Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study

Objective: Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1) to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2) to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3) to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Methods: Thirty-three healthy pregnant women were recruited from the Women’s Health Concerns Clinic at St. Joseph’s Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL)-6, IL-10, tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Results: Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001), IL-6 (p = 0.025), and IL-10 (p = 0.006) were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS) score. Conclusions: Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.

Comparison of the prevalence of anemia in the first, second and third trimester of pregnancy in a medical and educational center in Shiraz

The high rate of anemia in pregnancy is associated with complications of pregnancy and delivery; therefore, to assess the level of hemoglobin [Hb] in women who are at risk can prevent these complications. In this descriptive study, 108 pregnant women referred to a medical and educational center in Shiraz in 2006. They were enrolled in three different occasions: first trimester [10-14 weeks], second trimester [25-30 weeks], and third trimester [37-40 weeks]. The correlation of blood hemoglobin concentration with the risk of severe nausea, vomiting, and iron supplementation in pregnant women was estimated. Statistical analysis was done with SPSS 11.5 and Pearson correlation. The mean age of the participants is 25.74 +/- 5.66. In the first trimester of pregnancy 71.9% had normal hemoglobin level and 28.1% higher than normal with no case being anemic. In the second and third trimester of pregnancy, 29.2% of the subjects were anemic. The level of hemoglobin had positive correlation with the total amount of iron intake in the second trimester [p= 0.001 and r= 0.44], also in the third trimester [p< 0.001 and r= 0.46] and the whole pregnancy [p< 0.001 and r= 0.38]. This study indicated that despite regular intake of iron,%29.2 of the subjects had anemia. These findings emphasize the importance of treating these groups of patients and measuring levels of hemoglobin in each trimester together with reviewing other risk factors which are effective on anemia

role of calcium correction during normal pregnancy at third trimester in Mosul

To assess calcium status in healthy pregnant women during limited sun exposure time in winter, and to demonstrate the possible effect of serum albumin alterations on serum total calcium level and the role of albumin adjusted calcium concentration. Subjects enrolled in the study included 160 apparently healthy women divided equally into four groups [I-IV], group I was considered as the control group, composed of non-pregnant women. Groups II-IV were composed of pregnant women in the first, second and third trimesters respectively. Semiquantitative urine protein determination and measurement of serum total calcium, ionized calcium, albumin, phosphorous and creatinine with calculation of corrected calcium were performed in all groups. The results were statistically evaluated by standard statistical methods. There was no significant difference in serum ionized calcium, corrected calcium and phosphorous during pregnancy. However, there was a significant reduction of serum total calcium, albumin and creatinine in pregnant women at second and third trimesters. In each group, a significant positive correlation was observed between total calcium with corrected and ionized calcium. In healthy pregnant women even during limited sun exposure time in winter, there was no need for calcium supplementation in spite of the continuous and progressive reduction of serum measured total calcium during the second and third trimesters due to dilutional hypoalbuminemia. During pregnancy, measured calcium is parallel to both corrected and ionized calcium and since there was no significant difference between measured and corrected calcium, therefore, measured calcium is a useful test in assessing calcium status and suggests the need to establish a reference range for pregnant women

Role of iron supplementation in the improvement of hemoglobin level, in the third trimester of pregnancy and in the prevention of iron' deficiency anemia

To evaluate the role of iron supplementation in the improvement of hemoglobin level in the third trimester of pregnancy and in the prevention of iron deficiency anemia. This non-interventional descriptive study was conduced at Mother and Child Health Centre [MCH], Nishtar Hospital, Multan during the period from July 2003 to March 2004. A total of 100 women of variable age groups and of different socio-economic status with 5 months of pregnancy were included in the study. After history and clinical examination their hemoglobin level were. checked by photometric method. Then these women were provided iron supplement for three months and their hemoglobin levels were rechecked by same method and the results. were compared. Out of 100 women enrolled in the study the compliance of iron supplementation was seen only in 80 women. There mean hemoglobin level before iron intake was 8.8 gm/dl and 60 [75%] had hemoglobin level less than 10 gm/dl. Out of these 60 anemic women, 51[85%] were multiparae or grand multiparae. They mostly belonged to lower socio-economic status. Only 9 [15%] were primigravidae. Iron deficiency anemia is very common in pregnant women in Pakistan particularly in multiparous and grand multiparous women of lower socio-economic status. Improvement of diet especially enhancing assess to iron rich, foods and iron supplementation at least in third trimester can reduce the frequency of anemia in pregnant women

