Raiten, Daniel J; Mulligan, Kathleen; Papathakis, Peggy; Wanke, Christine
The HIV pandemic continues to place an unbearable burden on the international community, with disease prevalence remaining highest in resource-limited settings in Africa, Asia, and the Americas. HIV is most often imposed on conditions of food insecurity and consequent malnutrition, poor sanitation, and chronic exposure to a myriad of infectious (eg, malaria, tuberculosis, and diarrheal) and noncommunicable (eg, obesity, diabetes, cancer, and cardiovascular) diseases. Women and children continue to bear the greatest burden. Two essential tenets underpin our approach to HIV: 1) antiretroviral drugs (ARVs) are essential to prolong lives and to halt the spread of HIV and AIDS and 2) food and sound nutrition are essential to human health. The challenge is to apply sound principles of clinical care and nutrition science to the safe and efficacious implementation of ARVs and for long-term care for people living with HIV and AIDS. The WHO has played a leading role in developing guidelines to support this goal with the generation of general recommendations regarding nutritional needs of people living with HIV and AIDS and specific guidelines for the nutritional care of HIV-infected infants and children (<14 y of age). These proceedings represent a summary of the work accomplished at a workshop sponsored by the NIH to review the existing evidence to support changes in the recommendations regarding nutrient requirements for people living with HIV and AIDS; to support development of new WHO guidelines for adolescents and adults, including for pregnant and lactating women; and to identify a research agenda to address outstanding knowledge gaps. PMID:22089438
... Healthcare Professionals Lung Disease including Asthma and Adult Vaccination Language: English Español (Spanish) Recommend on Facebook Tweet ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...
Background Early and frequent antenatal care attendance during pregnancy is important to identify and mitigate risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. However, many pregnant women in sub-Saharan Africa start antenatal care attendance late, particularly adolescent pregnant women. Therefore they do not fully benefit from its preventive and curative services. This study assesses the timing of adult and adolescent pregnant women's first antenatal care visit and identifies factors influencing early and late attendance. Methods The study was conducted in the Ulanga and Kilombero rural Demographic Surveillance area in south-eastern Tanzania in 2008. Qualitative exploratory studies informed the design of a structured questionnaire. A total of 440 women who attended antenatal care participated in exit interviews. Socio-demographic, social, perception- and service related factors were analysed for associations with timing of antenatal care initiation using regression analysis. Results The majority of pregnant women initiated antenatal care attendance with an average of 5 gestational months. Belonging to the Sukuma ethnic group compared to other ethnic groups such as the Pogoro, Mhehe, Mgindo and others, perceived poor quality of care, late recognition of pregnancy and not being supported by the husband or partner were identified as factors associated with a later antenatal care enrolment (p < 0.05). Primiparity and previous experience of a miscarriage or stillbirth were associated with an earlier antenatal care attendance (p < 0.05). Adolescent pregnant women started antenatal care no later than adult pregnant women despite being more likely to be single. Conclusions Factors including poor quality of care, lack of awareness about the health benefit of antenatal care, late recognition of pregnancy, and social and economic factors may influence timing of antenatal care. Community-based interventions are needed that involve
Melzer, Katarina; Heydenreich, Juliane; Schutz, Yves; Renaud, Anne; Kayser, Bengt; Mäder, Urs
“Metabolic Equivalent” (MET) represents a standard amount of oxygen consumed by the body under resting conditions, and is defined as 3.5 mL O2/kg × min or ~1 kcal/kg × h. It is used to express the energy cost of physical activity in multiples of MET. However, universal application of the 1-MET standard was questioned in previous studies, because it does not apply well to all individuals. Height, weight and resting metabolic rate (RMR, measured by indirect calorimetry) were measured in adolescent males (n = 50) and females (n = 50), women during pregnancy (gestation week 35–41, n = 46), women 24–53 weeks postpartum (n = 27), and active men (n = 30), and were compared to values predicted by the 1-MET standard. The RMR of adolescent males (1.28 kcal/kg × h) was significantly higher than that of adolescent females (1.11 kcal/kg × h), with or without the effects of puberty stage and physical activity levels. The RMR of the pregnant and post-pregnant subjects were not significantly different. The RMR of the active normal weight (0.92 kcal/kg × h) and overweight (0.89 kcal/kg × h) adult males were significantly lower than the 1-MET value. It follows that the 1-MET standard is inadequate for use not only in adult men and women, but also in adolescents and physically active men. It is therefore recommended that practitioners estimate RMR with equations taking into account individual characteristics, such as sex, age and Body Mass Index, and not rely on the 1-MET standard. PMID:27447667
Melzer, Katarina; Heydenreich, Juliane; Schutz, Yves; Renaud, Anne; Kayser, Bengt; Mäder, Urs
"Metabolic Equivalent" (MET) represents a standard amount of oxygen consumed by the body under resting conditions, and is defined as 3.5 mL O₂/kg × min or ~1 kcal/kg × h. It is used to express the energy cost of physical activity in multiples of MET. However, universal application of the 1-MET standard was questioned in previous studies, because it does not apply well to all individuals. Height, weight and resting metabolic rate (RMR, measured by indirect calorimetry) were measured in adolescent males (n = 50) and females (n = 50), women during pregnancy (gestation week 35-41, n = 46), women 24-53 weeks postpartum (n = 27), and active men (n = 30), and were compared to values predicted by the 1-MET standard. The RMR of adolescent males (1.28 kcal/kg × h) was significantly higher than that of adolescent females (1.11 kcal/kg × h), with or without the effects of puberty stage and physical activity levels. The RMR of the pregnant and post-pregnant subjects were not significantly different. The RMR of the active normal weight (0.92 kcal/kg × h) and overweight (0.89 kcal/kg × h) adult males were significantly lower than the 1-MET value. It follows that the 1-MET standard is inadequate for use not only in adult men and women, but also in adolescents and physically active men. It is therefore recommended that practitioners estimate RMR with equations taking into account individual characteristics, such as sex, age and Body Mass Index, and not rely on the 1-MET standard. PMID:27447667
Briggs, Gerald G; Polifka, Janine E; Wisner, Katherine L; Gervais, Eric; Miller, Richard K; Berard, Anick; Koren, Gideon; Forinash, Alicia; Towers, Craig V
Relatively few drugs, especially those recently approved by the US Food and Drug Administration, have published human pregnancy experience. Although all drugs contain animal reproduction data, these are usually not predictive of human risk. Clinical trials in pregnant women are rarely conducted because of ethical and legal concerns, and it may be many years before sufficient observational data are collected to guide clinical treatment decisions. Because many of these drugs will be used in pregnancy, human data are needed shortly after the drugs come to the market. Lack of human data leads to uncertainty over whether a drug can be safely prescribed for a pregnant patient. Unless there are compelling scientific and ethical reasons to exclude them, pregnant women should be included in phase IV clinical trials (postmarketing studies to obtain additional information, including the risks, benefits, and optimal use of a drug). This paper examines how physicians currently counsel pregnant women when there are no human data and proposes an alternative method in which knowledge regarding risks associated with the use of drugs during pregnancy can be enhanced in a clinical trial setting. PMID:26008178
Hsu, Jean W; Thame, Minerva M; Gibson, Raquel; Baker, Tameka M; Tang, Grace J; Chacko, Shaji K; Jackson, Alan A; Jahoor, Farook
During pregnancy, glycine and serine become more important because they are the primary suppliers of methyl groups for the synthesis of fetal DNA, and more glycine is required for fetal collagen synthesis as pregnancy progresses. In an earlier study, we reported that glycine flux decreased by 39% from the first to the third trimester in pregnant adolescent girls. As serine is a primary precursor for glycine synthesis, the objective of this study was to measure and compare glycine and serine fluxes and inter-conversions in pregnant adolescent girls and adult women in the first and third trimesters. Measurements were made after an overnight fast by continuous intravenous infusions of 2H2-glycine and 15N-serine in eleven adolescent girls (17·4 (se 0·1) years of age) and in ten adult women (25·8 (se 0·5) years of age) for 4 h. Adolescent girls had significantly slower glycine flux and they made less glycine from serine in the third (P<0·05) than in the first trimester. Baby birth length was significantly shorter of adolescent girls (P=0·04) and was significantly associated with third trimester glycine flux. These findings suggest that the pregnant adolescent cannot maintain glycine flux in late pregnancy compared with early pregnancy because of decreased synthesis from serine. It is possible that the inability to maintain glycine synthesis makes her fetus vulnerable to impaired cartilage synthesis, and thus linear growth. PMID:26785702
Madigan, Sheri; Vaillancourt, Kyla; McKibbon, Amanda; Benoit, Diane
This present student examines maltreatment experiences reported by 55 high-risk pregnant adolescents in response to a slightly adapted version of the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996 ). Previous research has suggested that the rates of unresolved states of mind regarding trauma in response to the AAI may be underestimated due to the lack of direct questions and associated probes regarding physical, sexual, and emotional abuse. We address this concern by including behaviorally phrased questions and probes regarding maltreatment experiences into the original format of the AAI and examine the concordance between reports of maltreatment experiences in response to the AAI and the Childhood Trauma Questionnaire (CTQ). Maltreatment experiences in response to the AAI were evaluated using the Maltreatment Classification Scale developed by Barnett, Manly, and Cicchetti (1993). We also examine the association between unresolved states of mind and dissociation using the Adolescent Dissociative Experience Scale. Results revealed a significant concordance between reports of maltreatment in response to the AAI and CTQ measures. Reports of maltreatment were prevalent in this sample: across the AAI and CTQ measures, 96% of pregnant adolescents reported some form of emotional abuse, 84% physical abuse, 59% sexual abuse, and 88% reported neglect. Sexual abuse history uniquely predicted unresolved status in response to the AAI. Self-reports of dissociation were significantly associated with unresolved states of mind. Results suggest that the inclusion of behaviorally focused questions and probes regarding maltreatment in the AAI protocol can further contribute to the clinical and theoretical value of this tool. PMID:22385310
... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted before April 7, 2006. 26.1704 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted...
... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults initiated after April 7, 2006. 26.1705 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults initiated...
... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted after April 7, 2006. 26.1705 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted...
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted after April 7, 2006. 26.1705 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted...
... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults initiated after April 7, 2006. 26.1705 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults initiated...
... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted after April 7, 2006. 26.1705 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted...
... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted before April 7, 2006. 26.1704 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted...
... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults. 26.1704 Section 26.1704 Protection of Environment... research with non-pregnant, non-nursing adults. (a) This section applies to research subject to...
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted before April 7, 2006. 26.1704 Section 26... Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults conducted...
... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Prohibition of reliance on unethical human research with non-pregnant, non-nursing adults. 26.1704 Section 26.1704 Protection of Environment... research with non-pregnant, non-nursing adults. (a) This section applies to research subject to...
Escota, Gerome; Önen, Nur
Tobacco use is inextricably linked to a number of health risks both in the general and HIV-infected populations. There is, however, a dearth of research on effective tobacco control programs among people living with HIV, and especially among adolescents, young adults and pregnant women, groups with heightened or increased vulnerability secondary to tobacco use. Adolescents and young adults constitute a growing population of persons living with HIV infection. Early and continued tobacco use in this population living with a disease characterized by premature onset multimorbidity and chronic inflammation is of concern. Additionally, there is an increased acuity for tobacco control among HIV-infected pregnant women to reduce pregnancy morbidity and improve fetal outcome. This review will provide an important summary of current knowledge of tobacco use among HIV-infected adolescents, young adults and pregnant women. The effects of tobacco use in these specific populations will be presented and the current state of tobacco control within these populations, assessed. PMID:23778059
Hildebrand, Henner; Hinzen, Heribert
The Institute for International Co-operation of the German Adult Education Association, otherwise known as the IIZ/DVV, is based in Bonn. Germany and has more than 40 years of service in various projects in different countries. The Institute is known for the publication of the journal "Adult Education and Development," the most widely disseminated…
Jack, Allison; Pelphrey, Kevin A
Recent work suggests that biological motion perception is supported by interactions between posterior superior temporal sulcus (pSTS) and regions of the posterior lobe of the cerebellum. However, insufficient attention has been given to cerebellar contributions to most other social cognitive functions, including ones that rely upon the use of biological motion cues for making mental inferences. Here, using adapted Heider and Simmel stimuli in a passive-viewing paradigm, we present functional magnetic resonance imaging evidence detailing cerebellar contributions to animacy attribution processes in healthy adults. We found robust cerebellar activity associated with viewing animate versus random movement in hemispheric lobule VII bilaterally as well as in vermal and paravermal lobule IX. Stronger activity in left Crus I and lobule VI was associated with a greater tendency to describe the stimuli in social-affective versus motion-related terms. Psychophysiological interaction analysis indicated preferential effective connectivity between right pSTS and left Crus II during the viewing of animate than random stimuli, controlling for individual variance in social attributions. These findings indicate that lobules VI, VII, and IX participate in social functions even when no active response is required. This cerebellar activity may also partially explain individual differences in animacy attribution. PMID:24981794
Divney, Anna A.; Magriples, Urania; Hansen, Nathan; Gordon, Derrick; Kershaw, Trace
Abstract Background Rates of breastfeeding remain disproportionately low among young mothers in the United States. Although breastfeeding behavior may be most directly related to breastfeeding intention, little is known about breastfeeding intentions among young women who are expecting a baby. Subjects and Methods Pregnant adolescents and young adults (14–21 years old) and their male partners were recruited for participation. Females were asked if they intended to breastfeed, and their partners were asked if they wanted their partners to breastfeed; participants indicated reasons for their responses. Logistic regression modeling was used to determine the associations between breastfeeding intentions and sociodemographic characteristics, relationship characteristics, and partner's intention to breastfeed. Results Approximately 73% of females reported intending to breastfeed, and 80% of males reported wanting his partner to breastfeed, most commonly because it is “healthier for the baby” and “a more natural way to feed the baby.” Sociodemographic and relationship characteristics explained a small amount of variance of breastfeeding intention (15% and 4% among females, respectively, and 8% and 4% among males, respectively). Partner intention explained an additional 23% and 24% of the variance in individual intention for females and males, respectively. Females who had experienced intimate partner violence (IPV) from their current partner had lower odds of intending to breastfeed (odds ratio=0.37; 95% confidence interval=0.16, 0.84). Race/ethnicity modified associations among both genders. Conclusions These findings emphasize the importance of dyadic approaches and suggest strategies for improving breastfeeding intentions and behavior among young couples expecting a baby. These results are also among the first to document the relationship between IPV and breastfeeding intentions among young women. PMID:23611330
Kanfer, Frederick H.; Englund, Susan; Lennhoff, Claudia; Rhodes, Jean
Intended for adults working with expectant and new teen mothers, this guide provides techniques and strategies for helping the teen mother develop skills needed to achieve parenting and life goals. The first half of the guide explores the relationship between the adult mentor and teen parent, and steps toward problem solving and positive change.…
Poe, Elizabeth Ann
Applying reader response theory, a study explored the responses of 19 pregnant adolescents and teenage mothers to two dissimilar young adult novels, one about teenage pregnancy and one about adolescent alcoholism. Quantitative analysis, using a modified version of the Purves-Rippere (1968) system, and qualitative analysis of written answers to…
National Institute for Literacy, 2010
Included here are two appendixes to "Adult Education Literacy Instruction: A Review of the Research." Appendix A, "Adult Studies," contains: (1) Assessment Profiles; (2) Alphabetics; (3) Fluency; (4) Vocabulary; and (5) Comprehension. Appendix B, "Adolescent Studies," contains: (1) Alphabetics; (2) Fluency; (3) Vocabulary; and (4) Comprehension.…
McDonald, Katherine E.; Kidney, Colleen A.; Nelms, Sandra L.; Parker, Michael R.; Kimmel, Ali; Keys, Christopher B.
Social and cognitive characteristics of adults with intellectual disabilities (ID) place them at risk for inappropriate inclusion in or exclusion from research participation. As we grapple with how to include adults with ID in research in order to secure their right to contribute to scientific advancements and be positioned to derive benefit from…
Weber, M; Ayoubi, J-M; Picone, O
The developmental origins of human adult disease are thought to be secondary to a perturbation of the embryonic or fetal development, which leads to metabolic disorders such as diabetes or hypertension at adulthood. Maternal undernutrition or overnutrition, repeated glucocorticosteroids administered to the mother, or placental dysfunction are the most frequently considered causal factors. Therefore, it is necessary that the pediatrician is aware of these phenomena, as this knowledge may contribute to the prevention of adult diseases. Little is known yet, however, on the pathophysiological or epigenetic mechanisms that lead to theses observations, and more studies are needed both in humans and animal models. PMID:25440770
Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos
Depression during pregnancy has been scantily studied in Mexican women. We aimed to determine the prevalence and correlates of depression in adult pregnant women attending a public hospital in the northern Mexican city of Durango, Mexico. Through a cross-sectional study design, we assessed depression in 270 adult pregnant women attended for prenatal care in a public hospital using a validated Mexican version of the Edinburg Postnatal Depression Scale in pregnancy and further confirmation by a psychiatric evaluation using the DSM-IV criteria for depression. Prevalence association with socio-demographic, clinical and psychosocial characteristics of the pregnant women was also investigated. Of the 270 pregnant women studied, 101 (37.4%) had EPDS scores equal to or higher than nine. Depression was confirmed in 56 (20.7%) women. Of them, 42 suffered from minor depression and 14 from major depression. Multivariate analysis of socio-demographic, clinical and psychosocial characteristics of the women showed that depression was associated with depression before pregnancy (OR = 3.36; 95% CI: 1.20-9.40; P=0.02), anxiety during pregnancy (OR = 9.38; 95% CI: 1.87-46.96; P=0.006), smoking (OR = 25.05; 95% CI: 1.77-353.07; P=0.01), unhappy with the fetal sex (OR = 8.53; 95% CI: 2.46-29.48; P<0.001), and unintended pregnancy (OR = 2.90; 95% CI: 1.07-7.86; P=0.03). Results indicate that about one fifth of the pregnant women studied had confirmed depression. This is the first report of an association of prenatal depression with unhappiness with the fetal sex. Factors associated with prenatal depression found in this study may help for the optimal design of preventive measures against prenatal depression. PMID:27127452
Bhandari, Shreya; Bullock, Linda F. C.; Bair-Merritt, Megan; Rose, Linda; Marcantonio, Kristin; Campbell, Jacquelyn C.; Sharps, Phyllis
The current study explored the views of women experiencing interpersonal violence (IPV) and their relationship with their mothers or other supportive adult, and determines how this relationship affected perinatal depressive symptoms. The sample consisted of 30 urban and rural pregnant women enrolled in a larger ongoing randomized controlled trial. Data from quantitative instruments that measured depressive symptoms were examined in combination with qualitative interview data collected at baseline and six months post-natal. Women describing positive relationships with their mothers or another supportive adult reported statistically significant lower depressive symptoms scores (p < .05). PMID:23215984
Swamy, Geeta K.; Heine, R. Phillips
In the United States, eradication and reduction of vaccine-preventable diseases through immunization has directly increased life expectancy by reducing mortality. Although immunization is a public priority, vaccine coverage among adult Americans is inadequate. The Institute of Medicine, the Community Preventive Services Task Force, and other public health entities have called for the development of innovative programs to incorporate adult vaccination into routine clinical practice. Obstetrician–gynecologists are well-suited to serve as vaccinators of women in general and more specifically pregnant women. Pregnant women are at risk for vaccine-preventable disease–related morbidity and mortality and adverse pregnancy outcomes, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. In addition to providing direct maternal benefit, vaccination during pregnancy likely provides direct fetal and infant benefit through passive immunity (transplacental transfer of maternal vaccine-induced antibodies). This article reviews: 1) types of vaccines; 2) vaccines specifically recommended during pregnancy and postpartum; 3) vaccines recommended during pregnancy and postpartum based on risk factors and special circumstances; 4) vaccines currently under research and development for licensure for maternal-fetal immunization; and 5) barriers to maternal immunization and available patient and provider resources. PMID:25560127
Swamy, Geeta K; Heine, R Phillips
In the United States, eradication and reduction of vaccine-preventable diseases through immunization has directly increased life expectancy by reducing mortality. Although immunization is a public priority, vaccine coverage among adult Americans is inadequate. The Institute of Medicine, the Community Preventive Services Task Force, and other public health entities have called for the development of innovative programs to incorporate adult vaccination into routine clinical practice. Obstetrician-gynecologists are well suited to serve as vaccinators of women in general and more specifically pregnant women. Pregnant women are at risk for vaccine-preventable disease-related morbidity and mortality and adverse pregnancy outcomes, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. In addition to providing direct maternal benefit, vaccination during pregnancy likely provides direct fetal and neonatal benefit through passive immunity (transplacental transfer of maternal vaccine-induced antibodies). This article reviews: 1) types of vaccines; 2) vaccines specifically recommended during pregnancy and postpartum; 3) vaccines recommended during pregnancy and postpartum based on risk factors and special circumstances; 4) vaccines currently under research and development for licensure for maternal-fetal immunization; and 5) barriers to maternal immunization and available patient and health care provider resources. PMID:25560127
Bird, Brian H.; Maartens, Louis H.; Campbell, Shelley; Erasmus, Baltus J.; Erickson, Bobbie R.; Dodd, Kimberly A.; Spiropoulou, Christina F.; Cannon, Deborah; Drew, Clifton P.; Knust, Barbara; McElroy, Anita K.; Khristova, Marina L.; Albariño, César G.; Nichol, Stuart T.
Rift Valley fever virus (RVFV) is a mosquito-borne human and veterinary pathogen causing large outbreaks of severe disease throughout Africa and the Arabian Peninsula. Safe and effective vaccines are critically needed, especially those that can be used in a targeted one-health approach to prevent both livestock and human disease. We report here on the safety, immunogenicity, and efficacy of the ΔNSs-ΔNSm recombinant RVFV (rRVFV) vaccine (which lacks the NSs and NSm virulence factors) in a total of 41 sheep, including 29 timed-pregnant ewes. This vaccine was proven safe and immunogenic for adult animals at doses ranging from 1.0 × 103 to 1.0 × 105 PFU administered subcutaneously (s.c.). Pregnant animals were vaccinated with 1.0 × 104 PFU s.c. at day 42 of gestation, when fetal sensitivity to RVFV vaccine-induced teratogenesis is highest. No febrile reactions, clinical illness, or pregnancy loss was observed following vaccination. Vaccination resulted in a rapid increase in anti-RVFV IgM (day 4) and IgG (day 7) titers. No seroconversion occurred in cohoused control animals. A subset of 20 ewes progressed to full-term delivery after vaccination. All lambs were born without musculoskeletal, neurological, or histological birth defects. Vaccine efficacy was assessed in 9 pregnant animals challenged at day 122 of gestation with virulent RVFV (1.0 × 106 PFU intravenously). Following challenge, 100% (9/9) of the animals were protected, progressed to full term, and delivered healthy lambs. As expected, all 3 sham-vaccinated controls experienced viremia, fetal death, and abortion postchallenge. These results demonstrate that the ΔNSs-ΔNSm rRVFV vaccine is safe and nonteratogenic and confers high-level protection in sheep. PMID:21976656
Rothenberg, Sarah E.; Korrick, Susan A.; Fayad, Raja
Background In animal studies obesity is associated with higher blood and tissue mercury concentrations; however human studies are lacking. Although the mechanism underlying this association is uncertain, obesity may alter the metabolism and distribution of methylmercury. Objectives We determined whether obesity influenced blood mercury levels, the majority of which was methylmercury, for U.S. non-pregnant adults (≥20 years) and children (2–19 years) after controlling for methylmercury intake through fish and shellfish consumption, and other confounders. Methods We completed secondary data analysis of the National Health and Nutrition Examination Survey (NHANES) (2007–2010) for participants who consumed fish/shellfish within 24 hours of blood collection for mercury analysis. Weighted least squares regression models related blood mercury levels (the dependent variable) to methylmercury exposure (μg) from fish consumed in the previous 24 hours, body mass index (BMI) (for adults), BMI z-scores (for children), and other confounders. Results: In adjusted models, blood mercury levels were inversely correlated with BMI for adults [β, 95% confidence interval (CI) = −0.54 (−0.90, −0.18)]. For children, blood mercury levels were inversely correlated with BMI z-scores but the trend was not significant [β (95% CI) = −0.016 (−0.066, 0.035)]. When obese adults or children were compared with those who were overweight/normal weight, blood mercury averaged 22% lower for obese adults (95% CI: −33%, −8.2%), while blood mercury did not differ significantly for obese children [β (95% CI) = −1.7% (−31%, +39%)]. Conclusions After adjusting for the main, if not exclusive, exogenous source of methylmercury exposure (through fish/shellfish intake) and other confounders, our results support potential changes in the metabolism, distribution or excretion of methylmercury with increasing BMI (for adults). PMID:25721244
Fuchi, Naoki; Miura, Kiyonori; Imaizumi, Yoshitaka; Hasegawa, Hiroo; Yanagihara, Katsunori; Miyazaki, Yasushi; Masuzaki, Hideaki
Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia-lymphoma (ATL), which is difficult to cure. In Japan, a nationwide HTLV-1 screening test in pregnant women has been recommended since 2011. A 30-year-old woman was diagnosed as being an HTLV-1 carrier in her previous pregnancy. During the current pregnancy, she had persistent fever and cough. Although she had treatment with antibiotics, peripheral white blood cell count remained high, with an abnormal lymphocyte count. Given that she was an HTLV-1 carrier, she was diagnosed with unfavorable chronic ATL (aggressive ATL) at 12 weeks gestation. After pregnancy termination, her ATL status became favorable chronic ATL (indolent ATL). Therefore, watchful waiting was performed until disease progression. This is the first case report of chronic ATL in early pregnancy, in a woman already diagnosed as an HTLV-1 carrier on screening test. PMID:26663442
Kalra, Nishant; Klewer, Scott E; Raasch, Hannah; Sorrell, Vincent L
There has been a steady rise in the prevalence of severe congenital heart disease (CHD) in adults because of improved treatment and survival during childhood. This has resulted in a shift in CHD morbidity and mortality beyond 18 years of age. The healthcare community must be prepared to meet this new challenge. Adult cardiologists need to be aware of common CHD, such as tetralogy of Fallot (TOF), as they will encounter adults with this CHD in their practice. With routine monitoring, cardiac imaging, early intervention, and treatment as highlighted in this report, continued improvement in the long-term fitness and avoidance of late complications for adult TOF patient is anticipated. PMID:20576040
... gov/medlineplus/news/fullstory_157683.html Combo Treatment Protects Pregnant Women, Fetuses From Malaria in Study Findings ... widely used to treat malaria in adults also protects pregnant women and their fetuses from the disease, ...
Pinho, Teresa; Neves, Manuel; Alves, Célia
This article describes the complex dental treatment of an adult patient with multiple missing teeth, mild chronic periodontitis, and a malocclusion with a cant of the occlusal plane. After periodontal treatment, titanium implants and a miniscrew were placed to correct the occlusal plane canting with orthodontic treatment. Prosthodontic treatment was completed by using osseointegrated implants to replace the missing teeth. PMID:22858334
Sadler, Matthew D; Crotty, Pam; Fatovich, Linda; Wilson, Stephanie; Rabin, Harvey R; Myers, Robert P
BACKGROUND: Liver disease is the third leading cause of mortality in patients with cystic fibrosis (CF). However, detection of CF-associated liver disease (CFLD) is challenging. OBJECTIVE: To evaluate the diagnostic performance of noninvasive methods for the detection of CFLD with a focus on transient elastography (TE). METHODS: Patients at the Adult CF Clinic of Calgary and Southern Alberta (n=127) underwent liver stiffness measurement (LSM) by TE using the FibroScan (FS, Ecosens, France) M probe; aspartate amino-transferase to platelet ratio index (APRI) and FibroTest (FT) scores were also calculated. The diagnostic performance of these tools for the detection of CFLD (defined as two or more the following criteria: abnormal liver biochemistry, hepatomegaly or sonographic abnormalities other than steatosis) were compared using the area under ROC curves. RESULTS: Forty-seven percent of the cohort was male. The median age was 27 years (interquartile range [IQR] 22 to 37 years) and body mass index 21 kg/m2 (IQR 19 kg/m2 to 23 kg/m2); 25% of patients were on ursodeoxycholic acid and 12% had undergone lung transplantation. The prevalence of CFLD was 14% (n=18). FS was successful in all patients; one (0.8%) patient had poorly reliable results (IQR/M >30% and LSM ≥7.1kPa). Compared with patients without CFLD (n=109), individuals with CFLD had higher median LSM according to FS (3.9 kPa [IQR 3.4 to 4.9 kPa] versus 6.4 kPa [IQR 4.4 to 8.0 kPa]), APRI (0.24 [IQR 0.17 to 0.31] versus 0.50 [IQR 0.22 to 1.18]) and FT scores (0.08 [IQR 0.05 to 1.5] versus 0.18 [IQR 0.11 to 0.35]; all P<0.05). Area under ROC curve for FS, APRI and FT for the detection of CFLD were 0.78 (95% CI 0.65 to 0.92), 0.72 (95% CI 0.56 to 0.87) and 0.76 (95% CI 0.62 to 0.90) (P not significant). At a threshold of >5.2 kPa, the sensitivity, specificity, positive and negative predictive values of LSM according to FS for detecting CFLD were 67%, 83%, 40% and 94%, respectively. CONCLUSIONS: FS, APRI and FT
... Waste Food Safety Newsroom Dietary Guidelines Communicator’s Guide Food Safety You are here Home / Audience / Adults / Moms/ ... and raw sprouts. Do not eat these foods. Food safety advice when you are pregnant Follow the ...
