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Gembe M, Wosenyeleh T, Gezimu W. Protective doses of tetanus toxoid immunization and its associated factors among mothers in southern Ethiopia. Hum Vaccin Immunother 2024; 20:2320501. [PMID: 38466961 PMCID: PMC10936595 DOI: 10.1080/21645515.2024.2320501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/15/2024] [Indexed: 03/13/2024] Open
Abstract
The World Health Organization recommends tetanus toxoid immunization before or during pregnancy for all women of childbearing age. The goal is to reduce maternal and neonatal mortality due to tetanus. According to the 2016 Ethiopia Demographic and Health Survey (EDHS) report, more than half (51%) of women did not receive protective doses of tetanus immunization. To the best of our knowledge, this study uniquely tried to assess the level of protective doses of tetanus toxoid immunization in southern Ethiopia. A community-based cross-sectional study was conducted among 580 randomly selected participants. Variable with p-value of less than .25 in the bivariate analysis were included in the multivariable logistic regression analysis. Finally, statistical significance was declared at a p-value of less than .05. The proportion of protective doses of tetanus toxoid immunization uptake in the area was found to be 41.9% (95% CI: 38-46%). Being enrolled in formal education [AOR = 6.55, 95% CI: 3.23-9.01], having at least two postnatal care visits [AOR = 3.82; 95% CI: 1.78-6.40], having at least four antenatal care visits [AOR = 2.56; 95% CI: 1.41-4.34], and being visited by Health Extension Workers [AOR = 2.66; 95% CI: 1.42-4.01] were found to be factors enhancing the uptake of protective doses of tetanus toxoid immunization. Generally, the uptake or prevalence of the protective doses of tetanus toxoid immunization in the area was lower than the World Health Organization's target. Therefore, all responsible bodies, including healthcare providers, need to strengthen counseling mothers to enhance the uptake of tetanus toxoid immunization.
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Affiliation(s)
- Maycas Gembe
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Teklu Wosenyeleh
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Wubishet Gezimu
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
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Thibault M, Deceuninck G, Quach C, Brousseau N. Antenatal tetanus, diphtheria, and acellular pertussis (Tdap) immunization and risk of serogroup 19 IPD in children: An indirect cohort study. Hum Vaccin Immunother 2024; 20:2305522. [PMID: 38330991 PMCID: PMC10857563 DOI: 10.1080/21645515.2024.2305522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
The tetanus-diphtheria-acellular pertussis (Tdap) vaccine has been indicated for pregnant women in Quebec, Canada since 2018. Recent literature suggests maternal Tdap interferes with the pneumococcal vaccine response in children exposed in utero because of maternally transferred anti-diphtheria antibodies, a phenomenon known as blunting. Using an indirect cohort study, we investigated whether maternal Tdap vaccination could alter the protection of PCV vaccines against serotype 19A/F IPD (conjugated to diphtheria toxoid in PCV10). Thirty-seven immunized IPD cases (serotype 19A/F) and 90 immunized IPD controls (non-vaccine serotypes) were analyzed using multivariate logistic regression. Our analyses did not identify antenatal Tdap exposure as a risk factor for IPD in vaccinated children, with and odds ratio close to the null (odds ratio = 0.82, 95%CI = 0.32-2.07). As this study is the first to assess the impact of maternal immunization on pneumococcal disease risk, future investigations involving a larger number of cases should be conducted to confirm or infirm our findings.
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Affiliation(s)
- Melina Thibault
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Geneviève Deceuninck
- Infectious and immune diseases, Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, Canada
| | - Caroline Quach
- Division of Paediatric Infectious Diseases and Department of Medical Microbiology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
- Department of Microbiology, Infectious Diseases, and Immunology, University of Montreal, Montreal, Canada
| | - Nicholas Brousseau
- Infectious and immune diseases, Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, Canada
- Biological risks unit, Institut national de santé publique du Québec, Québec, Canada
- Department of Social and Preventive Medicine, Université Laval, Québec, Canada
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Lule SA, Kushitor SB, Grijalva-Eternod CS, Adjaye-Gbewonyo K, Sanuade OA, Kushitor MK, Okoibhole L, Awuah R, Baatiema L, Kretchy IA, Arhinful D, de-Graft Aikins A, Koram K, Fottrell E. The contextual awareness, response and evaluation (CARE) diabetes project: study design for a quantitative survey of diabetes prevalence and non-communicable disease risk in Ga Mashie, Accra, Ghana. Glob Health Action 2024; 17:2297513. [PMID: 38323339 PMCID: PMC10851827 DOI: 10.1080/16549716.2023.2297513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/16/2023] [Indexed: 02/08/2024] Open
Abstract
Diabetes is estimated to affect between 3.3% and 8.3% of adults in Ghana, and prevalence is expected to rise. The lack of cost-effective diabetes prevention programmes designed specifically for the Ghanaian population warrants urgent attention. The Contextual Awareness, Response and Evaluation (CARE): Diabetes Project in Ghana is a mixed methods study that aims to understand diabetes in the Ga Mashie area of Accra, identify opportunities for community-based intervention and inform future diabetes prevention and control strategies. This paper presents the study design for the quantitative survey within the CARE project. This survey will take place in the densely populated Ga Mashie area of Accra, Ghana. A household survey will be conducted using simple random sampling to select households from 80 enumeration areas identified in the 2021 Ghana Population and Housing Census. Trained enumerators will interview and collect data from permanent residents aged ≥ 25 years. Pregnant women and those who have given birth in the last six months will be excluded. Data analysis will use a combination of descriptive and inferential statistics, and all analyses will account for the cluster sampling design. Analyses will describe the prevalence of diabetes, other morbidities, and associated risk factors and identify the relationship between diabetes and physical, social, and behavioural parameters. This survey will generate evidence on drivers and consequences of diabetes and facilitate efforts to prevent and control diabetes and other NCDs in urban Ghana, with relevance for other low-income communities.
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Affiliation(s)
| | - Sandra Boatemaa Kushitor
- Department of Community Health, Ensign Global College, Kpong, Ghana
- Department of Food Science and Centre for Sustainability Studies, Stellenbosch University, Stellenbosch, South Africa
| | - Carlos S. Grijalva-Eternod
- Institute for Global Health, University College London, London, UK
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Olutobi Adekunle Sanuade
- Department of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Mawuli Komla Kushitor
- Department of Health Policy, Fred Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Lydia Okoibhole
- Institute for Global Health, University College London, London, UK
| | - Raphael Awuah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Leonard Baatiema
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana
- Center for Tropical Medicine and Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana
| | - Daniel Arhinful
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Edward Fottrell
- Institute for Global Health, University College London, London, UK
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Limaye RJ, Singh P, Fesshaye B, Lee C, Schue J, Karron RA. "Why has this new vaccine come and for what reasons?" key antecedents and questions for acceptance of a future maternal GBS vaccine: Perspectives of pregnant women, lactating women, and community members in Kenya. Hum Vaccin Immunother 2024; 20:2314826. [PMID: 38345050 PMCID: PMC10863339 DOI: 10.1080/21645515.2024.2314826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/02/2024] [Indexed: 02/15/2024] Open
Abstract
Group B streptococcus (GBS) is a leading global cause of neonatal sepsis and meningitis, stillbirth, and puerperal sepsis. While intrapartum antibiotic prophylaxis (IAP) is a currently available GBS disease prevention strategy, IAP is programmatically complex to implement, precluding use in low- and middle-income countries. In Kenya, 2% of stillbirths are attributable to GBS infection. Two maternal GBS vaccines are in late-stage clinical development. However, licensure of a maternal GBS vaccine does not translate into reduction of disease. We conducted 28 in-depth interviews with pregnant people, lactating people, and community members across two counties in Kenya to better understand the attitudes and informational needs of primary vaccine beneficiaries. We identified two emerging themes from the data. The first focused on antecedents to maternal GBS vaccine acceptability. The most common antecedents focused on the vaccine's ability to protect the baby and/or the mother, followed by community sensitization before the vaccine was available. The second key theme focused on questions that would need to be addressed before someone could accept a maternal GBS vaccine. Three key categories of questions were identified, including vaccine safety compared to vaccine benefits, who gets the vaccine, and how the vaccine works. Realizing the potential benefits of a future GBS maternal vaccine will require a multifactorial approach, including ensuring that communities are aware of GBS-related harms as well as the safety and effectiveness of a maternal GBS vaccine. Our study contributes to informing this multifactorial approach by elucidating the attitudes and concerns of key populations.
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Affiliation(s)
- Rupali J. Limaye
- Department of International Health, Department of Epidemiology, Department of Health, Behavior & Society, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Prachi Singh
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Berhaun Fesshaye
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Clarice Lee
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jessica Schue
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruth A. Karron
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Jiménez-Ruiz A, Aguilar-Fuentes V, Benavides-Gómez F, Ruiz-Sandoval JL. Cerebral Venous Thrombosis Presenting as Simultaneous Intracerebral Hemorrhage. Acta Neurol Taiwan 2024; 33(4):206-207. [PMID: 38073163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
A 37-year-old pregnant woman presented to the emergency department with central facial palsy, ipsilateral right hemiparesis, and seizures. Brain Computed Tomogram (CT) showed intracerebral hemorrhage (ICH) and bilateral frontal edema. Magnetic resonance imaging (MRI) revealed multifocal hemorrhages consistent with a diagnosis of multiple simultaneous ICH (MSICH) (Figure 1). We suspected cerebral venous thrombosis (CVT) and performed a MR angiogram confirming this diagnosis (Figure 2). Upon admission, the patient was treated with low-molecular-weight heparin and transitioned to direct oral anticoagulation at discharge. Non traumatic MSICH is a rare imaging finding with high mortality, usually arterial in origin (1). However, since treatment options vary, cerebral venous thrombosis should always be considered in the differential diagnosis, especially in young female patients with known risk factors, such as pregnancy and puerperium (2-4). MRI modalities (Echo-GRE) are valuable tools in identifying ICH when CT is inconclusive (5).
