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1.
Hypertension ; 81(4): 851-860, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38288610

RESUMO

BACKGROUND: Increased cardiovascular risk following preeclampsia is well established and there are signs of early cardiovascular aging 6 months postpartum. This study assessed whether blood pressure (BP) and other cardiovascular measures are abnormal 2 years postpartum in the same cohort to determine ongoing risk markers. METHODS: Six months and 2 years postpartum, BP was measured using sphygmomanometry, 24-hour ambulatory BP monitoring, and noninvasive central BP. Anthropometric measures, blood, and urine biochemistry were performed. Cross-sectional comparisons between preeclampsia and normotensive pregnancy (NP) groups and longitudinal comparisons within each group were made at 6 months and 2 years. RESULTS: Two years postpartum, 129 NP, and 52 preeclampsia women were studied who also had 6 months measures. At both time points, preeclampsia group had significantly higher BP (office BP 2 years, 112±12/72±8 versus 104±9/67±7 mm Hg NP; [P<0.001]; mean ambulatory BP monitoring 116±9/73±8 versus 106±8/67±6 mm Hg NP; [P<0.001]). No significant BP changes noted 6 months to 2 years within either group. Office BP thresholds of 140 mm Hg systolic and 90 mm Hg diastolic classified 2% preeclampsia and 0% NP at 2 years. American Heart Association 2017 criteria (above normal, >120/80 mm Hg) classified 25% versus 8% (P<0.002), as did our reference range threshold of 122/79 mm Hg. American Heart Association criteria classified 60% post-preeclampsia versus 16% after NP with above-normal ambulatory BP monitoring (P<0.001). Other cardiovascular risk markers more common 2 years post-preeclampsia included higher body mass index (median 26.6 versus 23.1, P=0.003) and insulin resistance. CONCLUSIONS: After preeclampsia, women have significantly higher BP 6 months and 2 years postpartum, and have higher body mass index and insulin-resistance scores, increasing their future cardiovascular risk. Regular cardiovascular risk screening should be implemented for all who have experienced preeclampsia.


Assuntos
Doenças Cardiovasculares , Hipertensão , Pré-Eclâmpsia , Gravidez , Feminino , Humanos , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Fatores de Risco , Hipertensão/diagnóstico , Pressão Sanguínea/fisiologia , Fatores de Risco de Doenças Cardíacas
2.
Artigo em Inglês | MEDLINE | ID: mdl-37754596

RESUMO

The microbiome has emerged as a key determinant of human health and reproduction, with recent evidence suggesting a dysbiotic microbiome is implicated in adverse perinatal health outcomes. The existing research has been limited by the sample collection and timing, cohort design, sample design, and lack of data on the preconception microbiome. This prospective, longitudinal cohort study will recruit 2000 Australian women, in order to fully explore the role of the microbiome in the development of adverse perinatal outcomes. Participants are enrolled for a maximum of 7 years, from 1 year preconception, through to 5 years postpartum. Assessment occurs every three months until pregnancy occurs, then during Trimester 1 (5 + 0-12 + 6 weeks gestation), Trimester 2 (20 + 0-24 + 6 weeks gestation), Trimester 3 (32 + 0-36 + 6 weeks gestation), and postpartum at 1 week, 2 months, 6 months, and then annually from 1 to 5 years. At each assessment, maternal participants self-collect oral, skin, vaginal, urine, and stool samples. Oral, skin, urine, and stool samples will be collected from children. Blood samples will be obtained from maternal participants who can access a study collection center. The measurements taken will include anthropometric, blood pressure, heart rate, and serum hormonal and metabolic parameters. Validated self-report questionnaires will be administered to assess diet, physical activity, mental health, and child developmental milestones. Medications, medical, surgical, obstetric history, the impact of COVID-19, living environments, and pregnancy and child health outcomes will be recorded. Multiomic bioinformatic and statistical analyses will assess the association between participants who developed high-risk and low-risk pregnancies, adverse postnatal conditions, and/or childhood disease, and their microbiome for the different sample types.


