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Cepeda J, Racca ME, Rossetti MF, Cardozo MA, Gaydou L, Luque EH, Muñoz-de-Toro M, Milesi MM, Varayoud J, Ramos JG. A Reliable Method for Quantifying Plasma Cell-Free DNA Using an Internal Standard Strategy: Evaluation in a Cohort of Non-Pregnant and Pregnant Women. Reprod Sci 2024; 31:987-996. [PMID: 38030813 DOI: 10.1007/s43032-023-01403-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023]
Abstract
The use of plasma cell-free DNA (cfDNA) as a useful biomarker in obstetric clinical practice has been delayed due to the lack of reliable quantification protocols. We developed a protocol to quantify plasma cfDNA using an internal standard strategy to overcome difficulties posed by low levels and high fragmentation of cfDNA. cfDNA was isolated from plasma samples of non-pregnant (NP, n = 26) and pregnant (P, n = 26) women using a commercial kit and several elution volumes were evaluated. qPCR parameters were optimized for cfDNA quantification, and several quantities of a recombinant standard were evaluated as internal standard. Absolute quantification was performed using a standard curve and the quality of the complete method was evaluated. cfDNA was eluted in a 50-μl volume, actin-β (ACTB) was selected as the target gene, and qPCR parameters were optimized. The ACTB standard was constructed and 1000 copies were selected as internal standard. The standard curve showed R2 = 0.993 and E = 109.7%, and the linear dynamic range was defined between 102 and 106 ACTB copies/tube. Repeatability and reproducibility in terms of CV were 19% and up to 49.5% for ACTB copies per milliliter of plasma, respectively. The range of cfDNA levels was 428-18,851 copies/mL in NP women and 4031-2,019,363 copies/mL in P women, showing significant differences between the groups. We recommend the application of internal standard strategy for a reliable plasma cfDNA quantification. This methodology holds great potential for a future application in the obstetric field.
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Affiliation(s)
- Julieta Cepeda
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
| | - M Emilia Racca
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - M Florencia Rossetti
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
| | - M Alejandra Cardozo
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
- Laboratorios BLUT, Santa Fe, Argentina
| | - Luisa Gaydou
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - Enrique H Luque
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Facultad de Bioquímica y Ciencias Biológicas, Cátedra de Fisiología Humana, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - Mónica Muñoz-de-Toro
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Facultad de Bioquímica y Ciencias Biológicas, Cátedra de Patología Humana, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - M Mercedes Milesi
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Facultad de Bioquímica y Ciencias Biológicas, Cátedra de Fisiología Humana, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - Jorgelina Varayoud
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- Facultad de Bioquímica y Ciencias Biológicas, Cátedra de Fisiología Humana, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - Jorge G Ramos
- Facultad de Bioquímica y Ciencias Biológicas, Instituto de Salud y Ambiente del Litoral (ISAL), Universidad Nacional del Litoral (UNL)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina.
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina.
