22 research outputs found
The effect of preexisting medical comorbidities on the preeclamptic phenotype: a retrospective cohort study
No full textPublished online: 26 Oct 2021Objective:To compare the effect of comorbidities on the phenotype and outcomes of preeclampsia. Methods:A matched retrospective cohort study of women delivering at a tertiary maternity center following a diagnosis of preeclampsia. We collected data on signs and symptoms, biochemical markers, and maternal and perinatal outcomes. Results:We studied 474 women; 158 women with and 316 without comorbidities. Compared to women without comorbidities, women with comorbidities delivered earlier. They suffered fewer maternal but more neonatal complications. Conclusion:Women with comorbidities receive earlier intervention than women without comorbidities, which may lead to fewer maternal complications but worse neonatal outcomes.Michael S. Tanner, Deborah De Guingand, Maya Reddy, Saskia Rowson, Daniel L. Rolnik, Fabricio Da Silva Costa, Mary-Ann Davey, Ben W. Mol, Euan M. Wallace, and Kirsten R. Palme
Creatine metabolism in human pregnancy and the potential for oral creatine supplementation in pregnancy
No full textGlobally, 4 million neonatal deaths occur annually. Many occur as a result of an acute low oxygen event to the fetus during labour or birth (intrapartum asphyxia). Currently, no oral therapy can minimise the impact of these unpredictable events. Maternal creatine supplementation during pregnancy could support ongoing cellular energy production and safeguard fetal organs from harm due to low oxygen. Although pre-clinical laboratory science is strong, further questions need to be answered, before progressing to human clinical trials. This thesis details the identified gaps in our knowledge and the translational research work undertaken to inform future pregnancy clinical trials.</p
The effect of comorbidities on the sFLT-1:PlGF ratio in preeclampsia
No full textResearch indicates that soluble fms-like tyrosine kinase 1 (sFLT-1) and placental growth factor (PLGF) have diagnostic and prognostic significance for women with preeclampsia. However, sparse research has studied these biomarkers in women with preexisting comorbidities such as chronic hypertension, diabetes mellitus, systemic lupus erythematosus and chronic kidney disease. We undertook a prospective longitudinal cohort study to compare the sFLT-1: PlGF ratio between women with and without comorbidities who did and did not go on to develop preeclampsia. We found that women with comorbidities may develop preeclampsia with a milder elevation in sFLT-1: PlGF than do women without comorbidities. This has clinical and research implications.No Full Tex
Photoprotective potential of emulsions formulated with Buriti oil (Mauritia flexuosa) and Vitamin E against UV irradiation on human keratinocytes and fibroblasts cell lines
No full textConsidering the belief that natural lipids and edible substances are safer for topical applications and that carotenoids are able to protect cells against photooxidative damage, wea have investigated whether topical creams and lotions, produced with Buriti oil and commercial surfactants, can exert photoprotective effect of against UVA and UVB irradiation. Emulsions and plain Buriti oil were diluted in DMEM medium supplemented with 10% FBS. Cell treatment was divided in two stages, prior and after being exposed to 30 minutes of UVA plus UVB radiation or 60 minutes to UVA radiation. Emulsions prepared with ethoxylated fatty alcohols as surfactants and containing α-tocopherol caused phototoxic damage to the cells, especially when applied prior to UV exposure. Damage reported was due to prooxidant activity and phototoxic effect of the surfactant. Emulsions prepared with Sorbitan Monooleate and PEG-40 castor oil and containing panthenol as active ingredient, were able to reduce the damages caused by radiation when compared to non-treated cells. When the different cells lines used in the study were compared, keratinocytes showed an increase in cell viability higher than fibroblasts. The Buriti oil emulsions can be considered potential vehicles to transport antioxidants precursors and also be used as adjuvant in sun protection
Recurrence of bacterial vaginosis is significantly associated with posttreatment sexual activities and hormonal contraceptive use
No full textRisk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate:A Systematic Review and Meta-Analysis
No full textCreatine Monohydrate (CrM) is a dietary supplement routinely used as an ergogenic aid for sport and training, and as a potential therapeutic aid to augment different disease processes. Despite its increased use in recent years, studies reporting potential adverse outcomes of CrM have been mostly derived from male or mixed sex populations. A systematic search was conducted, which included female participants on CrM, where adverse outcomes were reported, with meta-analysis performed where appropriate. Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%). Twenty-nine studies monitored for adverse outcomes, with 951 participants. There were no deaths or serious adverse outcomes reported. There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI -0.34, 2.82)) to 1.37 kg post-intervention (95% CI -0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis. No statistically significant difference was reported in measures of renal or hepatic function. In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females. Nor does the use of creatine supplementation increase the risk of total adverse outcomes, weight gain or renal and hepatic complications in females. However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.</p
