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Zhu Z, Hu H, Benmarhnia T, Ren Z, Luo J, Zhao W, Chen S, Wu K, Zhang X, Wang L, Di J, Huang C, Wang Q. Gestational PM 2.5 exposure may increase the risk of small for gestational age through maternal blood pressure and hemoglobin: A mediation analysis based on a prospective cohort in China, 2014-2018. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113836. [PMID: 35841656 DOI: 10.1016/j.ecoenv.2022.113836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Maternal gestational PM2.5 exposure was associated with small for gestational age (SGA). Identifying potential mediating factors may help design preventive strategies to reduce this risk. OBJECTIVE This study aimed to explore the roles of maternal blood pressure and hemoglobin may play in the PM2.5 exposure and SGA relationship among 117,162 births in 16 counties across China during 2014-2018. METHODS Daily PM2.5 concentration was collected from China National Environmental Monitoring Center. According to maternal residency during pregnancy, the PM2.5 exposure for each trimester and the whole pregnancy was assessed using an inverse-distance weighting approach. Repeated measurements of maternal blood pressure and hemoglobin during pregnancy were collected for each woman. We estimated the total effect of gestational PM2.5 exposure on SGA, and further tested the mediation effects of maternal blood pressure and hemoglobin concentration during pregnancy. RESULTS Of 117,162 included mother-infant pairs, 11,361 (9.7 %) were SGA. The odds ratios of SGA associated with PM2.5 exposure (per 10 μg/m3 increase) in the second trimester and the whole pregnancy were 1.023 (95 % CI: 1.009, 1.037) and 1.024 (1.001, 1.048), respectively. We identified the independent mediating effect of blood pressure and hemoglobin in the second and third trimesters, with the proportion of mediation ranging from 1.64 % to 5.78 % and 2.40 % to 8.70 %, respectively. When considering the mediators jointly, we found a stronger mediating effect with a proportion of mediation ranging from 3.93 % to 13.69 %. DISCUSSION Increases in maternal blood pressure and hemoglobin in the second and third trimesters can independently and jointly mediate the effects of gestational PM2.5 exposure on SGA. Monitoring and managing maternal blood pressure and hemoglobin during prenatal care may constitute a promising avenue to reducing SGA risk associated with gestational PM2.5 exposure.
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Affiliation(s)
- Zhenghong Zhu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huanqing Hu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Jiajun Luo
- Institute for Population and Precision Health, the University of Chicago, Chicago, USA
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sidi Chen
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kaipu Wu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxin Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liyun Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Cunrui Huang
- Wanke School of Public Health, Tsinghua University, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Severe early-onset PE with or without FGR in Chinese women. Placenta 2020; 101:108-114. [PMID: 32949793 DOI: 10.1016/j.placenta.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 08/15/2020] [Accepted: 09/07/2020] [Indexed: 12/27/2022]
Abstract
Early-onset preeclampsia (PE) is a severe condition with highest risk of perinatal complications. In current study, we compared PE severity, laboratory results and placental pathological lesions between early-onset PE with fetal growth restriction (PE + FGR) and appropriate gestational age (PE + AGA) neonates, with the aim to identify potential maternal risk factors associated with FGR. A retrospective case study was conducted in 304 PE women, and 31 cases with mild PE were excluded. 276 patients with severe PE were divided into PE + FGR (163, 59.1%) and PE + AGA (113, 40.9%) groups and underwent clinical analysis. 244 cases were further submitted for pathologic examinations to compare the differences of placental lesions between these two groups. As compared to PE + AGA, the maternal pre-pregnancy BMI (P = 0.003) and the rate of anemia (P = 0.004) were lower in PE + FGR; while the rate of severe low serum albumin (P = 0.020) was higher. Moreover, severe low serum albumin level (aOR = 2.43, P = 0.046) and abnormal uric acid (aOR = 2.19, P = 0.033) were positively correlated to the incidence of FGR, while pre-pregnancy BMI (aOR = 0.39, P = 0.001) and anemia (aOR = 0.33, P = 0.001) showed negative correlation. The placental examinations further showed positively correlation between chronic villitis (aOR = 4.32, P = 0.028) and FGR. Surprisingly, general measures of maternal illness severity failed to present any significant correlation to FGR, except for blood pressure, which showed negative correlation. For the first time, we studied a relatively large case series of Chinses early-onset PE women, and identified multiple factors associated with FGR incidence. Our study provided some opinions on clinal diagnosis and treatment for early-onset PE with FGR.
