ABSTRACT
Background: Serum pregnancy-associated plasma protein-A (PAPP-A) levels fluctuate in continuation with the pregnancy and thus become an important standalone marker in monitoring the adverse outcomes that may occur in pregnancy.Methods: A prospective observational study was conducted in the department of obstetrics and gynaecology. A total of 240 pregnant women in their first trimester were included in the study. Serum PAPP-A levels were measured at 11-13+6week of gestation and were evaluated with respect to the feto-maternal outcome. The data was entered in MS excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.Results: The mean age of the study population was 27 years. Among the maternal pregnancy parameters, PIH, pre-term labor and Emergency LSCS were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, P<0.05. All the fetal outcome measures: IUGR, IUD, low birth weight, SGA babies, prematurity and NICU admissions, were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, p <0.05.Conclusions: Serum PAPP-A in the early pregnancy showed significant correlation with feto-maternal outcome. Thus, it has the potential to be used as a prognostic factor and in the management of adverse outcomes by increasing surveillance for pregnant women with high-risk factors.
ABSTRACT
Background: Obesity has become a new worldwide health problem and is gradually moving towards an epidemic. overweight and obesity implies an abnormal excessive fat accumulation that poses health risk. According to National Family Health Survey-4, prevalence of obesity has doubled in country over the last decade. Asian Indians stand at higher risk for development of obesity related non-communicable diseases at lower body mass index levels.Methods: It was an observational interpretive study carried on 1000 randomly selected women over 3 months in a tertiary center of urban northern India. BMI was obtained by dividing weight in kilograms and height in meters squares. Patients were enquired about any menstrual complains, known comorbidities, awareness of obesity in terms of its cause and effects, about weight reduction and benefits of exercise and its practice and details noted in a preformed performa. No prior intervention or health education was given to avoid bias.Results: Out of 1000 women, mean BMI was found to be 31.85±8.85kg/m2. BMI classification (Asian standards) stated that 8.1% were overweight and 78% of patients were pre obese and obese (maximum in age of 21-40 years). Menstrual complaints were present among 39% of overweight and obese groups. Among comorbidities, hypothyroidism was found to be maximum being 9.5% in the obese group, followed by hypertension and diabetes mellitus. Only 26.3% of obese women were aware of the factors causing obesity. Knowledge of exercise benefits was grossly limited, with only one fourth of the pre obese and obese population being aware of it.Conclusions: Rising obesity in Indian women needs measures for prevention. Though there is knowledge of the cure among Indian females but there is limited ability to implement the same. Health education of women regarding obesity related comorbidities along with the benefits of weight loss with exercises should be promoted strongly.