Alterations in serum uric acid values in a sample of Nigerian pregnant women

Introduction: Serum uric acid level is an important prognostic variable in pregnancy as subjects with preeclampsia have elevated serum uric acid levels. Methods: The concentrations of serum uric acid were investigated in 100 women of which 75 were pregnant women and categorized into 3 groups of 25 each, based on their trimesters of pregnancy and 25 non-pregnant women, which served as control. Results: In the first trimester, the mean values of uric acid were 122 µmol/L with a decrease in the levels of uric acid when compared with the control levels of 308 µmol/L (p<0.05). In the second trimester, the values of uric acid were 199umol/l with a significant (p<0.05) decrease in the levels of uric acid when compared with the controls. In the third trimester of pregnancy, the values of uric acid were 360 µmol/L. There was a significant (p<0.05) increase in the level of uric acid when compared with the controls. Conclusion: The progressive increase in the levels of uric acid through the trimesters of pregnancy suggests an impairment in uric acid excretion, may be with concomitant increase in renal tubular re-absorp-tion of uric acid, thereby leading to hyperuricaemia.

Evaluation of immunological parameters in pregnant women: low levels of B and NK cells / Avaliação dos parâmetros imunológicos em mulheres gestantes: baixos níveis de células B e NK

Abstract Objective To describe the immunological and hematological reference intervals of low-risk pregnant women. Methods A cross-sectional retrospective database analysis of a basic and translational study analyzing the hematological evaluation blood counts and immunophenotyping of TCD3 + , TCD4 + , TCD8 + , B, and natural killer (NK) cells of the peripheral blood in 79 low-risk pregnant women and of 30 control women from the state of Pernambuco, Brazil, was performed. Results No significant differences were detected between the hematological profiles of the 2nd and 3rd trimesters. Nevertheless, the median level of B cells decreased significantly in the 2nd (174 x 103 μL; p < 0.002) and 3rd trimesters (160 x 103 μL; p < 0.001), compared with the control group (296 x 103 μL). Similarly, the median level of NK cells was lower in the 2nd (134 x 103 μL; p < 0.0004) and 3rd trimesters (100 x 103 μL, p < 0.0004), compared with the control group (183 x 103 μL). In contrast, relative TCD4+ and TCD8+ levels increased in the 2nd and 3rd trimesters compared with the controls (TCD4 + : 2nd trimester = 59%; p < 0.001; 3rd trimester = 57%; p < 0.01; control = 50%; and TCD8 + : 2nd trimester = 31%; p < 0.001; 3rd trimester = 36%; p < 0.01; control = 24%). Conclusion Low-risk pregnant women have ~ 40% less B and NK cells in the peripheral blood, compared with non-pregnant women. These parameters may improve health assistance for mothers and contribute to define reference values for normal pregnancies.

Resumo Objetivo Descrever o intervalo de referência imunológico e hematológico de gestantes de baixo risco. Métodos Realizou-se uma análise retrospectiva, de um estudo básico e translacional, analisando o perfil hematológico e a imunofenotipagem das células TCD3 + , TCD4 + , TCD8 + , B e natural killer (NK) do sangue periférico de 79 gestantes de baixo risco e de 30 mulheres (controles) do estado de Pernambuco, Brasil. Resultados Não observamos diferenças significativas entre os perfis hematológicos do 2° e 3° trimestres. No entanto, houve redução das células B no 2° (média = 174 x 103 μL; p < 0,002) e no 3° trimestres (160 x 103 μL; p < 0,001), comparado como grupo controle (296 x 103 μL). A mediana das células NK foi menor no 2° (134 x 103 μL; p < 0,0004) e no 3° trimestres (100 x 103 μL; p < 0,0004), comparado com o grupo controle (183 x 103 μL). Porém, o percentual de TCD4+ e de TCD8+ aumentou no 2° e 3° trimestres em relação aos controles (TCD4 + : 2° trimestre = 59%; p < 0,001; 3° trimestre = 57%; p < 0,01; controle = 50%; e TCD8 + : 2° trimestre = 31%; p < 0,001; 3° trimestre = 36%; p < 0,01; controle = 24%). Conclusão Mulheres grávidas de baixo risco têm ~ 40% menos células B e NK no sangue periférico em comparação com mulheres não grávidas. Estes parâmetros podem melhorar a assistência à saúde das mães e contribuir para a definição de valores de referência para gestações normais.

