Effect of porcine placental extract on menopausal symptoms in postmenopausal women: A prospective,randomized, double-blind,placebo-controlled trial

ObjectivesTo determine the effect of oral administration of porcine placental extract (PPE) on the menopausal symptoms of Korean women.Materials and methodsThis study was a multicenter, randomized double-blind placebo-controlled trial. A hundred menopausal Korean women were randomly allocated either to the PPE 400 mg per day or the control group during 12 weeks of the study period. Menopausal symptoms were evaluated using the Kupperman Index (KMI).ResultsThe KMI decreased after 12 weeks in both groups; however, the difference in the changes was not statistically significant. Among overweight or obese women whose body mass index (BMI) was 23 kg/m² or higher, the KMI decreased more significantly in the PPE group than placebo group after 12 weeks (−18.52 ± 9.09 vs −11.40 ± 10.68, P < 0.05). Among 49 early menopausal women whose duration of menopause was less than 3 years, the KMI decreased more significantly in the PPE group after 12 weeks (−17.29 ± 9.07 vs −11.29 ± 10.68, P < 0.05). The baseline estradiol level was not statistically different between the two groups before trial, but the estradiol level of the PPE group was significantly increased at 12 weeks (11.13 ± 35.13 pg/m, P < 0.05).ConclusionsOral administration of 400 mg PPE per day decreases menopausal symptoms in women with BMI 23 kg/m² or higher or in early menopausal women. PPE may be considered as a short-term complementary treatment to reduce menopausal symptoms, especially in overweight or early menopausal women.     

Early Postpartum Patterns of Breastfeeding Exclusivity and Perceived Insufficient Milk by Prepregnancy Body Mass Index

ObjectiveTo explore trajectories of breastfeeding exclusivity and perceived insufficient milk (PIM) over the first 8 weeks postpartum among primiparous women and the association of these trajectories with prepregnancy body mass index (BMI).DesignSecondary analysis of data from a randomized controlled trial.SettingRecruitment for the primary study was conducted in Pittsburgh, Pennsylvania.ParticipantsOne hundred twenty-two primiparous women with intention to exclusively breastfeed.MethodsWe used group-based trajectory modeling to classify participants into breastfeeding exclusivity and PIM trajectory groups. We used logistic regression to explore the predictive relationship between prepregnancy BMI and breastfeeding exclusivity and PIM trajectory group memberships.ResultsWe identified two trajectories each for breastfeeding exclusivity and PIM over the first 8 weeks postpartum. For breastfeeding exclusivity, one group (n = 60, 49%) had low initial probability of exclusive breastfeeding with linear decline in likelihood of exclusivity over time. The other group (n = 62, 51%) had greater initial probability of exclusive breastfeeding, which remained constant over time. For PIM, one group (n = 41, 34%) had consistently greater probability of endorsing PIM at each time point, whereas the other group (n = 81, 66%) had consistently low probability of endorsing PIM over time. Prepregnancy BMI did not predict group membership in breastfeeding exclusivity, χ²(1) = 2.8, p = .094, or PIM, χ²(1) = 0.72, p = .397.ConclusionBreastfeeding exclusivity and PIM appeared to be relatively stable phenomena in the postpartum period among a sample of predominately White primiparous women who intended to breastfeed. We did not find a clear association with prepregnancy BMI.     

Sexual orientations of women with polycystic ovary syndrome: Clinical observation in Taiwan

ObjectiveThis study was conducted to explore the association between sexual orientations and polycystic ovary syndrome (PCOS)-related parameters.Materials and methodsA cross-sectional study with participants recruited from the regular outpatient clinic at the Department of Obstetrics and Gynecology at Taipei Medical University Hospital, Taipei, Taiwan between July 2012 and December 2013 was carried out. A total of 97 women met the criterion of having been diagnosed with PCOS. Among these 97 women, 89 were heterosexuals and eight were self-identified as lesbians. At the same time, 78 women without PCOS were enrolled to serve as the control group. Participants were given a standard questionnaire and had blood withdrawn for biochemical analysis of androgen parameters—including total testosterone, androstenedione, sex hormone binding globulin, free androgen index, 17β-estradiol (E2), luteinizing hormone, and follicular-stimulating hormone. The biochemical data were measured to compare the PCOS clinical parameters present in people of different sexual orientations (lesbians and heterosexuals).ResultsThe women with PCOS, regardless of sexual orientation, had higher percentages and serum levels of hyperandrogenism-related clinical parameters than the women without PCOS [acne (87.5% and 60.7% vs. 23.1%), p < 0.001]; hirsutism (62.5% and 57.3% vs. 15.4%, p ≤ 0.001)]; and biochemical parameters (total T, p < 0.05 or p < 0.001, and luteinizing hormone/follicular-stimulating hormone ratio, p ≤ 0.001]. The sexual orientation of women with PCOS affected their body mass index (BMI), because lesbians with PCOS possessed higher BMI than heterosexual women with PCOS (26.5 ± 1.9 vs. 22.5 ± 0.55; p < 0.05). However, hyperandrogenism-related clinical and biochemical parameters were not significantly different statistically between women with PCOS but of different sexual orientations.ConclusionOur preliminary data showed that sexual orientation influenced the BMI of women with PCOS, but did not affect hyperandrogenism-related clinical or biochemical characteristics. This observation requires further confirmation.     