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Akther L, Rahman MM, Bhuiyan MES, Hosen MB, Nesa A, Kabir Y. Association of glutathione S-transferase theta 1 and glutathione S-transferase mu 1 gene polymorphism with the risk of pre-eclampsia during pregnancy in Bangladesh. J Obstet Gynaecol Res 2018; 45:113-118. [PMID: 30152122 DOI: 10.1111/jog.13791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/29/2018] [Indexed: 11/28/2022]
Abstract
AIM In this study, we analyzed the risk of developing pre-eclampsia with respect to glutathione S-transferase theta 1 (GSTT1) and glutathione S-transferase mu 1 (GSTM1) genotypes. We also tried to find relationship between genotypes and biochemical parameter change in pre-eclampsia patients. METHODS In total, 104 pre-eclampsia patients and 200 healthy controls were recruited for the study. Peripheral venous blood was drawn from study subjects and DNA was extracted from whole blood and multiplex polymerase chain reaction method was used to identify genotypes of GSTT1 and GSTM1 gene. All biochemical parameters were measured using colorimetric method. RESULTS Serum glutamic pyruvic transaminase level was significantly higher (P < 0.01) and hemoglobin level was significantly lower (P < 0.001) in pre-eclampsia patients compared to control subjects. Significant association was found in GSTM1 null genotype with pre-eclampsia (P < 0.001) with an odds ratio (OR) analysis showing more than four-fold increased risk (OR = 4.75; 95% CI = 2.17-10.39; P <0.001). But for GSTT1 gene, null genotype was not associated with increased risk of developing pre-eclampsia (P > 0.05). In case of GSTT1 and GSTM1, the patients having both null genotypes for GSTT1 and GSTM1 showed significant (P < 0.001) higher risk of developing pre-eclampsia (OR = 7.64; 95% CI = 2.38-24.60; P < 0.001). CONCLUSION GSTM1 null genotype increases the risk of pre-eclampsia. Combined GSTT1 and GSTM1 null genotype, the risk was even higher.
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Affiliation(s)
- Lutfa Akther
- Reproductive and Health Services, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Md Mostafijur Rahman
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh
| | - Md Elias S Bhuiyan
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh
| | - Md Bayejid Hosen
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh
| | - Ayatun Nesa
- Department of Laboratory Medicine, BIRDEM General Hospital, Dhaka, Bangladesh
| | - Yearul Kabir
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh
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Tsikouras P, Niesigk B, von Tempelhoff GF, Rath W, Schelkunov O, Daragó P, Csorba R. Blood rheology during normal pregnancy. Clin Hemorheol Microcirc 2018; 69:101-114. [PMID: 29758932 DOI: 10.3233/ch-189104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Recent studies have shown increased RBC aggregation and no difference in plasma viscosity in the presence of markedly lower hematocrit in women at term compared to non-pregnant women. Little is known about the outcome of blood rheological parameters and red blood cell (RBC) deformability particularly in the course of normal pregnancy. METHODS During a 36 months interval 1.913 blood samples were randomly collected from a total of 945 pregnant women in the course of their pregnancy (n = 1.259) and during puerperium (upto 1 week; n = 654). Next to the blood count, hemorheological parameters including red blood cell (RBC) -aggregation (stasis E0; low shear E1), -deformability (low, moderate and high shear conditions) and plasma viscosity (pv) were assessed. Plasma viscosity (pv) was examined using KSPV 1 Fresenius, RBC aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne and RBC deformability (def) was determined by Rheodyn SSD Diffractometer, Myrenne, Roetgen, Germany were tested. In some of these women laboratory results prior to pregnancy (n = 145) were available which were compared with those during pregnancy. RESULTS Mean maternal pv remained unchanged within each trimester and compared to the values before pregnancy and during early puerperium (Range of means: 1.18-1.20 mPa S). In contrast, RBC agg (E0 and E1) was markedly higher in the 2nd (21.8 ± 7.0 and 28.9 ± 9.4; p < 0.001) and 3rd trimester (18.74 ± 8.4 and 28.2 ± 9.4; p < 0.01) compared to the