Assuntos
COVID-19 , Gravidez , Feminino , Humanos , Criança , Estudos Prospectivos , Estudos Longitudinais , Austrália/epidemiologia , Período Pós-Parto
4.
BMC Pregnancy Childbirth ; 22(1): 108, 2022 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-35130869

RESUMO

BACKGROUND: Mental health is an integral part of overall health. Mental health disorders following childbirth are common and poor maternal mental health has consequences for both the mother and her infant. Preeclampsia is also relatively common in pregnancy but there is little known about the intersection between these two important conditions. Gaining a better understanding of the psychological consequences following preeclampsia is important, especially the link with depression, anxiety and posttraumatic stress disorder. If women who experience preeclampsia are recognised as being at increased risk of poor mental health, targeted screening in the postpartum period should be implemented. AIMS: To describe the prevalence and symptom severity of depression, anxiety and posttraumatic stress disorder at six months postpartum in women, who had a diagnosis of preeclampsia, compared to those who had normal blood pressure in pregnancy. METHODS: The mental health component of the prospective cohort study, the Postpartum, Physiology, Psychology and Paediatric follow-up study (P4 Study) was used. Women diagnosed with preeclampsia (n = 90) and those who were normotensive during pregnancy (n = 302) completed the Edinburgh Postnatal Depression Scale, General Anxiety Disorder Scale, and the Posttraumatic Stress Diagnostic Scale or Posttraumatic Stress Diagnostic Sclae-5 at six months postpartum. RESULTS: At six months postpartum, depressive scores were similar in both groups but a higher proportion of women from the preeclampsia group scored above the threshold for depression (2% v 7% p = 0.04). There were no differences between the groups in the prevalence or severity of anxiety or PTSD. However, more women in the preeclampsia group reported their birth experience as a traumatic event (1% vs 7%, p = 0.01). On correlation testing and modelling, booking Edinburgh Postnatal Depression Scale score, any mental health history, experiencing birth as traumatic and the General Anxiety Disorder Scale score were independent predictors of postpartum Edinburgh Postnatal Depression Scale scores. CONCLUSION: The postpartum clinical care of women with preeclampsia often focusses on the immediate physical health issues, but these women may also benefit from mental health screening. Targeted screening of preeclamptic women in the postpartum period may lead to more timely referral and initiation of treatment. TRIAL REGISTRATION: Retrospectively registered on 18/11/2013 with the Australian and New Zealand Clinical Trials Registry. Registration Number: ACTRN12613001260718 .


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Período Pós-Parto/psicologia , Pré-Eclâmpsia/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Austrália/epidemiologia , Estudos de Coortes , Feminino , Humanos , Questionário de Saúde do Paciente , Gravidez , Prevalência , Estudos Prospectivos , Escalas de Graduação Psiquiátrica
5.
Front Cell Infect Microbiol ; 12: 646165, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35198457

RESUMO

OBJECTIVE/HYPOTHESIS: To explore potential differences in faecal microbiome between women, and their infants, who had normotensive pregnancies (NP) and those who had a hypertensive pregnancy (HP), either gestational hypertension (GH) or preeclampsia (PE). METHODS: This is a sub study of P4 (Postpartum Physiology, Psychology, and Paediatrics Study) and includes 18 mother-infant pairs: 10 NP and 8 HP (HP as defined by blood pressure > 140/90mmHg; of which 6 had PE, and 2 GH), six months postpartum. The participating mothers collected stool samples from themselves and their infants. 16S rRNA V3-V4 amplicons were used to study the faecal microbiome. RESULTS: The sample of women and their infants were mostly primiparous (n =16) with vaginal birth (n = 14). At the time of faecal sampling 8 women were using hormonal contraception, and one HP woman remained on an antihypertensive. All women had blood pressure < 130/80mmHg, and 10 had high BMI (> 30). All infants had started solids, 8 were exclusively breastfed, 1 exclusively formula fed and 9 both. Three infants had been exposed to a course of antibiotics. Six months postpartum, there were no significant differences in alpha or beta diversity between the gut microbiota of HP and NP women (P > 0.05). However, a statistically significant difference was detected in alpha diversity between infants following HP and NP, with lower diversity levels in HP infants (P < 0.05). It was also found that at a genus and species level, the gut microbiota of HP women was enriched with Bifidobacterium and Bifididobacterium sp. and depleted in Barnisiella and Barnesiella intestinihominis when compared to NP women (P < 0.05). Similarly, the gut microbiota of infants born from HP was enriched in Streptococcus infantis and depleted in Sutterella, Sutterella sp., Bacteroides sp. and Clostridium aldenense compared to infants born from NP (P < 0.05). DISCUSSION: While our findings are at best preliminary, due to the very small sample size, they do suggest that the presence of hypertension in pregnancy may adversely affect the maternal microbiota postpartum, and that of their infants. Further analysis of postpartum microbiome data from future studies will be important to validate these early findings and provide further evidence about the changes in the microbiota in the offspring of women following hypertensive disorders of pregnancy (HDP), including possible links to the causes of long-term cardiovascular disease, the prevalence of which is increased in women who have experienced HDP.