TSH reference values in the first trimester of gestation and correlation between maternal TSH and obstetric and neonatal outcomes: a prospective Brazilian study

ABSTRACT Objective To define the normal range of TSH in the first trimester of gestation and to evaluate the correlation between maternal TSH and obstetric and neonatal outcomes. Subjects and methods Prospective study. Women without known or clinically suspected thyroid disease and without risk factors for thyroid dysfunction, who became pregnant spontaneously and were initially evaluated up to week 12 of gestation, were included. Women with positive anti-thyroperoxidase antibodies, twin pregnancy, hyperemesis gravidarum, and trophoblastic disease were excluded. Results In the 660 pregnant women, the mean, median, and 2.5th and 97.5th percentiles of TSH were 0.9, 0.96, 0.04 and 2.68 mIU/L, respectively. TSH was undetectable in 2%, < 0.5 mIU/L in 17.4%, > 2 mIU/L in 9.7%, > 2.5 mIU/L in 4.7%, and > 3 mIU/L in 1%. None of the women received levothyroxine or antithyroid drugs during pregnancy. In addition, there was no difference in obstetric or neonatal outcomes when women with TSH ≤ 0.1, between 0.1 and 2.5, and between 2.5 and 4 mIU/L were compared. Conclusion In the population studied, the TSH value corresponding to the 97.5th percentile was 2.68 mIU/L in the first trimester of gestation.

Perfil lipídico en mujeres embarazadas sanas de tres regiones de Chile / Lipid profile in healthy pregnant women in three regions of Chile

Antecedentes: Los lípidos plasmáticos maternos durante el embarazo pueden influir en el crecimiento fetal, particularmente en pacientes con diabetes gestacional; estos lípidos cambian su concentración plasmática materna a lo largo de la gestación. Objetivo: Calcular tablas y curvas de lípidos normales según edad gestacional en una población de embarazadas chilenas. Método: Se midió el colesterol total (CT), colesterol LDL (LDL-C) triglicéridos (TG), Colesterol-HDL (HDL-C), y ácidos grasos no esterificados (NEFA), en 94 embarazadas sanas y jóvenes (<33 años, edad media de 27,6 +/- 6,2 años), con peso pregestacional normal (Índice de Masa Corporal entre 20 y 24,9 Kg/m2 y medio de 23,3 +/- 2,0 Kg/m2). Las pacientes provenían de: Hospital Parroquial de San Bernardo, Santiago (n=55), Hospital de Talca (n=2); Hospital del Profesor, Santiago (n=18); Hospital Regional de Concepción (n=9) y Hospital Clínico de la Pontificia Universidad Católica de Chile (n=10). Resultados: Calculamos, para cada uno de los cuatro lípidos, las curvas de percentil 50, percentil 90 y percentil 10, en mg/dL y mmol/l. Los NEFA solo fueron expresados en mmol/l. Incluimos las funciones matemáticas de las curvas de regresión polinomial de los cuatro lípidos con el fin que sean fácilmente reproducibles en otros tamaños. Conclusiones: Calculamos las tablas y curvas de lípidos maternos normales a lo largo del embarazo, que sean aplicables a la población de embarazadas chilenas.

Background: In normal human pregnancy, maternal lipids can modify the rate of fetal growth, particularly in pregnancies with Gestational Diabetes Mellitus (GDM). These lipids change continuously their serum concentration in the mother along the pregnancy. Aim: To calculate tables and curves of normal serum lipids, according to gestational age, in healthy Chilean pregnant women. Methods: We measured total cholesterol (CT), LDL-cholesterol (LDL-C), triglycerides (TG), HDL-Cholesterol (HDL-C), and Non-Esterified Fatty Acids (NEFA) in 94 young and healthy pregnant women (< 33 years, mean age 27.6 +/- 6.2 years), with normal pregestational Body Mass Index (BMI, 20.0-24.9 Kg/m2 , mean value= 23.3 +/- 2.0 Kg/m2). The women of the study were patients of 5 hospitals: Hospital Parroquial de San Bernardo, Santiago (n=55), Hospital de Talca (n=2); Hospital del Profesor, Santiago (n=18); Hospital Regional de Concepción (n=9) and Hospital Clínico de la Pontificia Universidad Católica de Chile (n=10). Results: For each one of the lipids, we calculated curves of 50th, 90th and 10th percentiles, both in mg/dL and mmol/L (the NEFA were expressed only in mmol/L). The mathematical functions of the curves of polynomial regression of all lipids were included in the manuscript, in order to facilitate their reproduction. Conclusions: We calculated tables and curves of normal maternal serum lipids in relation to gestational, in order to make these available for use in the care of Chilean pregnant women.

