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1.
PLoS One ; 15(2): e0229079, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069319

RESUMO

AIM: To analyse i) the association of physical fitness during early second trimester and late pregnancy with maternal and neonatal outcomes; and ii) to investigate whether physical fitness is associated with the type of birth (vaginal or caesarean section). METHODS: Pregnant women from the GESTAFIT Project (n = 159) participated in this longitudinal study. Maternal physical fitness including upper- and lower-body strength, cardiorespiratory fitness (CRF) and flexibility were measured through objective physical fitness tests at the 16th and 34th gestational weeks. Maternal and neonatal outcomes were collected from obstetric medical records. Umbilical arterial and venous blood gas pH and partial pressure of carbon dioxide (PCO2) and oxygen (PO2), were assessed. RESULTS: At the 16th week, greater upper-body muscle strength was associated with greater neonatal birth weight (r = 0.191, p<0.05). Maternal flexibility was associated with a more alkaline arterial pH (r = 0.220, p<0.05), higher arterial PO2 (r = 0.237, p<0.05) and lower arterial PCO2 (r = -0.331, p<0.01) in umbilical cord blood. Maternal CRF at the 16th gestational week was related to higher arterial umbilical cord PO2 (r = 0.267, p<0.05). The women who had caesarean sections had lower CRF (p<0.001) at the 16th gestational week and worse clustered overall physical fitness, both at the 16th (-0.227, p = 0.003, confidence interval (CI): -0.376, -0.078) and 34th gestational week (-0.223; p = 0.018; CI: -0.432, -0.015) compared with the women who had vaginal births. CONCLUSION: Increasing physical fitness during pregnancy may promote better neonatal outcomes and is associated with a decrease in the risk of caesarean section. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.


Assuntos
Peso ao Nascer/fisiologia , Cesárea/estatística & dados numéricos , Recém-Nascido/fisiologia , Aptidão Física/fisiologia , Gravidez/fisiologia , Adulto , Dióxido de Carbono/análise , Feminino , Sangue Fetal/química , Humanos , Estudos Longitudinais , Oxigênio/análise , Pressão Parcial , Segundo Trimestre da Gravidez/fisiologia , Autorrelato
2.
Int J Gynaecol Obstet ; 148(1): 53-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31571213

RESUMO

OBJECTIVE: To evaluate the disability and functioning of women with low-risk pregnancy in the second and third gestational trimesters. METHODS: A longitudinal observational study was conducted from June 5, 2015, to April 30, 2016, in Family Health Units in the city of Santa Cruz, Rio Grande do Norte, Brazil, involving women who were in the second trimester of pregnancy where the pregnancy had been classified as low-risk. A form was designed specifically for the study to collect sociodemographic, urogynecological, and obstetric data. Functioning and disability were assessed using WHODAS 2.0, and descriptive and inferential statistical analyses were performed. RESULTS: Higher levels of disability were observed in cognition in the second trimester (P=0.021), while mobility and life activities domains had higher scores (higher score meaning the woman was more adversely affected) in the third trimester (P=0.007 and P=0.029). Urinary incontinence in the second trimester affected functioning in participation (P=0.023). Pain affected life activities (P=0.023) in the second trimester and participation in the third trimester (P=0.044); and general functioning (P=0.050 and P=0.025), mobility (P=0.002 and P=0.001), and self-care (P=0.0446 and P=0.023) in the second and third trimesters, respectively. CONCLUSION: The findings showed that, even in a low-risk pregnancy, functioning can be affected in different domains. The identification of impairments to functioning could enable improvement in care. Longitudinal studies involving the first trimester and postpartum are necessary to gain insight into women's disability and functioning during the pregnancy-puerperal period.