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Guo Y, Lu J, Bahani M, Ding G, Wang L, Zhang Y, Zhang H, Liu C, Zhou L, Liu X, Li F, Wang X, Ding H. Triglyceride-glucose index in early pregnancy predicts the risk of gestational diabetes: a prospective cohort study. Lipids Health Dis 2024; 23:87. [PMID: 38528508 DOI: 10.1186/s12944-024-02076-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/10/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the association between the triglyceride-glucose (TyG) index in early pregnancy and the development of gestational diabetes mellitus (GDM) in the second trimester. The primary objectives were to evaluate the predictive potential of the TyG index for GDM, determine the optimal threshold value of the TyG index for GDM assessment, and compare the predictive performance of the TyG index alone versus its combination with maternal age and pre-pregnancy body mass index on GDM. Moreover, the study explored the association between the TyG index in early pregnancy and the risk of other pregnancy-related complications (PRCs), such as placental abruption and gestational hypertension. PATIENTS AND METHODS This prospective cohort study recruited 1,624 pregnant women who underwent early pregnancy antenatal counseling and comprehensive assessments with continuous monitoring until delivery. To calculate the TyG index, health indicators, including maternal triglycerides and fasting plasma glucose, were measured in early pregnancy (< 14 weeks of gestation). The predictive power of the TyG index for evaluating GDM in Chinese pregnant women was determined using multifactorial logistic regression to derive the odds ratios and 95% confidence interval (CI). Subgroup analyses were conducted, and the efficacy of the TyG index in predicting PRCs was assessed via receiver operating characteristic (ROC) curve analysis and restricted cubic spline, with the optimal cutoff value calculated. RESULTS Logistic regression analyses revealed a 2.10-fold increase in the GDM risk for every 1-unit increase in the TyG index, after adjusting for covariates. The highest GDM risk was observed in the group with the highest TyG index compared with the lowest quintile group (odds ratios: 3.25; 95% CI: 2.23-4.75). Subgroup analyses indicated that exceeding the recommended range of gestational weight gain and an increased GDM risk were significantly associated (P = 0.001). Regarding predictive performance, the TyG index exhibited the highest area under the curve (AUC) value in the ROC curve for GDM (AUC: 0.641, 95% CI: 0.61-0.671). The optimal cutoff value was 8.890, with both sensitivity and specificity of 0.617.The combination of the TyG index, maternal age, and pre-pregnancy body mass index proved to be a superior predictor of GDM than the TyG index alone (AUC: 0.672 vs. 0.641, P < 0.01). After adjusting for multiple factors, the analyses indicated that the TyG index was associated with an increased risk of gestational hypertension. However, no significant association was noted between the TyG index and the risk of preeclampsia, placental abruption, intrauterine distress, or premature rupture of membranes. CONCLUSION The TyG index can effectively identify the occurrence of GDM in the second trimester, aligning with previous research. Incorporating the TyG index into routine clinical assessments of maternal health holds significant practical implications. Early identification of high-risk groups enables healthcare providers to implement timely interventions, such as increased monitoring frequency for high-risk pregnant women and personalized nutritional counseling and health education. These measures can help prevent or alleviate potential maternal and infant complications, thereby enhancing the overall health outcomes for both mothers and babies.
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Affiliation(s)
- Yufeng Guo
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Junwen Lu
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Mailiman Bahani
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Guifeng Ding
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Lei Wang
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Yuxia Zhang
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Huanmei Zhang
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Chengyao Liu
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Lijun Zhou
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Xiaolan Liu
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Fangshen Li
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Xiaoli Wang
- Maternal and Child Health Care Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China
| | - Hong Ding
- Department of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830000, China.
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Zhu J, Li Z, Deng Y, Lan L, Yang J. Comprehensive reference intervals for white blood cell counts during pregnancy. BMC Pregnancy Childbirth 2024; 24:35. [PMID: 38182972 PMCID: PMC10768452 DOI: 10.1186/s12884-023-06227-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/26/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND White blood cell (WBC) count increases during pregnancy, necessitating reliable reference intervals for assessing infections and pregnancy-related complications. This study aimed to establish comprehensive reference intervals for WBC counts during pregnancy. METHODS The analysis included 17,737 pregnant women, with weekly WBC count measurements from pre-pregnancy to postpartum. A threshold linear regression model determined reference intervals, while Harris and Boyd's test partitioned the intervals. RESULTS WBC count exhibited a significant increase during pregnancy, characterized by a rapid rise before 7 weeks of gestation, followed by a plateau. Neutrophils primarily drove this increase, showing a similar pattern. The threshold regression model and Harris and Boyd's test supported partitioned reference intervals for WBC counts: 4.0-10.0 × 10^9/L for < = 2 weeks, 4.7-11.9 × 10^9/L for 3-5 weeks, and 5.7-14.4 × 10^9/L for > = 6 weeks of gestation. These reference intervals identified pregnant women with high WBC counts, who had a higher incidence of pregnancy-related complications including placenta previa, oligohydramnios, secondary uterine inertia, and intrauterine growth restriction. CONCLUSION This study establishes comprehensive reference intervals for WBC counts during pregnancy. Monitoring WBC counts is clinically relevant, as elevated levels are associated with an increased risk of infection and pregnancy-related complications.
