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Schrager NL, Parker SE, Werler MM. The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study. Birth Defects Res 2024; 116:e2334. [PMID: 38578229 DOI: 10.1002/bdr2.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/31/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nausea and vomiting of pregnancy (NVP) occurs in approximately 70% of pregnant people, with varying severity and duration. Treatments include pharmacologic and herbal/natural medications. The associations between NVP and birth outcomes, including preterm birth, small for gestational age (SGA), and low birth weight are inconclusive. OBJECTIVE To determine whether NVP and reported medications are associated with adverse birth outcomes. METHODS We used data from the population-based, multisite National Birth Defects Prevention Study (1997-2011) to evaluate whether self-reported NVP according to timing, duration, and severity or its specific treatments were associated with preterm birth, SGA, and low birth weight among controls without birth defects. Odds ratios (aOR) and 95% confidence intervals (CI) were adjusted for sociodemographic, reproductive, and medical factors. For any NVP, duration, treatment use, and severity score analyses, the comparison group was participants with no reported NVP. For timing analyses, the comparison group was women with no reported NVP in the same trimester of pregnancy. RESULTS Among 6018 participants, 4339 (72.1%) reported any NVP. Among those with NVP, moderate or severe symptoms were more common than mild symptoms. Any versus no NVP was not associated with any of the outcomes of interest. NVP in months 4-6 (aOR 1.21, 95% CI: 1.00, 1.47) and 7-9 (aOR 1.57, 95% CI: 1.22, 2.01) of pregnancy were associated with an increase in the risk of preterm birth. NVP lasting one trimester in duration was associated with decrease in risk of SGA (aOR: 0.74, 95% CI: 0.58, 0.95), and NVP present in every trimester of pregnancy had a 50% increase in risk of preterm birth (aOR: 1.50, 95% CI: 1.11, 2.05). For NVP in months 7-9 and preterm birth, ORs were elevated for moderate (aOR: 1.82, 95% CI: 1.26, 2.63), and severe (aOR: 1.53, 95% CI: 1.06, 2.19) symptoms. NVP was not significantly associated with low birth weight. Our analyses of medications were limited by small numbers, but none suggested increased risk of adverse outcomes associated with use of the medication. CONCLUSION Mild NVP and NVP limited to early pregnancy appear to have no effect or a small protective effect on birth outcomes. Long-lasting NVP, severe NVP, and NVP later in pregnancy may increase risk of preterm birth and SGA.
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Affiliation(s)
- Nina L Schrager
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Samantha E Parker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
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Li N, Xue Z, Xu H, Yang P, Wang K, Li L, Kang H, Wang M, Deng Y, Li X, Wang Y, Zhu J, Yu P, Zhou S. Evaluation of nausea and vomiting in the first trimester on the risk of adverse birth outcomes and the contribution of genetic polymorphisms: a pilot prospective study. Arch Gynecol Obstet 2023; 308:1713-1721. [PMID: 36441230 DOI: 10.1007/s00404-022-06851-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the impact of Nausea and Vomiting in Pregnancy (NVP) on the risk of Preterm Birth (PTB) and Low Birth Weight (LBW), and explore the effect of genetic polymorphisms on the severity of NVP. METHODS A prospective study was conducted. Participants' experience of NVP prior to 12 gestational weeks were evaluated by a Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scale. 11 Single Nucleotide Polymorphisms (SNPs) loci located in growth differentiation factor 15 (GDF15) and leucine-rich repeat containing 25 (LRRC25) gene of chr19p13.11 and intergenic region of chr4q12 were genotyped, which were implicated as genetic risk factors for NVP. Logistic regression models were applied to determine the effect of NVP in the first trimester on the risk of PTB and LBW, and genetic polymorphisms on the risk of NVP. RESULTS Among 413 pregnant women, the incidence of nausea and vomiting was 85.5% (n = 353) in the first trimester, including 38.7% (n = 160) mild vomiting, 42.6% (n = 176) moderate vomiting and 4.1% (n = 17) severe vomiting. 33 were PTB, 20 were LBW. Compared with pregnant women without NVP, women with mild, moderate or severe NVP in the first trimester were not associated with the risk of PTB and LBW. Besides, the polymorphisms of 11 SNPs loci were not associated with the risk of NVP. CONCLUSIONS Our study indicated that symptoms of nausea and vomiting in the first trimester were not significantly associated with PTB and LBW, and there were also no associations between GDF15 and LRRC25 polymorphisms and NVP.
