Laboratory abnormalities and obesity may be associated with perinatal outcomes in patients with pre-eclampsia. Analysis of these factors may guide damage prevention strategies.
To associate ...laboratory variables and maternal body mass index (BMI) with childbirth outcome before 34 and 37 weeks and perinatal outcomes in cases of pre-eclampsia.
Cohort study. Location: Guilherme Álvaro Hospital, Santos/Brazil; (May/2017–April/ 2018). Inclusion: women with pre-eclampsia (NHBPEP; 2000) and preterm delivery. Group 1: delivery < 34 weeks. Group 2: childbirth < 37 weeks. Measured at admission: uric acid (> 6 mg/dl), liver enzymes (AST> 34 U/I and ALT> 35 U/I), obesity (BMI> 30), neonatal ICU admission. Statistical analysis: Fisher’s exact test (significance p < 0.05). The work has ethical approval.
Sample size: 90 patients. Group 1: AST elevation in 53.3% of the pacients (p = 0.001); ALT elevation in 46.7% (p = 0.001), uric acid elevation in 28.6% (p = 0.068) and 12.5% were obese (p = 0.044). Group 2: AST elevation in 30.2% of the pacients (p = 0.001); ALT elevation in 23.3% (p = 0.004); uric acid elevation in 20% (p = 0.085) and 24.4% were obese (p = 0.047). Of the total sample, 45.6% of newborns were admitted to the neonatal ICU.
In Group 1, with more severe prematurity, hepatic damage and elevated uricemia were more frequent. In Group 2, obesity was more prevalent, corroborating with the literature (Chaemsaithong P, 2018). The neonatal ICU admission of the total sample was significantly elevated. This behavior of the indirectly recognized target organ damage and lipotoxicity, associated with the severity of prematurity, may represent indicators regarding the higher expression of preeclampsia causing preterm delivery, the need to guide prophylaxis strategies and eventually prognostic counseling. Enlarging the sample may add information.
Lipotoxicity is a consequence from low grade inflammation caused by obesity. Women presenting body mass index (BMI) above 35 kg/mb have four times higher risk of preeclampsia development (Bianco, ...1998).
To characterize the association of BMI and maternal and perinatal variables between puerperas with and withoutpreeclampsia.
transversal study, Hospital Guilherme Álvaro-Santos/Brazil, (January/2015-March/2016). Antropometric data was collected from 160 women (immediate postpartum), 75 patients without preeclampsia (control group) and 85 with preeclampsia (case group). Variables: blood pressure (hospital admission), gestational age at childbirth and immediate perinatal outcome.
Average mother age and BMI were 25 years and 26 kg/mb for the control group, in the group case: 29 years and 35 kg/mb. Patients with pre-eclampsia showed higher blood pressure: medium level of 136 mmHg (sistolyc) and 85 mmHg (diastolic). 84% of the deliveries in the case group were cesarean sections and the majority of these women had gestation resolution above 37 weeks. Newborns out of pre-eclampsia mothers weighed among 2685 g and five-minute Apgar score was 8,7. Those neonates presented higher admission rates in a ICU (36.5%) and 12% were small for gestational age. Cesarean in 84% of births in the case group and 40% case of births occurred in prematurity. Newborns of mothers with preeclampsia weighed on average 2685 g, average 5’ Apgar score of 8,7, higher rates of admission to ICU (36.5%) and 12% were small for gestational age.
Was observed in women with preeclampsia higher average BMI and blood pressure values and their newborns showed smaller weight and 5’ Apgar score, need frequent admission to ICU and prematurity. Reproductive counseling appears to be relevant to the obese women to warn about potential complications, it’s important to adopt strategies for assistance to this population to qualify the attendance, particularly in actions preventive and possible reduction in the rate of cesarean section that could magnify risks.
The severity of the clinical expression of preeclampsia determines maternal-fetal repercussions. Recognize indicators of severity may guide the adoption of behaviors in a timely manner.
To relate ...maternal characteristics and perinatal outcomes in patients with severe preeclampsia and without signs of severity.
Cross-sectional study. Location: Hospital Guilherme Álvaro-Santos/Brazil, January/2015-May/2016. Patients with preeclampsia (NHBPEP/2000) were divided into two groups: no signs of severity (control) and severe (study). Maternal variables: age, body mass index (BMI), parity, prenatal care, gestational age at birth, serum creatinine, aspartate aminotransferase (AST) and alanine (ALT); and neonatal: weight and admission to the Intensive Care Unit (ICU). Statistical analysis: Fisher’s exact test (p significant <0.05).
