Stress experienced by women after premature labor is conditioned by their personality

Objectives: The aim of the study was to analyze a possible correlation between personality traits and the level of stress experienced by women after premature labor. Material and methods: The analysis was carried out on the basis of a study conducted in 96 women after premature labor. The following tools were used: Personality Inventory NEO-FFI, Parental Stressor Scale: NICU (SSR:OITN), and personal data questionnaire. It was an exploratory study since the SSR:OITN method is only applied to find out the characteristic features of stress induced by prematurity, and, therefore, it cannot be applied to study the control sample (i.e. women who delivered at term). Results: The obtained results revealed significant correlations between the level and structure of stress connected with premature labor and personality traits. The general level of stress and all its components (infant’s clinical characteristics and medical procedures, personal and interpersonal problems as well as parental competence) correlated positively with Neuroticism. Negative correlations between the general level of stress together with its parental competence factor and Extraversion and Openness to experience were found. Agreeableness correlated negatively with parental competence stress. No correlation between the level of stress and Conscientiousness was observed. Conclusions: Our findings shed new light on how women after premature labor experience stress, and suggested an ef­fective medical-psychological-therapeutic support aiming at reducing the level of trauma. The SSR:OITN Scale is proposed as one of the basic methods used to diagnose difficulties experienced by the investigated women

Secreted Frizzled-Related Protein 5 in Serum and Urine of Post-Partum Women with Gestational Diabetes Mellitus

Secreted frizzled-related protein 5 (SFRP5) is a newly identified member of the SFRP family produced by the adipose tissue which can act as an anti-inflammatory adipokine. The aim of the study was to assess SFRP5 levels in the serum and urine of women with gestational diabetes mellitus (GDM) in the early post-partum period with reference to their laboratory test results, body composition and hydration status. The study subjects included two groups: 22 GDM patients and 24 healthy controls. Maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. The serum and urine SFRP5, leptin and ghrelin concentrations were determined via enzyme-linked immunosorbent assay (ELISA). No significant differences were observed between the GDM and healthy groups with regard to the serum and urine SFRP5 concentrations. In the GDM group serum and urine SFRP5 levels correlated positively. The serum SFRP5 concentrations correlated negatively with hemoglobin A1c (HgbA1c) and leptin serum levels in the controls. In the control and GDM groups the serum and urine SFRP5 levels correlated negatively with the serum ghrelin levels. It appears that ghrelin as well as SFRP5 could influence the metabolic homeostasis 48 hours after delivery. A significant correlation between concentrations of SFRP5 in the serum and urine seems to suggest that urine sampling may represent an alternative to the current standard of management i.e. blood sampling. Further research in this field is required

Fatty Acid-Binding Protein 4 Serum/Urine Gradient of Post-Partum Women with Metabolic Disturbances

Among novel adipokines fatty acid binding protein 4 (FABP4) seems to be one of the most promising predictors of long-term metabolic pregnancy complications. The aim of the study was to evaluate FABP4 serum/urine gradients which are quotients of the serum FABP4 concentrations to the urine in women with excessive gestational weight gain (EGWG) and gestational diabetes mellitus (GDM) in the early post-partum period, with reference to their laboratory test results, body composition and hydration status. The study subjects were divided into three groups: 24 mothers with EGWG, 22 GDM patients and 24 healthy controls. Maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. Concentrations of FABP4, leptin, and ghrelin were determined via ELISA. The FABP4 serum/urine gradients were comparable in the three studied groups. This parameter was positively associated with the serum FABP4 level only in the control group, whereas it was highly negatively related to the urine FABP4 concentrations in all the three studied groups. We found positive correlations between the FABP4 serum/urine gradients with albumin and LDL concentrations but only in the healthy controls. No correlation was found between the FABP4 serum/urine gradient and biochemical results in the EGWG and GDM groups. The FABP4 serum/urine gradient positively correlated with all the studied BIA variables with the exception of extracellular water (ECW) in the healthy group. The EGWG group was characterized by positive correlations between the FABP4 serum/urine gradient and lean tissue index as well as negative correlations with ECW. No correlations were observed between this parameter and BIA findings in the GDM group. Our results seem to confirm that further studies should not be limited to evaluation of serum FABP4 levels only

SFRP5-leptin ratio as a promising index in post-partum women with gestational diabetes mellitus

