) rather than social media, with Twitter and Instagram comprising commercial elements and Facebook focused on community-based support. Thematic analysis revealed three major themes among the claims across all platforms: conception behaviour and monitoring, lifestyle and exposures, and medical. Fact-checking by the experts revealed that 40% of the information assessed was inaccurate, and that inaccuracies were more likely to be present in the conception behaviour and monitoring advice, the topics most amenable to modification. Since online information is a readily accessible and commonly utilized resource, there is opportunity for improved dissemination of evidence-based material to reach interested couples. Further cross-disciplinary and consumer-based research, such as a user survey, is required to understand how best to provide the 'trying to conceive' community with accurate information.
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Affiliation(s)
- Sophie G.E. Kedzior
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
| | - Tina Bianco-Miotto
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- School of Agriculture, Food and Wine & Waite Research Institute, University of Adelaide, Australia
| | - James Breen
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- University of Adelaide, Bioinformatics Hub, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Kerrilyn R. Diener
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- School of Pharmacy and Medical Science and UniSA Cancer Research Institute, University of South Australia, Australia
| | - Martin Donnelley
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- Respiratory and Sleep Medicine, Women’s and Children’s Hospital, Adelaide, Australia
| | - Kylie R. Dunning
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- ARC Centre for Nanoscale Biophotonics, University of Adelaide, Adelaide, Australia
| | - Megan A.S. Penno
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
| | - John E. Schjenken
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - David J. Sharkey
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
| | - Nicolette A. Hodyl
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
| | - Tod Fullston
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
| | - Maria Gardiner
- School of Psychology, Flinders University of South Australia, Adelaide, Australia
| | - Hannah M. Brown
- ARC Centre for Nanoscale Biophotonics, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Alice R. Rumbold
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
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Jo H, Eckel SP, Chen JC, Cockburn M, Martinez MP, Chow T, Lurmann F, Funk WE, McConnell R, Xiang AH. Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort. ENVIRONMENT INTERNATIONAL 2019; 130:104933. [PMID: 31234004 PMCID: PMC6684238 DOI: 10.1016/j.envint.2019.104933] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/31/2019] [Accepted: 06/13/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Studies of effects of air pollution on gestational diabetes mellitus (GDM) have not been consistent, and there has been little investigation of effects of exposure preceding pregnancy. In previous studies, the temporal relationship between exposure and GDM onset has been difficult to establish. METHODS Data were obtained for 239,574 pregnancies between 1999 and 2009 in a population-based health care system with comprehensive electronic medical records. Concentrations of ambient nitrogen dioxide (NO2), particulate matter (PM) ≤2.5 μm in aerodynamic diameter (PM2.5) and ≤10 μm (PM10), and ozone (O3) during preconception and the first trimester of pregnancy at the residential birth address were estimated from regulatory air monitoring stations. Odds ratios (ORs) of GDM diagnosed in the second and third trimesters in association with pollutant exposure were estimated using generalized estimating equation models adjusted for birth year, medical center service areas, maternal age, race/ethnicity, education, census-tract household income, and parity. RESULTS In single-pollutant models, preconception NO2 was associated with increased risk of GDM (OR = 1.10 per 10.4 ppb, 95% confidence interval [CI]: 1.07, 1.13). First trimester NO2 was weakly associated with GDM, and this was not statistically significant (OR = 1.02 per 10.4 ppb, 95% CI: 0.99, 1.05). Preconception NO2 associations were robust in multi-pollutant models adjusted for first trimester NO2 with another co-pollutant from both exposure windows. In single-pollutant models, preconception PM2.5 and PM10 associations were associated with increased risk of GDM (OR = 1.04 per 6.5 μg/m3, 95% CI: 1.01, 1.06; OR = 1.03 per 16.1 μg/m3, 95% CI: 1.00, 1.06, respectively), but these effect estimates were not robust to adjustment for other pollutants. In single-pollutant models, preconception and first trimester O3 were associated with reduced risk of GDM (OR = 0.94 per 15.7 ppb, 95% CI: 0.92, 0.95; OR = 0.95 per 15.7 ppb, 95% CI: 0.94, 0.97), associations that were robust to adjustment for co-pollutants. CONCLUSIONS Maternal exposure to NO2 during the preconception trimester may increase risk of GDM.