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Affiliation(s)
- Amado Jiménez-Ruiz
- Stroke and Cerebrovascular Disease Clinic, Neurology Department, Hospital Civil de Guadalajara "Fray Antonio Alcalde". Guadalajara, México
| | - Victor Aguilar-Fuentes
- Stroke and Cerebrovascular Disease Clinic, Neurology Department, Hospital Civil de Guadalajara "Fray Antonio Alcalde". Guadalajara, México
| | - Fernando Benavides-Gómez
- Stroke and Cerebrovascular Disease Clinic, Neurology Department, Hospital Civil de Guadalajara "Fray Antonio Alcalde". Guadalajara, México
| | - José Luis Ruiz-Sandoval
- Stroke and Cerebrovascular Disease Clinic, Neurology Department, Hospital Civil de Guadalajara "Fray Antonio Alcalde". Guadalajara, México
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Zhang D, Ji H, Wang S, Chen M, Liu H. Parity changed fecal microbiota of sows and its correlation with milk long-chain fatty acid profiles. Appl Microbiol Biotechnol 2024; 108:4. [PMID: 38170312 DOI: 10.1007/s00253-023-12852-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 01/05/2024]
Abstract
The goal of this study was to characterize the fecal microbiota profiles of gestating sows, along with the fecal microbiota and milk fatty acid contents of lactating sows and their correlations with reproductive performance at different parities. The results showed that the microbiota of third parity gestating sows contained a greater abundance of Prevotella compared to the other two parity groups, while lactating sows exhibiting higher reproductive performance at fifth parity exhibited a greater abundance of Lactobacillus species. The lactating sows with higher reproductive performance also exhibited higher total monounsaturated fatty acid (MUFA) and higher total polyunsaturated fatty acid (PUFA) levels relative to sows with lower reproductive performance at all three analyzed parities, especially sows at fifth parity produced the lowest total saturated fatty acid (SFA) levels, and showed the highest C18:1n9c and C18:2n6c concentrations. In correlational analyses, the abundance of Oligella, Lactobacillus, and Corynebacterium was highly positively correlated with C18:1n9c, C18:2n6c, and C20:4n6. Overall, these results provide a rational basis for efforts to improve sow reproductive performance through the provision of precisely regulated nutrition. KEY POINTS: • Clear differences in the fecal microbiota were evident between sows of different parities. • Lactating sows with high reproductive performance showed distinct milk fatty acid profiles.
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Affiliation(s)
- Dongyan Zhang
- Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, 100097, China.
| | - Haifeng Ji
- Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, 100097, China
| | - Sixin Wang
- Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, 100097, China
| | - Meixia Chen
- Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, 100097, China
| | - Hui Liu
- Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, 100097, China.
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Yuan RY, Li S, Feng X, Li XL, Lin XT, Gao FM, Zhu HJ, Li YS, Li YC, Ou XH. Comparison of embryo quality and pregnancy outcomes for patients with low ovarian reserve in natural cycles and mildly stimulated cycles: a cohort study. J OBSTET GYNAECOL 2024; 44:2303693. [PMID: 38263614 DOI: 10.1080/01443615.2024.2303693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND As women with low ovarian reserve embark on the challenging journey of in-vitro fertilisation (IVF) treatment, the choice between natural and mildly stimulated cycles becomes a pivotal consideration. It is unclear which of these two regimens is superior for women with low ovarian reserve. Our study aims to assess the impact of natural cycles on embryo quality and pregnancy outcomes in women with low ovarian reserve undergoing IVF treatment compared to mildly stimulated cycles. METHODS This retrospective study enrolled consecutive patients with low ovarian reserve who underwent IVF/intracytoplasmic sperm injection (ICSI) at Guangdong Second Provincial General Hospital between January 2017 and April 2021. The primary outcome for pregnancy rate of 478 natural cycles and 448 mild stimulated cycles was compared. Secondary outcomes included embryo quality and oocyte retrieval time of natural cycles. RESULTS The pregnancy rate in the natural cycle group was significantly higher than that in the mildly stimulated cycle group (51.8% vs. 40.1%, p = 0.046). Moreover, natural cycles exhibited higher rates of available embryos (84.1% vs. 78.6%, p = 0.040), high-quality embryos (61.8% vs. 53.2%, p = 0.008), and utilisation of oocytes (73% vs. 65%, p = 0.001) compared to mildly stimulated cycles. Oocyte retrievals in natural cycles were predominantly performed between 7:00 and 19:00, with 94.9% occurring during this time frame. In natural cycles with high-quality embryos, 96.4% of oocyte retrievals were also conducted between 7:00 and 19:00. CONCLUSION Natural cycles with appropriately timed oocyte retrieval may present a valuable option for patients with low ovarian reserve.
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Affiliation(s)
- Rui-Ying Yuan
- The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Sen Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xie Feng
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiao-Long Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiao-Ting Lin
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Fu-Min Gao
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Hai-Jing Zhu
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yong-Shi Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yan-Chu Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiang-Hong Ou
- The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
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Karimi A, Sayehmiri K, Vaismoradi M, Dianatinasab M, Daliri S. Vaginal bleeding in pregnancy and adverse clinical outcomes: a systematic review and meta-analysis. J OBSTET GYNAECOL 2024; 44:2288224. [PMID: 38305047 DOI: 10.1080/01443615.2023.2288224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/20/2023] [Indexed: 02/03/2024]
Abstract
Background: Vaginal bleeding during pregnancy has been recognised as a significant risk factor for adverse pregnancy outcomes. This study aimed to investigate the association between vaginal bleeding during the first trimester of pregnancy and clinical adverse effects using a systematic review and meta-analysis.Methods: Databases of Scopus, Web of Science, PubMed (including Medline), Cochrane Library and Science Direct were searched until June of 2023. Data analysis using statistical test fixed- and random-effects models in the meta-analysis, Cochran and meta-regression. The quality of the eligible studies was assessed by using the Newcastle-Ottawa Scale checklist (NOS).Results: A total of 46 relevant studies, with a sample size of 1,554,141 were entered into the meta-analysis. Vaginal bleeding during the first trimester of pregnancy increases the risk of preterm birth (OR: 1.8, CI 95%: 1.6-2.0), low birth weight (LBW; OR: 2.0, CI 95%: 1.5-2.6), premature rupture of membranes (PROMs; OR: 2.3, CI 95%: 1.8-3.0), abortion (OR: 4.3, CI 95%: 2.0-9.0), stillbirth (OR: 2.5, CI 95%: 1.2-5.0), placental abruption (OR: 2.2, CI 95%: 1.4-3.3) and placenta previa (OR: 1.9, CI 95%: 1.5-2.4).Conclusions: Vaginal bleeding in the first trimester of pregnancy is associated with preterm birth, LBW, PROMs, miscarriage, stillbirth, placental abruption and placenta previa. Therefore, physicians or midwives need to be aware of the possibility of these consequences and manage them when they occur.
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Affiliation(s)
- Arezoo Karimi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Kourosh Sayehmiri
- Prevention Center of Social-Mental injuries, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Mostafa Dianatinasab
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Salman Daliri
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
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Niu Y, Li W, Xu B, Chen W, Qi X, Zhou Y, Fu P, Ma X, Guo Y. Risk factors associated with food consumption and food-handling habits for sporadic listeriosis: a case-control study in China from 2013 to 2022. Emerg Microbes Infect 2024; 13:2307520. [PMID: 38341870 PMCID: PMC10860432 DOI: 10.1080/22221751.2024.2307520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/16/2024] [Indexed: 02/13/2024]
Abstract
The prevalence of listeriosis in China has been increasing in recent years. Listeriosis primarily spreads through contaminated food. However, the resilient causative organism, Listeria monocytogenes, and its extended incubation period pose challenges in identifying risk factors associated with food consumption and food-handling habits. This study aimed to identify the risk factors associated with food consumption and food-handling habits for listeriosis in China. A matched case-control study (1:1 ratio) was conducted, which enrolled all eligible cases of listeriosis between 1 January 2013 and 31 December 2022 in China. Basic information and possible risk factors associated with food consumption and food-handling habits were collected. Overall, 359 patients were enrolled, including 208 perinatal and 151 non-perinatal cases. Univariate and multivariable logistic analyzes were performed for the perinatal group. For the perinatal and non-perinatal groups, ice cream and Chinese cold dishes were the high-risk foods for listeriosis (odds ratio (OR) 2.09 95% confidence interval (CI): 1.23-3.55; OR 3.17 95% CI: 1.29-7.81), respectively; consumption of leftovers and pet ownership were the high-risk food-handling habits (OR 1.92 95% CI: 1.03-3.59; OR 3.00 95% CI: 1.11-8.11), respectively. In both groups, separation of raw and cooked foods was a protective factor (OR 0.27 95% CI: 0.14-0.51; OR 0.35 95% CI: 0.14-0.89), while refrigerator cleaning reduced the infection risk by 64.94-70.41% only in the perinatal group. The identification of high-risk foods and food-handling habits for listeriosis is important for improving food safety guidelines for vulnerable populations.
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Affiliation(s)
- Yanlin Niu
- Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Weiwei Li
- National Health Commission Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (No.2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People’s Republic of China
| | - Biyao Xu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Wen Chen
- Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Xiaojuan Qi
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People’s Republic of China
| | - Yijing Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People’s Republic of China
| | - Ping Fu
- National Health Commission Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (No.2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People’s Republic of China
| | - Xiaochen Ma
- Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Yunchang Guo
- National Health Commission Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (No.2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People’s Republic of China
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Diamond-Smith N, Baer RJ, Jelliffe-Pawlowski L. Impact of being underweight before pregnancy on preterm birth by race/ethnicity and insurance status in California: an analysis of birth records. J Matern Fetal Neonatal Med 2024; 37:2321486. [PMID: 38433400 DOI: 10.1080/14767058.2024.2321486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The US still has a high burden of preterm birth (PTB), with important disparities by race/ethnicity and poverty status. There is a large body of literature looking at the impact of pre-pregnancy obesity on PTB, but fewer studies have explored the association between underweight status on PTB, especially with a lens toward health disparities. Furthermore, little is known about how weight, specifically pre-pregnancy underweight status, and socio-economic-demographic factors such as race/ethnicity and insurance status, interact with each other to contribute to risks of PTB. OBJECTIVES The objective of this study was to measure the association between pre-pregnancy underweight and PTB and small for gestational age (SGA) among a large sample of births in the US. Our secondary objective was to see if underweight status and two markers of health disparities - race/ethnicity and insurance status (public vs. other) - on PTB. STUDY DESIGN We used data from all births in California from 2011 to 2017, which resulted in 3,070,241 singleton births with linked hospital discharge records. We ran regression models to estimate the relative risk of PTB by underweight status, by race/ethnicity, and by poverty (Medi-cal status). We then looked at the interaction between underweight status and race/ethnicity and underweight and poverty on PTB. RESULTS Black and Asian women were more likely to be underweight (aRR = 1.0, 95% CI: 1.01, 1.1 and aRR = 1.4, 95% CI: 1.4, 1.5, respectively), and Latina women were less likely to be underweight (aRR = 0.7, 95% CI: 0.7, 0.7). Being underweight was associated with increased odds of PTB (aRR = 1.3, 95% CI 1.3-1.3) and, after controlling for underweight, all nonwhite race/ethnic groups had increased odds of PTB compared to white women. In interaction models, the combined effect of being both underweight and Black, Indigenous and People of Color (BIPOC) statistically significantly reduced the relative risk of PTB (aRR = 0.9, 95% CI: 0.8, 0.9) and SGA (aRR = 1.0, 95% CI: 0.9, 1.0). The combined effect of being both underweight and on public insurance increased the relative risk of PTB (aRR = 1.1, 95% CI: 1.1, 1.2) but there was no additional effect of being both underweight and on public insurance on SGA (aRR = 1.0, 95% CI: 1.0, 1.0). CONCLUSIONS We confirm and build upon previous findings that being underweight preconception is associated with increased risk of PTB and SGA - a fact often overlooked in the focus on overweight and adverse birth outcomes. Additionally, our findings suggest that the effect of being underweight on PTB and SGA differs by race/ethnicity and by insurance status, emphasizing that other factors related to inequities in access to health care and poverty are contributing to disparities in PTB.