The preeclampsia group presented more commonly than women without signs of severity: age ⩾40 years (6%), obesity (56.5%) and nulliparity (38%) against 0%, 61.5%, 6.7%, respectively. Absence of prenatal care 24% against 6.7%. The childbirth occurred between 29–346/7weeks in 36% in the group with severe preeclampsia, whereas in the preeclampsia without signs of severity: 6.7%. Average weight of newborns of 3205 g and 02 (13.3%) ICU admissions, against 2528 g and 21 (42.9%). The average creatinine level was similar; AST and ALT was 18.67 and 12.53 in the control group compared to 22.63 and 15.65.
Similar rates of severe preeclampsia were found in the literature. (Batista, 2009). The severe expression of preeclampsia was associated with women in the extremes of age, with previous gestation, obesity and with worse perinatal performance. Noting that these women lack counseling and qualified care. Inadequate follow-up of prenatal care may be explained by the greater number of hospital admissions in severity. It is proposed a reflection on strategies to increase vaginal parturition in this group. The variations of AST-ALT indicate hepatic involvement anterior to the renal, which will be clearer with the continuation of the study.
Currently, two factors are considered important in the pathophysiology of preeclampsia: lipid peroxidation and exacerbated inflammatory response. The reduction in the clinical expression of ...preeclampsia 12 weeks postpartum motivates the search to recognize the behavior of lipoprotein and inflammatory substrates.
Evaluate the influence of lipoprotein and inflammatory markers in women with preeclampsia during the mediate and late postpartum.
Cohort study developed at the Guilherme Álvaro Hospital- Santos/Brazil. Were collected blood samples of 107 patients (48 case group and 59 control group) from January/2015 to May/2016 in the mediate postpartum. After that, the same women returned to the second sample, 12 weeks postpartum. It was a total of 31 patients (17 case group and 14 control group). Lipoprotein substrates and selected inflammatory possibly related to preeclampsia were analyzed. Group case: women with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: patients after vaginal delivery with term newborn without hypertension and/or other comorbidities. Exclusion criteria: collagen disease, smoking, twin pregnancy, previous diagnosis of diabetes mellitus and fetal malformations. Variables analyzed: total cholesterol, LDL (low-density lipoprotein) fraction, triglycerides, fasting glucose, insulin, HOMA-IR, C-reactive protein (CRP), total protein, albumin, globulin, uric acid, glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), gamma-glutamyl transferase (GGT). For the descriptive measures of each variable of interest we calculate in the two evaluations. Then to study the behavior of the variables of interest in the chosen group, in the two assessments, we used the model of multivariate analysis and repeated measures.
Comparison of possible lipoprotein and inflammatory markers results (∗p<0.05)
We considered p, as the variables that have changed uniformly between the groups comparing the mediate and the late puerperium.
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The glycidic and inflammation effectors such as blood glucose, insulin, HOMA -IR, C-reactive protein and uric acid showed uniform and significant changes between the groups comparing mediate and late postpartum. Lipoproteins indicated an upward trend in women with preeclampsia, while total protein, albumin and globulin fractions seem to be reduced in this group. Comparing the mediate and late postpartum period we identified a significant difference between the serum levels of lipotoxicity and inflammatory markers.