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Affiliation(s)
- Jinxiu Zhu
- Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, China
- Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Zexin Li
- Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, China
- Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Yuguo Deng
- Department of Obstetrics, Longgang District Maternity and Child Healthcare Hospital of Shenzhen City, Shenzhen, Guangdong, 518172, China
- Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, China
| | - Liting Lan
- Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, China
- Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Jinying Yang
- Department of Obstetrics, Longgang District Maternity and Child Healthcare Hospital of Shenzhen City, Shenzhen, Guangdong, 518172, China.
- Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, China.
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Rahu K, Allvee K, Karro H, Rahu M. Singleton pregnancies after in vitro fertilization in Estonia: a register-based study of complications and adverse outcomes in relation to the maternal socio-demographic background. BMC Pregnancy Childbirth 2019; 19:51. [PMID: 30696425 PMCID: PMC6352442 DOI: 10.1186/s12884-019-2194-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/16/2019] [Indexed: 12/18/2022] Open
Abstract
Background An increased risk of adverse conditions related to in vitro fertilization (IVF) pregnancies has been repeatedly reported. Our study aimed to summarize outcome differences between pregnancies after IVF and after spontaneous conception (SC) in Estonia. Methods Data on all liveborn singletons to primiparas women aged 25–40 years during the period 2005–2014 were obtained from the Estonian Medical Birth Registry. There were 1778 and 33,555 newborns in the IVF and SC cohort, respectively. The relative risk of pregnancy-related complications and adverse pregnancy outcomes in the IVF cohort in comparison with the SC cohort was quantified by prevalence proportion ratios (RR) with 95% confidence intervals (CI) using modified Poisson regression models adjusted for maternal age, education, ethnicity, marital status and study period. Results The cohort of IVF singletons experienced a higher risk of preterm birth (RR 1.51; 95% CI 1.28–1.78), iatrogenic preterm birth (RR 1.62; 95% CI 1.32–1.98), very preterm birth (RR 1.49; 95% CI 1.00–2.23), low birthweight (RR 1.47; 95% CI 1.20–1.80), congenital anomalies (RR 1.51; 95% CI 1.08–2.11), and admission to a neonatal intensive care unit (RR 1.13; 95% CI 1.01–1.26). Somewhat elevated risk of spontaneous preterm birth did not reach statistical significance (RR 1.32; 95% CI 0.97–1.80). IVF mothers were at increased risk of placenta previa (RR 7.15; 95% CI 4.04–12.66), placental abruption (RR 2.12; 1.43–3.14) and cesarean section (RR 1.28; 95% CI 1.20–1.37). The risk of pre-eclampsia was borderline (RR 1.25; 95% CI 0.98–1.59). Adjustment for maternal age attenuated the associations between IVF and adverse outcomes. Maternal education, ethnicity and marital status had no effect on the magnitude of the risk estimates. Conclusions The increased risk of pregnancy-related complications and adverse pregnancy outcomes was observed in the Estonian cohort of IVF singletons in comparison with the cohort of SC singletons. The relative risk estimates grew with maternal age but were not influenced by the maternal education, ethnicity and marital status. To monitor the efficacy and safety of the used assisted reproductive technology, a specialized country-wide register should be created in Estonia.
