Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 $$\pm$ 3.7\mu㏖/L,\;5.6 \pm4.1\mu㏖/L\; and\; 7.0\pm 4.5\mu㏖/L$, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.
Lee, Da Eun;Kim, Shin Young;Kim, Hyun Jin;Park, So Yeon;Kim, Min Hyoung;Han, You Jung;Ryu, Hyun Mee
Journal of Genetic Medicine
/
v.14
no.1
/
pp.1-7
/
2017
Purpose: The aim of this study was to assess the diagnostic efficacy of noninvasive prenatal screening for trisomy 18 by assessing the levels of unmethylated-maspin (U-maspin) and fetal nuchal translucency (NT) thickness during the first trimester of pregnancy. Materials and Methods: A nested case-control study was conducted using maternal plasma samples collected from 65 pregnant women carrying 11 fetuses with trisomy 18 and 54 normal fetuses. We compared the U-maspin levels, NT thicknesses, or a combination of both in the first trimester between the case and control groups. Results: U-maspin levels and NT thickness were significantly elevated in the first trimester in pregnant women carrying fetuses with trisomy 18 when compared to those carrying normal fetuses (27.2 vs. 6.6 copies/mL, P<0.001 for U-maspin; 5.9 vs. 2.0 mm, P<0.001 for NT). The sensitivities of the U-maspin levels and NT thickness in prenatal screening for fetal trisomy 18 were 90.9% and 90.9%, respectively, with a specificity of 98.1%. The combined U-maspin levels and NT thickness had a sensitivity of 100% in prenatal screening for fetal trisomy 18, with a specificity of 98.1%. Conclusion: A combination of U-maspin levels and NT thickness is highly efficacious for noninvasive prenatal screening of fetal trisomy 18 in the first trimester of pregnancy.
The purpose of this research is to assess th iron nutritional status of pregnant women and to evaluate the appropriateness of the present cut off levels of hemoglobin(Hgb), hematocrit(Hct) and total iron binding capacity(TIBC) for assessing iron deficiency status. Pregnant women who were visiting public helath centers in Ulsan were interviewed and agreed to attend the study. Blood sample was taken and biochemical analysis of blood was performed. The collected data were classified into 3 trimesters by gestational age and then statistical analysis was performed. The prevalence of anemia in all subjects was 32.3% by WHO criteria(Hgb < 11.0g/dl) and 17.8% of all subjects was iron deficient anemia by CDC criteria(Hgb < 11.0/dl and serum ferritin < 12.0ug/l). Since the iron deficient anemia generally occures at the last stage of iron deficiency, it is not efficient to diagnose and prevent the iron deficient anemia in pregnant women by using the present cut off level of Hgb. Therefore, the new cut off level of iron status indices is necessary for assessing iron deficiency in early pregnancy before manifestation of anemia and for reducing the prevalence of anemia in later pregnancy. For this reason, the present cut off levels of iron status indices were estimated and compared by assessing the iron deficiency judged by serum ferritin level (<12.0ug/l)as true iron deficiency. It follows from the results of this research that present cut off levels of Hgb, Hct and TIBC were very insensitive in identifying the subjection with iron deficiency. The appropriate cut off levels of Hgb were 11.5g/dl for total period of pregnancy, 12.0g/dl for 1st and 3rd trimester, and 11.5g/dl for 2nd trimester. The cut off level of Hct was 34.0% for total period for pregnancy, 35.0% for 1st trimester, and 34.0% for 2nd and 3rd trimester. The cut off level of TIBC was 400ug/dl for total period, 360ug/dl for 1st 2nd trimester, and 450ug/dl for 3rd trimester.