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Affiliation(s)
- Nadia Diamond-Smith
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Rebecca J Baer
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
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Barut S, Sabancı Baransel E, Çelik OT, Uçar T. The trends and hotspots of research on non-pharmacological interventions for labor pain management: a bibliometric analysis. J Psychosom Obstet Gynaecol 2024; 45:2322614. [PMID: 38444387 DOI: 10.1080/0167482x.2024.2322614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/18/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION This study aimed to examine important points of focus, trends, and depth of research on non-pharmacological interventions for the management of labor pain worldwide from a macro perspective and present an extensive definition of research fields regarding non-pharmacological interventions. METHODS Bibliometric methods were used in this study. With comprehensive keyword lists, the Web of Science and PubMed databases were searched using different screening strategies for publications made until 25 February 2023. RESULTS Studies on non-pharmacological interventions in the management of labor pain have continued to develop since 2003 with great momentum. In this study, the most productive country in research on non-pharmacological interventions was found to be Iran, while Australia, the USA, China, and the United Kingdom were the most notable ones in terms of collaboration. The most prevalently studied non-pharmacological interventions were hydrotherapy and acupuncture. The results of the co-word analysis revealed 5 main themes about this field of research. CONCLUSION The results of this study showed that interest in studies on non-pharmacological interventions in the management of labor pain has increased, the quality of research in the field is high, international collaboration is increasingly higher, and technological approaches have started to emerge in relevant studies.
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Affiliation(s)
- Sümeyye Barut
- Department of Midwifery, Fırat University, Elazığ, Türkiye
| | | | | | - Tuba Uçar
- Department of Midwifery, İnönü University, Malatya, Türkiye
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12
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Hassan MM, Ameeq M, Tahir MH, Naz S, Fatima L, Kargbo A. Investigating socioeconomic disparities of Kangaroo mother care on preterm infant health outcomes. J Psychosom Obstet Gynaecol 2024; 45:2299982. [PMID: 38189314 DOI: 10.1080/0167482x.2023.2299982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024] Open
Abstract
Several studies have been conducted to examine the complicated relationships between various factors that influence Kangaroo mother care (KMC) for preterm infants. However, the extended socio-economic model has not been seen in any of the previous studies that looked into the factors related to KMC and how it affects the health outcomes of babies born before in our study population. This study examines the various dimensions of KMC implementation and its influence on the health outcomes of premature infants. The current cross-sectional study was carried out in South Punjab, Pakistan, covering both private and public KMC units in obstetrics and gynecology departments. The study included a sample size of 719 patients and was conducted during a period covering 21 September 2022 to 14 October 2023. Multinomial logistic regression analysis is employed to ascertain the factors by using SPSS-26 (SPSS Inc., Chicago, IL). The use of folic acid (OR: 1.44; 95% CI: 0.87-3.11) and factor anemia (OR: 8.82; 95% CI: 1.69-14.59) no significantly correlated with better health outcomes, while environmental toxin exposure had a negative impact (OR: 0.90). The findings underscore the need for comprehensive interventions and policies to bridge socioeconomic gaps, ensuring all preterm infants benefit from KMC.
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Affiliation(s)
| | - Muhammad Ameeq
- Department of Statistics, The Islamia University, Bahawalpur, Pakistan
| | - M H Tahir
- Department of Statistics, The Islamia University, Bahawalpur, Pakistan
| | - Sidra Naz
- Department of Statistics, The Islamia University, Bahawalpur, Pakistan
| | - Laraib Fatima
- National College of Business Administration and Economics, Lahore, Pakistan
| | - Alpha Kargbo
- Department of Physical and Natural Sciences, University of The Gambia, Serrekunda, The Gambia
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Wu XM, Li YX, Zheng HS, Zhou XT, Ke Y, Liu XP, Kang XM. The effect and mechanism of low-molecular-weight heparin on the decidualization of stromal cells in early pregnancy. J Matern Fetal Neonatal Med 2024; 37:2294701. [PMID: 38177060 DOI: 10.1080/14767058.2023.2294701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/10/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE This study aimed to analyze the effect of low-molecular-weight heparin (LMWH) on the decidualization of stromal cells in early pregnancy and explore the effect of LMWH on pregnancy outcomes. METHODS Recurrent spontaneous abortion (RSA) mouse model (CBA/J × DBA/2) and normal pregnant mouse model (CBA/J × BALB/c) were established. The female mice were checked for a mucus plug twice daily to identify a potential pregnancy. When a mucus plug was found, conception was considered to have occurred 12 h previously. The pregnant mice were divided randomly into a normal pregnancy control group, an RSA model group, and an RSA + LMWH experimental group (n = 10 mice in each group). Halfway through the 12th day of pregnancy, the embryonic loss of the mice was observed; a real-time quantitative polymerase chain reaction was used to detect the messenger ribonucleic acid (mRNA) expressions of prolactin (PRL) and insulin-like growth factor-binding protein 1 (IGFBP1) in the decidua of the mice. Additionally, the decidual tissues of patients with RSA and those of normal women in early pregnancy who required artificial abortion were collected and divided into an RSA group and a control group. Decidual stromal cells were isolated and cultured to compare cell proliferation between the two groups, and cellular migration and invasion were detected by membrane stromal cells. Western blotting was used to detect the protein expressions of proliferating cell nuclear antigen (PCNA), cyclin D1, matrix metalloproteinase- (MMP) 2, and MMP-7 in stromal cells treated with LMWH. RESULTS Compared with the RSA group, LMWH significantly reduced the pregnancy loss rate in the RSA mice (p < 0.05). Compared with the RSA group, the LMWH + RSA group had significantly higher expression levels of PRL and IGFBP1 mRNA (p < 0.01). LMWH promoted the proliferation, migration, and invasion of human decidual stromal cells; compared with the control group, the expression levels of MMP-2, MMP-7, cyclin D1, and PCNA proteins in the decidual stromal cells of the LMWH group increased (p < 0.05). CONCLUSIONS The use of LMWH can improve pregnancy outcomes by enhancing the proliferation and migration of stromal cells in early pregnancy and the decidualization of stromal cells.
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Affiliation(s)
- Xiao-Mei Wu
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yun-Xiu Li
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Hai-Shan Zheng
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiao-Ting Zhou
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yang Ke
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiao-Ping Liu
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiao-Min Kang
- Department of Reproductive Medicine, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
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Mangos JG, Crocker S, Flood M, Martyn J, Roberts L, Henry A, Pettit F. Use of the USCOM® noninvasive cardiac output measurement system to predict the development of pre-eclampsia in hypertensive pregnancies. Hypertens Pregnancy 2024; 43:2310607. [PMID: 38353244 DOI: 10.1080/10641955.2024.2310607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To assess the ability of the USCOM® (USCOM), using measurements of cardiac output (CO) and systemic vascular resistance (SVR), to predict the development of pre-eclampsia (PE) and severe PE in hypertensive pregnancies. STUDY DESIGN Prospective cohort study of women in the second or third trimester recruited at a tertiary center in Sydney, Australia. Demographic data and hemodynamic measurements using the USCOM were taken for all study participants at recruitment. Pregnancy outcome, including development of PE and severe PE, was tracked. Data were analyzed using ANOVA testing, pair-wise comparison testing, and Student's t-testing. RESULTS Recruitment included 65 normotensive controls, 34 women with chronic hypertension (CH), 51 with gestational hypertension (GH), and 21 with PE. Significantly higher weight, body surface area, and blood pressure measurements were found in the hypertensive, compared with the normotensive control and pregnancies. There were no observed differences in USCOM-measured CO, cardiac index, SVR, or systemic vascular resistance index between hypertensive women who did versus did not develop PE or severe PE in later pregnancy. Analysis of the CH and GH subgroups, as well as only unmedicated hypertensive women (n = 24), also showed no significant difference in hemodynamic parameters between those who did or did not develop PE or severe PE. CONCLUSIONS Our group was unable to successfully predict the onset of PE or severe PE based on hemodynamic parameters measured with the USCOM. It is possible this relates to the high proportion of women on antihypertensive medication at recruitment.
