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1.
Int J Clin Pract ; 2023: 1907222, 2023.
Article in English | MEDLINE | ID: mdl-36713951

ABSTRACT

Background: Prevention and timely treatment of gestational diabetes mellitus (GDM) are important to the prognosis of pregnant women and neonates. We aimed to conduct a meta-analysis to evaluate the effects and safety of vitamin D supplementation on GDM patients and neonates, to provide insights into clinical GDM treatment. Methods: Two authors searched the Medline, PubMed, Cochrane Library, Web of Science, Embase, CNKI, and Wanfang databases for randomized controlled trials (RCTs) on the effects and safety of vitamin D supplementation in GDM patients. The quality of the included RCTs was evaluated according to Cochrane handbook. RevMan 5.3 software was used for statistical analysis. Results: A total of 20 RCTs involving 1682 GDM patients were finally included, of whom 837 received vitamin D supplementation. Vitamin D supplementation in GDM patients increased the serum 25(OH)D level (SMD = 4.07, 95% CI: (2.73, 5.41)) and HDL level (SMD = 0.41, 95% CI: (0.23, 0.58)) and reduced serum LDL (SMD = -0.49, 95% CI: (-0.68, -0.29)), TG (SMD = -0.59, 95% CI: (-1.01, -0.17)), and TC (SMD = -0.67, 95% CI: (-1.19, -0.14)) levels in GDM patients (all P < 0.05). Besides, vitamin D supplementation reduced the risk of premature birth (OR = 0.37, 95% CI: (0.22, 0.62)), hyperbilirubinemia (OR = 0.38, 95% CI: (0.25, 0.58)), and neonatal hospitalization (OR = 0.38, 95% CI: (0.25, 0.58)) of neonates (all P < 0.05). No significant publication bias in synthesized results was found (all P > 0.05). Conclusions: Vitamin D supplementation improves the blood lipid level in GDM patients and reduces adverse neonatal outcomes. The dose and duration of vitamin D supplementation for safety need to be further investigated in future high-quality studies.


Subject(s)
Diabetes, Gestational , Pregnancy Complications , Female , Humans , Infant, Newborn , Pregnancy , Diabetes, Gestational/drug therapy , Diabetes, Gestational/prevention & control , Dietary Supplements , Pregnancy Complications/drug therapy , Pregnancy Complications/prevention & control , Vitamin D/therapeutic use , Vitamins/therapeutic use
2.
Int J Environ Res Public Health ; 20(2)2023 Jan 10.
Article in English | MEDLINE | ID: mdl-36674022

ABSTRACT

Obesity is now recognized as a worldwide epidemic. An inadequate diet and reduced physical activity are acknowledged as the leading causes of excess body weight. Despite growing evidence that obesity is a risk factor for unsuccessful pregnancies, almost half of all women who become pregnant today are overweight or obese. Common complications of pregnancy in this group of women are preeclampsia and gestational hypertension. These conditions are also observed more frequently in women with excessive weight gain during pregnancy. Preeclampsia is one of the most serious pregnancy complications with an unpredictable course, which in its most severe forms, threatens the life and health of the mother and her baby. The early identification of the risk factors for preeclampsia development, including obesity, allows for the implementation of prophylaxis and a reduction in maternal and fetal complications risk. Additionally, preeclampsia and obesity are the recognized risk factors for developing cardiovascular disease in later life, so prophylaxis and treating obesity are paramount for their prevention. Thus, a proper diet and physical activity might play an essential role in the prophylaxis of preeclampsia in this group of women. Limiting weight gain during pregnancy and modifying the metabolic risk factors with regular physical exercise creates favorable metabolic conditions for pregnancy development and benefits the elements of the pathogenetic sequence for preeclampsia development. In addition, it is inexpensive, readily available and, in the absence of contraindications to its performance, safe for the mother and fetus. However, for this form of prevention to be effective, it should be applied early in pregnancy and, for overweight and obese women, proposed as an essential part of planning pregnancy. This paper aims to present the mechanisms of the development of hypertension in pregnancy in obese women and the importance of exercise in its prevention.