INTRODUCTION: Gestational diabetes mellitus (GDM) has often been referred to as the “marker” for the development of diabetes, obesity and cardiovascular diseases in future lives of women. In the current literature the adiponectin-leptin ratio is presented as a valuable index to estimate adipose tissue dysfunction. OBJECTIVES: The aim of the study was to investigate the significance of a novel parameter, i.e. the ratio of serum concentration of secreted frizzled-related protein 5 (SFRP5) to that of leptin in the early post-partum period. The associations between SFRP5/leptin ratio and maternal laboratory test results, body composition and hydration status were also assessed. PATIENTS AND METHODS: 26 mothers diagnosed with gestational diabetes mellitus (GDM) and 28 healthy controls were enrolled in the study. Body composition and hydration status of the patients were evaluated with the use of bioelectrical impedance analysis (BIA) method. The serum concentrations of SFRP5, leptin, fatty acid-binding protein 4 (FABP4) and ghrelin were determined via enzyme-linked immunosorbent assay (ELISA). RESULTS: SFRP5/leptin ratio was lower in the GDM mothers in comparison to that of the control group. There were positive correlations between SFRP5/leptin ratio and total cholesterol and low-density lipoprotein cholesterol (LDL) levels. The SFRP5/leptin ratio correlated negatively with total body water (TBW) and extracellular water (ECW). CONCLUSIONS: The SFRP5/leptin ratio appears to be a promising index for evaluating of metabolic disturbances in mothers with a history of GDM

Selected determinants of body mass in premature infants

Abstract Design: The following study is an attempt to determine whether and to what extent body mass at birth in premature infants is conditioned by some specific demographic and medical factors. Materials and Methods: The following investigation tools have been applied: standardized EUROPOP GROUP poll questionnaire with our own modifications and adjustments, corresponding to Polish conditions, as well as a poll questionnaire designed by the authors of the following work investigating women’s lifestyle during pregnancy, and medical records analysis. The study group consisted of 555 respondents, whose pregnancy ended between 22 and 36 completed weeks’ gestation, calculated from the first day of the last menstrual bleeding. Results: Statistical analysis of data confirmed the relationship between body mass in premature infants and family income (

Zastosowania Skali Stresu Rodziców: OITN (SSR:OITN) w diagnostyce klinicznej kobiet po porodzie przedwczesnym

Aim: The aims of the study were: 1) to evaluate the effectiveness of the Polish equivalent of the NUPS Scale, i.e. SSR: OITN [Skala Stresu Rodziców: Oddział Intensywnej Terapii Noworodka],2) to evaluate the possibilities of employing the described method in clinical diagnosis of women after preterm delivery. Material and methods: The analysis was carried out on the basis of the research conducted at the Department and Clinic of Obstetrics and Maternal–Fetal Medicine SPSK 4 [Autonomous Public Teaching Hospital No. 4] inLublin among 96 patients after preterm delivery. The factor validity of the questionnaire was evaluated on the basis of factor analysis with the use of identifying principal components method. The reliability was assessed with the use of Cronbach’s alpha coefficient as well as the correlation values of particular factors with the full scale score. Results: Strong psychometric properties of the method (global as well as concerning particular factors) substantiate its use and the statistical analysis of the obtained results. Conclusions: The results of this study validate the application of the SSR: OITN questionnaire to assess the level and structure of stress among women after preterm delivery.Cel pracy: Celem prezentowanej pracy była: 1) ocena trafności i rzetelności polskiej wersji narzędzia NUPS Scale, w polskiej wersji zwanego SSR:OITN (Skalą Stresu Rodziców: Oddział Intensywnej Terapii Noworodka); 2) ocena możliwości zastosowania opisanego narzędzia w diagnostyce klinicznej wśród pacjentek po porodzie przedwczesnym. Materiał i metody: Analizę przeprowadzono w oparciu o badania realizowane w Katedrze i Klinice Położnictwa i Perinatologii SPSK 4 w Lublinie wśród 96 pacjentek po porodzie przedwczesnym. Trafność czynnikową kwestionariusza oceniano stosując analizę czynnikową metodą wyodrębniania głównych składowych. Ocenę rzetelności dokonano przy użyciu współczynnika alpha Cronbacha oraz wartości korelacji poszczególnych czynników z sumarycznym wynikiem skali. Wyniki: Wysokie właściwości psychometryczne metody (globalne oraz dla poszczególnych czynników) uzasadniają możliwość jej stosowania oraz opracowywania statystycznego uzyskanych wyników. Wnioski: Uzyskane wyniki potwierdzają zasadność użycia kwestionariusza SSR:OITN do oceny poziomu i struktury stresu doznawanego przez pacjentki po porodzie przedwczesnym

The role of new adipokines in gestational diabetes mellitus pathogenesis

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition dur­ing pregnancy. Explanation of the GDM pathogenesis is important due to preventing gestational complications. During pregnancy there are significant changes in maternal metabolism. Many of these changes are influenced by different adi­pokines produced in the placenta and adipose tissue. The exact role of adipokines in the pathogenesis of GDM remains still unknown. Several adipokines have been analysed throughout gestation and their levels have been suggested as biomarkers of maternal–perinatal outcomes. Some of them have been postulated as significant in the pathogenesis of pregnancy complications like GDM. This report aims to review some of the recent topics of adipokine research that may be of particular importance in patho­physiology and diagnosis of gestational diabetes mellitus. Because of manuscript length limitations, after thorough literature review and in view of the recent evidence, we focus on the one of the most well-known adipokine: adiponectin, and not so well-studied: nesfatin-1, chemerin, ghrelin, and CTRP 1