The plasma protein patterns of non-pregnant women, pregnant women, and normal male individuals were analyzed by SDS/polyacrylamide gel electrophresis. When the protein patterns of plasma of normal male individuals ranging from 10, 000 to 110, 000 daltons in molecular weights are compared to non-pregnant women, their protein patterns were the same. In this study, when the plasma of non-pregnant women are compared to pregnant women, no bands were occurred newly, but the quantity of some protein bands were increased or decreased during the pregnant periods. According to the results of measuring the molecular weights of the characteristic protein patterns, which are increasing or decreasing during the pregnancy as compared to the non-pregnant women, it was observed that the proteins over 76, 000 daltons in molecular weights were concerned in the facts mentioned above. That is, the protein of 86, 000 dalton in molecular weight was not increased in quantity until the second trimester of pregnancy, but was increased in the third trimester of pregnancy. The proteins of 91, 000-105, 000 daltons in molecular weights were gradually increased in accordance with the periods of pregnancy. On the contrary, the protein of 94, 000 dalton was rather decreased by the second trimester of pregnancy, but increased in the third trimester of pregancy. And the band of 99, 000 dalton was not changed in quantity significantly until the first trimester of pregnancy, but increased continuously from the second trimester of pregnancy to the third trimester of pregnancy. We tentatively suggest that the stages (the first, the second, and the third trimester) of pregnancy can be identified by the study on the protein patterns of the specific bands in the blood plasma of pregnant women.
Objectives: The purpose of this study was to report the treatment progress of a pregnant women who were treated with Korean medical hospitalization due to threatened abortion in first trimester and plecenta previa in second trimester during pregnancy. Methods: A 36-year-old pregnant woman was hospitalized twice at 9 and 19 weeks of pregnancy due to threatened abortion in first trimester and plecenta previa in second trimester. The patient was prescribed Korean Medicine(Gamidanggui-san, Gamibosaeng-tang) and treated with acupuncture, moxa. Global Assessment(G/A) of bleeding volume and frequency, Numerical Rating Scale(NRS) of abdominal pain, Visual Analogue Scale(VAS) of symptoms was assessed during hospitalization days. Results: Amounts of bleeding, abdominal pain decreased, and other symptoms improved during hospitalization days. The patient maintained her pregnancy until 31st gestational week and gave a birth by Cesarean section. After giving birth, mother and infant are both in good health. Conclusions: This study suggests Korean medicine treatment has effectively reduced uterine bleeding and helped maintain pregnancy.
A study during second trimester of pregnancy was conducted among 100 women from a population with mild to moderate deficient iodine intake (median 7 ${\mu}g$/L)to monitor the changes in serum free thyroxin ($FT_4$), triiodothyionine ($T_3$) and thyrtropin (TSH). Thyroid related hormones were assessed using radioimmunoassay (RIA) and immunoradiometricassay (IRMA). As compared with non pregnant women, mean $FT_4$ levels decreased, $T_3$ levels increased and TSH levels were slightly depressed in pregnant women. Mean $FT_4$ concentration reached its highest level in the $4^{th}$ month and linearly decreased until the $6^{th}$ month. Mean $T_3$ level remained almost constant during $2^{nd}$ trimester of pregnancy. Mean TSH level remained unaltered during the $4^{th}$ and $5^{th}$ months and was slightly lower than that for the control group. However, these differences were statistically insignificant At the end of the second trimester, hypothyroxinemia and $T_3$ levels greater than the upper limit of the laboratory reference range were found in $34\%$ and $38\%$ of women, respectively. These changes in thyroid hormones reflect typical adaptations of the thyroid gland during pregnancy to the limited availability of iodine.
Park Jin-Ah;Yun Sung-Seob;Juhn Suk-Lak;Roxana Irimescu;Sakaguchi Noboru;Raj Juneja Lekh;Chun Ho-Nam
Nutritional Sciences
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v.9
no.3
/
pp.195-200
/
2006
We surveyed Korean pregnant women who participated in the Maeil mothers' club and factory tour from March to April, 2004 and assessed volunteers' hemoglobin (Hb) levels. The average Hb level of 747 subjects was $11.5{\pm}1.5g/dl$ and anemic subjects were 268 women, 35.9% of total subjects. The ratio of anemic subjects was 42.9% in the first trimester, 43.6% in the second trimester and 29.1 % in the third trimester. About 87.9% of subjects began to take health foods after conception. Seventy nine percent of subjects took iron supplement as one of health foods and 73.8% of them began it in the second trimester. The results of this study showed that health foods were more effective than iron supplement alone in improving the iron status of Korean pregnant women. Therefore, the better improvement effects are expected when pregnant women begin health food-based approaches as early as possible before pregnancy to improve pre-pregnancy iron reserve.
