Temporal and Spatial Trends of Adverse Pregnancy and Birth Outcomes in a Sample of Births from a Public Hospital in Chile

Understanding temporal and spatial trends in pregnancy and birth outcomes within an urban area is important for the monitoring of health indicators of a population. We conducted a retrospective cohort study of all births in the public hospital of Temuco, a medium-sized city in Southern Chile between 2009 and 2016 (n = 17,237). Information on adverse pregnancy and birth outcomes, as well as spatial and maternal characteristics (insurance type, employment, smoking, age, and overweight/obesity), was collected from medical charts. Home addresses were geocoded and assigned to neighborhood. We tested whether births and prevalence of adverse pregnancy outcomes changed over time, whether birth events were spatially clustered (Moran's I statistic), and whether neighborhood deprivation was correlated to outcomes (Spearman's rho). We observed decreases in eclampsia, hypertensive disorders of pregnancy, and small for gestational age, while gestational diabetes, preterm birth, and low birth weight increased over the study period (all p < 0.01 for trend), with little changes after adjusting for maternal characteristics. We observed neighborhood clusters for birth rate, preterm birth, and low birth weight. Neighborhood deprivation was negatively correlated with low birth weight and preterm birth, but not correlated with eclampsia, preeclampsia, hypertensive disorders of pregnancy, small for gestational age, gestational diabetes, nor stillbirth. Several encouraging downward trends and some increases in adverse pregnancy and birth outcomes, which, overall, were not explained by changes in maternal characteristics were observed. Identified clusters of higher adverse birth outcomes may be used to evaluate preventive health coverage in this setting.

Conformational and biochemical differences in the TCR.CD3 complex of CD8(+) versus CD4(+) mature lymphocytes revealed in the absence of CD3gamma

Mature CD4(+) and CD8(+) T lymphocytes are believed to build and express essentially identical surface alphabeta T-cell receptor-CD3 (TCR.CD3) complexes. However, TCR.CD3 expression has been shown to be more impaired in CD8(+) cells than in CD4(+) cells when CD3gamma is absent in humans or mice. We have addressed this paradox by performing a detailed phenotypical and biochemical analysis of the TCR.CD3 complex in human CD3gamma-deficient CD8(+) and CD4(+) T cells. The results indicated that the membrane TCR.CD3 complex of CD8(+) T lymphocytes was conformationally different from that of CD4(+) lymphocytes in the absence of CD3gamma. In addition, CD8(+), but not CD4(+), CD3gamma-deficient T lymphocytes were shown to contain abnormally glycosylated TCRbeta proteins, together with a smaller, abnormal TCR chain (probably incompletely processed TCRalpha). These results suggest the existence of hitherto unrecognized biochemical differences between mature CD4(+) and CD8(+) T lymphocytes in the intracellular control of alphabetaTCR. CD3 assembly, maturation, or transport that are revealed when CD3gamma is absent. Such lineage-specific differences may be important in receptor-coreceptor interactions during antigen recognition.