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Affiliation(s)
- Jack George Mangos
- Department of Anaesthesia, St. Vincent's Hospital, Darlinghurst, Australia
- Department of Anaesthesia, St. Vincent's Clinical School, UNSW Medicine, Darlinghurst, Australia
| | - Shyamalee Crocker
- Department of Renal Medicine, Calvary Public Hospital, Mary Potter Circuit, Bruce, Australia
| | - Macayla Flood
- Department of Renal Medicine, St. George Hospital, Kogarah, Australia
- St. George and Sutherland Clinical School, UNSW Medicine, Kogarah, Australia
| | - Jade Martyn
- Department of Renal Medicine, St. George Hospital, Kogarah, Australia
- St. George and Sutherland Clinical School, UNSW Medicine, Kogarah, Australia
| | - Lynne Roberts
- St. George and Sutherland Clinical School, UNSW Medicine, Kogarah, Australia
- Department of Women's Health, St. George Hospital, Kogarah, Australia
| | - Amanda Henry
- St. George and Sutherland Clinical School, UNSW Medicine, Kogarah, Australia
- Department of Women's Health, St. George Hospital, Kogarah, Australia
| | - Franziska Pettit
- St. George and Sutherland Clinical School, UNSW Medicine, Kogarah, Australia
- Department of Women's Health, St. George Hospital, Kogarah, Australia
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15
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Schumacher F, Barcos-Munoz F, Kunckler M, Vuilleumier N, Martinez de Tejada B. Newborn phosphocalcic metabolism after intravenous iron administration during pregnancy. J Matern Fetal Neonatal Med 2024; 37:2320671. [PMID: 38418194 DOI: 10.1080/14767058.2024.2320671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Iron deficiency anemia is a very common health problem during pregnancy and intravenous (IV) iron substitution has become part of routine management. However, recent studies have raised concerns about the association of IV iron infusion and the development of secondary transitory hypophosphatemia (HP) in adults, including pregnant women. We aimed to evaluate the impact of IV iron administration during pregnancy on the phosphocalcic metabolism of newborns. METHODS A prospective, single-center, observational study was performed from December 2022 to May 2023 at the maternity facility of Geneva University Hospitals. We included women treated with either IV or oral iron during pregnancy. At delivery, a maternal blood sample was collected to assess hemoglobin, hematocrit, and levels of ferritin, phosphate and calcium, as well as an umbilical cord blood sample to assess levels of phosphate and calcium. Univariate and multivariate analyses were performed to evaluate the contribution of IV iron substitution on cord blood phosphatemia and calcemia, considering potential confounding factors. Neonatal HP was defined as a phosphate level <1.3 mmol/L. RESULTS Forty-three pregnant women were included in our study. Among these, 22 were treated with ferric carboxymaltose and 21 with oral iron. There were three cases of maternal HP in the IV iron group (13.6%) and one (4.8%) in the control group (p value for the difference= .607). We observed one case (4.5%) of neonatal HP in the IV iron group and no cases in the control group. Median cord blood phosphatemia and calcemia were 1.7 mmol/L vs. 1.71 mmol/L and 2.67 mmol/L vs. 2.64 mmol/L in the IV iron and oral groups, respectively. After adjustment, IV iron administration had no impact on cord blood phosphate (p= .919) and calcium (p= .891) levels. CONCLUSION No impact of IV iron administration during pregnancy was observed on the newborn phosphocalcic metabolism.
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Affiliation(s)
- Fanny Schumacher
- Obstetrics Division, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
| | - Francisca Barcos-Munoz
- Neonatology Division, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
| | - Margot Kunckler
- Obstetrics Division, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Vuilleumier
- Laboratory Medicine Division, Diagnostic Department and Internal Medicine Specialties Department, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Obstetrics Division, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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16
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Zhu Z, Li H, Wang M. Second trimester screening for the basilar artery: a new approach using slowflowHD. J Matern Fetal Neonatal Med 2024; 37:2326302. [PMID: 38442990 DOI: 10.1080/14767058.2024.2326302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Sonographic evaluation of the basilar artery is challenging, and a limited number of reports are available about the prenatal period, as manual positioning of probes is technically difficult. The objective of this study was to describe a sonographic transabdominal approach based on slowflow HD for screening of the basilar artery during the second trimester scan. METHODS A total of 49 women who were enrolled in a second trimester screening were included when the fetus was in the occipitoanterior position. Dopper screening of the cerebral artery was performed, which revealed the "Y" sign indicating the basilar trunk arising from two vertebral arteries in the axial oblique view when the probe was located around the junction of the vertebral processes and occipital bone and was superior to the first vertebral body, sloping slightly to the cephalic side. The Doppler ultrasound probe was placed perpendicular to the basilar artery. The flow direction was below the baseline, away from the probe in the basilar artery, consistent with a caudocephalic orientation. Peak systolic and diastolic velocities were measured. RESULTS The basilar artery was identified in all 49 fetuses, with a mean gestational age of 22 weeks (range 20 to 26 weeks). The mean peak systolic velocity of the basilar artery was 15.8 cm/second (range 9.12-26.44 cm/second). There was a slight increase in peak systolic velocity according to the gestational age of the fetus. CONCLUSIONS This study demonstrated that evaluation of the basilar artery can be performed during the second trimester via a new transabdominal approach involving slowflow HD.
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Affiliation(s)
- Zhengfeng Zhu
- Ultrasound Department, Zhengzhou University Third Hospital and Henan Province Women and Children's Hospital, Zhengzhou, China
| | - Hezhou Li
- Ultrasound Department, Zhengzhou University Third Hospital and Henan Province Women and Children's Hospital, Zhengzhou, China
| | - Ming Wang
- Ultrasound Department, Zhengzhou University Third Hospital and Henan Province Women and Children's Hospital, Zhengzhou, China
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Pietersma CS, Rousian M, Moolenaar L, Steegers EAP, Mulders A. Impact of first-trimester anomaly scan on health-related quality of life and healthcare costs: a scoping review. J Psychosom Obstet Gynaecol 2024; 45:2330414. [PMID: 38511633 DOI: 10.1080/0167482x.2024.2330414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
IMPORTANCE The first-trimester anomaly scan (FTAS) has the potential to detect major congenital anomalies in an early stage of pregnancy. Due to this potential early detection, there is a trend to introduce FTAS in regular care. Data regarding the impact of FTAS on the patient's perspective are limited. OBJECTIVE To provide an overview of the literature assessing the impact of the FTAS on health-related quality of life (HRQoL) and healthcare costs. EVIDENCE ACQUISITION Literature search was performed in Embase, PubMed, Medline Ovid, Cochrane Library database, Web-of-Science, and Google Scholar were searched. All studies that reported the performance of a nuchal translucency measurement with a basic fetal assessment HRQoL or healthcare costs of FTAS were included. Studies solely describing screening of chromosomal anomalies were excluded. Three authors independently screened the studies and extracted the data. Results were combined using descriptive analysis. PROSPERO registration number: CRD42016045190. RESULTS The search yielded 3242 articles and 16 were included. Thirteen articles (7045 pregnancies) examined the relationship between FTAS and HRQoL. Anxiety scores were raised temporarily before FTAS and returned to early pregnancy baseline following the absence of anomalies. Depression scores did not change significantly as a result of FTAS. Three articles studied healthcare costs. These studies, published before 2005, found a combination of FTAS and second-trimester anomaly scan (STAS) resulted in an increased amount of detected anomalies when compared to a STAS-only regimen. However, the combination would also be more costly. CONCLUSIONS Women experience anxiety in anticipation of the FTAS result and following a reassuring FTAS result, anxiety returns to the baseline level. FTAS seems to be a reassuring experience. The included studies on costs showed the addition of FTAS is likely to increase the number of detected anomalies against an increase in healthcare costs per pregnancy.Review registration: PROSPERO CRD42016045190.
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Affiliation(s)
- Carsten S Pietersma
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, CA, The Netherlands
| | - Melek Rousian
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, CA, The Netherlands
| | - Lobke Moolenaar
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, CA, The Netherlands
| | - Annemarie Mulders
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, CA, The Netherlands
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Ito M, Sasaki A, Haga M, Iwatani A, Nishimura E, Arai H, Nagano N, Suga S, Araki S, Konishi A, Onouchi Y, Namba F. Association of hyaluronan and proteoglycan link protein 1 gene with the need of home oxygen therapy in premature Japanese infants with bronchopulmonary dysplasia. J Matern Fetal Neonatal Med 2024; 37:2332914. [PMID: 38522947 DOI: 10.1080/14767058.2024.2332914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD) has a lasting effect on the respiratory function of infants, imposing chronic health burdens. BPD is influenced by various prenatal, postnatal, and genetic factors. This study explored the connection between BPD and home oxygen therapy (HOT), and then we examined the association between HOT and a specific single-nucleotide polymorphism (SNP) in the hyaluronan and proteoglycan link protein 1 (HAPLN1) gene among premature Japanese infants. MATERIALS AND METHODS Prenatal and postnatal data from 212 premature infants were collected and analyzed by four SNPs (rs975563, rs10942332, rs179851, and rs4703570) around HAPLN1 using the TaqMan polymerase chain reaction method. The clinical characteristics and genotype frequencies of HAPLN1 were assessed and compared between HOT and non-HOT groups. RESULTS Individuals with AA/AC genotypes in the rs4703570 SNP exhibited significantly higher HOT rates at discharge than those with CC homozygotes (odds ratio, 1.20, 95% confidence interval, 1.07-1.35, p = .038). A logistic regression analysis determined that CC homozygotes in the rs4703570 SNP did not show a statistically significant independent association with HOT at discharge. CONCLUSIONS Although our study did not reveal a correlation between HAPLN1 and the onset of BPD, we observed that individuals with CC homozygosity at the rs4703570 SNP exhibit a reduced risk of HOT.
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Affiliation(s)
- Masato Ito
- Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan
| | - Ayumi Sasaki
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Mitsuhiro Haga
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Ayaka Iwatani
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Eri Nishimura
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Hirokazu Arai
- Department of Neonatology, Akita Red Cross Hospital, Akita, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Japan
| | - Shutaro Suga
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shunsuke Araki
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Asami Konishi
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
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Han N, Chang XY, Yuan ZL, Wang YZ. Expression and correlation analysis of silent information regulator 1 (SIRT1), sterol regulatory element-binding protein-1 (SREBP1), and pyroptosis factor in gestational diabetes mellitus. J Matern Fetal Neonatal Med 2024; 37:2311809. [PMID: 38326276 DOI: 10.1080/14767058.2024.2311809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND AND AIM Globally, the prevalence of gestational diabetes mellitus (GDM) is rising each year, yet its pathophysiology is still unclear. To shed new light on the pathogenesis of gestational diabetes mellitus and perhaps uncover new therapeutic targets, this study looked at the expression levels and correlations of SIRT1, SREBP1, and pyroptosis factors like NLRP3, Caspase-1, IL-1, and IL-18 in patients with GDM. METHODS This study involved a comparative analysis between two groups. The GDM group consisted of 50 GDM patients and the control group included 50 pregnant women with normal pregnancies. Detailed case data were collected for all participants. We utilized real-time quantitative PCR and Western Blot techniques to assess the expression levels of SIRT1 and SREBP1 in placental tissues from both groups. Additionally, we employed an enzyme-linked immunosorbent assay to measure the serum levels of SIRT1, SREBP1, and pyroptosis factors, namely NLRP3, Caspase-1, IL-1β, and IL-18, in the patients of both groups. Subsequently, we analyzed the correlations between these factors and clinical. RESULTS The results showed that there were significantly lower expression levels of SIRT1 in both GDM group placental tissue and serum compared to the control group (p < 0.01). In contrast, the expression of SREBP1 was significantly higher in the GDM group than in the control group (p < 0.05). Additionally, the serum levels of NLRP3, Caspase-1, IL-1β, and IL-18 were significantly elevated in the GDM group compared to the control group (p < 0.01). The expression of SIRT1 exhibited negative correlations with the expression of FPG, OGTT-1h, FINS, HOMA-IR, SREBP1, IL-1β, and IL-18. However, there was no significant correlation between SIRT1 expression and OGTT-2h, NLRP3, or Caspase-1. On the other hand, the expression of SREBP1 was positively correlated with the expression of IL-1β, Caspase-1, and IL-18, but has no apparent correlation with NLRP3. CONCLUSIONS Low SIRT1 levels and high SREBP1 levels in placental tissue and serum, coupled with elevated levels of pyroptosis factors NLRP3, Caspase-1, IL-1β, and IL-18 in serum, may be linked to the development of gestational diabetes mellitus. Furthermore, these three factors appear to correlate with each other in the pathogenesis of GDM, offering potential directions for future research and therapeutic strategies.