Assuntos
Avaliação da Deficiência , Segundo Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Gravidez/fisiologia , Atividades Cotidianas , Adulto , Brasil , Cognição/fisiologia , Feminino , Humanos , Estudos Longitudinais , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-31533206

RESUMO

OBJECTIVE: Maternal nutrition is considered an important pillar in the pregnancy outcomes for both mother and infant. A mother's malnutrition and inadequate nutrient intake is associated with many undesirable pregnancy outcomes. Hence, assessing the nutritional status of the mother in the early stages of the pregnancy and preventing any inadequacy can preclude many health problems for both mother and infant. Therefore, this study aimed to assess the adequacy of nutrient intakes among Jordanian pregnant women as compared to their corresponding dietary reference intakes (DRIs). METHODS: This cross-sectional study was conducted at a major University Hospital in Jordan. Three hundred pregnant women were invited to participate in the study and 286 agreed to participate. Fifty pregnant women were enrolled at week 9, then 96 pregnant women were at week 20 and 137 pregnant women were at week 30 of pregnancy. The participants completed the interview-based demographic questionnaire, pregnancy physical activity questionnaire, and quantitative food frequency questionnaire (FFQ). RESULTS: The mean energy intake was 2768.9 ± 767.8 kcal/day and it was significantly higher in the 3rd trimester (p < 0.05). Women in the 3rd trimester consumed significantly more protein, carbohydrates, and sugar than women in the 1st and 2nd trimesters (p < 0.05). The pregnant women in the 3rd trimester consumed more sodium than women in the 1st and 2nd trimesters (p < 0.05). The vitamin K intake was significantly (p = 0.045) lower in the 2nd trimester than the 1st and 3rd trimesters. The calcium intake was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p = 0.021). The total micronutrient (vitamins B1, B2, B3, B6, B12, and D, calcium, and iron) intakes derived from dietary supplements and food sources throughout the 3 trimesters was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p < 0.05). The vitamin D, calcium, and iron intakes had the most significant increases between the 1st and 3rd trimesters (p < 0.001), while folic acid intake was significantly higher in the 1st trimester than the 2nd and 3rd trimester (p < 0.001). Most women exceeded the tolerable upper intake level (UL) for sodium in all trimesters, while 82% of women exceeded the UL of folic acid in the 1st trimester and from the supplement, not the diet. CONCLUSION: While the intake of some nutrients from food alone remains below the DRIs in the diets of pregnant women, the intake of other nutrients is above the UL. Raising the awareness of pregnant women about their diet and how a supplement intake can reduce the risk of inadequate intake for many micronutrients and improve their pregnancy outcomes is of great importance.


Assuntos
Dieta , Ingestão de Energia , Estado Nutricional , Gravidez/fisiologia , Recomendações Nutricionais , Adulto , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Jordânia , Adulto Jovem
4.
BMC Med ; 17(1): 167, 2019 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-31506067

RESUMO

BACKGROUND: Current reference ranges for blood pressure and heart rate throughout pregnancy have a poor evidence base. METHODS: This is a systematic review and meta-analysis. We included studies measuring blood pressure or heart rate from healthy pregnant women within defined gestational periods of 16 weeks or less. We analysed systolic blood pressure, diastolic blood pressure and heart rate by gestational age. We assessed effects of measurement year and method. RESULTS: We included 39 studies undertaken in 1967-2017, containing 124,349 systolic measurements from 36,239 women, 124,291 diastolic measurements from 36,181 women and 10,948 heart rate measurements from 8317 women. Mean (95% CI) systolic blood pressure was lowest at 10 weeks gestation, 110.4 (108.5, 112.3) mmHg, rising to 116.0 (113.6, 118.4) mmHg at 40 weeks, mean (95% CI) change 5.6 (4.0, 7.2) mmHg. Mean (95% CI) diastolic blood pressure was lowest at 21 weeks gestation, 65.9 (64.2, 67.7) mmHg; rising to 72.8 (71.0, 74.6) mmHg at 40 weeks, mean (95% CI) change 6.9 (6.2, 7.5) mmHg. Mean (95% CI) heart rate rose from 79.3 (75.5, 83.1) beats/min at 10 weeks to 86.9 (82.2, 91.6) beats/min at 40 weeks gestation, mean (95% CI) change 7.6 (1.8, 13.4) beats/min. Studies using manual measurement reported higher diastolic blood pressures than studies using automated measurement, mean (95 CI) difference 4.9 (0.8, 8.9) mmHg. Diastolic blood pressure increased by 0.26 (95% CI 0.10-0.43) mmHg/year. Including only higher-quality studies had little effect on findings, with heterogeneity remaining high (I2 statistic > 50%). CONCLUSIONS: Significant gestational blood pressure and heart rate changes occur that should be taken into account when assessing pregnant women. Commonly taught substantial decreases in blood pressure mid-pregnancy were not seen and heart rate increases were lower than previously thought. Manual and automated blood pressure measurement cannot be used interchangeably. Increases in diastolic blood pressure over the last half-century and differences between published studies show contemporary data are required to define current normal ranges. STUDY REGISTRATION: PROSPERO CRD42014009673.