Introduction Currently, two factors are considered important in the pathophysiology of preeclampsia: lipid peroxidation and exacerbated inflammatory response. The reduction in the clinical expression ...of preeclampsia 12 weeks postpartum motivates the search to recognize the behavior of lipoprotein and inflammatory substrates. Objective Evaluate the influence of lipoprotein and inflammatory markers in women with preeclampsia during the mediate and late postpartum. Methods Cohort study developed at the Guilherme Álvaro Hospital- Santos/Brazil. Were collected blood samples of 107 patients (48 case group and 59 control group) from January/2015 to May/2016 in the mediate postpartum. After that, the same women returned to the second sample, 12 weeks postpartum. It was a total of 31 patients (17 case group and 14 control group). Lipoprotein substrates and selected inflammatory possibly related to preeclampsia were analyzed. Group case: women with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: patients after vaginal delivery with term newborn without hypertension and/or other comorbidities. Exclusion criteria: collagen disease, smoking, twin pregnancy, previous diagnosis of diabetes mellitus and fetal malformations. Variables analyzed: total cholesterol, LDL (low-density lipoprotein) fraction, triglycerides, fasting glucose, insulin, HOMA-IR, C-reactive protein (CRP), total protein, albumin, globulin, uric acid, glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), gamma-glutamyl transferase (GGT). For the descriptive measures of each variable of interest we calculate in the two evaluations. Then to study the behavior of the variables of interest in the chosen group, in the two assessments, we used the model of multivariate analysis and repeated measures. Results Comparison of possible lipoprotein and inflammatory markers results (∗ p < 0.05) We considered p , as the variables that have changed uniformly between the groups comparing the mediate and the late puerperium. Conclusion The glycidic and inflammation effectors such as blood glucose, insulin, HOMA -IR, C-reactive protein and uric acid showed uniform and significant changes between the groups comparing mediate and late postpartum. Lipoproteins indicated an upward trend in women with preeclampsia, while total protein, albumin and globulin fractions seem to be reduced in this group. Comparing the mediate and late postpartum period we identified a significant difference between the serum levels of lipotoxicity and inflammatory markers.
The WHO recommends calcium supplementation in pregnant with low calcium intake as part of the care for the prevention of preeclampsia.
Investigate the intake and calcium supplementation in pregnant.
...The study was performed involving pregnant women seen for their prenatal care at the Guilherme Alvaro Hospital, Santos, Brazil. Calcium intake was estimated through Food Frequency Questionnaire (FFQ) proposed by Fisberg et al. (2005) adapted. The Body Mass Index (BMI), calculated as kg/m2, was classified according Atalah et al. (1997). Data were compared using Mann–Whitney U or Kruskal–Wallis test (post hoc Dunn), p< 0.05 was considered significant. Spearman correlations were used to measure associations among variables.
We studied 72 pregnant, mean±standard deviation age of 30,7±6,8years, gestational age of 26,5±8,2 and BMI=32,7±6,9kg/m2 that characterizes 47,3% the sample as obesity pattern and 29,1% as overweight. Mean daily calcium intake from food records was low (723,4±372,5mg/day), 84,7% had lower average consumption that the WHO recommendation. The relationship between BMI classification and calcium intake mean not differed. It was found that milk was the most common (72,7%) among pregnant women with adequate dietary calcium intake (15,3%; 1353,4±119,5mg/day). Calcium supplementation with or without vitamin D was reported by 9,7% (n=7).The calcium intake from the group calcium supplementation (1000mg elemental calcium/day) said use was higher (median 1691,4mg/day; p<0,001) than the not used supplement (626,2mg/day) and not exceed UL.
Calcium supplementation was needed to the adequacy of calcium intake in this group of pregnant women, it is could contributes with reduced preeclampsia development.
This project is part of a line of research aimed at identifying possible laboratory and anthropometric markers in the mediate postpartum period, compared to healthy women. It observes the behavior of ...these effectors in the maternal organism, collaborating with the prediction and prevention of preeclampsia.
Identify in the mediate postpartum period, lipotoxicity markers and anthropometric profile in postpartum women with preeclampsia compared with control group.
Cross-sectional study developed at the Guilherme Álvaro Hospital – Santos/Brazil. It was collected blood samples and anthropometric data of 132 women (56 cases and 76 controls) in the mediate postpartum during January 2015 to May 2016. Laboratory markers were analyzed to possibly associate with preeclampsia. Case group: patients with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: women after vaginal delivery with term newborn, without hypertension and/or other comorbidities. Variables analyzed: maternal age, gestational age, body mass index (BMI), neck, arm and abdominal circumferences and newborn weight. Laboratory variables: total cholesterol and High Density Lipoprotein (HDL) fraction, triglycerides, serum creatinine, uric acid, alanine aminotransferase (ALT), total protein, albumin, C-reactive protein (CRP), fasting glucose and HOMA-IR index. Exclusion criteria for both groups: previously diagnosed diabetes mellitus, collagen diseases, smoking, twin pregnancy and fetal malformations. For the numerical variables of the research it was used the Student’s t test and for the statistical analysis the Fisher’s exact test. The significance level was p<0.05.
