The use of maternal C-reactive protein in the predicting of preterm labor and tocolytic therapy in preterm labor women

Background: Levels of a number of some biomarkers have been associated with spontaneous preterm birth. This study was aimed to evaluate the relation between C-reactive protein (CRP) with preterm labor and response to tocolytic therapy. Materials and Methods: Seventy five pregnant women with symptoms of preterm labor (cases) in compare with 75 term women (controls) were enrolled. Baseline data and CRP was recorded. So, cases were under treatment tocolysis with the use of magnesium sulfate, and then they were followed till delivery time to assess the response to the treatment. Results: Sixteen patients with symptoms of preterm labor did not response to the treatment and delivered prematurely and 59 women response to tocolytic treatment and delivered at term. The curve constructed cut-off value for >3.6 (AUC, 0.683; SE, 0.041; P < 0.0001) for CRP, indicating a significant relationship with preterm labor. Also, there was significant relationship between CRP level with response to the treatment in cut-off >1.8 (AUC, 0.738; SE, 0.076; P = 0.001) for CRP. Conclusions: Maternal concentrations of CRP can be used as appropriate biomarker for predicting preterm labor and response to tocolytic therapy in pregnant women

Maternal serum cytokines in the prediction of preterm labor and response to tocolytic therapy in preterm labor women

Background: One of the most important challenges in health care system is prevention of preterm birth. The present study was aimed to investigate the relation between interleukins 6 and 8 (IL-6 and IL-8) with preterm labor and response to tocolytic therapy. Materials and Methods: In the year 2012, 75 women with the symptoms of preterm labor (cases) in compare with 75 term women (controls) were randomly selected and evaluated. Baseline data and serum levels of IL-6 and IL-8 (using immunoassay method) recorded. Hence, tocolysis in women in case group was performed with the use of magnesium sulfate and then they were followed until delivery time to assess the response to treatment. Results: In case group, 59 women response to tocolytic treatment and delivered at term but 16 of them delivered prematurely. The curve constructed cut-off value for IL-6 was >37.9 (area under the curve [AUC], 0.674; standard error [SE], 0.043; P < 0.0001), and > 9.5 for IL-8 (AUC, 0.773; SE, 0.038; P < 0.0001), indicating a significant relationship with preterm labor. Furthermore, there was a significant relationship between serum IL-6 and IL-8 levels with the response to the treatment in cut-off >45 for IL-6 (AUC, 0.894; SE, 0.042; P < 0.0001) and >171 for IL-8 (AUC, 0.864; SE, 0.059; P < 0.0001). Conclusion: In summary, our results suggest that the assessment of maternal serum concentrations of IL-6 and IL-8 can be used as appropriate biomarkers for predicting preterm labor and response to tocolytic therapy in these women. However, further studies needs to be done

Crown-rump length discordance in twins in the first trimester and its correlation with perinatal complications

Background: A difference more than 15-40% in birth weight of twins can predict perinatal complications. As significant difference in twins growth has a very important effect on pregnancy and perinatal complications, this study aimed to evaluate crown-rump length discordance (ΔCRL) in the first trimester of pregnancy and its correlation with perinatal complications. Methods: A total number of 118 women in the first trimester of twin pregnancy underwent ultrasound examination to measure ΔCRL. Then, at the time of delivery, perinatal complications in twins were recorded and the correlation between ΔCRL and perinatal complications were evaluated. Results: Among 118 studied mothers with twin pregnancy, ΔCRL was normal (< 11%) in 96 cases (81.4%) and high (≥ 11%) in 22 cases (18.6%). Birth weight discordance was normal (< 20%) in 103 cases (87.3%) and above normal (≥ 20%) in 15 cases (12.7%). The results revealed a significant correlation between higher frequency of small for gestational age (SGA) and high ΔCRL (more than 11%) (p = 0.01). Conclusions: Our study concluded that SGA has a significant relationship with high ΔCRL (> 11%)

Predictive value of middle cerebral artery to umbilical artery pulsatility index ratio for neonatal outcomes in hypertensive disorders of pregnancy

Background: Hypertension may lead to notifying adverse perinatal events that should be diagnosed and managed precisely. This study aims to investigate the values of cerebroplacental ration for the prediction of adverse perinatal events in hypertensive disorders of pregnancy. Materials and Methods: The current descriptive-comparative study has been conducted on 100 singleton pregnant women with the diagnosis of preeclampsia or pregnancy-induced hypertension. The Cerebroplacental ratio (CPR) was measured for the included population and divided into normal and abnormal ranges of >1 and ≤1. The adverse perinatal outcomes, including abnormal 5 min APGAR, low birth weight, perinatal death, neonatal intensive care unit (NICU) admission, academia, seizure, emergency cesarean delivery, and Tchirikov index as the general manifestation of adverse perinatal outcomes were compared between the groups. The specificity, sensitivity, positive predictive value, negative predictive value (NPV), and accuracy were measured for the adverse perinatal outcomes. Results: The two groups were remarkably different in terms of 5 min APGAR, low birth weight, cesarean section delivery, and Tchirikov index (P < 0.05). The specificity of CPR for prediction of small-for-gestational age, poor APGAR, requirement of assisted respiration, academia, Tchirikov score and NICU admission was 93.1%, 93.1%, 67.1%, 91.8%, 71.2%, and 63%, and its sensitivity was 26%, 14.8%, 51.8%, 14.8%, 51.8%, and 37%, respectively. Conclusion: CPR seems to be an appropriate means for the prediction of adverse perinatal outcomes with diversity in the prediction values of different determinants of adverse perinatal outcomes; however, in general, it had sensitivity, specificity, PP, NPV, and accuracy of 51.8%, 71.2%, 40%, 80%, and 66%, respectively

