CS rates are generally very high in Brazil. They are significantly higher than the average among women attending private/insured antenatal care, among the highly educated, and in provinces with higher socioeconomic levels.
ObjectiveTo analyze serum fatty acids concentrations during healthy pregnancy and evaluate whether socioeconomic, demographic, obstetric, nutritional, anthropometric and lifestyle factors are associated with their longitudinal changes.Study designA prospective cohort of 225 pregnant women was followed in the 5th–13th, 20th–26th and 30th–36th weeks of gestation. Serum samples were collected in each trimester of pregnancy and analyzed to determine the fatty acids composition using a high-throughput robotic direct methylation method coupled with fast gas-liquid chromatography. The independent variables comprised the subjects’ socioeconomic and demographic status, obstetric history, early pregnancy body mass index (BMI), dietary and lifestyle parameters. Analyses were performed using linear mixed-effects models.ResultsThe overall absolute concentrations of fatty acids increased from the 1st to the 2nd trimester and slightly increased from the 2nd to the 3rd trimester. Early pregnancy BMI, inter-partum interval and weekly fish intake were the factors associated with changes in eicosapentaenoic + docosahexaenoic acids (EPA+DHA) and total n-3 polyunsaturated fatty acids (PUFAs). Early pregnancy BMI, age and monthly per-capita income were inversely associated with the changes in the n-6/n-3 ratio. Alcohol consumption was positively associated with the n-6/n-3 ratio.ConclusionEarly pregnancy BMI was positively associated with EPA+DHA and total n-3 PUFAs, while presenting a reduced weekly fish intake and a lower inter-partum interval were associated with lower levels of n-3 PUFAs. A lower per-capita family income and a drinking habit were factors that were positively associated with a higher n-6/n-3 ratio.
BackgroundThe maternal cardiovascular system undergoes progressive adaptations throughout
pregnancy, causing blood pressure fluctuations. However, no consensus has been
established on its normal variation in uncomplicated pregnancies.ObjectiveTo describe the variation in systolic blood pressure (SBP) and diastolic blood
pressure (DBP) levels during pregnancy according to early pregnancy body mass
index (BMI).MethodsSBP and DBP were measured during the first, second and third trimesters and at
30-45 days postpartum in a prospective cohort of 189 women aged 20-40 years. BMI
(kg/m2) was measured up to the 13th gestational week and
classified as normal-weight (<25.0) or excessive weight (≥25.0).
Longitudinal linear mixed-effects models were used for statistical analysis.ResultsA decrease in SBP and DBP was observed from the first to the second trimester
(βSBP=-0.394; 95%CI: -0.600- -0.188 and
βDBP=-0.617; 95%CI: -0.780- -0.454), as was an increase in
SBP and DBP up to 30-45 postpartum days (βSBP=0.010; 95%CI:
0.006-0.014 and βDBP=0.015; 95%CI: 0.012-0.018). Women with
excessive weight at early pregnancy showed higher mean SBP in all gestational
trimesters, and higher mean DBP in the first and third trimesters. Excessive early
pregnancy BMI was positively associated with prospective changes in SBP
(βSBP=7.055; 95%CI: 4.499-9.610) and in DBP
(βDBP=3.201; 95%CI: 1.136-5.266).ConclusionSBP and DBP decreased from the first to the second trimester and then increased up
to the postpartum period. Women with excessive early pregnancy BMI had higher SBP
and DBP than their normal-weight counterparts throughout pregnancy, but not in the
postpartum period.
The majority of high-quality studies suggest that lower vitamin D levels may be associated with postpartum depression. However, further evidence is needed for guiding clinical practice on nutritional biomarkers.
The pooled WMD suggest that women with higher levels of CRP may have an increased risk of developing preeclampsia. This association seems to be modified by confounders, such as BMI. Further studies of high methodological quality are needed.
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