Oxidative stress and impaired placental function – pathways implicated in the pathogenesis of placental abruption – have their origins extending to mitochondrial dysfunction. To the best of our knowledge, there are no published reports of associations of placental abruption with circulating mitochondrial DNA (mtDNA) copy number – a novel biomarker of systemic mitochondrial dysfunction. This pilot case-control study was comprised of 233 placental abruption cases and 238 non-abruption controls. Real-time quantitative polymerase chain reaction (PCR) was used to assess the relative copy number of mtDNA in maternal whole blood samples collected at delivery. Logistic regression procedures were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). There was some evidence of an increased odds of placental abruption with the highest quartile of mtDNA copy number (P f...

El Institute 2009 de Medicina (IOM) recomendaciones de peso gestacional se adaptan a índice de masa corporal previo al embarazo de las mujeres (IMC). Las pruebas limitadas existe en métodos para la estimación pre-embarazo índice de masa corporal de las mujeres, especialmente para las mujeres que viven en países de bajos y medianos ingresos. Utilizando los datos de recogida entre las mujeres embarazadas peruanas, se comparó la concordancia entre la percepción subjetiva de IMC antes del embarazo con el IMC medido en la visita de estudio prenatal temprana.Los datos fueron de la Embarazo resultados maternos y neonatales Estudio (Promis), una cohorte de mujeres embarazadas en el Instituto Nacional Materno Perinatal (INMP) en Lima, Perú. 2605 mujeres de 18 a 49 años (media ± desviación estándar de edad gestacional = 10,9 ± 3,3 semanas) fueron incluidos en el estudio. Auto-reporte ...

STUDY OBJECTIVES: We sought to evaluate the construct validity and factor structure of the Spanish-language version of the Pittsburgh Sleep Quality Index (PSQI) among pregnant Peruvian women. METHODS: A cohort of 642 women were interviewed at ≤ 16 weeks of gestation. During interview, we ascertained information about lifestyles, demographics, sleep characteristics, and mood symptoms. Stress induced sleep disturbance, depressive symptoms, and anxiety symptoms were evaluated using the Ford Insomnia Response to Stress Test (FIRST), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) assessment scales, respectively. Consistency indices, exploratory and confirmatory factor analyses, correlations, and logistic regressions were used. RESULTS: Both exploratory and confirmatory factor analyses indicated a three-factor solution: sleep quality, sleep efficiency, and...

OBJETIVE: To evaluate the association between the level of knowledge about cervical cancer and Pap smear (Pap) with fear, stress or embarrassment associated with this screening. DESIGN: Cross-sectional, prospective descriptive study based on community. MATERIALS AND METHODS: Using random cluster sampling, women in a poor community of Lima met, assessing their level of knowledge about cervical cancer and Pap smears and their perception of this screening. Chi square, odds ratios, confidence intervals were 95% and used logistic regression to assess the association study. RESULTS: Of 300 women between 18 and 50 years, 20% had their last Pap over two years and 20% had never done; 57 (19%) women reported having much fear, stress or embarrassment to screening, which was associated with being a teenager (OR 5.5, 95% CI 1.8 to 16.9), have five or less years of living in Lima from having llgado o...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Objectives To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures. Results Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep dis...

OBJETIVE: To evaluate the association between the level of knowledge about cervical cancer and Pap smear (Pap) with fear, stress or embarrassment associated with this screening. DESIGN: Cross-sectional, prospective descriptive study based on community. MATERIALS AND METHODS: Using random cluster sampling, women in a poor community of Lima met, assessing their level of knowledge about cervical cancer and Pap smears and their perception of this screening. Chi square, odds ratios, confidence intervals were 95% and used logistic regression to assess the association study. RESULTS: Of 300 women between 18 and 50 years, 20% had their last Pap over two years and 20% had never done; 57 (19%) women reported having much fear, stress or embarrassment to screening, which was associated with being a teenager (OR 5.5, 95% CI 1.8 to 16.9), have five or less years of living in Lima from having llgado o...