Assuntos
Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Gravidez/fisiologia , Adulto , Feminino , Idade Gestacional , Humanos , Valores de Referência
5.
PLoS Biol ; 17(9): e3000421, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31513564

RESUMO

Decidua is a transient uterine tissue shared by mammals with hemochorial placenta and is essential for pregnancy. The decidua is infiltrated by many immune cells promoting pregnancy. Adult bone marrow (BM)-derived cells (BMDCs) differentiate into rare populations of nonhematopoietic endometrial cells in the uterus. However, whether adult BMDCs become nonhematopoietic decidual cells and contribute functionally to pregnancy is unknown. Here, we show that pregnancy mobilizes mesenchymal stem cells (MSCs) to the circulation and that pregnancy induces considerable adult BMDCs recruitment to decidua, where some differentiate into nonhematopoietic prolactin-expressing decidual cells. To explore the functional importance of nonhematopoietic BMDCs to pregnancy, we used Homeobox a11 (Hoxa11)-deficient mice, having endometrial stromal-specific defects precluding decidualization and successful pregnancy. Hoxa11 expression in BM is restricted to nonhematopoietic cells. BM transplant (BMT) from wild-type (WT) to Hoxa11-/- mice results in stromal expansion, gland formation, and marked decidualization otherwise absent in Hoxa11-/- mice. Moreover, in Hoxa11+/- mice, which have increased pregnancy losses, BMT from WT donors leads to normalized uterine expression of numerous decidualization-related genes and rescue of pregnancy loss. Collectively, these findings reveal that adult BMDCs have a previously unrecognized nonhematopoietic physiologic contribution to decidual stroma, thereby playing important roles in decidualization and pregnancy.


Assuntos
Células da Medula Óssea/fisiologia , Decídua/citologia , Implantação do Embrião , Células-Tronco Mesenquimais/fisiologia , Gravidez/fisiologia , Animais , Feminino , Proteínas de Homeodomínio/genética , Masculino , Camundongos Knockout
7.
Gac. sanit. (Barc., Ed. impr.) ; 33(4): 369-376, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187994

RESUMO

Objective: To transculturally adapt the Spanish version of Pregnancy Physical Activity Questionnaire (PPAQ) analyzing its psychometric properties. Methods: The PPAQ was transculturally adapted into Spanish. Test-retest reliability was evaluated in a subsample of 109 pregnant women. The validity was evaluated in a sample of 208 pregnant women who answered the questionnaire and wore the multi-sensor monitor for 7 valid days. The reliability (intraclass correlation coefficient), concordance (concordance correlation coefficient), correlation (Pearson correlation coefficient), agreement (Bland-Altman plots) and relative activity levels (Jonckheere-Terpstra test) between both administrations and methods were examined. Results: Intraclass correlation coefficients between both administrations were good for all categories except transportation. A low but significant correlation was found for total activity (light and above) whereas no correlation was found for other intensities between both methods. Relative activity levels analysis showed a significant linear trend for increased total activity between both methods. Conclusions: Spanish version of PPAQ is a brief and easily interpretable questionnaire with good reliability and ability to rank individuals, and poor validity compared with multi-sensor monitor. The use of PPAQ provides information of pregnancy-specific activities in order to establish physical activity levels of pregnant women and adapt health promotion interventions