values before pregnancy (16.4 ± 6.4 and 20 ± 7.5) and during 1st trimester (17.49 ± 6.5 and 22.4 ± 7.4). There was a stat. significant temporary reduction in RBC def. under all shear rate conditions during 2nd trimester compared to the values before pregnancy which remained significantly lower during 3rd trimester only under high shear rates.An increase RBC agg was stat. significantly inversely correlated with reduced RBC def being most pronounced under low shear rate conditions. While RBC rigidity was stat. significantly correlated with higher hematocrit values there was only a weak correlation between RBC agg and haematocrit (E0: r = -0.084; p = 0.03; E1: r = -0.06; p = 0.1). Pv was not correlated with haematocrit or RBC def but stat. significantly correlated with RBC agg. CONCLUSIONS Blood rheological changes manifest during 1st trimester, and fairly remain unchanged during 2nd trimester until term. Physiologic hemodilution and increasing hypercoagulability is accompanied by high RBC -aggregation and - rigidity during 2nd trimester while plasma viscosity remains nearly unaffected throughout normal pregnancy.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Barbara Niesigk
- Department of Obstetrics and Gynecology, City Hospital of Aschaffenburg, Aschaffenburg, Germany
| | | | - Werner Rath
- Department of Obstetrics and Gynecology, University of Schleswig-Holstein Kiel, Germany
| | - Olga Schelkunov
- Department of Obstetrics and Gynecology, Vinzenz Hospital of Hanau, Germany
| | - Peter Daragó
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Hungary
| | - Roland Csorba
- Department of Obstetrics and Gynecology, City Hospital of Aschaffenburg, Aschaffenburg, Germany.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Hungary
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Elgari MM, Khabour OF, Alhag SM. Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns. Clin Exp Hypertens 2018; 41:58-61. [DOI: 10.1080/10641963.2018.1441861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Mahmoud M. Elgari
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
- Faculty of Medical Laboratory Sciences, Sudan University for Sciences and Technology, Khartoum, Sudan
| | - Omar F. Khabour
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Samaher M. Alhag
- Faculty of Medical Laboratory Sciences, Sudan University for Sciences and Technology, Khartoum, Sudan
- Department of Medical Laboratory, Al- Ghad College of Applied Medical Sciences, Medina, Saudi Arabia
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Harju M, Pekkanen J, Heinonen S, Keski-Nisula L. Maternal anemia during pregnancy and slightly higher risk of asthma in male offspring. J Obstet Gynaecol Res 2018; 44:614-622. [PMID: 29314471 DOI: 10.1111/jog.13569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 11/07/2017] [Indexed: 01/12/2023]
Abstract
AIM We aimed to determine whether maternal hemoglobin levels or anemia during pregnancy are associated with the development of asthma among offspring. METHODS Data were retrieved from the birth register database of Kuopio University Hospital between 1989 and 2007 (n = 38 381). Hemoglobin levels were measured during three trimesters of pregnancy and anemia was defined according to the World Health Organization criteria. The prevalence of asthma was determined from the register of reimbursement for medication for asthma at the Finnish Social Security Institution. Cox proportional hazard regression analysis was performed to evaluate the possible associations between prenatal factors and development of asthma ever. RESULTS A total of 8198 (21.4%) women had anemia at some stage of pregnancy. Mild maternal anemia during the first trimester was associated with an increased risk of asthma among male offspring (adjusted hazard ratio, 1.46; 95% confidence interval, 1.11-1.94) compared with those with normal maternal hemoglobin levels. This finding remained significant also after applying the Bonferroni correction. CONCLUSION Male offspring with maternal anemia during the first trimester of pregnancy had significantly more asthma ever than the offspring of women with normal hemoglobin levels during pregnancy. These findings were not strong but suggest possible sex-specific effects of maternal health on prenatal programming and future risk of asthma.