... Home / Audience / Adults Pregnancy & Breastfeeding Print Share Health & Nutrition Information When you are pregnant or breastfeeding, you ... Story Last Updated: Feb 2, 2016 RESOURCES FOR NUTRITION AND HEALTH MYPLATE What Is MyPlate? Fruits Vegetables ...
Background Epidemiological studies have indicated that maternal infection during pregnancy may lead to a higher incidence of schizophrenia in the offspring. It is assumed that the maternal infection increases the immune response, leading to neurodevelopmental disorders in the offspring. Maternal polyinosinic-polycytidilic acid (PolyI:C) treatment induces a wide range of characteristics in the offspring mimicking some schizophrenia symptoms in humans. These observations are consistent with the neurodevelopmental hypothesis of schizophrenia. Methods We examined whether suppression of the maternal immune response could prevent neurodevelopmental disorders in adult offspring. PolyI:C or saline was administered to early pregnant rats to mimic maternal infection, and the maternal immune response represented by tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10) levels was determined by enzyme-linked immunosorbent assays (ELISA). The NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC) was used to suppress the maternal immune response. Neurodevelopmental disorders in adult offspring were examined by prepulse inhibition (PPI), passive avoidance, and active avoidance tests. Results PolyI:C administration to early pregnant rats led to elevated serum cytokine levels as shown by massive increases in serum TNF-α and IL-10 levels. The adult offspring showed defects in prepulse inhibition, and passive avoidance and active avoidance tests. PDTC intervention in early pregnant rats suppressed cytokine increases and reduced the severity of neurodevelopmental defects in adult offspring. Conclusions Our findings suggest that PDTC can suppress the maternal immune response induced by PolyI:C and partially prevent neurodevelopmental disorders of adult offspring. PMID:22208616
Bottorff, Joan L; Seaton, Cherisse L; Johnson, Steve T; Caperchione, Cristina M; Oliffe, John L; More, Kimberly; Jaffer-Hirji, Haleema; Tillotson, Sherri M
The marked disparity in life expectancy between men and women suggests men are a vulnerable group requiring targeted health promotion programs. As such, there is an increasing need for health promotion strategies that effectively engage men with their health and/or illness management. Programs that promote physical activity could significantly improve the health of men. Although George et al. (Sports Med 42(3):281, 30) reviewed physical activity programs involving adult males published between 1990 and 2010, developments in men's health have prompted the emergence of new sex- and gender-specific approaches targeting men. The purpose of this review was to: (1) extend and update the review undertaken by George et al. (Sports Med 42(3):281, 30) concerning the effectiveness of physical activity programs in males, and (2) evaluate the integration of gender-specific influences in the content, design, and delivery of men's health promotion programs. A search of MEDLINE, CINAHL, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and the SPORTDiscus databases for articles published between January 2010 and August 2014 was conducted. In total, 35 studies, involving evaluations of 31 programs, were identified. Findings revealed that a variety of techniques and modes of delivery could effectively promote physical activity among men. Though the majority of programs were offered exclusively to men, 12 programs explicitly integrated gender-related influences in male-specific programs in ways that recognized men's interests and preferences. Innovations in male-only programs that focus on masculine ideals and gender influences to engage men in increasing their physical activity hold potential for informing strategies to promote other areas of men's health. PMID:25430599
Habal, Flavio M; Ravindran, Nikila C
Inflammatory bowel disease (IBD) is a chronic disorder affecting young adults in their reproductive years. Many young women with IBD express concern about the effect their disease will have on fertility, pregnancy course and fetal development. This article presents an approach to management of IBD in the pregnant patient, including counseling and investigation, and summarizes existing data on the safety of medications used to treat IBD in pregnancy and breastfeeding. PMID:18322943
Rizzo, Rachel A; Neumann, Anne M; King, Stella OC; Hoey, Robert F; Finnell, Deborah S; Blondell, Richard D
Purpose Opioid-dependent pregnant women are characterized by drug use during pregnancy and deficits in knowledge of newborn care and feeding, and of child development. We assessed parenting skills and concerns among pregnant women in buprenorphine treatment for prescription opioid-dependence. Study Design and Methods We interviewed 32 pregnant women who received buprenorphine treatment for prescription opioid dependence in a primary care setting and administered questionnaires, including the Adult-Adolescent Parenting Inventory version 2 (AAPI-2) and Childhood Experience of Care and Abuse Questionnaire. Results AAPI-2 scores revealed medium risk of abuse for all five scales: inappropriate expectations of the child, low level of empathy, strong belief in corporal punishment, reversal of parent-child roles, and oppression of children’s power and independence. Primary concerns of participants were neonatal abstinence syndrome (NAS) and their child’s health. Pregnant women who received buprenorphine for treatment of prescription opioid dependence showed a lack of appropriate parenting skills, but did not express concern about their ability to parent. Clinical Implications Our findings suggest need for nurses to assist prescription opioid-dependent pregnant women in acquiring additional parenting skills, to refer for educational parenting intervention, and to educate patients about NAS. PMID:25137081
The objective of this study was to provide specific characteristics of injuries and crash characteristics for pregnant occupants from the National Automotive Sampling System/Crashworthiness Data System (NASS/CDS) database for pregnant women as a group, broken down by trimester, and compared to non-pregnant women. Using all NASS/CDS cases collected between the years 2000 and 2012 with at least one pregnant occupant, the entire pregnant data set included 321,820 vehicles, 324,535 occupants, and 640,804 injuries. The pregnant occupant data were compared to the characteristics of NASS/CDS cases for 14,719,533 non-pregnant females 13-44 years old in vehicle crashes from 2000 to 2012. Sixty five percent of pregnant women were located in the front left seat position and roughly the same percentage of pregnant women was wearing a lap and shoulder belt. The average change in velocity was 11.6 mph for pregnant women and over 50% of crashes for pregnant women were frontal collisions. From these collisions, less than seven percent of pregnant women sustained MAIS 2+ injuries. Minor differences between the pregnant and non-pregnant occupants were identified in the body region and source of injuries sustained. However, the data indicated no large differences in injury or crash characteristics based on trimester of pregnancy. Moreover, the risk of an MAIS 2+ level injury for pregnant occupants is similar to the risk of injury for non-pregnant occupants based on the total vehicle change in velocity. Overall this study provides useful data for researchers to focus future efforts in pregnant occupant research. Additionally, this study reinforces that more detailed and complete data on pregnant crashes needs to be collected to understand the risk for pregnant occupants. PMID:25463946
Singh, S S; Biswas, Ashok Kumar; Shirley, P; Vijayachari, Paluru
Chelonitoxism is a type of seafood poisoning which usually occurs due to consumption of certain marine turtle flesh. As the pharmacology or chemistry of the toxin is still unknown, antidote or treatment to chelonitoxism is unavailable. The symptoms can vary from common gastro-intestinal symptoms to neurological manifestations and even death. This case report of community poisoning following consumption of turtle meat includes the death of an adult male (56 yrs.) being reported for the first time in the Great Nicobar Island, Andaman and Nicobar (A&N) Islands, India in August 2012. The patient encountered common gastrointestinal symptoms after one day of ingestion of green turtle flesh and later, he developed neurological symptoms and did not respond to symptomatic treatment and expired after four days after the consumption. However, out of 30 villagers who took the same food, six others developed symptoms and recovered within a period of 3-7 days while two pets (a dog and a cat) died within 24 hours as they were fed with the same food. In spite of several existing wildlife protection acts, catching a turtle and making them a source of food-celebration is quite common in coastal areas of the Indian Ocean and the Bay of Bengal which includes A&N Islands. A proper monitoring and follow-up of the food-borne diseases along with a wide range of explorative health education protocol should be implemented especially for the people who are not reachable via media to avoid such incidents in future. PMID:27103071
James, Vicki; McCamey, Jody
This illustrated guide for pregnant teenagers discusses the nutritional needs of the mother and her unborn child in a month-by-month format. The information presented for each of the 9 months typically includes a sample daily menu; a checklist of recommended servings per day for each of four food groups; a description of the usual emotional and…
Bernardoni, Brittney; Scerpella, Tamara A.; Rosenbaum, Paula F.; Kanaley, Jill A.; Raab, Lindsay N.; Li, Quefeng; Wang, Sijian; Dowthwaite, Jodi N.
We prospectively evaluated adolescent organized physical activity (PA) as a factor in adult female bone traits. Annual DXA scans accompanied semi-annual records of anthropometry, maturity and PA for 42 participants in this preliminary analysis (criteria: appropriately timed DXA scans at ~1 year pre-menarche [predictor] and ~5 years post-menarche [dependent variable]). Regression analysis evaluated total adolescent inter-scan PA and PA over 3 maturity sub-phases as predictors of young adult bone outcomes: 1) bone mineral content (BMC), geometry and strength indices at non-dominant distal radius and femoral neck; 2) sub-head BMC; 3) lumbar spine BMC. Analyses accounted for baseline gynecological age (years pre- or post-menarche), baseline bone status, adult body size and inter-scan body size change. Gymnastics training was evaluated as a potentially independent predictor, but did not improve models for any outcomes (p<0.07). Pre-menarcheal bone traits were strong predictors of most adult outcomes (semi-partial r2 = 0.21-0.59, p≤0.001). Adult 1/3 radius and sub-head BMC were predicted by both total PA and PA 1-3 years post-menarche (p<0.03). PA 3-5 years post-menarche predicted femoral narrow neck width, endosteal diameter and buckling ratio (p<0.05). Thus, participation in organized physical activity programs throughout middle and high school may reduce lifetime fracture risk in females. PMID:25386845
Bernardoni, Brittney; Scerpella, Tamara A; Rosenbaum, Paula F; Kanaley, Jill A; Raab, Lindsay N; Li, Quefeng; Wang, Sijian; Dowthwaite, Jodi N
We prospectively evaluated adolescent organized physical activity (PA) as a factor in adult female bone traits. Annual DXA scans accompanied semiannual records of anthropometry, maturity, and PA for 42 participants in this preliminary analysis (criteria: appropriately timed DXA scans at ~1 year premenarche [predictor] and ~5 years postmenarche [dependent variable]). Regression analysis evaluated total adolescent interscan PA and PA over 3 maturity subphases as predictors of young adult bone outcomes: 1) bone mineral content (BMC), geometry, and strength indices at nondominant distal radius and femoral neck; 2) subhead BMC; 3) lumbar spine BMC. Analyses accounted for baseline gynecological age (years pre- or postmenarche), baseline bone status, adult body size and interscan body size change. Gymnastics training was evaluated as a potentially independent predictor, but did not improve models for any outcomes (p > .07). Premenarcheal bone traits were strong predictors of most adult outcomes (semipartial r2 = .21-0.59, p ≤ .001). Adult 1/3 radius and subhead BMC were predicted by both total PA and PA 1-3 years postmenarche (p < .03). PA 3-5 years postmenarche predicted femoral narrow neck width, endosteal diameter, and buckling ratio (p < .05). Thus, participation in organized physical activity programs throughout middle and high school may reduce lifetime fracture risk in females. PMID:25386845
Little, Peter R; Hodge, Andrew; Maeder, Steven J; Wirtherle, Nicole C; Nicholas, David R; Cox, George G; Conder, George A
Derquantel (DQL), a semi-synthetic member of a novel anthelmintic class, the spiroindoles, in combination with abamectin (ABA) [as the combination product STARTECT(®)] is a new entry for the treatment and control of parasites in sheep. The 19 studies reported herein were conducted in Australia, New Zealand, South Africa and the United Kingdom to demonstrate the efficacy of derquantel-abamectin (DQL-ABA) against a broad spectrum of gastrointestinal and respiratory nematodes of sheep, and to support registration of the combination product. Eleven studies were conducted using natural or experimental parasite infections with unknown or unconfirmed resistance, while eight studies utilised isolates/strains with confirmed or well characterised resistance to one or more currently available anthelmintics, including macrocyclic lactones. All studies included DQL-ABA and negative control groups, and in selected studies one or more reference anthelmintic groups were included. In all studies the commercial formulation of DQL-ABA was administered orally at 2mg/kg DQL and 0.2mg/kg ABA; placebo was administered in the same volume as DQL-ABA; and reference anthelmintics were administered as per label recommendations, except in one instance where levamisole was administered at twice the label dose. Infection, necropsy, worm collection and worm counting procedures were performed using standard techniques. Efficacy was calculated based on the percentage reduction in geometric mean worm count relative to negative control for each nematode species and lifecycle stage targeted. Twenty-two isolates/strains used in the eight studies targeting resistant worms had proven resistance: three to one anthelmintic class, eleven to two classes and eight to three or more classes; of these resistant strains, 16 demonstrated resistance to a macrocyclic lactone anthelmintic. Regardless of resistance status in the 19 studies, DQL-ABA controlled a broad range of economically important gastrointestinal
Pfortmueller, Carmen Andrea; Schwetlick, Miriam; Mueller, Thomas; Lehmann, Beat; Exadaktylos, Aristomenis Konstantinos
Background Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study is to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria. Methods Our retrospective data analysis comprised adult patients presenting to our emergency department between 01.11.2011 and 30.06.2014 with the official resident status of an “asylum seeker” or “refugee” from the Middle East. Results In total, 880 patients were included in the study. Of these, 625 (71.0%) were male and 255 (29.0%) female. The median age was 34 (range 16–84). 222 (25.2%) of our patients were from Syria. The most common reason for presentation was surgical (381, 43.3%), followed by medical (321, 36.5%) and psychiatric (137, 15.6%). In patients with surgical presentations, trauma-related problems were most common (n = 196, 50.6%). Within the group of patients with medical presentation, acute infectious diseases were most common (n = 141, 43.9%), followed by neurological problems (n = 70, 21.8%) and gastrointestinal problems (n = 47, 14.6%). There were no differences between Syrian and non-Syrian refugees concerning surgical or medical admissions. The most common chronic disorder of unclear significance was chronic gastrointestinal problems (n = 132, 15%), followed by chronic musculoskeletal problems (n = 108, 12.3%) and chronic headaches (n = 78, 8.9%). Patients from Syria were significantly younger and more often suffered from a post-traumatic stress disorder than patients of other nationalities (p<0.0001, and p = 0.05, respectively). Conclusion Overall a remarkable number of our very young group of patients suffered from psychiatric disorders and unspecified somatic symptoms. Asylum seekers should be carefully evaluated when presenting to a medical facility and physicians should be aware of the high incidence of unspecified
Kennedy, Bebe C.; And Others
Reviews options counselors can suggest to pregnant adolescents, including abortion, adoption, marriage, and single parenthood. Discusses the need for counselors to be aware of their own values and help the client explore her values. (JAC)
Ke, Alice Ban; Nallani, Srikanth C; Zhao, Ping; Rostami-Hodjegan, Amin; Unadkat, Jashvant D
Aim Conducting PK studies in pregnant women is challenging. Therefore, we asked if a physiologically-based pharmacokinetic (PBPK) model could be used to predict the disposition in pregnant women of drugs cleared by multiple CYP enzymes. Methods We expanded and verified our previously published pregnancy PBPK model by incorporating hepatic CYP2B6 induction (based on in vitro data), CYP2C9 induction (based on phenytoin PK) and CYP2C19 suppression (based on proguanil PK), into the model. This model accounted for gestational age-dependent changes in maternal physiology and hepatic CYP3A, CYP1A2 and CYP2D6 activity. For verification, the pregnancy-related changes in the disposition of methadone (cleared by CYP2B6, 3A and 2C19) and glyburide (cleared by CYP3A, 2C9 and 2C19) were predicted. Results Predicted mean post-partum to second trimester (PP : T2) ratios of methadone AUC, Cmax and Cmin were 1.9, 1.7 and 2.0, vs. observed values 2.0, 2.0 and 2.6, respectively. Predicted mean post-partum to third trimester (PP : T3) ratios of methadone AUC, Cmax and Cmin were 2.1, 2.0 and 2.4, vs. observed values 1.7, 1.7 and 1.8, respectively. Predicted PP : T3 ratios of glyburide AUC, Cmax and Cmin were 2.6, 2.2 and 7.0 vs. observed values 2.1, 2.2 and 3.2, respectively. Conclusions Our PBPK model integrating prior physiological knowledge, in vitro and in vivo data, allowed successful prediction of methadone and glyburide disposition during pregnancy. We propose this expanded PBPK model can be used to evaluate different dosing scenarios, during pregnancy, of drugs cleared by single or multiple CYP enzymes. PMID:23834474
Moll, Xavier; García, Felix; Ferrer, Rosa Isabel; Santos, Laura; Aguilar, Adrià; Andaluz, Anna
The aim of the study was to determine the distribution of different volumes of methylene blue solution injected into the epidural space in anaesthetized pregnant and non-pregnant sheep, to evaluate its cranial distribution and to compare between them. Fifteen pregnant and fifteen non-pregnant sheep were included in the study. Sheep were anaesthetized and received 0.05, 0.1, or 0.2 mL/kg of a lumbosacral epidural solution containing 0.12% methylene blue in 0.9% saline. Thirty minutes after the epidural injection, the ewes were euthanized. The extension of the dye within the epidural space was measured, and the correlation between the volume of the dye injected and the number of stained vertebrae was evaluated. The cranial migration of the dye between pregnant and non-pregnant sheep was also compared. The results show that the volume of methylene blue injected epidurally into pregnant and non-pregnant sheep correlated directly with its cephalic distribution into the epidural space; and a volume of 0.1 mL/kg or 0.2 mL/kg stained up to the first lumbar segment in pregnant and non-pregnant sheep, respectively. Also, the results suggest that the volume of drugs administered into the epidural space of pregnant sheep should be half the volume that would be used in non-pregnant sheep. PMID:24709655
Escobar-Paucar, Gloria; Sosa-Palacio, Catalina; Sánchez-Mejía, Angela
Based on the theory of social representations, a qualitative investigation was conducted in order to assess social representations in oral heath in pregnant mothers living in an urban environment. Twenty-eight pregnant adult women attending a prenatal program at a health institution in the city of Medellín, Colombia, were interviewed. The interviews were recorded and transcribed; analysis was performed through open, axial and selective coding, in line with grounded theory. Findings revealed that although pregnant mothers are not greatly concerned about oral health after birth and in early childhood, it increases in importance during growth and development of the child when, besides chewing and feeding aspects, it acquires a socially important role. Analysis revealed how social representations anchored in tradition, with new elements from health professional discourses as well as mass media influences coexist in mothers in an urban environment. These include the close relationship between oral health and teeth, health linked to healthy practices as well as recourse to health services and oral health as a social advantage, related to esthetic aspects. PMID:22124835
Meyer, S; Nolte, J; Opitz, L; Salinas-Riester, G; Engel, W
DNA microarray analysis was performed with mouse multipotent adult germline stem cells (maGSCs) and embryonic stem cells (ESCs) from different genetic backgrounds cultured under standard ESC-culture conditions and under differentiation-promoting conditions by the withdrawal of the leukemia inhibitory factor (LIF) and treatment with retinoic acid (RA). The analyzed undifferentiated cell lines are very similar based on their global gene expression pattern and show 97-99% identity dependent on the analyzed background. Only 621 genes are differentially expressed in cells derived from mouse 129SV-background and 72 genes show differences in expression in cells generated from transgenic Stra8-EGFP/Rosa26-LacZ-background. Both maGSCs and ESCs express the same genes involved in the regulation of pluripotency and even show no differences in the expression level of these genes. When comparing maGSCs with previously published signature genes of other pluripotent cell lines, we found that maGSCs shared a very similar gene expression pattern with embryonic germ cells (EGCs). Also after differentiation of maGSCs and ESCs the transcriptomes of the cell lines are nearly identical which suggests that both cell types differentiate spontaneously in a very similar way. This is the first study, at transcriptome level, to compare ESCs and a pluripotent cell line derived from an adult organism (maGSCs). PMID:20624824
The Pregnant Guppy is a modified Boeing B-377 Stratocruiser used to transport the S-IV (second) stage for the Saturn I launch vehicle between manufacturing facilities on the West coast, and testing and launch facilities in the Southeast. The fuselage of the B-377 was lengthened to accommodate the S-IV stage and the plane's cabin section was enlarged to approximately double its normal volume. The idea was originated by John M. Conroy of Aero Spaceliners, Incorporated, in Van Nuys, California. The former Stratocruiser became a B-377 PG: the Pregnant Guppy. This photograph depicts the Pregnant Guppy in flight.
... animals presents risk of trauma to the abdomen. INFECTIOUS DISEASES Pregnant women who develop travelers’ diarrhea or other ... and Prevention National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Global Migration and Quarantine (DGMQ) ...
... mouth after changing a litter box, or while gardening without gloves. Fruits and vegetables may have contact ... pregnant. Keep outdoor sandboxes covered. Wear gloves when gardening and during contact with soil or sand because ...
Sheffield, Jeanne S.; Siegel, David; Mirochnick, Mark; Heine, R. Phillips; Nguyen, Christine; Bergman, Kimberly L.; Savic, Rada M.; Long, Jill; Dooley, Kelly E.; Nesin, Mirjana
Clinical pharmacology studies that describe the pharmacokinetics and pharmacodynamics of drugs in pregnant women are critical for informing on the safe and effective use of drugs during pregnancy. That being said, multiple factors have hindered the ability to study drugs in pregnant patients. These include concerns for maternal and fetal safety, ethical considerations, the difficulty in designing appropriate trials to assess the study objectives, and funding limitations. This document summarizes the recommendations of a panel of experts convened by the Division of Microbiology and Infectious Diseases at the National Institute of Allergy and Infectious Diseases, National Institutes of Health. These experts were charged with reviewing the issues related to the development of preclinical and clinical drug studies in pregnant women and to develop strategies for addressing these issues. These findings may also be utilized in the development of future drug studies involving pregnant women and their fetus/neonate. PMID:25425722
Möller, Eline L; Bögels, Susan M
With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd. PMID:27378317
Rawicki, B; Sheean, G; Fung, V S C; Goldsmith, S; Morgan, C; Novak, I
Evidence is emerging for the use of botulinum neurotoxin type-A (BoNT-A) for niche indications including pain independent of spasticity. Pain indications such as chronic nociceptive back pain, piriformis syndrome, chronic myofascial pain, pelvic pain, complex regional pain syndrome, facial pain and neuropathic pain are outlined in this paper. Of these, class I evidence is available for the treatment of chronic nociceptive low back pain, piriformis syndrome, myofascial pain, facial pain, neuropathic pain and plantar fasciitis. Peri-operative use of BoNT-A is emerging, with indications including planning for surgery and facilitating surgery, as well as healing and improving analgesia post-operatively. Evidence is limited, although there are some reports that clinicians are successfully using BoNT-A peri-operatively. There is class I evidence showing pre-operative use of BoNT-A has a beneficial effect on outcomes following adductor-release surgery. The use of BoNT for treatment of tremor, other than neck tremor in the setting of cervical dystonia, including evidence for upper limb tremor, cranial tremor and non-dystonic neck tremor is reviewed. The evidence is variable at this stage, and further study is required to develop definitive recommendations for the clinical utility of BoNT-A for these indications. PMID:20633183
Anisimova, E N; Axamit, L A; Manukhina, E I; Letunova, N Yu; Golikova, A M; Fedotova, T M
The aim of the study was to evaluate the algorithm of safe emergency dental care in pregnant patients. Eighty-five pregnant women aged 20-35 were included in the study. The paper presents elaborated state-of-the-art guidelines for emergency dental care in pregnant patients. Articaine 4% with epinephrine 1:200,000 is recommended as a choice agent for local anesthesia in these patients. PMID:27239992
The obesity epidemic, including a marked increase in the prevalence of obesity among pregnant women, represents a critical public health problem in the United States and throughout the world. Over the past two decades, it has been increasingly recognized that the risk of adult ...
Neiswanger, Katherine; McNeil, Daniel W.; Foxman, Betsy; Govil, Manika; Cooper, Margaret E.; Weyant, Robert J.; Shaffer, John R.; Crout, Richard J.; Simhan, Hyagriv N.; Beach, Scott R.; Chapman, Stella; Zovko, Jayme G.; Brown, Linda J.; Strotmeyer, Stephen J.; Maurer, Jennifer L.; Marazita, Mary L.
Background. Chronic poor oral health has a high prevalence in Appalachia, a large region in the eastern USA. The Center for Oral Health Research in Appalachia (COHRA) has been enrolling pregnant women and their babies since 2011 in the COHRA2 study of genetic, microbial, and environmental factors involved in oral health in Northern Appalachia. Methods. The COHRA2 protocol is presented in detail, including inclusion criteria (healthy, adult, pregnant, US Caucasian, English speaking, and nonimmunocompromised women), recruiting (two sites: Pittsburgh, Pennsylvania, and West Virginia, USA), assessments (demographic, medical, dental, psychosocial/behavioral, and oral microbial samples and DNA), timelines (longitudinal from pregnancy to young childhood), quality control, and retention rates. Results. Preliminary oral health and demographic data are presented in 727 pregnant women, half from the greater Pittsburgh region and half from West Virginia. Despite similar tooth brushing and flossing habits, COHRA2 women in West Virginia have significantly worse oral health than the Pittsburgh sample. Women from Pittsburgh are older and more educated and have less unemployment than the West Virginia sample. Conclusions. We observed different prevalence of oral health and demographic variables between pregnant women from West Virginia (primarily rural) and Pittsburgh (primarily urban). These observations suggest site-specific differences within Northern Appalachia that warrant future studies. PMID:26089906
Florek, Tewa; Ignatowicz, Ewa; Piekoszewski, Wojciech; Wachowiak, Anna; Wrzosek, Jagna
From among 4200 chemical compounds contained in the tobacco smoke, nicotine and carbon monoxide are responsible for changes in the heart-vessel system to the greatest extent. Additionally, other toxic compounds, including the carcinogenic ones, have a significant impact on the biological activity in the tissues of blood vessels. A particularly complex picture of the detrimental impact of the tobacco smoke is presented in case of pregnant women, fetuses and newborns. The aim of the research was to assess the impact of tobacco smoke on the permeability of capillaries in different tissues of rats (lungs, brain, liver, kidneys) and testing of the potentially protective impact of rutine (3-rutinozide of quercetin). The research on the permeability of capillaries has been carried out applying Evans blue. The animals were divided into 8 research groups: pregnant animals--"control", "rutine", "tobacco smoke", "rutine+tobacco smoke", and non-pregnant animals--"control", "rutine", "tobacco smoke", "rutine+tobacco smoke". In the first stage of research (pregnant, non-pregnant-- groups: "rutine" and "rutine+tobacco smoke"), the water rutine solution in a dose of 40 mg/kg of body weight was administered. The non-pregnant and pregnant animals from groups "tobacco smoke" and "rutine+tobacco smoke" were exposed to tobacco smoke via inhalation (1500 mg CO/m3 of air) for 21 days. All the animals were injected with the water Evans blue solution in a dose of 30 mg/kg of body weight. After 30 minutes, the animals were killed by cutting the abdominal aorta, and lungs, brain, liver and kidneys were taken for further testing. The cotinine in the urine was determined by the HPLC method, using norephedrine as the internal standard, after the preceding extraction by means of the liquid-liquid technique. The concentration of cotinine in case of non-pregnant and pregnant females was respectively 11.8 +/- 1.9 pg/ml of urine and 12.0 +/- 2.5 microg/ml of urine. In case of the rats, which
Background Luteal activity is dependent on the interaction of various growth factors, cytokines and hormones, including the thyroid hormones, being that hypo- and hyperthyroidism alter the gestational period and are also a cause of miscarriage and stillbirth. Because of that, we evaluated the proliferation, apoptosis and expression of angiogenic factors and COX-2 in the corpus luteum of hypo- and hyperthyroid pregnant rats. Methods Seventy-two adult female rats were equally distributed into three groups: hypothyroid, hyperthyroid and control. Hypo- and hyperthyroidism were induced by the daily administration of propylthiouracil and L-thyroxine, respectively. The administration began five days before becoming pregnant and the animals were sacrificed at days 10, 14, and 19 of gestation. We performed an immunohistochemical analysis to evaluate the expression of CDC-47, VEGF, Flk-1 (VEGF receptor) and COX-2. Apoptosis was evaluated by the TUNEL assay. We assessed the gene expression of VEGF, Flk-1, caspase 3, COX-2 and PGF2α receptor using real time RT-PCR. The data were analyzed by SNK test. Results Hypothyroidism reduced COX-2 expression on day 10 and 19 (P < 0.05), endothelial/pericyte and luteal cell proliferation on day 10 and 14 (p < 0.05), apoptotic cell numbers on day 19 (p < 0.05) and the expression of Flk-1 and VEGF on day 14 and 19, respectively (p < 0.05). Hyperthyroidism increased the expression of COX-2 on day 19 (P < 0.05) and the proliferative activity of endothelial/pericytes cells on day 14 (p <0.05), as well as the expression of VEGF and Flk-1 on day 19 (P < 0.05). Conclusions Hypothyroidism reduces the proliferation, apoptosis and expression of angiogenic factors and COX-2in the corpus luteum of pregnant rats, contrary to what is observed in hyperthyroid animals, being this effect dependent of the gestational period. PMID:25298361
Conference of Large City Boards of Education, Albany, NY.