Proteína S libre en embarazadas normales: comparación entre dos métodos / Free protein S (PS) in normal pregnancy: A comparison between two analytical methods

Background: Pregnancy is a physiological hypercoagulable state with an increased incidence of thromboembolic phenomena. There is an increase in the concentrations of most clotting factors, a decrease in concentration of some of the natural anticoagulants and reduced fibrinolytic activity. Changes in PS levels have also been reported. Aim: To establish referral range values of functional PS and free PS antigen, during the second (2nd T) and third trimester (3rd T) of normal gestation. Patients and methods: Forty one normal pregnant women were included in our study, 20 during the 2nd T (22-24 weeks) and 21 during the 3rd T (29-38 weeks). Functional PS was measured by a clot based test and free PS antigen by ELISA. Results: Free PS Antigen was 65.8±18.3% during the 2nd T and 62.3±16.5% during the 3rd T. The figures for normal controls were 106±6.5%. Functional PS was 43.8±13.3 and 25.9±14.6% during the 2nd T and 3rd T, respectively. The figures for normal controls were 97±24% (p <0.001 compared with pregnant women). Free PS antigen did not change from the 2nd to the 3rd T (p=NS), however functional PS fell significantly from the 2nd to the 3rd T (p <0.001) and was significantly lower than free PS antigen in both trimesters (p <0.001). Conclusions: Pregnancy is associated to a decrease in PS. This abnormality is more pronounced for functional PS than free PS antigen and functional PS falls progressively during pregnancy. These assays should not be used to screen for PS deficiency during pregnancy because they could lead to a misdiagnosis.

Thyroid status of normal pregnant women in Dhaka City.

The thyroid gland secretes thyroid hormones having important role in embryogenesis and fetal development during pregnancy. The present study was carried out to find out alteration in the thyroid size and serum thyroid hormonal levels (T4, T3 and TSH) in normal pregnant women as compared to non-pregnant women in Dhaka City. For this purpose, thirty-five pregnant women during third trimester attending OPD Dhaka Medical College Hospital from January 1998 to July 1998 were selected randomly and twenty-one non-pregnant women of childbearing age group were selected as control. The study revealed a high prevalence of goiter in both pregnant (34.2%) and non-pregnant women (28.5%). The study showed that the serum TT4 level of non-pregnant women was normal (mean +/- SD = 113 +/- 23 nmol/L) and the serum TT4 of pregnant mother during third trimester was significantly higher (mean +/- SD = 200 +/- 63 nmol/L, P < 0.001) compared to that of non-pregnant women. The serum TT3, levels of both pregnant and non-pregnant women were within normal range without significant difference between them. It was found that the serum TSH level of pregnant mother was within normal limit and was closely similar to that of non-pregnant women showing no significant difference between them. It can be concluded from the study that although goiter was present in a considerable number of pregnant women but they were euthyroid status as observed by increased production of serum total thyroxin (TT4) by thyroid to fulfill the maternal requirement, with nearly unchanged TT3 and TSH secretion.

Aloinmunización transplacentaria por antígenos plaquetarios específicos: prevalencia y características en una población chilena / Transplacental alloimmunization against platelet antigens: prevalence and features in a chilean population

Backgrour: Neonatal alloimmune thrombocytopenia (NAIT) is a result of fetomaternal incompatibility. Platelet destruction is caused by a maternal alntibody directed against a fetal platelet antigen inherited from the father and lacking on the mother's platelets. The incidence and features of transplacental alloimmunization depend on the frequency of expression of platelet specific antigens, which are highly variable among different populations. Aim: To determine the prevalence and characteristics of transplacental alloimmunization in a large, group of pregnant women in Chile. Material and methods: We, studied 3,041 samples obtained during the third trimester of gestation. In all samples, anti platelet antibodies were screened by ELISA with platelet membranes fixed to a microtiter plate. Positive samples were further studied for antigenic specificity with the monoclonal antibody specific immobilization of platelet antigens (MAIPA) test. Results: Anti platelet antibodies were found in 261 samples (8.5 percent). The MAIPA test identified 6 samples with antibodies directed against major platelet membrane glycoproteins, 2 anti GPIb, 2 anti GPIIb/IIIa and 2 anti GPIa/IIIa. In four cases, anti HLA antibodies coexisted. Two cases corresponded to well defined platelet antigen systems: one anti HPA-1a and one anti HPA-5b. No clinical evidence of thrombocytopenia of the newborn was detected in all these cases with anti GP antibodies. Conclusions: A prevalence of platelet specific antibodies of 0.2 por ciento with only one anti HPA-1a was detected. These findings are in contrast with those of other populations but in accordance with the low frequency of the HPA-1b/b phenotype in the Chilean population. The very low incidence of platelet specific antibodies and the lack of association with clinical thrombocytopenia in the newborn, do not support the recommendation of routine antenatal screening to all women in Chile