Assuntos
Microbioma Gastrointestinal , Hipertensão , Pressão Sanguínea , Criança , Feminino , Microbioma Gastrointestinal/genética , Humanos , Lactente , Período Pós-Parto , Gravidez , RNA Ribossômico 16S/genética
6.
J Clin Endocrinol Metab ; 106(8): e2941-e2952, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-33824990

RESUMO

BACKGROUND: Preeclampsia is a major pregnancy complication associated with long-term maternal cardiometabolic disease. Research generally is focused on metabolic and pathophysiological changes during pregnancy; however, there is much less focus on the early postpartum period in subjects who suffered preeclampsia. The aim of this study was to (1) characterize energy intake and expenditure 6 months following normotensive and preeclamptic pregnancies and (2) examine associations between energy balance, body composition, insulin resistance measures (HOMA-IR), and clinical characteristics. DESIGN: A cross-sectional study 6 months following normotensive (n = 75) and preeclamptic (n = 22) pregnancies was performed. Metabolic measurements included anthropometrics measures, body composition via bioelectrical impedance analysis, 24-h energy expenditure via SenseWear Armbands, energy intake via a 3-day food diary, and serum metabolic parameters. RESULTS: Six months following preeclampsia, women had a significantly higher weight (77.3 ± 20.9 kg vs 64.5 ± 11.4 kg, P = 0.01), fat mass percentage (FM%; 40.7 ± 7.4% vs 34.9 ± 8.1%, P = 0.004), and insulin resistance (HOMA-IR 2.2 ± 1.5 vs 1.0 ± 0.7, P = 0.003), as well as reduced HDL levels (1.5 ± 0.4 mmol/L vs 1.8 ± 0.4 mmol/L, P = 0.01) compared to normotensive women. Women post-preeclampsia had lower activity-related energy expenditure (P = 0.02) but a decreased total energy intake (P = 0.02), leading to a more negative energy balance compared to their normotensive counterparts (-1942 kJ/24 h vs -480 kJ/24 h, P = 0.02). CONCLUSION: Increases in insulin resistance and FM%, reduced high-density lipoprotein, and more sedentary lifestyles characterize the postpartum period following preeclamptic compared with normotensive pregnancies. Early post-preeclampsia interventions, such as lifestyle behavior change, should be implemented and assessed to determine whether they reduce long-term cardiometabolic risk in women who experienced preeclampsia during pregnancy.


Assuntos
Adiposidade/fisiologia , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Período Pós-Parto/metabolismo , Pré-Eclâmpsia/metabolismo , Adulto , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Humanos , Resistência à Insulina/fisiologia , Gravidez
7.
Aust N Z J Obstet Gynaecol ; 61(3): 474-477, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33734427

RESUMO

Women who have had hypertension in pregnancy, both pre-eclampsia and gestational hypertension, have a two- to three-fold increased risk of cardiovascular disease later in life. It is unclear whether this is an unmasking of latent risk, the result of damage to the vascular tree during pregnancy, or both. Irrespective of the underlying pathophysiology, these women are uniquely identified sufficiently early in their lives for lifestyle interventions, if adopted, to improve their long-term health. Currently, follow-up of these women is inadequate and implementation of a coordinated follow-up program, and further research into how best to provide it, is urgently needed.