This report presents case studies of pregnant and parenting teenagers in the "Big Five School Districts," New York State's five largest urban school districts: Buffalo, New York City, Rochester, Syracuse, and Yonkers. Adolescent parents and their children depend heavily on a number of services to survive, including education, health, and social…
Myors, K; Johnson, M; Langdon, R
This descriptive study examined the coping styles and specific strategies used by a group of pregnant adolescents attending an adolescent family support service. Seventy-one adolescents, with a mean age of 17 years, and a mean gestation of 25 weeks, completed the Revised Jalowiec Coping Scale (JCS-R). The findings demonstrated that the optimistic coping style (emotion-focused) was the most frequently used and most effective coping style for these young women. A confrontive coping style (problem-focused) was also used and found to be effective. A combination of problem-focused and emotion-focused styles is recommended, with an increased emphasis on problem-focused approaches. The focus by the adolescents on optimistic approaches is suggestive of a lack of understanding of the challenges that motherhood will place upon them, but is consistent with their age and developmental stage. A longitudinal study of coping styles and changes in style throughout pregnancy and early motherhood is recommended. Initial assessment and monitoring of coping styles of pregnant adolescents is proposed. This assessment would be the beginning point for a teaching program that highlights increased use of adaptive coping styles (problem-focused) with decreased use of maladaptive approaches, and includes emotion-focused styles. By expanding the repertoire of coping styles and strategies available to the adolescent, the public health nurse (PHN) prepares these vulnerable mothers for the challenges ahead. PMID:11251870
Malarewicz, Andrzej; Szymkiewicz, Jadwiga; Rogala, Jerzy
Over the time when the sexual intercourse has been considered merely one of a number of forms of sexual contact, views on sexuality during pregnancy have undergone considerable transformation. A great many of authors emphasise, that the pregnancy is a stimulus for partners to search for ways to maintain mutual emotional bond, close physical affinity and satisfy sexual needs not necessarily finished with an intercourse. The fact, that one of the two partners is pregnant, imposes some restrictions on sexual life. Not rarely, in particular in the first trimester of pregnancy, a female is little interested in sex. It is due to, inter alia, hormonal changes resulting in nausea, fatigue and increased nervosity. These symptoms contribute to general feebleness and reduction of the level of sexual needs and difficulty to become aroused and sexually ready. In spite of that, a lot of women have the need to keep physical and emotional contact with their partners. For a number of couples, pregnancy becomes a stimulus to search for new ways of pleasing each other in love play, that does not necessarily leads with an intercourse. Most studies concerning sexuality during pregnancy focus on observing sexual activity, physiological changes, mutual relationship of partners, analysis of sexual intercourses and investigation of so-called sexual satisfaction. Examination of sexual satisfaction ruchedes the frequency of sexual contacts, intercourses, foreplay, concurrence of orgasms in the two partners, partners' happiness, sexual satisfaction and mutual heartiness. In some researchers' opinion, sexual satisfaction correlates with the feeling of happiness resulting form being pregnant, pregnant woman's feeling still attractive and experience of orgasm. However, some researchers observe reduced sexual activity during pregnancy, except for the second trimester, when sexual activity is similar to the one outside pregnancy. Pregnant women prefer the following types of sexual activity: non
Rieger, E; Treasure, J; Swinbourne, J; Adam, B; Manns, C; Caterson, I
The well-documented finding that obese adults have a high likelihood of weight regain following participation in behavioural weight loss programmes highlights the importance of developing more effective approaches for weight loss maintenance. One promising approach is to improve the quality of social support for effective weight control available to an obese individual by including support people in behavioural weight loss programmes. This paper describes the rationale and design of a randomized controlled trial that evaluates the effectiveness of training support people to assist obese adults in their weight management. The study entails a two-arm randomized controlled trial in which obese participants take part in a 1-year (26-session) cognitive behaviour therapy group weight management programme, including motivational interviewing strategies (CBT-MI). In one arm, participants receive CBT-MI alone, while in the second arm (CBT-MI-SP), participants also have a support person who attends 10 group sessions designed to teach effective skills for supporting an individual in healthy weight control. More specifically, support people will be trained in skills that aim to promote self-motivation for weight management. Assessments of anthropometric, medical, behavioural, motivational, psychological and social functioning take place at pre-treatment, post-treatment and a 1-year follow-up. By helping obese participants to increase and sustain their motivation and skills for weight control both during treatment and in the crucial period after treatment cessation through the ongoing input of support people, the CBT-MI-SP approach of the current study has the potential to effectively help patients to achieve sustained weight loss while minimizing the patient's need for ongoing, intensive weight control treatment with its attendant costs. PMID:25826731
Fenyk, Julie; Maruyama, Geoffrey; Seiden, Katherine; Pain, Lorna; Hoxie, Ann
The Children and Adolescent Support and Self-Sufficiency (CAPSS) program serves pregnant and parenting adolescents eligible to attend an urban school district in the Midwest. It employs a Youth Development Framework promoting connections with caring adults. While pregnancy prevention has become a major initiative for schools, programming to help…
Although there has been long-standing reluctance to include pregnant women as clinical trial participants, increasing recognition of profound gaps in research on the safety and efficacy of drugs often prescribed to pregnant women calls into question the practice of routinely excluding them. This article presents compelling reasons for including pregnant women in clinical research, highlights certain regulatory barriers to the inclusion of pregnant women, and proposes that professional societies with expertise in obstetrics and maternal-fetal medicine can be instrumental in hastening the paradigm shift from the systematic exclusion of pregnant women in research to a one of responsible and fair inclusion. PMID:26385413
Wallace, Graham W; Davis, Melissa A; Semelka, Richard C; Fielding, Julia R
Imaging of pregnant patients with non-obstetric abdominal pain is reviewed, with an accompanying pictorial essay of cases with concentration on magnetic resonance imaging. Non-obstetric causes of abdominal pain during pregnancy are similar to those of non-pregnant patients. The most common causes are appendicitis and cholecystitis. Other causes are myriad and include biliary, gastrointestinal, infectious, inflammatory, and malignant etiologies, among others. The approach to imaging in pregnant patient is unique, as it is imperative to minimize potentially harmful radiation exposures to the fetus. Ultrasound and MRI are the primary modalities for evaluation of the pregnant patient with abdominal pain. The use of intravenous contrast is discouraged, except in highly-selected patients where there is no other way to obtain vital diagnostic information. CT is still used as the mainstay of evaluation of blunt abdominal trauma and is commonly used for diagnosis of small bowel obstruction, stone disease, and work-up of malignancy during pregnancy. A discussion of test selection and underlying rationale is presented. PMID:22160283
DiNardo, CD; Gharibyan, V; Yang, H; Wei, Y; Pierce, S; Kantarjian, HM; Garcia-Manero, G; Rytting, M
Introduction Aberrant promoter DNA methylation is a well-described mechanism of leukemogenesis within hematologic malignancies, including acute lymphoblastic leukemia (ALL). However, the importance of methylation patterns among the adolescent and young adult (AYA) ALL population has not been well established. Methods DNA methylation of 18 candidate genes in 33 AYA ALL patients was analyzed at diagnosis and during treatment, to evaluate the frequency and clinical relevance of aberrant methylation in an AYA population treated on a uniform therapeutic regimen. Results Of 16 informative genes, there was a median of 6 methylated genes per AYA ALL patient. Correlations were identified between increasing number of methylated genes with male sex (p=0.04), increased white blood cell (WBC) count (p=0.04) and increased bone-marrow blast percentage (p=0.04). Increasing age was associated with EPHA5 methylation (p=0.05). Overall, patients experienced favorable outcomes with median survival that was not reached. On univariate analysis, methylation of CYP1B1 was associated with worse overall survival (HR 10.7, 95% CI 1.3–87.6, p=0.03), disease-free survival (HR 3.7, 95% CI 1.1–9.2, p=0.04) and correlated with decreased CYP1B1 gene expression. Conclusions A significant incidence of methylation within the AYA ALL population was identified, with increased methylation associated with distinct clinicopathologic features including male gender and elevated WBC count. Our results suggest aberrant methylation among AYA patients is frequent, and may provide a common pathogenic mechanism. The inferior outcome identified with methylation of the cytochrome p450 gene CYP1B1, an enzyme involved in drug metabolism and steroid synthesis, warrants further investigation. PMID:23757320
Developmental exposure to inhaled ethanol-gasoline fuel blends is a potential public health concern. Here we assessed cognitive functions in adult offspring of pregnant rats that were exposed to vapors of gasoline blended with a range of ethanol concentrations, including gasoli...
Saghafi, Nafiseh; Mohammadzadeh Vatanchi, Atieh; Tara, Fatemeh; Pourali, Leila; Dadgar, Salmeh
Background: Preeclampsia is one of the common complications during pregnancy with considerable maternal and fetal mortality and morbidity. Hypercoagulability due to thrombophilic factors is discussed as the etiology involved in this disease. Objective: The aim of this study was to evaluate selected thrombotic factors among pregnant women with preeclampsia and normal pregnant women. Materials and Methods: This case-control study was performed on 200 pregnant women at third trimester of pregnancy between 2012 and 2013. 100 pregnant women admitted to Qaem and Imam Reza hospitals of Mashhad, due to preeclampsia, were selected as case group and 100 pregnant women without preeclampsia referred to OB/GYN clinic of these hospitals as control group. Blood samples were taken from two groups for evaluation of the coagulation factors including factor V Leiden, protein C, protein S, antithrombin III, anti-cardiolipin antibodies, and lupus anticoagulant antibodies. Results: Two groups were not significantly different in terms of maternal age and parity (p>0.05). Levels of factor V Leiden, protein C, protein S, antithrombin III, anti-cardiolipin antibodies and lupus anticoagulant antibodies were compared between two groups. The number of patients with abnormal factor V Leiden and protein C was significantly higher in case group than in the control group (p<0.01 respectively), but other factors were not significant different between two groups. Thrombophilia disorders were significantly more in case group compared to control (p<0.001). Conclusion: The risk of thrombophilia disorders is higher in preeclamptic patients than normal pregnant women. PMID:25709635
Korth-Bradley, J M
As part of drug development, drug companies conduct experiments to gather data about the potential toxicity of medications in pregnant and lactating animals. Increasingly, physiologically based pharmacokinetic models are developed to simulate drug concentrations in pregnant and lactating women. As these women are not usually included in clinical trials, targeted postapproval safety monitoring, registries, or clinical studies may be performed to gather safety and efficacy information about drug use in these special populations. PMID:27082822
Background Improvements in antenatal vitamin D status may have maternal-infant health benefits. To inform the design of prenatal vitamin D3 trials, we conducted a pharmacokinetic study of single-dose vitamin D3 supplementation in women of reproductive age. Methods A single oral vitamin D3 dose (70,000 IU) was administered to 34 non-pregnant and 27 pregnant women (27 to 30 weeks gestation) enrolled in Dhaka, Bangladesh (23°N). The primary pharmacokinetic outcome measure was the change in serum 25-hydroxyvitamin D concentration over time, estimated using model-independent pharmacokinetic parameters. Results Baseline mean serum 25-hydroxyvitamin D concentration was 54 nmol/L (95% CI 47, 62) in non-pregnant participants and 39 nmol/L (95% CI 34, 45) in pregnant women. Mean peak rise in serum 25-hydroxyvitamin D concentration above baseline was similar in non-pregnant and pregnant women (28 nmol/L and 32 nmol/L, respectively). However, the rate of rise was slightly slower in pregnant women (i.e., lower 25-hydroxyvitamin D on day 2 and higher 25-hydroxyvitamin D on day 21 versus non-pregnant participants). Overall, average 25-hydroxyvitamin D concentration was 19 nmol/L above baseline during the first month. Supplementation did not induce hypercalcemia, and there were no supplement-related adverse events. Conclusions The response to a single 70,000 IU dose of vitamin D3 was similar in pregnant and non-pregnant women in Dhaka and consistent with previous studies in non-pregnant adults. These preliminary data support the further investigation of antenatal vitamin D3 regimens involving doses of ≤70,000 IU in regions where maternal-infant vitamin D deficiency is common. Trial registration ClinicalTrials.gov (NCT00938600) PMID:23268736
Guillory, Jamie; Niederdeppe, Jeff; Kim, Hyekung; Pollak, JP; Graham, Meredith; Olson, Christine; Gay, Geri
Objectives We examine how social support (perceived support and support from a spouse, or committed partner) may influence pregnant women’s information seeking behaviors on a pregnancy website. We assess information seeking behavior among participants in a trial testing the effectiveness of a web-based intervention for appropriate gestational weight gain. Methods Participants were pregnant women (N= 1,329) recruited from clinics and private practices in one county in the Northeast United States. We used logistic regression models to estimate the likelihood of viewing articles, blogs, frequently asked questions (FAQs), and resources on the website as a function of perceived social support, and support from a spouse or relationship partner. All models included socio-demographic controls (income, education, number of adults and children living at home, home Internet use, and race/ethnicity). Results Compared to single women, women who were married or in a committed relationship were more likely to information seek online by viewing articles (OR= 1.95, 95%CI [1.26–3.03]), FAQs (OR= 1.64 [1.00–2.67]), and blogs (OR=1.88 [1.24–2.85]). Women who felt loved and valued (affective support) were more likely to seek information by viewing articles on the website (OR= 1.19 [1.00–1.42]). Conclusions While the Internet provides a space for people who have less social support to access health information, findings from this study suggest that for pregnant women, women who already had social support were most likely to seek information online. This finding has important implications for designing online systems and content to encourage pregnant women with fewer support resources to engage with content. PMID:24671467
... Medscape Podcasts Public Service Announcements (PSAs) Virus Images Influenza Types Seasonal Avian Swine Variant Pandemic Other Get ... What's this? Submit Button Past Newsletters Pregnant Women & Influenza (Flu) Language: English EspaÃ±ol Recommend on Facebook ...
MORALES-SUÁREZ-VARELA, María; LLOPIS-GONZÁLEZ, Agustín; GONZÁLEZ-CANDELA, Fernando; ASTRAY, Jenaro; ALONSO, Jordi; GARIN, Olatz; CASTRO, Ady; GALAN, Juan Carlos; SOLDEVILA, Nuria; CASTILLA, Jesús; GODOY, Pere; DELGADO-RODRÍGUEZ, Miguel; MARTIN, Vicente; MAYORAL, Jose María; PUMAROLA, Tomas; QUINTANA, José Maria; TAMAMES, Sonia; RUBIO-LÓPEZ, Nuria; DOMINGUEZ, Angela
Background: The healthcare and socio-economic burden resulting from influenza A (H1N1) pdm09 in Spain was considerable. Our aim was to estimate and compare the management (resource utilization) and economic healthcare impact in an at-risk group of unvaccinated pregnant women with an unvaccinated group of non-pregnant woman of childbearing age (15–44 yr old). Methods: We addressed this question with a longitudinal, observational, multicentre study. Inputs were the requirements in managing both groups of women. Outcome measures were healthcare costs. Direct healthcare (including medical utilisation, prescriptions of antivirals, medication, diagnostic tests, and hospitalisation) costs and indirect (productivity loss) costs were considered. Unit of cost was attributed to the frequency of health service resources utilisation. The mean cost per patient was calculated in this group of women. Results: We found that the influenza clinical pattern was worse in non-pregnant women as they had a high medical risk of 20.4% versus 6.1% of pregnant women. Non-pregnant required more antipyretics and antibiotics, and needed more health service resource utilisation (338 medical visits in non-pregnant women vs. 42 in pregnant women). The total cost of non-pregnant women was higher (€4,689.4/non-pregnant and €2,945.07/pregnant). Conclusions: Cost per (H1N1) pdm09 was lower for pregnant women, probably due to more preventive measures adopted for their protection in Spain. The highest costs were incurred by hospitalisations/day and work absenteeism for non-pregnant than for pregnant women. These data will allow better future pandemic influenza planning. PMID:27252911
Yoo, Jae Young; Rho, Mina; You, Young-Ah; Kwon, Eun Jin; Kim, Min-Hye; Kym, Sungmin; Jee, Young-Koo; Kim, Yoon-Keun; Kim, Young Ju
Recent evidence has indicated that bacteria-derived extracellular vesicles (EVs) are important for host–microbe communication. The aims of the present study were to evaluate whether bacteria-derived EVs are excreted via the urinary tract and to compare the composition of bacteria-derived EVs in the urine of pregnant and non-pregnant women. Seventy-three non-pregnant and seventy-four pregnant women were enrolled from Dankook University and Ewha Womans University hospitals. DNA was extracted from urine EVs after EV isolation using the differential centrifugation method. 16S ribosomal RNA (16S rRNA) gene sequencing was performed using high-throughput 454 pyrosequencing after amplification of the V1–V3 region of the 16S rDNA. The composition of 13 taxa differed significantly between the pregnant and non-pregnant women. At the genus level, Bacillus spp. EVs were more significantly enriched in the urine of the pregnant women than in that of the non-pregnant women (45.61% vs 0.12%, respectively). However, Pseudomonas spp. EVs were more dominant in non-pregnant women than in pregnant women (13.2% vs 4.09%, respectively). Regarding the compositional difference between pregnant women with normal and preterm delivery, EVs derived from Ureaplasma spp. and the family Veillonellaceae (including Megasphaera spp.) were more abundant in the urine of preterm-delivered women than in that of women with normal deliveries. Taken together, these data showed that Bacillus spp. EVs predominate in the urine of pregnant women, whereas Pseudomonas spp. EVs predominate in the urine of non-pregnant women; this suggests that Bacillus spp. EVs might have an important role in the maintenance of pregnancy. PMID:26846451
Yoo, Jae Young; Rho, Mina; You, Young-Ah; Kwon, Eun Jin; Kim, Min-Hye; Kym, Sungmin; Jee, Young-Koo; Kim, Yoon-Keun; Kim, Young Ju
Recent evidence has indicated that bacteria-derived extracellular vesicles (EVs) are important for host-microbe communication. The aims of the present study were to evaluate whether bacteria-derived EVs are excreted via the urinary tract and to compare the composition of bacteria-derived EVs in the urine of pregnant and non-pregnant women. Seventy-three non-pregnant and seventy-four pregnant women were enrolled from Dankook University and Ewha Womans University hospitals. DNA was extracted from urine EVs after EV isolation using the differential centrifugation method. 16S ribosomal RNA (16S rRNA) gene sequencing was performed using high-throughput 454 pyrosequencing after amplification of the V1-V3 region of the 16S rDNA. The composition of 13 taxa differed significantly between the pregnant and non-pregnant women. At the genus level, Bacillus spp. EVs were more significantly enriched in the urine of the pregnant women than in that of the non-pregnant women (45.61% vs 0.12%, respectively). However, Pseudomonas spp. EVs were more dominant in non-pregnant women than in pregnant women (13.2% vs 4.09%, respectively). Regarding the compositional difference between pregnant women with normal and preterm delivery, EVs derived from Ureaplasma spp. and the family Veillonellaceae (including Megasphaera spp.) were more abundant in the urine of preterm-delivered women than in that of women with normal deliveries. Taken together, these data showed that Bacillus spp. EVs predominate in the urine of pregnant women, whereas Pseudomonas spp. EVs predominate in the urine of non-pregnant women; this suggests that Bacillus spp. EVs might have an important role in the maintenance of pregnancy. PMID:26846451
Oreshnikov, E V; Oreshnikov, S F
The research includes 88 pregnant women, that had their purine basis and malondialdehyde in water thermocoagulate extract of venous blood and cerebrospinal fluid examined (along with common standards clinical-laboratory tests) before the spinal anesthesia for the caesarian section was provided It was detected that preeclampsy and HELLP-syndine feature the increased adenine guanine hypoxantine and uric acid levels in cerebrospinal fluid, as well as increased concentrations of blood malondyaldehyde (higher than upper normal level), accompany with the increased hemotaencephalic barrier permeability for adenine, guanine and hypoxantine. It's demonstrated that level of guanine in blood serum can be used as a prognostic factor of spinal anesthesia quality in obstetrics. It is supposed to examine purine levels in pregnant women not only in blood but also in cere brospinal fluid. PMID:26596029
Kayode, Oluwatosin O.; Odeniyi, Ifedayo A.; Iwuala, Sandra; Olopade, Oluwarotimi B.; Fasanmade, Olufemi A.; Ohwovoriole, Augustine E.
Context: Thyroid autoimmunity is a recognized disorder in pregnancy and is associated with a number of adverse pregnancy outcomes. Aim: This study set out to determine the relationship between pregnancy and thyroid autoimmunity in Nigerian women. Settings and Design: This was an analytical cross-sectional study carried out in a tertiary hospital in South Western Nigeria with a total study population of 108 pregnant and 52 nonpregnant women. Subjects and Methods: Serum thyroid stimulating hormone, free thyroxine and thyroid peroxidase antibodies (TPO-Ab) were quantitatively determined using enzyme linked immuno-assays. Pregnant women were grouped into three categories (<14 weeks, 14–28 weeks and > 28 weeks). The relationship between pregnancy and thyroid autoimmunity was determined using Spearman correlation. Analysis of variance was used in comparison of means, Chi-square test used in analyzing proportions while P ≤ 0.05 was considered as significant. Results: The mean age of the pregnant women was 30.4 ± 6.0 years while the mean gestational age of all pregnant women was 20.6 ± 9.6 weeks. The mean TPO-Ab of 11.58 IU/ml in the pregnant was significantly higher than that of the controls of 7.23 IU/ml (P < 0.001). Out of 108 pregnant women, 27 (25%) had elevated TPO-Ab as against about 2% of the nonpregnant women levels P < 0.001. The number of pregnant women with elevated TPO-Ab levels decreased from 33.3% in the first group to 25.6% and 15.2% in the second and third groups. Conclusion: Thyroid autoimmunity expressed by the presence of TPO-Ab is high among pregnant Nigerian women and the frequency of autoimmunity appears to decline with advancing gestational age. PMID:26425470
Background: An analysis of data from the National Health and Nutrition Examination Survey indicated that in older adults exposed to folic acid fortification, the combination of low serum vitamin B-12 and elevated folate is associated with higher concentrations of homocysteine and methylmalonic acid ...
Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.
For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…
Oriol, Albert; Vives, Susana; Hernández-Rivas, Jesús-María; Tormo, Mar; Heras, Inmaculada; Rivas, Concepción; Bethencourt, Concepción; Moscardó, Federico; Bueno, Javier; Grande, Carlos; del Potro, Eloy; Guardia, Ramon; Brunet, Salut; Bergua, Juan; Bernal, Teresa; Moreno, Maria-José; Calvo, Carlota; Bastida, Pilar; Feliu, Evarist; Ribera, Josep-Maria
Background About one half of adults with acute lymphoblastic leukemia are not cured of the disease and ultimately die. The objective of this study was to explore the factors influencing the outcome of adult patients with relapsed acute lymphoblastic leukemia. Design and Methods We analyzed the characteristics, the outcome and the prognostic factors for survival after first relapse in a series of 263 adult patients with acute lymphoblastic leukemia (excluding those with mature B-cell acute lymphoblastic leukemia) prospectively enrolled in four consecutive risk-adapted PETHEMA trials. Results The median overall survival after relapse was 4.5 months (95% CI, 4–5 months) with a 5-year overall survival of 10% (95% CI, 8%–12%); 45% of patients receiving intensive second-line treatment achieved a second complete remission and 22% (95% CI, 14%–30%) of them remained disease free at 5 years. Factors predicting a good outcome after rescue therapy were age less than 30 years (2-year overall survival of 21% versus 10% for those over 30 years old; P<0.022) and a first remission lasting more than 2 years (2-year overall survival of 36% versus 17% among those with a shorter first remission; P<0.001). Patients under 30 years old whose first complete remission lasted longer than 2 years had a 5-year overall survival of 38% (95% CI, 23%–53%) and a 5-year disease-free survival of 53% (95% CI, 34%–72%). Conclusions The prognosis of adult patients with acute lymphoblastic leukemia who relapse is poor. Those aged less than 30 years with a first complete remission lasting longer than 2 years have reasonable possibilities of becoming long-term survivors while patients over this age or those who relapse early cannot be successfully rescued using the therapies currently available. PMID:20145276
McCullough, Laurence B; Coverdale, John H; Chervenak, Frank A
There is a consistent view in the literature that research on pregnant woman with psychoses is ethically questionable or impermissible. This paper provides a critical appraisal of these views by asking whether pharmacologic research on pregnant women with psychosis for maternal, fetal, and newborn benefit is ethically permissible. We examine separately the documented clinical benefits and risks to the pregnant patient, the fetal patient, and the neonatal and pediatric patient. The outcomes reported in the pertinent literature do not support the conclusion that pharmacologic management of psychosis during pregnancy results in documented, unacceptable risk to the pregnant, fetal, or neonatal patient and is therefore ethically ruled out. Claims that research on the pharmacologic management of psychosis during pregnancy is ethically impermissible because of unacceptable risk of harm to pregnant, fetal, neonatal, or pediatric patients cannot therefore be supported. Having shown that such research is permissible, we then ask what ethical considerations should guide study design. We show that Phase I studies are appropriate and can meet the requirements of the Common Rule, which are more specific than international guidance. As a matter of professionally responsible obstetric practice, pregnant women with psychoses should be included, and not be neglected, in research for both maternal and fetal benefit. PMID:25389981
Background Text messaging (short message service, SMS) programs have been shown to be effective in helping adult smokers quit smoking. This study describes the results of a pilot test of Quit4baby, a smoking cessation text messaging program for pregnant smokers that was adapted from Text2quit. Objective The study aimed to demonstrate the feasibility and acceptability of Quit4baby for women currently enrolled in Text4baby, a perinatal health text messaging program. Methods Pregnant women enrolled in Text4baby and who were current smokers or had quit within the last 4 weeks (n=20) were enrolled in Quit4baby. Those under the age of 18, not pregnant, not current smokers, those using nicotine replacement therapy, and those not interested in participating were ineligible. Participants were surveyed at baseline and at 2 and 4 weeks postenrollment. Results Most participants responded to the program favorably. Highly rated aspects included the content of the program, skills taught within the program, and encouragement and social support provided by the program. Participants reported that the program was helpful in quitting, that the program gave good ideas on quitting, and that they would recommend the program to a friend. Suggestions for improvement included increasing the message dose and making the quitpal more interactive. Conclusions This pilot test provides support for the feasibility and acceptability of Quit4baby. Future studies are needed to assess whether Quit4baby is effective for smoking cessation during pregnancy. PMID:25650765
Background Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors. Methods/design The intervention development was guided by the Intervention Mapping protocol, ensuring a theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus version additionally addressing the home environment arrangement and the availability and price of healthy food products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables, high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months post-intervention, using online questionnaires. Both versions will
Moniuszko, Anna; Czupryna, Piotr; Pancewicz, Sławomir; Kondrusik, Maciej; Penza, Paweł; Zajkowska, Joanna
Borrelial lymphocytoma (BL) is a rare cutaneous manifestation of Lyme borreliosis. Epidemiological data show that BL is more common in children than in adults. It presents as a single bluish-red swelling located on the earlobe in children, near the nipple in adults. In our paper, we present a case of a pregnant woman with BL, which appeared after tick bite and disappeared completely after antibiotic therapy. The aim of the paper was to emphasize that in tick-borne disease endemic areas BL should be taken into consideration in cases of skin lesions. PMID:22906496
Friedel, David; Stavropoulos, Stavros; Iqbal, Shahzad; Cappell, Mitchell S
About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications, including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography (ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone
Hall, Ryan C H; Friedman, Susan Hatters; Jain, Abhishek
Recent evolving trends in the United States legal system regarding how policies and laws are applied to pregnant women include concerns over the use of restraints or shackles in pregnant inmates and forced treatment or commitment of pregnant women for substance abuse. These topics raise many questions, such as: how violent are women, particularly pregnant women; what are the informed consent and treatment implications; and who is at risk of harm? In addition, questions have been raised regarding maternal versus fetal rights, especially when the mother uses substances during a pregnancy. We review legal decisions and organizational position statements and highlight ethics-related concerns. PMID:26438814
... fullstory_158983.html Whooping Cough Shot Safe for Pregnant Women It also offers short-term protection to ... News) -- The whooping cough vaccine is safe for pregnant women, a new study indicates. The researchers also ...
... nih.gov/medlineplus/news/fullstory_158983.html Whooping Cough Shot Safe for Pregnant Women It also offers ... MONDAY, May 23, 2016 (HealthDay News) -- The whooping cough vaccine is safe for pregnant women, a new ...
Dennis, A T; Solnordal, C B
Acute pulmonary oedema in pregnant women is an uncommon but life-threatening event. The aims of this review are to address why pulmonary oedema occurs in pregnant women and to discuss immediate management. We performed a systematic literature search of electronic databases including MEDLINE, EMBASE and the Cochrane Library, using the key words obstetrics, pregnancy, acute pulmonary oedema, pregnancy complications, maternal, cardiac function and haemodynamics. We present a simple clinical classification of acute pulmonary oedema in pregnancy into pulmonary oedema occurring in normotensive or hypotensive women (i.e. without hypertension), and acute pulmonary oedema occurring in hypertensive women, which allows focused management. Pre-eclampsia remains an important cause of hypertensive acute pulmonary oedema in pregnancy and preventive strategies include close clinical monitoring and restricted fluid administration. Immediate management of acute pulmonary oedema includes oxygenation, ventilation and circulation control with venodilators. Pregnancy-specific issues include consideration of the physiological changes of pregnancy, the risk of aspiration and difficult airway, reduced respiratory and metabolic reserve, avoidance of aortocaval compression and delivery of the fetus. PMID:22420683
The Pregnant Gilt Model (PGM) is substantially complete and has provided substantive deliverables for the swine industry in Canada and beyond. The success of the PGM was largely dependent on a team of more than 30 researchers, students and technicians, along with external collaborators and instituti...
Duffy, Joanne; Coates, Thomas J.
