| 1. |
- Bärebring, Linnea, et al.
(författare)
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Preeclampsia and Blood Pressure Trajectory during Pregnancy in Relation to Vitamin D Status
- 2016
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- Every tenth pregnancy is affected by hypertension, one of the most common complications and leading causes of maternal death worldwide. Hypertensive disorders in pregnancy include pregnancy-induced hypertension and preeclampsia. The pathophysiology of the development of hypertension in pregnancy is unknown, but studies suggest an association with vitamin D status, measured as 25-hydroxyvitamin D (25(OH) D). The aim of this study was to investigate the association between gestational 25(OH) D concentration and preeclampsia, pregnancy-induced hypertension and blood pressure trajectory. This cohort study included 2000 women. Blood was collected at the first (T1) and third (T3) trimester (mean gestational weeks 10.8 and 33.4). Blood pressure at gestational weeks 10, 25, 32 and 37 as well as symptoms of preeclampsia and pregnancy-induced hypertension were retrieved from medical records. Serum 25(OH) D concentrations (LC-MS/MS) in T1 was not significantly associated with preeclampsia. However, both 25(OH) D in T3 and change in 25 (OH) D from T1 to T3 were significantly and negatively associated with preeclampsia. Women with a change in 25(OH) D concentration of >= 30 nmol/L had an odds ratio of 0.22 (p = 0.002) for preeclampsia. T1 25(OH) D was positively related to T1 systolic (beta = 0.03, p = 0.022) and T1 diastolic blood pressure (beta = 0.02, p = 0.016), and to systolic (beta = 0.02, p = 0.02) blood pressure trajectory during pregnancy, in adjusted analyses. There was no association between 25(OH) D and pregnancy-induced hypertension in adjusted analysis. In conclusion, an increase in 25(OH) D concentration during pregnancy of at least 30 nmol/L, regardless of vitamin D status in T1, was associated with a lower odds ratio for preeclampsia. Vitamin D status was significantly and positively associated with T1 blood pressure and gestational systolic blood pressure trajectory but not with pregnancy-induced hypertension.
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| 2. |
- Bärebring, Linnea, et al.
(författare)
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Trajectory of vitamin D status during pregnancy in relation to neonatal birth size and fetal survival: a prospective cohort study
- 2018
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: We investigated the associations between vitamin D status in early and late pregnancy with neonatal small for gestational age (SGA), low birth weight (LBW) and preterm delivery. Furthermore, associations between vitamin D status and pregnancy loss were studied. Methods: Serum 25-hydroxyvitamin D (25OHD) was sampled in gestational week <= 16 (trimester 1 (T1), N = 2046) and > 31 (trimester 3 (T3), N = 1816) and analysed using liquid chromatography tandem mass spectrometry. Pregnant women were recruited at antenatal clinics in south-west Sweden at latitude 57-58 degrees N. Gestational and neonatal data were retrieved from medical records. Multiple gestations and terminated pregnancies were excluded from the analyses. SGA was defined as weight and/or length at birth < 2 SD of the population mean and LBW as < 2500 g. Preterm delivery was defined as delivery < 37 + 0 gestational weeks and pregnancy loss as spontaneous abortion or intrauterine fetal death. Associations between neonatal outcomes and 25OHD at T1, T3 and change in 25OHD (T3-T1) were studied using logistic regression. Results: T1 25OHD was negatively associated with pregnancy loss and 1 nmol/L increase in 25OHD was associated with 1% lower odds of pregnancy loss (OR 0.99, p = 0.046). T3 25OHD >= 100 nmol/L (equal to 40 ng/ml) was associated with lower odds of SGA (OR 0.3, p = 0.031) and LBW (OR 0.2, p = 0.046), compared to vitamin D deficiency (25OHD < 30 nmol/L, or 12 ng/ml). Women with a >= 30 nmol/L increment in 25OHD from T1 to T3 had the lowest odds of SGA, LBW and preterm delivery. Conclusions: Vitamin D deficiency in late pregnancy was associated with higher odds of SGA and LBW. Lower 25OHD in early pregnancy was only associated with pregnancy loss. Vitamin D status trajectory from early to late pregnancy was inversely associated with SGA, LBW and preterm delivery with the lowest odds among women with the highest increment in 25OHD. Thus, both higher vitamin D status in late pregnancy and gestational vitamin D status trajectory can be suspected to play a role in healthy pregnancy.