HTLV em gestantes de dois municípios da região sul da Bahia e avaliação da transmissão materno-infantil / HTLV in pregnant women in two cities of southern Bahia and evaluation of maternal-infant transmission

A prevalência de HTLV- 1 no Brasil é diversa, dependendo tanto da região geográfica quanto do grupo analisado. Um estudo populacional realizado em Salvador detectou prevalência de 1,76%, além de maior prevalência em mulheres e associação com menores níveis de escolaridade e renda. Como a via mais frequente de transmissão vertical do HTLV-1 é a amamentação e considerando a maior prevalência nas mulheres, é muito importante a realização de exames de triagem para HTLV-1 como parte do prénatal. Até o momento, não existem estudos publicados sobre a soroprevalência do HTLV-1 em gestantes na região sul da Bahia. No presente estudo, as gestantes foram selecionadas em dois centros de referência regionais de saúde do sul da Bahia. Um total de 2.766 gestantes atendidas na sala de pré-parto entre novembro de 2008 e maio de 2010 foram analisados. Um questionário foi aplicado, e todas as amostras de plasma reagentes foram testadas em duplicata e confirmadas por Western blot e PCR. Além disso, mulheres positivas foram contactadas e visitadas. Os membros da família que estavam presentes durante a visita foram convidados a serem testados para o HTLV...

The prevalence of HTLV-1 in Brazil is diverse, depending on both the geographic region and the group analyzed. A study conducted on general population revealed that the prevalence in Salvador was 1.76%. Besides, it was also found that the prevalence was higher amongst women and that the virus was associated with lower education and lower income. As the most frequent pathway of vertical transmission of HTLV-1 is breast-feeding, and considering the higher prevalence in women, it is very important to perform screening examinations for anti-HTLV-1...

Valores de hemoglobina en mujeres embarazadas residentes en zonas de altitud media / Hemoglobin values for pregnant women residing at middle altitude

Objetivo. Determinar el comportamiento de la concentración de hemoglobina materna durante el embarazo en mujeres que residen en zonas de altitud media y compararlo con el reportado para poblaciones con y sin suplemento de hierro. Material y métodos. Valores hematológicos de 227 mujeres embarazadas, residentes a 2 240 metros de altitud (Ciudad de México), sin complicaciones obstétricas ni perinatales y recibiendo suplemento de hierro, fueron comparados con valores de referencia para mujeres embarazadas de otras altitudes. Resultados. Durante el primer y segundo trimestre, los valores de hemoglobina en nuestra población fueron similares a los observados en poblaciones con y sin suplemento de hierro (p>0.05). Durante el tercer trimestre, los valores fueron similares únicamente a los de poblaciones sin suplemento de hierro (p>0.05). Conclusiones. No obstante recibir hierro suplementario, el comportamiento de la concentración de hemoglobina durante el embarazo en mujeres residentes de la altitud media es similar al reportado para poblaciones sin hierro suplementario.

Objective. To determine maternal hemoglobin behavior during pregnancy for middle altitude residents and to compare it with that reported in other populations with or without iron supplementation. Materials and methods. Hematological values from 227 pregnant women residing at 2 240 m altitude (Mexico City), with low obstetric and perinatal risk, and receiving supplementary iron, were compared with reference values obtained from other populations of pregnant women residing at different altitudes, after correcting for altitude. Results. While the hemoglobin values for the first and second trimester of pregnancy in our studied population were similar to those reported for iron-supplemented populations (p>0.05), the third trimester values were similar to those reported for a population without this supplement (p>0.05). Conclusions. Despite receiving supplementary iron, hemoglobin values during pregnancy from women residing at middle altitude show similar behavior to that reported for pregnant women without iron supplementation.

