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1.
South Med J ; 113(6): 292-297, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32483639

RESUMO

OBJECTIVE: To assess patient- and hospital-level characteristics associated with opioid use in human immunodeficiency virus (HIV)-positive pregnant women and fetal health outcomes. METHODS: Using the 2002-2014 Nationwide Inpatient Sample database, we analyzed discharge records to describe the rates of opioid use among HIV-positive pregnant women. Logistic regression was used to quantify the magnitude of the association between exposure status and maternal-fetal outcomes. RESULTS: Opioid use was fourfold greater among HIV-positive pregnant women compared with their HIV-negative counterparts (odds ratio 4.0; 95% confidence interval 3.15-5.12). Relatively smaller but significant increases in the early onset of delivery, poor fetal growth, abortive pregnancy, and spontaneous abortion also were observed in association with HIV-positive status and opioid drug use during pregnancy. CONCLUSIONS: An increased risk of negative maternal-fetal complications persists among HIV-positive women who use opioids during pregnancy. Focusing on predisposing factors and monitoring opioid dispensing may mitigate overuse or abuse in this vulnerable population.


Assuntos
Aborto Espontâneo/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Infecções por HIV/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Aborto Induzido/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos de Casos e Controles , Depressão/epidemiologia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Sepse/epidemiologia , Uso de Tabaco/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
2.
Infez Med ; 28(suppl 1): 46-51, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32532938

RESUMO

BACKGROUND: Since December 2019, coronavirus disease 2019 (COVID-19) has become a major health problem that is spreading all over the world. Several viral infections such as SARS, MERS, and influenza have been associated with adverse pregnancy outcomes. The question arises whether pregnant women are at greater risk of complications related to COVID-19 compared to other people What complications should we expect in the fetuses whose mothers were infected? AIMS: This review aims to provide a summary of studies on symptoms of COVID-19 and the possible risks of COVID-19 among pregnant women, as well as complications in fetuses and neonates whose mothers were infected with COVID-19. METHODS: The included data were provided from Web of Science, Cochrane, PubMed, and Scopus which are extracted from the published studies in English until April 2nd, 2020 that contained data on the risk of COVID-19 in pregnancy. RESULTS: The early symptoms of patients with COVID-19 were fever, cough, dyspnea, myalgia, and fatigue; while production of sputum, headache, hemoptysis, and diarrhea were other symptoms which were less common. There is no evidence of vertical maternal-fetal transmission in pregnant women with COVID-19. CONCLUSIONS: The clinical findings in pregnant women with COVID-19 are not significantly different compared to other patients, and pregnant women with COVID-19 are not at a higher risk of developing critical pneumonia compared to non-pregnant women. Although, there has been no sign of vertical infection in infants, but maternal infection can cause serious problems such as preterm labour and fetal distress.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Proteína C-Reativa/análise , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Tosse/etiologia , Feminino , Sofrimento Fetal/etiologia , Febre/etiologia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Transmissão Vertical de Doença Infecciosa , Linfopenia/etiologia , Trabalho de Parto Prematuro/etiologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/transmissão , Gravidez , Complicações na Gravidez/etiologia , Resultado da Gravidez , Síndrome Respiratória Aguda Grave/epidemiologia , Avaliação de Sintomas , Adulto Jovem
3.
Rev Bras Epidemiol ; 23: e200037, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32491051

RESUMO

OBJECTIVES: To estimate the prevalence and characterize the occurrence of low back pain (LBP), posterior pelvic girdle pain (PPGP) and pubic symphysis pain (PSP) among pregnant women resident in Rio Grande, RS. METHODS: This was a cross-sectional study of all postpartum women who gave birth in 2016. Two pictures were used to investigate the presence of LBP, PPGP and PSP, both isolated and combined. Multinomial logistic regression was used to evaluate the factors associated with each symptom. RESULTS: LBP was reported by 42.2%, PSP by 4.9%, and PPGP by 2%, while LBP + PSP was reported by 9%, LBP and PPGP by 2.8% and PPGP + PSP by 1.1%, and pain in all three regions was reported by 3.9% of the sample. The more advanced the age of the pregnant women, the risk for LBP and of LBP combined with one of the pelvic girdle regions was reduced, while the risk for PPGP + PSP was increased. Depression during pregnancy increased the risk for all symptom combinations. CONCLUSION: This study provided a detailed description of the occurrence of the evaluated outcomes and its associated factors. Studies like this are rare in Brazil, especially a census with low rates of losses and refusals. The high prevalence of the evaluated symptoms suggests that it should be investigated routinely in prenatal care, taking into account the age of the pregnant women, depressive symptoms and those experiencing combined or intense pain.


