Does the COVID-19 Pandemic Affect Labor-Related Anxiety and Prevalence of Depressive Symptoms in Pregnant Women?

The COVID-19 pandemic undoubtedly had significant effects on women's health and the course of pregnancy. The aim of this single-center study was to explore the impact of the COVID-19 pandemic on adult pregnant and postpartum women's mental health, as well as to identify factors associated with depressive symptoms, anxiety and fear of delivery. The 465 women included in this questionnaire-based cohort study were divided into two groups: one (controls) of women who gave birth before (n = 190), and the second who were pregnant and delivered during the pandemic (n = 275). The COVID-19 pandemic affected the severity of self-reported anxiety regarding childbirth (mean scores 2.7 vs. 2.36, p = 0.01). The depression (19.84 ± 13.23) and anxiety (16.71 ± 12.53) scores were higher in pregnant women during the COVID 19 pandemic, compared to women who gave birth before the pandemic (8.21 ± 7.38 and 11.67 ± 9.23, respectively). These findings demonstrate the magnitude of the pandemic's impact on women's mental health, and actions to improve the mental health of pregnant women in Poland may be crucial for maternal and fetal well-being.

Effect of Dietary Macronutrients on Postprandial Glucagon and Insulin Release in Obese and Normal-Weight Women.

The aim of the study was to assess the effect of dietary macronutrients on circulating glucagon and insulin levels in obese and normal-weight women. Potentially, the impaired release of glucagon may proceed abnormal glucose metabolism in obese patients ahead of overt diabetes. In 20 insulin-sensitive women (11 obese and 9 normal-weight), plasma concentrations of insulin and glucagon levels were assessed before and after 3 different macronutrient test meals. AUCtotal insulin in the obese group was increased after protein and carbohydrates compared to fatty test meal consumption (3981 ± 2171 and 4869 ± 2784 vs. 2349 ± 1004 µIU∗h/m, p < 0.05, respectively), but without a difference between protein and carbohydrates ingestion. However, in the normal-weight group, AUCtotal insulin was increased after carbohydrates compared to fatty test meal ingestion (3929 ± 1719 vs. 2231 ± 509 µIU∗h/ml, p < 0.05) and similar after carbohydrate and protein as well as after fatty and protein test meals (3929 ± 1719 vs. 2231 ± 509 vs. 3046 ± 1406 µIU∗h/ml, respectively). However, AUCtotal insulin was significantly increased in obese compared to normal-weight women only after carbohydrate test meal ingestion (4869 ± 2784 vs. 3929 ± 1719 µIU∗h/ml, p < 0.05). AUCtotal glucagon was similar after carbohydrate, protein, and fatty test meals ingestion in obese and normal-weight women (921 ± 356 vs. 957 ± 368 vs. 926 ± 262 ng∗h/ml and 1196 ± 14 vs. 1360 ± 662 vs. 1792 ± 1176 ng∗h/ml, respectively). AUCtotal glucagon was significantly lower in obese than normal-weight women after a fatty meal (926 ± 262 vs. 1792 ± 1176 ng∗h/ml, p < 0.01). Postprandial glucagon secretion is not related to the macronutrient composition of the meal in normal-weight women since postprandial glucagon concentrations were stable and did not change after carbohydrate, protein, and fatty test meals. Lower glucagon secretion was observed in obese subjects after fatty meal consumption when compared to normal-weight subjects. Postprandial insulin profile was significantly higher after carbohydrate than fatty test meal intake in the obese group and did not differ between obese and normal-weight groups after carbohydrate, protein, and fatty test meals consumption. Impaired glucagon secretion after fatty meat suggests early pancreatic alpha-cell dysfunction, after a carbohydrate meal is a compensatory mechanism.

The levels of adipokines in relation to hormonal changes during the menstrual cycle in young, normal-weight women.