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Affiliation(s)
- Maijakaisa Harju
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland
| | - Juha Pekkanen
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland.,Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.,Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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7
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Maghsoudlou S, Cnattingius S, Stephansson O, Aarabi M, Semnani S, Montgomery SM, Bahmanyar S. Maternal haemoglobin concentrations before and during pregnancy and stillbirth risk: a population-based case-control study. BMC Pregnancy Childbirth 2016; 16:135. [PMID: 27259282 PMCID: PMC4893297 DOI: 10.1186/s12884-016-0924-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 05/27/2016] [Indexed: 12/29/2022] Open
Abstract
Background Results of previous studies on the association between maternal haemoglobin concentration during pregnancy and stillbirth risk are inconclusive. It is not clear if haemoglobin concentration before pregnancy has a role. Using prospectively collected information from pre-pregnancy and antenatal visits, we investigated associations of maternal haemoglobin concentrations before and during pregnancy and haemoglobin dilution with stillbirth risk. Methods In a population-based case–control study from rural Golestan, a province in northern Iran, we identified 495 stillbirths (cases) and randomly selected 2,888 control live births among antenatal health-care visits between 2007 and 2009. Using logistic regression, we estimated associations of maternal haemoglobin concentrations, haemoglobin dilution at different stages of pregnancy, with stillbirth risk. Results Compared with normal maternal haemoglobin concentration (110–120 g/l) at the end of the second trimester, high maternal haemoglobin concentration (≥140 g/l) was associated with a more than two-fold increased stillbirth risk (OR = 2.31, 95 % CI [1.30–4.10]), while low maternal haemoglobin concentration (<110 g/l) was associated with a 37 % reduction in stillbirth risk. Haemoglobin concentration before pregnancy was not associated with stillbirth risk. Decreased haemoglobin concentration, as measured during pregnancy (OR = 0.61, 95 % CI [0.46, 0.80]), or only during the second trimester (OR = 0.75, 95 % CI [0.62, 0.90]), were associated with reduced stillbirth risk. The associations were essentially similar for preterm and term stillbirths. Conclusions Haemoglobin concentration before pregnancy is not associated with stillbirth risk. High haemoglobin level and absence of haemoglobin dilution during pregnancy could be considered as indicators of a high-risk pregnancy. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0924-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Siavash Maghsoudlou
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, SE-171 76, Stockholm, Sweden. .,Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, SE-171 76, Stockholm, Sweden
| | - Olof Stephansson
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, SE-171 76, Stockholm, Sweden.,Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska University Hospital and Institute, Stockholm, Sweden
| | - Mohsen Aarabi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahriar Semnani
- Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Scott M Montgomery
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, SE-171 76, Stockholm, Sweden.,Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Shahram Bahmanyar
- Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.,Clinical Epidemiology Unit & Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institute, Solna, Sweden
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Fraser GM, Morton JS, Schmidt SM, Bourque S, Davidge ST, Davenport MH, Steinback CD. Reduced uterine perfusion pressure decreases functional capillary density in skeletal muscle. Am J Physiol Heart Circ Physiol 2015; 309:H2002-7. [PMID: 26475590 DOI: 10.1152/ajpheart.00641.2015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 10/13/2015] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine the functional and structural capillary density in the reduced uterine perfusion pressure (RUPP) model, which when performed during pregnancy is an established animal model of preeclampsia. We hypothesized that the RUPP model would be associated with capillary rarefaction and impaired capillary perfusion, which would be more pronounced in the pregnant state. Female Sprague-Dawley rats (n = 32) were randomized to nonpregnancy (Nonpregnant) or breeding (Pregnant) at 12 wk of age and again