Weight of Pregnant Women and their Influence on Second Trimester Biochemical Markers

Abstract

Fetal aneuploidies screening was based for a long time on ultrasonographic and biochemical markers measurement. The risk calculated in accordance with second trimester biochemical markers (STBM) values relies on calculation of corrected MoM values. MoM (multiple of Medians) signify the deviation of a measured value from the expected value (Median). The Median is measured at the same gestational age in pregnancies which involve healthy fetuses. The correction of MoM includes an adjustment for certain parameters that influence the STBM value: demographical (ethnicity), behavioral (smoking status, weight), and others (mode of conceiving, etc.). In our article we aim to analyze: (1) the accuracy of software to calculate STBM corrected MoM values, (2) the effect of weight of pregnant women on STBM and (3) the capability of software to counterbalance this influence. Pregnant women (n=1242) were screened for aneuploidies based on an integrated test: first trimester ultrasound and STBM (AFP, hCG and uE3). The absolute value, multiple of median (MoM) and corrected multiple of median (MoMc) values were 33.94�0.45, 1.04�0.12 and 0.98�0.01 for AFP, 22530�477, 0.87�0.01 and 0.85�0.01 for hCG, respectively 0.97�0.03, 0.99�0.01 and 0.98�0.01 for uE3. The weight of pregnant women inversely correlates with absolute and MoM AFP, hCG and uE3 values. No correlation was found with AFP and hCG MoMc values. A very weak inverse correlation was found between weight and uE3 corrected MoM values. Our study confirms that there is a difference between provider and own calculated hCG MoMc values. The weight of pregnant women inversely correlates with STBM values. The software used for aneuploidies risk evaluation corrects the influence of weight of pregnant women, but a minimal influence on uE3 corrected MoM values is still present.

Evaluating the Efficacy of the Treatment with Benfotiamine and Alpha-lipoic Acid in Distal Symmetric Painful Diabetic Polyneuropathy

“…Hyperglycaemia represents the most important factor in the pathogenesis of diabetic neuropathy [3][4][5][6][7] and is the main cause of the physio-pathological mechanisms that determine the appearance of diabetic neuropathy: increased influx on the polyol pathway, accumulation of glycosylation end products, increased influx on the hexosamine pathway, activation of protein-kinase C and oxidative stress [9].The excess of glucose metabolized on the polyol pathway leads to a decrease in NADPH concentration and as a consequence of glutathione concentration, this way glutathione antioxidant activity is diminished. Advanced glycosylation end products through binding on specific receptors activate intracellular pathways that increase oxidative stress, the activation of protein-kinase C decreases the tissue vascularization, promotes the pro-inflammatory gene expression, the metabolism of glucose on the hexosamine pathway accentuates even more the vascular dysfunction and oxidative stress [10][11][12]. Therefore, the metabolism of glucose on these alternative pathways generates a mitochondrial dysfunction that disrupts ATP production; as a result, the energy necessary for cell survival is no longer available.…”

Immuno-toxicological Evaluation of the Adjuvant Formulations for Experimental Anti-meningococcal Vaccines without Aluminium Hydroxide

“…The usual methodology to determine the immunotoxicological effects of a xenobiotic is the design of upgrading studies comprising different levels and following an evidence strategy [47]. Variations in the weights of relevant organs of the immune systems such as thymus, spleen, lymphatic nodes, and bone marrow indicated a potential toxicity on these organs and the immune system [48][49][50]. Due to its importance, this value is included in the immunopathological trials of the most important immunotoxicological studies [51,52].…”

Dietary behavior during pregnancy

“…Pregnant women should eat nutrient-dense foods to meet higher nutritional requirements during pregnancy without exceeding the caloric requirement (5). Consultation of a nutritionist with a special training in the maternal field is suitable and recommended for women with special nutritional considerations (6,7) such as metabolic disorders (diabetes, hypertension, phenylketonuria, gastrointestinal disorders, bariatric surgical or digestive tract resection history with impaired absorption), modified caloric requirements [extreme age (8), multiple pregnancy, underweight, overweight, obesity (9), personal history of major weight fluctuations, another fetus with neural tube defect (10)], unhealthy eating habits (restrictive diets, eating disorders that require medication or hospitalization, intolerance and food allergies, use of toxic substances or drugs that affect nutrition). Some women might need adjusted micronutrient supplementation (8,11,12).…”