Purpose Experiencing childhood abuse (CA) or intimate partner violence (IPV) has been linked to adverse pregnancy outcomes. We examined whether CA history and current IPV are independently and jointly associated with placental abruption (PA). Methods We recruited 662 PA cases and 665 controls in Lima, Peru. We used multivariate logistic regression to calculate odds ratios (OR), adjusting for age, education, and parity. Results Approximately 42% of cases and controls reported CA; 50% of cases and 49% of controls reported IPV. History of any CA was not associated with PA, but history of severe CA was associated with 38% increased odds of PA (adjusted OR [aOR], 1.38; 95% confidence interval (CI), 1.07–1.80), adjusting for IPV. There was a statistically nonsignificant association between severe IPV and odds of PA (aOR, 1.22; 95% CI, 0.92–1.62), adjusting for CA. Women who experienced sev...

Purpose Preterm birth (PTB) is a major cause of neonatal mortality. The vaginal microbiome is associated with PTB, but results vary across racial/ethnic populations. Some evidence suggests gestational age affects this association. We investigated these associations in a novel population, conducting a post hoc analysis assessing if associations differed between women swabbed at different gestational ages. Methods We compared vaginal microbiomes from women with PTB (n = 25) to a random sample of women with term births (n = 100) among participants in the Pregnancy Outcomes, Maternal and Infant Study, conducted in Lima, Peru. Using DADA2, we identified taxa from 16S DNA sequencing and used Dirichlet multinomial mixture models to group into community state types (CSTs). Results If gestational age at sampling was not considered, no CST (diverse, Lactobacillus-dominated or Lactobacillus inersâ€...

Background: : Few investigators have evaluated the association between early pregnancy social support and depression; however, increased social support may improve mental health during pregnancy. Our objective is to examine whether in early pregnancy there is an association between social support and maternal depression among women in Peru. Methods: : 2,062 pregnant women participated in structured interviews. Early pregnancy social support was measured using the Social Support Questionnaire (SSQ-6). We evaluated the number of individuals that participants could turn to in different situations (Social Support Number Score; SSQN) and their satisfaction with support received (Social Support Satisfaction Score; SSQS). Median SSQN and SSQS characterized participants according to high and low levels of support. SSQN family vs. non-family support were also evaluated separately. Antepartum depr...

Background Mitochondrial biogenesis and adequate energy production are important for embryogenesis and placentation. Previous studies documented alterations in maternal blood mitochondrial DNA (mtDNA) copy number—a marker of mitochondrial dysfunction—in pregnancies complicated by placental abruption. To further understand the role of mitochondrial dysfunction in the pathogenesis of placental abruption, we conducted a pilot study using placental specimen collected from 103 placental abruption cases and 102 non-abruption controls. Real-time quantitative polymerase chain reaction (PCR) was used to assess the relative copy number of mtDNA in DNA extracted from placental samples collected immediately after delivery. Logistic regression procedures were used to estimate adjusted odds ratios (OR) and 95 % confidence intervals (CI). Results Higher odds of placental abruption was observed with...

Objective We sought to evaluate the validity of the Spanish language version of the patient health questionnaire-9 (PHQ-9) depression scale in a large sample of pregnant Peruvian women using Rasch item response theory (IRT) approaches. We further sought to examine the appropriateness of the response formats, reliability and potential differential item functioning (DIF) by maternal age, educational attainment and employment status. Methods This cross-sectional study was conducted among 1520 pregnant women in Lima, Peru. A structured interview was used to collect information on demographic characteristics and PHQ-9 items. Data from the PHQ-9 were fitted to the Rasch IRT model and tested for appropriate category ordering, the assumptions of unidimensionality and local independence, item fit, reliability and presence of DIF. Results The Spanish language version of PHQ-9 demonstrated unidimen...

OBJECTIVE: To examine the association between the levels of Papanicolaou (Pap) test and cervical cancer knowledge with fear, stress, or shame related to these. DESIGN: A simple random sample of all households within the community was conducted. MATERIAL AND METHODS: A survery was administered to women in a low socioeconomic community of Lima, Peru. Chisquare analysis, odds ratios and 95% confidence intervals were used to measure association of the variables studied with fear, stress, or shame. Logistic regression was used to control for confounding variables. RESULTS: From 300 women interviewed ages between 18 and 50, 20% had their last Pap test over two years and another 20% had never had a Pap smear. Nineteen percent (57) of women reported a high level of lear, stress or shame to the Pap test and cervical cancer, all associated to adolescence (OR 5,5 CI95% 1,8 16,9), living in Lima 5 y...