Subject(s)
Pre-Eclampsia , Pregnancy Complications , Humans , Pregnancy , Female , Overweight/epidemiology , Pre-Eclampsia/epidemiology , Pre-Eclampsia/prevention & control , Obesity/complications , Obesity/epidemiology , Obesity/therapy , Weight Gain , Exercise , Pregnancy Complications/epidemiology , Pregnancy Complications/prevention & control , Body Mass Index
4.
Rev. medica electron ; 43(6): 1585-1594, dic. 2021.
Article in Spanish | LILACS-Express | ID: biblio-1409687

ABSTRACT

RESUMEN Introducción: muchas gestantes que se atienden en consulta de Genética prenatal provienen de familias con diabetes mellitus y desarrollan diabetes gestacional, por lo que requieren el asesoramiento genético preconcepcional sobre factores de riesgo, que en muchos casos no reciben. Objetivo: identificar los antecedentes familiares de diabetes mellitus en las gestantes que debutan con diabetes gestacional, sin haber tenido asesoramiento genético preconcepcional. Materiales y métodos: se realizó un estudio descriptivo retrospectivo durante el período 2017 a 2019 en 186 embarazadas diagnosticadas con diabetes gestacional, del municipio Matanzas. Resultados: el 39,7 % de las gestantes con diabetes gestacional pertenecían a familias con diabetes mellitus; el 27,02 % tenía un familiar de primer grado afectado; en el 59,45 % predominó la vía materna de transmisión hereditaria; un 22,58 % presentó defectos congénitos, y el 54,05 % no recibió asesoramiento genético preconcepcional. Conclusiones: no todas las embarazadas con antecedentes familiares de diabetes mellitus recibieron asesoramiento genético preconcepcional, indispensable para minimizar el riesgo de diabetes gestacional (AU).


ABSTRACT Introduction: many pregnant women attended in prenatal genetic consultation come from families with diabetes mellitus and develop gestational diabetes, so they require preconception genetic counseling on risk factors, which they do not receive in many cases. Objective: to identify family antecedents of diabetes mellitus in pregnant women who debut with gestational diabetes, without having received preconceptional genetic counseling. Materials and methods: a retrospective descriptive study was carried out during the period 2017 to 2019 in 186 pregnant women from the municipality of Matanzas, diagnosed with gestational diabetes. Results: 39.7 % of the pregnant with gestational diabetes came from families with diabetes mellitus; 27.02 % of them had an affected first-grade relative; maternal hereditary transmission predominated in 59.45 %; 22.58 % presented congenital defects, and 54.05 % did not received preconceptional genetic counseling. Conclusions: not all the pregnant women with family antecedents of diabetes mellitus received preconceptional genetic counseling, which is essential to minimize the risk of gestational diabetes (AU).


Subject(s)
Humans , Male , Female , Diabetes, Gestational/prevention & control , Genetic Counseling/methods , Pregnancy Complications/diagnosis , Pregnancy Complications/prevention & control , Risk Factors , Diabetes, Gestational/therapy , Medical History Taking/methods
5.
Wiad Lek ; 75(10): 2379-2385, 2022.
Article in English | MEDLINE | ID: mdl-36472264

ABSTRACT

OBJECTIVE: The aim: To conduct analyses of structure and incidence of extragenital pathology, course of pregnancy and labour in pregnant from 2011 to 2020 years. PATIENTS AND METHODS: Materials and methods: Clinical and statistical analysis of 159,367 births over 2011-2020 years in Transcarpathian region was conducted. All complications of pregnancy were divided into 6 subgroups depending on the available obstetric pathology and extragenital pathology. RESULTS: Results: The incidence of extragenital pathology among women born in the Transcarpathian region over the past 10 years has increased by an average of 6-10%. The incidence of placental dysfunction on the background of somatic morbidity in the maternity hospital in Uzhgorod increased during the study period from 6.1% (2011) to 10.9% (2020). A significant reduction in the number of births from 18,168,000 in 2011 to 13,150,000 in 2020 was noted. The incidence of combined somatic pathology increased from 10.4% in 2011 to 23.8% in 2020. (p <0.001). CONCLUSION: Conclusions: It is necessary to develop comprehensive modern measures to prevent obstetric and perinatal complications in this group of pregnant women.