to RUPP or SHAM surgeries on gestational day (GD) 14 (or equivalent age in nonpregnant rats). On GD 20 (or equivalent), capillary structure and perfusion of the extensor digitorum longus were imaged using digital intravital video microscopy. Functional videos were analyzed by a blinded observer to measure capillary density, expressed as capillaries per millimeter intersecting three staggered reference lines (200 μm). Flow was scored as the percentage of capillaries having 1) continuous, 2) intermittent, or 3) stopped flow. Total capillary density was not different between groups. There was a main effect of RUPP surgery resulting in decreased continuous flow vessels (P < 0.01) and increased stopped flow (P < 0.01), which was driven by differences between pregnant animals (Continuous flow: pregnant SHAM 80.1 ± 7.8% vs. pregnant RUPP 67.8 ± 11.2%, P < 0.05) (Stopped flow: pregnant SHAM 8.7 ± 3.2% vs. pregnant RUPP 17.9 ± 5.7%, P < 0.01). Our results demonstrate that the RUPP surgery is associated with a decrease in functional capillary density in skeletal muscle that is more pronounced in the pregnant state, which may contribute to the vascular pathophysiology observed in preeclampsia.
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Affiliation(s)
- Graham M Fraser
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jude S Morton
- Department of Obstetrics & Gynecology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Sydney M Schmidt
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada; Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada; and
| | - Stephane Bourque
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Sandra T Davidge
- Department of Obstetrics & Gynecology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Margie H Davenport
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada; Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada; and Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Craig D Steinback
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada; Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada; and Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
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Nasiri M, Faghihzadeh S, Alavi Majd H, Zayeri F, Kariman N, Safavi Ardebili N. Longitudinal discriminant analysis of hemoglobin level for predicting preeclampsia. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e19489. [PMID: 26019901 PMCID: PMC4441775 DOI: 10.5812/ircmj.19489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/10/2014] [Accepted: 06/09/2014] [Indexed: 01/06/2023]
Abstract
Background: Preeclampsia is one of the most serious complications during pregnancy with important effects on health of mother and fetus that causes maternal and fetal morbidity and mortality. This study was performed to evaluate whether high levels of hemoglobin may increase the risk of preeclampsia. Objectives: The present study aimed to predict preeclampsia by the hemoglobin profiles through longitudinal discriminant analysis and comparing the error rate of discrimination in longitudinal and cross sectional data. Patients and Methods: In a prospective cohort study from October 2010 to July 2011, 650 pregnant women referred to the prenatal clinic of Milad Hospital in Tehran were evaluated in 3 stages. The hemoglobin level of each woman was measured in the first, second, and third trimester of pregnancy by an expert technician. The subjects were followed up to delivery and preeclampsia was the main outcome under study. The covariance pattern and linear-mixed effects models are common methods that were applied for discriminant analysis of longitudinal data. Also Student t, Mann-Whitney U, and chi-square tests were used for comparing the demographic and clinical characteristics between two groups. Statistical analyses were performed using the SAS software version 9.1. Results: The prevalence rate of preeclampsia was 7.2% (47 women). The women with preeclampsia had a higher mean of hemoglobin values and the difference was 0.46 g/dL (P = 0.003). Also the mean of hemoglobin in the first trimester was higher than that of the second trimester, and was lower than that of the third trimester and the differences were significant (P = 0.015 and P < 0.001, respectively). The sensitivity for longitudinal data and cross-sectional data in three trimesters was 90%, 67%, 72%, and 54% and the specificity was 88%, 55%, 63%, and 50%, respectively. Conclusions: The levels of hemoglobin can be used to predict preeclampsia and monitoring the pregnant women and its regular measure in 3 trimesters help us to identify women at risk for preeclampsia.