Assuntos
Doenças Cardiovasculares , Hipertensão Induzida pela Gravidez , Hipertensão , Pré-Eclâmpsia , Feminino , Humanos , Estilo de Vida , Gravidez , Fatores de Risco
8.
J Am Heart Assoc ; 9(22): e018604, 2020 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-33170079

RESUMO

Background There is increased risk of hypertension, early cardiovascular disease, and premature mortality in women who have had preeclampsia. This study was undertaken to determine the upper limit of normal blood pressure (BP) 6 months postpartum and the frequency of women with prior preeclampsia who had BP above these limits, as part of the P4 (Post-Partum Physiology, Psychology and Pediatric) follow-up study. Methods and Results BP was measured by sphygmomanometer, 24-hour ambulatory BP monitoring, and non-invasive central BP at 6 months postpartum in 302 women who had normotensive pregnancy and 90 who had preeclampsia. The upper limit of normal BP (mean+2 SD) for women with normotensive pregnancy was 122/79 mm Hg for routine BP, 115/81 mm Hg for central BP, and 121/78 mm Hg for 24-hour ambulatory BP monitoring. Traditional normal values detected only 3% of women who had preeclampsia as having high BP 6 months postpartum whereas these new values detected between 13% and 19%. Women with preeclampsia had greater body mass index (27.8 versus 25.0, P<0.001) and left ventricular wall thickness but similar augmentation index. They also had lower high-density lipoprotein (59±15 versus 65±16 mg/dL, P=0.002), higher triglycerides (77±51 versus 61±35 mg/dL, P=0.005), and higher homeostatic model assessment score (2.1±1.8 versus 1.3±1.9, P<0.001). Conclusions Clinicians wishing to detect high BP in these women should be aware of the lower than usual upper limit of normal for this young cohort and where possible should use 24-hour ambulatory BP monitoring to detect these changes. This may define a subgroup of women who had preeclampsia for whom targeted BP lowering therapy would be successful. Registration URL: https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365295&isReview=true; Unique identifier: ACTRN12613001260718.


Assuntos
Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Pré-Eclâmpsia/fisiopatologia , Adulto , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Doenças Cardiovasculares/fisiopatologia , Feminino , Seguimentos , Fatores de Risco de Doenças Cardíacas , Humanos , Período Pós-Parto/fisiologia , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/etiologia , Gravidez , Estudos Prospectivos
9.
CBE Life Sci Educ ; 16(4)2017.
Artigo em Inglês | MEDLINE | ID: mdl-29196427

RESUMO

Multiple reports highlight the increasingly quantitative nature of biological research and the need to innovate means to ensure that students acquire quantitative skills. We present a tool to support such innovation. The Biological Science Quantitative Reasoning Exam (BioSQuaRE) is an assessment instrument designed to measure the quantitative skills of undergraduate students within a biological context. The instrument was developed by an interdisciplinary team of educators and aligns with skills included in national reports such as BIO2010, Scientific Foundations for Future Physicians, and Vision and Change Undergraduate biology educators also confirmed the importance of items included in the instrument. The current version of the BioSQuaRE was developed through an iterative process using data from students at 12 postsecondary institutions. A psychometric analysis of these data provides multiple lines of evidence for the validity of inferences made using the instrument. Our results suggest that the BioSQuaRE will prove useful to faculty and departments interested in helping students acquire the quantitative competencies they need to successfully pursue biology, and useful to biology students by communicating the importance of quantitative skills. We invite educators to use the BioSQuaRE at their own institutions.


Assuntos
Disciplinas das Ciências Biológicas/educação , Avaliação Educacional , Modelos Educacionais , Reprodutibilidade dos Testes
10.
Obstet Med ; 10(4): 192-194, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29225682

RESUMO

We report a case of a left frontal lobe meningioma presenting in a woman with proteinuric preeclampsia in her first term pregnancy. The patient had a background of antepartum migraines that resolved in the second trimester of pregnancy. Postpartum, she required urgent surgery and sustained convulsions after surgery. She had no residual disease and has had another successful pregnancy. This case highlights the importance of cerebral imaging in the context of an atypical clinical course of preeclampsia. Although headaches are common in pregnancy and usually benign, other, more serious, diagnoses should be considered with atypical headaches, a change in the nature of the headache, and headaches that persist despite appropriate treatment. A full neurological examination including fundoscopy to exclude papilloedema should be performed and abnormal findings require further investigation.

