scholarly journals Association of Colecalciferol, Ferritin, and Anemia among Pregnant Women: Result from Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia

Anemia ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Raden Tina Dewi Judistiani ◽  
Lani Gumilang ◽  
Sefita Aryuti Nirmala ◽  
Setyorini Irianti ◽  
Deni Wirhana ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
First Trimester ◽  
Strongly Correlated ◽  
Second Trimester ◽  
Iron Cycling ◽  
Third Trimester ◽  
Prepregnancy Body Mass Index ◽  
25 Oh Vitamin D

Studies had shown that iron-cycling was disturbed by inflammatory process through the role of hepcidin. Pregnancy is characterized by shifts of interleukin. Our objective was to determine if 25(OH) vitamin D (colecalciferol) status was associated with ferritin, anemia, and its changes during pregnancy. Method. A cohort study was done in 4 cities in West Java, Indonesia, beginning in July 2016. Subjects were followed up until third trimester. Examinations included were maternal ferritin, colecalciferol, and haemoglobin level. Result. 191 (95.5%) subjects had low colecalciferol, and 151 (75.5%) among them were at deficient state. Anemia is found in 15 (7.5%) subjects, much lower than previous report. Proportion of anemia increased by trimester among women with colecalciferol deficiency. Ferritin status and prepregnancy body mass index in the first trimester were correlated with anemia (r=0.147, p=0.038 and r=-0.56, p=0.03). Anemia in the second trimester was strongly correlated with anemia in the third trimester (r=0.676, p<0.01). Conclusion. Our study showed that the state of colecalciferol was not associated with either ferritin state or anemia, but proportion of anemia tends to increase by trimester in the colecalciferol deficient subjects.

scholarly journals Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels

2011 ◽  
Vol 106 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
R. K. Marwaha ◽  
N. Tandon ◽  
S. Chopra ◽  
N. Agarwal ◽  
M. K. Garg ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hypovitaminosis D ◽  
First Trimester ◽  
Strong Positive Correlation ◽  
Vitamin D Status ◽  
Second Trimester ◽  
Third Trimester ◽  
Indian Women ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

The present cross-sectional study was conducted to determine the vitamin D status of pregnant Indian women and their breast-fed infants. Subjects were recruited from the Department of Obstetrics, Armed Forces Clinic and Army Hospital (Research and Referral), Delhi. A total of 541 apparently healthy women with uncomplicated, single, intra-uterine gestation reporting in any trimester were consecutively recruited. Of these 541 women, 299 (first trimester, ninety-seven; second trimester, 125; third trimester, seventy-seven) were recruited in summer (April–October) and 242 (first trimester, fifty-nine, second trimester, ninety-three; third trimester, ninety) were recruited in winter (November–March) to study seasonal variations in vitamin D status. Clinical, dietary, biochemical and hormonal evaluations for the Ca–vitamin D–parathormone axis were performed. A subset of 342 mother–infant pairs was re-evaluated 6 weeks postpartum. Mean serum 25-hydroxyvitamin D (25(OH)D) of pregnant women was 23·2 (sd 12·2) nmol/l. Hypovitaminosis D (25(OH)D < 50 nmol/l) was observed in 96·3 % of the subjects. Serum 25(OH)D levels were significantly lower in winter in the second and third trimesters, while serum intact parathormone (iPTH) and alkaline phosphatase levels were significantly higher in winter in all three trimesters. A significant negative correlation was found between serum 25(OH)D and iPTH in mothers (r − 0·367, P = 0·0001) and infants (r − 0·56, P = 0·0001). A strong positive correlation was observed between 25(OH)D levels of mother–infant pairs (r 0·779, P = 0·0001). A high prevalence of hypovitaminosis D was observed in pregnancy, lactation and infancy with no significant inter-trimester differences in serum 25(OH)D levels.