Effect of the presence of support person and routine intervention for women during childbirth in Isfahan, Iran: A randomized controlled trial

Background: The aim of this study was to examine the effects of the presence of continuous support person and routine interventions during labor and delivery in Isfahan, Iran. Materials and Methods: One hundred pregnant women in spontaneous labor were assessed in four groups: Group 1; received routine intervention with a support person, Group 2; received routine intervention without support person, Group 3; received support person without routine intervention, Group 4; did not receive routine intervention or a support person. Sociodemographic, antenatal characteristics, length of stage of labor, instrumental delivery, the cervical laceration, perineal tear, labor pain, satisfaction and Apgar score collected and analyzed. Results: Based on the results there was no significant difference in regard to maternal age, BMI, maternal education and working statutes among the studied groups (P-value >0.05). Also, 1 and 5-min Apgar 0.05). Length of first and second stage of labor, perineal tear, satisfaction score and pain before and after labor were significant among studied groups (P-value <0.05). Conclusions: Presence of a support person and routine intervention during labor did not effect on incidence of cervical lacerations, instrumental delivery and Apgar <7. Labor pain and women′s dissatisfaction, and number women with third and fourth degree of perineal tear among women who received routine intervention were increased compare to others. Interventions makes decreased the length of first and second stage of labor. In totally, the presence of a support person during labor in Iranian women decrease length of labor and improved labor outcomes

Comparative study on the influence of three delivery positions on pain intensity during the second stage of labor

Background: Labor is a physiologic process, and consideration of labor pain and relieving that is among the major components of maternal care. Application of some labor position can lay the fetus better in pelvic canal direction. The present study aimed to investigate the effect of laying the mother in three labor positions on the pain severity in the second, third, and fourth stages of labor. Materials and Methods: This is a clinical trial conducted on 96 primiparous pregnant women randomly selected through convenient sampling from those who were hospitalized in the hospitals of Isfahan and Jahrom. Women with a gestational age of 37-42 weeks, singleton pregnancy, who had passed the first labor stage through physiologic process, and with cephalic presentation were selected. The subjects were randomly allocated to be in the groups of lithotomy, sitting, and squatting positions. Pain severity in the second, third, and fourth labor stages was measured with visual analog scale (VAS) as well as McGill present pain intensity (PPI). The data were collected through interviews and observations with the help of VAS. The data were analyzed by Chi-square and Kruskal-Wallis statistical tests. Results: In the latent phase of the second labor stage, mean pain severity in lithotomy (2.27) and squatting positions (2.48) was significantly less than the mean pain severity in sitting (5.33) position (P = 0.001). Pain severity in the active phase of the second and third labor stages was significantly less in squatting position (6.14) group compared to the other two groups (7.59 and 7.41 in sitting and lithotomy positions, respectively) (P = 0.024). Pain severity in the fourth labor stage showed no significant difference in all three groups. Conclusions: Application of various labor positions as one of the non-medicational methods to reduce pain in the second and third stages of labor leads to labor pain reduction

Maternal plasma nitric oxide metabolites and cervical length assessment in predicting the tocolytic therapy in preterm labor in Isfahan

Background: Preterm labor (PTL) is the main challenge in prenatal health care, leads to high rate of mortality and increases cost of health services. To evaluate the preterm delivery (PTD)-related risk factors, we decided to measure nitrite oxide metabolites and cervical length (CL) as the diagnostic and predictive tools for PTD in women and response to tocolytic therapy. Materials and Methods: In this case–control study, sixty women of 18–35 years with first pregnancy during the 24–34 gestational weeks with PTL in case group admitted to the delivery section of Beheshti Hospital, Isfahan, Iran were included. Sixty women in control group have the same specifications. NO and CL level were assessed, and the collected data were analyzed by SPSS software, version 20 and MedCalc software, version 15.1. Results: The two groups were similar regarding maternal and gestational age (P > 0.05). Lower level of NO was observed in PTL women with a mean of 35.30 ± 8.27 μmol/L compared to the normal gestation group with a mean of 39.05 ± 10.17 μmol/L (P = 0.035). In addition, the diagnostic accuracy of both PTL-predicting factors was determined (NO ≤31, sensitivity 99.7%, specificity 82.5% and CL ≤22, sensitivity 80%, specificity 99.9%). Conclusion: As the previous investigations stated, it can be claimed that NO might be the reliable marker for predicting the PTL, and administration of NO synthesis could be a candidate for the future therapeutic target

Major Maternal Dietary Patterns during Early Pregnancy and Their Association with Neonatal Anthropometric Measurement

Background. Anthropometric measurements of newborn infant are widely assessed as determinants of maternal nutrition. Although earlier studies have mostly examined the effects of particular nutrients or foods during gestational period on neonatal anthropometric measurements, there are few studies regarding the association of dietary patterns and mentioned measurements. So, the purpose of the current study was to investigate the association between major maternal dietary patterns and neonatal anthropometric measurements including body weight, head circumference, and height. Methods. The current prospective observational study is based on the data collected from 812 pregnant women. Dietary data was collected using a validated semiquantitative food frequency questionnaire. Results. Three identified major dietary patterns according to the results obtained from the factor loading matrix were (i) “western dietary pattern”; (ii) “traditional dietary pattern”; (iii) “healthy dietary pattern”. Overall, this study demonstrated a positive significant association between high adherences to western dietary pattern and chance of having low birth weight infant. However, such associations were not seen in women taking healthy and traditional dietary patterns. Conclusion. We found that healthier maternal dietary patterns during early pregnancy might be associated with lower risk of low birth weight. Further studies are required to confirm these findings