Vitamin d levels among pregnant and lactating women

To assess the serum level of vitamin D in pregnant and lactating women. Case-control study. Gynaecological Unit 1 of Jinnah Hospital, Lahore, from December 2010 to May 2011. A total of 100 women comprised of three groups: pregnant [n = 40], lactating [n = 40] and control [n = 20] groups. The information regarding age, educational level, socioeconomic status, exposure to sunlight and dietary vitamin D intake were collected through self-structured questionnaire. Serum concentration of vitamin D was measured by ELISA and serum calcium and phosphate levels were measured by chemistry analyzer. Statistical analysis was done using SPSS [version 13]. The values were considered significant at 0.05 level of significance. The mean serum vitamin D level in the pregnant and lactating mothers was 26.5 +/- 17.1 nmol/L and 21.4 +/- 16.3 nmol/L respectively and in control group was 33.8 +/- 21.1 nmol/L. The mean calcium level in the pregnant, lactating and control group was 10.3 +/- 1.2 mg/dL, 9.7 +/- 1.3 mg/dL and 9.7 +/- 1.3 mg/dL respectively. The mean phosphate in pregnant was 3.2 +/- 0.76 mg/dl, in lactating was 3.3 +/- 0.76 mg/dl and in control was 3.5 +/- 0.92 mg/dl. Significant difference [p = 0.041 and p = 0.037 respectively] in the serum levels of vitamin D and calcium was observed among the pregnant and lactating women as compared to control group. Low serum vitamin D concentration was observed in lactating women and pregnant women as compared to control group.

[Comparison of serum androgens and progesterone in preeclampsia and normal pregnancy]

Androgens are among the causative factors in preeclampsia. This study was done to compare the serum androgens and progesterone in preeclampsia and normal pregnancy. This case-control study was done on 30 preeclamptic and 30 healthy pregnant women in Gorgan, Iran. Higher or equal to 140/90 mmHg and proteinuria equal or more than +1 in dip stick test in the third trimester of pregnancy were considered as the diagnostic criteria of preeclampsia. Progesterone, free and total testosterone, and dehydroepiandrosterone sulphate [DHEA] were measured by ELISA method. Total testosterone level was 1.8 +/- 0.3 ng/ml and 1.3 +/- 0.9 ng/ml in cases and controls, respectively. This difference was not significant. Progesterone was lower in cases [95 +/- 46.9 ng/ml] than in controls [165.4 +/- 75 ng/ml] [P<0.01]. Free testosterone and DHEA were 5.6 +/- 2.3 ng/ml and 1 +/- 0.5 ng/ml in cases, respectively which was significantly higher than the controls [3.2 +/- 1.5 ng/ml and 0.7 +/- 0.4 ng/ml, respectively] [P<0.045]. Serum level of free testosterone, DHEA and progesterone increased and reduced respectively in preeclampsia

Hemoglobina materna en la salud perinatal y materna en la altura: implicancias en la región andina / Mother’s hemoglobin in perinatal and mother health in the highlands: implications in the andean region

Esta revisión analiza la importancia del valor de la hemoglobina en la gestante, y su implicancia sobre el embarazo. Discute el uso de combustible de biomasa y la repercusión en el peso del recién nacido, los valores de hemoglobina materna y el riesgo de muerte fetal tardía, parto pretérmino y nacer pequeño para la edad gestacional. Asimismo, se aborda la necesidad de corregir el punto de corte de los valores de hemoglobina para definir anemia en la altura. La evidencia actual sugiere no corregirla, así también, la suplementación de hierro a las gestantes debería ser dirigida a los casos de anemia moderada o severa. Se discute si se debería reorientar la suplementación de hierro a niños de 6 a menos de 36 meses de edad.

This review analyzes the importance of hemoglobin levels in pregnant women and its implications in pregnancy. It discuss the use of biomass fuel for cooking and the impact on birthweight, maternal hemoglobin levels and the risk of late fetal death, pre-term delivery, and small for gestational age. Furthermore, the need to correct the cut-off points of hemoglobin level to define anemia at high altitudes is addressed. Current evidence suggests that corrections should not be made and iron supplements should be given to pregnant mothers with moderate or severe anemia. It is discussed whether iron supplementation should change its target population from pregnant women to infants aged 6 to 36 months.

