Comparative Study to Determine the Prevalence and Socio-Cultural Practices of Infertility in Rural and Urban Field Practice Area of Tertiary Care Hospital, Vijayapura, Karnataka.

BACKGROUND: Infertility is an iceberg phenomenon where the majority of couples are undiagnosed. The main challenge in estimating the actual burden of infertility is the paucity of population-based studies. Various sociocultural practices such as believing infertility as curse and seeking healing from supernatural powers are still predominant in the community. Hence, the present study was undertaken to know the prevalence and sociocultural practices of infertility in field practice area. MATERIALS AND METHODS: A cross-sectional study was conducted in rural and urban field practice areas of tertiary care hospital. A complete enumeration of all the houses was done to list all the eligible couples residing in the area; among them, those at risk of pregnancy were identified so as to find out couples with either primary or secondary infertility. Data were tabulated and analyzed using the SPSS software version 16. The results were expressed in terms of percentages, and Fisher's exact test was used wherever applicable. RESULTS: The prevalence of infertility in rural area was 7.6% and in urban slum, it was 8.8%. Most of them think infertility as a result of past sins and practice unscientific methods to overcome the problem. CONCLUSION: Infertility stigma is high and there is no proper knowledge about infertility, fertile period and most of them think it as result of past sins.

Increased homocysteine levels exist in women with preeclampsia from early pregnancy.

OBJECTIVE: The present prospective study examines the levels of maternal plasma folate, vitamin B12 and homocysteine in normotensive control (NC) women and women with preeclampsia (PE) from early pregnancy till delivery. METHODS: The present study includes 126 NC and 62 PE women. Maternal blood was collected at 3 time points during pregnancy (T1 = 16th-20th weeks, T2 = 26th-30th weeks and T3 = at delivery). Levels of folate, vitamin B12 and homocysteine were estimated by the chemiluminescent microparticle immunoassay technology. RESULTS: Maternal plasma folate levels were similar between NC and PE women at all the time points across gestation. Maternal plasma vitamin B12 levels were significantly higher in PE (p < 0.05) as compared with NC at T2. Maternal plasma homocysteine levels were higher in PE as compared with NC at all the time points, i.e. T1, T2 (p < 0.05 for both) and T3 (p < 0.01). CONCLUSION: Our results indicate that higher homocysteine levels exist in women with PE from early pregnancy and continue till delivery.

A longitudinal study of circulating angiogenic and antiangiogenic factors and AT1-AA levels in preeclampsia.

Our earlier studies of preeclampsia (PE) at delivery have demonstrated the alteration of one carbon cycle, reduced placental omega 3 fatty acids, altered circulating levels of angiogenic factors and differential placental gene-specific methylation patterns of angiogenic factors. This study was undertaken to examine changes in the levels of angiogenic factors and angiotensin II type 1 receptor autoantibodies (AT1-AAs) throughout gestation, from early pregnancy until delivery, in women with PE and to examine their association with cord angiogenic factors, blood pressure and infant weight. A total of 81 pregnant women (46 normotensive and 35 with PE) were followed at three different time points during pregnancy: 16-20 weeks (T1), 26-30 weeks (T2) and at the time of delivery (T3). The plasma levels of angiogenic factors and AT1-AAs were determined in the maternal and cord plasma by commercial enzyme-linked immunosorbent assay kits. Maternal plasma levels of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) were lower (P<0.05 for both), whereas soluble fms-like tyrosine kinase-1 (sFlt-1; P<0.05) and the sFlt-1/PlGF ratio (P<0.01) were higher in early pregnancy in the PE group. Maternal plasma AT1-AA levels were higher (P<0.05) at T2 in women with PE. Cord plasma VEGF and soluble kinase insert domain receptor (sKDR) levels were lower (P<0.01 and P<0.05, respectively), whereas AT1-AA levels were higher (P<0.05) in the PE group. Maternal plasma VEGF levels in early pregnancy were positively associated with systolic blood pressure, whereas the sFlt-1/PlGF ratio at T2 was negatively associated with infant weight in the PE group. Low levels of proangiogenic factors (VEGF and PlGF) and high levels of AT1-AAs and antiangiogenic factors (sFlt-1 and sFlt-1/PlGF ratio) are present in the maternal circulation during early gestation in women with PE.