scholarly journals The Mediating Role of Placental Weight Change in the Association Between Prenatal Exposure to Thallium and Birth Weight: A Prospective Birth Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
He Zhou ◽  
Xiaoli Sun ◽  
Yiding Wang ◽  
Yufeng Ye ◽  
Hanwei Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Prenatal Exposure ◽  
Inductively Coupled Plasma ◽  
First Trimester ◽  
Placental Weight ◽  
Birth Cohort Study ◽  
Third Trimester ◽  
Mediating Role

Background: Previous studies have demonstrated the embryotoxicity and fetotoxicity of thallium (Tl). However, the effects of prenatal exposure to Tl on birth weight and placental weight and the mediating role of placental weight in the association of Tl with birth weight remain unclear.Methods: We recruited 2,748 participants from the ongoing Prenatal Environment and Offspring Health Cohort (PEOH Cohort) study, which was initiated in 2016 in Guangzhou, China. The Tl concentrations in maternal urine samples collected during the first and third trimester were determined by inductively coupled plasma mass spectrometry. Birth weight and placental weight were extracted from maternal medical records.Results: Pregnant women exposed to the highest tertile of Tl in the first trimester (β = −42.7 g, 95% CI: −82.3, −3.1 g) and third trimester (β = −50.6 g, 95% CI: −99.0, −2.3 g) had babies with lower birth weights than those exposed to the lowest tertile. We also found significant negative associations of exposure to Tl concentrations in the first and third trimester with placental weight. Mediation analyses showed that 50.3% (95% CI: 15.9, 79.2%) and 33.5% (95% CI: 1.3, 80.3%) of the effects of Tl exposure in the first and third trimester on birth weight were mediated by decreased placental weight.Conclusion: Our results suggest that prenatal exposure to Tl is negatively associated with birth weight and that this association may be mediated by decreased placental weight.

scholarly journals Maternal exposure to ambient fine particulate matter and risk of premature rupture of membranes in Wuhan, Central China: a cohort study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Kun Wang ◽  
Yu Tian ◽  
Huabo Zheng ◽  
Shengshuai Shan ◽  
Xiaofang Zhao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Additive Model ◽  
Final Analysis ◽  
First Trimester ◽  
Maternal Exposure ◽  
Central China ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Third Trimester ◽  
Premature Rupture

Abstract Background The associations between maternal exposure to ambient PM2.5 during pregnancy and the risk of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) are controversial. And no relevant study has been conducted in Asia. This study aimed to determine the association between maternal exposure to ambient PM2.5 during pregnancy and the risk of (P)PROM. Methods A cohort study including all singleton births in a hospital located in Central China from January 2015 through December 2017 was conducted. Multivariable logistic regression models, stratified analysis, generalized additive model, and two-piece-wise linear regression were conducted to evaluate how exposure to ambient PM2.5 during pregnancy is associated with the risks of PROM and PPROM. Results A total of 4364 participants were included in the final analysis, where 11.71 and 2.34% of births were complicated by PROM and PPROM, respectively. The level of PM2.5 exhibited a degree of seasonal variation, and its median concentrations were 63.7, 59.3, 55.8, and 61.8 μg/m3 for the first trimester, second trimester, third trimester, and the whole duration of pregnancy, respectively. After adjustment for potential confounders, PROM was positively associated with PM2.5 exposure (per 10 μg/m3) [Odds Ratio (OR) = 1.14, 95% Confidence Interval (CI), 1.02–1.26 for the first trimester; OR = 1.09, 95% CI, 1.00–1.18 for the second trimester; OR = 1.13, 95% CI, 1.03–1.24 for the third trimester; OR = 1.35, 95% CI, 1.12–1.63 for the whole pregnancy]. PPROM had positive relationship with PM2.5 exposure (per 10 μg/m3) (OR = 1.17, 95% CI, 0.94–1.45 for first trimester; OR = 1.11, 95% CI, 0.92–1.33 for second trimester; OR = 1.19, 95% CI, 0.99–1.44 for third trimester; OR = 1.53, 95% CI, 1.03–2.27 for the whole pregnancy) Positive trends between the acute exposure window (mean concentration of PM2.5 in the last week and day of pregnancy) and risks of PROM and PPROM were also observed. Conclusions Exposure to ambient PM2.5 during pregnancy was associated with the risk of PROM and PPROM.