Assuntos
Artralgia/epidemiologia , Dor Lombar/epidemiologia , Vértebras Lombares , Dor da Cintura Pélvica/epidemiologia , Complicações na Gravidez/epidemiologia , Sínfise Pubiana , Adolescente , Adulto , Fatores Etários , Artralgia/etiologia , Brasil/epidemiologia , Criança , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Feminino , Idade Gestacional , Humanos , Modelos Logísticos , Dor Lombar/etiologia , Medição da Dor , Dor da Cintura Pélvica/etiologia , Gravidez , Complicações na Gravidez/etiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
4.
Medicine (Baltimore) ; 99(23): e20641, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502049

RESUMO

BACKGROUND: Universal 2-child policy was proposed in 2015 in China, but it was still uncertain whether having a second child would have any impacts on maternal health, especially mental health. So, the aim of this study was to compare the incidence of perinatal depression between the first-child women and the second-child women and to describe the patterns of perinatal depression from the first and third trimesters to 6 weeks postpartum. METHODS: A prospective cohort study was conducted in a university hospital, 969 first-child women and 492 second-child women registered in this hospital from Dec 2017 to Mar 2018 were involved in the study. The Mainland Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was applied to screen perinatal depressive symptoms, while socio-demographic and obstetric data were obtained by self-administered questionnaires. Multiple logistic regression analyses were used to compare the risk of depression between 2 groups, and repeated measures of analysis of variances (ANOVAs) were used to determine the EPDS scores of 2 groups across 3 stages. RESULTS: The incidence of perinatal depression was 21.78% to 24.87% and 18.29% to 22.15% in the first-child group and the second-child group, respectively. The second-child women were less likely to exhibit depressive symptoms than the first-child women in the first trimester (Adjusted OR = 0.630, 95%CI = 0.457-0.868, P = .005), but no significant difference was found between the 2 groups in the third trimester and at postpartum period. During the whole perinatal period, no significant difference was found in EPDS scores of the first-child group among the three stages. However, the EPDS scores of the second-child group were higher in the first trimester than that at the postpartum period. CONCLUSION: The risk of perinatal depression for the second-child women was no higher than for the first-child women, and the EPDS scores of the second-child women were decreasing during the perinatal period. So couples in West China are recommended to consider having a second child without much worry about its negative effects on mental health under the universal 2-child policy.


Assuntos
Depressão/epidemiologia , Mães/psicologia , Complicações na Gravidez/epidemiologia , Adulto , China/epidemiologia , Política de Planejamento Familiar , Feminino , Humanos , Incidência , Mães/estatística & dados numéricos , Gravidez , Estudos Prospectivos , Escalas de Graduação Psiquiátrica
6.
Rev Med Suisse ; 16(695): 1106-1113, 2020 May 27.
Artigo em Francês | MEDLINE | ID: mdl-32462840

RESUMO

Breast cancer is the most frequently diagnosed neoplasm and principal one responsible for most death in women, specially under the age of 40. Hereditary and genetic syndromes are more prevalent among young breast cancer patients and require genetic counseling. Young women also exhibit larger tumors, with more frequent nodal involvement and aggressive features (triple negative, high grade and proliferation rate) than menopausal women. Fertility preservation and pregnancy-associated cancer are issues specific to this age group and need to be addressed accordingly.


Assuntos
Neoplasias da Mama/terapia , Preservação da Fertilidade/métodos , Neoplasias da Mama/genética , Feminino , Aconselhamento Genético , Humanos , Gravidez , Complicações na Gravidez/genética , Complicações na Gravidez/terapia
7.
Compend Contin Educ Dent ; 41(5): 272-276; quiz 277, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32369384

RESUMO

While most pregnancies are healthy and uncomplicated, adverse pregnancy outcomes and pregnancy complications do occur and may frequently present in the dental office. Management of patients with high-risk pregnancies and/or established pregnancy complications within the dental office should be undertaken to establish and maintain optimal oral health and an integrated approach to overall health. The dental team's understanding of potential pregnancy complications, their implications for oral health, and standards for management of patients with a complicated pregnancy within the dental office is critical to the overall well-being of all pregnant patients. Recognizing and differentiating between normal pregnancy sequelae and more serious complications, as well as proper referral to and adequate communication with the perinatal team, are critical to promoting wellness for patients experiencing pregnancy complications.