Obesity among women. Pregnancy after bariatric surgery: a qualitative review

Abstract Bariatric surgery is a safe and most effective method of achieving substantial long-term weight loss. Surgery should be considered in case of all patients with a BMI of more than 40kg/m2 and for those with a BMI of over 35kg/m2 with obesity-related co-morbidities, after conventional treatment failure. The most frequently used procedures in surgical treatment of obesity, performed mostly laparoscopically, are restrictive operations limiting energy intake by reducing gastric capacity (vertical banded gastroplasty, adjustable gastric band, sleeve gastrectomy) and restrictive/ malabsorptive surgeries also inducing decreased absorption of nutrients by shortening the functional length of the small intestine (Roux-en-Y gastric bypass). Frequent complications following surgery may include hyperemesis, intragastric band migration, gastric perforation, nutritional deficiencies, anastomotic leak, bleeding, anastomotic stricture, internal hernia, wound infection. It is generally recommended for women after bariatric surgery to wait approximately at least 12 months before becoming pregnant. There exists considerable threat that rapid weight loss (relative starvation phase) may be unhealthy for a mother and a baby. Pregnancy after weight loss surgery is not only safe for the mother and the baby but may also be less risky than pregnancy in morbidly obese patients. Postoperative nutrient supplementation and close supervision before, during, and after pregnancy adjusted to individual requirements of a woman can help to prevent nutrition-related complications such as deficiencies in iron, vitamin A, vitamin B12, vitamin K, folate and calcium, and improve maternal and fetal health

Efficacy and safety of Black cohosh (Actaea/Cimicifuga racemosa) in the treatment of vasomotor symptoms – review of clinical trials

Abstract The occurrence of vasomotor symptoms in women is directly related to deficiency of estrogen, which occurs as a result of natural or surgical menopause. Hot flushes may also be a major problem for patients with a history of breast cancer, as they may result directly from cancer treatment (oophorectomy, chemotherapy-induced ovarian failure or adjuvant tamoxifen citrate therapy). Despite the lack of reliable data regarding their efficacy and safety, in recent years the usage of herbs among menopausal women has increased dynamically all over the world. The following paper reviews professional literature about Black Cohosh (Actaea/Cimicifuga racemosa), either used alone or in combination with other medicinal herbs administered in management of vasomotor symptoms. Extracts of the rootstock of Black cohosh contain such potentially biologically active constituents as triterpene glycosides (actein, cimicifugoside, deoxyacetein), isoferulic acid and alkaloids (n-methylcytisine). The mechanism of its action remains unclear. Some authors suggest that Black Cohosh contains substances with selective estrogen receptor modulator (SERM) activity. Recent data has demonstrated that Black Cohosh may have an effect on dopaminergic and serotoninergic systems. Thirty-two papers formed the basis for this review. Openlabel, noncomparative studies, as well as treatment-controlled, randomized, open trials, have proven that Black Cohosh significantly reduced frequency or severity of hot flashes. The results of randomized, placebo-controlled, double-blind clinical trials were contradictory. Adverse symptoms have been rare (5,4%), mild and reversible. Most of them included gastrointestinal upsets, rashes, headaches, dizziness and mastalgia. Nevertheless, single cases of serious adverse events, including acute hepatocellular damage, have been reported, but without a clear causality relationship

Adipokines and C-peptide in overweight and obese pregnant women

Objectives: The aim of the study was to evaluate the levels of adipokines such as adiponectin, resistin, leptin as well as C-peptide in overweight and obese pregnant women. Material and methods: The adipokines and C-peptide concentrations were measured in the group of 38 overweight/obese pregnant women (BMI > 25 kg/m2) and in 42 pregnant women of normal weight (BMI < 25 kg/m2) with ELISA tests between 24th and 34th weeks of gestation. Results: The overweight/obese women compared to lean ones were characterized by significantly higher concentrations of leptin (43.44 ± 31.41 vs. 21.29 ± 12.67 ng/mL, p = 0.0001) and C-peptide (2.77 ± 1.88 vs. 2.25 ± 1.42 ng/mL, p = 0.034). There were no significant differences between groups in resistin (17.39 ± 7.59 vs. 15.76 ± 6.64 ng/mL, NS) and adiponectin (6.93 ± 3.52 vs. 8.07 ± 6.53 μg/mL, NS) levels. In the overweight/obese patients, no relationships between the adipokines, C-peptide and CRP concentrations were found. BMI was negatively correlated with the resistin levels (R = –0.406, p = 0.011). The significant correlation between leptin and C-peptide concentrations was observed in the study group (R = 0.517, p = 0.012). In the control group, the negative correlation between adiponectin concentrations and BMI was shown (R = –0.446, p = 0.003). Conclusions: The higher levels of leptin in the overweight and obese pregnant women seem to reflect the leptin resistance condition and the higher levels of C-peptide in this group is suggestive for hyperinsulinemia. The positive correlation between C-peptide and leptin levels but not with resistin and adiponectin might confirm the role of leptin in the hyperinsulinemia development in overweight and obesity during pregnancy