Subject(s)
Labor, Obstetric , Pregnancy Complications , Female , Pregnancy , Humans , Incidence , Placenta , Pregnancy Complications/prevention & control , Pregnant Women
6.
Int J Public Health ; 67: 1604620, 2022.
Article in English | MEDLINE | ID: mdl-36405527

ABSTRACT

Objectives: Interventions in pregnancy are commonly evaluated for their effects on birth outcomes because maternal infection and poor nutrition are the primary contributors to adverse pregnancy outcomes, especially in low- and middle-income countries (LMICs). However, the extent to which such interventions directly impact maternal health and nutrition has not been succinctly characterized. Methods: We conducted a scoping review of systematic reviews and meta-analyses of 27 pregnancy interventions to summarize the evidence of impact on maternal outcomes. Results: Overall, these were reported incompletely, and we failed to find any evidence for eight interventions. Influenza vaccination, insecticide-treated bed nets, intermittent preventive treatment for malaria, anthelmintic therapy, and treatment of bacterial vaginosis, asymptomatic bacteriuria, and periodontal disease during pregnancy provided direct benefit to women, with reductions in infection risk. Nutritional interventions such as micronutrient supplementation and balanced energy and protein improved outcomes of maternal anemia and gestational weight gain, particularly in deficient populations. Calcium and low dose aspirin significantly reduced the risk of pre-eclampsia. Conclusion: These findings highlight antenatal interventions benefitting maternal health and provide insights into pathways for impacting birth and infant outcomes.


Subject(s)
Malnutrition , Pregnancy Complications , Infant , Pregnancy , Female , Humans , Systematic Reviews as Topic , Pregnancy Outcome , Pregnancy Complications/prevention & control , Poverty
7.
J. obstet. gynaecol. Can ; 44(7)20220701.
Article in English | BIGG | ID: biblio-1399532

ABSTRACT

To review evidence-based recommendations for the management of dichorionic twin pregnancies. Pregnant women with a dichorionic twin pregnancy. Implementation of the recommendations in this guideline may improve the management of twin pregnancies and reduce neonatal and maternal morbidity and mortality. Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate controlled vocabulary (e.g., twin, preterm birth). Results were restricted to systematic reviews, randomized controlled trials, controlled clinical trials, and observational studies. There were no date limits, but results were limited to English- or French-language materials. The content and recommendations were drafted and agreed upon by the principal authors. The Board of the SOGC approved the final draft for publication. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). Obstetricians, family physicians, nurses, midwives, maternal-fetal medicine specialists, radiologists, and other health care providers who care for women with twin pregnancies.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/prevention & control , Cesarean Section , Fetal Growth Retardation/diagnosis , Pregnancy, Twin
8.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 48(6): 423-430, sept, 2022. tab
Article in Spanish | IBECS | ID: ibc-211027

ABSTRACT

La actividad física durante el embarazo promueve la salud materna, fetal y neonatal. Los beneficios para la salud de la actividad física prenatal incluyen un riesgo reducido de aumento de peso gestacional excesivo, diabetes gestacional, preeclampsia, complicaciones del parto, parto prematuro, complicaciones del recién nacido y depresión posparto. Las principales guías de actividad física/ejercicio durante el embarazo recomiendan que todas las mujeres embarazadas sin contraindicaciones médicas u obstétricas se mantengan activas físicamente durante la gestación, con el objetivo de conseguir beneficios para su salud y, al mismo tiempo, reducir la posibilidad de complicaciones durante el embarazo. Analizamos en este artículo lo que la medicina basada en la evidencia (MBE) indica con respecto al ejercicio físico y el embarazo. Para ello, nos basamos en las diferentes Revisiones Cochrane existentes, así como en las principales Guías de práctica clínica y Documentos de consenso (AU)


Physical activity during pregnancy promotes maternal, fetal and neonatal health. The health benefits of prenatal physical activity include a reduced risk of excess gestational weight gain, gestational diabetes, preeclampsia, labor complications, preterm labor, newborn complications, and postpartum depression. The main guidelines for physical activity/exercise during pregnancy recommend that all pregnant women without medical or obstetric contraindications, remain physically active during the gestation, in order to achieve benefits for their health and at the same time reduce the possibility of complications during pregnancy. We analyze in this article what evidence based medicine (EBM) indicates regarding physical exercise and pregnancy. To do this, we draw on the different existing Cochrane reviews, as well as on the main Clinical practice guidelines and Consensus documents (AU)


Subject(s)
Humans , Female , Pregnancy , Evidence-Based Medicine , Pregnancy Complications/prevention & control , Exercise
9.
Obstet Gynecol Clin North Am ; 49(4): 665-692, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36328674

ABSTRACT

Optimal care during the antenatal and postnatal phases of the life cycle is a potentially positive determinant of health elsewhere in the continuum. A successful transition from the antenatal to the postnatal period requires early detection, optimal management, and prevention of disease; health promotion; birth preparedness; and complication readiness. Women, their babies, and families need appropriate evidence-based care based on their dignity and human rights before, during, and after birth. In this review, we present an overview of the components of antenatal and postnatal care needed to provide women a culturally sensitive and positive pregnancy and postnatal experience. The challenge of antenatal and postnatal care is determining their core components and underpinning them with evidence without overmedicalizing their practice.