CONTEXT: The aim of this study was to assess the plasma leptin, adiponectin, resistin, visfatin/NAMPT, omentin-1, vaspin, apelin, TNF-α, IL-6 and RBP4 levels in relation to hormonal changes during the menstrual cycle in young, healthy, normal-weight women. METHODS: The study involved 52 young, healthy, normal-weight women. Anthropometric parameters, body composition and levels of plasma leptin, adiponectin, resistin, visfatin/NAMPT, omentin-1, vaspin, apelin, TNF-α, IL-6 and RBP4 in addition to serum FSH, LH, estradiol, progesterone, 17-OH progesterone, androgens, SHBG and insulin concentrations were measured during a morning in fasting state three times: between days 2-4, days 12-14 and days 24-26 of the menstrual cycle. RESULTS: Plasma adiponectin, omentin-1, resistin and visfatin/NAMPT, apelin, TNF-α, IL-6 and RBP4 concentrations were stable during the menstrual cycle, while leptin and vaspin levels were significantly higher in both the midcycle and the luteal phases than those in the follicular phase. Multivariate regression analyses revealed that changes in leptin and vaspin levels between the follicular and the luteal phase are strongly related to changes in total testosterone levels. CONCLUSIONS: Our results revealed stable levels of adipokines during the phases of the physiological menstrual cycle, except for leptin and vaspin, which showed increased levels in both the midcycle and the luteal phases. This effect was significantly associated with changes in the secretion of testosterone, 17-OH progesterone and insulin in the luteal phase.

Effect of dietary macronutrients on postprandial incretin hormone release and satiety in obese and normal-weight women.

The aim of the present study was to assess the effect of dietary macronutrients on postprandial incretin responses and satiety and hunger sensation in obese and normal-weight women. A total of eleven obese and nine normal-weight women were recruited for the assessment of plasma concentrations of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and insulin and the sensation of satiety and hunger using a visual analogue scale before and during a 6 h period after administration of three different macronutrient test meals. The AUCtotal GLP-1 and AUCtotal GIP values were decreased in obese women after the consumption of a fatty meal and all the test meals, respectively. However, the AUCtotal insulin value after a carbohydrate meal was greater in the obese group. The AUCtotal satiety value was decreased only after the intake of the protein meal in obese women when compared with normal-weight women. After the consumption of the fatty meal, a significant positive correlation between maximum satiety sensation and the AUCtotal GLP-1 value in the obese group and that between minimum hunger sensation and the AUCtotal GLP-1 value in the normal-weight group were observed. In conclusion, the findings of the present study suggest that: (1) satiety sensation after consumption of carbohydrate and protein meals in the obese group is related to the postprandial insulin response, while after consumption of a fatty meal, it is related to the postprandial GLP-1 release; (2) the postprandial GIP response does not influence the sensation of satiety and hunger; (3) the reduced GLP-1 release after the intake of a fatty meal in obese individuals may explain impaired satiety sensation; (4) the impaired postprandial GIP response is not related to the consumption of macronutrients and may be the early indicator of incretin axis dysfunction in obese women.

[Pregnancy in a woman with chronic renal failure--the case of two successfully completed pregnancies and the review of the literature]. / Ciaza u chorej z przewlekla niewydolnoscia nerek--opis przebiegu dwóch ciaz zakonczonych powodzeniem i przeglad pismiennictwa.

Together with the prolongation and improving the quality of life of young women with chronic renal failure (CRF), procreation becomes an important issue. Pregnancies in women on renal replacement therapy are associated with an increased risk of health complications, both for mothers and for fetuses. Medical management of pregnant women with CRF is a great challenge and requires a close co-operation of nephrologists, transplantologists, gynecologists and neonatologists. The complexity of problems in these particular pregnancies has urged us to describe the case of a woman with CRF who successfully delivered two babies. We also review the current state of knowledge on the topic. The first pregnancy five years after renal transplantation, was completed with the delivery of term newborn with Tetralogy of Fallot. Also the second pregnancy on hemodialysis therapy was finished by the birth of a healthy neonate at term. The described case indicates that the gynecologists should be prepared for the challenge of the care for pregnancies in women suffering from chronic renal failure on renal replacement therapy.

[Anti-Müllerian hormone and fertility disturbances in obese women and women with polycystic ovary syndrome]. / Hormon anty-Müllerowski a zaburzenia plodnosci u otylych kobiet i kobiet z zespolem policystycznych jajników.