A study was done to identify the differences of women's perception of fatigue according to the period of pregnancy. Questionnaires were collected from 510 normal pregnant women in 3 University Hospitals in Korea from April to November of 1999. The questionnaires used to measure pregnant women's fatigue were the "Subjective Symptoms of Fatigue Test" designed by the Research Committee of Industrial Fatigue in Hygienic Association of Japanese Industry. The collected data was analyzed by SPSS-Win. The results revealed that there was a significant difference according to the periods of pregnancy: The degree of fatigue was the highest in the first trimester and then third and second trimester in decreasing order (F=89.53, p=0.000). The degree of fatigue was also compared with the respect to the general characteristics of women: There were statistically significant differences according to number of pregnancy (t=6.41, p=0.000), expectation of pregnancy (t=-291, p=0.004) and weight change (F=8.07, p=0.000). Therefore, variable nursing intervention should be provided to alleviate the fatigue according to the each trimester of pregnant period. Especially the nursing intervention program to alleviate the physical fatigue in the first trimester is necessary.
Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preform delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal se겨m iron levels of the trimester and delivery were $124.27\;{\mu}g/dl,\;97.03\;{\mu}g/dl,\;94.32\;{\mu}g/dl,\;and\;145.53\;{\mu}g/dl$. Those maternal levels were significantly lower than that of umbilical cord blood ($222.59\;{\mu}g/dl$). Serum ferritin levels of maternal trimester and delivery were 22.68 $22.68\;{\mu}g/l,\;11.09\;{\mu}g/l,\;14.18\;{\mu}g/l,\;and\;\;24.54\;{\mu}g/l$, which were significantly lower than those of umbilical cord blood ($184.35\;{\mu}g/l$) (p < 0.0001). This prevalence of anemia of total subjects was $30.3\%$ by WHO criteria (Hb < 11.0 g/dl, Hct < $33\%$). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual Pregnant women on the basis of pre-Pregnancy nutrition. (Korean J Community Nutrition 10(6) : $860\∼868$, 2005)
The study was designed to assess the zinc nutritional status by gestational age of pregnant women visiting in public health centers in Ulsan. The subjects were divided into 3 trimester by last menstrual period(LMP). Interview for dietary zinc intake and general characteristics of each subjects was given and biochemical analysis of blood and urine was performed. Serum zinc concentration and urinary zinc excretion were analyzed by Flame Atomic Absorption Spectrophotometer, and alkaline phosphatase(ALP) activity was analyzed by Bowers & McComb\\`s method with Schimadzu automatic analyser. Also urinary creatinine was analyzed by Hawk\\`s method. Mean intake of zinc was 6.61${\pm}$1.57mg and did not meet the RDA(44.1% of RDA) for pregnant women by gestational age. Zn intake of 3rd trimester was significantly increased but dietary zinc was almost supplied with cereal and grain (47.30%) which were reported with low zinc availability due to phytate. Mean concentration of serum Zn in 1st trimester was 86.4${\pm}$10.5$\mu\textrm{g}$/dl, was 72.4${\pm}$10.3$\mu\textrm{g}$/dl in trimester and 65.1${\pm}$10.8$\mu\textrm{g}$/dl in 3rd trimester and was declined significantly by gestational age during pregnancy. In was concluded that a decline in serum Zn by gestional age was not influenced by amount of Zn intake. However ALP activity and urinary zinc excretion increased significantly by gestational age. Zinc nutritional status of pregnant women was not confirmed yet due to the physiological changes during pregnancy. However, the pregnant woman may be in a marginal zinc deficient status because of low amount of Zn intake and low bioavailability of Zn from dietary sources. (Korean J Nutrition 33(8) : 848-856, 2000)
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