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Affiliation(s)
- Kaja Rahu
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
| | - Kärt Allvee
- Estonian Medical Birth Registry, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Helle Karro
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, L. Puusepa 8, 51014, Tartu, Estonia.,Tartu University Hospitals Womens Clinic, L. Puusepa 8, 51014, Tartu, Estonia
| | - Mati Rahu
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
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Hajianfar H, Esmaillzadeh A, Feizi A, Shahshahan Z, Azadbakht L. The Association Between Major Dietary Patterns and Pregnancy-related Complications. Arch Iran Med 2018; 21:443-451. [PMID: 30415552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/27/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Most pregnancy-related complications are associated with increased risks of adverse outcomes for mother and her infant. Although, relations between diet and pregnancy's complications indicate that there may be some benefits of nutritional factors to prevent such disorders, there are rare studies regarding the associations of dietary patterns and mentioned complications. So, the aim of the present study was to determine the relationship between dietary patterns and risk of pregnancy-related complications. METHODS The current prospective observational study was based on the data collected from 812 pregnant women. Dietary data was collected using a validated semi-quantitative food frequency questionnaire. RESULTS Three major dietary patterns identified according to the results from the factor loading matrix were: (i) 'western dietary pattern'; (ii) 'traditional dietary pattern'; (iii) 'healthy dietary pattern'. Overall, this study demonstrated a marginal significant inverse association between high adherence to healthy dietary pattern and chance of having pre-eclampsia. Also, a high chance of pre-eclampsia was observed among women with the most adherence to western dietary pattern. CONCLUSION We found that dietary patterns might be associated with the risk of pregnancy-related complications. Further studies are required to confirm these findings.
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Affiliation(s)
- Hossein Hajianfar
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Food Safety Research Center(SALT), Semnan University of Medical Sciences, Semnan, Iran
- Department of Nutrition, School of Nutrition and Food Science, Semnan University of Medical Sciences, Semnan, Iran
- Research Committee of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Awat Feizi
- Departments of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Shahshahan
- Departments of Gynecology, School of Medicine Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Nateghi Rostami M, Hossein Rashidi B, Habibi A, Nazari R, Dolati M. Genital infections and reproductive complications associated with Trichomonas vaginalis, Neisseria gonorrhoeae, and Streptococcus agalactiae in women of Qom, central Iran. Int J Reprod Biomed 2017; 15:357-366. [PMID: 29177239 PMCID: PMC5605857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Trichomonas vaginalis (T.vaginalis) and Neisseria gonorrhoeae (N.gonorrhoeae) are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran. OBJECTIVE Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran. MATERIALS AND METHODS Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler® real-time PCR (for N.gonorrhoeae) and ITS-PCR (for T.vaginalis). RESULTS Of 420 volunteers, 277 (65.9%) had genital signs/symptoms, including 38.3% malodorous discharge, 37.9% dyspareunia, and 54.8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens (1.2%) in Thayer-Martin culture and 17 (4.1%) in real-time PCR were identified as N.gonorrhoeae. Fifty-four specimens (12.9%) in wet mount, 64 (15.2%) in Dorset's culture, and 81 (19.3%) in ITS-PCR showed positive results for T.vaginalis. Five mixed infections of T.vaginalis+ N.gonorrhoeae were found. The risk of T.vaginalis infection was increased in women with low-birth-weight (p=0.00; OR=43.29), history of abortion (p=0.00; OR=91.84), and premature rupture of membranes (PROM) (p=0.00; OR=21.75). The probability of finding nuclear leukocytes (p=0.00; OR=43.34) in vaginal smear was higher in T.vaginalis infection. CONCLUSION The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women.
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Affiliation(s)
- Mahmoud Nateghi Rostami
- Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran.,Department of Microbiology and Immunology, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
| | - Batool Hossein Rashidi
- Department of Obstetrics and Gynecology, Vali-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Azam Habibi
- Department of Microbiology, Science and Research Branch, Islamic Azad University, Arak, Iran.
| | - Razieh Nazari
- Department of Microbiology, Islamic Azad University, Qom Branch, Qom, Iran.
| | - Masoumeh Dolati
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran.