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Affiliation(s)
- Nana Li
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Zhiwei Xue
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongmei Xu
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Gynecology and Obstetrics, The People's Hospital of Leshan, Leshan, Sichuan, China
| | - Ping Yang
- Department of Obstetrics and Gynecology, Maternal and Child, Healthcare Hospital of Peng'an County, Nanchong, China
| | - Ke Wang
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
| | - Lu Li
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
| | - Hong Kang
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
| | - Meixian Wang
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
| | - Ying Deng
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
| | - Xiaohong Li
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Yanping Wang
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jun Zhu
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Ping Yu
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Sec.3 No.17, South RenMin Road, Chengdu, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
| | - Shu Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
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Reijonen JK, Tihtonen KMH, Luukkaala TH, Uotila JT. Association of dietary fiber, liquid intake and lifestyle characteristics with gastrointestinal symptoms and pregnancy outcome. Eur J Obstet Gynecol Reprod Biol X 2022; 16:100168. [PMID: 36312325 PMCID: PMC9614560 DOI: 10.1016/j.eurox.2022.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives Heartburn and constipation are common gastrointestinal symptoms during pregnancy. High fiber and liquid intake have beneficial effects on these symptoms in non- pregnant population. Our aim was to evaluate the association of dietary fiber, fluid intake and lifestyle characteristics with constipation, heartburn, and pregnancy outcome. Study design Two hundred pregnant women were enrolled in this prospective cohort study during the 1st trimester of pregnancy. Participants completed a self- administered questionnaire concerning bowel symptoms, dietary fiber, liquid intake, and lifestyle characteristics before pregnancy, during pregnancy and post-partum. After exclusions 173 pregnant women participated the study and 173, 173, 136, 109 and 91 completed pre-pregnancy, and 1st, 2nd, and 3rd trimester, and post-partum questionnaires, respectively. Data on deliveries and perinatal outcome (n = 173) were collected from hospital records. In trajectory analysis, the women were clustered in groups based on the intake of fiber and liquids. Generalized linear mixed models and logistic regression analyses were used to find associations of fiber and fluid intake with constipation, heartburn and pregnancy outcome. Results and conclusions Heartburn increased significantly during pregnancy and the highest prevalence (33%) was during the third trimester. A combination of low fiber and low fluid intake increased the risk of constipation during pregnancy (OR 5.9, 95% CI 2.00-17.4). Low fiber intake increased the risk of combined adverse outcome (cesarean section, premature delivery and/or small for gestational age; OR 3.4, 95% CI 1.2-9.6). Sufficient fiber and liquid intake may be protective against pregnancy-associated constipation and may be associated with improved pregnancy outcome.
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Affiliation(s)
| | | | - Tiina Hannele Luukkaala
- Tampere University Hospital, Research, Development and Innovation Center, and Tampere University, Faculty of Sciences, Health Sciences, Finland
| | - Jukka Tapio Uotila
- Tampere University Hospital, Department of Obstetrics and Gynecology, PL 2000, 33521 Tampere, Finland
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Dunbar K, Yadlapati R, Konda V. Heartburn, Nausea, and Vomiting During Pregnancy. Am J Gastroenterol 2022; 117:10-15. [PMID: 36194028 PMCID: PMC10782592 DOI: 10.14309/ajg.0000000000001958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/30/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Kerry Dunbar
- Division of Gastroenterology and Hepatology, Department of Medicine, Dallas VA Medical Center and University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rena Yadlapati
- Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
| | - Vani Konda
- Baylor Scott and White Center for Esophageal Diseases, Department of Gastroenterology, Baylor University Medical Center, Dallas, Texas, USA
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Ali RAR, Hassan J, Egan LJ. Review of recent evidence on the management of heartburn in pregnant and breastfeeding women. BMC Gastroenterol 2022; 22:219. [PMID: 35508989 PMCID: PMC9066781 DOI: 10.1186/s12876-022-02287-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Gastroesophageal reflux disease (GERD) is one the most common medical complaints in pregnant women. Some women continue to experience GERD symptoms after delivery. Effective management of GERD symptoms is important to improve productivity and quality of life. Management of heartburn in pregnant and breastfeeding women involves lifestyle modifications, dietary modifications, non-pharmaceutical remedies and pharmaceutical drugs. For most patients, lifestyle/dietary modifications are helpful in reducing GERD symptoms. For patients who require a more intense intervention, various types of pharmaceutical drugs are available. However, the suitability of each treatment for use during pregnancy and lactation must be taken into consideration. This article explores the reported efficacy and safety of these treatment options in pregnant and breastfeeding women. Recommended treatment algorithm in pregnant and breastfeeding women have been developed.