The results allow us to affirm that the groups differ from each other in the variables: maternal age, gestational age, newborn weight, BMI, abdominal, arm and neck circumferences, albumin, CRP, ALT, uric acid, glucose, and HOMA-IR.
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The present study shows that women with preeclampsia have higher body mass index, larger body circumferences, they are older and have an increased insulin resistance than normal ones. Analyzing the study group individually, we can observe that those patients have premature babies and lower birth weight more often. It is also notice increased levels in the study group compared to the control group in non-specific inflammatory (CRP), hepatic (ALT) and renal (uric acid) markers. Albumin was higher in the control group.
Introduction The WHO recommends calcium supplementation in pregnant with low calcium intake as part of the care for the prevention of preeclampsia. Objective Investigate the intake and calcium ...supplementation in pregnant. Methods The study was performed involving pregnant women seen for their prenatal care at the Guilherme Alvaro Hospital, Santos, Brazil. Calcium intake was estimated through Food Frequency Questionnaire (FFQ) proposed by Fisberg et al. (2005) adapted. The Body Mass Index (BMI), calculated as kg/m2 , was classified according Atalah et al. (1997). Data were compared using Mann–Whitney U or Kruskal–Wallis test (post hoc Dunn), p < 0.05 was considered significant. Spearman correlations were used to measure associations among variables. Results We studied 72 pregnant, mean ± standard deviation age of 30,7 ± 6,8 years, gestational age of 26,5 ± 8,2 and BMI = 32,7 ± 6,9kg/m2 that characterizes 47,3% the sample as obesity pattern and 29,1% as overweight. Mean daily calcium intake from food records was low (723,4 ± 372,5 mg/day), 84,7% had lower average consumption that the WHO recommendation. The relationship between BMI classification and calcium intake mean not differed. It was found that milk was the most common (72,7%) among pregnant women with adequate dietary calcium intake (15,3%; 1353,4 ± 119,5 mg/day). Calcium supplementation with or without vitamin D was reported by 9,7% ( n = 7).The calcium intake from the group calcium supplementation (1000 mg elemental calcium/day) said use was higher (median 1691,4 mg/day; p < 0,001) than the not used supplement (626,2 mg/day) and not exceed UL. Conclusion Calcium supplementation was needed to the adequacy of calcium intake in this group of pregnant women, it is could contributes with reduced preeclampsia development.
Introduction This project is part of a line of research aimed at identifying possible laboratory and anthropometric markers in the mediate postpartum period, compared to healthy women. It observes ...the behavior of these effectors in the maternal organism, collaborating with the prediction and prevention of preeclampsia. Objective Identify in the mediate postpartum period, lipotoxicity markers and anthropometric profile in postpartum women with preeclampsia compared with control group. Methods Cross-sectional study developed at the Guilherme Álvaro Hospital – Santos/Brazil. It was collected blood samples and anthropometric data of 132 women (56 cases and 76 controls) in the mediate postpartum during January 2015 to May 2016. Laboratory markers were analyzed to possibly associate with preeclampsia. Case group: patients with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: women after vaginal delivery with term newborn, without hypertension and/or other comorbidities. Variables analyzed: maternal age, gestational age, body mass index (BMI), neck, arm and abdominal circumferences and newborn weight. Laboratory variables: total cholesterol and High Density Lipoprotein (HDL) fraction, triglycerides, serum creatinine, uric acid, alanine aminotransferase (ALT), total protein, albumin, C-reactive protein (CRP), fasting glucose and HOMA-IR index. Exclusion criteria for both groups: previously diagnosed diabetes mellitus, collagen diseases, smoking, twin pregnancy and fetal malformations. For the numerical variables of the research it was used the Student’s t test and for the statistical analysis the Fisher’s exact test. The significance level was p < 0.05. Results The results allow us to affirm that the groups differ from each other in the variables: maternal age, gestational age, newborn weight, BMI, abdominal, arm and neck circumferences, albumin, CRP, ALT, uric acid, glucose, and HOMA-IR. Conclusion The present study shows that women with preeclampsia have higher body mass index, larger body circumferences, they are older and have an increased insulin resistance than normal ones. Analyzing the study group individually, we can observe that those patients have premature babies and lower birth weight more often. It is also notice increased levels in the study group compared to the control group in non-specific inflammatory (CRP), hepatic (ALT) and renal (uric acid) markers. Albumin was higher in the control group.