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Affiliation(s)
- Heejoo Jo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America
| | - Sandrah P Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America; Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO, United States of America
| | - Mayra P Martinez
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America
| | - Ting Chow
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America
| | - Fred Lurmann
- Sonoma Technology, Inc., Petaluma, CA, United States of America
| | - William E Funk
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Rob McConnell
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America.
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Sethi V, Dinachandra K, Murira Z, Gausman J, Bhanot A, de Wagt A, Unisa S, Bhatia S, Baswal D, Subramanian SV. Nutrition status of nulliparous married Indian women 15-24 years: Decadal trends, predictors and program implications. PLoS One 2019; 14:e0221125. [PMID: 31454363 PMCID: PMC6711595 DOI: 10.1371/journal.pone.0221125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/12/2019] [Indexed: 01/15/2023] Open
Abstract
In India, 66% of 8 million married adolescents (~5.3 million) are nulliparous and likely to conceive soon. Among married young women aged 20–24 years about 9.1 million are nulliparous. This group remains relatively less reached in maternal nutrition programs. Current estimates of their nutritional status and predictors of body mass index (BMI) are unavailable. Thinness (BMI <18.5 kg/m2), severe thinness (BMI <16 kg/m2), overweight or obesity (BMI ≥ 23kg/m2) prevalence estimates are presented based on a sample of 11,265 married nulliparous adolescents (15–19 years, married, no parity) and 15,358 young women (20–24 years, married, no parity) drawn from the National Family Health Surveys 2005–06 and 2015–16. Trends by age, time and state were analysed. Predictors of BMI were investigated using linear regression. Using BMI for age z score (BAZ) as standard reference, BMI cut-off was calculated for thinness (-2SD) and overweight or obesity (+1SD) among married nulliparous adolescents as recommended for population under 19 years. 35% sampled adolescents and 26% young women were thin; 4%-5% severely thin. Overweight or obesity was higher among married nulliparous young women than married nulliparous adolescents (21% versus 11%). Eight in 1000 were short, thin and young and six in 1000 were short, thin, anemic and young. At 15 years of age, prevalence of thinness based on BMI was 46.5% while based on BAZ, 7.6%. At 24 years of age thinness was 22.5%. Decadal reduction in thinness was half among married nulliparous adolescents (4% points) compared with married nulliparous young women (8% points). Decadal increase in overweight/ obesity ranged from 4% to 5% in both age groups. Western states had high prevalence of thinness; Tamil Nadu had highest prevalence of overweight or obesity. Incremental increase in age and wealth increased BMI among young women more than adolescents. BMI was lower among adolescents and young women wanting a child later than soon [β -0.28 (CI -0.49- -0.07), β -0.33(CI -0.56- -0.093), respectively]. BMI cut-off 16.49 kg/m2 and 24.12 kg/m2 had a high sensitivity (100%, 99.7%) and specificity (98.9%, 98.5%) to screen thin and overweight or obese adolescents, respectively. Owing to the high prevalence of both thinness and overweight/obesity among nulliparous married adolescents and women, nutritional anthropometry based screening should be initiated for this target group, along with a treatment package in states with high and persistent malnutrition. Family planning services should be integrated in nutrition programs for this target group to achieve normal nutritional status before conception.