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Affiliation(s)
- Raja Affendi Raja Ali
- Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. .,GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Jamiyah Hassan
- Faculty of Medicine and Hospital, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Laurence J Egan
- Department of Clinical Pharmacology, Galway University Hospital, The National University of Ireland, Galway, Ireland
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6
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Short Meal-to-Bed Time Is a Predominant Risk Factor of Gastroesophageal Reflux Disease in Pregnancy. J Clin Gastroenterol 2021; 55:316-320. [PMID: 32694265 DOI: 10.1097/mcg.0000000000001399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/20/2020] [Indexed: 12/10/2022]
Abstract
BACKGROUND Short meal-to-bed time (MTBT) has been reported to relate to gastroesophageal reflux disease (GERD), but evidence is lacking in pregnant women. We aimed to assess the characteristics of GERD and the association between MTBT and GERD during pregnancy. PATIENTS AND METHODS A cross-sectional study was carried out on 400 pregnant women aged 18 years and older visiting the antenatal clinic of Gia-Dinh People's Hospital, Vietnam. GERD was defined as having troublesome heartburn and/or regurgitation at least once a week. Reflux-related insomnia was defined as having difficulties in initiating or maintaining sleep through the night. MTBT was defined as "short" if it was ≤2 hours in more than two thirds of days in a week. RESULTS There were 154 (38.5%) patients with GERD and 20 (13.0%) patients with reflux-related insomnia. In multivariate analysis, there were 3 factors significantly associated with GERD: third trimester [odds ratio (OR)=1.66; 95% confidence interval (CI): 1.03-2.69], previous history of typical reflux symptoms (OR=9.05; 95% CI: 5.29-15.50), and short MTBT (OR=12.73; 95% CI: 2.92-55.45). The frequency of reflux symptoms progressively increased across subgroups of patients with no short MTBT, either daytime or nighttime short MTBT, and with both daytime and nighttime short MTBT. Nighttime MTBT was also a significant risk factor for reflux-related insomnia (OR=4.60; 95% CI: 1.64-12.92). CONCLUSIONS We reported for the first time that short MTBT was a predominant risk factor of GERD in pregnancy. This dieting habit was significantly associated with reflux symptom frequency and reflux-related insomnia.
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7
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Mitsuda N, Eitoku M, Maeda N, Fujieda M, Suganuma N. Severity of Nausea and Vomiting in Singleton and Twin Pregnancies in Relation to Fetal Sex: The Japan Environment and Children's Study (JECS). J Epidemiol 2019; 29:340-346. [PMID: 30416162 PMCID: PMC6680056 DOI: 10.2188/jea.je20180059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/01/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Some studies have indicated that female birth and multiple births were risk factors for nausea and vomiting during pregnancy (NVP). The results, however, were conflicting. Our study was conducted to evaluate the association of maternal NVP with fetal sex in singleton and twin pregnancies. METHODS We used the data set from a birth cohort study, the Japan Environment and Children's Study (JECS). In the self-administered questionnaire, participants were asked whether they experienced NVP prior to 12 gestational weeks. Main outcome measures were the presence of NVP and severity of NVP. We estimated the association of fetal sex and birth plurality with NVP using logistic regression analysis, followed by interaction analysis. RESULTS Of 91,666 women, 75,828 (82.7%) experienced at least some symptoms of NVP and 10,159 (11.1%) experienced severe NVP. Women with female pregnancies and twin pregnancies had higher odds for the presence of NVP and severe NVP compared to women with male pregnancies and singleton pregnancies, respectively. Moreover, of mothers with twin pregnancies, higher odds for the presence of NVP and severe NVP were reported when one or both infants were female, compared to those in which both infants were male. There was no significant interaction between fetal sex and birth plurality. CONCLUSIONS Female sex birth and multiple births are risk factors for the presence of NVP, and especially for severe NVP without interaction. These findings suggest that a factor abundant in the female fetus associates with the severity of NVP.
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Affiliation(s)
- Naomi Mitsuda
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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8
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Mitsuda N, Eitoku M, Yamasaki K, Sakaguchi M, Yasumitsu-Lovell K, Maeda N, Fujieda M, Suganuma N. Nausea and vomiting during pregnancy associated with lower incidence of preterm births: the Japan Environment and Children's Study (JECS). BMC Pregnancy Childbirth 2018; 18:268. [PMID: 29945561 PMCID: PMC6020391 DOI: 10.1186/s12884-018-1911-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/21/2018] [Indexed: 11/12/2022] Open
Abstract
Background Nausea and vomiting during pregnancy (NVP) is considered to be associated with favorable fetal outcomes, such as a decreased risk for spontaneous abortion. However, the relationship between NVP and preterm births remains unknown. This study was conducted to evaluate the association between NVP and the risk of preterm births. Methods The dataset of a birth cohort study, the Japan Environment and Children’s Study (JECS), was retrospectively reviewed. Participants’ experience of NVP prior to 12 gestational weeks were evaluated by a questionnaire administered from 22 weeks of pregnancy to 1 month before delivery. NVP responses were elicited against four choices based on which the study population was divided into four subcohorts. Preterm birth was the main study outcome. Logistic regression analysis was used to quantify an association between NVP and risk of preterm birth. Results Of 96,056 women, 79,460 (82.7%) experienced some symptoms of NVP and 10,518 (10.9%) experienced severe NVP. Compared to those who did not experience NVP, women with severe NVP had lower odds for preterm birth [adjusted odds ratio (aOR) 0.84, 95% confidence interval (95% CI) 0.74–0.95]. An even lower OR was found among very preterm birth and extremely preterm birth (aOR 0.44, 95% CI 0.29–0.65). Conclusion An inverse association exists between NVP and preterm births, especially, very preterm births and extremely preterm births.