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Affiliation(s)
- Malihe Nasiri
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Soghrat Faghihzadeh
- Department of Biostatistics, Faculty of Medical Sciences, Zanjan University of Medical Sciences, Zanjan, IR Iran
- Corresponding Author: Soghrat Faghihzadeh, Department of Biostatistics, Faculty of Medical Sciences, Zanjan University of Medical Sciences, Zanjan, IR Iran. Tel: +98-2414240301, E-mail:
| | - Hamid Alavi Majd
- Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Farid Zayeri
- Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Noorosadat Kariman
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Cordina M, Bhatti S, Fernandez M, Syngelaki A, Nicolaides KH, Kametas NA. Maternal hemoglobin at 27–29 weeks’ gestation and severity of pre-eclampsia. J Matern Fetal Neonatal Med 2015; 28:1575-80. [DOI: 10.3109/14767058.2014.961006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Shin YO, Yeon H, Lee OY, Kim E, Kyeong KS, Jeong EH. Association of maternal iron status with birthweight at third trimester in pregnant women. J Biomed Res 2014. [DOI: 10.12729/jbr.2014.15.3.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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12
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Savajols E, Burguet A, Grimaldi M, Godoy F, Sagot P, Semama DS. Maternal haemoglobin and short-term neonatal outcome in preterm neonates. PLoS One 2014; 9:e89530. [PMID: 24586850 PMCID: PMC3934893 DOI: 10.1371/journal.pone.0089530] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/22/2014] [Indexed: 12/05/2022] Open
Abstract
Objective To determine whether there is a significant association between maternal haemoglobin measured before delivery and short-term neonatal outcome in very preterm neonates. Study design We included prospectively all live births occurring from 25 to 32+6 weeks of gestation in a tertiary care centre between January 1st 2009 and December 31st 2011. Outborn infants and infants presenting with lethal malformations were excluded. Three hundred and thirty-nine mothers and 409 infants met the inclusion criteria. For each mother-infant pair a prospective record of epidemiologic data was performed and maternal haemoglobin concentration recorded within 24 hours before delivery was retrospectively researched. Maternal haemoglobin was divided into quartiles with the second and the third one regarded as reference as they were composed of normal haemoglobin values. Short-term outcome was defined as poor in case of death during hospital stay and/or grades III/IV intraventricular haemorrhage and/or periventricular leukomalacia and/or necessity of ventriculoperitoneal shunt. Results The global rate of poor short-term neonatal outcome was 11.4% and was significantly associated with low maternal haemoglobin values. This association remained significant after adjustment for antenatal corticosteroids therapy, gestational age, parity, mechanism of preterm birth, mode of delivery and birth weight (aOR = 2.97 CI 95% [1.36–6.47]). There was no relation between short-term neonatal outcome and high maternal haemoglobin concentration values. Conclusion We show that low maternal haemoglobin concentration at delivery is an independent risk factor for poor short-term neonatal outcome in very preterm neonates. This study is one of the first to show such an association within the preterm population.