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Affiliation(s)
- Vani Sethi
- Nutrition Section, UNICEF India, Country Office, New Delhi, India
- * E-mail:
| | | | - Zivai Murira
- Regional Office for South Asia, UNICEF, Kathmandu, Nepal
| | - Jewel Gausman
- Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | | | - Arjan de Wagt
- Nutrition Section, UNICEF India, Country Office, New Delhi, India
| | - Sayeed Unisa
- International Institute for Population Sciences, Mumbai, India
| | - Salima Bhatia
- Ministry of Health and Family Welfare, Government of India, Guwahati, Assam, India
| | - Dinesh Baswal
- Ministry of Health and Family Welfare, Government of India, Guwahati, Assam, India
| | - S. V. Subramanian
- Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Yamamoto K, Nomura S, Tsubokura M, Murakami M, Ozaki A, Leppold C, Sawano T, Takita M, Kato S, Kanazawa Y, Anbe H. Internal exposure risk due to radiocesium and the consuming behaviour of local foodstuffs among pregnant women in Minamisoma City near the Fukushima nuclear power plant: a retrospective observational study. BMJ Open 2019; 9:e023654. [PMID: 31289047 PMCID: PMC6615778 DOI: 10.1136/bmjopen-2018-023654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the internal cesium (Cs) level among pregnant women in Minamisoma City (the area straddling the evacuation zones) over a 5-year period after Japan's 2011 Fukushima nuclear accident and assess the status and transition of their food-acquiring preferences during this period. DESIGN A retrospective observational study of a screening along with a questionnaire survey. SETTING This study was conducted in an obstetrics and gynaecology service in Minamisoma City in Fukushima, Japan. PARTICIPANTS Participants included pregnant women who applied for the voluntary internal radiation exposure screening programme. PRIMARY AND SECONDARY OUTCOME MEASURES Internal radiation exposure was evaluated using the whole-body counter (WBC) in the screening programme. Data from a food acquisition preference questionnaire administered to the participants were analysed and compared across the 5-year period after adjusting for covariates. RESULTS Overall, 804 screening programmes were conducted with 579 participants during the study period. All participants had internal contamination levels below the detection limit of the WBC unit (220 and 250 Bq/body for Cs-134 and Cs-137, respectively). Based on the most conservative assumption, their maximum annual effective doses by Cs-134 and Cs-137 together were estimated at 16 µSv/year. Contrary to limited internal contamination risks and counter-dose initiatives by the government, a considerable number of pregnant women were still concerned about consuming potentially contaminated local food products when purchasing them at supermarkets between 2012 (78.4%) and 2015 (75.0%). CONCLUSIONS Health effects from post-accident internal radiation exposure were likely to be insignificant in pregnant women. National/local action is urgently needed to promote scientific understanding in pregnant women regarding limited internal exposure risks from local food products in the market. However, few mothers chose to participate in the internal radiation exposure screening programme, and thus, caution is required in interpreting the results of analyses.
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Affiliation(s)
- Kana Yamamoto
- Department of Internal Medicine, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Shuhei Nomura
- Department of Global Health Policy, The University of Tokyo, Tokyo, Bunkyo-ku, Japan
| | - Masaharu Tsubokura
- Department of Research, Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima City, Japan
| | - Akihiko Ozaki
- Department of Research, Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Claire Leppold
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Morihito Takita
- Department of Internal Medicine, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Shigeaki Kato
- Research Institute of Innovative Medicine, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yukio Kanazawa
- Department of Gastroenterology, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Hiroshi Anbe
- Department of Obstetrics and Gynecology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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Abstract
Research has documented a negative association between women's educational attainment and early sexual intercourse, union formation, and pregnancy. However, the implications that school progression relative to age may have for the timing and order of such transitions are poorly understood. In this article, I argue that educational attainment has different implications depending on a student's progression through school grades relative to her age. Using month of birth and age-at-school-entry policies to estimate the effect of advanced school progression by age, I show that it accelerates the occurrence of family formation and sexual onset among teenage women in Mexico. Focusing on girls aged 15-17 interviewed by a national survey, I find that those who progress through school ahead of their birth cohort have a higher probability of having had sex, been pregnant, and cohabited by the time of interview. I argue that this pattern of behaviors is explained by experiences that lead them to accelerate their transition to adulthood compared with same-age students with fewer completed school grades, such as exposure to relatively older peers in school and completing academic milestones earlier in life. Among girls who got pregnant, those with an advanced school progression by age are more likely to engage in drug use, alcohol consumption, and smoking before conception; more likely to have pregnancy-related health complications; and less likely to attend prenatal care visits. Thus, an advanced school progression by age has substantial implications for the health and well-being of young women, with potential intergenerational consequences.