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Semasaka JPS, Krantz G, Nzayirambaho M, Munyanshongore C, Edvardsson K, Mogren I. Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study. BMC Pregnancy Childbirth 2016; 16:340. [PMID: 27821082 PMCID: PMC5100328 DOI: 10.1186/s12884-016-1138-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 10/30/2016] [Indexed: 11/28/2022] Open
Abstract
Background Self-rated health status (SRH) can be used as a predictor of morbidity and mortality. Postpartum self-rated health has been used to estimate maternal morbidity and postpartum problems. Reproductive history factors are associated with poor self-rated health postpartum. This study investigated prevalence of self-reported health problems during first, second, and third trimesters of pregnancy, delivery, and postpartum. In addition, this study investigated SRH in Rwandan women up to 13 months from partus. Methods This population-based, cross-sectional study collected data in 2014 using structured interviews (N = 921). Univariable analysis was used to identify variables that were associated with poor self-rated health status (poor-SRH). Logistic regression analyses were performed to identify factors associated with poor-SRH at one day, one week, and one month postpartum and at the time of the interview. Results Mean time between latest delivery and the time of interview was 7.1 months. Prevalence of anaemia, hypertension, diabetes mellitus during pregnancy, and severe bleeding during pregnancy and labour were 15.0, 4.9, 2.4, and 3.7 %, respectively. The prevalence of poor-SRH was 32.2 % at one day postpartum, 7.8 % at one month, and 11.7 % at time of the interview. Hypertension during pregnancy and significant postpartum haemorrhage were associated with poor-SRH at one day and one week postpartum. Severe bleeding during pregnancy and labour were associated with poor-SRH at one week and one month postpartum. Infection and anaemia during pregnancy were associated with poor-SRH at one month postpartum and at the time of interview. The Kaplan-Meier curves illustrate restitution of health for most women during the study period. Conclusions This population-based study reports a high prevalence of poor SRH status among Rwandan women in the early postpartum period. Identified factors associated with poor-SRH were severe bleeding, hypertension, infection, and anaemia during pregnancy and postpartum haemorrhage. These factors may be prevented or reduced by providing more frequent and specific attention during pregnancy and by providing timely measures that address complications during delivery, including adequate postpartum care.
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Affiliation(s)
- Jean Paul S Semasaka
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. .,University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda.
| | - Gunilla Krantz
- Department of Community Medicine and Public Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Manasse Nzayirambaho
- University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda
| | - Cyprien Munyanshongore
- University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda
| | - Kristina Edvardsson
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
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Tamayo T, Tamayo M, Rathmann W, Potthoff P. Prevalence of gestational diabetes and risk of complications before and after initiation of a general systematic two-step screening strategy in Germany (2012-2014). Diabetes Res Clin Pract 2016; 115:1-8. [PMID: 27242116 DOI: 10.1016/j.diabres.2016.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 02/02/2016] [Accepted: 03/01/2016] [Indexed: 11/24/2022]
Abstract
AIMS Information on the prevalence of gestational diabetes mellitus is scarce on national and international level. On July 1st, 2013, a general two-step screening was implemented in Germany harmonizing gestational diabetes diagnoses. We aim to provide prevalence estimates for gestational diabetes and pregnancy-related complications for the large region of North Rhine for the 12 months before and after introduction of the general screening. METHODS Routine care data covering all outpatient diagnoses of more than 150,000 pregnancies per 12-month period in women aged 15-55 years was used to determine cases of gestational diabetes. Gestational diabetes diagnosis and pregnancy-related complications were assessed according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Relative Risks for pregnancy-related complications were calculated in pregnancies with and without gestational diabetes. RESULTS Before the screening, diagnosis of gestational diabetes was made in 6.02% of pregnancies and in 6.81% after this date (other types of diabetes mellitus: 1.67% and 1.76% respectively). The prevalence of GDM increased with age and was highest at age 36-40 years (8.45%). The relative increase in prevalence after introduction of the screening was highest in the age group≤25 years (24.9%). The frequency of pregnancy-related complications such as hypertension, pre-eclampsia, cesarean section was increased in pregnancies with gestational diabetes in comparison to those without independent of observation period. CONCLUSIONS We found a high prevalence of gestational diabetes, which has relatively increased by 13.12% after the introduction of the general screening.
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Affiliation(s)
- T Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - M Tamayo
- Kassenärztliche Vereinigung Nordrhein, Düsseldorf, Germany
| | - W Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - P Potthoff
- Kassenärztliche Vereinigung Nordrhein, Düsseldorf, Germany
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