Maternal pre-pregnancy body mass index and the risk for gestational diabetes mellitus in women with twin pregnancy in South Korea

ObjectiveTo investigate the association between maternal pre-pregnancy body mass index (BMI) and the risk for gestational diabetes mellitus (GDM) in women with twin pregnancy in South Korea.Materials and methodsWe performed a single-center, retrospective cohort study involving 1028 women with twin pregnancy from January 2006 to December 2018 in South Korea. Pregnancies with monoamnionic twins, twin–twin transfusion syndrome, fetal death in utero before 24 weeks, pre-gestational diabetes mellitus, and unknown BMI or GDM status were excluded. Subjects were grouped into four groups based on pre-pregnancy BMI: underweight (<18.5 kg/m²), normal (18.5–22.9 kg/m²), overweight (23.0–24.9 kg/m²), and obese (≥25.0 kg/m²).ResultsAmong 1028 women who were included in the analysis, 169 (16.4%), 655 (63.7%), 111 (10.8%), and 93 (9.0%) women were underweight, normal, overweight, and obese, respectively, before pregnancy. The incidence of GDM was 8.9% in the total study population: 4.7%, 8.2%, 11.7%, and 17.2% in the underweight, normal, overweight, and obese group, respectively (p = 0.005). The incidence of GDM significantly increased according to the increase in pre-pregnancy BMI (p < 0.001). Women in the obese group were more likely to be affected by GDM compared to the normal group (adjusted odds ratio = 2.20, 95% confidence interval = 1.19–4.08) after controlling for maternal age, parity, type of conception, and chorionicity.ConclusionIn twin pregnancies in South Korea, the risk of GDM increased as maternal pre-pregnancy BMI increased and obese women before pregnancy were more likely to be affected by GDM.     

The relation of body mass index,menopausal symptoms,and lipid profile with bone mineral density in postmenopausal women

ObjectiveWe aimed to evaluate the relationship of menopausal symptoms, body mass index (BMI), and serum lipid profile with Bone Mineral Density (BMD) levels.Materials and methods452 postmenopausal women were included in this case–control study at our outpatient clinic between January 2012 and January 2015. The patients were stratified according to their BMD, based on dual-energy X-ray absorptiometer (DXA) results, as the normal group (−1 ≤ T-score), osteopenia group (−2.5 < T-score < −1), and osteoporosis group (T-score ≤ −2.5). High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG), fasting plasma glucose (FPG) levels were measured. To assess the menopausal symptoms, the Menopause Rating Scale (MRS) questionnaire was used.ResultsWaist circumference (WC) and BMI were significantly lower in the osteoporosis group than in normal and osteopenia groups (p: 0.001, p: 0.001, respectively). L2-L4 measurements were negatively correlated with Low Density Lipoprotein (LDL) levels, but positively correlated with WC. BMI showed significant positive correlation with Femur Neck (FN), L1–L2, and L2–L4 measurements. Among menopausal symptoms, there was a significant negative correlation between heart discomfort and L1–L2 levels. On multiple regression analysis, a relation between FN scores and somatic symptom scores was identified.ConclusionHyperlipidemia, lower BMI, lower WC, and severe somatic symptoms may be associated with decreased BMD.     