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Choosing Pre-conception Planning for Women/Families: Counselling and Informed Consent (Part 2) – Pre-conception Reproductive Planning, Lifestyle, Immunization, and Psychosocial Issues. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:666-678. [DOI: 10.1016/j.jogc.2017.08.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 11/23/2022]
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Can hair steroids predict pregnancy longevity? Reprod Biol 2018; 18:410-415. [DOI: 10.1016/j.repbio.2018.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 11/21/2022]
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Sarkozy A, De Potter T, Heidbuchel H, Ernst S, Kosiuk J, Vano E, Picano E, Arbelo E, Tedrow U. Occupational radiation exposure in the electrophysiology laboratory with a focus on personnel with reproductive potential and during pregnancy: A European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS). Europace 2018; 19:1909-1922. [PMID: 29126278 DOI: 10.1093/europace/eux252] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/07/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Andrea Sarkozy
- University Antwerp and University Hospital of Antwerp, Cardiology department, Antwerp, Belgium
| | - Tom De Potter
- Cardiology Department, OLV Hospital, Moorselbaan, 164 Aalst B-9300, Belgium
| | - Hein Heidbuchel
- University Antwerp and University Hospital of Antwerp, Cardiology department, Antwerp, Belgium
| | - Sabine Ernst
- Cardiology Department, Royal Brompton And Harefield Hospital Sydney Street Chelsea Wing, Level 4 London, SW3 6NP, UK
| | - Jedrzej Kosiuk
- Cardiology Department, University Hospital of Leipzig, Leipzig, Germany
| | - Eliseo Vano
- Department Radiology, Medical School and San Carlos University Hosp Radiology, Madrid 28040, Spain
| | | | - Elena Arbelo
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona. IDIBAPS, Institut d'Investigació August Pi i Sunyer, Hospital Clínic de Barcelona Villarroel, 17008036 Barcelona, Spain
| | - Usha Tedrow
- Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street Boston, MA 02115, USA
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Vaiman D. Mother smoking leads to methylation anomalies on 'smoke' genes in the offspring: Indelible traces of previous injuries. EBioMedicine 2018; 38:11-12. [PMID: 30449702 PMCID: PMC6306332 DOI: 10.1016/j.ebiom.2018.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 11/20/2022] Open
Affiliation(s)
- Daniel Vaiman
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France.
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Bateson DJ, Black KI. Pre‐conception care: an important yet underutilised preventive care strategy. Med J Aust 2018; 209:389-391. [DOI: 10.5694/mja18.00769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Deborah J Bateson
- Family Planning New South Wales, Sydney, NSW
- University of Sydney, Sydney, NSW
| | - Kirsten I Black
- Family Planning New South Wales, Sydney, NSW
- Royal Prince Alfred Hospital, Sydney, NSW
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Błaszczyk-Bębenek E, Piórecka B, Kopytko M, Chadzińska Z, Jagielski P, Schlegel-Zawadzka M. Evaluation of Caffeine Consumption among Pregnant Women from Southern Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2373. [PMID: 30373178 PMCID: PMC6266219 DOI: 10.3390/ijerph15112373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/15/2018] [Accepted: 10/23/2018] [Indexed: 12/20/2022]
Abstract
Caffeine is the most widely consumed stimulant worldwide, including by pregnant women. Products containing caffeine should be limited in accordance with the recommendations for pregnancy. The purpose of this study was to evaluate consumption of caffeinated products and daily caffeine intake from food by pregnant women. The study was conducted on a group of healthy pregnant women: attendees of antenatal classes (n = 70) and patients of an outpatient gynecological clinic (n = 70) from Krakow (Southern Poland). A questionnaire about the frequency of consumption of selected foods and drinks containing caffeine was used. The average caffeine content in food products obtained from other Polish studies was used to estimate average daily caffeine intake in our study group. Mean daily caffeine intake was 49.60 ± 59.15 mg/day and the maximum was 498.0 mg/day. The main sources of caffeine were as follows: black tea (bags, leaf), instant coffee and ground coffee. No statistically significant differences in caffeine intake between the groups were found. A weak negative correlation (rs) = -0.28 (p = 0.0208) between month of pregnancy and caffeine intake was observed among attendees of antenatal classes. Mean daily caffeine intake did not exceed the maximum recommended dose in our study group.