OBJECTIVE: To examine the association between the levels of Papanicolaou (Pap) test and cervical cancer knowledge with fear, stress, or shame related to these. DESIGN: A simple random sample of all households within the community was conducted. MATERIAL AND METHODS: A survery was administered to women in a low socioeconomic community of Lima, Peru. Chisquare analysis, odds ratios and 95% confidence intervals were used to measure association of the variables studied with fear, stress, or shame. Logistic regression was used to control for confounding variables. RESULTS: From 300 women interviewed ages between 18 and 50, 20% had their last Pap test over two years and another 20% had never had a Pap smear. Nineteen percent (57) of women reported a high level of lear, stress or shame to the Pap test and cervical cancer, all associated to adolescence (OR 5,5 CI95% 1,8 16,9), living in Lima 5 y...

Objective We examined the ability of anthropometric measures to predict the risk of metabolic syndrome (MetS) and its components in Peruvian adults. Methods Participants were 1,815 Peruvian adults. Body mass index (BMI), waist circumference (WC), A Body Shape Index (ABSI), Body Roundness Index (BRI) and Visceral Adiposity Index were examined. MetS components were defined using the National Cholesterol Education Program’s Adult Treatment Panel III. Logistic regression was used to calculate odds ratios of MetS and MetS components in relation to increases in anthropometric measures. Receiver operating characteristic curves (and area under the curve) were calculated to compare each measure’s power to predict MetS and MetS components. Results BRI performed similar to or better than BMI and WC at predicting MetS and MetS components. ABSI underperformed other measures. In men, the odds of M...

OBJECTIVE: To identify risk factors for preeclampsia in Peruvían women. Design: Prospective case control clinical study. SETTING: Materno Perinatal Institute and Dos de Mayo Hospital between August 1997 and January 1998. MATERIAL AND METHODS: One hundred eighty-seven preeclampsic women were compared with 193 normotensive pregnant women. Cases were matched to controls regarding Inaternal age and gestational age. Potential associated factors were analyzed using univariated analysis and then logistic regression to adjust to confounders. RESULTS: Pre eclampsia was associated to primiparity but only by univaried analysis (OR. 1,86, IC95: 1,2-3,0). History of a previous pregnancy complicated with preeclampsia was the main risk factor associated to preeclampsia (OR: 9,7. IC95%: 3,4-27,3). Obesity was marginally associated to preeclampsia (OR: 2,1. IC95%: 0,8-5,4) and there was a marginally sig...

Background Preterm birth is a leading cause of perinatal morbidity and mortality worldwide, resulting in a pressing need to identify risk factors leading to effective interventions. Limited evidence suggests potential relationships between maternal sleep or vital exhaustion and preterm birth, yet the literature is generally inconclusive. Methods We examined the relationship between maternal sleep duration and vital exhaustion in the first six months of pregnancy and spontaneous (non-medically indicated) preterm birth among 479 Peruvian women who delivered a preterm singleton infant (<37 weeks gestation) and 480 term controls who delivered a singleton infant at term (≥37 weeks gestation). Maternal nightly sleep and reports of vital exhaustion were ascertained through in-person interviews. Spontaneous preterm birth cases were further categorized as those following either spontaneous pret...

OBJECTIVE: To identify risk factors for preeclampsia in Peruvían women. Design: Prospective case control clinical study. SETTING: Materno Perinatal Institute and Dos de Mayo Hospital between August 1997 and January 1998. MATERIAL AND METHODS: One hundred eighty-seven preeclampsic women were compared with 193 normotensive pregnant women. Cases were matched to controls regarding Inaternal age and gestational age. Potential associated factors were analyzed using univariated analysis and then logistic regression to adjust to confounders. RESULTS: Pre eclampsia was associated to primiparity but only by univaried analysis (OR. 1,86, IC95: 1,2-3,0). History of a previous pregnancy complicated with preeclampsia was the main risk factor associated to preeclampsia (OR: 9,7. IC95%: 3,4-27,3). Obesity was marginally associated to preeclampsia (OR: 2,1. IC95%: 0,8-5,4) and there was a marginally sig...

BACKGROUND: Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. OBJECTIVE: To examine the association between migraine and suicidal ideation among a cohort of pregnant women. METHODS: A cross-sectional study was conducted among 3372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders-III beta criteria. Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Sui...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.