Objetivo: Adaptar transculturalmente la versión española del Pregnancy Physical Activity Questionnaire (cuestionario de actividad física en el embarazo) analizando sus propiedades psicométricas. Método: El cuestionario de actividad física en el embarazo fue transculturalmente adaptado al español. La fiabilidad test-retest se evaluó en una submuestra de 109 embarazadas. La validez se evaluó en una muestra de 208 embarazadas que respondieron el cuestionario y llevaron colocado el monitor multisensor durante 7 días válidos. Se valoraron la fiabilidad (coeficiente de correlación intraclase), la concordancia (coeficiente de correlación de concordancia), la correlación (coeficiente de correlación de Pearson), el grado de acuerdo (gráfico Bland-Altman) y los niveles de actividad relativos (test Jonckheere-Terpstra) entre las dos administraciones y los dos métodos. Resultados: Los coeficientes de correlación intraclase entre las dos administraciones fueron buenos para todas las categorías, excepto el transporte. Una correlación baja, pero significativa, se encontró para la actividad total (suave y superior), mientras que no se encontró correlación para otras intensidades entre los dos métodos. El análisis de los niveles de actividad relativos mostró una tendencia lineal significativa para el incremento de actividad total entre ambos métodos. Conclusiones: La versión española del cuestionario de actividad física en el embarazo es un breve y fácilmente interpretable cuestionario, con buena fiabilidad y habilidad para ordenar personas, y baja validez en comparación con el monitor multisensor. El uso del cuestionario de actividad física en el embarazo aporta información sobre actividades específicas del embarazo con el objetivo de establecer los niveles de actividad física de las mujeres embarazadas y adaptar intervenciones para la mejora de la salud


Assuntos
Humanos , Feminino , Gravidez , Adulto Jovem , Adulto , Psicometria/instrumentação , Atividade Motora/fisiologia , Esforço Físico/fisiologia , Tolerância ao Exercício/fisiologia , Gravidez/fisiologia , Comparação Transcultural , Complicações na Gravidez/prevenção & controle , Estilo de Vida
8.
Anim Genet ; 50(5): 539-542, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31297858

RESUMO

Selection for increased litter size in swine has potentially resulted in a correlated increase in preweaning mortality. Additional selection criteria should be considered when selecting for increased litter size to account for associated decreases in piglet quality, specifically piglet survival, initial weight and growth. Traits such as gestation length (GL), which have been associated with piglet performance, could be utilized to improve piglet development and survivability. The objective of this study was to conduct a genome-wide association study to identify genomic regions associated with GL in differing parities in swine (n = 831) from the University of Nebraska-Lincoln reproductive longevity project. Gestation length was calculated as the number of days between last insemination administered and farrowing. Sows were genotyped with the Illumina SNP60 BeadArray, and the data were analyzed using Bayesian mixture models for GL at parity 1, 2, 3 and 4 (GL1, GL2, GL3 and GL4 respectively). Means (SD) for GL1-GL4 were 113 (1.4), 114 (1.2), 114 (1.3) and 115 (1.2) respectively. Posterior mean heritability estimates (PSD) for GL1, GL2, GL3 and GL4 were 0.33 (0.06), 0.34 (0.07), 0.32 (0.08) and 0.20 (0.08) respectively. Rank correlations between genomic estimated breeding values between GL1 and GL2, GL3 and GL4 respectively were moderate: 0.67, 0.65 and 0.60. The top SNP (ASGA0017859, SSC4, 7.8 Mb), located in the top common genomic region associated with GL1, GL2 and GL3, was associated with a difference of 1.1 days in GL1 between homozygote genotypes (P < 0.0001). The results of this study suggest that GL is a largely polygenic trait with relatively minor contributions from multiple genomic regions.


Assuntos
Gravidez/fisiologia , Suínos/genética , Animais , Feminino , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas , Fatores de Tempo
11.
Nutr. hosp ; 36(extr.3): 44-48, jul. 2019. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-184434

RESUMO

La importancia de una correcta alimentación y nutrición desde antes del embarazo hasta el final de la lactancia está fuera de cualquier duda basándonos en la información y en la evidencia científica disponibles en la actualidad. A pesar de ello, estudios recientes han puesto de manifiesto que la alimentación de las madres en nuestro medio es inadecuada. Se han detectado carencias en cuanto a la ingesta de determinados nutrientes críticos en esta etapa. La importancia de una correcta nutrición de la madre ya ha sido reconocida desde hace décadas, ya que influye no solo en el desarrollo fetal, sino también en la organización genética de la respuesta metabólica futura del niño, y después del adulto, como ponen de manifiesto varias publicaciones recientes que relacionan la nutrición materna con un posible efecto programador responsable de la aparición de diversas alteraciones metabólicas en la vida adulta que condicionan la aparición de varias enfermedades crónicas. Por estas razones, la gestación supone un reto para la madre en cuanto a su nutrición debido al incremento en los requerimientos de energía y nutrientes, que tiene por objetivo alcanzar una adecuada salud materno-fetal. En la alimentación cotidiana, la leche y los productos lácteos son fuente de nutrientes críticos para el correcto desarrollo del feto y, posteriormente, del recién nacido. En este artículo, se revisa la influencia de los productos lácteos convencionales y de los lácteos enriquecidos y fortificados con diversos nutrientes sobre el estado nutricional durante la gestación y la lactancia y los resultados perinatales relacionados con ello