Conocimientos, actitudes y prácticasde las mujeres con VIH durante lagestación y crianza (Popayán, 2009) / Knowledge, attitudes and practices of HIV-positive women during pregnancy and parenting (Popayán, 2009) / Conhecimentos, atitudes e práticas das mulheres com HIV durante a gestação e criação (Popayán, 2009)

Objetivo: describir los conocimientos, actitudes y prácticas de las gestantes y madres con VIH de niños menores de un año, en torno a su cuidado y el de su hijo en el Hospital Universitario San José y Servicios Integrales Especializados en Salud de la ciudad de Popayán, en el 2009. Materiales y métodos: estudio cualitativo etnográfico focalizado. Participaron seis mujeres con VIH, seropositivas (mediante el Western Blot) con un hijo menor de un año. previo consentimiento informado, se procedió a recoger la información, a través de una entrevista a profundidad y el diario de campo. Resultados: desde la perspectiva Etic de tres categorías: (conocimientos, actitudes y prácticas) y desde la Emic emergen las subcategorías: conceto de VIH, formas de trasmisión, sentimientos, socialización, cuidados y vínculo. Relaciones estables, confianza y fidelidad dan la percepción de inmunidad ante la infección, lo que facilita la negación al riesgo, y las mujeres contrajeron el virus por su único compañero. La maternidad genera respuestas físicas y psicológicas, encaminadas a suplir necesidades del nuevo ser. Los estímulos del entrono pueden llegar a romper el equilibrio y su estilo de vida. El temor a reanudar nuevos afectos y el aislamietno social deterioran la capacidad de relacionarse con personas significativas que faciliten sus procesos de adaptación y cuidado. Conclusiones: la falta de conocimiento sobre VIH fue el mayor estímulo negativo para las participantes, que dificultó el proceso de afrontamiento y adaptación al proceso de infección. El diagnóstico de seropistividad las deja enfrentadas a cambios que involucarn sus redes de apoyo personal, familiar y social, lo que influye en sus expectativas de vida, eclipsadas por alteraciones en su estado de salud y estrés generado por la estigmatización de su seropositividad...

Objetive: to describe the knowledge, attitudes and practices that HIV poitive pregnant women and mothers of children under one year of age regarding their self-care and the care of their children at the San José Teaching Hospital and the integrated Specialized Health Services of the City of Popayán, in teh year 2009. Materials and Methods: qualitative ethnographic focused study. The participants were six HIV seropositive women (confirmed by Western Blot) with one child under one year of age. After obtaining informed consent, the information was collected through a personal in-depth interview and field diaries. Results: three categories (knowledge, attitudes and practices) were established from the Etic perspective; and from the Emic, we defined the following subcategories: the concept of HIV, modes of transmission, feelings, socialization, care and bonding. Stable relationships, trust and faithfulness give the impression of immunity to infection, which facilitates the denial of risk, and these women contracted the virus from their only partner. Motherhood generates physical and psychological responses aimed at meeting the needs of the new being, while environmental stimuli might break the balance and change the previous lifestyle. The fear to establish or renew relationships and the social isolation impair the ability to relate to meaningful others who can facilitate the processes of adaptation and care. Conclusions: the lack of knowledge about HIV was the most negative stimulus for participants, and hampered the process of coping and adaptation to the infection. The HIV seropisitivity diagnosis left them facing changes involving their personal support networks, family and social milieu, which affected their life expectations, overshadowed by changes in their health and by the stress associated with the stigma of the HIV status...

Objetivo: Descrever os conhecimentos, atitudes e práticas das gestantes e máes com HIV de criancas menores de um ano, em torno a seu cuidado e o de seu filho no Hospital Universitario San José e Servicos Integráis Especializados em Saúde da cidade de Popayán, em 2009. Materiais e métodos: Estudo qualitativo etnográfico focalizado. Participaram seis mulheres com HIV, soropositivas (mediante o Western Blot) comum filho menor de um ano. Prévio consentimento informado se procedeu a recolher a informacáo, através de urna entrevista extensiva e diario de campo. Resultados: Desde a perspectiva Ética de trés categorías (conhecimentos, atitudes e práticas) e desde a Emic emergem as subcategorias: conceito do HIV, formas de transmissáo, sentimentos, socializacáo, cuidados e vinculo. Relacóes estáveis, confianca e fideli- dade dáo a percepcáo de imunidade diante da infeccáo, o que facilita a negacáo aorisco, e as mulheres contrairam o virus através de seu único companheiro. A maternidade gera resposta físicas e psicológicas, encaminhadas a suprir as necesidades do novo ser. Os estímulos do entorno podem chegar a quebrar o equilibrio e seu estilo de vida. O temor a retomar afetos e o isolamento social deterioram a capacidade de relacionarse com pessoas significativas que facilitem seus processos de adaptacáo e cuidado. Conclusóes: A falta de conhecimento sobre o HIV foi o maior estímulo negativo para as participantes, que dificultou o procos so de afróntamento e adaptacáo ao processo de infeccáo. O diagnóstico de soropositividade as deixa enfrentadas a mudancas que envolvem suas redes de apoto pessoal, familiar e social, o que influí em suas expectativas de vida, eclipsadas por alteracóes em seu estado de saúde e estresse gerado pela estigmatizacáo de sua soropositividade…