Venous Thrombosis during Pregnancy: Leg and Trimester of Presentation

1992 ◽  
Vol 67 (05) ◽  
pp. 519-520 ◽  
Author(s):  
J S Ginsberg ◽  
P Brill-Edwards ◽  
R F Burrows ◽  
R Bona ◽  
P Prandoni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thrombosis ◽  
First Trimester ◽  
Leg Pain ◽  
First Episode ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Left And Right ◽  
The Right

SummaryIn order to determine the relative frequencies of left and right leg venous thrombosis during pregnancy and the frequencies of venous thrombosis during the three trimesters, a cohort study of 60 consecutive patients with a first episode of venous thrombosis during pregnancy was performed. Fifty-eight women had isolated left leg thrombosis, two patients had bilateral venous thrombosis and no patient had isolated right leg venous thrombosis. Thirteen patients had venous thrombosis during the first trimester (21.7%), 28 during the second trimester (46.7%) and 19 during the third trimester (31.7%). These findings indicate that patients with symptoms in the right leg rarely have venous thrombosis. Because leg pain and swelling occur most frequently during the third trimester but venous thrombosis is relatively equally distributed during all three trimesters, patients presenting earlier during pregnancy are more likely to have venous thrombosis than patients presenting later during pregnancy.

scholarly journals The Role of Fetal Kidney Length and Fetal Transverse Diameter of Heart in Prediction of Gestational Age

2020 ◽  
Vol 5 (04) ◽  
Author(s):  
Panda Subrat ◽  
Rudrapal Gouri Sankar ◽  
Das Ananya ◽  
Ray Baruah Surajit ◽  
Sharma Nalini
Keyword(s):  
Gestational Age ◽  
First Trimester ◽  
Accurate Estimation ◽  
Transverse Diameter ◽  
Second Trimester ◽  
Fetal Kidney ◽  
Third Trimester ◽  
Kidney Length ◽  
Singleton Pregnancies

Objective: Currently there is no single ultrasonological parameter for accurate estimation of gestational age in third trimester. The present study is undertaken to validate the fetal kidney length and fetal transverse diameter of heart measurement as a measurement of fetal growth with less variability. Materials & Methods: It is a cohort study conducted in Department of Obstetrics and Gynaecology, NEIGRIHMS from 2015 to 2016. 224 women with singleton pregnancies and sure of LMP were enrolled. Each woman underwent minimum three ultrasonographic measurements- at first trimester for gestational age by CRL, at second trimester with fetal conventional biometry, at third trimester with Fetal kidney length, transverse diameter of heart and fetal conventional biometric parameters and analysed with SPSS Version22. Results: The gestational age with CRL was within three days of the menstrual age. In second trimester, conventional parameter (BPD,HC,AC,FL) were better parameters. Conventional parameter did not correspond to gestational age calculated from LMP. (BPD, R2= 0.4819, HC R2- 0.507, AC R2- 0.5175, FL R2-0.5243, Combined Conventional parameter R2- 0.5888). Fetal kidney length (R2-0.8356) and transverse diameter of heart (R2-0.8795) better correlated with gestational age. Conclusion: Kidney length and transverse diameter of heart are better predictors of gestational age in third trimester.