11.
Midwifery ; 46: 17-23, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28110162

RESUMO

BACKGROUND: Hypertension complicates 10% of pregnancies and involves specialised care of the woman and her baby, a longer stay in hospital, and an increased risk of physical and mental morbidity. There is limited research reporting the woman's perspective on her experience, how she coped with it psychologically, and whether the care she received influenced her experience. AIM: To gain insight into women's experience of hypertension in pregnancy and to report on what mediating factors may help improve their experience. METHODS: A qualitative descriptive study was undertaken. Data were collected through a semi-structured, face to face interview at 10-12 months postpartum. In total, 20 women who had experienced hypertension in their pregnancy were interviewed. Thematic analysis was used to analyse the data. FINDINGS: Four main themes were identified. These were: Reacting to the diagnosis, Challenges of being a mother, Processing and accepting the situation, and Moving on from the experience. The mediating factors that improved the experience were Feeling safe and trusting the care providers, Having continuity of care and carer, and Valuing social support from partner, family and friends. CONCLUSION: The diagnosis of hypertension in pregnancy has a significant impact on women. This affects their pregnancy and birth experience and their pathway to motherhood. The implications of the findings for midwifery practice include having access to multidisciplinary continuity models of care and facilitating the support for these women.


Assuntos
Hipertensão Induzida pela Gravidez/psicologia , Hipertensão Induzida pela Gravidez/terapia , Mães/psicologia , Adulto , Austrália , Feminino , Humanos , Gravidez , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia , Pesquisa Qualitativa , Estresse Psicológico/complicações , Estresse Psicológico/psicologia
12.
Pregnancy Hypertens ; 6(4): 374-379, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27939485

RESUMO

BACKGROUND: Women who have had hypertension in pregnancy are at greater risk of long term cardiovascular disease (CVD). Little is known about their cardiovascular risk postpartum or the effects on the woman's mental health and the outcomes of their infants. In this project we will study the physiological and psychological health of women and the physical health and development of their infants six months, two years and five years after birth. We will establish normal blood pressure (BP) and metabolic function for women who were normotensive in pregnancy and use these to assess women who had gestational hypertension (GH) or preeclampsia (PE). DESIGN/METHODS: Women will be asked to participate if they have given birth in the preceding six months. They will be excluded if they had diabetes, hypertension, renal or other serious maternal disease prior to pregnancy or congenital anomaly in the pregnancy. We will recruit 292 women who were normotensive and their babies, 100 who had GH and 100 who had PE and their babies. They will be assessed at six months, two and five years after birth. At each assessment mothers will have their blood pressure (BP) assessed peripherally with a liquid crystal sphygmomanometer and 24h ambulatory blood pressure monitoring (ABPM), and centrally with non-invasive applanation tonometry. Additional physiological testing will include: body composition; energy balance; vascular compliance; cardiac function; liver and renal function, lipids and biochemistry; glucose and insulin; and urinalysis. Psychological status will be assessed with validated self-report questionnaires for depression, anxiety, post-traumatic stress disorder (PTSD) and mother-infant bonding. The babies will have a medical examination by a paediatrician at each assessment. Their behavioural development will be assessed with an Ages and Stages Questionnaire completed by their mother at each assessment and a developmental assessment by a child psychologist at two and five years. CONCLUSIONS: This study will re-define normal BP and other physiological parameters for young parous women thereby permitting a more sensitive assessment of post-partum BP and other cardiovascular risk markers in women who have had GH or PE. It will also determine the extent, if any, of psychological disorders in these women and developmental or other concerns in their babies. TRIALS REGISTRATION: Australian and New Zealand Clinical Trials Registry Number: ACTRN12613001260718.


