Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting:A secondary data-analysis of the DELIVER study

BACKGROUND: In several developed countries women with a low risk of complications during pregnancy and childbirth can make choices regarding place of birth. In the Netherlands, these women receive midwife-led care and can choose between a home or hospital birth. The declining rate of midwife-led home births alongside the recent debate on safety of home births in the Netherlands, however, suggest an association of choice of birth place with psychological factors related to safety and risk perception. In this study associations of pregnancy related anxiety and general anxious or depressed mood with (changes in) planned place of birth were explored in low risk women in midwife-led care until the start of labour. METHODS: Data (n = 2854 low risk women in midwife-led care at the onset of labour) were selected from the prospective multicenter DELIVER study. Women completed the Pregnancy Related Anxiety Questionnaire-Revised (PRAQ-R) to assess pregnancy related anxiety and the EuroQol-6D (EQ-6D) for an anxious and/or depressed mood. RESULTS: A high PRAQ-R score was associated with planned hospital birth in nulliparous (aOR 1.92; 95% CI 1.32–2.81) and parous women (aOR 2.08; 95% CI 1.55–2.80). An anxious or depressed mood was associated with planned hospital birth (aOR 1.58; 95% CI 1.20–2.08) and with being undecided (aOR 1.99; 95% CI 1.23–2.99) in parous women only. The majority of women did not change their planned place of birth. Changing from an initially planned home birth to a hospital birth later in pregnancy was, however, associated with becoming anxious or depressed after 35 weeks gestation in nulliparous women (aOR 4.17; 95% CI 1.35–12.89) and with pregnancy related anxiety at 20 weeks gestation in parous women (aOR 3.91; 95% CI 1.32–11.61). CONCLUSION: Low risk women who planned hospital birth (or who were undecided) more often reported pregnancy related anxiety or an anxious or depressed mood. Women who changed from home to hospital birth during pregnancy more often reported pregnancy related anxiety or an anxious or depressed mood in late pregnancy. Anxiety should be adequately addressed in the process of informed decision-making regarding planned place of birth in low risk women

An array of low-background 3He proportional counters for theSudbury Neutrino Observatory

An array of Neutral-Current Detectors (NCDs) has been builtin order to make a unique measurement of the total active ux of solarneutrinos in the Sudbury Neutrino Observatory (SNO). Data in the thirdphase of the SNO experiment were collected between November 2004 andNovember 2006, after the NCD array was added to improve theneutral-current sensitivity of the SNO detector. This array consisted of36 strings of proportional counters lled with a mixture of 3He and CF4gas capable of detecting the neutrons liberated by the neutrino-deuteronneutral current reaction in the D2O, and four strings lled with a mixtureof 4He and CF4 gas for background measurements. The proportional counterdiameter is 5 cm. The total deployed array length was 398 m. The SNO NCDarray is the lowest-radioactivity large array of proportional countersever produced. This article describes the design, construction,deployment, and characterization of the NCD array, discusses theelectronics and data acquisition system, and considers event signaturesand backgrounds

Third trimester plasma neurokinin B levels in women with and without preeclampsia

Objective. This study was undertaken to measure neurokinin B (NKB) levels in pregnant women with and without preeclampsia (PE) in the third trimester. The study focused on the Black (sub-Saharan ancestry) and 'mixed ancestry' (synonymous with 'colored' and denotes an established race group of Khoisan, European, Malay, Malagascan, African, and South Indian ancestry) populations, constituting the majority of inhabitants of the Western Cape Province of South Africa. Methods. Questionnaires were used to obtain clinical data from pregnant 'mixed ancestry' and Black women. Third trimester plasma NKB levels were determined by enzyme-linked immunosorbent assay technique (EIA) in 72 pregnant women with PE and in 94 healthy women. The EIA results were then correlated with clinical data. Results. The mean NKB concentration in the PE groups (23.5 ng/L for 'mixed ancestry' and 15.0 ng/L for Black women) was significantly higher than in the control groups (3.8 ng/L and 4.4 ng/L, respectively; p ≤ 0.001). No significant differences in maternal clinical data were found between the diseased groups. Conclusions. Using the EIA technique, this study confirms previous reports of elevated NKB levels in the plasma of PE women in the third trimester. Whether increased NKB levels are causative or merely associated with PE remains unknown, as do the causative molecular mechanisms. Future longitudinal studies are certainly needed to further elucidate the predictive value of NKB in PE. © 2008 Informa UK Ltd.Articl

Altered plasma neurokinin B levels in patients with pre-eclampsia

Objective(s): This study determines the levels of Neurokinin B (NKB) in the plasma of South African coloured pregnant women with and without pre-eclampsia (PE) and correlates these results with clinical data. Additionally, the peptide radioimmunoassay (RIA) and peptide enzyme immunoassay (EIA) methods were compared in the determination of the Neurokinin B levels, using 58 samples from patients with PE. Methods: At the Tygerberg Hospital, Cape Town, SA, 43 pregnant women with PE and 62 healthy pregnant women were recruited, and clinical data were gathered using questionnaires; 58 patient samples were tested by both RIA and EIA. Results: The comparison of RIA and EIA revealed an r-value of 0.904. The mean NKB concentration in the PE group (23.5 ng/l) was significantly higher than in the control group (3.8 ng/l). Within the PE cohort, two NKB subgroups could be discerned: those with levels 30 ng/l. Conclusion(s): This study, carried out within a distinct population, confirms previous reports of elevated NKB levels in the plasma of pre-eclamptic women in the third trimester, and established the suitability of EIA for determining NKB levels. Whether the altered NKB levels are causative or merely associated with PE still remains to be determined. The split in the two NKB groups (high and low values) needs further evaluation, as does whether NKB could be used as a screening test or as a predictive factor. © 2007 Springer-Verlag.Articl

Neurokinin B and pre-eclampsia: a decade of discovery

ABSTRACT: At the start of the last decade, we provided evidence that levels of the peptide neurokinin B were highly elevated in pre-eclampsia. We hypothesized that elevated levels of neurokinin B may be an indicator of pre-eclampsia and that treatment with certain neurokinin receptor antagonists may be useful in alleviating the symptoms. At the time of the original hypothesis many questions remained outstanding. These included - Does neurokinin B have any diagnostic value in the detection and diagnosis of pre-eclampsia? - What is the cause of the elevated levels of neurokinin B during pre-eclampsia? - What is the physiological significance of neurokinin B in the placenta? This review discusses the answers to these questions taking into account the subsequent developments of the past ten years and analyzing the plethora of discoveries that have arisen from those initial observations