Assuntos
Saúde Bucal , Complicações na Gravidez , Feminino , Humanos , Gravidez
8.
Rev Med Suisse ; 16(693): 989-992, 2020 May 13.
Artigo em Francês | MEDLINE | ID: mdl-32401439

RESUMO

When considering women's health during travels, it is mainly pregnant women who are concerned. Indeed, because of the physiological changes, they are more vulnerable to infectious and non-infectious diseases related to the trip itself or to specific activities. This article lists the essential risks for pregnant women travelling in tropical countries and provides specific recommendations, so that the general practitioner is better able to advise this vulnerable population. If the trip is suitable and in the absence of any pre-existing complication, travelling during pregnancy is not contraindicated.


Assuntos
Complicações na Gravidez/prevenção & controle , Gestantes , Medicina de Viagem , Medicina Tropical , Saúde da Mulher , Feminino , Humanos , Gravidez , Complicações na Gravidez/epidemiologia
10.
Ceska Gynekol ; 85(1): 15-17, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32414280

RESUMO

OBJECTIVE: We present a rare case of peroperatively diagnosed bilateral tubular pregnancy. DESIGN: Case report. SETTING: Department of Obstetrics and Gynekology, Novy Jicin Hospital. CONCLUSION: In the case of ectopic pregnancy always think about the possibility of contralateral pathology and during the surgical revision remember a thorough inspection of both fallopian tubes.


Assuntos
Tubas Uterinas/cirurgia , Gravidez Ectópica/cirurgia , Gravidez Tubária/cirurgia , Feminino , Humanos , Obstetrícia , Gravidez , Complicações na Gravidez/cirurgia , Gravidez Ectópica/diagnóstico , Gravidez Tubária/diagnóstico , Salpingectomia , Resultado do Tratamento
11.
Arch Endocrinol Metab ; 64(2): 159-164, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32236307

RESUMO

Objective Maternal hypothyroidism during pregnancy may lead to adverse outcomes. Recently published guidelines by the American Thyroid Association (ATA) do not advocate for universal screening but recommend a case-finding approach in high-risk pregnant women. The present study aims to evaluate the accuracy of this approach in identifying women with thyroid dysfunction during early pregnancy. Subjects and methods This is a multiple-center, cross-sectional study. Three hundred and one pregnant women were enrolled. Anamnesis and a physical examination were performed to detect which women fulfilled the criteria to undergo laboratory screening of thyroid dysfunction, according to the ATA's 2017 guidelines. The Zulewski's validated clinical score was applied to assess signs and symptoms of hypothyroidism. Serum levels of thyrotropin (TSH), free thyroxine (FT4), anti-thyroperoxidase (TPO-Ab), and anti-thyroglobulin (Tg-Ab) antibodies were determined. Results Two hundred and thirty one women (78%) were classified as high risk, and 65 (22%) were classified as low risk for thyroid dysfunction. Regarding the clinical score, 75 patients (31.2%) presented mild symptoms that were compatible with SCH, of which 22 (7.4%) had symptoms as the only risk factor for thyroid disease. 17 patients (5.7%) had SCH, of which 10 (58.8%) belonged to the high-risk group, and 7 (41.2%) belonged to the low-risk group. OH was found in 4 patients (1.4%): 3 (75%) in the high-risk group and 1 (25%) in the low-risk group. Conclusions The ATA's proposed screening criteria were not accurate in the diagnosis of thyroid dysfunction in pregnancy. Testing only the high-risk pregnant women would miss approximately 40% of all hypothyroid patients.


Assuntos
Hipotireoidismo/diagnóstico , Programas de Rastreamento/métodos , Complicações na Gravidez/diagnóstico , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Medição de Risco , Fatores de Risco , Testes de Função Tireóidea
13.
Oral Health Prev Dent ; 18(2): 165-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32238988