Impact of twice weekly versus daily iron supplementation during pregnancy on maternal and fetal haematological indices: a randomized clinical trial

A randomized clinical trial examined the efficiency and tolerability of twice weekly versus daily iron supplementation during pregnancy. A total of 370 pregnant women were randomly assigned to receive either daily or twice weekly iron supplementation during pregnancy. There were no significant differences in initial and delivery haemoglobin and haematocrit levels between the 2 groups. Ferritin concentrations were significantly lower in the twice weekly group at delivery, but hypoferritinaemia [ferritin < 15 microg/L] was not observed in either group. The frequency of nausea, vomiting and constipation were significantly lower in the twice weekly group. Birth weight and length were significantly higher in the daily supplemented group. In non-anaemic mothers, a smaller dose of iron may be sufficient and also might prevent the complications of iron excess

Comparison of serum levels of tri-iodothyronine [T3], thyroxine [T4], and thyroid-stimulating hormone [TSH] in preeclampsia and normal pregnancy

The physiological changes in thyroid gland during pregnancy have been suggested as one of the pathophysiologic causes of preeclampsia. The aim of this study was comparison of serum levels of Tri-iodothyronine [T3], Thyroxine [T4], and Thyroid-Stimulating Hormone [TSH] in preeclampsia and normal pregnancy. In this case-control study, 40 normal pregnant women and 40 cases of preeclamsia in third trimester of pregnancy were evaluated. They were compared for serum levels of Free T3 [FT3], Free T4 [FT4] and TSH. The data was analyzed by SPSS software with the use of t-student, Chi-square, Independent sample T-test and Bivariate correlation test. P

Reticulocyte assessment as an indirect evaluation and elaboration of erythroid marrow output in the groups of pregnant women in Maiduguri, Nigeria

Nutritional anaemia is one of Nigeria's major public health problem among pregnant women. In this locality, no large scale study has been done to assess bone marrow activity in groups of pregnant women using Reticulocyte assessment. This result will serve as indirect evaluation and elaboration of erythroid marrow output in the pregnant women. To assess bone marrow activity in groups of pregnant women using Reticulocyte assessment as an indirect evaluation. 150 women covering the three trimesters of pregnancy were recruited into the study, prospectively. 101 multiparous and 49 primiparous pregnant women, consisting of 33 in the first trimester, 74 in the second trimester and 43 in the third trimester were investigated. Red blood cell count, Reticulocyte count and assessment were conducted by standard methods. The patients in the third trimester had statistically significant [P<0.05] lower reticulocyte values than those in the first and second trimesters. The primiparous pregnant women had statistically significant [P<0.05] higher reticulocyte values than the multiparous pregnant women. Absolute reticulocyte count results were 50.0 +/- 15.2, 60.0 +/- 18.4, 34.0 +/- 12.8 and 48.0 +/- 12.0 for first, second and third trimesters and combined group, respectively. Reticulocyte index was 1.5 +/- 0.6, 1.9 +/- 0.8, 0.8 +/- 0.6 for first, second and third trimesters, respectively and 1.5 +/- 0.5 for combined group. Reticulocyte production index was 0.9 +/- 0.2, 1.1 +/- 0.4, 0.7 +/- 0.5 and 0.7 +/- 0.4 for first, second and third trimesters and combined group, respectively. In this study, bone marrow activity as assessed by reticulocyte studies is on the lower side of the normal range, more so in the third trimester of pregnancy. Severe anaemia during pregnancy therefore remains endemic despite intervention measures such as the distribution of iron and folate tablets. One of the problems yet uninvestigated is the bone marrow turnover as affected by some other nutritional differences as well as malaria, heavy loads of helminths, and other inflammatory or infectious diseases. A successful strategy to combat anaemia, therefore, should address all the casual factors after their elucidation