Describes psychosocial intervention designed to reduce smoking in a group of pregnant teenagers. Five modules are presented, each being designed to heighten awareness of the issue; provide motivational messages; enhance the adolescent's social skills; and teach specific smoking-cessation skills. (Author/NB)
Dentico, Pietro; Volpe, Anna; Putoto, Giovanni; Ramadani, Naser; Bertinato, Luigi; Berisha, Merita; Schinaia, Nicola; Quaglio, Gianluca; Maggi, Paolo
This study presents the initial results of a collaborative project aimed at the evaluation of Toxoplasma seroprevalence in a population of Kosovar pregnant women. The serum samples of 334 pregnant women were tested to detect IgG, IgM, IgG avidity for toxoplasmosis. Data regarding age, occupation, area of origin and education were also obtained for the pregnant women examined; 97/334 (29.4%) resulted positive for IgG antibodies, four of whom (4.1%) were also positive for IgM, (1.2% of the total population examined). All four IgM-positive pregnant women also demonstrated low avidity tests. The rate of IgG seroprevalence found in our study was lower than that observed in various European countries, especially those of western Europe. Conversely, the percentage of recent infections was higher than expected. The higher rate of infections could be the result of a recent toxoplasmosis epidemic in Kosovo, most likely due to the altered hygienic conditions caused by the forced transfer of the ethnic-Albanian population from an area of low (Serbia) to high (Kosovo) toxoplasmosis prevalence. PMID:21617833
Sales of raw or unpasteurized milk and milk products are still legal in at least 30 states in the United States. Raw milk and milk products from cows, goats, and sheep continue to be a source of bacterial infections attributable to a number of virulent pathogens, including Listeria monocytogenes, Campylobacter jejuni, Salmonella species, Brucella species, and Escherichia coli O157. These infections can occur in both healthy and immunocompromised individuals, including older adults, infants, young children, and pregnant women and their unborn fetuses, in whom life-threatening infections and fetal miscarriage can occur. Efforts to limit the sale of raw milk products have met with opposition from those who are proponents of the purported health benefits of consuming raw milk products, which contain natural or unprocessed factors not inactivated by pasteurization. However, the benefits of these natural factors have not been clearly demonstrated in evidence-based studies and, therefore, do not outweigh the risks of raw milk consumption. Substantial data suggest that pasteurized milk confers equivalent health benefits compared with raw milk, without the additional risk of bacterial infections. The purpose of this policy statement was to review the risks of raw milk consumption in the United States and to provide evidence of the risks of infectious complications associated with consumption of unpasteurized milk and milk products, especially among pregnant women, infants, and children. PMID:24344105
Liotta, Giuseppe; Chimbwandira, Frank; Wouters, Kristien; Nielsen-Saines, Karin; Jere, Haswell; Mancinelli, Sandro; Ceffa, Susanna; Erba, Fulvio; Palombi, Leonardo; Marazzi, Maria Cristina
Combination antiretroviral therapy has been shown to reduce HIV transmission and incident infections. In recent years, Malawi has significantly increased the number of individuals on combination antiretroviral drugs through more inclusive treatment policies. Using a retrospective observational cohort design, records with HIV test results were reviewed for pregnant women attending a referral hospital in Malawi over a 5-year period, with viral load measurements recorded. HIV prevalence over time was determined, and results correlated with population viral load. A total of 11 052 women were included in this analysis, with 440 (4.1%) HIV infections identified. HIV prevalence rates in pregnant women in Malawi halved from 6.4% to 3.0% over 5 years. Mean viral loads of adult patients decreased from 120 000 copies/mL to less than 20 000 copies/mL. Results suggest that community viral load has an effect on HIV incidence rates in the population, which in turn correlates with reduced HIV prevalence rates in pregnant women. PMID:26512040
Raguž, Marjana Jerković; Brzica, Jerko
Objective The objective of this study was to determine the effect of body mass index (BMI) during pregnancy in laboratory parameters in the serum of the three groups of pregnant women and in their newborns. Methods This prospective study is comparison between the three groups of pregnant women and their newborns categorized according to their BMI. The study included 128 pregnant women and their newborns. In this study, the concentration of blood count, iron, ferritin, and bilirubin were analyzed in the subjects. Results The pregnant women in the three groups significantly differ in the values of blood count (p < 0.001). Statistically significant difference in iron and ferritin was not found between individual three studied groups of pregnant women (p = 0.947). The newborn of the first group of pregnant women had significantly lower values of ferritin (p < 0.001), leucocytes (p < 0.001), and bilirubin (p < 0.001). Significant positive correlation between BMI of pregnant women and leucocytes, ferritin, and bilirubin of the newborn was found (p < 0.001). Conclusion In this study, the tested pregnant women do not have biochemical signs of anemia, neither do their newborns. It was noted that there was no negative correlation between individual tested biochemical parameters for anemia in pregnant women and their newborns. PMID:27119047
Rodríguez-Morales, Alfonso J.; Barbella, Rosa A.; Case, Cynthia; Arria, Melissa; Ravelo, Marisela; Perez, Henry; Urdaneta, Oscar; Gervasio, Gloria; Rubio, Nestor; Maldonado, Andrea; Aguilera, Ymora; Viloria, Anna; Blanco, Juan J.; Colina, Magdary; Hernández, Elizabeth; Araujo, Elianet; Cabaniel, Gilberto; Benitez, Jesús; Rifakis, Pedro
Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 (P < .01). Discussion. Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered. PMID:17093349
Zhang, Yi; Guo, Sa; Wang, Jing; Wang, Jianjun
Aim To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors. Methods We searched hospital databases for women who were 37–41 weeks pregnant (1698 cases) from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software. Results Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history. Conclusion The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population. PMID:26208169
Expectations and Anticipations of Middle and High School Special Education Teachers in Preparing Their Students with Intellectual Disability for Future Adult Roles Including Those as Partner and Parent
Through a series of individual ethnographic interviews and focus groups, I explored the expectations and anticipations of middle and high school special education teachers as they carry out their professional charge of educating their students with intellectual disability for lives in the least restrictive environment, including possible adult…
Auriault, F; Thollon, L; Peres, J; Delotte, J; Kayvantash, K; Brunet, C; Behr, M
This study report documents the development of a finite element (FE) model for analyzing trauma in pregnant women involved in road accidents and help the design of a specific safety device. The model is representative of a 50th percentile pregnant woman at 26 weeks of pregnancy in sitting position. To achieve this, the HUMOS 2 model, which has been validated in a wide range of dynamic tests, was scaled to the morphology of a woman in the 50th percentile and coupled with a model of gravid uterus. During scaling, special attention was paid to the pelvic region which is known to differ considerably in morphological terms between men and women. The gravid uterus model includes a placenta, a fetus, uterosacral ligaments and the amniotic fluid by means of fluid structure interaction formulation. The uterus and the female model were coupled using an original method whereby the growth of an uterus was simulated to compress the abdominal organs in a realistic manner. The model was validated based on experimental tests described in the literature. Additional tests based on abdominal loadings with a seatbelt on Post Mortem Human Surrogates (PMHS) coupled to silicone uterus were also performed. Results highlighted the role of the possible interaction of the fetus in the pregnant woman abdominal response. Experimental corridors taking into account the presence of this fetus could therefore be proposed. PMID:24182770
Labrecque, Matthew T; Malone, D’eldra; Caldwell, Katharine E; Allan, Andrea M
Research identifying connections between the gastrointestinal flora and human health has developed at a rapid pace. Several studies link the gut microbiome to a variety of biological functions beyond the gastrointestinal tract. Changes in our diets, including the consumption of artificial sweeteners, have profound effects on the composition of the gut microbiome and can, in turn, affect brain function, glucose tolerance, and inflammation. Sweeteners are often used to encourage consumption of agents such as ethanol and nicotine in laboratory studies using rodents. Studies aiming to examine the effects of agents like ethanol on the developing nervous system administer these agents during pregnancy. To date, there have been no studies exploring the impact of the combination of dietary ethanol and saccharin during pregnancy on the gut microbiome in either humans or laboratory animal models. In the study presented, we evaluated the impact of ethanol in either water or saccharin on the fecal microbiome in pregnant and non-pregnant mice using a qPCR approach. We found that the combination of ethanol and saccharin produced different effects than ethanol in water, depending on pregnancy status. Levels of Clostridium were reduced in ethanol-saccharin but not ethanol-water drinking mice, even though the total levels of ethanol consumed were the same for the two groups. Eubacteria were increased in the pregnant, but decreased in the non-pregnant, ethanol-saccharin drinking group. These treatment and pregnancy specific changes could impact the development of the offspring. In developing and quality checking our primer sets for these studies we identified several problems within previous research in the field. The technical drawbacks in previous studies, as well as our own study, are discussed. Despite some progress in the ability to study the gut microbiome, more advances and standardization of practices should be established to improve the reliability and validity of
Gara, Edit; Gesztes, Éva; Doroszlai, Richárd; Zacher, Gábor
Recognition of carbon monoxide is difficult due to its plain physical-chemical properties. Carbon and gas operating heating systems may cause severe poisoning. Carbon-monoxide intoxication may generate severe hypoxic damage and it may cause death. The authors present the case of severe carbon monoxide poisoning affecting one young child and five adults, including a pregnant woman. Because the availability of hyperbaric oxygen therapy is limited in Hungary, urgent cesarean section was performed to avoid intrauterine hypoxic damage. The authors note that there are no standardized non-invasive methods for measuring fetal carbon-monoxide level and that the level of carbon monoxide accumulation is higher and the clearance is longer in the fetus than in the mother. The pathophysiology of carbon monoxide intoxication and therapeutic options in pregnancy are discussed. PMID:24860052
Fernandes, Susan M; Arendt, Katherine W; Landzberg, Michael J; Economy, Katherine E; Khairy, Paul
Remarkable advances in surgical and clinical management have resulted in survival to adulthood in the large majority of patients with congenital heart malformations, even with the most complex disease. Over 1 million adults with congenital heart disease currently live in the USA, approximately half of whom are women of childbearing age. Collectively, congenital malformations are the most common form of heart disease in pregnant women. Indeed, in North America, congenital defects are now the leading cause of maternal morbidity and mortality from heart disease. This article begins with a summary of cardiovascular changes during pregnancy and highlights key features in pre-pregnancy counseling, maternal cardiac and obstetric risk, and neonatal complications. Management issues regarding pregnancy and delivery are elaborated, including anesthesia considerations. While it is beyond the scope of this article to discuss particulars related to all forms of congenital heart disease, selected subtypes are detailed at greater length. In the absence of clinical trial evidence to inform the care of pregnant women with congenital heart disease, this article is inspired by the premise that knowledgeable multidisciplinary assessment and management provides the best opportunity to substantially improve outcomes for mother and baby. PMID:20222821
Mercurio, Mark R
Pregnancy in an early adolescent carries with it specific ethical considerations, in some ways different from pregnancy in an adult and from medical care of a non-pregnant adolescent. Obstetrical ethics emphasizes the right of the patient to autonomy and bodily integrity, including the right to refuse medical intervention. Pediatric ethics recognizes the right of parents, within limits, to make medical decisions for their children, and the right of a child to receive medical or surgical interventions likely to be of benefit to her, sometimes over her own objections. As the child gets older, and particularly during the years of adolescence, there is also a recognition of the right to an increasingly prominent role in decisions about her own healthcare. Pediatric obstetrical ethics, referring to ethical decisions made by, with, and for pregnant early adolescents, represents the intersection of these different cultures. Principles and approaches from both obstetrical and pediatric ethics, as well as a unified understanding of rights, obligations, and practical considerations, will be needed. PMID:26916394
LOTH, Eduardo Alexandre; CECATTO, Vanessa; BIAZIM, Samia Khalil; FERREIRA, José Henrique Fermino; DANIELLI, Caroline; GENSKE, Rodrigo Daniel; GANDRA, Rinaldo Ferreira; de FRANCO, Marcello Fabiano
Paracoccidioidomycosis (PCM), caused by the dimorphic fungus Paracoccidioides brasiliensis (Pb), is the most prevalent systemic mycosis in Latin America. There are few reports in the literature about the disease damages during pregnancy and the consequences to the fetuses and breeding. This study evaluated the implications of PCM during pregnancy on offspring and mothers in Wistar rats. Groups of rats were submitted to systemic Pb infection, by intraperitoneal infusion, and mated 30 days after the infection date. Immediately after birth, rats and neonates were sacrificed to obtain organs for standard histological examination, morphometric analysis, fungi recovery by plating (CFU) and dosing of anti-Pb antibodies by ELISA. There were no stillbirths or miscarriages, however, the fetuses from infected pregnant rats had lower body and organ weight but the fertility rate was 100%. The largest number of CFU was recovered from the organ of pregnant rats, the pathological examination revealed more severe infection in the same group, further on the largest number of granulomas and fungal field. It can be concluded that the PCM was more severe in the group of pregnant rats, with implications to the weight of offspring. PMID:27049707
Richard-Lenoble, D; Chandenier, J; Duong, T H
Like antibacterial agents, antiparasite drugs for pregnant women and children must be chosen in function of the stage of pregnancy, age of the child, and expected benefit-risk ratio. While no agent is totally safe, there are few absolute contraindications. Most zones of serious endemic parasite disease are located in developing countries where parasite, bacterial, or viral conditions combined with poor nutrition treatment make it necessary to treat disease in a complex pathogenic environment that weakens pregnant women and children with multiple parasite infections. In both temperate and tropical zones, there have been few real therapeutic advances involving release of new products on the market or development of new indications for existing products. Constant appearance and extension of hematozoa resistance to conventional and even more recent antimalarial agents have prompted research to find new active drugs and long-lasting treatment combinations. Real therapeutic breakthroughs have resulted from the need to develop safe drugs without substantial side-effects for single-dose use in control programs against endemic parasite diseases in mass populations including pregnant women and young children in tropical zones. There are several notable examples in the field of major verminous diseases. Ivermectin is a versatile drug that can be used against filariasis as well as for management of intestinal worms or ectoparasitosis in temperate and tropical countries. Praziquantel is an important advance in platyhelminthiasis, especially bilharziais. Triclabendazole, the latest addition to the benzimidazole family, has shown promise as a substitute for bithionol, that is difficult to procure and not recommended in pregnant women, for treatment distomiasis occurring in pregnant women and children. Other examples include albendazole against giardiasis, nitazoxamide against cryptosporidiosis, artemisinine against bilharziasis, and paramomycine, not recommended in pregnant women
Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...
Clinical experience and recent research challenge the current standards of exercise duration and intensity for pregnant women. By carefully assessing patients' self-monitoring techniques, physicians can work with active women to create safe exercise programs during pregnancy. Safety guidelines for developing home exercise programs are included.…
Childs, Robert D.
This study had two purposes. The primary purpose was to determine the current legal status of pregnant students in the public schools in the fifty states in 1972. The secondary purpose was to examine implications of the findings for administrators faced with this student problem. The design of the study included a combination of the following…
Aerts, L; Van Assche, F A
Gestational diabetes compromises fetal development and induces a diabetogenic effect in the offspring, including the development of gestational diabetes and the transmission of the effect to the next generation. Changes are not limited to glucose and insulin metabolism, and appear to be modulated by alterations at the hypothalamo-hypophyseal axis. In the present work, serum concentrations are given for the non-protein amino-acids taurine and gamma-aminobutyric acid (GABA), both neurotransmitters essential for normal brain development, and for the endogenous neuroprotector carnosine, a known anti-oxydans. Taurine levels are significantly below normal values in mildly diabetic mothers, in their fetal and adult offspring, virgin and pregnant, and in the fetuses of these pregnant offspring. GABA and carnosine levels are at the limit of detection in the diabetic mothers and their offspring at every stage. It is concluded that the low taurine, GABA and carnosine levels in diabetic mothers and their fetuses might compromise the normal structural and functional development of the fetal brain. When adult, these offspring present a deficiency of the circulating levels of these neurotransmitters involved in the hypothalamo-hypophyseal regulation of insulin secretion. This might contribute to the development of impaired glucose tolerance and gestational diabetes, thereby transmitting the effect to the next generation. PMID:11234622
Morchiladze, N; Tkeshelashvili, B; Gagua, D; Gagua, T
Several medical - biological and social - hygienic factors have been found to account for the definite increase in the incidence of thyroid gland disorders in reproductive age and pregnant women. Aim of our study was to identify the risk factors for development of thyroid gland pathology in outpatient pregnant women. Observational study - "case - control" study has been conducted at the base of David Gagua Hospital Ltd. Main (study) group involved 292 pregnant patients with established thyroid pathology. Control group included 58 conditionally healthy pregnant participants without any demonstrated thyroid pathology. Study of risk factors was performed by initial interviewing and specialized questionnaire recording process (so-called two-stage model of interviewing). Characteristics of diet, sleep, physical activity, including harmful habits, socio-economic and hereditary factors were studied; quantitative indices of risk for each component were calculated: odds ratio (OR) and attributable risk (AR), taking into account 95% confidence interval (CI). The Pearson's criterion χ2 with respective P value and the calculator developed by International Society of Evidence-based Medicine were used to obtain the final results. Statistically significant risk factors for development of thyroid pathology were identified, which included: Thyroid gland diseases and hereditary history of diabetes mellitus; low economic income, unfavorable living conditions, unhealthy dietary habits. Despite of the difficulty of assessment of causative relationship between above mentioned components, their strong correlation should be taken into account when defining the strategy of preventive measures, moreover the most part of identified risk factors are manageable. PMID:27441534
Background This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. Results A retrospective case–control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. Conclusion We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the
Rademacher, Ryan D; Warr, Brian N; Booker, Calvin W
Pregnant heifers in the feedlot pose many economic and management issues to the producer. Heifers that enter the feedlot pregnant will have increased costs associated with them regardless of the management strategy implemented. It is imperative that practitioners be aware of management concerns associated with pregnant heifers in order to provide sound recommendations for their clients. The purpose of this article is to provide the bovine practitioner with a summary of current literature and present common options for managing pregnant heifers in a feedlot setting. PMID:26139188
Durandy, A.; Fischer, A.; Griscelli, C.
Although an excess of human adult blood adherent cells inhibits the pokeweed mitogen- (PWM) induced normal adult lymphocyte proliferation and B cell maturation into immunoglobulin-containing cells (ICC), adherent cells collected from newborn infants or pregnant women at time of delivery were unable to exert a similar suppressor activity. After activation by Concanavalin A (Con A), newborns' and pregnant women's adherent cells acquired a suppressor activity comparable to that of control adult adherent cells. The adherent suppressor cell was shown to be radioresistant (3000 rad), indicating its probable monocytic orgin. Both monocyte-suppressor activities (MSA) observed in adulthood (spontaneously) and in the neonatal period (after activation) were dependent on prostaglandin E/sub 2/ (PGE/sub 2/) secretion, because they were abolished by indomethacin or a specific anti-PGE/sub 2/ anti-serum. Expression of MSA appeared to be under a negative regulation exerted by naturally occurring T suppressor lymphocytes present in the blood of newborns or pregnant women, because incubation of adult monocytes or Con A-activated newborn monocytes with newborns' or pregnant women's T lymphocytes resulted in a dramatic decrease of their MSA. These results strongly suggest that the lack of MSA in the neonatal period and in late pregnancy is a consequence of activation of T suppressor lymphocytes.
Establishing integrated rural–urban cohorts to assess air pollution-related health effects in pregnant women, children and adults in Southern India: an overview of objectives, design and methods in the Tamil Nadu Air Pollution and Health Effects (TAPHE) study
Balakrishnan, Kalpana; Sambandam, Sankar; Ramaswamy, Padmavathi; Ghosh, Santu; Venkatesan, Vettriselvi; Thangavel, Gurusamy; Mukhopadhyay, Krishnendu; Johnson, Priscilla; Paul, Solomon; Puttaswamy, Naveen; Dhaliwal, Rupinder S; Shukla, D K
Introduction In rapidly developing countries such as India, the ubiquity of air pollution sources in urban and rural communities often results in ambient and household exposures significantly in excess of health-based air quality guidelines. Few efforts, however, have been directed at establishing quantitative exposure–response relationships in such settings. We describe study protocols for The Tamil Nadu Air Pollution and Health Effects (TAPHE) study, which aims to examine the association between fine particulate matter (PM2.5) exposures and select maternal, child and adult health outcomes in integrated rural–urban cohorts. Methods and analyses The TAPHE study is organised into five component studies with participants drawn from a pregnant mother–child cohort and an adult cohort (n=1200 participants in each cohort). Exposures are assessed through serial measurements of 24–48 h PM2.5 area concentrations in household microenvironments together with ambient measurements and time-activity recalls, allowing exposure reconstructions. Generalised additive models will be developed to examine the association between PM2.5 exposures, maternal (birth weight), child (acute respiratory infections) and adult (chronic respiratory symptoms and lung function) health outcomes while adjusting for multiple covariates. In addition, exposure models are being developed to predict PM2.5 exposures in relation to household and community level variables as well as to explore inter-relationships between household concentrations of PM2.5 and air toxics. Finally, a bio-repository of peripheral and cord blood samples is being created to explore the role of gene–environment interactions in follow-up studies. Ethics and dissemination The study protocols have been approved by the Institutional Ethics Committee of Sri Ramachandra University, the host institution for the investigators in this study. Study results will be widely disseminated through peer-reviewed publications and
Popovski, N; Popovski, K; Nedelkovski, V
Vaginal infections /VI/ represent some of the most common diseases by infection of FGS. The aim of this study is to analyze clinical and bacteriological efficacy of Polygynax in the treatment of vaginal infections and to take into account the correlation between the results of microbiological controls and reduction of clinical symptoms. The study included 100 patients, including 50 pregnant and non-pregnant 50 for a period of 3 months. All of them was diagnosed with vaginitis clinical examination, taken material from vagina for microbiological testing. The studied women was conducted targeted therapy Polygynax 12 capsules, in the form of vaginal capsules for 12 days, after which the sample control microbiology. Behind the subjective complaints of the patient and to reduce them as a result of treatment. The effective implementation of Polygynax 12 capsules is equally good as in non-pregnant and pregnant women. In a summary of the survey data to make relevant analyzes and conclusions from the results. PMID:27509660
Wosu, Adaeze C; Gelaye, Bizu; Williams, Michelle A
The aims of this review are (i) to summarize and evaluate current knowledge on the association between childhood sexual abuse (CSA) and posttraumatic stress disorder (PTSD) in pregnant and postpartum women, (ii) to provide suggestions for future research on this topic, and (iii) to highlight some clinical implications. Relevant publications were identified through literature searches of four databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and PsycARTICLES) using keywords such as "child abuse," "posttraumatic stress," "pregnancy," and "postpartum". Five studies were included in this review. Findings across all studies were consistent with higher prevalence of PTSD diagnosis or symptomatology among women with history of CSA. However, only findings from two studies were statistically significant. One study observed higher overall PTSD scores in women with CSA history compared to women with non-CSA trauma history or no trauma history during pregnancy (mean ± SD 1.47 (0.51) vs. 1.33 (0.41) vs. 1.22 (0.29), p < 0.001), at 2 months postpartum (mean ± SD 1.43 (0.49) vs. 1.26 (0.38) vs. 1.19 (0.35), p < 0.001), and at 6 months postpartum (mean ± SD 1.36 (1.43) vs. 1.20 (0.33) vs. 1.14 (0.27), p < 0.001). Another study observed that the prevalence of PTSD during pregnancy was 4.1 % in women with no history of physical or sexual abuse, 11.4 % in women with adult physical or sexual abuse history, 16.0 % in women with childhood physical or sexual abuse history, and 39.0 % in women exposed to both childhood and adult physical or sexual abuse (p < 0.001); in a subsequent analysis, the investigators reported that pregnant women with PTSD had over 5-fold odds of having a history of childhood completed rape compared to counterparts without PTSD (OR = 5.3, 95 % CI 3.2, 8.7). Overall, available evidence suggests positive associations of CSA with clinical PTSD or PTSD symptomatology among pregnant and
Wosu, Adaeze C.; Gelaye, Bizu; Williams, Michelle A.
Purpose The aims of this review are i) to summarize and evaluate current knowledge on the association between childhood sexual abuse (CSA) and posttraumatic stress disorder (PTSD) in pregnant and postpartum women, ii) to provide suggestions for future research on this topic, and iii) to highlight some clinical implications. Methods Relevant publications were identified through literature searches of four databases (PubMed, CINAHL, PsycINFO, and PsycARTICLES) using keywords such as “child abuse,” “posttraumatic stress,” “pregnancy” and “postpartum”. Results Five studies were included in this review. Findings across all studies were consistent with higher prevalence of PTSD diagnosis or symptomatology among women with history of CSA. However, only findings from two studies were statistically significant. One study observed higher overall PTSD scores in women with CSA history compared to women with non-CSA trauma history or no trauma history during pregnancy (mean±SD 1.47 (0.51) vs. 1.33 (0.41) vs. 1.22 (0.29), p<0.001), at 2 months postpartum (mean±SD 1.43 (0.49) vs. 1.26 (0.38) vs. 1.19 (0.35), p<0.001), and at 6 months postpartum (mean±SD 1.36 (1.43) vs. 1.20 (0.33) vs. 1.14 (0.27), p<0.001). Another study observed that the prevalence of PTSD during pregnancy was 4.1 % in women with no history of physical or sexual abuse, 11.4 % in women with adult physical or sexual abuse history, 16.0 % in women with childhood physical or sexual abuse history, and 39.0 % in women exposed to both childhood and adult physical or sexual abuse (p<0.001); in a subsequent analysis, the investigators reported that pregnant women with PTSD had over 5-fold odds of having a history of childhood completed rape compared to counterparts without PTSD (OR = 5.3, 95 % CI 3.2, 8.7). Conclusions Overall, available evidence suggests positive associations of CSA with clinical PTSD or PTSD symptomatology among pregnant and postpartum women. PMID:25380784
Al-Faris, Nora A.
Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OH)D) was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OH)D < 50 nmol/L) and insufficiency (25(OH)D = 50–74 nmol/L) were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OH)D concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day) was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements. PMID:26861386
Drewery, M L; Gaitán, A V; Thaxton, C; Xu, W; Lammi-Keefe, C J
Background. The 2015-2020 Dietary Guidelines for Americans recommend that pregnant women and women of childbearing ages consume 8-12 oz. of seafood per week. Fish are the major dietary source of omega-3 long chain polyunsaturated fatty acids, which have benefits for the mother and fetus. Methods. In this observational study, we investigated dietary habits of pregnant women in Baton Rouge, Louisiana, USA, to determine if they achieve recommended seafood intake. A print survey, which included commonly consumed foods from protein sources (beef, chicken, pork, and fish), was completed by pregnant women at a single-day hospital convention for expecting families in October 2015. Women (n = 221) chose from six predefined responses to answer how frequently they were consuming each food. Results. Chicken was consumed most frequently (75% of women), followed by beef (71%), pork (65%), and fish (22%), respectively. Consumption frequency for the most consumed fish (catfish, once per month) was similar to or lower than that of the least consumed beef, chicken, and pork foods. Consumption frequency for the most consumed chicken and beef foods was at least once per week. Conclusion. Our data indicate that pregnant women in Louisiana often consume protein sources other than fish and likely fail to meet dietary seafood recommendations. PMID:27504202
Al-Faris, Nora A
Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OH)D) was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OH)D < 50 nmol/L) and insufficiency (25(OH)D = 50-74 nmol/L) were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OH)D concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day) was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements. PMID:26861386
Lammi-Keefe, C. J.
Background. The 2015–2020 Dietary Guidelines for Americans recommend that pregnant women and women of childbearing ages consume 8–12 oz. of seafood per week. Fish are the major dietary source of omega-3 long chain polyunsaturated fatty acids, which have benefits for the mother and fetus. Methods. In this observational study, we investigated dietary habits of pregnant women in Baton Rouge, Louisiana, USA, to determine if they achieve recommended seafood intake. A print survey, which included commonly consumed foods from protein sources (beef, chicken, pork, and fish), was completed by pregnant women at a single-day hospital convention for expecting families in October 2015. Women (n = 221) chose from six predefined responses to answer how frequently they were consuming each food. Results. Chicken was consumed most frequently (75% of women), followed by beef (71%), pork (65%), and fish (22%), respectively. Consumption frequency for the most consumed fish (catfish, once per month) was similar to or lower than that of the least consumed beef, chicken, and pork foods. Consumption frequency for the most consumed chicken and beef foods was at least once per week. Conclusion. Our data indicate that pregnant women in Louisiana often consume protein sources other than fish and likely fail to meet dietary seafood recommendations. PMID:27504202
Kahan, David; Barnett, David W.
Discusses medical and pedagogical issues of concern to physical educators as they confront and respond to adolescent pregnancy in their schools, making recommendations for the role higher education can play in facilitating exercise programs for pregnant students and discussing an exercise program for pregnant adolescents that has served students…
Oral glucose tolerance test - non-pregnant; OGTT - non-pregnant; Diabetes - glucose tolerance test ... The most common glucose tolerance test is the oral glucose tolerance test (OGTT). Before the test begins, a sample of blood will be taken. You will then ...
McKnight, A. James
This document is the final report on the Pregnant Adolescent Substance Abuse Project (PASAP) conducted in Prince Georges County (Maryland) in 1987 and 1988. The PASAP consisted of two components that operated independently: an Early Intervention Program that increased the proportion of pregnant adolescent substance users who were using various…
Link, Patricia W.