Assuntos
Comportamento Infantil , Desenvolvimento Infantil , Hipertensão Induzida pela Gravidez/fisiopatologia , Hipertensão Induzida pela Gravidez/psicologia , Projetos de Pesquisa , Ansiedade/etiologia , Pressão Sanguínea , Vasos Sanguíneos/fisiologia , Composição Corporal , Estudos de Casos e Controles , Pré-Escolar , Complacência (Medida de Distensibilidade) , Depressão/etiologia , Feminino , Humanos , Lactente , Rim/fisiologia , Fígado/fisiologia , Período Pós-Parto , Pré-Eclâmpsia/fisiopatologia , Pré-Eclâmpsia/psicologia , Gravidez , Estudos Prospectivos , Transtornos de Estresse Pós-Traumáticos/etiologia , Rigidez Vascular , Função Ventricular
13.
CBE Life Sci Educ ; 15(3)2016.
Artigo em Inglês | MEDLINE | ID: mdl-27562960

RESUMO

Best-practices pedagogy in science, technology, engineering, and mathematics (STEM) aims for inclusive excellence that fosters student persistence. This paper describes principles of inclusivity across 11 primarily undergraduate institutions designated as Capstone Awardees in Howard Hughes Medical Institute's (HHMI) 2012 competition. The Capstones represent a range of institutional missions, student profiles, and geographical locations. Each successfully directed activities toward persistence of STEM students, especially those from traditionally underrepresented groups, through a set of common elements: mentoring programs to build community; research experiences to strengthen scientific skill/identity; attention to quantitative skills; and outreach/bridge programs to broaden the student pool. This paper grounds these program elements in learning theory, emphasizing their essential principles with examples of how they were implemented within institutional contexts. We also describe common assessment approaches that in many cases informed programming and created traction for stakeholder buy-in. The lessons learned from our shared experiences in pursuit of inclusive excellence, including the resources housed on our companion website, can inform others' efforts to increase access to and persistence in STEM in higher education.


Assuntos
Academias e Institutos , Educação de Pós-Graduação , Relações Comunidade-Instituição , Avaliação Educacional , Engenharia/educação , Humanos , Matemática/educação , Desenvolvimento de Programas , Ciência/educação , Estudantes , Tecnologia/educação , Pensamento
14.
Aust N Z J Obstet Gynaecol ; 56(1): 42-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26817524

RESUMO

BACKGROUND: Pregnancy is associated with an increase in body fat; however, excessive gestational weight gain predisposes to significant maternal and neonatal morbidity and mortality. It remains unclear whether alterations in energy homeostasis have a major influence on fat storage. AIMS: To evaluate longitudinal changes in body composition and energy metabolism in healthy pregnant women. MATERIALS AND METHODS: Body composition, energy expenditure and energy intake were measured longitudinally in 26 women with singleton pregnancies at 12-14 weeks, 24-26 weeks and 34-36 weeks of gestation. Fat mass (FM) and lean body mass (LBM) were measured using bio-impedance analysis, total energy expenditure (TEE) using the Sensewear Armband and energy intake through a 3-day food recall diary. RESULTS: Throughout pregnancy, all women remained healthy. Body weight increased by 10.8 ± 3.9 kg, from 67.3 ± 14.1 kg to 78.1 ± 13.8 kg from the first to the third trimester (P < 0.001). Body fat percentage increased by 4.5 ± 4.2% (P < 0.001). LBM also increased throughout pregnancy, by 3.9 ± 2.4 kg (P < 0.001). TEE increased significantly from the first to the third trimesters (9514 kJ/day to 10 263 kJ/day; P < 0.05). In contrast, energy expenditure due to physical activity, energy intake and macronutrient intake did not change significantly throughout pregnancy. CONCLUSION: Healthy women increase FM during pregnancy despite slight increases in TEE and no change in energy intake. This suggests that energy storage efficiency improves during pregnancy, which may be related to alterations in gut microbiota and activation of anabolic pathways during pregnancy. Clarifying factors leading to this more efficient fat and energy storing state, and the role of the pregnancy-related changes in gut microbiota, may be important for managing gestational weight gain.


Assuntos
Adiposidade/fisiologia , Metabolismo Energético/fisiologia , Homeostase/fisiologia , Gravidez/fisiologia , Aumento de Peso/fisiologia , Acelerometria , Adolescente , Adulto , Inquéritos sobre Dietas , Ingestão de Energia/fisiologia , Feminino , Humanos , Estudos Longitudinais , Pletismografia de Impedância , Adulto Jovem
15.
Curr Opin Insect Sci ; 13: 1-6, 2016 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-26693142

RESUMO

Polyphenism is a form of developmental plasticity in which organisms respond to environmental cues by producing adaptive, discrete, alternative phenotypes known as morphs. The phenomenon is common and important as both a form of adaptation and a source of variation for natural selection. Understanding the evolution of polyphenism will require understanding the proximate factors that regulate alternative morph production. Renewed interest and technological advances have fueled multiple approaches to the latter, including hormone manipulation studies, targeted transcriptomic studies, and epigenetic profiling. We review these studies and suggest that integration of multilayered approaches will be necessary to understand the complex mechanisms involved in regulating alternative morphologies.

