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\begin{document}

\title{Interaction and influence of parity and gestational age on the lung
volume and lung density by computed tomography images during normal
pregnancy}



\author[1]{Luman Li}%
\author[2]{Jie Chen}%
\author[1]{Shumin Pan}%
\author[1]{Yun Tao}%
\author[3]{Hui Xie}%
\author[3]{Quan Zhu}%
\author[1]{Zihan Wang}%
\author[1]{Huanyu Liu}%
\author[2]{Meiyan Liao}%
\author[1]{Yuanzhen Zhang}%
\affil[1]{Zhongnan Hospital of Wuhan University Department of Obstetrics}%
\affil[2]{Zhongnan Hospital of Wuhan University Department of Nuclear Medicine}%
\affil[3]{Hubei Province Women and Children Hospital}%


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  \date{May 27, 2024}


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\begin{abstract}
\textbf{Objectives}: The aim of this study was to demonstrate the
interaction and influence of gestational age and parity on the lung
volume and lung density through Computed Tomography (CT) imaging data
among healthy pregnant women. \textbf{Design:} Retrospective
cross-sectional study \textbf{Setting:} Two clinical sites in Wuhan
Hubei Province. \textbf{Sample:} pregnant women and non-pregnant women.
\textbf{Methods}: Linear mixed-effects regression model and generalized
additive mixed model (GAMM) were taken to control the potential
confounders and evaluate the interact effects of lung volume and lung
density. Univariate analysis estimated the influence of gestational age
and parity on the lung volume and lung density. \textbf{Main Outcome
Measures:} Lung volume (left, right, total), lung density (left, right,
total). \textbf{Results:} The total lung density of all patients in GAMM
was significantly increased with gestational age (p\textless{}0.001).
Univariate analysis showed that the absolute value of total lung volume
decreases with the progression of gestation ( \emph{p}=0.040), this
tendency is also displayed in both the left lung and right volume. Lung
volume of multipara in the third trimester was lower than the first
trimester, and it had significant difference between T1 and T3 (
\emph{p}=0.0196). Furthermore, this study found that the lung volume of
multiparous women was lower that primiparous in the third trimester (
\emph{p}=0.009). Nevertheless, the lung density increased with
gestational age in primiparous, particularly in the third trimester (
\emph{p}=0.007), the lung density of multipara was lower than nullipara
( \emph{p}\textless{}0.001), more delivery times follow lower lung
density, and there was a significant difference when compared with each
parity state. During the third trimester, the lung density of
multiparous declined when compared with primiparous (
\emph{p}\textless{}0.001). \textbf{Conclusion:} Parity and gestation age
tended to have an impact on the alterations of lung volume and lung
density in physiological pregnant women. Lung density of multipara was
lower than nullipara, more delivery times follow lower lung density,
indicating parity was associated with lung density.%
\end{abstract}%



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\textbf{Hosted file}

\verb`main.doc`  available at \url{https://authorea.com/users/773955/articles/867645-interaction-and-influence-of-parity-and-gestational-age-on-the-lung-volume-and-lung-density-by-computed-tomography-images-during-normal-pregnancy}

\textbf{Hosted file}

\verb`supplementary figures.doc`  available at \url{https://authorea.com/users/773955/articles/867645-interaction-and-influence-of-parity-and-gestational-age-on-the-lung-volume-and-lung-density-by-computed-tomography-images-during-normal-pregnancy}

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