The paper describes the Lafayette Parish Homebound Program (Louisiana) for students in grades K-12, with particular emphasis on the program's services for pregnant girls. Procedures for admitting students into the program, objectives for the pregnant girls (12-18 years old), and program components are considered. It is explained that the special…
Langley, Ricky Lee
This is a review of Medline and PubMed articles on venomous animal bites and stings during pregnancy reported in English literature from 1966 to 2002. Eighty-five venomous snakebites were reported in pregnant women. Although there are frequent anecdotal reports of scorpion stings in pregnant women, few case reports are documented. Other venomous animal bites or stings to pregnant women that have been reported include spiders, jellyfish, and insects, and these are described. Adverse reproductive and teratogenic effects of venoms on gravid animals are also briefly reviewed. Although uncommon, venomous bites and stings during pregnancy may have significant adverse effects on the fetus and the mother. PMID:15473462
Wen, Xia; Donepudi, Ajay C.; Thomas, Paul E.; Slitt, Angela L.; King, Roberta S.
Phase II enzymes, including Ugts, Sults, and Gsts, are critical for the disposition and detoxification of endo- and xenobiotics. In this study, the mRNA and protein expression of major phase II enzymes, as well as key regulatory transcription factors, were quantified in livers of time-matched pregnant and virgin control C57BL/6 mice on gestation days (GD) 7, 11, 14, 17, and postnatal days (PND) 1, 15, and 30. Compared with virgin controls, the mRNA expression of Ugt1a1, 1a6, 1a9, 2a3, 2b1, 2b34, and 2b35 decreased 40 to 80% in pregnant dams. Protein expression of Ugt1a6 also decreased and corresponded with reduced in vitro glucuronidation of bisphenol A in S9 fractions from livers of pregnant mice. Similar to Ugts levels, Gsta1 and a4 mRNAs were reduced in pregnant dams in mid to late gestation; however no change in protein expression was observed. Conversely, Sult1a1, 2a1/2, and 3a1 mRNAs increased 100 to 500% at various time points in pregnant and lactating mice and corresponded with enhanced in vitro sulfation of acetaminophen in liver S9 fractions. Coinciding with maximal decreases in Ugts as well as increases in Sults, the expression of transcription factors CAR, PPARα, and PXR and their target genes were downregulated, whereas ERα mRNA was upregulated. Collectively, these data demonstrate altered regulation of hepatic phase II metabolism in mice during pregnancy and suggest that CAR, PPARα, PXR, and ERα signaling pathways may be candidate signaling pathways responsible for these changes. PMID:23055538
Fetal energy demands are met mostly from oxidation of maternally supplied glucose. In pregnant adults this increased glucose requirement is met by an increase in gluconeogenesis. It is not known, however, whether, like their adult counterparts, pregnant adolescent girls can increase gluconeogenesis ...
Allesee, Lori; Gallagher, Colleen M.
The call for the inclusion of pregnant women in clinical trials has received renewed attention recently. This interest springs from articles in various medical journals highlighting the gaps in medical knowledge and the need to improve health care for pregnant women. It is not a simple decision whether to include pregnant women in studies or not. The general thought is that it’s too dangerous for the baby if a pregnant woman is participating in a trial, and the absence of research on how medications work in pregnant women leave doctors guessing about how to safely and effectively treat patients through pregnancy. Excluding pregnant women from clinical trials are not automatic, not unethical nor is it arbitrarily determined. The regulatory framework is based on sound ethical and legal reasoning that demonstrates when inclusion in a clinical trial is appropriate or when clear and compelling reasons for exclusion are presented. Learning objective Readers will learn about limitations of research, history of the inclusion and exclusion of pregnant women in clinical trials, reticence for inclusions, as well as regulations designed using reasoned legal and ethical principles, such as: Principle of Autonomy, Informed Consent, and Beneficence and Nonmaleficence. PMID:21863146
Hsia, Jason; Tu, Xiaoming; Xia, Yang; Zhang, Lihong; Bi, Zhenqiang; Liu, Hongyan; Li, Xiaoming; Stanton, Bonita
Introduction Smoking prevalence is high among men in China. One result is that a large number of nonsmoking Chinese women may be exposed daily to secondhand smoke (SHS). Exposure is particularly problematic for pregnant women because of potential adverse reproductive effects. To determine the extent of this exposure and to summarize existing intervention studies designed to reduce SHS exposure in China, a systematic review of the literature published from 1995 through 2012 was conducted. Methods We searched the PubMed and Wanfang databases for studies published from 1995 through 2012 using various search terms including SHS, pregnant women, and China. Only articles on prevalence of SHS exposure and interventions to reduce exposure to SHS were selected. Results We identified 132 studies during the initial searches. Eight of 13 eligible studies reported the prevalence of SHS exposure among pregnant women; estimates ranged from 38.9% to 75.1%. Few SHS prevention interventions among pregnant women in China have been studied; we found only 5 such studies. The interventions primarily focused on changing husbands’ smoking behaviors; some interventions focused on women’s avoidance behaviors. Conclusion Prevalence of exposure to SHS among pregnant women is high in China. Information is limited on effective interventions to protect pregnant women from exposure. The results of this review can provide the basis for the design and evaluation of interventions to help pregnant women avoid SHS exposure. PMID:25789496
Wei, Jin-Song; Jin, Zhe-Bin; Yin, Zhi-Qiang; Xie, Qiang-Min; Chen, Ji-Qiang; Li, Zi-Gang; Tang, Hui-Fang
In order to determine whether local anesthetics directly affect the propagation and strength of myometrial contractions, we compared the effects of bupivacaine, ropivacaine, lidocaine and tetracaine on the contractions of myometrium isolated from pregnant and non-pregnant rats. Full-thickness myometrial strips were obtained from 18- to 21-day pregnant and non-pregnant Sprague-Dawley rats and incubated in an organ bath. When spontaneous contractions became regular, strips were exposed to cumulative concentrations of the four local anesthetics ranging from 0.01 to 300 μmol/L and the amplitude and frequency of contraction were recorded. All four compounds caused a concentration-dependent inhibition of the contractility of pregnant and non-pregnant uterine muscle. In pregnant myometrium, the concentration that caused 50% inhibition (IC(50)) was 100 μmol/L for bupivacaine, 157 μmol/L for ropivacaine, > 1000 μmol/L for lidocaine, and 26.3 μmol/L for tetracaine. In non-pregnant myometrium, the IC(50) was 26.9 μmol/L for bupivacaine, 40 μmol/L for ropivacaine, 384 μmol/L for lidocaine, and 7.4 μmol/L for tetracaine. These results suggested that local anesthetics do inhibit myometrial contractions in pregnant and non-pregnant rats in a concentration-dependent manner. PMID:24901082
Silveira, Marushka Leanne; Pekow, Penelope S.; Dole, Nancy; Markenson, Glenn; Chasan-Taber, Lisa
Objectives Prenatal psychosocial stress has been associated with adverse pregnancy outcomes, even after controlling for known risk factors. This paper aims to evaluate correlates of high perceived stress among Hispanic women, a group with elevated rates of stress during pregnancy. Methods We conducted this analysis among 1426 pregnant Hispanic women using data from Proyecto Buena Salud, a prospective cohort study conducted in Western Massachusetts. Cohen’s Perceived Stress Scale (PSS-14) validated in English and Spanish was administered in early (mean=12.4 wks gestation), mid (mean=21.3 wks gestation) and late (mean=30.8 wks gestation) pregnancy at which time bilingual interviewers collected data on socio-demographic, acculturation, behavioral, and psychosocial factors. High perceived stress was defined as a PSS score>30. Results Young maternal age (odds ratio (OR) =0.6; 95% confidence interval (CI) 0.4-0.9 for <19 vs. 19-23yrs), pre-pregnancy consumption of alcohol (OR=2.2; 95% CI 1.4-3.5 for >12 drinks/mo. vs. none) and smoking (OR=2.2; 95% CI 1.3-3.7 for >10 cigarettes/day vs. none) were associated with high perceived stress during early pregnancy. Furthermore, higher annual household income (OR=0.4; 95% CI 0.1-0.9 for >$30,000 vs. <$15,000), greater number of adults in the household (OR=1.8; 95% CI 1.1-3.0 for ≥3 vs. 1) and language preference (OR=0.6; 95% CI 0.4-0.9 for Spanish vs. English) were associated with high stress during mid-pregnancy. Likewise, annual household income was inversely associated with high stress during late pregnancy. Conclusion Our results have important implications for incorporation of routine screening for psychosocial stress during prenatal visits and implementation of psychosocial counseling services for women at high risk. PMID:23010861
Vandse, Rashmi; Cook, Meghan; Bergese, Sergio
Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management. PMID:26309729
... Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults) ... Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, ...
Heminger, Christina L; Schindler-Ruwisch, Jennifer M; Abroms, Lorien C
Background Smoking during pregnancy has deleterious health effects for the fetus and mother. Given the high risks associated with smoking in pregnancy, smoking cessation programs that are designed specifically for pregnant smokers are needed. This paper summarizes the current landscape of mHealth cessation programs aimed at pregnant smokers and where available reviews evidence to support their use. Methods A search strategy was conducted in June–August 2015 to identify mHealth programs with at least one component or activity that was explicitly directed at smoking cessation assistance for pregnant women. The search for text messaging programs and applications included keyword searches within public health and medical databases of peer-reviewed literature, Google Play/iTunes stores, and gray literature via Google. Results Five unique short message service programs and two mobile applications were identified and reviewed. Little evidence was identified to support their use. Common tools and features identified included the ability to set your quit date, ability to track smoking status, ability to get help during cravings, referral to quitline, and tailored content for the individual participant. The theoretical approach utilized was varied, and approximately half of the programs included pregnancy-related content, in addition to cessation content. With one exception, the mHealth programs identified were found to have low enrollment. Conclusion Globally, there are a handful of applications and text-based mHealth programs available for pregnant smokers. Future studies are needed that examine the efficacy of such programs, as well as strategies to best promote enrollment. PMID:27110146
Mazzuca, Marc Q; Tare, Marianne; Parkington, Helena C; Dragomir, Nicoleta M; Parry, Laura J; Wlodek, Mary E
Intrauterine growth restriction is a risk factor for cardiovascular disease in adulthood. We have previously shown that intrauterine growth restriction caused by uteroplacental insufficiency programmes uterine vascular dysfunction and increased arterial stiffness in adult female rat offspring. The aim of this study was to investigate vascular adaptations in growth restricted female offspring when they in turn become pregnant. Uteroplacental insufficiency was induced in WKY rats by bilateral uterine vessel ligation (Restricted) or sham surgery (Control) on day 18 of pregnancy. F0 pregnant females delivered naturally at term. F1 Control and Restricted offspring were mated at 4 months of age and studied on day 20 of pregnancy. Age-matched non-pregnant F1 Control and Restricted females were also studied. Wire and pressure myography were used to test endothelial and smooth muscle function, and passive mechanical wall properties, respectively, in uterine, mesenteric, renal and femoral arteries of all four groups. Collagen and elastin fibres were quantified using polarized light microscopy and qRT-PCR. F1 Restricted females were born 10–15% lighter than Controls (P <0.05). Non-pregnant Restricted females had increased uterine and renal artery stiffness compared with Controls (P <0.05), but this difference was abolished at day 20 of pregnancy. Vascular smooth muscle and endothelial function were preserved in all arteries of non-pregnant and pregnant Restricted rats. Collagen and elastin content were unaltered in uterine arteries of Restricted females. Growth restricted females develop compensatory vascular changes during late pregnancy, such that region-specific vascular deficits observed in the non-pregnant state did not persist in late pregnancy. PMID:22586217
... on eating seafood while you are pregnant or breastfeeding. Learn more from the link below. Check with ... or concern. Food safety advice while you are breastfeeding your baby: Follow the food safety advice for ...
... shot. Top of Page Can pregnant women with egg allergies get vaccinated? Most people who have an ... reaction following a flu shot. Special Consideration Regarding Egg Allergy The recommendations for vaccination of people with ...
Ulvedal, Susan K.; Feeg, Veronica D.
Characteristics of pregnant students attending the Family Center, an alternative educational program in Arlington County, Virginia, are described. Investigated are variables such as family configuration and relationships, substance use, special problems, and outcome of pregnancy. (CJ)
... fullstory_160106.html Quitting Smoking While Pregnant: What Works Nicotine patches, Zyban helped 4 out of 5 ... cessation programs implemented in the general population." Zyban works by reducing nicotine cravings and other withdrawal effects. ...
... in pregnancy. Stop Smoking, Alcohol, and Drugs. Limit Caffeine If you smoke, drink alcohol, or use drugs, ... your life. You should also cut down on caffeine when you are trying to get pregnant. Women ...
Basta, Pawel; Bak, Anna; Roszkowski, Krzysztof
In general, strategies for the treatment of cancer in pregnancy should not differ significantly from the treatment regimens in non-pregnant women. However, this is difficult due to either the effects of anticancer drugs on the developing foetus or the possibility of long-term complications after the exposure to drugs and radiation. The decision about the introduction and continuation of treatment in the event of pregnancy should be preceded by a detailed analysis of the potential benefits and risks. There are no data to suggest that pregnancy termination alters the biological behaviour of the tumour or patient prognosis in the presence of appropriate antineoplastic therapy. All patients should be given appropriate advice and informed that there are insufficient scientific data to determine any generally accepted consensus. It is very important to always respect the will of the patient, and the moral judgment of the physician should have no impact on the decisions taken by the woman. If the woman decides to undergo active treatment and maintain her pregnancy, it is necessary to carry out consultations with experts in the field appropriate to the type of cancer. This paper presents a basic review of the literature on the targeted therapies currently used in selected cancers diagnosed during pregnancy: breast cancer, cervical cancer, Hodgkin's disease, melanoma, thyroid cancer, ovarian cancer, and colorectal cancer. PMID:26793018
Gadit, Amin Muhammad
A pregnant woman is exposed to a number of stress factors that can affect the pregnancy, maternal health and well-being of the foetus. Among these are the biological, social/environmental and psychological factors. The biological factors include medical condition of the pregnant woman, most notable is the gestational diabetes. The increased glucose levels can cause detrimental effect on the foetus and also cause maternal distress. This factor becomes more complicated if the woman is exposed to environmental stressors. The result is evident in the form of complications during pregnancy and psychological effects like depression and anxiety. Appropriate steps are important to address these issues in order to maintain the mother and prospective child\\'s well-being. PMID:27582167
Jaques, S C; Kingsbury, A; Henshcke, P; Chomchai, C; Clews, S; Falconer, J; Abdel-Latif, M E; Feller, J M; Oei, J L
To review and summarise the literature reporting on cannabis use within western communities with specific reference to patterns of use, the pharmacology of its major psychoactive compounds, including placental and fetal transfer, and the impact of maternal cannabis use on pregnancy, the newborn infant and the developing child. Review of published articles, governmental guidelines and data and book chapters. Although cannabis is one of the most widely used illegal drugs, there is limited data about the prevalence of cannabis use in pregnant women, and it is likely that reported rates of exposure are significantly underestimated. With much of the available literature focusing on the impact of other illicit drugs such as opioids and stimulants, the effects of cannabis use in pregnancy on the developing fetus remain uncertain. Current evidence indicates that cannabis use both during pregnancy and lactation, may adversely affect neurodevelopment, especially during periods of critical brain growth both in the developing fetal brain and during adolescent maturation, with impacts on neuropsychiatric, behavioural and executive functioning. These reported effects may influence future adult productivity and lifetime outcomes. Despite the widespread use of cannabis by young women, there is limited information available about the impact perinatal cannabis use on the developing fetus and child, particularly the effects of cannabis use while breast feeding. Women who are using cannabis while pregnant and breast feeding should be advised of what is known about the potential adverse effects on fetal growth and development and encouraged to either stop using or decrease their use. Long-term follow-up of exposed children is crucial as neurocognitive and behavioural problems may benefit from early intervention aimed to reduce future problems such as delinquency, depression and substance use. PMID:24457255
Heberlein, Annemarie; Leggio, Lorenzo; Stichtenoth, Dirk; Thomas, Hillemacher
Purpose of the review This article addresses the question of “best treatment options,” which clinicians face when treating pregnant women with alcohol and/or opioid dependence. Recent findings Alcohol Studies show that alcohol consumption is associated with fetal abnormalities and long-term cognitive problems depending on amount consumed, drinking pattern, and time of gestation. Screening and evaluation of specific interventions are important to reduce alcohol consumption during pregnancy and associated problems in infants. Opioids Withdrawal-induced fetal distress and the risk of relapse are the primary reasons why opioid detoxification is only recommended in the second or third trimesters and only in those pregnant women who refuse opioid maintenance therapy (OMT). Methadone is the most established treatment of pregnant opioid-dependent women, but recent investigations suggest that substitution with buprenorphine may have advantages over methadone in terms of neonatal abstinence syndrome (NAS). Promising results have been also reported for slow-release oral methadone and the heroin equivalent diamorphin. Summary Data regarding the pharmacological treatment of alcohol abuse and/or dependence is limited in pregnant women. So far, benzodiazepines seem to be the most recommendable option for managing alcohol withdrawal, and psychosocial interventions succeed in reducing alcohol consumption or in maintaining abstinence in alcohol-dependent pregnant women. Recent data, albeit preliminary, support the use of naltrexone in the treatment of alcohol-dependent pregnant women. Regarding opioid dependence meta-analyses do not clearly support the superiority of one substitute over the other during pregnancy owing to the presence of interfering factors (such as illicit drug use) in the studies conducted. Current results suggest that factors like the health status of the mother, the need for additional medications (e.g. treatment for HIV), comorbid drug dependence, and
DiPietro, Janet A.; Voegtline, Kristin M.; Costigan, Kathleen A.; Aguirre, Frank; Kivlighan, Katie; Chen, Ping
Objective The bidirectional nature of mother-child interaction is widely acknowledged during infancy and childhood. Prevailing models during pregnancy focus on unidirectional influences exerted by the pregnant woman on the developing fetus. Prior work has indicated that the fetus also affects the pregnant woman. Our objective was to determine whether a maternal psychophysiological response to stimulation of the fetus could be isolated. Methods Using a longitudinal design, an airborne auditory stimulus was used to elicit a fetal heart rate and motor response at 24 (n = 47) and 36 weeks (n = 45) gestation. Women were blind to condition (stimulus versus sham). Maternal parameters included cardiac (heart rate) and electrodermal (skin conductance) responses. Multilevel modeling of repeated measures with 5 data points per second was used to examine fetal and maternal responses. Results As expected, compared to a sham condition, the stimulus generated a fetal motor response at both gestational ages, consistent with a mild fetal startle. Fetal stimulation was associated with significant, transient slowing of maternal heart rate coupled with increased skin conductance within 10 s of the stimulus at both gestational ages. Nulliparous women showed greater electrodermal responsiveness. The magnitude of the fetal motor response significantly corresponded to the maternal skin conductance response at 5, 10, 15, and 30 s following stimulation. Conclusion Elicited fetal movement exerts an independent influence on the maternal autonomic nervous system. This finding contributes to current models of the dyadic relationship during pregnancy between fetus and pregnant woman. PMID:24119937
Nyunt, Myaing M.; Nguyen, Vy K.; Kajubi, Richard; Huang, Liusheng; Ssebuliba, Joshua; Kiconco, Sylvia; Mwima, Moses W.; Achan, Jane; Aweeka, Francesca
Artemether-lumefantrine is a first-line regimen for the treatment of uncomplicated malaria during the second and third trimesters of pregnancy. Previous studies have reported changes in the pharmacokinetics and clinical outcomes following treatment with artemether-lumefantrine in pregnant women compared to nonpregnant adults; however, the results are inconclusive. We conducted a study in rural Uganda to compare the pharmacokinetics of artemether-lumefantrine and the treatment responses between 30 pregnant women and 30 nonpregnant adults with uncomplicated Plasmodium falciparum malaria. All participants were uninfected with HIV, treated with a six-dose regimen of artemether-lumefantrine, and monitored clinically for 42 days. The pharmacokinetics of artemether, its metabolite dihydroartemisinin, and lumefantrine were evaluated for 21 days following treatment. We found no significant differences in the overall pharmacokinetics of artemether, dihydroartemisinin, or lumefantrine in a direct comparison of pregnant women to nonpregnant adults, except for a statistically significant but small difference in the terminal elimination half-lives of both dihydroartemisinin and lumefantrine. There were seven PCR-confirmed reinfections (5 pregnant and 2 nonpregnant participants). The observation of a shorter terminal half-life for lumefantrine may have contributed to a higher frequency of reinfection or a shorter posttreatment prophylactic period in pregnant women than in nonpregnant adults. While the comparable overall pharmacokinetic exposure is reassuring, studies are needed to further optimize antimalarial efficacy in pregnant women, particularly in high-transmission settings and because of emerging drug resistance. (This study is registered at ClinicalTrials.gov under registration no. NCT01717885.) PMID:26666942
Nyunt, Myaing M; Nguyen, Vy K; Kajubi, Richard; Huang, Liusheng; Ssebuliba, Joshua; Kiconco, Sylvia; Mwima, Moses W; Achan, Jane; Aweeka, Francesca; Parikh, Sunil; Mwebaza, Norah
Artemether-lumefantrine is a first-line regimen for the treatment of uncomplicated malaria during the second and third trimesters of pregnancy. Previous studies have reported changes in the pharmacokinetics and clinical outcomes following treatment with artemether-lumefantrine in pregnant women compared to nonpregnant adults; however, the results are inconclusive. We conducted a study in rural Uganda to compare the pharmacokinetics of artemether-lumefantrine and the treatment responses between 30 pregnant women and 30 nonpregnant adults with uncomplicated Plasmodium falciparum malaria. All participants were uninfected with HIV, treated with a six-dose regimen of artemether-lumefantrine, and monitored clinically for 42 days. The pharmacokinetics of artemether, its metabolite dihydroartemisinin, and lumefantrine were evaluated for 21 days following treatment. We found no significant differences in the overall pharmacokinetics of artemether, dihydroartemisinin, or lumefantrine in a direct comparison of pregnant women to nonpregnant adults, except for a statistically significant but small difference in the terminal elimination half-lives of both dihydroartemisinin and lumefantrine. There were seven PCR-confirmed reinfections (5 pregnant and 2 nonpregnant participants). The observation of a shorter terminal half-life for lumefantrine may have contributed to a higher frequency of reinfection or a shorter posttreatment prophylactic period in pregnant women than in nonpregnant adults. While the comparable overall pharmacokinetic exposure is reassuring, studies are needed to further optimize antimalarial efficacy in pregnant women, particularly in high-transmission settings and because of emerging drug resistance. (This study is registered at ClinicalTrials.gov under registration no. NCT01717885.). PMID:26666942
Background Toxoplasmosis is a common parasitic infection caused by an obligate intracellular protozoan, Toxoplasma gondii. If primary toxoplasmosis occurs during pregnancy about one third of the cases could lead to congenital toxoplasmosis, with subsequent pathological effects. This study aimed at determining the seroprevalence of T. gondii among pregnant women in Jimma town, Southwest Ethiopia. Methods A community based cross-sectional study was conducted to assess the seroprevalence and associated factors in pregnant women from August to September, 2011. A total of 201 study participants were included in this study. Data on socio-demographic and predisposing factors were collected from each study participant. Moreover, venous blood specimens were collected following Standard Operating Procedures. All the collected specimens were tested for IgM and IgG anti-T. gondii antibodies by enzyme-linked immunosorbent assay (ELISA). Results The overall seroprevalence of T. gondii in the study area was 83.6%. One hundred and sixty three (81.1%) of the pregnant women were IgG seropositive, five (2.5%) were IgM seropositive. Three of the 5 pregnant women were positive for both IgG and IgM. Presence of domestic cat at home showed significant association with anti-T. gondii seropositivity (OR = 5.82, 95% CI: 1.61- 20.99; p < 0.05). Conclusion The seroprevalence of T. gondii antibodies was high among the pregnant women. Pregnant women having domestic cat at their home were at higher risk of T. gondii infection. Hence, health education and awareness on the disease and its transmission to women of reproductive age group in general and pregnant women in particular should be created during antenatal follow up to reduce the risk of T. gondii infection in pregnant women. PMID:23216887
Kihara, J H; Kutima, H L; Ouma, J; Churcher, T S; Changoma, J M; Mwalisetso, M A; French, M D; Mwandawiro, C S
Generally, women residing in areas endemic for urinary schistosomiasis may suffer from female genital schistosomiasis which is acquired during childhood. The objective of this cross-sectional study was to estimate the prevalence and intensity of infection of Schistosoma haematobium in women of reproductive age (16-45 years) and to investigate whether S. haematobium had any effect on kidney function. A total of 394 women of known pregnancy status (158 pregnant and 236 non-pregnant) were recruited from five villages (known for their high prevalence of infection of S. haematobium) in Kwale County. Serum samples were analysed to determine levels of urea and creatinine as proxy indicators of kidney function. Data revealed that pregnant women did not, on average, have a higher prevalence or intensity of infection of urinary schistosomiasis than non-pregnant women. During pregnancy, the level of prevalence and intensity of infection of S. haematobium was highest in the first trimester (0-13 weeks), dropped in the second trimester (14-26 weeks) and rose again in the third trimester (27-40 weeks). In addition, 24.8% of women were infected with hookworm, while none were diagnosed with malaria parasites. Of 250 samples analysed for serum urea and creatinine, none had significant levels of pathology, either in pregnant or non-pregnant women. Despite World Health Organization (WHO) recommendations that pregnant women should be treated with praziquantel after the first trimester, in practice this has not been the case in many countries, including Kenya. In view of this, healthcare providers should be informed to consider treatment of pregnant women infected with schistosomiasis during antenatal visits and whenever there is mass drug administration as recommended by the WHO. PMID:24103656
Yad Yad, Mohammad Jafar; Jomehzadeh, Nabi; Jafar Sameri, Maryam; Noorshahi, Nooshin
Background: Acute toxoplasmosis may lead to congenital toxoplasmosis with fetal complications outcome during pregnancy. Anti- Toxoplasma gondii antibody seroprevalence is unclear in pregnant women of south of Khuzestan province, since limited data about T. gondii seroepidemiology has been published in pregnant women of this area (Abadan, Shadegan, Khoramshar). Objectives: The aim of this study was to clarify the status of T. gondii seroprevalence in pregnant women of south of Khuzestan province. Materials and Methods: In this cross-sectional study, 501 full-term pregnant women were included. This study was carried out in Taleghani teaching hospital for six 6 months from May to October 2011. Informed consents signed by the patients were obtained. Blood IgG and IgM were measured using ELISA technique. The data was analyzed by SPSS 13 (Chicago, IL, USA). Chi-square test was used for comparison. Results: The participants’ age range was 15 to 45 years (average: 27.4 ± 13). Of the 501 pregnant women, 70.65 % (n = 354) were seronegative for T. gondii IgG and IgM antibodies. There were statistical relationships between IgG seroprevalence and age, as well as IgG seroprevalence and cat holding. Conclusions: There was high percentage of seronegative (70.65 %) IgG and IgM antibodies in full-term pregnant women. They were susceptible to acute toxoplasmosis; thus, prenatal screening was recommend in our province after cost-beneficial analyses. PMID:25147724
Petersen, Emily E; Staples, J Erin; Meaney-Delman, Dana; Fischer, Marc; Ellington, Sascha R; Callaghan, William M; Jamieson, Denise J
CDC has developed interim guidelines for health care providers in the United States caring for pregnant women during a Zika virus outbreak. These guidelines include recommendations for pregnant women considering travel to an area with Zika virus transmission and recommendations for screening, testing, and management of pregnant returning travelers. Updates on areas with ongoing Zika virus transmission are available online (http://wwwnc.cdc.gov/travel/notices/). Health care providers should ask all pregnant women about recent travel. Pregnant women with a history of travel to an area with Zika virus transmission and who report two or more symptoms consistent with Zika virus disease (acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis) during or within 2 weeks of travel, or who have ultrasound findings of fetal microcephaly or intracranial calcifications, should be tested for Zika virus infection in consultation with their state or local health department. Testing is not indicated for women without a travel history to an area with Zika virus transmission. In pregnant women with laboratory evidence of Zika virus infection, serial ultrasound examination should be considered to monitor fetal growth and anatomy and referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended. There is no specific antiviral treatment for Zika virus; supportive care is recommended. PMID:26796813
Objective This study explores the views of pregnant women and clinicians regarding discussion of exposure to phthalate plasticizers during pregnancy, subsequent to the 2011 Health Canada ban of certain phthalates at a concentration greater than 1000 mg/kg in baby toys. This occurred with no regulation of products to which pregnant women are exposed, such as food packaging and cosmetics. Methods Pregnant women, physicians and midwives were recruited through posters and pamphlets in prenatal clinics in Southwestern Ontario for a semi-structured interview. All interviews were audiotaped, transcribed, and subjected to rigorous qualitative analysis through a grounded theory approach, supported by NVIVO™ software. Themes emerged from line by line, open, and axial coding in an iterative manner. Results Theoretical sufficiency was reached after 23 pregnant women and 11 clinicians had been interviewed. The themes (and subthemes from which they arose) were: Theme I-Information Provision (IA-Sources of Information, IB-Standardization, IC-Constraints, ID-Role of Government); Theme II-Risk (IIA-Significant Risk, IIB-Perceived Relevance, IIC-Reconciliation); and Theme III- Factors Influencing Level of Concern (IIIA-Current Knowledge, IIIB-Demographic Factors). Conclusion To respond to the increasing media and research attention regarding risk of phthalates to women, and pregnant women in particular, national professional organizations should provide patient information. This could include pamphlets on what a pregnant woman should know about phthalates and how they can be avoided, as well as information to clinicians to facilitate this discussion. PMID:24952638
Iranzad, Ilnaz; Bani, Soheila; Hasanpour, Shirin; Mohammadalizadeh, Sakineh; Mirghafourvand, Mozhgan
