Reducing the Risk of Pre-Eclampsia in Women with Polycystic Ovary Syndrome Using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(6), P. 1774 - 1774

Published: March 20, 2024

Polycystic ovary syndrome (PCOS) is a multisystem disorder that presents with variety of phenotypes involving metabolic, endocrine, reproductive, and psychological symptoms signs. Women PCOS are at increased risk pregnancy complications including implantation failure, miscarriage, gestational diabetes, fetal growth restriction, preterm labor, pre-eclampsia (PE). This may be attributed to the presence specific susceptibility features associated before during pregnancy, such as chronic systemic inflammation, insulin resistance (IR), hyperandrogenism, all which have been an complications. Many reversible following lifestyle interventions diet exercise, pregnant women healthy found lower complications, PE. narrative synthesis summarizes evidence investigating PE role nutritional factors in PCOS. The findings suggest beneficial aspects management PCOS, recommended evidence-based international guidelines, extend improved outcomes. Identifying high-risk will allow targeted interventions, early-pregnancy screening, surveillance for should included assessment algorithms

Language: Английский

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The influence of early environment and micronutrient availability on developmental epigenetic programming: lessons from the placenta

Frontiers in Cell and Developmental Biology, Journal Year: 2023, Volume and Issue: 11

Published: July 6, 2023

DNA methylation is the most commonly studied epigenetic mark in humans, as it well recognised a stable, heritable that can affect genome function and influence gene expression. Somatic patterns persist throughout life are established shortly after fertilisation when majority of marks, including methylation, erased from pre-implantation embryo. Therefore, period around conception potentially critical for influencing at imprinted alleles metastable epialleles (MEs), loci where varies between individuals but correlated across tissues. Exposures before during pregnancy outcomes health life. Retrospective studies survivors famines, such those exposed to Dutch Hunger Winter 1944-45, have linked exposures later disease outcomes, some which correlate with changes certain genes. Animal models shown more directly be affected by dietary supplements act cofactors one-carbon metabolism, birth has been associated peri-conceptional micronutrient supplementation. However, showing role micronutrients shaping epigenome proven difficult. Recently, placenta, tissue unique hypomethylated methylome, possess great inter-individual variability, we highlight promising target studying MEs mixed environmental exposures. The placenta fetus. Placenta-associated complications, preeclampsia intrauterine growth restriction, all aberrant expression only now being risk

Language: Английский

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Current evidence around key underrepresented women’s health topics in pregnancy and postpartum nutrition: a narrative review

Applied Physiology Nutrition and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 8, 2025

Adequate nutrition during pregnancy and postpartum is critical to maternal child health, but there often a missing focus around health outcomes specifically for women. Women’s includes sex-specific biological attributes socially constructed gender roles framing behaviours practices. This narrative review aims highlight key areas where women’s has been underrepresented in research. Current evidence research gaps are discussed nutritional requirements lactation, mortality morbidity risk factors, preconception nutrition, gendered cultural norms inequities access nutritious foods postpartum. Important future include strengthening empirical pregnant lactating populations, the relationship between iron status, anaemia morbidities, linkages nutrient status among women adolescent girls outcomes, recovery, long-term strength-based practices that can support adequate nutrition. There an ongoing need research, measure ensure creation of evidence-base on both sex gender-based datasets.

Language: Английский

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Standardised Methods for Developing Conceptual Frameworks for Placental Disorders of Pregnancy: Pre‐Eclampsia and Stillbirth

BJOG An International Journal of Obstetrics & Gynaecology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 19, 2025

ABSTRACT Background Risk factors for the placental disorders of pregnancy (pre‐eclampsia, fetal growth restriction, preterm birth, and stillbirth) are complex, frequently involving interplay between clinical wider social environmental determinants health. Biomarkers modulate maternal responses to biological processes that underlie development disorders. Objectives To develop a standardised methodology assess importance of, inter‐relationships between, candidate risk various Search Strategy Systematic searches were conducted using Medline, Embase, Health Technology Assessments, Database Abstracts Reviews Effects, Cochrane Library databases, Google Scholar, reference lists retrieved papers. Selection Criteria We deployed hierarchy reviews, systematic cohort studies with at least 1000 participants (100 biomarker studies), published in prior decade. Data Collection Analysis assessed strengths association quality evidence linking individual outcomes. Conclusions have developed approach inter‐relatedness putative pregnancy.