RESUMO

PURPOSE: The aim of the present study was to analyse the role of the main diagnostic signs of poor periodontal status, probing depth (PD) ≥4 mm and bleeding on probing (BOP) ≥50%, both simultaneously and individually in preterm birth (PB) and their effect on the birth weight (BW). Prematurity is a major health concern and it is the leading contributing factor to neonatal morbidity and mortality worldwide. Conflicting results exist on the relation between poor maternal, periodontal status and adverse pregnancy outcome, including preterm deliveries and low birth weight (LBW). MATERIALS AND METHODS: Seventy-seven PBs and 165 deliveries at term were analysed out of 242 patients. The perinatal factors such as gestational age (GA) and BW were analysed by BOP, categorised as ≥50% (high BOP) vs <50% (non-high BOP) and PD ≥4 mm vs <4 mm, in combination or separately. RESULTS: The obtained results suggest that maternal periodontal inflammation, represented particularly by BOP, might be a triggering factor and can be associated with PB and LBW. For women with high BOP the adjusted odds ratio (AOR) for LBW was 2.28-fold and they were likely to have PB, with a 2.02-fold higher rate. CONCLUSION: An increasing tendency of BOP seemed to be associated with a tendency to PB and LBW. Further investigations are necessary to underline this relationship, but the role of good oral health status in general, and particularly in case of pregnancy, is unequivocal.


Assuntos
Complicações na Gravidez , Nascimento Prematuro , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Resultado da Gravidez , Fatores de Risco
14.
Gac Med Mex ; 156(2): 156-163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285855

RESUMO

Introduction: Pregnancies resulting from assisted reproductive technologies (ART) have been documented to have a higher risk of adverse effects. Objective: To provide evidence on obstetric and perinatal complications associated with conceptions by ART versus spontaneous pregnancies. Method: Comprehensive review of original articles published between 2010 and 2018 addressing the more common obstetric and perinatal complications in pregnancies resulting from in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), in comparison with spontaneous conceptions. Results: Thirty-seven original articles, which reported on 26 cohort studies and 11 case-control trials, were included. IVF and ICSI conceptions were associated with a larger number of obstetric and perinatal complications such as low birth weight, prematurity, low weight for gestational age, admission to the neonatal intensive care unit, congenital malformations, C-sectionand premature rupture of membranes, among others. Conclusions: Pregnancies by ART are associated with an increased risk of obstetric and perinatal complications in comparison with spontaneous conceptions. Further research is needed to determine which aspects result in higher risk.


Assuntos
Fertilização In Vitro , Complicações na Gravidez , Injeções de Esperma Intracitoplásmicas , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Gravidez
15.
Scand J Immunol ; 92(1): e12892, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32335925

RESUMO

Mannose-binding lectin (MBL) is an important component of the innate immunity, and it is responsible not only for opsonization of micro-organisms, but also for efferocytosis. The aim of this study was to investigate whether MBL concentrations and lectin complement pathway activity are altered in non-pregnant women with previous adverse pregnancy outcomes. Patients were divided into four groups on the basis of their history of pregnancy complications, including control patients who had uncomplicated pregnancies and term deliveries (control, n = 33), and three groups of patients with a history of pregnancy complications, including preterm labour (n = 29), recurrent miscarriage (n = 19) or unexplained intrauterine foetal death (IUFD; n = 17). All women enrolled in the study had an interval of three to six months following their previous pregnancy, and they agreed to have a blood sample taken. We found significantly higher MBL concentrations and functional activity of the lectin complement pathway in healthy controls who had previous uneventful term pregnancies (1341 ng/mL; activity 100% (IQR: 62%-100%)), compared to women with the history of IUFD (684 ng/mL, P = .008; activity 8.5% (IQR: 0%-97.8%), P = .011), recurrent miscarriage (524 ng/mL, P = .022; activity 44% (IQR: 4%-83%), P = .011) or preterm labour (799 ng/mL, P = .022; activity 62.5% (IQR: 0%-83%), P = .003). Our results suggest that inadequate function of the complement lectin pathway is associated with a higher risk of preterm labour, recurrent miscarriage and unexplained intrauterine foetal death.


Assuntos
Lectina de Ligação a Manose da Via do Complemento/imunologia , Lectina de Ligação a Manose/sangue , Complicações na Gravidez/sangue , Adulto , Feminino , Humanos , Imunidade Inata/imunologia , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Estudos Prospectivos , Fatores de Risco
16.
Life Sci ; 251: 117597, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32243926