Improved resolution of liver and bone alkaline phosphatase isoenzymes using wheat germ lectin or neuraminidase pretreatment with the introduction of some technical modifications

This study aims to establish a routine reliable electrophoresis method with improved separation of liver and bone alkaline phosphatase isoenzymes, which allows for their quantitation. Modifications of the already available techniques will also be studied. Samples were collected from patients with liver diseases [n = 26], with bone diseases and from children [n = 24] and from pregnant females in the third trimester [n = 10]. Control sera containing liver and intestinal isoenzymes were also used. Samples were subjected to liver function tests, calcium and phosphorus determination, cellulose acetate electrophoresis : ordinary, with germ wheat lectin and with neuraminidase pretreatment. Agarose gel electrophoresis was done with and without lectin. Samples were also subjected to sequential heat inactivation. Results showed that cellulose acetate electro-phoresis gave better separation of liver and bone fractions when done with germ wheat lectin or when samples were pretreated with neuraminidase. Several modifications were suggested to improve the technique. Agarose gel affinity electrophoresis [i.e., with lectin] gave the best separation of liver and bone isoenzymes into sharply defined bands. Sequential heat inactivation was tedious and needed scrupulous control of time and temperature. It overestimated the liver isoenzyme due to inclusion of biliary and intestinal fractions in its estimation. Excellent correlation was found between the different methods used for both bone and liver isoenzymes, Biliary isoenzyme was best separated by ordinary electrophoresis whether on cellulose acetate or agarose gel. Placental isoenzyme separation required preheating the sample at 65°C for 10 minutes to destroy the bone fraction which had the same migration mobility as placental isoenzyme. It was concluded that agarose affinity gel electrophoresis gave the sharpest and clearest separation of liver and bone fractions. On the other hand, cellulose acetate electrophoresis was less expensive, more sensitive and precise. Both methods were more suitable than the heat separation analysis method

Digoxin like immunoreactive substance in preeclampsia

50 normotensive pregnant vronen in the third trimester and 30 pre-eclamptic [group I, group II] were enrolled for studying the Digoxin like immunoreactive substance, there, was statistically significant increase in pre-eclampse group [120.8 +/- 8.9] compared to [78.3 +/- .9 in control group [P < 0.001]. these was a positive correlation between Doppler ultrasound, systolic, diastolic blood pressure and blood uric acid. So this substance may be implicated in the pathogensis and as indicator of severity of pre-eclampsia

Immunoassays of secretory IgA and secretory component

1. A sandwich-type enzyme-linked immunosorbent (ELISA) is described for quantitation of secretory IgA (sIgA) in human serum, as well as an ELISA and a radioimmunoassay (RIA) for measurement of secretory component (SC) is human serum. Samples were reduced and alkylated prior to the measurement of SC. 2. Healthy individuals (N = 53) presented low levels of SC (median, 0.9 mg/l). The protein levels were significantly elevated when compared with the controls, in sera of women during the second (N = 31; median, 1.5 mg/l) and third (N = 35; median, 2.4 mg/l) and acute viral hepatitis (N = 25; median 2.4 mg/l). SC levels of women in the first trimester of pregnancy (N = 24; median, 0.5 mg/l) did not differ from the controls. 3. sIgA levels were also significantly elevated when sera of women in the third trimester of pregnancy (N = 41; median, 25.4 mg/l) and sera of patients with alcoholic cirrhosis (N = 32; median, 75.0 mg/l) or acute viral hepatitis (N = 38; median, 28.5 mg/l) were compared with controls (N = 49; median, 9.0 mg/l). women in the first (N = 25; median, 7.7 mg/l) and second (N = 29; median, 10.2 mg/l trimester of pregnancy did not present levels statistically different from the controls. 4. The results obtained for SC by RIA and ELISA were positively correlated (rs = 0.88; P < 0.001). sIgA levels determined by ELISA were also positively correlated with the results of RIA-SC(rs = 0.77;P<0.001) or ELISA-SC (rs = 0.79; P < 0.001). 5. The assays described are specific, relatively simple to perform, and can be useful for the study of the secretory system

study of folates in late pregnancy and puerperium

Twenty five women were studied during the last trimester of pregnancy and during the puerperium for serum folate and erythrocyte folate, Hb concentration and haematocrit value. The results and discussion are presented