Introduction: Social support is considered the interaction between the person and environment, which reduces stressors, covers the effects of stress and consequently protects individuals from the harmful effects of stressful situations. This study aimed to determine social support in pregnant women and its relationship with the rate of pregnant women's perceived stress at health centers of Tabriz in 2012-13. Methods: This cross-sectional study was carried out on 450 pregnant women selected through cluster sampling. Data collection tools consisted of a demographic questionnaire, interpersonal support evaluation list (ISEL) and perceived stress questionnaire (PSS) that were completed in an interview. The range of obtainable score for social support and perceived stress was 0-90 and 0-30, respectively. Descriptive and analytical statistics including Pearson and Independent t-test were used for analyzing the data. Results: The mean score of social support and perceived stress in pregnant women was 96.6 (14.6), and 11.5 (5.5), respectively .The women with favorable social support had significantly less stress than the women with unfavorable social support. Conclusion: The study finding showed that the rate of social support in highly stressful women is significantly less than low-stress mothers. Therefore, considering adverse effects of the stress on pregnancy outcomes, some strategies should be designed and implemented in order to strengthen and improve the social support for pregnant women so that it can reduce the rate of pregnant women's stress. PMID:25709981
Sato, Mari; Nakamura, Yasuka; Atogami, Fumi; Horiguchi, Ribeka; Tamaki, Raita; Yoshizawa, Toyoko; Oshitani, Hitoshi
Introduction: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon. Methods: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis. Result: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the
Kurien, Sophia; Kattimani, Vivekanand S; Sriram, Roopa Rani; Sriram, Sanjay Krishna; Rao V K, Prabhakara; Bhupathi, Anitha; Bodduru, Rupa Rani; N Patil, Namrata
The purpose of this article is to update general dentists and maxillofacial surgeons in the perioperative management of the pregnant patient. Pregnancy results in physiologic changes in almost all organ systems in the body mediated mainly by hormones; which influences the treatment schedule. Understanding these normal changes is essential for providing quality care for pregnant women. The general principles that apply in this situation are discussed, followed by the relevant physiologic changes and their treatment implications, the risks of various medications to the mother and fetus, the management of concomitant medical problems in the pregnant patient, appropriate timing of oral and maxillofacial surgery during pregnancy, and management of emergencies during pregnancy. Information about the compatibility, complications, and excretion of the common drugs during pregnancy is provided. Guidelines for the management of a pregnant patient in the dental office are summarized. How to cite this article: Kurien S, Kattimani V S, Sriram R, Sriram S K, Prabhakar Rao V K, Bhupathi A, Bodduru R, Patil N N. Management of Pregnant Patient in Dentistry. J Int Oral Health 2013; 5(1):88-97. PMID:24155583
Rodriguez, Michael; Shoultz, Jan; Richardson, Erin
Little is known about factors associated with healthcare screening of Intimate Partner Violence (IPV) for Latinas during pregnancy. This study builds on current research examining IPV-associated outcomes among Latinas by analyzing 210 pregnant Latina responses to a patient survey. A multivariate logistic regression model examined factors associated with being screened for IPV. One-third of pregnant women reported being screened for IPV. Factors related to being screened for IPV are reported and did not match those associated with having experienced IPV. While most pregnant Latinas were not screened for IPV, having systematic processes in place for IPV screening and fostering good patient-provider communication may facilitate identification of IPV. Having a greater awareness of the risk factors associated with IPV may also provide cues for clinicians to better address the issue of IPV. PMID:19694355
Moon, Eunice K.; Wang, Weiping; Newman, James S.; Bayona-Molano, Maria Del Pilar
A pregnant patient presenting to interventional radiology (IR) has a different set of needs from any other patient requiring a procedure. Often, the patient's care can be in direct conflict with the growth and development of the fetus, whether it be optimal fluoroscopic imaging, adequate sedation of the mother, or the timing of the needed procedure. Despite the additional risks and complexities associated with pregnancy, IR procedures can be performed safely for the pregnant patient with knowledge of the special and general needs of the pregnant patient, use of acceptable medications and procedures likely to be encountered during pregnancy, in addition to strategies to protect the patient and her fetus from the hazards of radiation. PMID:24436567
Bivolarska, Anelia; Gatseva, Penka; Nikolova, Julia; Argirova, Mariana; Atanasova, Victoria
The aim of this study was to assess the thyroid status of pregnant women on the basis of biochemical indicators and to evaluate the potential risk of developing iodine deficiency as a result of tobacco smoke exposure by assessing the association between urinary thiocyanate levels and the manifestation of iodine deficiency. The study included 219 pregnant women from the town of Plovdiv and Plovdiv District in Southern Bulgaria. The levels of urinary iodine, thyroid-stimulating hormone (TSH), free thyroxine (FT4), and urinary thiocyanate as indicators of tobacco smoke exposure were measured. Most of the pregnant women (60.1 %) were found to have iodine deficiency, 10.6 % of them had TSH values greater than 4 mIU/L, and 16.4 % had FT4 below 9 pmol/L. There were negative correlations between urinary iodine levels and thiocyanate/creatinine ratio (R = -0.148, р = 0.034) and between thiocyanate/creatinine ratio and FT4 (R = -0.379, p < 0.0001); thiocyanate/creatinine ratio and serum TSH were positively correlated (R = 0.169, p = 0.019). Logistic regression analysis showed that pregnant women in whom the thiocyanate/creatinine ratio was greater than the median value of 3.57 mg/g had a 3.882-fold higher risk of developing iodine deficiency (urinary iodine <150 μg/L) than the pregnant women with lower thiocyanate levels (OR = 3.882, 95 % CI 1.402-10.751, p = 0.009). Higher levels of urinary thiocyanate were found in women exposed to tobacco smoke, and quantification of these ions in urine provided a fast non-invasive method to monitor thiocyanate load. Due to the competitive inhibition of iodine intake by thiocyanates, their levels should be carefully monitored, especially in cases of severe iodine deficiency. PMID:26676231
Franco, D J; Josephson, J K; Moehn, S; Pencharz, P B; Ball, R O
Amino acid requirements of sows may change from early to late gestation due to the accelerated growth of products of conception after d 70 of pregnancy. The objective of this study was to determine the Trp requirement, Phe kinetics, and energy expenditure in early (d 35 to 53) and late (d 92 to 111) pregnancy using the indicator amino acid oxidation method and indirect calorimetry. The same 6 second parity sows were fed 6 diets in a Latin square design in both early and late pregnancy. The diets based on corn, corn starch, and sugar provided 20 to 120% of the current recommended Trp intake (2.5 g/d) in early pregnancy and 60 to 180% in late pregnancy. Feed allowance was constant for each sow at 2.41 kg/d (SE 0.029). Expired air and blood were collected every 30 min for 5 1/2 h. After three 30-min periods to determine background (13)C enrichment in expired CO2 and plasma Phe, L[1-(13)C]Phe was given orally at a rate of 2 mg/(kg BW · h) with 8 1/2 hourly meals. Expired air and plasma were analyzed for (13)CO2 and (13)C-Phe enrichment, respectively. Requirements were determined as the breakpoint of 2-phase linear models. Sows grew from 167.7 kg (SE 3.93) at breeding to 211.9 kg (SE 5.18) post-farrowing and had litters of 14.5 piglets (SE 0.43) weighing 19.0 kg (SE 1.41) at birth. The Trp requirement was 1.7 g/d (SE 0.29, P = 0.001) in early pregnancy and 2.6 g/d (SE 0.37, P = 0.013) in late pregnancy, or 0.7 g/kg and 1.1 g/kg diet of total Trp, respectively, for a feed allowance of 2.4 kg/d. The Trp requirement in late pregnancy tended (P = 0.056) to be greater than in early pregnancy. Quantitative Phe kinetics were not affected by Trp intake except for a quadratic response of Phe oxidation and retention (P < 0.1) to Trp intake in early pregnancy. In late pregnancy, sows oxidized less Phe and retained more Phe (P = 0.001) than in early pregnancy, indicating that young, growing pregnant sows increase the efficiency of utilizing AA in late pregnancy to maintain protein
Background Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). However, to date, little is known of how these services provide support across England. The aim of this study was to describe the key elements of support provided through English SSSP. Methods SSSP managers were invited to participate in this survey by email. Data were then collected via an online questionnaire; one survey was completed for each SSSP. Up to four reminder emails were sent over a two month period. Results 86% (121 of 141) of services completed the survey. Responding services were, on average, larger than non-responding services in terms of the number of pregnant women setting quit dates and successfully quitting (p < 0.01). In line with the 2010 NICE guidelines, Stop Smoking in Pregnancy and following Childbirth, one in five SSSP identified pregnant smokers using carbon monoxide (CO) testing and refer via an opt-out pathway. All services offered nicotine replacement therapy (NRT) to pregnant women and 87% of services also offered dual therapy NRT, i.e. combination of a patch and short acting NRT product.. The 2010 NICE guidelines note that services should be flexible and client-centred. Consistent with this, SSSP offer pregnant women a range of support types (median 4) including couple/family, group (open or closed) or one-to-one. These are available in a number of locations (median 5), including in community venues, clinics and women’s homes. Conclusions English Stop Smoking Services offer behavioural support and pharmacotherapy to pregnant women motivated to quit smoking. Interventions provided are generally evidence-based and delivered in a variety of both social and health care settings. PMID:24593130
Tsai, Chih-Hsin; Liang, Wei-Yen; Li, Sih-Syuan; Huang, Han-Bin
Introduction Previous studies revealed that phthalate exposure could alter thyroid hormones during the last trimester of pregnancy. However, thyroid hormones are crucial for fetal development during the first trimester. We aimed to clarify the effect of phthalate exposure on thyroid hormones during early pregnancy. Method We recruited 97 pregnant women who were offered an amniocentesis during the early trimester from an obstetrics clinic in southern Taiwan from 2013 to 2014. After signing an informed consent form, we collected amniotic fluid and urine samples from pregnant women to analyze 11 metabolites, including mono-ethyl phthalate (MEP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-(2-ethylhexyl) phthalate (MEHP), mono-butyl phthalate (MnBP), of 9 phthalates using liquid chromatography/ tandem mass spectrometry. We collected blood samples from each subject to analyze serum thyroid hormones including thyroxine (T4), free T4, and thyroid-binding globulin (TBG). Results Three phthalate metabolites were discovered to be >80% in the urine samples of the pregnant women: MEP (88%), MnBP (81%) and MECPP (86%). Median MnBP and MECPP levels in pregnant Taiwanese women were 21.5 and 17.6 μg/g-creatinine, respectively, that decreased after the 2011 Taiwan DEHP scandal. Results of principal component analysis suggested two major sources (DEHP and other phthalates) of phthalates exposure in pregnant women. After adjusting for age, gestational age, TBG, urinary creatinine, and other phthalate metabolites, we found a significantly negative association between urinary MnBP levels and serum T4 (β = –5.41; p-value = 0.012; n = 97) in pregnant women using Bonferroni correction. Conclusion We observed a potential change in the thyroid hormones of pregnant women during early pregnancy after DnBP exposure. Additional study is necessitated to clarify these associations. PMID:27455052
Meaney-Delman, Dana; Hills, Susan L; Williams, Charnetta; Galang, Romeo R; Iyengar, Preetha; Hennenfent, Andrew K; Rabe, Ingrid B; Panella, Amanda; Oduyebo, Titilope; Honein, Margaret A; Zaki, Sherif; Lindsey, Nicole; Lehman, Jennifer A; Kwit, Natalie; Bertolli, Jeanne; Ellington, Sascha; Igbinosa, Irogue; Minta, Anna A; Petersen, Emily E; Mead, Paul; Rasmussen, Sonja A; Jamieson, Denise J
After reports of microcephaly and other adverse pregnancy outcomes in infants of mothers infected with Zika virus during pregnancy, CDC issued a travel alert on January 15, 2016, advising pregnant women to consider postponing travel to areas with active transmission of Zika virus. On January 19, CDC released interim guidelines for U.S. health care providers caring for pregnant women with travel to an affected area, and an update was released on February 5. As of February 17, CDC had received reports of nine pregnant travelers with laboratory-confirmed Zika virus disease; 10 additional reports of Zika virus disease among pregnant women are currently under investigation. No Zika virus-related hospitalizations or deaths among pregnant women were reported. Pregnancy outcomes among the nine confirmed cases included two early pregnancy losses, two elective terminations, and three live births (two apparently healthy infants and one infant with severe microcephaly); two pregnancies (approximately 18 weeks' and 34 weeks' gestation) are continuing without known complications. Confirmed cases of Zika virus infection were reported among women who had traveled to one or more of the following nine areas with ongoing local transmission of Zika virus: American Samoa, Brazil, El Salvador, Guatemala, Haiti, Honduras, Mexico, Puerto Rico, and Samoa. This report summarizes findings from the nine women with confirmed Zika virus infection during pregnancy, including case reports for four women with various clinical outcomes. U.S. health care providers caring for pregnant women with possible Zika virus exposure during pregnancy should follow CDC guidelines for patient evaluation and management. Zika virus disease is a nationally notifiable condition. CDC has developed a voluntary registry to collect information about U.S. pregnant women with confirmed Zika virus infection and their infants. Information about the registry is in preparation and will be available on the CDC website. PMID
Horney, Jennifer; Zotti, Marianne E.; Williams, Amy; Hsia, Jason
Introduction and Background Women of reproductive age, in particular women who are pregnant or fewer than 6 months postpartum, are uniquely vulnerable to the effects of natural disasters, which may create stressors for caregivers, limit access to prenatal/postpartum care, or interrupt contraception. Traditional approaches (e.g., newborn records, community surveys) to survey women of reproductive age about unmet needs may not be practical after disasters. Finding pregnant or postpartum women is especially challenging because fewer than 5% of women of reproductive age are pregnant or postpartum at any time. Methods From 2009 to 2011, we conducted three pilots of a sampling strategy that aimed to increase the proportion of pregnant and postpartum women of reproductive age who were included in postdisaster reproductive health assessments in Johnston County, North Carolina, after tornadoes, Cobb/Douglas Counties, Georgia, after flooding, and Bertie County, North Carolina, after hurricane-related flooding. Results Using this method, the percentage of pregnant and postpartum women interviewed in each pilot increased from 0.06% to 21%, 8% to 19%, and 9% to 17%, respectively. Conclusion and Discussion Two-stage cluster sampling with referral can be used to increase the proportion of pregnant and postpartum women included in a postdisaster assessment. This strategy may be a promising way to assess unmet needs of pregnant and postpartum women in disaster-affected communities. PMID:22365134
... pregnant? Pregnant women need to be careful of toxoplasmosis when handling their cat. This is an infection ... cats may have been. You also can get toxoplasmosis from eating undercooked meat, especially pork, lamb or ...
Casanova Román, Gerardo; Reyna Figueroa, Jesús; Figueroa Damián, Ricardo; Ortiz Ibarra, Javier
A prospective and descriptive study was done in pregnant women diagnosed with herpes zoster, to know the demographic characteristics and clinical manifestations as well as maternal and/or neonatal complications to cause by this viral infection during pregnancy. The study included all pregnant women diagnosed with herpes zoster at the Department of Infectious Diseases of the Instituto Nacional de Perinatologia México, between 1994 and 2002. A total of 17 women were included in the study. All were given clinical and ultrasound follow-up to discard any maternal or fetal complications also at the moment of birth. A review in the newborn was made to establish the demographic, anthropometric and clinical characteristics; also the data collected included mother's age, gestational age at the moment of diagnosis with herpes zoster, anatomical lesion site, treatments administered, ultrasound characteristics, newborn's gestational age, weight, height, Apgar at birth and type of delivery. The most frequent site (58.8%) for herpes zoster lesions on the mother was the intercostal area, followed by the scapular region, the lumbar region and the limbs. None of the patients experienced complications during pregnancy, including post-herpetic pain. Sixteen of the newborns had no complications and one was a stillborn due to 60% of placental separation. These findings suggest a benign evolution of herpes zoster during pregnancy, supporting similar findings in the literature. No complications during pregnancy are suggested, and no phenotypical alterations occurred in the child at the moment of birth. PMID:15216903
Trivette, Evan T.; Hoedebecke, Kyle; Berry-Cabán, Cristóbal S.; Jacobs, Brandy R.
Summary Background: Nitrous oxide can cause disordered blood cell proliferation and lead to pancytopenia and altered immune function. Case Report: A young pregnant female patient presented after binge nitrous oxide abuse with altered mental status and abnormal vital signs. From her initial assessment she was noted to have pancytopenia and was found to have megaloblastic, hyper-cellular changes in a subsequent bone marrow biopsy. This presentation was determined to be secondary to toxic effects after heavy use of nitrous oxide. Conclusions: Nitrous oxide exposure, including use as an inhalant, over 12 hours can lead to bone marrow abnormalities such as megaloblastic hematopoiesis. PMID:23569553
Friedman, Susan Hatters; Hendrix, Todd; Haberman, Jessica; Jain, Abhishek
Pregnant minors can obtain an abortion without parental consent through a judicial bypass procedure in 38 states. To grant such a petition in Ohio, the Court must determine that the young woman is either "sufficiently mature and well enough informed to intelligently decide whether to have an abortion," or that notification of her parents is "not in her best interest," usually due to abuse. For the sake of anonymity in these emotionally and politically charged cases, the evaluee is referred to as "Jane Doe." This project sought to describe characteristics of teenagers seeking judicial bypass for abortion, which have not been well described in the scientific literature. Data were collected from Jane Doe evaluations completed at a metropolitan juvenile court psychiatric clinic, over 3 years. The mean age of the evaluees (N = 55) was 16.4 years. The vast majority (95%) were granted a judicial bypass. They usually had long-term boyfriends of comparable age. They had often told trusted adults about their pregnancy, though not their parents, due to concerns of violence or being excluded from the family. This study presents the first comprehensive description of characteristics of minors seeking judicial bypasses for abortion. Psychiatrists may apply general principles of informed consent in such evaluations, including ascertaining whether the decision is being made voluntarily, knowingly, and with sufficient decision-making capacity. PMID:26034870
Brydak, Lidia Bernadeta; Nitsch-Osuch, Aneta
Pregnancy places otherwise healthy women at an increased risk of complications arising from an influenza infection. It is suggested that physiological changes such as immunological changes, increased cardiac output and oxygen consumption, as well as lung tidal volume might increase the susceptibility to influenza complications if infection occurs during pregnancy. Immunization of pregnant women against influenza is currently recommended in many countries and has been proven to be safe and effective in reducing rates and severity of the disease in vaccinated mothers and their children. Influenza vaccination is also cost-effective. Nevertheless, influenza vaccine coverage remains low in pregnant women. This might stem from the lack of healthcare workers' education, a feeling among the general public that influenza is not a serious disease and a failure of prenatal care providers to offer the vaccine. In order to protect pregnant women and infants from influenza related morbidity and mortality an educational programme targeting healthcare workers in charge of pregnant women should be implemented. PMID:25195141
Shimshoni, Jakob Avi; Britzi, Malka; Pozzi, Paolo S; Edery, Nir; Berkowitz, Asaf; Bouznach, Arieli; Cuneah, Olga; Soback, Stefan; Bellaiche, Michel; Younis, Ahmad; Blech, Einat; Oren, Pnina; Galon, Nadav; Shlosberg, Alan; Perl, Samuel
Ionophores are used as feed additives for the control of coccidiosis and growth promotion in farm animals. Reports of maduramicin toxicosis in farm animals are scarce. The present work describes an acute maduramicin toxicosis affecting 22 pregnant gilts, 2 pregnant sows and 2 boars, resulting in a total mortality of 65% within 2days. The clinical and histopathological findings observed shared similar characteristics to acute ionophore toxicosis in pigs, being characterized by severe myodegeneration in skeletal muscle and degenerative changes in the myocardium. Important clinical pathology indices found were elevated levels of CPK and ALT. In contrast to the pregnant gilts, the two pregnant sows completely recovered after 1month and farrowed 2months after the intoxication event healthy piglets. The lack of effect of maduramicin on the fetuses might be indicative of poor placental penetration of maduramicin. Moreover, the present work reports for the first time maduramicin levels in livers (0.5mg/kg) of gilts exposed to lethal concentrations of maduramicin (18.5mg/kg) in the feed. As the average feed intake of the gilts was estimated to be 3.5kg feed/day, the mean maduramicin intake leading to the observed high mortality rate was 0.4mg/kg body weight/day. PMID:24705019
Borodulin, Katja; Evenson, Kelly R; Monda, Keri; Wen, Fang; Herring, Amy H; Dole, Nancy
Sleep disturbances are common among pregnant women and safe treatments to improve sleep are needed. Generally, physical activity improves sleep, but studies are lacking on the associations of physical activity with sleep among pregnant women. Our aim was to investigate the cross-sectional association of various modes of physical activity and activity clusters with sleep quality and duration among 1259 pregnant women. Participants were recruited into the Pregnancy, Infection, and Nutrition Study from prenatal clinics at the University of North Carolina Hospitals. Women self-reported sleep quality and duration and physical activity in the past week. We used cluster analysis to create seven physical activity profiles and multivariable logistic regression analysis, with adjustments for age, race/ethnicity, education, marital status, parity, self-rated general health, anxiety and depressive symptoms. Women with higher levels of occupational physical activity were more likely to report either short or normal sleep duration than longer duration. Women with higher levels of indoor household physical activity were less likely to report normal sleep duration than shorter duration. Women in the recreational-indoor household activity cluster were less likely than women in the inactivity cluster to report normal sleep duration as compared with longer duration. Our data suggest weak associations of physical activity with sleep duration and quality in late pregnancy. Physical activity is recommended to pregnant women for health benefits, yet more research is needed to understand if physical activity should be recommended for improving sleep. PMID:20078829
Kaplan, Michael B.; Blinn-Pike, Lynn; Wittstruck, Guriana; Berger, Thomas J.; Leigh, Sharon
Describes a workshop designed to assist pregnant and parenting adolescents through the use of journaling techniques. Concludes that journaling can increase the adolescents' receptivity to social and emotional introspection and may be beneficial as an opening exercise to clinical interventions. (JDM)
Treluyer, Jean-Marc; Préta, Laure-Helene; Valade, Elodie; Pannier, Emmanuelle; Urien, Saik; Hirt, Déborah
For the first time, a population approach was used to describe abacavir (ABC) pharmacokinetics in HIV-infected pregnant and nonpregnant women. A total of 266 samples from 150 women were obtained. No covariate effect (from age, body weight, pregnancy, or gestational age) on ABC pharmacokinetics was found. Thus, it seems unnecessary to adapt the ABC dosing regimen during pregnancy. PMID:25070097
October 19 is the deadline for employers to implement improvements in maternity rights laid down by the Trade Union Reform and Employment Rights Act (TURERA) and the European directive to protect pregnant women's health and safety at work. Christina Potrykus outlines what the government and, separately, the general Whitley council have in store for women employees. PMID:8194968
Pregnant women may face additional risks when travelling overseas, which must be considered with assessment and travel health advice before they decide to travel. A careful risk assessment should be completed to identify the key risks and strategies for staying safe while travelling. PMID:24772798
Kendall, A; Olson, C M; Frongillo, E A
The greatest weight gain for US. women occurs during the childbearing years of 25 to 34, and many obese women attribute their adult weight gain to childbearing. Few studies have examined psychosocial influences on women's behaviors during pregnancy, in part because of the lack of valid and reliable measures of psychosocial constructs relevant to pregnant women. Based on existing theory and an in-depth interview study, the psychosocial constructs of locus of control, self-efficacy, body image, feelings about motherhood, and career orientation were identified. Scales for each construct were constructed by drawing items from existing validated scales and writing items based on the in-depth interviews; their content validity assessed using factor analysis with oblique rotation and their reliability using Cronbach's alpha. Construct validity was assessed by examining the associations between scale scores and preexisting conditions of participants. Data for evaluating the scales came from a study of 622 pregnant women in a rural health care system who completed questionnaires and whose medical records were audited. Cronbach's alpha of the scales ranged from 0.73 to 0.89. Scale scores were strongly associated with lifestyle behaviors, body weight, and demographic characteristics of the participants. The analysis provides evidence of the validity of measures of psychosocial factors related to health behaviors of pregnant women. These measures should be useful in studying weight-related behaviors in pregnant women. PMID:11302356
Watanabe, Y; Mitsuyama, M; Sano, M; Nakano, H; Nomoto, K
We investigated the pregnancy-induced changes in macrophage activity which are important in the expression of host defense against infections. Several macrophage functions were examined by using Listeria monocytogenes. In pregnant mice, prolonged survival and enhanced in vivo elimination of bacteria were observed in the early phase of primary infection. Functions of peritoneal macrophages, including in vitro phagocytosis intracellular killing, glucose consumption, generation of superoxide anion, and intracellular beta-glucuronidase activity were shown to be enhanced in pregnant mice. These findings indicate that pregnancy enhances macrophage functions qualitatively. Possible mechanisms for this enhancement and the significance of macrophage activation for pregnant hosts are discussed. PMID:3011673
Usselman, Charlotte W.; Skow, Rachel J.; Matenchuk, Brittany A.; Chari, Radha S.; Julian, Colleen G.; Stickland, Michael K.; Davenport, Margie H.
Muscle sympathetic nerve activity is increased during normotensive pregnancy while mean arterial pressure is maintained or reduced, suggesting baroreflex resetting. We hypothesized spontaneous sympathetic baroreflex gain would be reduced in normotensive pregnant women relative to nonpregnant matched controls. Integrated muscle sympathetic burst incidence and total sympathetic activity (microneurography), blood pressure (Finometer), and R-R interval (ECG) were assessed at rest in 11 pregnant women (33 ± 1 wk gestation, 31 ± 1 yr, prepregnancy BMI: 23.5 ± 0.9 kg/m2) and 11 nonpregnant controls (29 ± 1 yr; BMI: 25.2 ± 1.7 kg/m2). Pregnant women had elevated baseline sympathetic burst incidence (43 ± 2 vs. 33 ± 2 bursts/100 heart beats, P = 0.01) and total sympathetic activity (1,811 ± 148 vs. 1,140 ± 55 au, P < 0.01) relative to controls. Both mean (88 ± 3 vs. 91 ± 2 mmHg, P = 0.4) and diastolic (DBP) (72 ± 3 vs. 73 ± 2 mmHg, P = 0.7) pressures were similar between pregnant and nonpregnant women, respectively, indicating an upward resetting of the baroreflex set point with pregnancy. Baroreflex gain, calculated as the linear relationship between sympathetic burst incidence and DBP, was reduced in pregnant women relative to controls (−3.7 ± 0.5 vs. −5.4 ± 0.5 bursts·100 heart beats−1·mmHg−1, P = 0.03), as was baroreflex gain calculated with total sympathetic activity (−294 ± 24 vs. −210 ± 24 au·100 heart beats−1·mmHg−1; P = 0.03). Cardiovagal baroreflex gain (sequence method) was not different between nonpregnant controls and pregnant women (49 ± 8 vs. 36 ± 8 ms/mmHg; P = 0.2). However, sympathetic (burst incidence) and cardiovagal gains were negatively correlated in pregnant women (R = −0.7; P = 0.02). Together, these data indicate that the influence of the sympathetic nervous system over arterial blood pressure is reduced in normotensive pregnancy, in terms of both long-term and beat-to-beat regulation of arterial pressure
Mukherjee, Soumyadeep; Pierre-Victor, Dudith; Bahelah, Raed; Madhivanan, Purnima
Incarceration-induced stress makes pregnant women in correctional facilities a high-risk group for mental health problems, resulting in adverse maternal and fetal outcomes. A systematic review was conducted to examine the prevalence and correlates of mental health issues among pregnant inmates. Databases searched included PubMed, Medline, CINAHL Plus, PsycINFO, National Criminal Justice Reference System, Social Work Abstracts, Cochrane and Campbell libraries, which were searched for studies published in English from 1950 till July 2013. Eleven studies were included of pregnant women in correctional facilities and addressed at least one mental illness. Quality score was assigned to these eligible articles. Due to heterogeneity, a narrative review was performed. All of the studies were conducted in the United States, with quality scores ranging from 7 to 10 out of 10. Only one of these studies used mixed methods, the rest were quantitative. Tobacco use among pregnant inmates exceeded 50%, with some studies reporting as high as 84%. Alcohol use was common; 36% of the inmates used illicit drugs in one study. Depression and anxiety levels were high-some studies reported depression among 80% of inmates. Findings suggest that mental health among pregnant prisoners is a huge concern that has not been adequately addressed. PMID:25190332
Ghafari, Mahin; Baigi, Vali; Cheraghi, Zahra
Background Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in urine without having signs and symptoms. The aim of this meta-analysis was to estimate the overall prevalence of asymptomatic bacteriuria among Iranian pregnant women. Methods Major national and international databases were searched up to November 2015, including Scientific Information Database, MagIran, Web of Science, Medline, Scopus, Science Direct and Ovid. The checklist of the STROBE statement was used for evaluating the quality of reporting. The extracted data were analyzed and the results were reported using a random-effects model with 95% confidence interval (CI). Results From 3709 obtained studies, 20 included in the meta-analysis, which involved 15108 pregnant women. The overall prevalence of ASB was 0.13 (95% CI: 0.09, 0.17). The prevalence of ASB in the northern and southern regions of Iran was 0.13 (95% CI: 0.09, 0.18) and 0.11 (95% CI: 0.05, 0.16), respectively. Conclusion Prevalence of ASB among Iranian pregnant women is considerable. Due to the complications of ASB for pregnant women and their children, preventative planning and control of ASB among pregnant women in Iran is necessary. PMID:27336476
Bloom, Tina L; Bullock, Linda F C; Parsons, Lindsay
Rural residence and maternal stress are risk factors for adverse maternal-child health outcomes across the globe, but rural women have been largely overlooked in maternal stress research. We recruited low-income, rural pregnant women for qualitative interviews to explore their stress exposures during pregnancy, reactions to stress, and priorities for stress reduction. We also used quantitative measures (Perceived Stress Scale, Center for Epidemiologic Studies of Depression Scale-Revised, Posttraumatic Stress Disorder Checklist-Civilian, Lifetime Exposure to Violence Scale) to describe stress exposures and reactions. We interviewed 24 pregnant rural women from a Midwestern US state, who were primarily young, white, partnered, and unemployed. Women's predominant stressor was financial stress, compounded by a lack of employment, transportation, and affordable housing options; extended family interdependence; small-town gossip; isolation/loneliness; and boredom. Quantitative measures revealed high levels of global perceived stress, violence exposure, and symptoms of depression and posttraumatic stress disorder among the sample. Women most commonly reported that employment and interventions to increase their employability would most effectively decrease their stress, but faced numerous barriers to education or job training. Tested maternal stress interventions to date include nurse-case management, teaching women stress management techniques, and mind-body interventions. Pregnant women's own priorities for stress-reduction intervention may differ, depending on the population under study. Our findings suggest that rural clinicians should address maternal stress, violence exposure, and mental health symptoms in prenatal care visits and that clinicians and researchers should include the voices of rural women in the conceptualization, design, implementation, and evaluation of maternal stress-reduction interventions. PMID:23215982
... Cuts? I'm Pregnant. Should I Get a Flu Shot? KidsHealth > For Teens > I'm Pregnant. Should I Get a Flu Shot? Print A A A Text Size I ... weeks pregnant. Do I need to get the flu vaccine or will it affect my pregnancy? – Eliza* ...