Vaginal delivery or caesarean section – Severity of early symptoms of postpartum depression and assessment of pain in Polish women in the early puerperium

ObjectivesThe primary objective of this study is to examine the differences between women following vaginal delivery and caesarean section (elective or emergency) in terms of early symptoms of postpartum depression, and to evaluate pain during labour and in the early puerperium. An additional goal was to determine if pain evaluation is associated with depressive symptoms.Materials and methodsA cross-sectional study was conducted among 224 women in the early puerperium recruited from a public hospital in Poland, who were divided into three groups by method of delivery: caesarean section – elective and emergency, and a vaginal delivery. The measurement tools used in the research were the Edinburgh Postnatal Depression Scale (EPDS) and a Numerical Rating Scale (NRS). A Pearson correlation analysis, a Student's t-test, a Mann–Whitney U test for independent groups and nonparametric multivariate analyses of variance (Kruskal–Wallis test) were carried out.ResultsThe number of early symptoms of postpartum depression and the level of pain experienced vary depending on type of delivery. Following a caesarean section, women have more early symptoms of depression (M_CS = 7.40; SD_CS= 5.18 vs M_{VD =} 5.98; SD_VD = 4.19; p = 0.03) (especially an emergency CS: Mean rank_Em-CS=141.41 vs Mean rank_El-CS = 100.94 vs Mean rank_VD = 100.93; p < 0.01) and more pain on discharge (Mean rank_CC=126.51 vs Mean rank_VD = 84.11; p < 0.01) (especially after Em-CS: Mean rank_Em-CS =130.38 vs Mean rank_El-CS=123.62 vs Mean rank_VD = 84.11; p < 0.01), compared to women following a vaginal delivery. Pain in a time of discharge from hospital was found to be associated with increased frequency of EPSD but only in El-CS group (r = 0.24; p = 0.02).ConclusionsCaesarean section (especially emergency CS) is a risk factor for postpartum depression, and the level of pain experienced is a marker of its potential severity. Evaluation of factors associated with postpartum pain and depressive symptoms can help midwives to counsel women better about their delivery alternatives and can promote improved management of women undergoing both types of delivery experiences.     

The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life

PurposeThis study aims to identify the effects of foot reflexology applied to women on their vasomotor complaints and quality of life.MethodsA randomised controlled study was conducted with 120 women. The experimental group received foot reflexology treatment, while the control group received nonspecific foot massage.ResultsThe mean scores for hot flashes, sweats, and night sweats, were lower in the reflexology group than the control group after the practice; and the difference between the groups was statistically significant (p < 0.001). The mean scores for the sub-groups of the MENQOL demonstrated improvements in both groups after the application (p < 0.001). As for the sexual domain, there was a significant improvement in the reflexology group (p < 0.05), but no improvements were found in the control group (p > 0.05).ConclusionResults showed that reflexology might be effective in decreasing vasomotor problems and increasing quality of life in women in the menopausal period.     

Maternal factors associated with prematurity in public maternity hospitals at the Brazilian Western Amazon

ObjectiveTo analyse maternal factors associated with prematurity in public maternity hospitals.DesignRetrospective unmatched case-control study on two public maternity hospitals in the State of Acre, Brazil.Setting and ParticipantsA sample of 341 newborn infants of premature birth (< 37 weeks; case group) and 388 newborn infants of term delivery (≥ 37 weeks; control group).MethodsA validated instrument was used for interviews, and information was collected from hospital records. The variables were divided into five blocks: (1) maternal sociodemographic and economic characteristics, (2) maternal biological and reproductive characteristics, (3) maternal habits, (4) pregnancy complications, and (5) neonatal characteristics. The hierarchical analysis was performed using multiple logistic regression.ResultsThe risk factors associated with premature birth were as follows: newborn infants of mothers who were born premature (p = 0.005), with low BMI (p = 0.006), history of a previous preterm child (p<0.003), who had stress (p = 0.020) and physical injury during pregnancy (p = 0.025), with quality of prenatal care classified as inadequate II (p = 0.001), which presented abnormal amniotic fluid volume (p<0.001), pre-eclampsia/eclampsia (p<0.001), bleeding (p = 0.013) and hospitalization during pregnancy (p = 0.001).ConclusionThe variables that were associated with premature birth were mother born preterm, low BMI, previous premature child, stress and physical injury during pregnancy, prenatal care inadequate II, bleeding, abnormal amniotic fluid volume, pre-eclampsia/eclampsia and hospitalization during pregnancy. It is important to properly perform prenatal care, having a multidisciplinary approach as support, with the objective of keep up with changes in nutritional classification and monitoring of adverse clinical conditions.     