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Affiliation(s)
- Ning Han
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Xin-Yuan Chang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Zi-Li Yuan
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Yi-Zhan Wang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
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20
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Linhuan H, Danlei C, Zhiming H, Shu K, Jiayi C, Jiayi P, Chuqi S, Yinghong Y, Ding W, Yingjun X, Yanmin L. The use of high-resolution SNP arrays to detect congenital cardiac defects. J Matern Fetal Neonatal Med 2024; 37:2301831. [PMID: 38311547 DOI: 10.1080/14767058.2024.2301831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE Copy number variations (CNVs) detected by high-resolution single nucleotide polymorphism microarrays (SNP arrays) have been associated with congenital heart defects (CHDs). The genetic mechanism underlying the development of CHDs remains unclear. METHODS High-resolution SNP arrays were used to detect CNVs and traditional chromosomal analyses, respectively, were carried out on 60 and 249 fetuses from gestational 12-37 weeks old, having isolated or complex CHDs that were diagnosed using prenatal ultrasound. RESULTS Twenty of the 60 fetuses (33.5%) had abnormalities, of which 23 CNVs (12 pathogenic, five probable pathogenic and six of undetermined significance) were detected by SNP arrays, and two distinct CNVs were present in three of these fetuses. In addition, in 39 patients with isolated congenital heart disease who had normal karyotypes, abnormal CNVs were present in 28.2% (11/39), and in patients with complex coronary artery disease, 19.0% (4/21) had abnormal karyotypes and 42.9% (9/21) had abnormal CNVs. In patients with complex coronary artery disease, 19.0% (4/21) had abnormal karyotypes and 42.9% (9/21) had abnormal CNVs. CONCLUSIONS In conclusion, genome-wide high-resolution SNP array can improve the diagnostic rate and uncover additional pathogenic CNVs. The submicroscopic deletions and duplications of Online Mendelian Inheritance in Man (OMIM) genes found in this study have haploinsufficient (deletion) or triplosensitive (duplication) traits, which further clarify the etiology and inheritance of CHDs.
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Affiliation(s)
- Huang Linhuan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Cai Danlei
- Department of Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - He Zhiming
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Kong Shu
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chen Jiayi
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Peng Jiayi
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Su Chuqi
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yang Yinghong
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wang Ding
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xie Yingjun
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Luo Yanmin
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
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21
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Stavridis K, Pisimisi M, Triantafyllidou O, Kalampokas T, Vlahos N, Kastora SL. The association of assisted reproductive technology with fetal malpresentation: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2024; 37:2313143. [PMID: 38316567 DOI: 10.1080/14767058.2024.2313143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Since its introduction, assisted reproductive technology (ART) has developed into a common clinical practice around the world; yet it still raises a lot of questions. Throughout time, many researchers have investigated its association with several obstetric incidences and its consequences on perinatal outcomes. The aim of the current meta-analysis was to estimate the correlation between ART procedures and malpresentation of the fetus in singleton pregnancies. METHODS The study was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) guidelines and prospectively registered under the PROSPERO database (CRD42023458084). Five databases (Embase, MEDLINE®, APA PsycInfo, Global Health, Health Management Information Consortium (HMIC)) and two additional sources were searched from inception to 31 May 2023. Quality of the included studies was assessed using the ROBINS-1 scale, whilst quality of evidence by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Summative and subgroup data as well as heterogeneity were generated by the Cochrane platform RevMan Web. RESULTS Overall, 11 studies were included in the study with a total of 3,360,134 deliveries. Results indicate a higher risk of malpresentation at delivery in fetuses conceived through ART than those conceived naturally (RR: 1.50, (95% confidence interval (CI):1.30, 1.73)). This risk decreased when adjustments for potential confounders were applied (RR = 1.12, 95% CI 1.02, 1.23). CONCLUSIONS Based on observational studies, this meta-analysis indicated that singleton pregnancies conceived through ART are associated with higher risk of malpresentation than those conceived naturally, albeit the difference was lower when potential confounders were examined. Thus, future large studies are required to better understand possible reversible and irreversible factors of this relationship.
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Affiliation(s)
- Konstantinos Stavridis
- 2nd Department of Obstetrics and Gynecology, "Aretaieion" University Hospital, Athens, Greece
| | - Maria Pisimisi
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Olga Triantafyllidou
- 2nd Department of Obstetrics and Gynecology, "Aretaieion" University Hospital, Athens, Greece
| | - Theodoros Kalampokas
- 2nd Department of Obstetrics and Gynecology, "Aretaieion" University Hospital, Athens, Greece
| | - Nikolaos Vlahos
- 2nd Department of Obstetrics and Gynecology, "Aretaieion" University Hospital, Athens, Greece
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22
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Biswakarma R, Maslowski K, Reiss MJ, Harper JC. Parenthood intentions of 16-18-year-olds in England: a survey of school students. HUM FERTIL 2024; 27:2310639. [PMID: 38346450 DOI: 10.1080/14647273.2024.2310639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
There is a need to understand teenagers' views towards having children to better tailor sexuality and reproductive health education. We conducted a survey of parenthood intentions for 16-18-year-old students. The survey was anonymous, contained open-ended and multiple-choice questions and was live from 10 May 2021 to 18 July 2022. The sample size was n = 931. Quantitative data were analysed descriptively and using chi-squared tests; qualitative data were analysed thematically. The majority of students (64%) indicated they wanted to have children in the future, with 49% desiring to have two children. Students who opted against having children cited the turbulent state of the world, concerns about parenthood, and, for many females, negative associations to pregnancy and childbirth. Many students felt concern about the possibility of having children in the future (45%), expressing concerns about their ability to have healthy children and worries about the lives their children might lead. Six themes were identified in their responses to the question 'What are your concerns about the possibility of having children in the future?': Fears; Self-doubt; Health and wellbeing; Big investment; Hinderance to personal aspirations; and Non-inclusive LGBTQ+ education. We conclude by making recommendations as to how school reproductive health and sex education might be improved.
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Affiliation(s)
- Rina Biswakarma
- IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | | | - Michael J Reiss
- IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | - Joyce C Harper
- EGA Institute for Women's Health, University College London, London, UK
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23
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Yamanaka R, Ichii O, Nakamura T, Otani Y, Namaba T, Kon Y. Effects of autoimmune abnormalities on fertility and placental morphology in mice. Autoimmunity 2024; 57:2319209. [PMID: 38389171 DOI: 10.1080/08916934.2024.2319209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
Autoimmune diseases (AIDs) alter the placental immune environment leading to fetal loss. This study investigated the effects of AIDs on pregnancy and the placenta in AID-prone MRL/MpJ-Faslpr/lpr mice and wild-type MRL/MpJ, which were mated with male MRL/MpJ and MRL/MpJ-Faslpr/lpr at five months and defined as moLpr and moMpJ, respectively. AID indices (spleen weight and serum autoantibody levels) and fertility status (number and size of fetuses, morphology, and comprehensive gene expression of placentas) were evaluated on gestational day 15.5. Both strains showed equivalent fertility, but moLpr showed lighter placentas and fetuses than moMpJ, and decreased fertility with AID severity. moLpr placentas had a higher number of T cells, higher expression of genes associated with T helper 2 and T follicular helper functions, and altered expression of genes (Krt15, Slc7a3, Sprr2a3) that significantly regulate pregnancy or immunity. The gene expression of T cell migration-associated chemokines (Ccl5, Cxcl9) was significantly increased in moLpr placentas, and CCL5 and CXCL9 were detected in moLpr placentas, particularly in T cells and placenta-component cells, respectively. Thus, AID altered placental morphofunction and fertility in mice; however, fertility was maintained at the examined time points. This study enhances our understanding of placental alterations and gestational risk due to AIDs.
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Affiliation(s)
- Risa Yamanaka
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Hokkaido University, Sapporo, Japan
| | - Osamu Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Hokkaido University, Sapporo, Japan
- Laboratory of Agrobiomedical Science, Faculty of Agriculture, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Teppei Nakamura
- Laboratory of Agrobiomedical Science, Faculty of Agriculture, Hokkaido University, Sapporo, Japan
- Laboratory of Laboratory Animal Science and Medicine, Department of Applied Veterinary Sciences, Hokkaido Universityty, Sapporo, Japan
| | - Yuki Otani
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Takashi Namaba
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Hokkaido University, Sapporo, Japan
| | - Yasuhiro Kon
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Hokkaido University, Sapporo, Japan
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24
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Brik M, Sandonis M, Cabeza Oliver C, Temprado J, Hernández Fleury A, Sánchez Echevarria E, Carreras E. Predictors for cannabis cessation during pregnancy: a 10-year cohort study. J Psychosom Obstet Gynaecol 2024; 45:2319290. [PMID: 38401055 DOI: 10.1080/0167482x.2024.2319290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/11/2024] [Indexed: 02/26/2024] Open
Abstract
The aim of this study is to determine factors associated with cannabis discontinuation, to assess the impact of mental health and addiction interventions on cannabis discontinuation during pregnancy and to investigate the neonatal impact of cannabis discontinuation. This is a 10-year cohort study in a tertiary hospital in Barcelona, Spain, including women with self-reported cannabis use during pregnancy. Main outcome was cannabis discontinuation based on biological sample testing. Secondary outcomes were neonatal intensive care unit (NICU) admission, preterm birth, birth weight and bottle-feeding. When cannabis use was detected during pregnancy, 32 out of 81 (38.3%) discontinued cannabis during pregnancy vs. four out of 61 (6.6%) when detected at birth (p < .001). Multivariate binary logistic regression showed that null parity (OR: 6.95, p = .011), detection of cannabis use during pregnancy (OR: 5.35, p = .018) and early detection and referral to mental health care for counseling on cannabis cessation and interventions on the first trimester (OR: 25.46, p < .001) increased cannabis discontinuation. Risk for preterm birth <37 weeks (11.4% vs. 30.8%) and NICU admission (25.7% vs. 54.2%) were lower when discontinuation. Early detection of cannabis use during pregnancy, cessation counseling with mental health interventions, and null parity are predictors for cannabis discontinuation during pregnancy.