The importance of a correct diet and nutrition before pregnancy to the end of lactation seems to be without doubt with the scientific information and evidence that we have today. Despite this, recent studies have shown that the mother's diet is not as adequate as it should be and deficiencies of certain critical nutrients have been detected at this stage. The importance of a correct nutrition of the mother at this stage has already been recognized for decades and today we can affirm that it will affect not only the development of the fetus but also the genetic organization of the future metabolic response of the child and later of the adult. Several recent publications seem to have made clear that they seem to relate maternal nutrition with a possible programming effect related to the appearance of various metabolic alterations in adult life giving rise to the possible appearance of various chronic diseases. For this reason, gestation is going to be a challenge for the mother at the nutritional level due to increase energy and nutrient needs and their relationship to maternal and child health. In the daily diet, milk and milk products are critical sources of nutrients for the correct development of the fetus and the early development of the child. The purpose of this text is to highlight them, to review the effects of conventional dairy products and dairy products fortified with various nutrients on nutritional status during pregnancy and lactation


Assuntos
Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Leite/fisiologia , Lactação , Laticínios , Estado Nutricional , Gravidez/fisiologia , Nutrientes , Vitaminas Lipossolúveis , Assistência Perinatal , Cálcio , Vitamina D
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 697-701, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238622

RESUMO

Objective: To investigate the relations between dietary intake during pregnancy and the incidence of their babies with small for gestational age (SGA). Methods: Data on demographics, dietary intake of protein, fat, and carbohydrates of the pregnant mothers during the first, second and third trimester, were collected. Information related to birth weight and gestational age of the infants were also gathered. A total of 8 102 women, who delivered their babies at the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016, were enrolled in this project. Among them, 961 mothers had infants with SGA but the other 7 141 of them having normal infants. Unconditional logistic regression model was used to analyze the effect of dietary nutrient intake on SGA the first, second and third trimester. Results: We found that low dietary intake of protein during the first trimester and following trimesters during pregnancy were positively associated with higher risk of SGA (OR=1.534, 95%CI: 1.217-1.934; OR=1.268, 95%CI: 1.005-1.599; OR=1.310, 95%CI: 1.036-1.655). When adjusting for maternal pre-pregnancy BMI, we found that when mothers were with a pre-pregnancy BMI less than 18.5 or with low maternal intake of protein during the first trimester, positive association with higher risk of SGA (OR=1.872, 95%CI: 1.033-3.395; OR=1.754, 95%CI: 1.125-2.734), was noticed. However, for mothers with a pre-pregnancy BMI between 18.5 and 24.0 or with low protein intake during the first trimester, significant association with higher risk of SGA (OR=1.465, 95%CI: 1.089-1.972) was found. Conclusions: Through our observation, maternal dietary intake during pregnancy seemed to be associated with the risk of SGA but the effects of dietary intake were different, according to the BMI of pre-pregnancy population. Early pregnancy appeares as the key period for dietary intake which may influence the SGA.


Assuntos
Dieta/estatística & dados numéricos , Ingestão de Energia , Recém-Nascido Pequeno para a Idade Gestacional , Peso ao Nascer , China/epidemiologia , Feminino , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Gravidez/fisiologia , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez
13.
Nat Med ; 25(6): 1001-1011, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31142850

RESUMO

The microbiome of the female reproductive tract has implications for women's reproductive health. We examined the vaginal microbiome in two cohorts of women who experienced normal term births: a cross-sectionally sampled cohort of 613 pregnant and 1,969 non-pregnant women, focusing on 300 pregnant and 300 non-pregnant women of African, Hispanic or European ancestry case-matched for race, gestational age and household income; and a longitudinally sampled cohort of 90 pregnant women of African or non-African ancestry. In these women, the vaginal microbiome shifted during pregnancy toward Lactobacillus-dominated profiles at the expense of taxa often associated with vaginal dysbiosis. The shifts occurred early in pregnancy, followed predictable patterns, were associated with simplification of the metabolic capacity of the microbiome and were significant only in women of African or Hispanic ancestry. Both genomic and environmental factors are likely contributors to these trends, with socioeconomic status as a likely environmental influence.