Language: Английский

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Longitudinal Assessment of Serum 25-Hydroxyvitamin D Levels during Pregnancy and Postpartum—Are the Current Recommendations for Supplementation Sufficient?

Nutrients, Journal Year: 2023, Volume and Issue: 15(2), P. 339 - 339

Published: Jan. 10, 2023

(1) Background: Pregnant women are at risk of vitamin D deficiency. Data on pregnancy outcomes in with deficiency during controversial, and prospective longitudinal data consistent definitions pregnant scarce. (2) Methods: The aim this cohort study was to investigate 25-hydroxyvitamin levels over the course postpartum singleton twin pregnancies regard dietary supplemental intake environmental factors influencing levels, evaluated by a standardized food frequency questionnaire. (3) Results: We included 198 healthy 51 for analysis. A total 967 visits were performed 3-year period. Overall, 59.5% classified as deficient first trimester, 54.8% second 58.5% third 66.9% birth, 60% 12 weeks postpartum, even though 66.4% population reported daily containing D. Dietary did not affect significantly. (4) Conclusions: majority deficient, despite administration vitamins Individualized assessment should be considered ensure adequate supplementation prevention hypovitaminosis

Language: Английский

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Prevention of Pregnancy Complications Using a Multimodal Lifestyle, Screening, and Medical Model

Published: June 19, 2024

Understanding and preventing the “great obstetrical syndromes” has been focus of pregnancy research for decades. The combined global impact from these syndromes on maternal perinatal morbidity mortality is compounded by increased long-term risk adverse health effects following pregnancy. Accumulating evidence indicates that conditions such as pre-eclampsia, fetal growth restriction, spontaneous preterm labour, stillbirth, are with etiologic heterogeneity share common pathophysiologic pathways involving placental dysfunction. Recently, importance interaction between genomes extended to include epigenetic pre-existing pathophysiology development highlights nutritional environmental factors in altered placentation. Validated first-trimester screening algorithms preeclampsia can identify high-risk women prophylactic treatment low-dose aspirin be initiated. High-risk monitored during second trimester using clinical assessment, ultrasound, biochemical markers, able predict complications prior signs symptoms. integration lifestyle interventions, screening, medical management represents a conceptual advance care. This approach potential significantly reduce complications, mortality, outcomes later life, health-care costs.

Language: Английский

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Prevention of Pregnancy Complications Using a Multimodal Lifestyle, Screening, and Medical Model

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(15), P. 4344 - 4344

Published: July 25, 2024

Prevention of pregnancy complications related to the “great obstetrical syndromes” (preeclampsia, fetal growth restriction, spontaneous preterm labor, and stillbirth) is a global research clinical management priority. These syndromes share many common pathophysiological mechanisms that may contribute altered placental development function. The resulting adverse outcomes are associated with increased maternal perinatal morbidity mortality post-partum risk cardiometabolic disease. Maternal nutritional environmental factors known play significant role in altering bidirectional communication between fetal-derived trophoblast cells decidual abnormal placentation. As result, lifestyle-based interventions have increasingly been recommended before, during, after pregnancy, order reduce decrease long-term risk. Antenatal screening strategies developed following extensive studies diverse populations. Multivariate preeclampsia using combination maternal, biophysical, serum biochemical markers at 11–14 weeks’ gestation can be performed same time as first-trimester ultrasound blood tests. Women identified high-risk offered prophylactic low dose aspirin monitored angiogenic factor assessment from 22 gestation, assessment, biochemistry, ultrasound. Lifestyle reassessed during counseling antenatal interventions. integration lifestyle interventions, screening, medical represents conceptual advance care has potential significantly later life outcomes.

