Summary
Context
There are limited data on the prevalence of vitamin D inadequacy in pregnant women living in Southeast Asia and changes in their vitamin D status during pregnancy.
Objectives
To determine the prevalence of vitamin D inadequacy, its predictive factors and the changes in vitamin D status during the course of pregnancy.
Design and patients
A prospective study of 120 pregnant Thai women with gestational age <14 weeks.
Measurements
Serum 25 hydroxyvitamin D (25OHD) and clinical data were obtained at the first visit, in the second and third trimesters of pregnancy. Vitamin D inadequacy was defined as 25OHD <75 nm.
Results
The prevalences of vitamin D inadequacy were 83·3%, 30·9% and 27·4% for the first, second and third trimesters. The independent predictors of vitamin D inadequacy in the third trimester were not drinking vitamin‐fortified milk (OR 11·42; 95% CI: 3·12–41·86), not taking prenatal vitamins (OR 9·70; 95% CI: 2·28–41·19) and having vitamin D deficiency in the first trimester (OR 10·58; 95% CI: 2·89–38·80). Vitamin D deficiency was not found in women taking prenatal vitamins. However, 20 women who took at least 400 IU/day of vitamin D from prenatal vitamins still had vitamin D insufficiency in the third trimester.
Conclusions
Vitamin D inadequacy is common in pregnant Thai women, especially in the first trimester. Vitamin D supplementation may be needed prior to conception and during pregnancy. For areas with abundant sun exposure like Thailand, vitamin D supplementation at 400 IU/day is likely to prevent vitamin D deficiency, but is inadequate to prevent vitamin D insufficiency even at 800 IU/day.
SGA fetuses with abnormal UA Doppler suffered more morbidity and mortality compared to those with normal UA Doppler. SGA fetuses with normal UA PI but abnormal MCA PI had worse outcomes compared to those with normal UA and MCA PI.
Aim
To compare effects of cold therapy on patient pain score during and after amniocentesis procedure.
Methods
We performed a prospective randomized‐controlled study comparing the anticipated pain, perceived pain during the procedure, and pain after 15 and 30 min of amniocentesis between pregnant women receiving cold therapy before (group 1), after (group 2), and both before and after amniocentesis (group 3) with a control group (group 4). Pain was measured using a visual analog scale (VAS) score.
Results
A total of 480 participants were recruited and randomly assigned into four groups of 120 each. Anticipated pain scores in all groups were not statistically different. When compared with group 4, groups 1 and 3 experienced significant pain reduction during amniocentesis, while VAS scores at 15 and 30 min after amniocentesis in groups 1–3 were significantly lower as compared to group 4.
Conclusion
Cold therapy both before and after amniocentesis procedure is most effective in pain reduction. It encourages the pregnant woman's cooperation during the procedure and provides a good amniocentesis experience. Application of cold compression is also beneficial in other aspects as it is simple, safe, convenient, and yet reusable and economically efficient for routine use in all pregnant women undergoing amniocentesis.
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