Subject(s)
Postnatal Care , Pregnancy Complications , Female , Pregnancy , Humans , Prenatal Care , Parturition , Pregnancy Complications/prevention & control
10.
JAMA ; 328(19): 1893-1895, 2022 11 15.
Article in English | MEDLINE | ID: mdl-36301578

ABSTRACT

This Medical News article discusses a new report from the US Centers for Disease Control and Prevention on maternal deaths during and up to a year after pregnancy, racial disparities, and new models of care aimed at reducing maternal mortality.


Subject(s)
Maternal Death , Pregnancy Complications , Female , Humans , Pregnancy , Cause of Death , Maternal Mortality , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Pregnancy Complications/mortality , Pregnancy Complications/prevention & control , United States/epidemiology , Maternal Death/etiology , Maternal Death/prevention & control , Maternal Death/statistics & numerical data
11.
Nutrients ; 14(19)2022 Oct 04.
Article in English | MEDLINE | ID: mdl-36235776

ABSTRACT

Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] levels <20 ng/mL in serum) is a common health condition among pregnant women, especially in high-risk groups. Evidence has connected vitamin D levels with many health-related problems during pregnancy, including gestational diabetes and preeclampsia. Because of vitamin D's effect on both mother and fetus, we systematically review the association between 25(OH)D level and its health effects. From a total of 143 studies, 43 came from PubMed, 4 from Cochrane, and 96 from EMBASE. After screening, we identified 38 studies as candidates for inclusion. Ultimately, we limited this review to 23 articles originating from 12 countries, written in English or Spanish, and conducted between 2010 and 2022. We conducted this review according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and evaluated the quality and strength of the evidence by using the Navigation Guide Systematic Review Methodology (SING). These systematic reviews summarize findings that support vitamin D's role in reducing risks of multiple outcomes and the possible contribution of adequate vitamin D levels to a healthy pregnancy.


Subject(s)
Pregnancy Complications , Vitamin D Deficiency , Female , Humans , Pregnancy , Pregnancy Complications/prevention & control , Pregnancy Outcome , Risk Factors , Vitamin D , Vitamins
14.
Int J Obes (Lond) ; 46(12): 2145-2155, 2022 12.
Article in English | MEDLINE | ID: mdl-36224375

ABSTRACT

BACKGROUND/OBJECTIVES: Obesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk. SUBJECTS/METHODS: Children were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram. RESULTS: Compared to offspring of normal BMI women (n = 51), children of women with obesity from the trial standard care arm (n = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm (n = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS -0.03 cm (-0.05 to -0.008); PW -0.03 cm (-0.05 to -0.01); RWT -0.02 cm (-0.04 to -0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis. CONCLUSIONS: Maternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: The UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.


Subject(s)
Carotid Intima-Media Thickness , Pregnancy Complications , Female , Humans , Pregnancy , Child, Preschool , Child , Ventricular Remodeling , Pregnancy Complications/prevention & control , Life Style , Obesity/complications , Obesity/therapy
15.
Public Health Res Pract ; 32(3)2022 Oct 12.
Article in English | MEDLINE | ID: mdl-36220558

ABSTRACT

Pregnancy is a high-risk period for excess gestational weight gain and subsequent obesity development. Antenatal lifestyle interventions are prioritised to optimise weight, with current evidence demonstrating efficacy and associated reduction in risk of adverse maternal and neonatal outcomes. Yet, evidence to guide the field from efficacy-based to implementation research within real-world settings is lacking, and several key challenges remain. Here, we discuss key considerations to support the implementation of accessible, relevant, effective, and low-cost lifestyle interventions in routine pregnancy care. This includes identifying what components of lifestyle interventions are most effective, with pragmatic guidance on how to conduct implementation research, improving rigour in reporting to ensure learnings from implementation are captured, and recognising and addressing the socioecological aspects of obesity prevention, including supporting women living with socioeconomic disadvantage and reducing weight stigma.