Clinical and urodynamic effects of tolterodine in women with an overactive bladder

ObjectiveThe aim of this study was to compare the changes in urinary symptoms and urodynamic parameters after administration of tolterodine in women with an overactive bladder (OAB).Materials and MethodsThirty-eight women diagnosed with OAB and treated with tolterodine were reviewed. Urinalysis, pelvic examination, 3-day bladder diary, urodynamic study, and a personal interview to identify urinary symptoms prior to and 3 months after treatment were recorded and interpreted.ResultsMost of our patients were menopausal (76.3%; mean age 55.7 years) and multiparous (mean parity 3.3) women. Urinary symptoms such as urinary frequency, urgency, urge incontinence, and nocturia were decreased significantly (p < 0.05). All urodynamic parameters did not change significantly except for the maximum cystometric capacity (p < 0.05), showing a significant increase after 3 months of medication.ConclusionsTolterodine, at a recommended dose, improves the symptoms of OAB syndrome without causing urine retention, as proved by the changes of urodynamic parameters.     

Body mass index and hypertensive disorders of pregnancy

ObjectivesWe compared the incidence of the hypertensive disorders of pregnancy in obese women with women of a normal body mass index (BMI).Study designProspective observational study in which BMI was calculated accurately early in pregnancy. Women were enrolled after a sonographic confirmation of an ongoing pregnancy. To reduce confounding variables the study was confined to white European women with a singleton pregnancy.Main outcome measuresIncidence of pre-eclampsia and gestational hypertension.ResultsIn 2230 women, 16.8% were obese. Pre-eclampsia was diagnosed in 3.3% (n = 74) and gestational hypertension in 3.0% (n = 67). Both pre-eclampsia (p = 0.01) and gestational hypertension (p < 0.01) were common in obese women compared with normal weight women. Overall 13.1% of obese women developed a hypertensive disorder during pregnancy. When analysed by parity pre-eclampsia occurred in 2.1% of primigravidas and 0.3% of multigravidas. Pre-eclampsia was increased in obese multigravidas (p = 0.001), but not obese primigravidas, suggesting that parity is more influential than obesity in the development of pre-eclampsia.ConclusionsObese multigravidas are more likely to develop hypertensive disorders in pregnancy and obese primigravidas are more likely to develop gestational hypertension. This is important in clinical practice because maternal weight, unlike parity, is potentially modifiable before or during pregnancy.     

Eclampsia: Maternal and neonatal outcomes

The objective of our study is to define the maternal and neonatal outcomes associated with eclampsia. This retrospective cohort study was performed using the Consortium on Safe Labor, database from 12 clinical centers, including 19 hospitals, from 2002–2008. All patients admitted with a diagnosis of eclampsia or seizure in labor and delivery or postpartum were included in the analysis. Patients with history of seizure disorder were excluded. Maternal and neonatal outcomes were compared to outcomes of women with preeclampsia and their neonates. Statistical analyses were performed using SAS. Chi square and t-test were used for categorical and continuous variables, respectively. Logistic regression and general linear regression were used to calculate odds ratios and 95% confidence intervals. p < 0.05 was considered significant. The eclampsia prevalence was 0.08% (n = 191) in our population; the preeclampsia cohort had 7012 women. There were significantly more eclamptic women (49%) delivered by cesarean section, as compared to preeclamptic women (36%), OR 1.7 (1.28–2.28). These women were more likely to have an ICU admission OR 12.9 (7.0–23.7). The mean gestational ages and birthweights were lower in the neonates of the eclampsia group. A multivariate analysis revealed that low cord arterial pH, low 5 min Apgar score, respiratory distress syndrome OR 5.5, (1.11–27.66) and seizures OR 10.3 (3.12–33.68), p < 0.05, were significantly elevated in the eclampsia cohort. The prevalence of eclampsia in our contemporary obstetrics population was 0.08%. Both mothers as well as neonates of eclamptics are at significant risk for complications due to their illness.     