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Affiliation(s)
- Ewa Błaszczyk-Bębenek
- Human Nutrition Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531 Krakow, Poland.
| | - Beata Piórecka
- Human Nutrition Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531 Krakow, Poland.
| | - Monika Kopytko
- Human Nutrition Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531 Krakow, Poland.
| | - Zuzanna Chadzińska
- Human Nutrition Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531 Krakow, Poland.
| | - Paweł Jagielski
- Human Nutrition Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531 Krakow, Poland.
| | - Małgorzata Schlegel-Zawadzka
- Human Nutrition Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531 Krakow, Poland.
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49
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Oostingh EC, Hall J, Koster MPH, Grace B, Jauniaux E, Steegers-Theunissen RPM. The impact of maternal lifestyle factors on periconception outcomes: a systematic review of observational studies. Reprod Biomed Online 2018; 38:77-94. [PMID: 30424937 DOI: 10.1016/j.rbmo.2018.09.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 12/20/2022]
Abstract
The main risk factors for important reproductive health issues such as subfertility and perinatal mortality largely originate in the periconception period. To evaluate associations between modifiable maternal lifestyle factors and periconception outcomes, a systematic search was conducted for relevant studies published from 1990 to February 2017 on Embase, Medline, Web of Science, Cochrane database, PubMed and Google Scholar. The initial search identified 6166 articles, of which 49 studies were eligible for inclusion. Fecundity (the capacity to have a live birth) showed significant inverse associations with smoking, alcohol use and poor diet. Studies regarding time to pregnancy showed a decline in fecundity ratios (the monthly conception rate among exposed relative to unexposed couples) with increasing body mass index (BMI). Furthermore, risk of first-trimester miscarriage was found to be increased in smokers, alcohol and caffeine consumers, and with increasing BMI. Vitamin supplement use showed a decrease in this risk. This review demonstrates that maternal modifiable lifestyle factors affect periconception outcomes. If couples planning a pregnancy are more aware and supported to adopt healthy lifestyles during the periconceptional 'window of opportunity', short-term reproductive health as well as health in later life and even of future generations can be further improved.
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Affiliation(s)
- Elsje C Oostingh
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Jennifer Hall
- Research Department of Reproductive Health, EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London (UCL), London, United Kingdom
| | - Maria P H Koster
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Bola Grace
- Research Department of Reproductive Health, EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London (UCL), London, United Kingdom
| | - Eric Jauniaux
- Research Department of Reproductive Health, EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London (UCL), London, United Kingdom
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50
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Duque PA, Valencia Rico CL, Araujo JJ. Socio-demographic and preconception risk factors in parents of children suffering from congenital cardiopathy. ENFERMERIA CLINICA 2018; 28:300-308. [PMID: 29891353 DOI: 10.1016/j.enfcli.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 02/06/2018] [Accepted: 03/18/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To identify the preconception risk factors in parents of children suffering from congenital cardiopathy. METHOD A cross-sectional descriptive study, which included parents of children suffering from cardiopathy, attended at consultations in a not-for-profit organization, in order to be diagnosed and referred for heart surgery or to be assessed in postoperative cardiac monitoring. The sample population included 500 people who responded to a survey for the identification of socio-demographic and preconception risk factors. RESULTS Couples were found with up to 3 cardiac children. Parents with 2 or more children suffering from cardiopathy were classified in the majority as belonging to the middle socioeconomic level and not owning their own house. An association with the number of children with cardiopathy, the educational level of their parents (P=.013), their home area (P=.041) and type of accommodation (P=.045) was found. Regarding the preconception risk factors, there was evidence of statistically significant associations among the number of children with cardiopathy and their exposure to fertilizers (P=.024), their exposure to fuels (P=.025), the use of antihypertensive medication (P=.37), and alcohol consumption (P=.042) and cocaine use (P=.039) by their parents. CONCLUSIONS The population of parents with a greater number of children suffering from cardiopathy were characterized as having socioeconomic and educational constraints. The preconception risk factors which show an association with the number of children suffering from cardiopathy were characterized as physical and/or chemical environmental risk factors and the consumption of certain psychoactive substances and medication by their parents. It is necessary to analyze each risk factor separately, taking into account the different types of cardiopathy.
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Affiliation(s)
- Paula Andrea Duque
- Programa Enfermería, Universidad Católica de Manizales, Caldas, Colombia.
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