Serum 25 hydroxycholecalciferol levels throughout pregnancy - A cross-sectional study in South Indian Pregnant Women

2021 ◽  
Vol 12 (4) ◽  
pp. 2330-2334
Author(s):  
Julie Christy A ◽  
Saraswathi Perumal ◽  
Sumathy G
Keyword(s):  
Vitamin D ◽  
Venous Blood ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Cross Sectional ◽  
The Third ◽  
South Indian ◽  
Vitamin D Levels

Vitamin D deficiency has been reported worldwide. It has been reported at suboptimal levels in gestation. The levels vary during various trimesters of pregnancy. This article focuses on the gestation week wise variations observed in the serum cholecalciferol levels during gestation. 100 venous blood samples were collected from singleton, non-smoking pregnancies. The samples were collected in the summer and winter seasons during various weeks of pregnancy. The samples were collected randomly in patients who were not supplemented with vitamin D. The serum cholecalciferol levels were observed to be deficient during the first trimester (below<30 ng/ml), there was an increase in the vitamin D levels in the second trimester (levels<30 ng/ml). During the third trimester, the levels increased gradually. The ratio of cases deficient during the first trimester was higher when compared to the second and third trimesters. The serum cholecalciferol levels remain deficient due to the foetal organogenesis in the first trimester. The serum 25 hydroxy cholecalciferol levels are compensated with the development of the placenta. During the second trimester, it gradually increases and reaches sufficient limits during the third trimester.

scholarly journals Serum cystatin is not a marker of glomerular filtration rate in pregnancy

2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata
Keyword(s):  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Serum Cystatin ◽  
In Pregnancy

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

scholarly journals Infliximab clearance decreases in the second and third trimesters of pregnancy in inflammatory bowel disease

2020 ◽  
pp. 205064062096461
Author(s):  
Ana-Marija Grišić ◽  
Maria Dorn-Rasmussen ◽  
Bella Ungar ◽  
Jørn Brynskov ◽  
Johan F K F Ilvemark ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
First Trimester ◽  
Interquartile Range ◽  
Therapeutic Drug ◽  
Population Pharmacokinetic ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Inflammatory Bowel

Background Infliximab therapy during pregnancy in inflammatory bowel disease is challenged by a dilemma between maintaining adequate maternal disease control while minimizing fetal infliximab exposure. We investigated the effects of pregnancy on infliximab pharmacokinetics. Methods The study population comprised 23 retrospectively identified pregnancies. Patients with inflammatory bowel disease were generally in clinical remission at pregnancy conception (74%) and received steady infliximab maintenance therapy (5 mg/kg q8w n = 17; q6w n = 4; q10w n = 1; 10 mg/kg q8w n = 1). Trough blood samples had been obtained in the same patients prior to pregnancy ( n = 119), the first trimester ( n = 16), second trimester ( n = 18), third trimester ( n = 7), and post-pregnancy ( n = 12). Data were analyzed using nonlinear mixed-effects population pharmacokinetic modelling. Results Dose-normalized infliximab concentrations were significantly higher during the second trimester (median 15 µg/mL/kg, interquartile range 10–21) compared to pre-pregnancy (7, 2–12; p = 0.003), the first trimester (9, 1–12; p = 0.04), or post-pregnancy (6, interquartile range 3–11; p > 0.05) in patients with inflammatory bowel disease. Similar trends were observed in the third trimester (13, 7–36; p > 0.05). A one-compartment model with linear elimination described the pharmacokinetics of infliximab (volume of distribution = 18.2 L; clearance 0.61 L/day). Maternal infliximab exposure was influenced by the second and third trimester of pregnancy and anti-infliximab antibodies, and not by pregnancy-imposed physiological changes in, for example, body weight or albumin. Infliximab clearance decreased significantly during the second and third trimesters by up to 15% as compared to pre- and post-pregnancy and the first trimester. The increased maternal infliximab exposure was weakly associated with lowered clinical disease activity. Pharmacokinetic model simulations of virtual patients indicated the increased maternal infliximab trough concentrations imposed by pregnancy will not completely counteract the decrease in infliximab concentration if therapy is paused in the third trimester. Conclusion Infliximab clearance decreases significantly in the second and third trimesters, leading to increasing maternal infliximab concentrations in any given regimen. Maternal infliximab levels may thus be maintained as constant in a de-intensified regimen by therapeutic drug monitoring guidance in inflammatory bowel disease.

Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

1997 ◽  
pp. 402-409 ◽  
Author(s):  
MS Ardawi ◽  
HA Nasrat ◽  
HS BA'Aqueel
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Longitudinal Study ◽  
First Trimester ◽  
Second Trimester ◽  
Human Pregnancy ◽  
Pregnancy And Postpartum ◽  
Normal Human ◽  
Parathyroid Hormone Related Peptide

OBJECTIVES: To evaluate calcium-regulating hormones and parathyroid hormone-related peptide (PTHrP) in normal human pregnancy and postpartum in women not deficient in vitamin D. DESIGN: A prospective longitudinal study was conducted in pregnant Saudi women during the course of pregnancy (n = 40), at term and 6 weeks postpartum (n = 18). Maternal concentrations of serum calcidiol and calcitriol were determined, together with those of serum intact-parathyroid hormone (PTH), PTHrP, calcitonin, osteocalcin, human placental lactogen (hPL), prolactin, vitamin D binding protein, alkaline phosphatase, calcium, phosphate and magnesium. A group of non-pregnant women (n = 280) were included for comparative purposes. RESULTS: The calcidiol concentrations decreased (mean +/- S.D.) significantly from 54 +/- 10 nmol/l in the first trimester to 33 +/- 8 nmol/l in the third trimester (P < 0.001) and remained decreased at term and postpartum (both P < 0.001). The calcitriol concentration increased through pregnancy, from 69 +/- 17 pmol/l in the first trimester to 333 +/- 83 pmol/l at term (P < 0.001). Intact-PTH concentrations increased from 1.31 +/- 0.25 pmol/l in the first trimester to 2.26 +/- 0.39 pmol/l in the second trimester, but then declined to values of the first trimester and increased significantly postpartum (4.02 +/- 0.36 pmol/l) (P < 0.001). PTHrP concentration increased through pregnancy from 0.81 +/- 0.12 pmol/l in the first trimester to 2.01 +/- 0.22 pmol/l at term and continued its increase postpartum (2.63 +/- 0.15 pmol/l) (P < 0.001). Significant positive correlations were evident between PTHrP and alkaline phosphatase up to term (r = 0.051, P < 0.001) and between PTHrP and calcitriol (r = 0.46, P < 0.001), osteocalcin (r = 0.23, P < 0.05) and prolactin (r = 0.41, P < 0.05) during pregnancy. Osteocalcin started to increase from 0.13 +/- 0.01 nmol/l in the second trimester, through pregnancy and postpartum (P < 0.001). Calcitonin was increased more than twofold by the second trimester compared with the first trimester (P < 0.001) and subsequently decreased (P < 0.001). Prolactin concentrations were significantly greater in the second (6724 +/- 1459 pmol/l) and third (8394 +/- 2086 pmol/l) trimesters compared with values before pregnancy (P < 0.001). hPL, increased throughout the course of pregnancy, reaching a maximum at term (7.61 +/- 2.57 microIU/ml). There was no direct correlation between serum calcitriol concentrations during pregnancy and serum prolactin (r = -0.12, P < 0.19) or serum hPL (r = 0.17, P < 0.21). Significant changes were observed in the serum concentrations of calcium and phosphate, but not in that of magnesium, during the course of pregnancy; calcium concentrations showed a maximal decrease at term. CONCLUSIONS: Changes in serum PTHrP during the course of pregnancy, at term and postpartum have been demonstrated, suggesting that the placenta (during pregnancy) and mammary glands (postpartum) are the main sources of PTHrP. No support for the concept of 'physiological hyperparathyroidism' of pregnancy could be demonstrated in the present work. The pregnancy-induced increase in calcitriol concentration may thus be the primary mediator of the changes in maternal calcium metabolism, but the involvement of other factors cannot be excluded.

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