Phytoestrogens are increasingly incorporated into the diet of menopausal women. However, there are limited data on the efficacy of flaxseed on the consequences of estrogen deficiency in menopausal women. The purpose of the study was to assess the effects of flaxseed incorporation into the diet of healthy menopausal women. One hundred and ninety-nine menopausal women were randomly assigned to consume 40 g flaxseed/d (n = 101) or wheat germ placebo (n = 98) for 12 months. At baseline and at month 12, serum levels of lipids, bone mineral density (BMD), and menopausal symptoms were evaluated. Statistical analysis was performed under the intention to treat principle. Flaxseed reduced serum total (-0.20 +/- 0.51 mmol/liter; P = 0.012) and high-density lipoprotein (-0.08 +/- 0.24 mmol/liter; P = 0.031) cholesterol concentrations compared with wheat germ placebo. BMD did not differ significantly between the two arms. Both flaxseed and wheat germ reduced (P < 0.0001) the severity scores of menopausal symptoms, but no statistical difference was found between the two arms. Our findings suggest that 1-yr incorporation of flaxseed into the diet produced a favorable, but not clinically significant, effect on blood cholesterol and caused no significant change in BMD or symptoms in healthy menopausal women.

Knowledge of the consequences of maternal obesity in human placental fatty acids (FA) transport and metabolism is limited. Animal studies suggest that placental uptake of maternal FA is altered by maternal overnutrition. We hypothesized that high maternal body mass index (BMI) affects human placental FA transport by modifying expression of key transporters. Full-term placentas were obtained by vaginal delivery from normal weight (BMI, 18.5-24.9 kg/m(2)) and obese (BMI > 30 kg/m(2)) women. Blood samples were collected from the mother at each trimester and from cord blood at delivery. mRNA and protein expression levels were evaluated with real-time RT-PCR and Western blotting. Lipoprotein lipase (LPL) activity was evaluated using enzyme fluorescence. In vitro linoleic acid transport was studied with isolated trophoblasts. Our results demonstrated that maternal obesity is associated with increased placental weight, decreased gestational age, decreased maternal high-density lipoprotein (HDL) levels during the first and third trimesters, increased maternal triglyceride levels during the second and third trimesters, and increased maternal T3 levels during all trimesters, and decreased maternal cholesterol (CHOL) and low-density lipoprotein (LDL) levels during the third trimester; and increased newborn CHOL, LDL, apolipoprotein B100, and T3 levels. Increases in placental CD36 mRNA and protein expression levels, decreased SLC27A4 and FABP1 mRNA and protein and FABP3 protein expression, and increased LPL activity and decreased villus cytotrophoblast linoleic acid transport were also observed. No changes were seen in expression of PPARA, PPARD, or PPARG mRNA and protein. Overall this study demonstrated that maternal obesity impacts placental FA uptake without affecting fetal growth. These changes, however, could modify the fetus metabolism and its predisposition to develop diseases later in life.

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Objective To assess the performance of four previously reported Doppler abnormalities of uterine artery velocity waveforms (presence of a protodiastolic notch, peak systolic over protodiastolic velocities (A:C ratio) > 2.5, peak systolic over end diastolic velocities (A:B ratio) > 90th centile, resistance index (RI) ([A-B]/A) 2 0.58) in predicting pre-eclampsia, low birthweight and prematurity.Design Prospective cohort study.Setting Tertiary care university hospital in Quebec City.Population 13 1 1 nulliparous women.Methods Evaluation of pulsed Doppler abnormalities of uterine artery velocity waveforms was carried out in 1000 and 1 194 of women at 18.3 (SD 0.9) or 26.7 (SD 0.9) weeks of pregnancy.Main outcome measures Pre-eclampsia, birthweight below the 10th centile for gestational age and spontaneous preterm birth (< 37 completed gestation weeks).Results Pre-eclampsia, low birthweight for gestation and prematurity occured in 4%, 1 1% and 7% of the pregnancies, respectively. At 26 weeks all the abnormalities of the studied Doppler indices were significantly associated with pre-eclampsia and low birthweight for gestation as reflected by the 95% confidence intervals of the positive likelihood ratios which did not include the value 1. However, sensitivities (26% to 34%) and positive predictive values (7% to 28%) were low. No Doppler indices performed significantly better than the others. The abnormalities of the Doppler indices were not associated with spontaneous prematurity. The performance of the Doppler measurements performed at 18 weeks was poor.Conclusions Uterine artery Doppler velocimetry waveform analysis does not qualify as a reliable screening test for pre-eclampsia or low birthweight for gestation in low risk pregnancies but may be useful in selected high risk populations.

Abstract-Insulin resistance syndrome has been observed in women with hypertensive disease of pregnancy, but few studies evaluated the presence of the syndrome a few years after delivery. The objective of this study was to evaluate the presence of insulin resistance and its metabolic alterations in these women compared with those who had a normal pregnancy. We performed an observational study in 168 women with previous hypertensive disease of pregnancy and 168 control subjects with normal pregnancy contacted, on average, 7.8 years after their first delivery (mean age: 34.8 years). Complete blood lipid profile, insulin, glucose, homocysteine, adipokins, and markers of inflammation were measured. Also, an oral glucose tolerance test was performed in 146 case and 135 control subjects. Case subjects were more overweight compared with control subjects. We found significantly lower high-density lipoprotein cholesterol and adiponectin levels and higher apolipoprotein (apo) apoB/apoA1 ratio, homocysteine, leptin, and insulin levels among case subjects compared with control subjects (PՅ0.004). Also, case subjects were more insulin resistant in the basal state estimated by homeostasis assessment model 2, as well as in the nonbasal state as estimated by insulin sensitivity indices calculated from the oral glucose tolerance test. Finally, in a multivariate regression model, leptin, apoB/apoA1 ratio, waist circumference, adiponectin, and free fatty acids explained 40% of homeostasis assessment model 2 variance. Young women with previous hypertensive disease of pregnancy show signs of insulin resistance within the first decade after delivery. These findings suggest that insulin resistance may be the link between hypertensive disease of pregnancy and increased cardiovascular risk later in life. Key Words: hypertension Ⅲ insulin resistance Ⅲ obesity Ⅲ preeclampsia Ⅲ gestational hypertension Ⅲ cardiovascular diseases Ⅲ dyslipidemia H ypertensive disease of pregnancy (HDP) appears after the 20th week of gestation in women and is classified into 2 main groups: the nonproteinuric group, including gestational hypertension (GH) and transient hypertension, and the preeclampsia (PE) group characterized by proteinuria, returning to normal values in the postpartum period. All together, they occur in Ϸ8% of pregnancies. 1 Epidemiological data suggest that women with previous HDP are at increased risk of cardiovascular disease (CVD) later in life. [2][3][4] Also, review articles proposed that insulin resistance could play a role bridging HDP to long-term CVD, but data are lacking to validate the hypothesis. 5,6 During normal pregnancy, insulin resistance progresses until the third trimester to facilitate the transfer of glucose to the fetus, and insulin returns to a normal level after delivery. However, in women suffering from HDP, recent data indicate that insulin resistance and the associated metabolic disturbances, such as dyslipidemia and hyperinsulinemia, are more pronounced compared with pregnant women without this complication. 7,8 A...

Interventions regarding a decision about prenatal testing for Down syndrome should address many decisional needs, which may indeed vary among the parties involved, whether women, their partners or health professionals. Very little is known about the decisional needs of partners and health professionals.