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Affiliation(s)
- Elodie Savajols
- Department of Paediatrics, Centre Hospitalier Universitaire, Dijon, France
| | - Antoine Burguet
- Department of Paediatrics, Centre Hospitalier Universitaire, Dijon, France
| | - Marianne Grimaldi
- Department of Paediatrics, Centre Hospitalier Universitaire, Dijon, France
| | - Florence Godoy
- Department of Paediatrics, Centre Hospitalier Universitaire, Dijon, France
| | - Paul Sagot
- Department of Obstetrics, Centre Hospitalier Universitaire, Dijon, France
| | - Denis S. Semama
- Department of Paediatrics, Centre Hospitalier Universitaire, Dijon, France
- * E-mail:
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Wang F, Shi Z, Wang P, You W, Liang G. Comparative proteome profile of human placenta from normal and preeclamptic pregnancies. PLoS One 2013; 8:e78025. [PMID: 24205073 PMCID: PMC3799759 DOI: 10.1371/journal.pone.0078025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/09/2013] [Indexed: 12/17/2022] Open
Abstract
To better understand the molecular mechanisms involved in pathological development of placenta in preeclampsia, we used LC-MS/MS to construct a large-scale comparative proteome profile of human placentas from normal and preeclamptic pregnancies. A total of 2636 proteins were detected in human placentas, and 171 different proteins were definitively identified between control and preeclamptic placentas. Further bioinformatics analysis indicated that these differentially expressed proteins correlate with several specific cellular processes which occur during pathological changes of preeclamptic placenta. 6 proteins were randomly selected to verify their expression patterns with Western blotting. Of which, 3 proteins’ cellular localizations were validated with immunohistochemistry. Elucidation of how protein-expression changes coordinate the pathological development would provide researchers with a better understanding of the critical biological processes of preeclampsia and potential targets for therapeutic agents to regulate placenta function, and eventually benefit the treatment of preeclampsia.
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Affiliation(s)
- Fuqiang Wang
- CAS Key Laboratory of Soft Matter Chemistry, Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
- State Key Laboratory of Reproductive Medicine, Analysis Center, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhonghua Shi
- State Key Laboratory of Reproductive Medicine, Analysis Center, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ping Wang
- Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Department of Liver Transplantation Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China;
| | - Wei You
- Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Department of Liver Transplantation Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China;
- * E-mails: (GL); (WY)
| | - Gaolin Liang
- CAS Key Laboratory of Soft Matter Chemistry, Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
- * E-mails: (GL); (WY)
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The relationship of hemoglobin and hematocrit in the first and second half of pregnancy with pregnancy outcome. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2012; 17:S165-70. [PMID: 23833600 PMCID: PMC3696966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Considering the relationship of low and high levels of hemoglobin and hematocrit with some pregnancy complications, we decided to study their relationship with pregnancy outcome. This study also aimed to investigate the changes in hemoglobin and hematocrit values during the second and first half of pregnancy and its relationship with pregnancy outcome. MATERIALS AND METHODS In a prospective cohort study, 520 Iranian pregnant women, aged 15 to 45 years that were supported by health centers in Isfahan, Iran, were recruited using quota sampling method. Exclusion criteria comprised of 36 conditions that were related to the maternal and infant outcomes. Hemoglobin and hematocrit were measured in eligible mothers during the 6(th)-11(th) weeks and 26(th)-30(th) weeks of pregnancy. They were monitored until delivery and the data regarding their pregnancy outcome were collected. FINDINGS Low levels of hemoglobin during the first half of pregnancy was associated with preeclampsia (p = 0.024). Moreover, low levels of hemoglobin during the second half of pregnancy was associated with the risk of preterm premature rupture of membranes (p = 0.01). In addition, mothers with lower blood dilution, as a physiological process during pregnancy, were more prone to preeclampsia (p = 0.04). CONCLUSIONS Hemoglobin levels in the first and second half of pregnancy can predict preeclampsia and premature preterm rupture of membranes. Increased hematocrit levels in the second half of pregnancy or lack of reduction of hematocrit levels in the second half compared to the first half can estimate preeclampsia.
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Tejera E, Areias MJ, Rodrigues AI, Ramõa A, Nieto-Villar JM, Rebelo I. Relationship between Heart Rate Variability Indexes and Common Biochemical Markers in Normal and Hypertensive Third Trimester Pregnancy. Hypertens Pregnancy 2011; 31:59-69. [DOI: 10.3109/10641955.2010.544802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Siddiqui IA, Jaleel A, Kadri HMFA, Saeed WA, Tamimi W. Iron status parameters in preeclamptic women. Arch Gynecol Obstet 2010; 284:587-91. [DOI: 10.1007/s00404-010-1728-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 10/14/2010] [Indexed: 01/10/2023]
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