Subject(s)
Obesity, Maternal , Pregnancy Complications , Female , Humans , Infant, Newborn , Obesity/prevention & control , Pregnancy , Pregnancy Complications/prevention & control , Prenatal Care , Weight Gain
16.
JAMA Netw Open ; 5(10): e2234870, 2022 10 03.
Article in English | MEDLINE | ID: mdl-36197663

ABSTRACT

Importance: Lifestyle interventions in pregnancy optimize gestational weight gain and improve pregnancy outcomes, with implementation recommended by the US Preventive Services Task Force. Yet, implementation research taking these efficacy trials into pragmatic translation remains limited. Objective: To evaluate success factors for implementing pregnancy lifestyle interventions into antenatal care settings in a meta-analysis, using the penetration, implementation, participation, and effectiveness (PIPE) impact metric. Data Sources: Data from a previous systematic review that searched across 9 databases, including MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database, were obtained, in 2 stages, up to May 6, 2020. Study Selection: Randomized clinical trials reporting gestational weight gain in singleton pregnancies. Data Extraction and Synthesis: The association of penetration, implementation, and participation with effectiveness of antenatal lifestyle interventions in optimizing gestational weight gain was estimated using random-effects meta-analyses. The Cochrane risk of bias tool, version 1.0, was used to assess risk of bias. Main Outcomes and Measures: Penetration (reach), implementation (fidelity), participation, and effectiveness of randomized clinical trials of lifestyle interventions in pregnancy. Results: Ninety-nine studies with 34 546 participants were included. Only 14 studies reported penetration of target populations. Overall, 38 studies (38.4%) had moderate fidelity, 25 (25.2%) had high fidelity, and 36 (36.4%) had unclear fidelity. Participation was reported in 84 studies (84.8%). Lifestyle interventions were associated with reducing gestational weight gain by 1.15 kg (95% CI, -1.40 to -0.91 kg). Conclusions and Relevance: The findings of this systematic review and meta-analysis suggest that, despite the large body of evidence on efficacy of lifestyle interventions during pregnancy in optimizing gestational weight gain, little guidance is available to inform implementation of this evidence into practice. There is a need to better elucidate implementation outcomes in trial design alongside pragmatic implementation research to improve the health of women who are pregnant and the next generation.


Subject(s)
Gestational Weight Gain , Pregnancy Complications , Female , Humans , Life Style , Pregnancy , Pregnancy Complications/prevention & control , Pregnancy Outcome , Systematic Reviews as Topic
17.
Harefuah ; 161(9): 567-571, 2022 Sep.
Article in Hebrew | MEDLINE | ID: mdl-36168160

ABSTRACT

INTRODUCTION: Pregnant women have been told that gaining weight during pregnancy is important for maternal and perinatal health outcomes. However, today it is known that excessive weight gain during pregnancy is associated with adverse health outcomes. This article presents the connection between gestational weight gain and long-term postpartum weight retention as well as relevant epidemiology, predictors for postpartum weight retention and implications of its occurrence. In addition, in this review we raise possible prevention and intervention strategies for preventing weight retention following delivery. Maintaining proper weight gain after delivery, supported by appropriate prevention and intervention for postpartum weight retention, such as counseling regarding a healthy diet and physical activity, social support for postpartum women and social awareness for this important issue can aid in reducing the possible complications of future weight retention.


Subject(s)
Gestational Weight Gain , Pregnancy Complications , Body Mass Index , Exercise , Female , Humans , Postpartum Period , Pregnancy , Pregnancy Complications/etiology , Pregnancy Complications/prevention & control , Weight Gain
18.
Clin Obstet Gynecol ; 65(4): 868-876, 2022 12 01.
Article in English | MEDLINE | ID: mdl-36162090

ABSTRACT

Increasing hospital and labor & delivery (L&D) closures have led to declining access to hospital obstetric care in rural areas across the country. These closures increase the burden on women and families living in rural communities, who often must drive long distances for prenatal visits and delivery. The lack of maternal health care in rural America can also result in several adverse maternal and infant outcomes including premature birth, low birth weight, out of hospital births, maternal and infant morbidity and mortality, and increased risk of postpartum depression. The reasons for these closures are multifactorial, and include, workforce shortages, financial viability, low volume of patients, concerns over maintaining the knowledge base and skill sets of the obstetrical health care team required to provide high quality and safe care, as well as medical-legal concerns. The problems of providing and accessing quality maternal and obstetrical care in rural America have not happened overnight, Likewise, the solutions to these problems will also not occur overnight and must also address the multifactorial nature of the problem. However, there are several opportunities to improve access to maternal health care in rural communities. Programs, policies, and funding need to be designed and provided to make these opportunities a reality.