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Affiliation(s)
- Naomi Mitsuda
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Keiko Yamasaki
- Integrated Center for Advanced Medical Technologies, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masahiko Sakaguchi
- Integrated Center for Advanced Medical Technologies, Kochi Medical School, Kochi University, Kochi, Japan.,Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan
| | - Kahoko Yasumitsu-Lovell
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
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Ma E, Brown N, Alshaikh B, Slater D, Yusuf K. Comparison of the Fagerström Test for Cigarette Dependence and the Heaviness of Smoking Index in the Second and Third Trimester of Pregnancy. Nicotine Tob Res 2017; 20:124-129. [PMID: 27698094 DOI: 10.1093/ntr/ntw271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 09/28/2016] [Indexed: 12/12/2022]
Abstract
Introduction Smoking cessation at any stage of pregnancy can benefit the mother and fetus. Cigarette dependence is a significant factor in women who continue to smoke during pregnancy and accurate assessment of cigarette dependence can be helpful in planning smoking cessation programs. The objective of our study was to investigate the validity of the Fagerstrom Test for Cigarette Dependence (FTCD) and Heaviness of Smoking Index (HSI) as measures of cigarette dependence in the second and third trimesters of pregnancy by comparing them to serum cotinine levels. Methods Prospective cohort study of 167 women in their second and third trimester of pregnancy who self-reported cigarette smoking. They were administered the FTCD questionnaire and blood was drawn for cotinine measurements using a direct enzyme linked immunoassay. Linear regression was used to adjust for maternal age, body mass index, gestation, and parity to investigate the association between cotinine levels and the two scores. Results Both the FTCD and HSI correlated significantly with serum cotinine levels (Spearman coefficient 0.42 and 0.37, respectively, p < .001). The correlation coefficients of both scores were higher in primigravidas (n = 51) compared to multigravidas, but the difference was statistically nonsignificant. Using multiple linear regression, both scores were significantly related to serum cotinine levels. For each unit increase in the FTCD and HSI, the serum cotinine level increased by 21.4 ng/mL (95% confidence interval 10.1-32.7, p <0.001) and 37 ng/mL (95% confidence interval 18.6-55.4, p < 0.001), respectively. Conclusions Both the FTCD and HSI can be used to assess cigarette dependence in the second and third trimester of pregnancy. Implications There is lack of data on the validity of the FTCD and the HSI as markers of cigarette dependence during the second and third trimester of pregnancy. Our study suggests that both the FTCD and HSI perform well in assessing cigarette dependence in the second and third trimester of pregnancy and can be used to plan smoking cessation programs.
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Affiliation(s)
- Evelyn Ma
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Nicole Brown
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Belal Alshaikh
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Donna Slater
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, AB, Canada.,Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Kamran Yusuf
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, AB, Canada
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Hu R, Chen Y, Zhang Y, Qian Z, Liu Y, Vaughn MG, Xu S, Zheng T, Liu M, Zhang B. Association between vomiting in the first trimester and preterm birth: a retrospective birth cohort study in Wuhan, China. BMJ Open 2017; 7:e017309. [PMID: 28963301 PMCID: PMC5623485 DOI: 10.1136/bmjopen-2017-017309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Although vomiting in the first trimester has been reported to be associated with preterm birth (PTB), findings supporting this association remain inconsistent. Our aim was to assess the association between vomiting and PTB, as well as evaluate if the association is modified by pre-pregnancy body mass index (BMI). DESIGN A retrospective cohort study. SETTING Wuhan, a central city of China. PARTICIPANTS A total of 317 463 pregnant women who had a live, singleton newborn from 1 January 2010 to 23 May 2016 were enrolled in our study. MAIN OUTCOME MEASURE PTB was defined as gestational age <37 gestational weeks. Gestational age was calculated using reports from mothers based on the first day of their last menstrual period. An ultrasound was routinely used to determine gestational age before 12 gestational weeks. RESULTS Of the 317 463 pregnant women, 29.88% (94 857) experienced vomiting in the first trimester and 5.00% (15 889) experienced a PTB. Vomiting in the first trimester increased the risk for PTB and the multivariable adjusted OR was 1.05 (95% CI 1.02 to 1.09). In the stratified analyses, the association of vomiting in the first trimester was significant among underweight women (adjusted OR=1.08, 95% CI 1.04 to 1.17) and normal pre-pregnancy BMI women (adjusted OR=1.06, 95% CI 1.02 to 1.11), but not in overweight women (adjusted OR=1.01, 95% CI 0.90 to 1.14) and obese women (adjusted OR=0.93, 95% CI 0.73 to 1.19). CONCLUSIONS Our study indicates that vomiting in the first trimester was associated with PTB. Additionally, women with underweight and normal pre-pregnancy BMI who experienced vomiting are more likely to have a PTB.