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| 3. |
- Fernandes, Cláudio Pinheiro, et al.
(författare)
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A Novel Sensor for Bite Force Determinations
- 2003
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Ingår i: Dental Materials. - 0109-5641 .- 1879-0097. ; 19:2, s. 118-126
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: The clinical usefulness, accuracy and precision of a novel bite force sensor based on force sensing resistors were tested in six subjects wearing maxillary removable partial dentures retained by conical crowns. METHODS: The surfaces of the sensor were manufactured in a silicone material that had mechanical properties similar to those of tough foodstuffs. In two separate series of standardized bite force tests, submaximum force levels were recorded with the sensor and with a strain gaged bite fork. Subjects were assisted in the loading tests with visual feedback instrumentation. Reliability estimates for the bite force sensor were calculated in order to show their reproducibility. Strain gages attached to the prostheses were used to determine the pattern of force distribution during loading tests. The bite force results obtained with the new bite force sensor and with the bite fork were analyzed with ANOVA and Scheffes tests. The strain patterns registered with strain gages were analyzed with F-test. RE-SULTS: The bite force sensor and the bite fork transducer showed no statistically significant differences in respect of intra-individual bite force levels (range 50-300N). The bite forces registered with the new sensor were dependent on the loading position (p<0.05), sex (p<0.05) and test subject (p<0.05). The reliability of the new sensor for sub-maximum bite forces was calculated to be 93%. Strain gage results showed that the new sensor generated strain patterns of less variance (p<0.05) than the bite fork and therefore allowed for higher precision during biting tests. SIGNIFICANCE: The presented instrument has such clinical merits, as to favor its use in experimental clinical studies on the biomechanics of prosthetic appliances.
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| 4. |
- Petrov Fieril, Karolina, et al.
(författare)
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Hemodynamic responses to single sessions of aerobic exercise and resistance exercise in pregnancy
- 2016
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 95:9, s. 1042-1047
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Previous research on maternal hemodynamic responses to a single exercise session during pregnancy is sparse, especially considering immediate responses to resistance exercise. The aim of the study was to examine blood pressure, heart rate, body temperature, and Rating of Perceived Exertion in healthy pregnant women during single sessions of continuous submaximal exercise in pregnancy week 21. Material and methods: A cross-over design was used. Twenty healthy pregnant women from four prenatal clinics in Gothenburg, Sweden, were included. On day 1, the women did 30 min of aerobic exercise and on day 3 they did 30 min of resistance exercise. Blood pressure, heart rate, and Rating of Perceived Exertion were measured after 15 and 30 min of exercise. Results: After 15 and 30 min of exercise, there was a significant increase in systolic blood pressure and heart rate (p < 0.001). Diastolic blood pressure increased slightly more after 15 and 30 min of aerobic exercise (p = 0.01) than resistance exercise (p = 0.03). Resistance exercise was perceived as more intense than aerobic exercise after 15 min (p = 0.02) and 30 min (p = 0.001) of exercise. Five minutes after completing the exercise, blood pressure quickly reverted to normal although heart rate was still increased (p = 0.001). There was no correlation between heart rate and Rating of Perceived Exertion (rs = 0.05–0.43). Conclusions: Maternal hemodynamic responses were essentially the same, regardless of whether the exercise was submaximal aerobic or resistance exercise, although resistance exercise was perceived as more intense. Aerobic and resistance exercise corresponding to “somewhat hard” seems to have no adverse effect with regard to maternal hemodynamic responses in healthy pregnancy. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology
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| 5. |
- Augustin, Hanna, et al.
(författare)
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Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section: A Prospective Cohort Study
- 2020
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Ingår i: Maternal and Child Health Journal. - : Springer Science and Business Media LLC. - 1092-7875 .- 1573-6628. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.
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