Assuntos
Microbiota , Gravidez/fisiologia , Vagina/microbiologia , Adulto , Afro-Americanos , Biodiversidade , Estudos de Coortes , Estudos Transversais , Grupo com Ancestrais do Continente Europeu , Feminino , Hispano-Americanos , Interações entre Hospedeiro e Microrganismos/genética , Interações entre Hospedeiro e Microrganismos/fisiologia , Humanos , Microbiota/genética , Microbiota/fisiologia , Classe Social
14.
PLoS One ; 14(5): e0216814, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31120913

RESUMO

Recent studies indicate that FoxO1 has roles in female reproductive system, especially in maternal endometrium. Although various cellular aspects and molecular pathways have been identified, the exact molecular characteristics of embryo implantation are still not completely understood. In this study, we aimed to investigate uterine expression and regulation of FoxO1 during peri-implantation period in mice. Experimental mouse models including, normal pregnancy, pseudopregnancy, artificial decidualization, and delayed implantation and activation were performed. Our results showed that FoxO1 expression was spatiotemporal in mouse endometrial tissue throughout peri-implantation period and its expression was significantly upregulated in luminal and glandular epithelium at the time of implantation. Moreover, on day 5 morning (09:00 AM) of pregnancy, expression of FoxO1 was cytoplasmic in endometrial luminal epithelial cells where embryo homing takes place. With progressing time on day 5 evening (19:00 PM) of pregnancy FoxO1 expression was nuclear in luminal epithelium at implantation site. Pseudopregnancy and artificial decidualization models indicated that FoxO1 expression was regulated by pregnancy hormones. Delayed implantation and activation model indicated that FoxO1 expression at the time of implantation is dependent upon activation status of blastocyst due to E2 induction and uterine sensitivity to implantation. In conclusion, our findings highlight a perspective for FoxO1 expression and regulation in mouse uterus during peri-implantation period indicating that its expression is regulated by implanting embryo and pregnancy hormones.


Assuntos
Decídua/metabolismo , Implantação Tardia do Embrião/fisiologia , Proteína Forkhead Box O1/biossíntese , Regulação da Expressão Gênica/fisiologia , Gravidez/fisiologia , Pseudogravidez/metabolismo , Animais , Blastocisto/metabolismo , Feminino , Camundongos , Camundongos Endogâmicos BALB C
15.
Rev Saude Publica ; 53: 41, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31066819

RESUMO

OBJECTIVE: To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS: An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS: There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS: The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.


Assuntos
Exercício Físico/fisiologia , Gravidez/fisiologia , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/estatística & dados numéricos , Descanso/fisiologia , Adolescente , Adulto , Antropometria , Colômbia , Feminino , Pessoal de Saúde , Humanos , Registros Médicos , Pessoa de Meia-Idade , Educação Pré-Natal/métodos , Educação Pré-Natal/estatística & dados numéricos , Valores de Referência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
16.
Am J Obstet Gynecol ; 221(3): 255.e1-255.e9, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31051121