Martyn, M; Anderson, V; Archibald, A; Carter, R; Cohen, J; Delatycki, M; Donath, S; Emery, J; Halliday, J; Hill, M; Sheffield, L; Slater, H; Tassone, F; Younie, S; Metcalfe, S
Introduction Fragile X syndrome (FXS) is the leading cause of inherited intellectual and developmental disability. Policy development relating to carrier screening programmes for FXS requires input from large studies examining not only test uptake but also psychosocial aspects. This study will compare carrier screening in pregnant and non-pregnant populations, examining informed decision-making, psychosocial issues and health economics. Methods and Analysis Pregnant and non-pregnant women are being recruited from general practices and obstetric services. Women receive study information either in person or through clinic mail outs. Women are provided pretest counselling by a genetic counsellor and make a decision about testing in their own time. Data are being collected from two questionnaires: one completed at the time of making the decision about testing and the second 1 month later. Additional data are gathered through qualitative interviews conducted at several time points with a subset of participating women, including all women with a positive test result, and with staff from recruiting clinics. A minimum sample size of 500 women/group has been calculated to give us 88% power to detect a 10% difference in test uptake and 87% power to detect a 10% difference in informed choice between the pregnant and non-pregnant groups. Questionnaire data will be analysed using descriptive statistics and multivariate logistic regression models. Interview data will be thematically analysed. Willingness-to-pay and cost effectiveness analyses will also be performed. Recruitment started in July 2009 and data collection will be completed by December 2013. Ethics and Dissemination Ethics approval has been granted by the Universities of Melbourne and Western Australia and by recruiting clinics, where required. Results will be reported in peer-reviewed publications, conference presentations and through a website http://www.fragilexscreening.net.au. The results of this study will
Beceriklisoy, H B; Schäfer-Somi, S; Kücükaslan, I; Agaoglu, R; Gültiken, N; Ay, S S; Kaya, D; Aslan, S
Uterine tissue from pregnant bitches was investigated by qualitative RT-PCR for the gene expression of local factors potentially important for the implantation of canine embryos. For this purpose, 10 bitches identified as being at the time of implantation or early placentation by means of ultrasonography before ovariohysterectomy (days 20-35, n = 10) provided tissues for comparison to tissue collected in a previous study and identified as early pregnant (n = 10) or non-pregnant (n = 4) by embryo flushing after ovariohysterectomy (days 10-12 after mating; Schäfer-Somi et al. 2008). Uterine tissue was excised from the middle of the left horn from early pregnant and non-pregnant animals, including from interplacental and placentation sites. The following genes were investigated: CD-4, -8; cyclooxygenase (COX)-1, -2; granulocyte macrophage-colony stimulating factor (GM-CSF); hepatocyte growth factor (HGF); insulin-like growth factor (IGF)-1, -2; transforming growth factor (TGF) and tumour necrosis factor (TNF)-alpha; interferon (IFN)-gamma; interleukin (IL)-1beta, -2, -4, -6, -8, -10, -12; leukaemia inhibitory factor (LIF) and leptin. Gene expression for CD-8, COX-1, TGF-beta, HGF, IGF-1, IL-2, -4,-10, IFN-gamma and LIF were detected in the pre-implantation uterus, and all except IL-2 and -10 were still detectable during the implantation and placentation stage. During implantation, mRNA for IGF-2 and GM-CSF were additionally detected. The dioestrous uterus differed from the pregnant uterus because of the absence of CD-8, IL-4 and IFN-gamma and the expression of CD-4, TNF-alpha and IL-6. The results suggest that IL-4, IFN-gamma, CD-8, GM-CSF and IGF-2 are regulated in a pregnancy-specific manner and that GM-CSF and IGF-2 probably have growth supporting and immune modulating functions during implantation of the canine embryo. PMID:19754548
Sha, Xiao-yan; Xiong, Zheng-fang; Liu, Hui-shu; Zheng, Zheng; Ma, Tong-hui
Aim: Aquaporin 8 (AQP8) is expressed within the female reproductive system but its physiological function reminds to be elucidated. This study investigates the role of AQP8 during pregnancy using AQP8-knockout (AQP8-KO) mice. Methods: Homozygous AQP8-KO mice were mated, and the conception rate was recorded. AQP8-KO pregnant mice or their offspring were divided into 5 subgroups according to fetal gestational day (7, 13, 16, 18 GD) and newborn. Wild type C57 pregnant mice served as the control group. The number of pregnant mice, total embryos and atrophic embryos, as well as fetal weight, placental weight and placental area were recorded for each subgroup. The amount of amniotic fluid in each sac at 13, 16, and 18 GD was calculated. Statistical significance was determined by analysis of variance of factorial design and chi-square tests. Results: Conception rates did not differ significantly between AQP8-KO and wild type mice. AQP8-KO pregnant mice had a significantly higher number of embryos compared to wild type controls. Fetal/neonatal weight was also significantly greater in the AQP8-KO group compared to age-matched wild type controls. The amount of amniotic fluid was greater in AQP8-KO pregnant mice than wild type controls, although the FM/AFA (fetal weight/amniotic fluid amount) did not differ. While AQP8-KO placental weight was significantly larger than wild type controls, there was no evidence of placental pathology in either group. Conclusion: The results suggest that AQP8 deficiency plays an important role in pregnancy outcome. PMID:21602842
Alvarado-Esquivel, Cosme; Terrones-Saldívar, María del Carmen; Hernández-Tinoco, Jesús; Muñoz-Terrones, María Daniela Enriqueta; Gallegos-González, Roberto Oswaldo; Sánchez-Anguiano, Luis Francisco; Reyes-Robles, Martha Elena; Jaramillo-Juárez, Fernando; Liesenfeld, Oliver; Estrada-Martínez, Sergio
Objectives We determined the seroprevalence and correlates of Toxoplasma gondii infection in pregnant women in Aguascalientes City, Mexico. Design A cross-sectional survey. Setting Pregnant women were enrolled in the central Mexican city of Aguascalientes. Participants We studied 338 pregnant women who attended prenatal care in 3 public health centres. Primary and secondary outcome measures Women were examined for IgG/IgM antibodies to T. gondii by using commercially available enzyme immunoassays, and an avidity test. Multiple analyses were used to determine the association of T. gondii seropositivity with the characteristics of the pregnant women. Results Of the 338 pregnant women studied, 21 (6.2%) had IgG antibodies to T. gondii, and 1 (4.8%) of them was also positive for IgM antibodies to T. gondii. Avidity of IgG antibodies to T. gondii was high in the IgM-positive sample. Logistic regression analysis of sociodemographic, behavioural and housing variables showed that T. gondii seropositivity was associated with white ethnicity (OR=149.4; 95% CI 10.8 to 2054.1; p<0.01), not washing hands before eating (OR=6.41; 95% CI 1.73 to 23.6; p=0.005) and use of latrine (OR=37.6; 95% CI 4.63 to 306.31; p=0.001). Conclusions Results demonstrate that pregnant women in Aguascalientes City have a low seroprevalence of T. gondii infection. However, this low prevalence indicates that most pregnant women are at risk for a primary infection. Factors associated with T. gondii exposure found in this study, including food hygiene, may be useful to determine preventive measures against T. gondii infection and its sequelae. PMID:27371556
Sugarman, J; Kaplan, L; Cogswell, B; Olson, J
Promising clinical results suggest that umbilical cord blood (UCB) collected after delivery of a child may have many advantages over bone marrow for transplantation. As there are an increasing number of options regarding the collection of UCB, including private and public banking, more pregnant women are likely to be asked to make decisions about UCB collection. We conducted three focus groups with pregnant women to learn about their perspectives on this emerging technology. All the women in these focus groups indicated that they would choose to have UCB collected. Reasons leading to this choice were that the UCB would otherwise be discarded and altruism. Participants indicated that possible reasons to decide not to have UCB collected include concerns about the safety of the mother and neonate, beliefs about the placenta, threats against confidentiality, rejection of UCB, and the influence of fathers. While feeling confident in making an anticipatory decision about UCB collection, women expressed a clear desire to learn much more about the collection, storage (including distinctions between public and private banking), and use of UCB. In addition, they believed that recruitment for UCB collection should occur after sufficient education about UCB and certainly not after delivery and collection. These data will be useful in guiding efforts to help women make decisions about having UCB collected and in developing an appropriate recruitment and informed consent process for donating UCB to a public bank. PMID:9718543
Hinwood, A.L.; Callan, A.C.; Ramalingam, M.; Boyce, M.; Heyworth, J.; McCafferty, P.; Odland, J.Ø.
Recent literature suggests that exposure to low concentrations of heavy metals may affect both maternal and child health. This study aimed to determine the biological heavy metals concentrations of pregnant women as well as environmental and dietary factors that may influence exposure concentrations. One hundred and seventy three pregnant women were recruited from Western Australia, each providing a sample of blood, first morning void urine, residential soil, dust and drinking water samples. Participants also completed a questionnaire which included a food frequency component. All biological and environmental samples were analysed for heavy metals using ICP-MS. Biological and environmental concentrations of lead and mercury were generally low (Median Pb Drinking Water (DW) 0.04 µg/L; Pb soil <3.0 µg/g; Pb dust 16.5 µg/g; Pb blood 3.67 µg/L; Pb urine 0.55; µg/L Hg DW <0.03; Hg soil <1.0 µg/g; Hg dust <1.0 µg/g; Hg blood 0.46 µg/L; Hg urine <0.40 µg/L). Cadmium concentrations were low in environmental samples (Median CdDW 0.02 µg/L; Cdsoil <0.30 ug/g; Cddust <0.30) but elevated in urine samples (Median 0.55 µg/L, creatinine corrected 0.70 µg/g (range <0.2–7.06 µg/g creatinine) compared with other studies of pregnant women. Predictors of increased biological metals concentrations in regression models for blood cadmium were residing in the Great Southern region of Western Australia and not using iron/folic acid supplements and for urinary cadmium was having lower household annual income. However, these factors explained little of the variation in respective biological metals concentrations. The importance of establishing factors that influence low human exposure concentrations is becoming critical in efforts to reduce exposures and hence the potential for adverse health effects. -- Highlights: • Biological heavy metals concentrations in women in their 3rd trimester of pregnancy. • Exposure assessment including environmental, lifestyle and activity
Rached-Paoli, Ingrid; Henriquez-Pérez, Gladys; Azuaje-Sánchez, Arelis
Our goal was to analyze the concordances and non-concordances of the nutritional classification in pregnant women and to evaluate their effectiveness when different BMI classification methodologies were applied. The study consisted of 314 adult healthy pregnant women in their first trimester, of socioeconomic status IV. In all of them, two nutritional classification criteria were applied: the integral nutritional diagnosis (IND) and different BMI reference values (Institute of Medicine, FAO/OMS, Frisancho, Bray, and Atalah). Kappa, concordance and nonconcordance, sensitivity, specificity, positive and negative predictive values were calculated. The highest frequency of concordance between IND and the analyzed classification criteria in comparing four and three nutritional categories was Frisancho's with the following results 89.2%, Kappa = 0.81 in the first case, and 91.4, Kappa = 0.84 in the second case. In deficit, the Bray and Atalah classification criteria were the highest sensitivities. In excess, FAO/ OMS, Frisancho, and Bray had a high sensitivity (1 - 0.99). Frisancho, in addition, had a high specificity with respect to FAO/OMS and Bray. Frisancho's classification criteria are the best choice for diagnosing adult pregnant women's nutritional status during the first trimester within population groups with these characteristics. PMID:16187677
Rakchanok, Noochpoung; Amporn, Dejpitak; Yoshida, Yoshitoku; Harun-Or-Rashid, Md; Sakamoto, Junichi
The aims of this study were to identify dental caries and gingivitis among pregnant women, and to compare it with those in non-pregnant women in Chiang Mai, Thailand. Data were collected from 197 women (94 pregnant and 103 non-pregnant) from June to August, 2008. Dental caries and gingivitis was defined clinically according to the World Health Organization (WHO) diagnostic criteria. Over 74.0% of pregnant women had caries, and 86.2% had gingivitis. There were significant differences between pregnant and non-pregnant women with regard to dental caries (p < 0.001) and gingivitis (p = 0.021). The pregnant women were 2.9 times more likely to suffer from dental caries (95% confidence intervals (CI), 1.6-5.4), and 2.2 times more (95% CI, 1.1-4.7) from gingivitis compared to non-pregnant women. Farmers (Odd ratio (OR), 7.0; 95% CI, 1.8-26.3), high school graduation (OR, 3.0; 95% CI, 1.2-7.3), and universal health insurance coverage (OR, 2.1; 95% CI, 1.0-4.3) were significant predictors for gingivitis. Only high school graduates were found to be significant predictors of dental caries with an OR of 2.8 (95% CI, 1.2-6.3). Poor oral hygiene (OR, 2.2; 95% CI, 0.8-6.5), lack of knowledge (OR, 2.0; 95% CI, 0.6-6.3), and poor oral hygiene habits (OR, 3.0; 95% CI, 1.1-8.6) were important risk factors for dental caries. Similarly, inadequate oral hygiene status (OR, 24.8; 95% CI, 5.5-112.2), and poor oral health habits (OR, 5.2; 95% CI, 1.1-25.2) were found to be significant risk factors for gingivitis among pregnant women indicating, that most women should be trained in proper oral hygiene practices. Community awareness programs should be conducted to increase women's awareness of such hygienic practices. PMID:20229702
Ali, Nurshad; Blaszkewicz, Meinolf; Nahid, Abdullah Al; Rahman, Mustafizur; Degen, Gisela H.
The trichothecene mycotoxin deoxynivalenol (DON) is a contaminant of crops worldwide and known to cause adverse health effects in exposed animals and humans. A small survey reported the presence of DON in maize samples in Bangladesh, but these data are insufficient to assess human exposure, and also, biomonitoring data are still scarce. The present study applied biomarker analysis to investigate the DON exposure of pregnant women in Bangladesh. Urine samples were collected from pregnant women living in a rural (n = 32) and in a suburban (n = 22) area of the country. Urines were subjected to enzymatic hydrolysis of glucuronic acid conjugates and to immunoaffinity column clean-up prior to LC-MS/MS analysis of DON and its de-epoxy metabolite DOM-1. The limits of detection (LOD) for DON and DOM-1 in urine were 0.16 ng/mL and 0.10 ng/mL, respectively. DOM-1 was not detected in any of the urines, whilst DON was detectable in 52% of the samples at levels ranging from 0.18–7.16 ng/mL and a mean DON concentration of 0.86 ± 1.57 ng/mL or 2.14 ± 4.74 ng/mg creatinine. A significant difference in mean urinary DON levels was found between the rural (0.47 ± 0.73 ng/mL) and suburban (1.44 ± 2.20 ng/mL) cohort, which may be related to different food habits in the two cohorts. Analysis of food consumption data for the participants did not show significant correlations between their intake of typical staple foods and DON levels in urine. The biomarker concentrations found and published urinary excretion rates for DON were used to estimate daily mycotoxin intake in the cohort: the mean DON intake was 0.05 µg/kg b.w., and the maximum intake was 0.46 µg/kg b.w., values lower than the tolerable daily intake of 1 µg/kg b.w. These first results indicate a low dietary exposure of pregnant women in Bangladesh to DON. Nonetheless, further biomonitoring studies in children and in adult cohorts from other parts of the country are of interest to gain more insight into DON exposure in
Ali, Nurshad; Blaszkewicz, Meinolf; Al Nahid, Abdullah; Rahman, Mustafizur; Degen, Gisela H
The trichothecene mycotoxin deoxynivalenol (DON) is a contaminant of crops worldwide and known to cause adverse health effects in exposed animals and humans. A small survey reported the presence of DON in maize samples in Bangladesh, but these data are insufficient to assess human exposure, and also, biomonitoring data are still scarce. The present study applied biomarker analysis to investigate the DON exposure of pregnant women in Bangladesh. Urine samples were collected from pregnant women living in a rural (n = 32) and in a suburban (n = 22) area of the country. Urines were subjected to enzymatic hydrolysis of glucuronic acid conjugates and to immunoaffinity column clean-up prior to LC-MS/MS analysis of DON and its de-epoxy metabolite DOM-1. The limits of detection (LOD) for DON and DOM-1 in urine were 0.16 ng/mL and 0.10 ng/mL, respectively. DOM-1 was not detected in any of the urines, whilst DON was detectable in 52% of the samples at levels ranging from 0.18-7.16 ng/mL and a mean DON concentration of 0.86 ± 1.57 ng/mL or 2.14 ± 4.74 ng/mg creatinine. A significant difference in mean urinary DON levels was found between the rural (0.47 ± 0.73 ng/mL) and suburban (1.44 ± 2.20 ng/mL) cohort, which may be related to different food habits in the two cohorts. Analysis of food consumption data for the participants did not show significant correlations between their intake of typical staple foods and DON levels in urine. The biomarker concentrations found and published urinary excretion rates for DON were used to estimate daily mycotoxin intake in the cohort: the mean DON intake was 0.05 µg/kg b.w., and the maximum intake was 0.46 µg/kg b.w., values lower than the tolerable daily intake of 1 µg/kg b.w. These first results indicate a low dietary exposure of pregnant women in Bangladesh to DON. Nonetheless, further biomonitoring studies in children and in adult cohorts from other parts of the country are of interest to gain more insight into DON exposure in the
Jackson, Afton; Shannon, Lisa
Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women. The purpose of this study is to explore barriers for rural pregnant women seeking substance abuse treatment. There were three eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index. Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability, accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant women seeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and services. PMID:22139045
Göya, Cemil; Tunç, Senem; Teke, Memik; Hattapoğlu, Salih
Objective We aimed to evaluate placental stiffness measured by acoustic radiation force impulse (ARFI) elastography in pregnant women in the second trimester with a normal fetus versus those with structural anomalies and non-structural findings. Materials and Methods Forty pregnant women carrying a fetus with structural anomalies diagnosed sonographically at 18–28 weeks of gestation comprised the study group. The control group consisted of 34 healthy pregnant women with a sonographically normal fetus at a similar gestational age. Placental shear wave velocity (SWV) was measured by ARFI elastography and compared between the two groups. Structural anomalies and non-structural findings were scored based on sonographic markers. Placental stiffness measurements were compared among fetus anomaly categories. Doppler parameters of umbilical and uterine arteries were compared with placental SWV measurements. Results All placental SWV measurements, including minimum SWV, maximum SWV, and mean SWV were significantly higher in the study group than the control group ([0.86 ± 0.2, 0.74 ± 0.1; p < 0.001], [1.89 ± 0.7, 1.59 ± 0.5; p = 0.04], and [1.26 ± 0.4, 1.09 ± 0.2; p = 0.01]), respectively. Conclusion Placental stiffness evaluated by ARFI elastography during the second trimester in pregnant women with fetuses with congenital structural anomalies is higher than that of pregnant women with normal fetuses. PMID:26957906
Altay, Mehmet Metin; Demirok, Gulizar; Balta, Ozgur; Bolu, Hulya
Purpose. To show whether pregnancy affects the measurements of pupillary diameter and wavefront (WF) aberrations. Methods. This was a case-control study including 34 healthy pregnant women in the third trimester and age-matched 34 nonpregnant women. Only women who had no ocular abnormalities and no refractive error were included. We measured photopic and mesopic pupil diameter and WF aberrations at the third trimester and at the second postpartum month. Measurements of the right eyes were used in this study. The differences between groups were analysed by paired t-test and t-test. Results. Pregnant women's mean photopic pupil size in the third trimester was significantly higher than in postpartum period and in control group (3.74 ± 0.77, 3.45 ± 0.53, and 3.49 ± 0.15 mm, p < 0.05, resp.). Mesopic pupil size in the third trimester was also higher than in postpartum period and in control group (6.77 ± 0.52, 6.42 ± 0.55, and 6.38 ± 0.21 mm, p < 0.05, resp.). RMS-3 and RMS-5 values were higher in pregnancy but these differences were not statistically significant. Conclusion. Pregnancy increased photopic and mesopic pupil size significantly but did not increase wavefront aberrations notably. Increased pupil size may be due to increased sympathetic activity during pregnancy. And this activity can be noninvasively determined by measuring pupil size. PMID:26998383
Lewis, Peter R; Karpa, Kelly Dowhower; Felix, Todd Matthew
Although drugs can be an essential and lifesaving component of the care of adult patients, their use frequently is accompanied by adverse effects and life-threatening adverse drug reactions that can result in significant disability and mortality. The potential for drug-related severe morbidity and mortality is compounded during periods of hospitalization, when high-risk drugs such as anticoagulants or insulin are used, and when care in an intensive care unit is required. Patient factors in adults that can increase the risk of drug harms include immunosuppression, cognitive impairment, depression, alcoholism and other substance abuse disorders, chronic kidney disease, hepatic dysfunction, coagulopathies, limited English proficiency, institutional/nursing home care, and underinsurance or lack of insurance. Physician factors that can increase the risk of drug harms include inappropriate prescribing of drugs (including to pregnant and breastfeeding women), failure to appropriately discontinue/deprescribe drugs, insufficient drug reconciliation, failure to coordinate care among multiple prescribing clinicians, and failure to elicit and incorporate into health histories and clinical decision-making the widespread use of nonprescription drugs, herbal products, and dietary supplements. PMID:26375995
Salmela-Aro, Katariina; Read, Sanna; Rouhe, Hanna; Halmesmäki, Erja; Toivanen, Riikka Maria; Tokola, Maiju Ilona; Saisto, Terhi
This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a 'fear of childbirth' questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups. They rated themselves on a preparedness scale in middle and late pregnancy, and on a motherhood scale three months after childbirth. The intervention included six psycho-education group sessions during pregnancy and one after childbirth. This intervention increased the mothers' preparedness for childbirth, which predicted an increase in positive motherhood. PMID:21963681
Balogun, S T; Fehintola, F A; Adeyanju, O A; Adedeji, A A
Susceptibility to infection by Plasmodium falciparum is increased in pregnant women. In sub-Saharan Africa, the consequences of maternal malaria include preterm birth, fetal growth restriction and increased infant mortality. Malaria transmission requires the circulation of viable gametocytes that can be ingested by the female mosquito taking a blood meal. This study was conducted to evaluate the presence of asexual and sexual stages of P. falciparum in pregnant women attending antenatal booking clinics in south-western Nigeria, an area hyper-endemic for malaria. Gametocyte carriage was about 13%, similar to that documented for children symptomatic for malaria in our area of study.
Maraspin, Vera; Strle, Franc
In this report, we present basic data pertinent to the current understanding of borrelial infection in pregnancy, and propose a rationale for the management of Lyme borreliosis in pregnant women. We advocate early detection of attached ticks and their prompt removal. We do not recommend the use of prophylactic antibiotics in pregnant women but support the 'wait and watch' strategy, including early treatment with antibiotics if signs/symptoms of the disease arise. We encourage the approach that antibiotic treatment of pregnant patients is restricted to those having a reliable clinical diagnosis of Lyme borreliosis, and propose intravenous antibiotic treatment with penicillin, or preferably ceftriaxone 2 g daily for 14 days, not only for patients with early disseminated disease but also for those with solitary erythema migrans. PMID:19367103
Pregnant African American women are at higher risk for multiple complex health issues, including depression, than their European American counterparts (Canady, Bullen, Holzman, Broman, & Tian, 2008; Martin et al, 2011; Mathews & MacDorman, 2007; Orr, Blazer, & James, 2006; Segre, Losch, & O'Hara, 2006). Various strategies must be used to address depression through preventive care and promotion of access to appropriate mental health services. Nurses and other health care providers need to examine the relationships between the multifactorial problems to improve the health and well-being of pregnant African American women and their unborn children. This article presents a case study demonstrating the use of complexity science theory to understand and prevent poor health outcomes for pregnant African American women with depression and their unborn children. PMID:26050422
Park, Chul Min; Seo, Hye-Jin; Jung, Young-Eun; Kim, Moon-Doo; Hong, Seong-Chul; Bahk, Won-Myong; Yoon, Bo-Hyun; Hur, Min Hee; Song, Jae Min
Background This cross-sectional study sought to identify factors associated with antenatal depression in pregnant Korean females, including sociodemographic parameters, social support, social conflict, and bipolarity. Methods Eighty-four pregnant women were recruited to complete questionnaires on sociodemographic factors, obstetric history, depressive symptoms, and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale. Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire. Results Nineteen participants (22.6%) had positive Mood Disorder Questionnaire scores, suggesting the presence of bipolarity, and were significantly more likely to score high on the Edinburgh Postnatal Depression Scale. Antenatal depression was associated with bad marital communication and marital dissatisfaction. Conclusion These results suggest that spousal interactions play a significant role in antenatal depression, and pregnant women with bipolarity may be more depressed than those without bipolarity. PMID:24966674
Yang, Zhaohua; Yang, Shouguo; Wang, Fangshun; Wang, Chunsheng
Acute aortic dissection occurring during pregnancy represents a lethal risk to both the mother and fetus. Management of parturient with acute aortic dissection is complex. We report our experience of two pregnancies with type A acute aortic dissection. One patient is a 31-year-old pregnant woman (33rd gestational week) with a bicuspid aortic valve and the other is a 32-year-old pregnant woman (30th gestational week) with the Marfan syndrome. In both cases, a combined emergency operation consisting of Cesarean section, total hysterectomy prior to corrective surgery for aortic dissection was successfully performed within a relatively short period of time after the onset. Both patients' postoperative recovery was uneventful, and we achieved a favorable maternal and fetal outcome. PMID:25085319
Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.
This study demonstrates the normal technetium-99m diethylenetriaminepentaacetic acid ((/sup 99m/Tc)DTPA) renal scan in pregnant patients with transplanted kidneys. Five pregnant renal transplant patients had seven (/sup 99m/Tc)DTPA renal studies to assess allograft perfusion and function. All scans showed the uteroplacental complex. The bladder was always compressed and distorted. The transplanted kidney was frequently rotated to a more vertical position. In all patients allograft flow and function were maintained. There was calyceal retention on all studies and ureteral retention activity in three of five patients. Using the MIRD formalism, the total radiation absorbed dose to the fetus was calculated to be 271 mrad. This radiation exposure is well within NRCP limits for the fetus of radiation workers and an acceptable low risk in the management of these high risk obstetric patients.
Kaur, Paramjit; Kaur, Gagandeep; Basu, Sabita; Kaur, Ravneet
Among the antibodies of the MNS blood group system, anti S antibody is generally IgG antibody reacting at 37 °C. It is rarely implicated in hemolytic transfusion reaction; however, it can lead to potentially severe transfusion reactions. Anti S is also capable of causing mild to severe fatal hemolytic disease of newborn. We report a case of anti S antibody in a pregnant patient with complicated falciparum malaria. PMID:24485071
Hotelling, Barbara A.
Pregnant prisoners have health-care needs that are minimally met by prison systems. Many of these mothers have high-risk pregnancies due to the economic and social problems that led them to be incarcerated: poverty, lack of education, inadequate health care, and substance abuse. Lamaze educators and doulas have the opportunity to replicate model programs that provide these women and their children with support, information, and empowering affirmation that improve parenting outcomes and decrease recidivism. PMID:19252687
Khan, Farhan R.; Ahmad, Tashfeen; Hussain, Rabia; Bhutta, Zulfiqar A.
