Association between physical activity in early pregnancy and markers of placental growth and function.

OBJECTIVES: It has been suggested that physical activity (PA) can influence the development of the placenta and the risk of placenta-mediated complications of pregnancy. We evaluated the association between PA and early markers of placental development. METHODS: Ninety-four nulliparous women were invited to participate in a prospective observational cohort study. Assessment included measurement of placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) concentrations (expressed in multiples of the median), an ultrasound at 11 to 13 weeks for measurement of placental volume and the mean uterine artery (UtA) pulsatility index, and a questionnaire on PA. The association between PA and these markers was evaluated using univariate and multivariate regression analyses. RESULTS: We found a significantly lower concentration of PlGF and a trend towards lower placenta volume and lower PAPP-A concentration with increased PA frequency. The negative association between PA frequency and PlGF concentration remained significant after adjustment for potential confounding factors. CONCLUSION: Our results suggest that PA in early pregnancy could negatively affect placental development. This finding could explain the association between PA and severe preeclampsia. This finding deserves confirmation in a larger cohort.

Objectifs : On a avancé que l'activité physique (AP) pouvait influencer le développement du placenta et le risque de complications de grossesse à médiation placentaire. Nous avons évalué l'association entre l'AP et les marqueurs précoces du développement placentaire. Méthodes : Quatre-vingt-quatorze femmes nullipares ont été invitées à participer à une étude de cohorte observationnelle prospective. L'évaluation comprenait la mesure des concentrations en (exprimées sous forme de multiples de la médiane) en facteur de croissance placentaire (PlGF) et en protéine plasmatique placentaire de type A (PAPP-A), une échographie menée à 11 - 13 semaines aux fins de la mesure du volume placentaire et de l'indice de pulsatilité moyen de l'artère utérine (AUt), et un questionnaire sur l'AP. L'association entre l'AP et ces marqueurs a été évaluée au moyen d'analyses de régression univariées et multivariées. Résultats : Nous avons constaté que la hausse de la fréquence de l'AP s'accompagnait d'une concentration en PlGF considérablement moindre et d'une tendance à la baisse en ce qui concerne le volume placentaire et la concentration en PAPP-A. L'association négative entre la fréquence de l'AP et la concentration en PlGF est demeurée significative à la suite de la neutralisation de l'effet des facteurs de confusion potentiels. Conclusion : Nos résultats semblent indiquer que l'AP aux débuts de la grossesse pourrait exercer un effet négatif sur le développement placentaire. Cette constatation pourrait expliquer l'association entre l'AP et la prééclampsie grave. La tenue d'une étude auprès d'une cohorte de plus grande envergure à des fins de confirmation s'avère justifiée.

Bacteriology of amniotic fluid in women with suspected cervical insufficiency.

OBJECTIVE: To determine the prevalence of mid-trimester microbial invasion of the amniotic cavity (MIAC) in women with suspected cervical insufficiency. METHODS: A prospective observational cohort study was performed in women with suspected cervical insufficiency and visible fetal membranes who were undergoing amniocentesis to rule out MIAC between 16 and 26 weeks of gestation. Women with preterm premature rupture of membranes, regular uterine contractions, or who had a cervical cerclage were excluded. Gram staining of amniotic fluid, glucose and lactate dehydrogenase (LDH) levels in amniotic fluid, and aerobic and anaerobic amniotic fluid cultures were performed, along with polymerase chain reaction (PCR) for the detection of Ureaplasma and Mycoplasma species. RESULTS: Fifteen women with a mean gestational age of 22.6 +/- 2.3 weeks were included in the study. The diagnosis of MIAC was confirmed in 47% (7/15), of whom 20% (3/15) were infected with more than one bacterial strain and 33% (5/15) with Ureaplasma species. According to receiver-operator curve analyses, amniotic fluid levels of glucose were associated with MIAC (P = 0.02), but not amniotic fluid LDH (P = 0.25). CONCLUSION: MIAC is present in approximately one half of women with suspected cervical insufficiency and visible fetal membranes at speculum examination.

Factors influencing the initiation and duration of breastfeeding among low-income women followed by the Canada prenatal nutrition program in 4 regions of quebec.

The factors that influence the actual initiation and duration of breastfeeding were studied among low-income women followed by the Canada Prenatal Nutrition Program (CPNP). A group of 196 pregnant women were selected at random from a sample of 6223 pregnant women who registered with the CPNP. Two 24-hour recalls and information regarding lifestyle habits, peer support, and infant-feeding practices were obtained between 26 and 34 weeks of gestation and 21 days and 6 months after birth. Women who received a university education (completed or not completed) versus women with < or = high school education (odds ratio [OR], 8.40; 95% confidence interval [CI], 1.02-69.50), women born outside Canada (OR,8.81; 95% CI, 3.34-23.19), and women of low birth weight infants (OR, 0.39; 95% CI, 0.16-0.96) were more likely to initiate breastfeeding. Late introduction of solid foods (P = .004), nonsmoking (P = .005), multiparity (P = .012), and a higher level of education (P = .049) were positively associated with the duration of breastfeeding among initiators. Understanding factors associated with initiation and duration of breastfeeding among low-income women is critical to better target breastfeeding promotion.

Maternal dietary intake and pregnancy outcome.

OBJECTIVE: To study the relationship between maternal diet and infant anthropometric measurements in 56 women, aged 28 +/- 5.1 years, with singleton pregnancies. STUDY DESIGN: The overall quality of the diet (three 24-hour recalls), including supplementation, was evaluated at 34 +/- 1.3 weeks using a total mean adequacy ratio (TMAR) of 12 nutrients. Specific interviewing techniques were used to minimize social desirability bias. Anthropometric measurements of both parents and maternal lifestyle practices were also obtained. Infant weight, crown-heel length and head circumference were measured 14.6 +/- 4.4 days after birth. RESULTS: Stepwise multiple regression analysis revealed that maternal diet quality (TMAR) was significantly related to infant weight (r = .039, P = .036) and crown-heel length (r = .071, P = .007). Other significant predictors included gestational age, maternal height, sex, smoking and physical activity. CONCLUSION: Maternal diet was positively associated with infant weight and crown-heel length.