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Affiliation(s)
- Ronghua Hu
- Health Surveillance Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yawen Chen
- Health Surveillance Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiming Zhang
- Health Surveillance Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhengmin Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Yan Liu
- Health Surveillance Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Michael G Vaughn
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Shunqing Xu
- Key Laboratory of Environment and Health Department, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Mingzhu Liu
- Health Surveillance Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Zhang
- Health Surveillance Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Fecal Calprotectin Is Not Affected by Pregnancy: Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis 2017; 23:1240-1246. [PMID: 28498159 DOI: 10.1097/mib.0000000000001136] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Noninvasive biomarkers of inflammation for monitoring inflammatory bowel disease (IBD) are important in pregnancy. Clinical and laboratory markers are often affected by the physiological adaption that occurs during pregnancy, although, few, if any, data exist on fecal calprotectin (FC). We investigated FC concentrations in pregnant controls and IBD women, and whether FC correlated with physician global assessment (PGA), C-reactive protein (CRP), and Harvey-Bradshaw Index (HBI)/Simple Clinical Colitis Activity Index (SCCAI) before and after pregnancy, as well as during each trimester. METHODS The study is a prospective multicenter study of 46 pregnant women with and 21 without IBD in Denmark, Australia, and New Zealand. Demographics, clinical parameters, and HBI/SCCAI were recorded. Stool and blood samples were obtained to determine FC and CRP concentrations. RESULTS From pregnant IBD women and pregnant controls, 174 and 21 fecal samples were collected, respectively. The median FC concentration in pregnant IBD women was 131 μg/g (range 0-3600) and in controls 0 μg/g (range 0-84) (P < 0.0001). FC strongly correlated with PGA at all 5 timepoints (r ≥ 0.80; P < 0.0001) and with HBI/SCCAI before (r = 0.66; P < 0.0001) and after pregnancy (r = 0.47; P < 0.003) but not during pregnancy (P > 0.05). An FC cutoff concentration of 250 μg/g significantly correlated with active disease according to PGA in all 5 periods (P ≤ 0.0002). CRP only significantly correlated with FC (P = 0.0007) and PGA in the second trimester (P = 0.0003). No significant correlation was found between CRP and HBI/SCCAI at any timepoint (P > 0.05). CONCLUSIONS The physiological changes that occur during pregnancy do not affect FC, in contrast to CRP and HBI/SCCAI. The combined use of FC and PGA seems optimal to assess disease activity in IBD during pregnancy.
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Bachiri M, Idri A, Fernández-Alemán JL, Toval A. Mobile personal health records for pregnancy monitoring functionalities: Analysis and potential. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 134:121-35. [PMID: 27480737 DOI: 10.1016/j.cmpb.2016.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 05/20/2016] [Accepted: 06/30/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND AND OBJECTIVE Personal Health Records (PHRs) are a rapidly growing area of health information technology. PHR users are able to manage their own health data and communicate with doctors in order to improve healthcare quality and efficiency. Mobile PHR (mPHR) applications for mobile devices have obtained an interesting market quota since the appearance of more powerful mobile devices. These devices allow users to gain access to applications that used to be available only for personal computers. This paper analyzes the functionalities of mobile PHRs that are specific to pregnancy monitoring. METHODS A well-known Systematic Literature Review (SLR) protocol was used in the analysis process. A questionnaire was developed for this task, based on the rigorous study of scientific literature concerning pregnancy and applications available on the market, with 9 data items and 35 quality assessments. The data items contain calendars, pregnancy information, health habits, counters, diaries, mobile features, security, backup, configuration and architectural design. RESULTS A total of 33 mPHRs for pregnancy monitoring, available for iOS and Android, were selected from Apple App store and Google Play store, respectively. The results show that none of the mPHRs selected met 100% of the functionalities analyzed in this paper. The highest score achieved was 77%, while the lowest was 17%. CONCLUSIONS In this paper, these features are discussed and possible paths for future development of similar applications are proposed, which may lead to a more efficient use of smartphone capabilities.
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Affiliation(s)
- Mariam Bachiri
- Software Project Management research Team, ENSIAS, Mohammed V University in Rabat, Rabat, Morocco.
| | - Ali Idri
- Software Project Management research Team, ENSIAS, Mohammed V University in Rabat, Rabat, Morocco
| | | | - Ambrosio Toval
- Department of Informatics and Systems, Faculty of Computer Science, University of Murcia, Murcia, Spain
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Frawley J, Hall H, Adams J, Sibbritt D. Health care utilisation of women who experience pregnancy-related reflux, nausea and/or vomiting. J Matern Fetal Neonatal Med 2016; 30:1938-1943. [PMID: 27594351 DOI: 10.1080/14767058.2016.1232711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Nausea, vomiting and reflux are common conditions experienced by women during pregnancy. The objective of this project was to examine women's use of health services for these conditions. METHODS The study sample was obtained via the Australian Longitudinal Study on Women's Health. A total of 2445 women who were pregnant or who had recently given birth in 2009 were invited to complete a sub-survey in 2010 about pregnancy and health service utilisation. A response rate of 79.2% was obtained. RESULTS During their pregnancy, 604 (32.9%) respondents experienced nausea, with 255 (42.2%) of these women seeking help from a health care practitioner. A total of 201 women (11%) reported repeated vomiting, and 637 women (34.7%) reported reflux, of which 78.6% and 59.2% sought help, respectively. There were no significant differences in the mental and physical health measures between women with nausea, vomiting and/or reflux who sought help and women who did not. Having private health insurance with obstetric cover was associated with seeking help for reflux; this was the only demographic measure significantly associated with seeking help for any condition. CONCLUSION Research is required to understand why many women do not seek professional help for common gastrointestinal conditions during pregnancy.