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Affiliation(s)
- Maia Brik
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Obstetrics and Gynaecology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miguel Sandonis
- Mental Health Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carmen Cabeza Oliver
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Joaquín Temprado
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Alina Hernández Fleury
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Elena Sánchez Echevarria
- Department of Social Work Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Elena Carreras
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Obstetrics and Gynaecology, Universitat Autònoma de Barcelona, Barcelona, Spain
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25
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Jin M, Liu X, Liu X, Wu Y, Zhang Y, Zhang L, Li Z, Ye R, Li N. Association of pre-/early pregnancy high blood pressure and pregnancy outcomes: a systemic review and meta-analysis. J Matern Fetal Neonatal Med 2024; 37:2296366. [PMID: 38151254 DOI: 10.1080/14767058.2023.2296366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Maternal high blood pressure (BP) was associated with adverse pregnancy outcomes. This study aimed to synthesize evidence on the association between high BP prior to or in early pregnancy with maternal and fetal complications. METHODS We searched the cohort studies assessing the effect of high BP in the Medline, Embase, Web of Science and China National Knowledge Internet databases. A random-effects model was used to estimate the pooled odds ratios (ORs) with 95% confidence intervals (CIs). The protocol was registered in PROSPERRO (CRD 42023414945). RESULTS 23 eligible studies were identified. High BP prior to or in early pregnancy was associated with higher odds of hypertensive disorders of pregnancy (OR 2.90, 95% CI 1.91-3.89), gestational hypertension (2.56, 2.01-3.12), preeclampsia (3.20, 2.66-3.74), gestational diabetes mellitus (1.71, 1.36-2.06), preterm birth (1.66, 1.39-1.93), stillbirth (2.01, 1.45-2.58) and neonatal intensive care unit admission (1.22, 1.08-1.37). Subgroup analyses indicated that pre-hypertension could significantly increase the odds of these outcomes except for stillbirth, though the odds were lower than hypertension. CONCLUSIONS High BP prior to or in early pregnancy was associated with adverse pregnancy outcomes and this association increased with hypertension severity. The findings emphasized an urgent need for heightened surveillance for maternal BP, especially pre-hypertensive status.
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Affiliation(s)
- Ming Jin
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Xiaowen Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Xiaojing Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Yaxian Wu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Yali Zhang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Le Zhang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Zhiwen Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Rongwei Ye
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Nan Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
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26
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Ganeshan G, Sekar H, Reilly S, Kuo C, Singh S, Michaels J, Yoong W. The effect of the COVID-19 pandemic on the mental health of obstetrics and gynaecology trainees: a world-wide literature review. J OBSTET GYNAECOL 2024; 44:2319791. [PMID: 38419407 DOI: 10.1080/01443615.2024.2319791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/10/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Coronavirus (COVID-19) pandemic has affected the training and wellbeing of obstetrics and gynaecology (O&G) trainees. The aim of this review is to offer a worldwide overview on its' impact on the mental health of O&G trainees, so that measures can be put into place to better support trainees during the transition back to the 'new normal'. METHODS Key search terms used on PubMed and Google Scholar databases include: mental health, COVID-19, O&G, trainees, residents. RESULTS Fifteen articles (cumulative number of respondents = 3230) were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). Studies showed that COVID-19 appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Validated and non-validated questionnaires suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus. DISCUSSION This review analyses the global impact of COVID-19 on O&G trainees' mental health, showing a pervasive negative effect linked to fear of the virus. Limited psychological support has led to prolonged issues, hindering patient safety and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being during and beyond pandemics.
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Affiliation(s)
- G Ganeshan
- St George's International School of Medicine, Grenada, Caribbean
| | - H Sekar
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - S Reilly
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - C Kuo
- St George's International School of Medicine, Grenada, Caribbean
| | - S Singh
- St George's International School of Medicine, Grenada, Caribbean
| | - J Michaels
- St George's International School of Medicine, Grenada, Caribbean
| | - W Yoong
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
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Parker SE, Annapragada B, Chestnut I, Fuchs J, Lee A, Sabharwal V, Wachman E, Yarrington C. Trimester and severity of SARS-CoV-2 infection during pregnancy and risk of hypertensive disorders in pregnancy. Hypertens Pregnancy 2024; 43:2308922. [PMID: 38279906 PMCID: PMC10962656 DOI: 10.1080/10641955.2024.2308922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE SARS-CoV-2 infection during pregnancy has been linked with an increased risk of hypertensive disorders of pregnancy (HDP). The aim of this study was to examine how both trimester and severity of SARS-CoV-2 infection impact HDP. METHODS We conducted a cohort study of SARS-CoV-2-infected individuals during pregnancy (n = 205) and examined the association between trimester and severity of infection with incidence of HDP using modified Poisson regression models to calculate risk ratios (RR) and 95% confidence intervals (CI). We stratified the analysis of trimester by severity to understand the role of timing of infection among those with similar symptomatology and also examined timing of infection as a continuous variable. RESULTS Compared to a reference cohort from 2018, SARS-CoV-2 infection did not largely increase the risk of HDP (RR: 1.17; CI:0.90, 1.51), but a non-statistically significant higher risk of preeclampsia was observed (RR: 1.33; CI:0.89, 1.98), in our small sample. Among the SARS-CoV-2 cohort, severity was linked with risk of HDP, with infections requiring hospitalization increasing the risk of HDP compared to asymptomatic/mild infections. Trimester of infection was not associated with risk of HDP, but a slight decline in the risk of HDP was observed with later gestational week of infection. Among patients with asymptomatic or mild symptoms, SARS-CoV-2 in the first trimester conferred a higher risk of HDP compared to the third trimester (RR: 1.70; CI:0.77, 3.77), although estimates were imprecise. CONCLUSION SARS-CoV-2 infection in early pregnancy may increase the risk of HDP compared to infection later in pregnancy.
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Affiliation(s)
| | | | - Idalis Chestnut
- Department of Epidemiology, Boston University School of Public Health
| | - Jessica Fuchs
- Department of Epidemiology, Boston University School of Public Health
| | - Annette Lee
- Department of Epidemiology, Boston University School of Public Health
| | - Vishakha Sabharwal
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine
| | - Elisha Wachman
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine
| | - Christina Yarrington
- Department of Obstetrics and Gynecology, Boston University Chobanian & Avedisian School of Medicine
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Yang H, Shi Y, Ji G. Minimally invasive surgical treatment of Robert's uterus with missed miscarriage: case report. J OBSTET GYNAECOL 2024; 44:2305204. [PMID: 38247302 DOI: 10.1080/01443615.2024.2305204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024]
Abstract
Robert's uterus was firstly reported in 1970, it's a rare Müllerian duct anomaly with 2 intra-uterine cavities divided by asymmetrical septum. One of the cavities is completely obstructed to cervix by septum and menstruation fluid retents in this blind cavity, periodical pelvic pain during menstruation can lead attendance to hospital. We report a gravida of Robert's uterus with missed abortion in the blind cavity, who had mild dysmenorrhoea since adolescent age, diagnosed and treated by minimally invasive surgical methods. To our knowledge, it's a previously unreported case which gynaecologists terminated pregnancy in blind cavity of Robert's uterus without resecting the septum while dysmenorrhoea relieved entirely and postoperative volume of menstruation stayed the same as preoperative.
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Affiliation(s)
- Houyu Yang
- Department of Gynaecology, The Second People's Hospital of Guiyang, Guiyang, China
| | - Yuanjunzi Shi
- Department of Gynaecology, The Second People's Hospital of Guiyang, Guiyang, China
| | - Gang Ji
- Department of Gynaecology, The Second People's Hospital of Guiyang, Guiyang, China
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29
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Zhang L, Piao J, Zhang W, Liu N, Zhang X, Shen Y, Jin Y, Wang F, Feng S. Physical activity changes and influencing factors among Chinese pregnant women: a longitudinal study. J Matern Fetal Neonatal Med 2024; 37:2306190. [PMID: 38262926 DOI: 10.1080/14767058.2024.2306190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Participating in physical activity during pregnancy has benefited a lot from maternal and child health. However, there are few longitudinal studies describing activity patterns and related factors during pregnancy. The aim of this study is to investigate longitudinal physical activity changes and the influencing factors of Chinese pregnant women. METHODS From January to August 2020, 240 pregnant women were recruited in Hangzhou, China. Physical activity during pregnancy was assessed in the first, second, and third trimesters of pregnancy by using the Pregnancy Physical Activity Questionnaire. RESULTS The daily energy consumption during first, second, and third trimesters was 20.55, 20.76, 17.19 METs-h/d. The results of repeated-measure analysis of variance and pairwise comparison showed that the total daily energy consumption of physical activity in the third trimester was significantly lower than that in the first and second trimesters, with statistical significance (p < 0.001). The generalized estimation equation showed that education level, pre-pregnancy BMI, gravidity, unnaturally conceived and pre-pregnancy exercise habits were the influencing factors of physical activity during pregnancy (p < 0.05). CONCLUSION Physical activity levels of pregnant women during different trimester were not optimistic. In order to improve physical activity during pregnancy and promote the health status of both mother and the developing baby, more attention should be paid on pregnant women with low education level, high BMI before pregnancy, primipara, unnaturally conceived and no good exercise habits before pregnancy.
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Affiliation(s)
- Le Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinlan Piao
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ningning Liu
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xuesong Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yu Shen
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Jin
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fangfang Wang
- Department of Obstetric, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Suwen Feng
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Algera E, Leusink P, Gerrits T, Pols J, Ravesloot JH. mHealth technologies for pregnancy prevention: A challenge for patient-centred contraceptive counselling in Dutch general practice. Eur J Gen Pract 2024; 30:2302435. [PMID: 38264977 PMCID: PMC10810654 DOI: 10.1080/13814788.2024.2302435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND A general practitioner (GP) standardly provides contraceptive counselling and care in the Netherlands. Recent years have seen the rise of mobile health technologies that aim to prevent pregnancy based on fertility awareness-based methods (FABMs). We lack high-quality evidence of these methods' effectiveness and clarity on how healthcare professionals include them in contraceptive counselling. OBJECTIVES To analyse how Dutch healthcare professionals include pregnancy-prevention mobile health technologies (mHealth contraception) in contraceptive counselling and to propose practice recommendations based on our findings. METHODS We used ethnographic methods, including semi-structured interviews with nine professionals who were recruited using purposive sampling, 10 observations of contraceptive counselling by four professionals, six observations of teaching sessions in medical training on contraception and reproductive health, one national clinical guideline, and seven Dutch patient decision aids. Data were collected between 2018 and 2021 and analysed inductively using praxiographic and thematic analysis. RESULTS In contraceptive counselling and care, professionals tended to blend two approaches: 1) individual patient-tailored treatment and 2) risk minimisation. When interviewed about mHealth contraception, most professionals prioritised risk minimisation and forewent tailored treatment. Some did not consider mHealth contraception or FABMs as contraceptives or deemed them inferior methods. CONCLUSION To minimise risk of unintended pregnancy, professionals hesitated to include mHealth contraception or other FABMs in contraceptive consultations. This may hamper adequate patient-centred counselling for patients with preference for mHealth contraception.Based on these results, we proposed recommendations that foster a patient-tailored approach to mHealth contraceptives.