RESUMO

Stress during pregnancy adversely affects foetal development and leads to later behavioural outcomes in offspring. Preclinical studies have reported conflicting effects of prenatal stress on depression-related symptoms in rodent offspring. This study aimed to study the combined effect of strain and sex on prenatal stress outcomes in a single study. To this end, male and female offspring from outbred Wistar and inbred Lewis rats, and outbred NMRI and inbred C57BL6 mice were compared. As outcomes we focussed on depression-related behaviour and related molecular and neurochemical parameters. Prenatally stressed and non-stressed offspring were subjected to the sucrose preference, novelty-suppressed feeding, tail suspension, and forced swim tests. We measured basal and stress-induced corticosterone levels in the serum, and brain-derived-neurotrophic-factor (BDNF), interleukin-1ß, tumor necrosis factor-α, glutamate and serotonin in the brain to determine changes in hypothalamic-pituitary-adrenal-(HPA)-axis function, neuroplasticity, neuroinflammation, and neurotransmission. Our findings revealed that prenatal stress increases depression-like behaviour, HPA-axis (re) activity, pro-inflammatory cytokines and glutamate levels, and decreases BDNF and serotonin levels in a strain and sex-dependent manner in rodent offspring. Overall, male and female Lewis rats, female Wistar rats, male NMRI mice and female C57BL6 mice were found to be most responsive to prenatal stress. Based on these results, we conclude that genetic background and sex contribute to the great diversity in the effects of prenatal maternal stress in rodents.


Assuntos
Depressão/psicologia , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/psicologia , Estresse Psicológico/psicologia , Animais , Encéfalo/metabolismo , Corticosterona/sangue , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , Ratos , Ratos Endogâmicos Lew , Ratos Wistar , Fatores Sexuais , Especificidade da Espécie
17.
Zhonghua Fu Chan Ke Za Zhi ; 55(3): 172-176, 2020 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-32268714

RESUMO

Objective: To construct the pregnancy risk prediction model of chronic kidney disease (CKD) pregnant women by analyzing their renal function and pregnancy outcome in the first trimester. Method: Totally 313 CKD women with 322 pregnancies who had deliveries in Peking University First Hospital from March 2009 to December 2018 were retrospectively analyzed. The history of kidney disease and renal function in the first trimester were collected, and the relationship between CKD and premature delivery, low birth weight infants, severe preeclampsia and fetal loss were analyzed. Result: Among 322 pregnancies with CKD, 120 (37.3%, 120/322) had adverse pregnancy outcomes. CKD stage, serum creatinine, urea, albumin, hemoglobin, 24-hour urine protein quantity and whether complicated with hypertension were independent predictors of adverse pregnancy outcome. A prediction model logit (P)=2.107+0.255×24-hour urine protein quantitative (g/24-hour)-0.107×albumin (g/L)+1.677×whether complicated with hypertension (1 or 0)+ 0.639×CKD stage was established. The area under curve value of the model was 0.812, the best threshold, sensitivity, specificity and Yoden index were 0.436, 0.658, 0.856 and 0.802, respectively. Conclusion: CKD stage, serum albumin, 24-hour urine protein quantity in the first trimester and hypertension are the main risk factors of adverse pregnancy outcome, which could predict the occurrence of adverse pregnancy outcome of CKD pregnant women and deserve further study.


Assuntos
Complicações na Gravidez , Nascimento Prematuro , Insuficiência Renal Crônica , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Insuficiência Renal Crônica/complicações , Estudos Retrospectivos , Fatores de Risco
18.
Rev Med Suisse ; 16(689): 670-674, 2020 Apr 08.
Artigo em Francês | MEDLINE | ID: mdl-32270932

RESUMO

The antiphospholipid syndrome (APS) is a complex autoimmune -disease characterized by the expression of antiphospholipid -antibodies (APL) and a variety of clinical presentation. The latest classification defines APS by the occurrence of vascular thrombosis and/or typical obstetrical morbidity together with persistently -detectable APL at least 12 weeks apart. The latest recommendation proposes a risk profile based on the type and titer of APL detected, in order to guide the intensity of prophylactic measures. Based on current knowledge, novel oral anticoagulants should not be used in APS, particularly in patients with a high-risk APL profile or arterial thrombosis. Beyond the mere aspect of anticoagulant treatment, immunomodulatory approaches to the APS such as hydroxychloroquine are under investigation.