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Affiliation(s)
- Jane Frawley
- a Faculty of Health , University of Technology Sydney , Ultimo , NSW , Australia and
| | - Helen Hall
- b School of Nursing and Midwifery, Monash University , Frankston , VIC , Australia
| | - Jon Adams
- a Faculty of Health , University of Technology Sydney , Ultimo , NSW , Australia and
| | - David Sibbritt
- b School of Nursing and Midwifery, Monash University , Frankston , VIC , Australia
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Wolf JL. The past, the present, and the future in the gastrointestinal health of women: An interview with Dr Jacqueline L Wolf. WOMEN'S HEALTH (LONDON, ENGLAND) 2016; 12:393-395. [PMID: 27638891 PMCID: PMC5373278 DOI: 10.1177/1745505716655556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Jacqueline L Wolf
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Zia JK, Heitkemper MM. Upper Gastrointestinal Tract Motility Disorders in Women, Gastroparesis, and Gastroesophageal Reflux Disease. Gastroenterol Clin North Am 2016; 45:239-51. [PMID: 27261896 DOI: 10.1016/j.gtc.2016.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article reviews the sex differences in upper gastrointestinal (GI) motility for both healthy and common dysmotility conditions. It focuses on gastroesophageal reflux disease and other esophageal motor disorders for the esophagus and on gastroparesis and accelerated gastric emptying for the stomach. It also describes differences in upper GI motility signs and symptoms during each female hormonal stage (ie, menstrual cycle, pregnancy, perimenopause, menopause) for both healthy participants and those suffering from one of the aforementioned upper GI dysmotility conditions. More research still needs to be conducted to better understand sex differences in upper GI motility.
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Affiliation(s)
- Jasmine K Zia
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356424, Seattle, WA 98195-6424, USA.
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Systems, University of Washington, 1959 Northeast Pacific Street, Box 357266, Seattle, WA 98195-7266, USA
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DiPietro JA, Voegtline KM. The gestational foundation of sex differences in development and vulnerability. Neuroscience 2015; 342:4-20. [PMID: 26232714 DOI: 10.1016/j.neuroscience.2015.07.068] [Citation(s) in RCA: 184] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/22/2015] [Accepted: 07/24/2015] [Indexed: 01/06/2023]
Abstract
Despite long-standing interest in the role of sex on human development, the functional consequences of fetal sex on early development are not well-understood. Here we explore the gestational origins of sex as a moderator of development. In accordance with the focus of this special issue, we examine evidence for a sex differential in vulnerability to prenatal and perinatal risks. Exposures evaluated include those present in the external environment (e.g., lead, pesticides), those introduced by maternal behaviors (e.g., alcohol, opioid use), and those resulting from an adverse intrauterine environment (e.g., preterm birth). We also provide current knowledge on the degree to which sex differences in fetal neurobehavioral development (i.e., cardiac and motor patterns) are present prior to birth. Also considered are contemporaneous and persistent sex of fetus effects on the pregnant woman. Converging evidence confirms that infant and early childhood developmental outcomes of male fetuses exposed to prenatal and perinatal adversities are more highly impaired than those of female fetuses. In certain circumstances, male fetuses are both more frequently exposed to early adversities and more affected by them when exposed than are female fetuses. The mechanisms through which biological sex imparts vulnerability or protection on the developing nervous system are largely unknown. We consider models that implicate variation in maturation, placental functioning, and the neuroendocrine milieu as potential contributors. Many studies use sex as a control variable, some analyze and report main effects for sex, but those that report interaction terms for sex are scarce. As a result, the true scope of sex differences in vulnerability is unknown.