Early pregnancy vitamin d binding protein is independently associated with the development of gestational diabetes:A retrospective cohort study
No full textBackground: Vitamin D-binding protein (VDBP) has been implicated in several adverse pregnancy outcomes either directly or indirectly via influencing the concentrations of biologically active vitamin D metabolites. However, human studies exploring these metabolites in pregnancy remain sparse. Here, we examine whether VDBP and total, free, and bioavailable 25-hydroxyvitamin D (25(OH)D) metabolites in early pregnancy are associated with subsequent adverse pregnancy outcomes. Methods: We conducted a retrospective analysis of 304 pregnant women in early pregnancy (<20 weeks gestation). The demographic characteristics, anthropometric data, and total 25(OH)D were measured and plasma or serum samples were collected and bio-banked. Using these samples, we measured VDBP (polyclonal ELISA) and albumin (automated colorimetry), and calculated free and bioavailable 25(OH)D using validated formulae. Pregnancy outcomes were derived from scanned medical records. Regression models were used to analyse the relationships between vitamin D metabolites in early pregnancy and subsequent pregnancy outcomes (gestational diabetes mellitus (GDM), pre-eclampsia, preterm birth), with adjustment for predetermined clinically relevant maternal factors including age, body mass index (BMI), and ethnicity. Results: Lower VDBP concentrations were associated with higher glucose levels and a greater likelihood of developing GDM at 26–28 weeks gestation (odds ratio [OR] (95% CI) = 0.98 (0.97,0.99), p = 0.015). This finding remained significant after adjustment for maternal covariates including age, BMI, and ethnicity (β = −0.003, p = 0.03). Lower total, free and bioavailable 25(OH)D, but not VDBP, were associated with a shorter length of gestation, but only the relationship with total 25(OH)D remained significant after adjustment for the above maternal covariates (β = 0.02, p = 0.006). Conclusions: This is the first study to examine VDBP, and total, free and bioavailable 25(OH)D in relation to pregnancy outcomes in a well characterised multi-ethnic cohort of pregnant women. Our findings show that VDBP and total 25(OH)D are associated with GDM and length of gestation, respectively; however, further investigations using large-scale prospective studies are needed to confirm our findings.</p
Relationships between Total, Free and Bioavailable Vitamin D and Vitamin D Binding Protein in Early Pregnancy with Neonatal Outcomes: A Retrospective Cohort Study
No full textMaternal vitamin D deficiency has been associated with adverse neonatal outcomes, however, existing results are inconsistent. Current data focus on total 25-hydroxyvitamin D (25(OH)D) as the common measure of vitamin D status, while additional measures including vitamin D-binding protein (VDBP) and free and bioavailable metabolites have not been explored in relation to neonatal outcomes. We examined whether VDBP and total, free, and bioavailable vitamin D metabolites in early pregnancy are associated with subsequent neonatal outcomes. In this retrospective analysis of 304 women in early pregnancy (<20 weeks gestation), demographic and anthropometric data were collected and total 25(OH)D (chemiluminescent assay), VDBP (polyclonal enzyme-linked immunosorbent assay (ELISA)) and albumin (automated colorimetry) were measured in bio-banked samples. Free and bioavailable 25(OH)D were calculated using validated formulae. Neonatal outcomes were derived from a medical record database. Higher maternal total and free 25(OH)D concentrations were associated with higher neonatal birthweight (β = 5.05, p = 0.002 and β = 18.06, p = 0.02, respectively), including after adjustment for maternal covariates including age, body mass index (BMI) and ethnicity (all p ≤ 0.04). Higher total 25(OH)D and VDBP concentrations were associated with a lower likelihood of neonatal jaundice (odds ratio [OR] [95%CI] = 0.997 [0.994, 1.000], p = 0.04 and 0.98 [0.96, 0.99], p = 0.03, respectively), but these were attenuated after adjustment for the above maternal covariates (both p = 0.09). Our findings suggest a novel association between free 25(OH)D and neonatal birthweight. Total 25(OH)D concentrations were also associated with birthweight, and both total 25(OH)D and VDBP were associated with jaundice, but the latter were not significant after adjustment. These results suggest a potential link between these metabolites and neonatal outcomes; however, further large-scale prospective studies are warranted.</p
Additional file 1 of Maternal plasma vitamin D levels across pregnancy are not associated with neonatal birthweight: findings from an Australian cohort study of low-risk pregnant women
No full textAdditional file 1
THE ROLE OF CREATINE IN PLACENTAL ENERGY METABOLISM AT BIRTH: INITIAL INSIGHTS FROM THE CREATINE AND PREGNANCY OUTCOMES (CPO) COHORT STUDY OF LOW-RISK PREGNANCY
No full textTHE ROLE OF CREATINE IN PLACENTAL ENERGY METABOLISM AT BIRTH: INITIAL INSIGHTS FROM THE CREATINE AND PREGNANCY OUTCOMES (CPO) COHORT STUDY OF LOW-RISK PREGNANC