Assuntos
Anticorpos Antifosfolipídeos/sangue , Síndrome Antifosfolipídica , Trombose , Adulto , Anticoagulantes/uso terapêutico , Síndrome Antifosfolipídica/sangue , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/tratamento farmacológico , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Conhecimento , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/tratamento farmacológico , Fatores de Risco , Trombose/sangue , Trombose/tratamento farmacológico , Trombose/etiologia
19.
Anticancer Res ; 40(4): 1997-2001, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234889

RESUMO

BACKGROUND/AIM: The liver of pregnant women undergoes physiological and pathological changes and the changes in liver enzyme activity and release reflect changes in serum enzymatic activity. We aimed to assess the activity of alcohol dehydrogenase (ADH) isoenzymes, and aldehyde dehydrogenase (ALDH) in the sera of women with intrahepatic cholestasis of pregnancy (ICP), the most common pregnancy-related liver disease. PATIENTS AND METHODS: Serum samples were taken from 40 women with ICP in the second or third trimester of pregnancy. Serum samples were also obtained from 40 healthy pregnant women at the same time of pregnancy and 40 healthy non-pregnant women. Class I and II of ADH and ALDH activity was measured by a spectrofluorometric method. Class III, IV ADH and total ADH activity was measured by photometric methods. RESULTS: The total ADH activity was significantly higher in women with ICP than in healthy pregnant and non-pregnant women (about 42%). The median total activity of ADH was 1067 mU/l in women with ICP, 628 mU/l in healthy pregnant and 605 mU/l in non-pregnant women. A statistically significant increase in class I ADH isoenzymes was found in the sera of pregnant women with ICP. The median activity of this class in the ICP group increased about 62% and 80% in comparison to the healthy pregnant women and non-pregnant women, respectively. CONCLUSION: The activity of class I ADH isoenzymes in the sera of women with ICP is statistically significantly increased and may have a diagnostic significance.


Assuntos
Álcool Desidrogenase/sangue , Aldeído Desidrogenase/sangue , Colestase Intra-Hepática/sangue , Fígado/enzimologia , Complicações na Gravidez/sangue , Adulto , Estudos de Casos e Controles , Colestase Intra-Hepática/enzimologia , Colestase Intra-Hepática/patologia , Feminino , Humanos , Isoenzimas/sangue , Fígado/patologia , Oxirredução , Gravidez , Complicações na Gravidez/enzimologia , Complicações na Gravidez/patologia , Espectrometria de Fluorescência
20.
Medicine (Baltimore) ; 99(16): e19797, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311994

RESUMO

BACKGROUND: Recent guidelines provide better treatment and management of pregnancy in women with systemic lupus erythematosus (SLE). In this analysis, we aimed to systematically assess the maternal and fetal complications associated with SLE using the most recent studies (2017-2019) to obtain an updated result of the present situation. METHODS: http://www.clinicaltrials.gov, MEDLINE, Cochrane Central, Web of Science, EMBASE, and Google Scholar were searched for English based studies comparing maternal and fetal complications in pregnant women with versus without SLE. Maternal and fetal complications were the endpoints in this analysis. The RevMan software 5.3 (latest version) was the most suitable analytical software for this analysis. Data were represented by risk ratio (RR) with 95% confidence interval (CI). RESULTS: A total number of eight million eight hundred and twelve thousand two hundred seventy-two (8,812,272) participants were included in this analysis, consisting of 9696 SLE-associated pregnancy. Based on an analysis of recently published studies (2017-2019), pre-eclampsia/eclampsia was significantly higher in pregnant women with SLE (RR: 3.38, 95% CI: 3.15-3.62; P = .00001). SLE was also associated with an increased risk of stillbirth (RR: 16.49, 95% CI: 2.95-92.13; P = .001) and fetal loss (RR: 7.55, 95% CI: 4.75-11.99; P = .00001). Abortion (RR: 4.70, 95% CI: 3.02-7.29; P = .00001) and the risk for cesarean section due to complications (RR: 1.38, 95% CI: 1.11-1.70; P = .003) were also significantly higher in pregnant women with SLE. In addition, fetal complications including preterm birth (RR: 2.33, 95% CI: 1.78-3.05; P = .00001), infants who were small for gestational age (RR: 2.50, 95% CI: 1.41-4.45; P = .002) and infants with low birth weight (RR: 4.78, 95% CI: 3.65-6.26; P = .00001) were also significantly higher in newborns from mothers with SLE. Moreover, the risk of newborns who were admitted to the neonatal intensive care unit (RR: 2.79, 95% CI: 2.31-3.37; P = .00001), newborns with an APGAR score <7 within 1 minute (RR: 2.47, 95% CI: 1.68-3.62; P = .00001) and 5 minutes (RR: 3.63, 95% CI: 2.04-6.45; P = .0001) respectively, were significantly highly associated with SLE. CONCLUSIONS: Based on the most recent studies, we could conclude that maternal and fetal complications were significantly higher in SLE-associated pregnancy. Therefore, SLE should still be considered a severe risk factor for pregnancy.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Complicações na Gravidez/etiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez
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