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Affiliation(s)
- J A DiPietro
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - K M Voegtline
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Chortatos A, Haugen M, Iversen PO, Vikanes Å, Eberhard-Gran M, Bjelland EK, Magnus P, Veierød MB. Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the Norwegian Mother and Child Cohort Study. BMC Pregnancy Childbirth 2015; 15:138. [PMID: 26100060 PMCID: PMC4477493 DOI: 10.1186/s12884-015-0580-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 06/17/2015] [Indexed: 12/27/2022] Open
Abstract
Background To compare pregnancy complications and birth outcomes for women experiencing nausea and vomiting in pregnancy, or nausea only, with symptom-free women. Methods Pregnancies from the Norwegian Mother and Child Cohort Study (n = 51 675), a population-based prospective cohort study, were examined. Data on nausea and/or vomiting during gestation and birth outcomes were collected from three questionnaires answered between gestation weeks 15 and 30, and linked with data from the Medical Birth Registry of Norway. Chi-squared tests, one way analysis of variance, multiple linear and logistic regression analyses were used. Results Women with nausea and vomiting (NVP) totalled 17 070 (33 %), while 20 371 (39 %) experienced nausea only (NP), and 14 234 (28 %) were symptom-free (SF). When compared to SF women, NVP and NP women had significantly increased odds for pelvic girdle pain (adjusted odds ratio, aOR, 2.26, 95 % confidence interval, 95 % CI, 2.09–2.43, and aOR 1.90, 95 % CI, 1.76–2.05, respectively) and proteinuria (aOR 1.50, 95 % CI 1.38–1.63, and 1.20, 95 % CI 1.10–1.31, respectively). Women with NVP also had significantly increased odds for high blood pressure (aOR 1.40, 95 % CI 1.17–1.67) and preeclampsia (aOR 1.13, 95 % CI 1.01–1.27). Conversely, the NVP and NP groups had significantly reduced odds for unfavourable birth outcomes such as low birth weight infants (aOR 0.72, 95 % CI 0.60–0.88, and aOR 0.73, 95 % CI 0.60–0.88, respectively) and small for gestational age infants (aOR 0.78, 95 % CI 0.73–0.84, and aOR 0.87, 95 % CI 0.81–0.93, respectively). Conclusions We found that women with NVP and NP are more likely to develop pregnancy complications, yet they display mostly favourable delivery and birth outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12884-015-0580-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Arthur Chortatos
- Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, PO Box 1122, Blindern, N-0317, Oslo, Norway. .,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO Box 1046, Blindern, N-0317, Oslo, Norway.
| | - Margaretha Haugen
- Division of Environmental Medicine, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway.
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO Box 1046, Blindern, N-0317, Oslo, Norway. .,Department of Hematology, Oslo University Hospital, PO Box 4950, Nydalen, N-0424, Oslo, Norway.
| | - Åse Vikanes
- Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway.
| | - Malin Eberhard-Gran
- Department of Psychosomatics and Health Behaviour, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway. .,Health Services Research Unit, Akershus University Hospital, PO Box 1000, N-1478, Lørenskog, Norway.
| | - Elisabeth Krefting Bjelland
- Department of Psychosomatics and Health Behaviour, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway. .,Health Services Research Unit, Akershus University Hospital, PO Box 1000, N-1478, Lørenskog, Norway.
| | - Per Magnus
- Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway.
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, PO Box 1122, Blindern, N-0317, Oslo, Norway. .,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO Box 1046, Blindern, N-0317, Oslo, Norway.
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Clark SM, Dutta E, Hankins GDV. The outpatient management and special considerations of nausea and vomiting in pregnancy. Semin Perinatol 2014; 38:496-502. [PMID: 25267280 DOI: 10.1053/j.semperi.2014.08.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
With 50-90% of pregnant women experiencing nausea and vomiting of pregnancy (NVP), the burden of illness can become quite significant if symptoms are under-treated and/or under-diagnosed, thus allowing for progression of the disease. The majority of these women will necessitate at least one visit with a provider to specifically address NVP, and up to 10% or greater will require pharmacotherapy after failure of conservative measures to adequately control symptoms. As a result, initiation of prompt and effective treatment in the outpatient setting is ideal. Once NVP is diagnosed and treatment is started, it is crucial to track symptoms in order to assess for a decrease in or resolution of symptoms as well as an escalation in symptoms requiring additional therapy. Of note, co-existing gastroesophageal reflux disease (GERD), Helicobacter pylori infection, and psychosocial factors may have a negative impact on the management of NVP. Ultimately, every woman has her own perception of disease severity and desire for treatment. It is critical that both the provider and patient be proactive in the diagnosis and management of NVP.
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Affiliation(s)
- Shannon M Clark
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555.
| | - Eryn Dutta
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555; US Navy Medicine Professional Development Center, Bethesda, MD
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A longitudinal study on the relationship between eating style and gestational weight gain. Appetite 2014; 83:304-308. [PMID: 25218880 DOI: 10.1016/j.appet.2014.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 09/02/2014] [Accepted: 09/05/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Gaining too much weight in pregnancy poses health risks for mother and child. Eating style has been shown to be related to weight gain in general but the relation to maternal weight gain in pregnancy is unclear. OBJECTIVES To assess the influence of eating style and psycho social factors on maternal weight gain. METHODS Healthy pregnant women (n = 161), filled in a questionnaire at 15 and 35 weeks of pregnancy. Eating style, social norm, self-efficacy and attitude with regard to weight gain and health during pregnancy were measured. Self-reported pre-pregnancy body mass index (BMI) was used to determine weight category and weight was objectively measured at 15 and 35 weeks of gestation. Linear regression was used to study the relationship between eating style, psychosocial factors and gestational weight gain, controlling for BMI and age. Hierarchical regression analyses were carried out where the effects of the other eating styles were partialled out. RESULTS During pregnancy, 66% of the women remained stable as far as individual eating style concerned. At 15 weeks of gestation, 11 (7%) women were classified as emotional eaters, 89 (55%) as external eaters and 61 (38%) as restrained eaters. At first sight being an emotional eater was associated with higher weight gain in pregnancy. In hierarchical regression analyses however none of the eating styles was associated with higher gestational weight gain. Of the psychosocial factors, a better healthy pregnancy attitude at 35 weeks of gestation was associated with less weight gain. DISCUSSION In the long list of potential drivers of gestational weight gain, eating style does not seem to be of any significance. Healthy pregnancy attitude in late pregnancy was found to be related with less weight gain.