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Affiliation(s)
- Ellen Algera
- Department of Anthropology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Department of Ethics, Law & Medical Humanities, Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Biology, Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, The Netherlands
- Institute for Interdisciplinary Studies, Faculty of Science, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Trudie Gerrits
- Department of Anthropology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeannette Pols
- Department of Anthropology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Department of Ethics, Law & Medical Humanities, Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Hindrik Ravesloot
- Department of Medical Biology, Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, The Netherlands
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31
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Yang L, You Y, Li Z, Song Y, Jia X. Successful management of pyoderma gangrenosum after caesarean section: a case report. J OBSTET GYNAECOL 2024; 44:2289546. [PMID: 38149623 DOI: 10.1080/01443615.2023.2289546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/24/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Liqin Yang
- Department of Obstetrics, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, P. R. China
| | - Yiping You
- Department of Obstetrics, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, P. R. China
| | - Zheng Li
- NHC Key Laboratory of Carcinogenesis, Cancer Research Institute and School of Basic Medical, Central South University, Changsha, Hunan, P. R. China
| | - Yingxue Song
- Department of Dermatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiaozhou Jia
- Department of Obstetrics, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, P. R. China
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Kasahara M, Koshida S, Tokoro S, Katsura D, Tsuji S, Murakami T, Takahashi K. Potential prevention of stillbirth caused by placental abruption: a regional population-based study in Japan. J Matern Fetal Neonatal Med 2024; 37:2321485. [PMID: 38403932 DOI: 10.1080/14767058.2024.2321485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Placental abruption is associated with adverse perinatal outcomes including intrauterine fetal demise, which subsequently results in stillbirth. However, few studies have demonstrated the preventability of stillbirth due to placental abruption. Therefore, we evaluated the possibility of preventing stillbirth caused by placental abruption by reviewing all stillbirths in our region. METHODS This study reviewed all stillbirths after 22 weeks of gestation in Shiga Prefecture, Japan from 2010 to 2019, excluding lethal disorders. We evaluated 350 stillbirth cases, with and without placental abruption. RESULTS There were 32 stillbirths with PA and 318 without placental abruption. The probability of preventing stillbirth was significantly higher in patients with placental abruption than in those without (30% vs. 8%, p < 0.001). We also determined the recommendations for preventing stillbirths with placental abruption. CONCLUSION Some stillbirths caused by placental abruption can be prevented. We recommend improvements to perinatal maternal-fetal care and perinatal emergency transport systems.
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Affiliation(s)
- Makiko Kasahara
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Shigeki Koshida
- Perinatal Center, Shiga University of Medical Science, Otsu-city, Japan
| | - Shinsuke Tokoro
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Daisuke Katsura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Shunichiro Tsuji
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Kentaro Takahashi
- Perinatal Center, Shiga University of Medical Science, Otsu-city, Japan
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Kang T, Tao J, Wang X, Liu Y, Jin D. Epidural ropivacaine versus bupivacaine for cesarean sections: a system review and meta-analysis. J Matern Fetal Neonatal Med 2024; 37:2313356. [PMID: 38342577 DOI: 10.1080/14767058.2024.2313356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Abstract
INTRODUCTION It is still no consensus on the use of ropivacaine or bupivacaine in epidural anesthesia for cesarean section (CS), because their anesthetic potency and relative complications remains controversial. This system review and meta-analysis aimed to compare the efficacy of epidural ropivacaine and bupivacaine for elective CSs and investigate relative complications for parturients and neonates. METHODS We searched PubMed, MEDLINE, Embase, Cochrane Library, Science-Direct, and Google Scholar to June 30, 2023 for randomized controlled trials (RCTs), which compared epidural ropivacaine with bupivacaine for elective CSs. The success rate of epidural anesthesia (EA) was primary outcome. The secondary outcomes included onset times of sensory block, maternal side effects, neonatal Apgar scores and umbilical artery pH. RESULTS We analyzed 8 RCTs with 532 parturients. 0.75% ropivacaine is associated with a shorter onset time of sensory block than 0.5% bupivacaine (SMD = -0.43, 95% CI: -0.70 to -0.17; p = .001). 0.5% ropivacaine resulted in a reduced nausea than 0.5% bupivacaine (RR = 0.49, 95% CI: 0.28 to 0.83; p = .008). In addition, there were no significant difference between ropivacaine and bupivacaine groups in terms of success rate of epidural anesthesia, maternal side effects (hypotension, bradycardia, shivering), and neonatal Apgar scores and umbilical artery pH. CONCLUSIONS The findings suggest that there were no significant difference between epidural ropivacaine and bupivacaine for elective CSs in terms of the success rate (85.9% vs. 83.5), maternal side effects (hypotension, bradycardia, shivering), and neonatal Apgar scores and umbilical artery pH. But compared with 0.5% bupivacaine, epidural 0.75% ropivacaine was mildly effective for reducing onset time of sensory block and 0.5% ropivacaine reduced the incidence of maternal nausea.
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Affiliation(s)
- Tao Kang
- Department of Neurosurgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Jiwei Tao
- Department of Neurosurgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Xuetao Wang
- Department of Neurosurgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Yu Liu
- Department of Neurosurgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Dan Jin
- Department of Neurosurgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
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Zhang B, Chen X, Yang C, Shi H, Xiu W. Effects of hypertensive disorders of pregnancy on the complications in very low birth weight neonates. Hypertens Pregnancy 2024; 43:2314576. [PMID: 38375828 DOI: 10.1080/10641955.2024.2314576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the complications in very low birth weight (VLBW) neonates. METHODS We retrospectively included VLBW neonates (<37 weeks) who were delivered by HDP pregnant women with a body weight of < 1,500 g (HDP group) hospitalized in our hospital between January 2016 and July 2021. Gestational age matched VLBW neonates delivered by pregnant women with a normal blood pressure, with a proportion of 1:1 to the HDP group in number, served as normal control. RESULTS Then we compared the peripartum data and major complications between HDP group and control. The body weight, prelabor rupture of membrane (PROM), maternal age, cesarean section rate, fetal distress, small for gestational age (SGA), mechanical ventilation, RDS, necrotizing enterocolitis (NEC) (≥2 stage), Apgar score at 1 min, and mortality in HDP group showed statistical differences compared with those of the control (all p < 0.05). To compare the major complications among HDP subgroups, we classified the VLBW neonates of the HDP group into three subgroups including gestational hypertension group (n = 72), pre-eclampsia (PE) group (n = 222), and eclampsia group (n = 14), which showed significant differences in the fetal distress, Apgar score at 1 min, SGA, ventilation, RDS and NEC (≥2 stage) among these subgroups (all p < 0.05). Multivariate regression analysis showed that eclampsia and PE were the independent risk factors for SGA and NEC, respectively. CONCLUSION HDP was associated with increased incidence of neonatal asphyxia, fatal distress, SGA, mechanical ventilation, RDS, NEC and mortality. Besides, eclampsia and PE were independent risk factors for SGA and NEC.
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Affiliation(s)
- Baoquan Zhang
- Neonatology Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Xiujuan Chen
- Neonatology Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Changyi Yang
- Neonatology Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Huiying Shi
- Neonatology Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Wenlong Xiu
- Neonatology Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
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35
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Lan X, Ao WL, Li J. Preimplantation genetic testing as a preventive strategy for the transmission of mitochondrial DNA disorders. Syst Biol Reprod Med 2024; 70:38-51. [PMID: 38323618 DOI: 10.1080/19396368.2024.2306389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/07/2024] [Indexed: 02/08/2024]
Abstract
Mitochondrial diseases are distinct types of metabolic and/or neurologic abnormalities that occur as a consequence of dysfunction in oxidative phosphorylation, affecting several systems in the body. There is no effective treatment modality for mitochondrial disorders so far, emphasizing the clinical significance of preventing the inheritance of these disorders. Various reproductive options are available to reduce the probability of inheriting mitochondrial disorders, including in vitro fertilization (IVF) using donated oocytes, preimplantation genetic testing (PGT), and prenatal diagnosis (PND), among which PGT not only makes it possible for families to have genetically-owned children but also PGT has the advantage that couples do not have to decide to terminate the pregnancy if a mutation is detected in the fetus. PGT for mitochondrial diseases originating from nuclear DNA includes analyzing the nuclear genome for the presence or absence of corresponding mutations. However, PGT for mitochondrial disorders arising from mutations in mitochondrial DNA (mtDNA) is more intricate, due to the specific characteristics of mtDNA such as multicopy nature, heteroplasmy phenomenon, and exclusive maternal inheritance. Therefore, the present review aims to discuss the utility and challenges of PGT as a preventive approach to inherited mitochondrial diseases caused by mtDNA mutations.
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Affiliation(s)
- Xinpeng Lan
- College of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Wu Liji Ao
- College of Mongolian Medicine and Pharmacy, Inner Mongolia University for Nationalities, Tongliao, Inner Mongolia, China
| | - Ji Li
- College of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, China
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Jin F, Yang Y, Sun J, Li R, Yao F, Liu X. Factors that influence the choice of long-acting reversible contraceptive use among adolescents post-abortion in Chongqing, China: a cross-sectional study. J OBSTET GYNAECOL 2024; 44:2316625. [PMID: 38353518 DOI: 10.1080/01443615.2024.2316625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Induced abortion can seriously harm the physical and mental health of adolescent women. Long-acting reversible contraception (LARC) can effectively reduce unplanned pregnancies and prevent repeated abortions among adolescents. This study aimed to analyse the factors affecting the choice of LARC among adolescents in Chongqing of China. METHODS A total of 555 adolescents who underwent induced abortions for unplanned pregnancies between January 2019 and October 2021 were selected as study subjects. Logistic regression analysis was used to determine the factors affecting adolescent LARC choices following induced abortions. RESULTS The factors that affected adolescent LARC choices included an average monthly income ≥ ¥3000 (OR = 3.432, 95% CI: 1.429∼8.244), history of previous abortions (OR = 3.141, 95% CI: 1.632∼6.045), worrying about unplanned pregnancy (OR = 0.365, 95% CI: 0.180∼0.740), parental support for using LARC (OR = 3.549, 95% CI: 1.607∼7.839), sexual partners' support for using LARC (OR = 2.349, 95% CI: 1.068∼5.167), concerns about using LARC (OR = 0.362, 95% CI: 0.176∼0.745), and willingness to use free IUDs (OR = 13.582, 95% CI: 7.173∼25.717). CONCLUSION Cost is one of the factors affecting LARC choices. Parents and sexual partners may play important role in the choice of LARC.