Aim: To compare pregnant and non-pregnant females for vitamin D level and periodontal status and to determine if there is any association between the periodontal health and hypovitaminosis D in pregnant women. Materials and Methods: A cross-sectional study was conducted in Jhelum, Pakistan. Participants were pregnant females at ~ 12 weeks of gestation (n = 36) and non-pregnant (n = 35) females selected from the same locality. Periodontal parameters such as probing depth, bleeding on probing, and attachment loss were recorded. Serum samples were taken to measure blood indices and vitamin D levels. Chi-square test and Odds ratio were applied to determine the association between hypovitaminosis D and periodontal status. Results: Vitamin D deficiency was common in the pregnant group compared to non-pregnant (P < 0.001). Blood indices (hemoglobin, hematocrit, mean corpuscular volume) were significantly lower among the pregnant compared to the non-pregnant group (P < 0.001). However, there was no significant difference between the two groups for probing depth and attachment loss. Conclusions: Pregnant women were more deficient in Vitamin D than non-pregnant women. However, no association between low vitamin D levels and periodontal disease was seen in the studied population. PMID:27382540
Sandbu, Synne; Nøkleby, Hanne
Pregnant women and parents of young children travelling to non-western countries should consider the risks to which they expose themselves and their children. Travelling during these periods of life needs to be particularly well planned. Travel insurance should cover the whole family, and for pregnant women also the risk of premature birth. Travelling long distances during pregnancy involves a certain amount of risk in itself. This risk could be increased if complications were to occur in areas with a lower standard of health service. As a rule, infants and young children easily adapt to new environments but children abroad should be expected to need a doctor at least as often as at home. Some vaccines and antimalarials must not be used for children below a certain age. Only a few vaccines and antimalarials have been systematically studied in pregnant women in order to exclude teratogenicity. We present some aspects of vaccination and malaria prevention, transport, climate and environment, nutrition, food and drinking water hygiene. PMID:12119785
Cassidy, Christine; MacDonald, Noni E.; Steenbeek, Audrey; Ortiz, Justin R.; Zuber, Patrick L. F.; Top, Karina A.
ABSTRACT Strengthening antenatal care as a platform for maternal immunization is a priority of the World Health Organization (WHO). Systematic surveillance for adverse events following immunization (AEFI) in pregnancy is needed to identify vaccine safety events. We sought to identify active and passive AEFI surveillance systems for pregnant women and infants. Representatives from all National Pharmacovigilance Centers and a convenience sample of vaccine safety experts were invited to complete a 14-item online survey in English, French or Spanish. The survey captured maternal immunization policies, and active and passive AEFI surveillance systems for pregnant women and infants in respondents' countries. The analysis was descriptive. We received responses from 51/185 (28%) invited persons from 47/148 (32%) countries representing all WHO regions, and low, middle and high-income countries. Thirty countries had national immunization policies targeting pregnant women. Eleven countries had active surveillance systems to detect serious AEFI in pregnant women and/or their infants, including six low and middle-income countries (LMIC). Thirty-nine countries had passive surveillance systems, including 23 LMIC. These active and passive surveillance programs cover approximately 8% and 56% of the worldwide annual birth cohort, respectively. Data from one active and four passive systems have been published. We identified 50 active and passive AEFI surveillance systems for pregnant women and infants, but few have published their findings. AEFI surveillance appears to be feasible in low and high resource settings. Further expansion of AEFI surveillance for pregnant women and sharing of vaccine safety information will provide additional evidence in support of maternal immunization policies. PMID:27159639
This paper describes brief work with pregnant teenagers, adolescent mothers, their infants and their wider families, a group who would not ordinarily seek treatment in child and adolescent mental health services. The work takes place in a community context in London and includes a home visiting service for young people unable to attend…
Osofsky, Howard J.
Concerned with teen-aged pregnancy, the text includes discussions of premarital pregnancy, the pregnant teen as a member of the poor, as nonwhite, and as a teen-ager, obstetrical concepts, pregnancy results, factors which influence medical prognosis, and solutions to minimize medical risk. Additional areas of concern are a research review and a…
Costello, Cynthia B.
This report focuses on pathways to postsecondary education (PSE), including high school completion, for pregnant and parenting teens. Although birth rates among teens have declined in the United States over the last 20 years, one in seven adolescent females (14.4 percent) is expected to give birth before age 20 with females of color (24 percent of…
Kerker, Bonnie D.; Horwitz, Sarah M.; Leventhal, John M.
Objective: This study's aim was to determine how patients' and providers' characteristics affect hospital providers' decisions to screen pregnant and postpartum women for illicit substances. Methods: A retrospective design was used. Participants included all low-income women (N=1,100) who delivered at an urban teaching hospital over a 12-month…
Lewis, Marilyn W.; Cavanagh, Paul K.; Ahn, Grace; Yoshioka, Marianne R.
Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and…
Kuhlen, James L; Blumenthal, Kimberly G; Sokol, Caroline L; Balekian, Diana S; Weil, Ana A; Varughese, Christy A; Shenoy, Erica S; Banerji, Aleena
Validated skin testing is lacking for many drugs, including ceftaroline. The cross-reactivity between ceftaroline and other β-lactam antibiotics is unknown. We report a case of a pregnant patient with cystic fibrosis and multiple drug allergies who required ceftaroline for methicillin-resistant Staphylococcus aureus pneumonia and underwent an uncomplicated empiric desensitization procedure. PMID:26034776
From 2000-2009, 44% of United States (US) pregnant women had gestational weight gain (GWG) above and 20% had GWG below the recommended range of 15 to 40 pounds, which depends on starting weight. GWG outside the recommended range is associated with adverse outcomes including pre-e...
Pollack, Andrew M.
Describes a program to reduce the dropout rate for pregnant and parenting teens at York Vocational-Technical School (Pennsylvania) for the second semester of 1985-86. One successful feature was a "caring class" providing information about pregnancy, childcare, nutrition, and other subjects. The program retained most of its enrollees. Includes 1…
Zhang, Jie; Hisada, Aya; Yoshinaga, Jun; Shiraishi, Hiroaki; Shimodaira, Kazuhisa; Okai, Takashi; Noda, Yumiko; Shirakawa, Miyako; Kato, Nobumasa
Possible association between environmental exposure to pyrethroid insecticides and serum thyroid-related measures was explored in 231 pregnant women of 10–12 gestational weeks recruited at a university hospital in Tokyo during 2009–2011. Serum levels of free thyroxine (fT4), thyroid stimulating hormone (TSH) and thyroid biding globulin (TBG) and urinary pyrethroid insecticide metabolite (3-phenoxybenzoic acid, 3-PBA) were measured. Obstetrical information was obtained from medical records and dietary and lifestyle information was collected by self-administered questionnaire. Geometric mean concentration of creatinine-adjusted urinary 3-PBA was 0.363 (geometric standard deviation: 3.06) μg/g cre, which was consistent with the previously reported levels for non-exposed Japanese adult females. The range of serum fT4, TSH and TBG level was 0.83–3.41 ng/dL, 0.01–27.4 μIU/mL and 16.4–54.4 μg/mL, respectively. Multiple regression analysis was carried out by using either one of serum levels of thyroid-related measures as a dependent variable and urinary 3-PBA as well as other potential covariates (age, pre-pregnancy BMI, parity, urinary iodine, smoking and drinking status) as independent variables: 3-PBA was not found as a significant predictor of serum level of thyroid-related measures. Lack of association may be due to lower pyrethroid insecticide exposure level of the present subjects. Taking the ability of pyrethroid insecticides and their metabolite to bind to nuclear thyroid hormone (TH) receptor, as well as their ability of placental transfer, into consideration, it is warranted to investigate if pyrethroid pesticides do not have any effect on TH actions in fetus brain even though maternal circulating TH level is not affected. -- Highlights: • Pyrethroid exposure and thyroid hormone status was examined in pregnant women. • Urinary 3-phenoxybenzoic acid was used as a biomarker of exposure. • Iodine nutrition, age and other covariates were included
Skjeldestad, Finn Egil; Sandvik, Leiv
The aim of this study was to assess the prevalence and risk factors of anal incontinence in an unselected pregnant population at second trimester. A survey of pregnant women attending a routine ultrasound examination was conducted in a university hospital in Oslo, Norway. A questionnaire consisting of 105 items concerning anal incontinence (including St. Mark's score), urinary incontinence, medication use, and comorbidity was posted to women when invited to the ultrasound examination. Results. Prevalence of self-reported anal incontinence (St. Mark's score ≥ 3) was the lowest in the group of women with a previous cesarean section only (6.4%) and the highest among women with a previous delivery complicated by obstetric anal sphincter injury (24.4%). Among nulliparous women the prevalence of anal incontinence was 7.7% and was associated to low educational level and comorbidity. Prevalence of anal incontinence increased with increasing parity. Urinary incontinence was associated with anal incontinence in all parity groups. Conclusions. Anal incontinence was most frequent among women with a history of obstetric anal sphincter injury. Other obstetrical events had a minor effect on prevalence of anal incontinence among parous women. Prevention of obstetrical sphincter injury is likely the most important factor for reducing bothersome anal incontinence among fertile women. PMID:23819058
Farshbaf Khalili, Azizeh; Shahnazi, Mahnaz; Hajizadeh, Khadijeh; Shekari Khaniani, Mahmoud
Introduction: Down syndrome is one of the most prevalent genetic diseases. Screening methods for this syndrome are easy and safe and are recommended to all pregnant women particularly mothers over 35 years of age. This study aimed to review the status of Down syndrome screening and related factors in Iranian pregnant women. Methods: This descriptive analytical study was carried out in 2011. It included 400 women who were randomly selected from those referring to Alzahra Hospital (Tabriz, Iran) during their third trimester of pregnancy. Data was collected through a question-naire whose reliability and validity have been approved. The data was analyzed by chi-square test in SPSS13. Results: The results showed that while 28 and 26 women imple-mented screening tests during the first and second trimesters, respectively, only 5 sub-jects benefited from both (integrated test). Chi-square test showed significant correla-tions between the implementation of screening methods and age, education level, in-come, and the location of prenatal care (p < 0.05). Conclusion: The findings of the present study showed women to poorly implement Down syndrome screening methods. Therefore, the necessity of providing appropriate educational programs for health staff and mothers seems undeniable. Moreover, paying attention to the related factors such as income, educational level, and adequate training of mothers during pregnancy is essential. PMID:25276689
Galvao, Tais F.; Silva, Marcus T.; Zimmermann, Ivan R.; Lopes, Luiz Antonio B.; Bernardo, Eneida F.; Pereira, Mauricio G.
Objective. To assess the effects of the inactivated influenza virus vaccine on influenza outcomes in pregnant women and their infants. Methods. We performed a systematic review of the literature. We searched for randomized controlled trials and cohort studies in the MEDLINE, Embase, and other relevant databases (inception to September 2013). Two researchers selected studies and extracted the data independently. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the quality of the evidence. Results. We included eight studies out of 1,967 retrieved records. Influenza vaccination in pregnant women significantly reduced the incidence of influenza-like illness in mothers and their infants when compared with control groups (high-quality evidence) and reduced the incidence of laboratory-confirmed influenza in infants (moderate-quality evidence). No difference was found with regard to influenza-like illness with fever higher than 38°C (moderate-quality evidence) or upper respiratory infection (very-low-quality evidence) in mothers and infants. Conclusions. Maternal vaccination against influenza was shown to prevent influenza-like illness in women and infants; no differences were found for other outcomes. As the quality of evidence was not high overall, further research is needed to increase confidence and could possibly change these estimates. PMID:24971194
Finkelstein, Julia L; Pressman, Eva K; Cooper, Elizabeth M; Kent, Tera R; Bar, Haim Y; O'Brien, Kimberly O
Vitamin D is linked to a number of adverse pregnancy outcomes through largely unknown mechanisms. This study was conducted to examine the role of vitamin D status in metabolomic profiles in a group of 30 pregnant, African American adolescents (17.1 ± 1.1 years) at midgestation (26.8 ± 2.8 weeks), in 15 adolescents with 25-hydroxy vitamin D (25(OH)D) ≥20 ng/mL, and in 15 teens with 25(OH)D <20 ng/mL. Serum metabolomic profiles were examined using gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry. A novel hierarchical mixture model was used to evaluate differences in metabolite profiles between low and high groups. A total of 326 compounds were identified and included in subsequent statistical analyses. Eleven metabolites had significantly different means between the 2 vitamin D groups, after correcting for multiple hypothesis testing: pyridoxate, bilirubin, xylose, and cholate were higher, and leukotrienes, 1,2-propanediol, azelate, undecanedioate, sebacate, inflammation associated complement component 3 peptide (HWESASXX), and piperine were lower in serum from adolescents with 25(OH)D ≥20 ng/mL. Lower maternal vitamin D status at midgestation impacted serum metabolic profiles in pregnant adolescents. PMID:25367051
Abu-Salem, A N; Qublan, H S
The objective of this study was to determine the views and compliance of a group of pregnant women regarding obstetric-related blood transfusion. In this prospective questionnaire-based analysis, a total of 300 pregnant women who attended the antenatal care clinic were included. The mean age and gestational age of patients were 31.6 years and 27.4 weeks, respectively. All demographic and questionnaire data were recorded and analysed. A total of 41% of participants were aware of the possible need for blood transfusion in pregnancy and 88% of all women would accept blood transfusion when necessary. The remaining 12% would refuse blood transfusion, even if it was life-saving, because of the fear of blood transfusion complications. It is concluded that counselling and a management plan should be scheduled for pregnancy, and management protocols should be developed for women who refuse blood transfusion. Transfusion alternatives should be discussed with women who will not accept the allogenic blood transfusion. PMID:19358029
Hoover, Edward A.; Griesemer, Richard A.
Intravenous inoculation of pregnant cats with feline herpesvirus produced minimal illness but resulted in abortion, intrauterine fetal death and congenital fetal infection. Placental lesions included multiple infarcts in the placental labyrinth, thrombosis of maternal vessels in the endometrium and placenta, and multifocal necrosis of the giant-cell trophoblast and endometrial epithelium in the junctional zone of the placenta associated with eosinophilic intranuclear inclusion bodies. The virus was isolated from all the placentas and uteri but from none of the fetuses aborted 6-9 days after maternal intravenous inoculation. Viral antigen was demonstrated in the uterine vessels and in the junctional zone of the placenta at this time. On postinoculation day 26, viral antigen was demonstrated in the chorioallantoic membrane on the fetal side of the placenta and in the liver of a congenitally infected fetus. Although all 4 pregnant cats inoculated intranasally with feline herpesvirus aborted, neither virus, viral antigen nor significant lesions were detected in the uteri, placentas or fetuses. Abortion after intranasal inoculation was interpreted as a nonspecific reaction secondary to the severe, debilitating upper respiratory disease that occurred. ImagesFig 1Fig 2Fig 7Fig 8Fig 9Fig 3Fig 4Fig 5Fig 6 PMID:4328861
... 34 Education 2 2010-07-01 2010-07-01 false Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS...
Rice, Nicklaus T.; Szlam, Fania; Varner, Jeffrey D.; Bernstein, Peter S.; Szlam, Arthur D.; Tanaka, Kenichi A.
Background Thrombin generation (TG) is a pivotal process in achieving hemostasis. Coagulation profiles during pregnancy and early neonatal period are different from that of normal (non-pregnant) adults. In this ex vivo study, the differences in TG in maternal and cord plasma relative to normal adult plasma were studied. Methods Twenty consented pregnant women and ten consented healthy adults were included in the study. Maternal and cord blood samples were collected at the time of delivery. Platelet-poor plasma was isolated for the measurement of TG. In some samples, anti-FIXa aptamer, RB006, or a TFPI inhibitor, BAX499 were added to elucidate the contribution of intrinsic and extrinsic pathway to TG. Additionally, procoagulant and inhibitor levels were measured in maternal and cord plasma, and these values were used to mathematically simulate TG. Results Peak TG was increased in maternal plasma (393.6±57.9 nM) compared to adult and cord samples (323.2±38.9 nM and 209.9±29.5 nM, respectively). Inhibitory effects of RB006 on TG were less robust in maternal or cord plasma (52% vs. 12% respectively) than in adult plasma (81%). Likewise the effectiveness of BAX499 as represented by the increase in peak TG was much greater in adult (21%) than in maternal (10%) or cord plasma (12%). Further, BAX499 was more effective in reversing RB006 in adult plasma than in maternal or cord plasma. Ex vivo data were reproducible with the results of the mathematical simulation of TG. Conclusion Normal parturient plasma shows a large intrinsic pathway reserve for TG compared to adult and cord plasma, while TG in cord plasma is sustained by extrinsic pathway, and low levels of TFPI and AT. PMID:27196067
Background Placental malaria is the predominant pathology secondary to malaria in pregnancy, causing substantial maternal and infant morbidity and mortality in tropical areas. While it is clear that placental parasites are phenotypically different from those in the peripheral circulation, it is not known whether unique genotypes are associated specifically with placental infection or perhaps more generally with pregnancy. In this study, genetic analysis was performed on Plasmodium vivax and Plasmodium falciparum parasites isolated from peripheral and placental blood in pregnant women living in North-west Colombia, and compared with parasites causing acute malaria in non-pregnant populations. Methods A total of 57 pregnant women at delivery with malaria infection confirmed by real-time PCR in peripheral or placental blood were included, as well as 50 pregnant women in antenatal care and 80 men or non-pregnant women with acute malaria confirmed by a positive thick smear for P. vivax or P. falciparum. Five molecular markers per species were genotyped by nested PCR and capillary electrophoresis. Genetic diversity and the fixation index FST per species and study group were calculated and compared. Results Almost all infections at delivery were asymptomatic with significantly lower levels of infection compared with the groups with acute malaria. Expected heterozygosity for P. vivax molecular markers ranged from 0.765 to 0.928 and for P. falciparum markers ranged from 0.331 to 0.604. For P. vivax infections, the genetic diversity was similar amongst the four study groups and the fixation index from each pairwise comparison failed to show significant genetic differentiation. For P. falciparum, no genetic differentiation was observed between placental and peripheral parasites from the same woman at delivery, but the parasites isolated at delivery showed significant genetic differentiation compared with parasites isolated from subjects with acute malaria. Conclusions In
Chang, Mei-Wei; Nitzke, Susan; Buist, Diana; Cain, Deborah; Horning, Stefanie; Eghtedary, Kobra
This study was conducted to identify factors that influenced stress, healthy eating and physical activity among low-income overweight or obese pregnant women. We conducted seven focus groups with 96 low-income overweight and obese pregnant women. Common themes were identified from audio tapes and transcripts. Women said that poor communication affected their relationships with spouses or significant others. They were frustrated or upset with significant others for three key reasons: failure to understand or listen to the pregnant women's pregnancy concerns, refusal to be helpful when asked and being overly concerned with the woman's safety. Most women said that they were emotional and took naps throughout the day after becoming pregnant. Many withdrew from their social interactions. They also faced numerous challenges that made healthy eating more difficult, e.g., craving for unhealthy foods and eating foods for comfort. To eat healthier, some reminded themselves to avoid overeating or stop eating in the car. Women were not physically active because of tiredness, lack of motivation, inadequate social support, or bad weather. Some stayed physically active to prevent excessive pregnancy weight gain and have an easier labor. Women equivocally said weighing themselves to manage weight would add to their stress and make them feel more depressed. When designing interventions to help low-income overweight and obese pregnant women avoid excessive pregnancy weight gain, it is important to include information and practical advice on stress management, emphasizing effective communication skills with significant others and helping them plan effective ways to manage negative feelings. PMID:25115522
Iakovets, O V
The features of morphological picture facies oral fluid of pregnant women with intact periodontal inflammatory diseases periodontal tissues. Results of the study were compared with the clinical picture. The features of morphological picture of the oral liquid with a healthy non-pregnant and periodontal inflammatory periodontal diseases in pregnant women. Revealed signs of inflammation markers in oral fluid facies in inflammatory processes in periodontal tissues. PMID:27089718
Bakhmudov, B R; Alieva, Z B; Bakhmudov, M B
Caries incidence was assessed in young (15-17 years) and mature (30-34 years) nulliparous pregnant. In young women the incidence was 1.62 +/- 0.16, while in mature pregnant--1.38 +/- 0.17. This values are significantly higher than in non-pregnant women of the same age: 0.48 +/- 0.09 and 0.24 +/- 0.08, correspondently. PMID:22332376
Stabin, M.G.; Watson, E.E.; Cristy, M.; Ryman, J.C.; Eckerman, K.F.; Davis, J.L.; Marshall, D.; Gehlen, M.K.
Mathematical phantoms representing the adult female at three, six, and nine months of gestation are described. They are modifications of the 15-year-old male/adult female phantom (15-AF phantom) of Cristy and Eckerman (1987). The model of uterine contents includes the fetus, fetal skeleton, and placenta. The model is suitable for dose calculations for the fetus as a whole; individual organs within the fetus (other than the skeleton) are not modeled. A new model for the nonpregnant adult female is also described, comprising (1) the 15-AF phantom; (2) an adjustment to specific absorbed fractions for organ self-dose from photons to better match Reference Woman masses; and (3) computation of specific absorbed fractions with Reference Woman masses from ICRP Publication 23 for both penetrating and nonpenetrating radiations. Specific absorbed fractions for photons emitted from various source regions are tabulated for the new non;pregnant adult female model and the three pregnancy models.
Sutherland, Peter, Ed.
This book on adult learning is divided into six sections. Section 1, Cognitive Processes, includes the following chapters: "Cognitive Processes: Contemporary Paradigms of Learning" (Jack Mezirow); "Information Processing, Memory, Age and Adult Learning" (Gillian Boulton-Lewis); "Adult Learners' Metacognitive Behaviour in Higher Education" (Barry…
This book presents an overview of and prescription for adult education in India. Following an introduction to the problem of illiteracy in India, the book's 14 chapters cover a broad spectrum of adult education issues. Topics discussed include adult education and national development; roles of voluntary organizations, universities, colleges, and…
The 14 chapters of this textbook chronicle adult development from youth through old age, emphasizing both research and interviews with adults at various stages in their lives. Topics covered include the following: (1) the academic field of adult development; (2) theories and research methods; (3) aging and disease prevention; (4) sexuality and…
Simeone, Regina M; Shapiro-Mendoza, Carrie K; Meaney-Delman, Dana; Petersen, Emily E; Galang, Romeo R; Oduyebo, Titilope; Rivera-Garcia, Brenda; Valencia-Prado, Miguel; Newsome, Kimberly B; Pérez-Padilla, Janice; Williams, Tonya R; Biggerstaff, Matthew; Jamieson, Denise J; Honein, Margaret A
Zika virus is a cause of microcephaly and brain abnormalities (1), and it is the first known mosquito-borne infection to cause congenital anomalies in humans. The establishment of a comprehensive surveillance system to monitor pregnant women with Zika virus infection will provide data to further elucidate the full range of potential outcomes for fetuses and infants of mothers with asymptomatic and symptomatic Zika virus infection during pregnancy. In February 2016, Zika virus disease and congenital Zika virus infections became nationally notifiable conditions in the United States (2). Cases in pregnant women with laboratory evidence of Zika virus infection who have either 1) symptomatic infection or 2) asymptomatic infection with diagnosed complications of pregnancy can be reported as cases of Zika virus disease to ArboNET* (2), CDC's national arboviral diseases surveillance system. Under existing interim guidelines from the Council for State and Territorial Epidemiologists (CSTE), asymptomatic Zika virus infections in pregnant women who do not have known pregnancy complications are not reportable. ArboNET does not currently include pregnancy surveillance information (e.g., gestational age or pregnancy exposures) or pregnancy outcomes. To understand the full impact of infection on the fetus and neonate, other systems are needed for reporting and active monitoring of pregnant women with laboratory evidence of possible Zika virus infection during pregnancy. Thus, in collaboration with state, local, tribal, and territorial health departments, CDC established two surveillance systems to monitor pregnancies and congenital outcomes among women with laboratory evidence of Zika virus infection(†) in the United States and territories: 1) the U.S. Zika Pregnancy Registry (USZPR),(§) which monitors pregnant women residing in U.S. states and all U.S. territories except Puerto Rico, and 2) the Zika Active Pregnancy Surveillance System (ZAPSS), which monitors pregnant women
Osaro, Erhabor; Ladan, Malami Aisha; Zama, Isaac; Ahmed, Yakubu; Mairo, Hassan
Introduction Kell antigen is highly immunogenic and is the common cause of antibody production in mismatched blood transfusions, haemolytic transfusion reaction (HTR) and maternal alloimmunization, which causes severe anaemia in neonates. The aim of this study is to determine the prevalence and ethnic variation of the Kell phenotype among pregnant women in Sokoto, Nigeria. Methods Kell antigen status of 150 pregnant women aged 18-45 years and mean age 27.19 ±4.69 years attending antenatal clinic in UDUTH Sokoto Nigeria was determined using the conventional tube method and anti-Kell reagents (Lorne Laboratories, UK). Results Among the 150 subjects studied, 3 (2.0%) of subjects were positive and 147 (98.0) were negative for K antigen. Of the 150 pregnant subjects; 32 (21.3%) were primigravidae while 118 (78.7%) were multigravidae. Kell phenotype was more prevalent among primigravidae (3.1%) compared to multigravidae (1.7%) women. The distribution of Kell phenotype among the pregnant subjects was compared based on ethnicity. The prevalence of Kell antigen was significantly higher among the Hausa ethnic group (3.2%) compared to other ethnic groups which indicated zero prevalence (p = 0.001). Kell negative phenotype was ≥ 96.8% among all the ethnic groups. Conclusion Our observed prevalence of Kell phenotype is consistent with previous studies among Blacks and Asians but significantly lower than values observed in previous studies among Caucasians. We recommend that all pregnant women should be screened for the presence clinically significant red cell antigens including Kell antigen on their first antenatal visit. Kell negative red cell should be routinely provided for all pregnant women and women with child bearing potential to reduce the risk of Kell-associated HDFN. There is need to introduce routine screening of pregnant women for clinically significant red cell antibodies to facilitate the effective management of HDFN as well as prevent HTR. There is also need
Lai, Ming-Cheng; Chou, Feng-Sha; Wang, Chih-Chien; Yang, Yann-Jy
Tobacco use is a global health problem, including in Taiwan. The present study evaluated the perceived risk of smoking and second-hand smoke among pregnant Taiwanese women using a questionnaire. Seven hundred twenty-four pregnant Taiwanese women were recruited from an online parenting community using convenience sampling in 2013. Pregnant smokers and non-smokers had significantly different perceptions regarding risk of smoking and second-hand smoke during pregnancy. Pregnant non-smokers adopted more behaviors to avoid second-hand smoke both at home and in public than pregnant smokers. We conclude that perceived fetal health risks from smoking and second-hand smoke influenced maternal behavior during pregnancy. Pregnant women's perceptions of the risk of tobacco smoke depended on whether their focus in the decision-making process was on prevention or promotion. Understanding the risk factors associated with smoking and exposure to second-hand smoke during pregnancy may help in developing strategies to reduce such exposure. PMID:26867368
Alhusen, Jeanne L.; Rahman, Damali
Objective To explore the perceptions of pregnant women on the experience of intimate partner violence (IPV) as it affects maternal and fetal health. Design Secondary qualitative content analysis. Setting Individual interviews conducted within three urban obstetric and gynecologic clinics Participants Our sample included a subset of eight pregnant women experiencing IPV during the current pregnancy. Participants were selected from a larger parent study that included qualitative data from 13 women. Methods We analyzed in-depth individual interview transcripts in which participants discussed how they perceived IPV to affect their health as well as the health of their unborn children. Constant comparative techniques and conventional content analysis methodology were used in analysis. Results Three themes emerged to illustrate mothers’ perceptions of how IPV influenced maternal and fetal outcomes: protection, fetal awareness, and fetal well-being. Conclusions This analysis provides important insights into concerns that pregnant women experiencing IPV shared about maternal attachment and fetal well-being. Health care providers can use these findings to better assess the physical and psychological concerns of pregnant women experiencing IPV. Further research is needed to better understand how IPV contributes to adverse neonatal outcomes, particularly from a biological perspective. PMID:25651808
Handley, Marilyn Cooper; Avery, Daniel M
This article reviews the persistent problem of smoking, especially as it relates to the rural and underserved population. The negative effects of smoking and disparities in health that occur as a result are highlighted. The article reviews the general state of smoking in the United States and discusses health-related issues and concerns of individuals who continue to smoke. The report explores individuals' rationale for smoking, barriers to cessation, and general knowledge related to the outcomes of smoking during pregnancy. The conclusions highlight the need for providers to provide information and interventions to reduce the smoking rates of pregnant women. PMID:26333611
Høgh, Birthe; Rønn, Anita Mandrup
Pregnant women and children have special needs and vulnerabilities that should be addressed when preparing for travel abroad. The most stable time for travel during pregnancy is the second trimester. Live vaccines should be avoided during pregnancy. Children should be up to date on both routine and travel-related vaccines. Elective travel to malarious areas, especially where chloroquine-resistant malaria is endemic, should be avoided, as some vaccines and antimalarial drugs may not be used during pregnancy and for children below a certain age. Guidelines on preventive measures are given. PMID:16232399
AL-Dughaym, A.M.; Homeida, A.M.
Intravenous administration of Escherichia coli endotoxin at a dose of 0.05 μg/kg bodyweight to pregnant camels resulted in abortion. The injection of endotoxin caused significant increases in the plasma concentration of 13,14-dihydro-15-prostaglandin F2α, the metabolite of prostaglandin F2α (PG F2α) and cortisol and a significant decrease in the concentration of progesterone. It is suggested that endotoxin caused abortion in camels was a consequence of endotoxin induced PG F2α secretion resulting in luteal regression and decreased progesterone concentration. PMID:23961064
... Food Safety Newsroom Dietary Guidelines Communicator’s Guide Pregnancy & Breastfeeding You are here Home / Audience / Adults Pregnancy & Breastfeeding Print Share Health & Nutrition Information When you are ...