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Hope CK, Wang Q, Burnside G, Adeyemi AA, Quenby S, Smith PW, Higham SM, Whitworth M. Assessing the association between oral hygiene and preterm birth by quantitative light-induced fluorescence. ScientificWorldJournal 2014; 2014:374694. [PMID: 24511282 PMCID: PMC3913385 DOI: 10.1155/2014/374694] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 10/10/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to investigate the purported link between oral hygiene and preterm birth by using image analysis tools to quantify dental plaque biofilm. Volunteers (n = 91) attending an antenatal clinic were identified as those considered to be "at high risk" of preterm delivery (i.e., a previous history of idiopathic preterm delivery, case group) or those who were not considered to be at risk (control group). The women had images of their anterior teeth captured using quantitative light-induced fluorescence (QLF). These images were analysed to calculate the amount of red fluorescent plaque (ΔR%) and percentage of plaque coverage. QLF showed little difference in ΔR% between the two groups, 65.00% case versus 68.70% control, whereas there was 19.29% difference with regard to the mean plaque coverage, 25.50% case versus 20.58% control. A logistic regression model showed a significant association between plaque coverage and case/control status (P = 0.031), controlling for other potential predictor variables, namely, smoking status, maternal age, and body mass index (BMI).
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Affiliation(s)
- Christopher K. Hope
- Department of Health Services Research, University of Liverpool, Liverpool L69 3GN, UK
- School of Dentistry, University of Liverpool, Liverpool L3 5PS, UK
| | - Qian Wang
- Department of Health Services Research, University of Liverpool, Liverpool L69 3GN, UK
- School of Dentistry, University of Liverpool, Liverpool L3 5PS, UK
| | - Girvan Burnside
- School of Dentistry, University of Liverpool, Liverpool L3 5PS, UK
- Department of Biostatistics, University of Liverpool, Liverpool L69 3BX, UK
| | - Adejumoke A. Adeyemi
- Department of Health Services Research, University of Liverpool, Liverpool L69 3GN, UK
- School of Dentistry, University of Liverpool, Liverpool L3 5PS, UK
| | - Siobhan Quenby
- Department of Women's and Children's Health, University of Liverpool, Liverpool L8 7SS, UK
- Division of Reproductive Health, The University of Warwick, Coventry CV4 7AL, UK
| | - Philip W. Smith
- Department of Health Services Research, University of Liverpool, Liverpool L69 3GN, UK
- School of Dentistry, University of Liverpool, Liverpool L3 5PS, UK
| | - Susan M. Higham
- Department of Health Services Research, University of Liverpool, Liverpool L69 3GN, UK
- School of Dentistry, University of Liverpool, Liverpool L3 5PS, UK
| | - Melissa Whitworth
- Department of Women's and Children's Health, University of Liverpool, Liverpool L8 7SS, UK
- Centre for Women's Health, The University of Manchester, Manchester M13 9WL, UK
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Temming L, Franco A, Istwan N, Rhea D, Desch C, Stanziano G, Joy S. Adverse pregnancy outcomes in women with nausea and vomiting of pregnancy. J Matern Fetal Neonatal Med 2013; 27:84-8. [PMID: 23682702 DOI: 10.3109/14767058.2013.806473] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine the influence of nausea and vomiting of pregnancy (NVP) on pregnancy outcomes. METHODS Outcomes were compared for primigravidas with a current singleton gestation enrolled at <20 weeks' gestation in a maternity risk screening and education program (n = 81 486). Patient-reported maternal characteristics and pregnancy outcomes were compared for women with and without NVP and within the NVP group for those with and without poor weight gain. RESULTS 6.4% of women reported NVP as a pregnancy complication. Women reporting NVP were more likely to be younger, obese, single and smoke. They had higher rates of preterm delivery, pregnancy-induced hypertension and low birth weight <2500 g. Almost one-quarter of women with NVP had lower than recommended weight gain. Poor weight gain was associated with a higher incidence of adverse outcomes. Obesity, tobacco use and poor pregnancy weight gain independently increased the odds of an adverse outcome. CONCLUSION NVP and subsequent poor weight gain may be associated with adverse pregnancy outcomes.
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Affiliation(s)
- Lorene Temming
- Department of Obstetrics and Gynecology, Carolinas Medical Center , Charlotte, NC , USA
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