Language: Английский

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Use of multiple micronutrient supplementation integrated into routine antenatal care: A discussion of research priorities

Maternal and Child Nutrition, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 2, 2024

Abstract Optimal maternal nutrition, including adequate intake and status of essential micronutrients, is important for the health women developing infants. Currently, World Health Organization (WHO) Antenatal care recommendations a positive pregnancy experience recommend daily iron folic acid (IFA) supplementation as standard care. The use multiple micronutrient supplements (MMSs) recommended in context rigorous research more evidence was needed regarding impact switching from IFA to MMS, evaluation critical clinical perinatal outcomes, acceptability, feasibility, sustainability, equity cost‐effectiveness. WHO convened technical consultation key stakeholders discuss priorities with objective providing guidance clarity donors, implementers researchers about this recommendation. overarching principles agenda include indicators measures that are applicable across studies settings inclusion outcomes women. Future should consider using standardized protocols based on current best practices measure such gestational age (GA) birthweight (BW) studies. As GA BW influenced by factors, understand biological pathways, how initiation considerations timing MMS influence these outcomes. A set core agreed upon during consultation. For implementation research, Evidence‐to‐Decision framework used resource discussing components research. questions, performance will depend country‐specific bottlenecks require further improved solutions enable successful iron‐containing supplements.

Language: Английский

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Reducing the Risk of Pre-eclampsia in Women with Polycystic Ovary Syndrome using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

Published: Dec. 27, 2023

Polycystic ovary syndrome (PCOS) is a multisystem disorder that presents with variety of phenotypes involving metabolic, endocrine, reproductive, and psychological symptoms signs. Women PCOS are at increased risk pregnancy complications including implantation failure, miscarriage, gestational diabetes, fetal growth restriction, preterm labour, preeclampsia (PE). This may be attributed to the presence specific susceptibility features associated before during pregnancy, such as chronic systemic inflammation, insulin resistance (IR), hyperandrogenism, all which have been an complications. Many reversible following lifestyle interventions diet exercise, pregnant women healthy found lower complications, PE. review summarizes evidence investigating PE role nutritional factors in PCOS. The findings suggest beneficial aspects management PCOS, recommended evidenced-based international guidelines, extend improved outcomes. Identifying high-risk will allow targeted interventions, early screening, surveillance for should included assessment algorithms

Language: Английский

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Revisão do efeito da vitamina D na pré-eclâmpsia

Contribuciones a las Ciencias Sociales, Journal Year: 2024, Volume and Issue: 17(2), P. e5335 - e5335

Published: Feb. 21, 2024

Este estudo tem por objetivo a checagem dos efeitos da vitamina D na pré-eclâmpsia. Tratando-se de uma revisão integrativa, sendo realizado partir pesquisa base dados PubMed, em que se utilizou os seguintes Descritores Ciências Saúde (DeCS): vitamin D; and; preeclampsia. Foram selecionados artigos publicados anos 2022 2024 e, assim, obteve-se 18 que, após análise enquadramento ao tema, restaram-se apenas 14. A pré-eclâmpsia (PE) é doença afeta diversos sistemas do organismo humano e caracterizada hipertensão arterial proteinúria. É alto risco materno fetal necessita tratamento prevenção, suplementação (VD) um métodos podem ser utilizados para diminuição ocorrência O verificou pacientes receberam torno 25.000 UI/mL D3 tiveram menor desenvolver Dessa forma, foi possível observar interação entre essa benefícios as gestantes obter dela. Tendo vista essas informações sobre o efeito benéfico pré-eclâmpsia, pode graves problemas saúde, faz-se necessário mais estudos estabeleçam evidências concretas seguras riscos sejam cada vez mitigados relação VD-PE seja bem estudada.

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