Efeito da suplementação com vitamina E sobre a concentração de alfa-tocoferol no colostro humano / Effect of vitamin E supplementation on alpha-tocopherol levels in human colostrum

OBJETIVO: Avaliar a concentração de alfa-tocoferol no colostro humano em condições de suplementação com cápsulas de vitamina A acrescidas de vitamina E sintética. MÉTODOS: Foram recrutadas para o estudo 30 parturientes saudáveis atendidas em uma maternidade pública. Após jejum noturno, foram coletadas amostras de sangue e de colostro (2 mL) das parturientes. Após a primeira coleta, as mesmas receberam suplemento na forma de uma cápsula de palmitato de retinila (200000 UI ou 60 mg) acrescido de vitamina E sintética (49,4 mg de dl-alfa-tocoferol). Após 24 horas da suplementação, foi realizada nova coleta de 2 mL de colostro, também em jejum. RESULTADOS: A concentração sérica de alfa-tocoferol foi de 1 042,9 ± 319,0 μg/dL. Os teores de alfa-tocoferol no colostro antes da suplementação foram de 1155,4 ± 811,0 μg/dL, vs. 1396,3 ± 862,2 μg/dL 24 horas depois da suplementação (P > 0,05). Foi encontrada correlação entre o alfa-tocoferol do colostro na condição de jejum antes da suplementação e 24 horas após a suplementação (P = 0,001; r = 0,58), mas não entre soro e o colostro em nenhuma das condições acima citadas. CONCLUSÕES: Não houve aumento na concentração de alfa-tocoferol do colostro 24 horas após a suplementação. Isso indica que não é vantajoso suplementar a mãe com vitamina E sintética. Entretanto, os resultados também sugerem que, se o estado nutricional prévio à suplementação estiver adequado, mais tocoferol será encontrado no colostro após a suplementação. Novos estudos devem ser realizados para investigar o efeito da suplementação com a forma natural do alfa-tocoferol.

OBJECTIVE: To assess the levels of alpha-tocopherol in human colostrum following supplementation with capsules containing vitamin A plus synthetic vitamin E. METHODS: Thirty healthy women about to give birth were recruited from a public maternity hospital. After overnight fasting, blood samples as well as colostrum samples (2 mL) were collected. After the first collection, the women received supplementation with a capsule containing retinyl palmitate (200 000 IU or 60 mg) plus synthetic vitamin E (49.4 mg dl-alpha tocopherol). Twenty-four hours after supplementation, a second 2 mL colostrum sample was collected after overnight fasting. RESULTS: The serum concentration of alpha-tocopherol was 1 042,9 ± 319.0 µg/dL. The concentration of alpha-tocopherol in colostrum before supplementation was 155.4 ± 811.0 µg/dL, vs. 1 396.3 ± 862.2 µg/dL 24 hours after supplementation (P > 0.05). A correlation was found between fasting levels of alpha-tocopherol in colostrum before supplementation and 24 hours after supplementation (P = 0.001; r = 0.58), but not between the concentrations in serum and colostrum. CONCLUSIONS: There was no increase in the levels of alpha-tocopherol in colostrum 24 hours after supplementation. This suggests that supplementation with synthetic vitamin E is not advantageous. However, the present results also suggest that if the nutritional state is adequate prior to supplementation, more tocopherol will be available in colostrum after supplementation. Further studies should be carried out to investigate the effects of supplementation with the natural form of alpha-tocopherol.