RESUMO

BACKGROUND: The benefit of aspirin in preventing preeclampsia is well established; however, studies over the years have demonstrated variability in outcomes with its use. Potential contributing factors to this variation in efficacy include dosing, time of dosing, and preparation of aspirin. OBJECTIVE: We aimed to compare the difference in pharmacokinetics of aspirin, through its major active metabolite, salicylic acid, in pregnant women and nonpregnant women, and to examine the effect of dose (100 mg vs 150 mg), preparation (enteric coated vs non-enteric-coated), and chronotherapy of aspirin (morning vs evening) between the 2 groups. MATERIALS AND METHODS: Twelve high-risk pregnant women and 3 nonpregnant women were enrolled in this study. Pregnant women were in 1 of 4 groups (100 mg enteric coated, 100 mg non-enteric-coated, 150 mg non-enteric-coated morning dosing, and 150 mg non-enteric-coated evening dosing), whereas nonpregnant women undertook each of the 4 dosing schedules with at least a 30-day washout period. Blood samples were collected at baseline (before ingestion) and at 1, 2, 4, 6, 12, and 24 hours after ingestion of aspirin. Plasma obtained was analyzed for salicylic acid levels by means of liquid chromatography-mass spectrometry. Pharmacokinetic values of area under the curve from time point 0 to 24 hours point of maximum concentration, time of maximum concentration, volume of distribution, clearance, and elimination half-life were analyzed for statistical significance with SPSS v25 software. RESULTS: Pregnant women had a 40% ± 4% reduction in area under the curve from time point 0 to 24 hours (P < .01) and 29% ± 3% reduction in point of maximum concentration (P < .01) with a 44% ± 8% increase in clearance (P < .01) in comparison to that in nonpregnant women when 100 mg aspirin was administered. The reduction in the area under the curve from time point 0 to 24 hours, however, was minimized with the use of 150 mg aspirin in pregnant women, with which the area under the curve from time point 0 to 24 hours was closer to that achieved with the use of 100 mg aspirin in nonpregnant women. There was a 4-hour delay (P < .01) in the time of maximum concentration, a 47% ± 3% reduction in point of maximum concentration (P < .01) and a 48% ± 1% increase in volume of distribution (P < .01) with the use of 100 mg enteric-coated aspirin compared to non-enteric-coated aspirin, with no difference in the overall area under the curve. There was no difference in the pharmacokinetics of aspirin between morning and evening dosing. CONCLUSION: There is a reduction in the total drug metabolite concentration of aspirin in pregnancy, and therefore a dose adjustment is potentially required in pregnant women. This is likely due to the altered pharmacokinetics of aspirin in pregnancy, with an increase in clearance. There was no difference in the total drug metabolite concentration of aspirin between enteric-coated and non-enteric-coated aspirin and between morning and evening dosing of aspirin. Further pharmacodynamic and clinical studies are required to examine the clinical relevance of these pharmacokinetic findings.


Assuntos
Aspirina/farmacocinética , Cronoterapia Farmacológica , Inibidores da Agregação de Plaquetas/farmacocinética , Gravidez/fisiologia , Adulto , Área Sob a Curva , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Estudos de Casos e Controles , Relação Dose-Resposta a Droga , Feminino , Humanos , Inibidores da Agregação de Plaquetas/administração & dosagem , Inibidores da Agregação de Plaquetas/uso terapêutico , Pré-Eclâmpsia/prevenção & controle , Comprimidos com Revestimento Entérico
17.
J Ayub Med Coll Abbottabad ; 31(2): 196-200, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31094116

RESUMO

BACKGROUND: World Health Organization recommends eight antenatal visits throughout pregnancy. Along with full blood count and fasting blood sugar tests, thirty-nine recommendations are given. The objective of this study was to find out significance of difference in haematological profile of pregnant women. METHODS: This cross-sectional study on 384 pregnant women attending outpatient department of combined military hospital Quetta, Pakistan, was conducted from 1st November 2017 to 28th February 2018. Simple random sampling technique through random number table was used. Data collected through structured questionnaire from participants and their laboratory reports was grouped trimester wise. Apart from descriptive statistics, one-way ANOVA with post hoc Tukey test was used to find out significant difference at p≤0.05. SPSS Version 20 and MS Excel 2007 were used for data analysis and plotting graphs. Principles of research ethics were exercised. RESULTS: Mean age (±SD) of the study participants was 27.5 (±4.8) years. Statistically significant difference was found for variables like haemoglobin, haematocrit and MCHC in different trimesters. Only 2 (0.5%) of the total participants had gestational diabetes mellitus. CONCLUSIONS: For getting normal reference ranges in our setting, large population-based studies are needed.