Subject(s)
Maternal Health Services , Pregnancy Complications , Pregnancy , Infant , Humans , Female , Rural Population , Maternal Health , Prenatal Care , Pregnancy Complications/prevention & control , Maternal Mortality
19.
PLoS One ; 17(9): e0274471, 2022.
Article in English | MEDLINE | ID: mdl-36137127

ABSTRACT

BACKGROUND: The female body changes during pregnancy to create a favorable environment for fetal development which may result in musculoskeletal disorder and painful symptoms in the lumbopelvic region. OBJECTIVE: To analyze the evidence of therapeutic exercise versus other modalities to prevent and treat LBP, LGP, and LPP during pregnancy. METHODS: Full text randomized controlled trials (RCT) evaluating interventions to prevent or treat LBP, PGP, and LPP during pregnancy (any gestational age) that comparing therapeutic exercises with usual care or other modalities to reduce the incidence or severity of LBP or PGP or both during pregnancy will be included. 5 electronic databases will be searched to identify studies. Assess risk of bias in each study using the Cochrane Handbook for Systematic Reviews of Interventions and quality of overall body of evidence for all primary outcomes will be assessed for all comparisons using the approach outlined in GRADE Handbook.


Subject(s)
Low Back Pain , Pelvic Girdle Pain , Pregnancy Complications , Exercise Therapy/methods , Female , Humans , Low Back Pain/epidemiology , Low Back Pain/prevention & control , Pelvic Girdle Pain/prevention & control , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/prevention & control , Review Literature as Topic , Systematic Reviews as Topic
20.
Front Immunol ; 13: 966522, 2022.
Article in English | MEDLINE | ID: mdl-36091061

ABSTRACT

Prenatal stress can affect pregnant women in an epigenetic way during the critical period of conception of their offspring. The study aims to investigate the relationship between peritraumatic distress, prenatal perceived stress, depression, and glucocorticoid receptor (NR3C1) DNA methylation among pregnant women who experienced COVID-19 lockdown in China. Study data were collected from 30 pregnant women in Wuhan and Huanggang, China. The Peritraumatic Distress Inventory was used to measure peritraumatic distress, the Edinburgh Postnatal Depression Scale was used to measure depressive symptoms, and the Perceived Stress Scale was used to measure perceived stress. DNA methylation in the exon 1F promoter region of NR3C1 gene from the venous blood mononuclear cell genome was characterized by bisulfite sequencing. Correlation and linear regression were used for data analysis. The mean level of peritraumatic distress, perceived stress, and depression was 6.30 (SD = 5.09), 6.50 (SD = 5.41), and 6.60 (SD = 4.85), respectively, with 23.33% of pregnant women being depressed. The mean NR3C1 methylation was 0.65 (SD = 0.22). Prenatal depression was positively correlated with the degree of methylation in venous blood from the mother (r = 0.59, p = 0.001), and depression predicted methylation of NR3C1 gene at the CpG 8 site (ß = 0.05, p = 0.03). No association was found between peritraumatic distress as well as perceived stress and methylation of NR3C1. NR3C1 gene was susceptible to epigenetic modification of DNA methylation in the context of prenatal stress, and maternal depression was associated with increased NR3C1 methylation among women who experienced COVID-19 lockdown.


Subject(s)
COVID-19 , Depression , Pregnancy Complications , Quarantine , Receptors, Glucocorticoid , Stress Disorders, Traumatic , COVID-19/epidemiology , COVID-19/genetics , COVID-19/prevention & control , COVID-19/psychology , China/epidemiology , Communicable Disease Control/methods , DNA Methylation/genetics , Depression/epidemiology , Depression/genetics , Depression/psychology , Female , Humans , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/genetics , Pregnancy Complications/prevention & control , Pregnancy Complications/psychology , Pregnant Women , Quarantine/methods , Quarantine/psychology , Receptors, Glucocorticoid/genetics , Stress Disorders, Traumatic/epidemiology , Stress Disorders, Traumatic/genetics , Stress Disorders, Traumatic/psychology , Stress, Psychological/epidemiology , Stress, Psychological/genetics , Stress, Psychological/psychology
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