16.
J Hypertens ; 33(3): 499-505; discussion 505-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25380148

RESUMO

OBJECTIVE: To find a suitable replacement for mercury sphygmomanometry to measure blood pressure (BP) accurately in normal and hypertensive pregnancy. METHODS: Two parallel validation studies were carried out in 340 pregnant women, 170 with a hypertensive disorder and 170 normotensive women. An auscultatory hybrid sphygmomanometer, A&D UM-101, and a professional automated oscillometric device for office and clinic use, Omron HEM-907, were tested. Using a modified British Hypertension Society (BHS) Protocol, nine sequential BP recordings were taken alternating between the mercury sphygmomanometer and the study device. The first readings for each device were discarded, and three differences between mercury and study device were calculated for each woman for SBP and DBP. Main outcome measures were the percentages of BP readings that were within 5, 10 and 15 mmHg absolute difference from mercury sphygmomanometry. RESULTS: Women in both studies were an average of 34 weeks' gestation and of similar ethnicity, age and BMI. In hypertensive women, 29% had preeclampsia and 73% were receiving antihypertensives. Amongst hypertensive women, SBP was within 5 mmHg of mercury BP in 94% of readings with the auscultatory device and 75% with the automated device (P = 0.021); DBP was within 5 mmHg in 97 and 61% readings, respectively (P = 0.001). Results were similar amongst normotensive pregnant women. Both devices achieved an A/A rating according to the BHS protocol. CONCLUSION: The auscultatory hybrid sphygmomanometer is more accurate than the automated oscillometric device in pregnancy, specifically in hypertensive pregnancies. It is an acceptable replacement for mercury sphygmomanometry in pregnancy.


Assuntos
Determinação da Pressão Arterial/instrumentação , Hipertensão Induzida pela Gravidez/diagnóstico , Esfigmomanômetros/estatística & dados numéricos , Adulto , Instituições de Assistência Ambulatorial , Pressão Sanguínea , Determinação da Pressão Arterial/métodos , Etnicidade , Feminino , Idade Gestacional , Humanos , Hipertensão , Mercúrio , Oscilometria/instrumentação , Avaliação de Resultados em Cuidados de Saúde , Pré-Eclâmpsia , Gravidez , Estudos Prospectivos
17.
CBE Life Sci Educ ; 12(4): 665-75, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24297293

RESUMO

The American Association for the Advancement of Science 2011 report Vision and Change in Undergraduate Biology Education encourages the teaching of developmental biology as an important part of teaching evolution. Recently, however, we found that biology majors often lack the developmental knowledge needed to understand evolutionary developmental biology, or "evo-devo." To assist in efforts to improve evo-devo instruction among undergraduate biology majors, we designed a concept inventory (CI) for evolutionary developmental biology, the EvoDevoCI. The CI measures student understanding of six core evo-devo concepts using four scenarios and 11 multiple-choice items, all inspired by authentic scientific examples. Distracters were designed to represent the common conceptual difficulties students have with each evo-devo concept. The tool was validated by experts and administered at four institutions to 1191 students during preliminary (n = 652) and final (n = 539) field trials. We used student responses to evaluate the readability, difficulty, discriminability, validity, and reliability of the EvoDevoCI, which included items ranging in difficulty from 0.22-0.55 and in discriminability from 0.19-0.38. Such measures suggest the EvoDevoCI is an effective tool for assessing student understanding of evo-devo concepts and the prevalence of associated common conceptual difficulties among both novice and advanced undergraduate biology majors.