Assuntos
Testes Hematológicos/normas , Gravidez , Estudos Transversais , Feminino , Hemoglobinas/análise , Hospitais Militares , Humanos , Paquistão/epidemiologia , Gravidez/sangue , Gravidez/fisiologia , Gravidez/estatística & dados numéricos , Inquéritos e Questionários
18.
Med Sci Sports Exerc ; 51(6): 1292-1302, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31095086

RESUMO

PURPOSE: This study aimed to summarize the evidence from the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, including new evidence from an updated search of the effects of physical activity on maternal health during pregnancy and postpartum. METHODS: An initial search was undertaken to identify systematic reviews and meta-analyses published between 2006 and 2016. An updated search then identified additional systematic reviews and meta-analyses published between January 2017 and February 2018. The searches were conducted in PubMed®, CINAHL, and Cochrane Library and supplemented through hand searches of reference lists of included articles and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: The original and updated searches yielded a total of 76 systematic reviews and meta-analyses. Strong evidence demonstrated that moderate-intensity physical activity reduced the risk of excessive gestational weight gain, gestational diabetes, and symptoms of postpartum depression. Limited evidence suggested an inverse relationship between physical activity and risk of preeclampsia, gestational hypertension, and antenatal anxiety and depressive symptomology. Insufficient evidence was available to determine the effect of physical activity on postpartum weight loss, postpartum anxiety, and affect during both pregnancy and postpartum. For all health outcomes, there was insufficient evidence to determine whether the relationships varied by age, race/ethnicity, socioeconomic status, or prepregnancy weight status. CONCLUSIONS: The gestational period is an opportunity to promote positive health behaviors that can have both short- and long-term benefits for the mother. Given the low prevalence of physical activity in young women in general, and the high prevalence of obesity and cardiometabolic diseases among the U.S. population, the public health importance of increasing physical activity in women of childbearing age before, during, and after pregnancy is substantial.


Assuntos
Exercício Físico , Período Pós-Parto/fisiologia , Gravidez/fisiologia , Pesquisa Biomédica , Depressão Pós-Parto/prevenção & controle , Feminino , Ganho de Peso na Gestação/fisiologia , Humanos , Saúde Materna , Guias de Prática Clínica como Assunto , Complicações na Gravidez/prevenção & controle , Fatores Socioeconômicos , Perda de Peso/fisiologia
19.
Nat Commun ; 10(1): 1517, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30944304

RESUMO

Perinatal factors impact gut microbiota development in early life, however, little is known on the effects of these factors on microbes in later life. Here we sequence DNA from faecal samples of children over the first four years and reveal a perpetual evolution of the gut microbiota during this period. The significant impact of gestational age at birth and delivery mode on gut microbiota progression is evident in the first four years of life, while no measurable effects of antibiotics are found in the first year. Microbiota profiles are also characteristic in children dependant on gestational age and maturity. Full term delivery is characterised by Bacteroides (year one), Parabacteroides (year two) and Christensenellaceae (year four). Preterm delivery is characterised by Lactobacillus (year one), Streptococcus (year two) and Carnobacterium (year four). This study reveals that the gut retains distinct microbial profiles of perinatal factors up to four years of age.


Assuntos
Microbioma Gastrointestinal/fisiologia , Trato Gastrointestinal/microbiologia , Microbiota/fisiologia , Gravidez/fisiologia , Antibacterianos/farmacologia , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Pré-Escolar , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/efeitos dos fármacos , Microbioma Gastrointestinal/genética , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez/efeitos dos fármacos , Nascimento Prematuro , RNA Ribossômico 16S/genética
20.
Emerg Med Clin North Am ; 37(2): 351-363, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30940377

RESUMO

Many health care providers lack familiarity with maternal physiologic changes and the distinctive underlying etiology of cardiac arrest in pregnancy. Knowledge of what changes are expected in pregnancy and an understanding of how to adapt clinical practice is essential for the care of the pregnant woman in the emergency department. Amniotic fluid embolism should be recognized as a rare cause of cardiac arrest in pregnancy, characterized by the triad of cardiovascular collapse, hypoxic respiratory failure, and coagulopathy. Cardiopulmonary resuscitation should follow standard AHA ACLS guidelines. Resuscitative hysterotomy may be attempted to restore perfusion to both mother and fetus.


Assuntos
Serviço Hospitalar de Emergência , Complicações na Gravidez/terapia , Ressuscitação , Manuseio das Vias Aéreas , Reanimação Cardiopulmonar , Cesárea , Embolia Amniótica/diagnóstico , Embolia Amniótica/terapia , Feminino , Parada Cardíaca/complicações , Parada Cardíaca/diagnóstico , Parada Cardíaca/terapia , Humanos , Gravidez/fisiologia
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