Effect of stay in a postpartum care institution on postpartum depression in women

IntroductionPregnancy and childbirth can cause substantial psychological and social changes and may lead to mental disorders. Women who are discharged directly from the maternity hospital after delivery without social support may have postpartum psychological health issues. Rarely have studies focused on the effect of postpartum care institutions on postpartum depression in women.MethodsWe conducted a longitudinal study in Taiwan from January 2017 to July 2018. The data were collected via questionnaires administered at four time points: the first trimester of pregnancy (n = 309), the second trimester of pregnancy (n = 269), the third trimester of pregnancy (n = 257) and six weeks postpartum (n = 252). Among the participants, 130 women stayed in e postpartum care institutions, while 122 did not stay in an institution. Analysis included student t test, chi-square test, and difference in differences analysis. Linear regression analysis was used to determine the independence of the related factors for postpartum depression.ResultsThe women who stayed at postpartum care institutions (n = 130) had a higher education status, higher income, higher percentage of assisted reproductive technology (ART) treatment, higher cesarean section rate, and lower postpartum Edinburgh Perinatal Depression Scale (EPDS) scores (14.6% vs. 27.8%) compared with those who did not stay at postpartum care institutions. Among the women who stayed in postpartum care institutions, the average EPDS scores were 8.74 ± 0.46 and 8.15 ± 0.49 in the ART and natural pregnancy groups at baseline (3rd month), respectively, and there was no significant difference (p = 0.59). The EPDS scores in the ART group significantly declined at the 6th month (difference = −0.67, p<0.05), 9th month (difference = −2.00, p<0.01) and postpartum (difference = −4.01, p<0.01). Multivariate linear regression analysis indicated that postpartum care institutions was the main factor (r = 1.38, p = 0.014) correlating to postpartum depression in women.ConclusionProviding maternal and infant care in postpartum care institutions allows the mother to rest; and the professional guidance from the medical staff can provide the necessary support and help mothers to learn. Postpartum care institutions can decrease the incidence and severity of postpartum depression.     

A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight polypropylene meshes for prolapse repair

ObjectiveUse of vaginal meshes for treatment of pelvic organ prolapse (POP) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes.Materials and methodsSixty-nine (95.8%) of 72 women with POP Stage ≥ 2, who underwent laparoscopic sacrocolpopexy (LSC) (n = 39) or a total vaginal mesh (TVM) procedure (n = 30) using lightweight polypropylene meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods.ResultsCompared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p < 0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p < 0.001). Objective anatomic success (POP Stage ≤ 1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p = 0.94), respectively. However, the dominant recurrence sites were different with anterior (n = 6) most frequent after LSC and apical (n = 4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found “cystocele as the dominant prolapse” (p = 0.016; odds ratio = 6.94) and “suspension of prolapsed (POP Stage ≥ 2) uterus” (p = 0.025; odds ratio = 7.00) significantly affected recurrence after LSC and TVM, respectively.ConclusionPOP repair by LSC or TVM using the new lightweight polypropylene meshes seems to be safe and has comparable outcomes, but limitations may vary.     

The effect of prenatal Hatha yoga on affect,cortisol and depressive symptoms

Perinatal depression impacts maternal and child health, and little is known about effective interventions. The effects of prenatal Hatha yoga on cortisol, affect and depressive symptoms were investigated in 51 women. Twice during pregnancy, yoga group participants reported on affect and provided a saliva sample before and after a 90-min prenatal Hatha yoga session. Corresponding measures were obtained from yoga and control group participants on days of usual activity. Depressive symptoms were assessed in pregnancy and post partum. Cortisol was lower (p < .01) and positive affect higher (p < .001) on yoga compared to usual activity days. Negative affect and contentment (p < .05) improved more in response to the yoga session. Yoga group participants showed fewer postpartum (p < .05) but not antepartum depressive symptoms than control group participants. Findings indicate that prenatal Hatha yoga may improve current mood and may be effective in reducing postpartum depressive symptoms.     

Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles

ObjectivesSuccessful implantation depends on interaction between a blastocyst and a receptive endometrium. Endometrial vasculature is important in the early endometrial response to blastocyst implantation, and vascular changes can affect uterine receptivity. This study aims to investigate whether vascular parameters measured using three-dimensional power Doppler ultrasound (3D PD-US) could predict pregnancy following fresh in vitro fertilization and embryo transfer (IVF–ET) using a gonadotropin releasing hormone (GnRH) agonist long protocol.Materials and methodsThis prospective observational study enrolled 236 nulliparous women who underwent a first IVF–ET using a GnRH long protocol with stimulation by recombinant FSH (rFSH) from May 2009 to April 2012. After excluding two cases of tubal pregnancy, 234 women were in either a pregnant group (n = 113) or a nonpregnant group (n = 121). Color Doppler ultrasound and 3D PD-US examinations were performed on the day of embryo transfer. Main outcomes were pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) of the uterine artery, vascularization index (VI), flow index (FI), and vascularization flow index (VFI) of the endometrium and subendometrial region. Measurements were analyzed relative to IVF–ET outcome (pregnant vs. nonpregnant).ResultsNo significant differences were observed in patient age, infertility duration, body mass index (BMI), basal FSH levels, number of retrieved oocytes or good quality embryos, or endometrial thickness or volume between the two groups. The pregnant group had higher endometrial VI, FI, and VFI scores than the nonpregnant group (p = 0.001, p = 0.000, p = 0.021, respectively). By contrast, neither subendometrial region VI, FI, and VFI scores (p = 0.770, p = 0.252, p = 0.451), nor uterine artery PI, RI, or S/D scores (p = 0.256, p = 0.527, p = 0.365) differed between groups. Cut-off values of endometrial VI, FI, and VFI scores were 0.95, 12.94, and 0.15 for pregnancy achievement.ConclusionThree dimensional PD-US was a useful and effective method for assessing endometrial blood flow in IVF cycles. Good endometrial blood flow on the day of embryo transfer might be associated with high pregnancy success with a GnRH long protocol, because this is indicative of endometrial receptivity in fresh IVF cycles.     

Evaluating pentraxin-3 and hypersensitivity CRP expression in obese pregnancies

ObjectiveThis study was designed to evaluate the correlation between serum pentraxin-3 (PTX3)/hypersensitivity CRP (hs-CRP) expression and obesity during pregnancy and their application as inflammatory biomarkers in obese pregnant women.Materials and methodsPregnant women scheduled to experience a single-birth at our hospital between 2016 and 2017 were selected for this nested case–control study. These patients were evaluated for age and gestational age in the first trimester (11–14 weeks), had their body mass index (BMI) calculated and were subjected to an OGTT between Week 24 and 28 of pregnancy. Obese patients with normal OGTT and a BMI of ≥30 kg/m² in the second trimester were selected as the obese group (OBE, n = 80), and non-obese pregnant women with normal OGTT with a BMI of <30 kg/m² were selected as the control group (CON, n = 80). ELISA was used to detect the expression of PTX3 and hs-CRP.ResultsThe expression of both PTX3 and hs-CRP increased in both groups, with increasing gestational age (P < 0.05). However, hs-CRP level in Group OBE was increased, compared to that in the healthy control (P < 0.01), during the second trimester. PTX3 expression was also significantly higher in OBE samples than in the control (P < 0.05), during the third trimester; correlation analysis demonstrated that PTX3 was positively correlated with hs-CRP, BMI, fasting plasma glucose and HOMA-IR.ConclusionsThe expression levels of both PTX3 and hs-CRP increased with increasing gestational age, and PTX3 expression was related to BMI, which serves to confirm the inflammatory response in these patients.     

It’s not as bad as you think: menopausal representations are more positive in postmenopausal women

Introduction: The menopausal transition is associated with underlying hormonal changes that can contribute to a range of physical and emotional symptoms. Psycho-social factors including attitudes and internal representations play a central role in women’s experience of the menopause, but very little is known about how representations might differ across menopausal stages.

Methods: A sample of 387 women aged 40–60 completed a postal questionnaire that included the menopausal representations questionnaire, the emotional representation subscale adapted from the illness perception questionnaire, and data on menopausal status.

Results: Significant differences across menopausal stages were found for both cognitive [F(2, 381)?=?4.32, p?<?.05, η²?=?0.022], and emotional [F(2, 381)?=?9.70, p?<?.01, η²?=?0.048] menopausal representations. Postmenopausal women had a significantly more positive cognitive representations of the menopause relative to perimenopausal women (standardised mean difference?=?0.25, p?>?.05). Postmenopausal women held a significantly more positive emotional representation of the menopause than both premenopausal (standardised mean difference?=?0.56, p?<?.05) and perimenopausal (standardised mean difference?=?0.43, p?<?.05) women.

Discussion: Women’s emotional and cognitive representations of the menopause are more positive among postmenopausal women, compared to women in the late premenopausal stage. This is consistent with the affective forecasting theory, which proposes the tendency to overestimate the intensity and duration of emotional reactions to future events. Given the association between representations and bothersomeness of menopausal symptoms, clinicians should educate women about their expectations, and challenge their negative beliefs about the menopause.