Assuntos
Biologia do Desenvolvimento/educação , Avaliação Educacional , Humanos , Reprodutibilidade dos Testes , Estudantes
18.
CBE Life Sci Educ ; 12(3): 494-508, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24006397

RESUMO

To examine how well biology majors have achieved the necessary foundation in evolution, numerous studies have examined how students learn natural selection. However, no studies to date have examined how students learn developmental aspects of evolution (evo-devo). Although evo-devo plays an increasing role in undergraduate biology curricula, we find that instruction often addresses development cursorily, with most of the treatment embedded within instruction on evolution. Based on results of surveys and interviews with students, we suggest that teaching core concepts (CCs) within a framework that integrates supporting concepts (SCs) from both evolutionary and developmental biology can improve evo-devo instruction. We articulate CCs, SCs, and foundational concepts (FCs) that provide an integrative framework to help students master evo-devo concepts and to help educators address specific conceptual difficulties their students have with evo-devo. We then identify the difficulties that undergraduates have with these concepts. Most of these difficulties are of two types: those that are ubiquitous among students in all areas of biology and those that stem from an inadequate understanding of FCs from developmental, cell, and molecular biology.


Assuntos
Evolução Biológica , Formação de Conceito , Biologia do Desenvolvimento/educação , Aprendizagem , Estudantes , Animais , Avaliação Educacional
19.
Evodevo ; 4(1): 10, 2013 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-23552511

RESUMO

BACKGROUND: In most species of aphid, female nymphs develop into either sexual or asexual adults depending on the length of the photoperiod to which their mothers were exposed. The progeny of these sexual and asexual females, in turn, develop in dramatically different ways. The fertilized oocytes of sexual females begin embryogenesis after being deposited on leaves (oviparous development) while the oocytes of asexual females complete embryogenesis within the mother (viviparous development). Compared with oviparous development, viviparous development involves a smaller transient oocyte surrounded by fewer somatic epithelial cells and a smaller early embryo that comprises fewer cells. To investigate whether patterning mechanisms differ between the earliest stages of the oviparous and viviparous modes of pea aphid development, we examined the expression of pea aphid orthologs of genes known to specify embryonic termini in other insects. RESULTS: Here we show that pea aphid oviparous ovaries express torso-like in somatic posterior follicle cells and activate ERK MAP kinase at the posterior of the oocyte. In addition to suggesting that some posterior features of the terminal system are evolutionarily conserved, our detection of activated ERK in the oocyte, rather than in the embryo, suggests that pea aphids may transduce the terminal signal using a mechanism distinct from the one used in Drosophila. In contrast with oviparous development, the pea aphid version of the terminal system does not appear to be used during viviparous development, since we did not detect expression of torso-like in the somatic epithelial cells that surround either the oocyte or the blastoderm embryo and we did not observe restricted activated ERK in the oocyte. CONCLUSIONS: We suggest that while oviparous oocytes and embryos may specify posterior fate through an aphid terminal system, viviparous oocytes and embryos employ a different mechanism, perhaps one that does not rely on an interaction between the oocyte and surrounding somatic cells. Together, these observations provide a striking example of a difference in the fundamental events of early development that is both environmentally induced and encoded by the same genome.

20.
J Exp Zool B Mol Dev Evol ; 318(6): 448-59, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22644631

RESUMO

Evolutionary novelties represent challenges to biologists, particularly those who would like to understand the developmental and genetic changes responsible for their appearance. Most modern aphids possess two apparent evolutionary novelties: cyclical parthenogenesis (a life cycle with both sexual and asexual phases) and viviparity (internal development and live birth of progeny) in their asexual phase. Here I discuss the evolution of these apparent novelties from a developmental standpoint. Although a full understanding of the evolution of cyclical parthenogenesis and viviparity in aphids can seem a daunting task, these complex transitions can at least be broken down into a handful of steps. I argue that these should include the following: a differentiation of two developmentally distinct oocytes; de novo synthesis of centrosomes and modification of meiosis during asexual oogenesis; a loss or bypass of any cell cycle arrest and changes in key developmental events during viviparous oogenesis; and a change in how mothers specify the sexual vs. asexual fates of their progeny. Grappling with the nature of such steps and the order in which they occurred ought to increase our understanding and reduce the apparent novelty of complex evolutionary transitions.


Assuntos
Afídeos/genética , Afídeos/fisiologia , Evolução Biológica , Partenogênese/genética , Viviparidade não Mamífera/genética , Animais , Feminino , Masculino , Partenogênese/fisiologia , Viviparidade não Mamífera/fisiologia
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