Anti-Müllerian hormone (AMH) belongs to a family of growth and differentiation factors beta (TGF-beta). In male fetuses AMH induces regression of Müller's ducts whereas in female ones this hormone plays an important role during adolescence and reproductive period. AMH participates in regulation of folliculogenesis by inhibiting the recruitment of prenatal and antral follicles. The aim of the present study was to summarize the current knowledge of the role of AMH in menstrual and fertility disturbances in obese women and those with polycystic ovary syndrome.

Are plasma ghrelin and PYY concentrations associated with obesity-related depression?

INTRODUCTION: Recent experimental studies have revealed that increased ghrelin levels protect against depressive symptoms of chronic stress in rats. Moreover it was shown that neuropeptide Y (NPY) has an anxiolytic-like effect mediated through both Y1 and Y5 receptors. On the other hand, peptide YY inhibits, while ghrelin stimulates, the release of NPY. The aim of this study was to assess the association between plasma concentrations of ghrelin and PYY and the level of depression in obese women. MATERIAL AND METHODS: In forty-five obese women (55 +/- 7 years old) without concomitant diseases, body composition was estimated by bioimpedance method, in addition to anthropometric measurements. Beck's Depression Inventory (BDI) was used for the evaluation of depression levels. Plasma concentrations of ghrelin and PYY were measured in collected blood samples. RESULTS: 23 (55.1%) women had severe (22.0 +/- 5.2 pts) and 10 (22.2%) had mild (12.1 +/- 1.9 pts) levels of depression. Obese women with concomitant depression were of similar age and had comparable body mass, BMI, and body composition as those without depression. In addition, there were no differences in plasma ghrelin and PYY levels between the study subgroups. No correlation between BDI and plasma concentrations of ghrelin or PYY was found. CONCLUSIONS: Depression in obese women does not seem to be related to the plasma levels of ghrelin and PYY.

Is chronic inflammation a possible cause of obesity-related depression?

Adult obesity has been associated with depression, especially in women. Whether depression leads to obesity or obesity causes depression is unclear. Chronic inflammation is observed in obesity and depression. In 63 obese women without additional diseases depression level was assessed with the Beck's questionnaire. After evaluation of depression level study group was divided into groups according to the mood status (A--without depression, B-mild depression, and C--severe depression), and serum concentration of TNF-alpha, sTNFs, leptin, and IL-6 were measured by ELISA. No differences in age, body mass, BMI, and body composition were observed in study groups. We did not observe differences of serum concentrations of TNF-alpha, sTNFRs, leptin, and IL-6 between subgroup A and subgroups B and C. It seems that circulating adipokines did not exert influence on depression levels in obese women.

Depression in obese persons before starting complex group weight-reduction programme.

BACKGROUND: The aim of the present study was to assess the prevalence of depression in subjects before starting a weight-reduction programme. METHODS: The study group involved 173 obese subjects aged 47.0 +/- 16.5 years, body mass index (BMI) 36.1 +/- 6.3, weight 96.2 +/- 18.3 kg. The body weight and height were measured and BMI was calculated. Beck's Depression Inventory (BDI) was used for the evaluation of depressive symptoms. RESULTS: Severe depression was diagnosed in 84 subjects (mean BMI 37.5 +/- 6.3, mean weight 98.1 +/- 17.6 kg, age 48.7 +/- 16.0, 22.2 +/- 1.6 points), mild depression was diagnosed in 65 subjects (mean BMI 34.7 +/- 4.8, mean weight 95.3 +/- 18.1 kg, age 45.9 +/- 16.6; 10.8 +/- 2.0 points), and 24 subjects (mean BMI 35.0 +/- 8.7, mean weight 92.2 +/- 21.1 kg, age 44.0 +/- 17.5, 6.5 +/- 0.5 points) did not have depression. We observed differences in BMI between subjects without depression and severe depression (p < 0.05) and between mild and severe depression. We did not observe differences of age and body mass between these subgroups. Correlations between weight, BMI and BDI score were found in all subjects. CONCLUSION: Depression often accompanies obesity. The depression levels increased in morbidly obese persons in comparison to moderately obese patients.