Vitamin D status in healthy Omani women of childbearing age. Study of female staff at the Royal Hospital, Muscat, Oman

Sunlight exposure has a vital role in vitamin D synthesis. Although vitamin D deficiency has been well documented in temperate zones, studies have been scarce in tropical countries where the population is well covered and for various reasons avoids sun exposure. The objective of this study was to investigate serum 25-hydroxyvitamin D [25[OH]D] levels and its relationship to biochemical bone profile, exposure to sunlight and vitamin D intake amongst Omani women of childbearing age. 41 apparently healthy women working at the Royal Hospital, Muscat, Oman and aged 18-45 years, with mean +/- SD of 29 +/- 6 years, were included in this study conducted in December 2006. They completed a questionnaire regarding the duration of sun exposure, food intake and type of clothing worn. Blood samples were collected from them and analyzed for serum 25[OH]D, calcium, phosphate, alkaline phosphatise and parathyroid hormone levels. All the women had a 25[OH]D level <50 nmol/L as the cut-off for deficiency. 25[OH]D levels were strongly correlated with the lack of sun exposure [r = 0.672, P < 0.001] and a significant correlation was also found between 25[OH] D level and food intake [r = 0.482, P < 0.01]. Subclinical 25[OH]D deficiency may be prevalent amongst Omani women. Risk factors such as poor sunlight exposure should be addressed in women of childbearing age and, if increased sunlight exposure is not possible, oral supplementation should be considered to avoid all the consequence and complications of vitamin D deficiency

Comparison of maternal and neonatal serum leptin levels in preeclampsia and normal pregnancy

Leptin is a protein product of obesity gene and is synthesized mainly by adipose tissue. The aim of this study was to determine maternal and neonatal serum leptin levels in term preeclamptic and normal pregnancies. This cross sectional study was performed on 37 preeclamptic and 40 normotensive term pregnant women without other disease. Serum level of leptin was measured in all of pregnant mothers and after delivery, their neonates. This study was performed in Babol Yahyanejad Hospital from March 2006 to December 2006. Infants with preeclamptic mothers had significantly lower leptin level than control group [p=0.02]. There was no significant difference in serum leptin levels between normal and preeclamptic women [p=0.749]. According to the results, it would be concluded that leptin level in infants of preeclamptic mothers is lower than infants of normal mothers. This can only confirm the diagnosis of disease after birth but it cannot predict the preeclampsia

[ relationship between Serum C-reactive protein levels in early pregnancy and preeclampsia onset]

Preeclampsia is one of the most common medical complications during pregnancy that can be a major cause of prenatal morbidity and mortality. One of the most studied biomarkers in the prediction of preeclampsia is C-reactive protein. The objective of this study was to assess the relationship between maternal serum CRP concentrations in early pregnancy and the onset of preeclampsia during the gestational period. In this prospective cohort study, serum CRP levels were measured in 400 pregnant women in their 20th week of gestation. They were all followed up till delivery. The data were finally analyzed statistically. After controlling for the effects of maternal age [<19 and>35 years], multiple regression analysis for primiparity, supplementary calcium intake, BMI and CRP depicted a statistically significant relationship between CRP levels and mild [OR=1.71, 95% CI=1.39-2.11] and severe [OR=2.45, 95% CI=1.80-3.34] preeclampsia onsets. Among all the aforementioned variables, only supplementary calcium intake was significantly effective in the prevention of preeclampsia. In ROC curve analysis, the CRP cut-off point in moderate preeclampsia was 5.35 mg/l [with 94% sensitivity and 81% specificity], and in severe preeclampsia it was 5.45 mg/l [with 94.4% sensitivity and 82.5% specificity]. It seems that CRP can help identify pregnant women who are at high risks of preeclampsia but larger studies are needed to establish a definitive relationship

Low concentrations of maternal thyroxin during early gestation: a risk factor of breech presentation

Approximately 3-5% of all pregnancies at term are with the fetus in the breech presentation in which whatever thier mode of delivery, is a signal for potential fetal handicap Little is known about the etiology; However there are several etiological factors might be related to fetal movement during pregnancy. Maternal hypothyroxinaema early in gestation may have effect on fetal movement during pregnancy through its effect on fetal brain maturation. To evaluate the relation between breech presentation at term and low maternal free thyroxin levels during early gestation in women not suffering from overt thyroid dysfunction. A prospective observational study of pregnant women. Analysis refers to 70 women who met the inclusion and exclusion criteria. Main outcome assessment, Fetal presentation [cephalic-breech] at term gestation in relation to maternal thyroid function at 12 weeks of gestation. Breech presentation at term delivery was independently related to maternal free thyroxin [FT4] levels <10th cectile at 12 weeks of gestation [OR 4.63, 95% CI 0.8- 22]. Women with hypothyroxinaemia [FT level <10th centile] during their early gestation [without overt thyroid dysfunction] are at risk for persistent breech presentation