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Affiliation(s)
- Fengzhen Jin
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
- National Key Clinical Speciality Construction Project (Obstetrics and Gynecology), Chongqing, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing, China
| | - Yuanpei Yang
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
- National Key Clinical Speciality Construction Project (Obstetrics and Gynecology), Chongqing, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing, China
| | - Junjie Sun
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
- National Key Clinical Speciality Construction Project (Obstetrics and Gynecology), Chongqing, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing, China
| | - Ruiyue Li
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
- National Key Clinical Speciality Construction Project (Obstetrics and Gynecology), Chongqing, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing, China
| | - Fei Yao
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
- National Key Clinical Speciality Construction Project (Obstetrics and Gynecology), Chongqing, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing, China
| | - Xiaoli Liu
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
- National Key Clinical Speciality Construction Project (Obstetrics and Gynecology), Chongqing, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing, China
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Sun S, An S. Associations between patterns of social support and perinatal mental health among Chinese mother: the mediating role of social trust. J Psychosom Obstet Gynaecol 2024; 45:2325451. [PMID: 38465671 DOI: 10.1080/0167482x.2024.2325451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
This study aims to explore the correlation between different social support patterns and perinatal mental health, and the mediating role of social trust in this. A cross-sectional survey was conducted in Jiangsu, China, with a sample size of 1705 pregnant respondents. Latent class analysis (LCA) was utilized to identify various social support patterns, while a multiple regression model was employed to analyze the mediating effect of social trust on the relationship between social support patterns and perinatal mental health. The study found four distinct social support patterns among the respondents: primary relationship-centric support, overall weak support, primary-secondary relationship-balanced support, and overall strong support. In the relationship between social support patterns and perinatal mental health, social trust played both a partial and full mediating role. The findings indicate that a social support system that enhances maternal trust and promotes honest disclosure of symptoms can effectively promote perinatal mental health.
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Affiliation(s)
- Sheng Sun
- Department of Sociology, School of Law, Jiangnan University, Wuxi, China
| | - Shanshan An
- Department of Sociology, School of Law, Jiangnan University, Wuxi, China
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Howley LW, Eyerly-Webb SA, Killen SAS, Paul E, Krishnan A, Gropler MRF, Drewes B, Dion E, Lund A, Buyon JP, Cuneo BF. Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies. J Matern Fetal Neonatal Med 2024; 37:2323623. [PMID: 38443062 DOI: 10.1080/14767058.2024.2323623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies. STUDY DESIGN An electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal Therapy Network members which queried institution-based risk stratification, surveillance methods/frequency, conduction abnormality treatments, and postnatal anti-SSA/Ro pregnancy assessment. RESULTS 101 responses from 59 centers (59% US, 17% international) were collected. Most (79%) do not risk stratify pregnancies by anti-SSA/Ro titer; those that do use varied cutoff values. Many pregnant rheumatology patients are monitored for cardiac abnormalities regardless of maternal anti-SSA/Ro status. Surveillance strategies were based on maternal factors (anti-SSA/Ro status 85%, titer 25%, prior affected child 79%) and monitoring durations varied. Most respondents treat 2° and 3° fetal atrioventricular block, commonly with dexamethasone and/or IVIG. CONCLUSIONS Wide variation exists in current fetal cardiac surveillance and treatment for anti-SSA/Ro autoantibody positive pregnancies, highlighting the need for evidence-based protocols to optimize care.
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Affiliation(s)
- Lisa W Howley
- Midwest Fetal Care Center, Children's Minnesota, Minneapolis, MN, USA
- The Children's Heart Clinic, Children's Minnesota, Minneapolis, MN, USA
| | | | - Stacy A S Killen
- Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital, Nashville, TN, USA
| | - Erin Paul
- Icahn School of Medicine, Mount Sinai Children's Heart Center, New York, NY, USA
| | | | | | - Bailey Drewes
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Eric Dion
- Midwest Fetal Care Center, Children's Minnesota, Minneapolis, MN, USA
| | - Amy Lund
- Midwest Fetal Care Center, Children's Minnesota, Minneapolis, MN, USA
- The Children's Heart Clinic, Children's Minnesota, Minneapolis, MN, USA
| | - Jill P Buyon
- New York University Grossman School of Medicine, NYU Langone Medical Center, New York, NY, USA
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Oğlak SC, Yılmaz EZ, Budak MŞ. Abdominal subcutaneous fat thickness combined with a 50-g glucose challenge test at 24-28 weeks of pregnancy in predicting gestational diabetes mellitus. J OBSTET GYNAECOL 2024; 44:2329880. [PMID: 38516715 DOI: 10.1080/01443615.2024.2329880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/06/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND This investigation aimed to analyse the efficacy of abdominal subcutaneous fat thickness (ASFT) value >18.1 mm combined with a 50-g glucose challenge test (GCT) between 24-28 weeks of gestation in predicting gestational diabetes mellitus (GDM) cases. METHODS This cross-sectional study was carried out from February 2021 to December 2022. All pregnant women received a 50-g GCT at 24-28 weeks of pregnancy for the GDM screening. Pregnant women with a blood glucose value between 140-190 mg/dl experienced 100 g OGTT. Even if 50-g GCT was normal, 100-g OGTT was offered to patients with an ASFT value above 18.1 mm. RESULTS Among the 728 pregnant women we enrolled, 154 (21.2%) cases were screened as positive. The number of patients who first screened positive and determined to be GDM after the 100-g oral glucose tolerance test (OGTT) was 43 (5.9%). A total of 67 cases (9.2%) had an ASFT measurement above 18.1 mm. Two cases with a negative 50-g GCT and ASFT <18.1 mm were diagnosed as GDM in the later weeks of pregnancy. A 50-g GCT combined with ASFT measurement above 18.1 mm predicted GDM with a sensitivity of 87.9%, a specificity of 88.7%, a positive predictive value (PPV) of 36.0%, and a negative PV (NPV) of 99.7%. CONCLUSIONS A 50-g GCT combined with ASFT measurement that can be easily and accurately obtained during routine antenatal care in the second trimester might be a beneficial indicator for predicting GDM cases.
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Affiliation(s)
- Süleyman Cemil Oğlak
- Department of Obstetrics and Gynaecology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Emine Zeynep Yılmaz
- Department of Obstetrics and Gynaecology, Bahçelievler Memorial Hospital, Istanbul, Turkey
| | - Mehmet Şükrü Budak
- Department of Obstetrics and Gynaecology, Private Can Hospital, Izmir, Turkey
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Zou Y, Jiang Y, Zhu D, Liu L, Zheng X, Gu X, Huang C, Li L. Fibrinogen as a potential diagnostic marker for prediction and evaluation of postpartum hemorrhage: a retrospective study. J Matern Fetal Neonatal Med 2024; 37:2300418. [PMID: 38185650 DOI: 10.1080/14767058.2023.2300418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/23/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To investigate whether prenatal fibrinogen (FIB) or other related factors could be utilized to evaluate the risk of postpartum hemorrhage (PPH). METHODS A retrospective study was conducted in a database from January 2015 to December 2019. A total of 128 patients were enrolled and evaluated with FIB, in which 55 patients were assigned to low FIB and 73 in normal FIB. RESULTS According to the volume of blood loss, the mean of the low FIB group (<4 g/L) was markedly higher than that of the normal FIB group (≥4 g/L). Prenatal FIB was negatively correlated with PPH volume. The receiver operating characteristic (ROC) curve results indicated that the value of prenatal FIB was 0.701 to predict refractory PPH. CONCLUSIONS Prenatal FIB was significantly related to thrombin time (TT), which may be an independent factor to predict the coagulation state of prenatal pregnancy.
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Affiliation(s)
- Yanke Zou
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Yixiao Jiang
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Dawei Zhu
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Ling Liu
- Department of Health Statistics, Army Military Medical University, Army Medical University, Chongqing, China
| | - Xiuhui Zheng
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Xing Gu
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Changxiao Huang
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Li Li
- Department of Cardiology, Daping Hospital, Army Military Medical University, Chongqing, China
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Sha Y, Liu W, Hong J, Yang Y, Yu J, Fu X. A noninvasive method for the detection of foetal DNA in early pregnancy based on differential methylation pattern of Ras association domain family member 1A. J OBSTET GYNAECOL 2024; 44:2292611. [PMID: 38197583 DOI: 10.1080/01443615.2023.2292611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND The detection of foetal DNA and extravillus trophoblasts (EVTs) in early pregnancy in cervical and uterine samples offers a potential pathway for non-invasive prenatal diagnostics. However, the challenge lies in effectively quantifying these samples. This study introduces a novel approach using the Ras association domain family 1 A (RASSF1A), which exhibits hypermethylation in foetal cells and hypomethylation in maternal cells. The differential methylation pattern of RASSF1A provides a unique biomarker for quantifying foetal cells in cervical and intrauterine samples. METHODS This study was conducted between September 2022 and May 2023. In total, 23 samples (12 cervical cell samples and 11 intrauterine samples) were collected from women in the Sichuan Jinxin Women & Children Hospital, Jingxiu District, Chengdu, China. The cervical cell samples were collected via lavage and brush techniques, and the intrauterine cell samples were obtained via uterine lavage. These samples were collected as part of a broader effort to advance our understanding of foetal cell dynamics during early pregnancy. The sampling methods were chosen for their minimally invasive nature and their potential in capturing a representative cell population from the respective sites. After digestion of the cell samples using a methylation-sensitive restriction enzyme cocktail, a critical step to differentiate between maternal and foetal DNA, the quantitative polymerase chain reaction (qPCR) of RASSF1A and β-actin (ACTB) were employed to measure foetal DNA and cell concentrations. Immunofluorescence techniques targeting histocompatibility complex, class I G (HLA-G) and GATA binding protein 3 (GATA-3) were employed to detect EVTs in the cell samples and in decidual tissue, with the latter providing an additional layer of confirmation for the presence of foetal cells. RESULTS The results showed no hypermethylated RASSF1A was detected in any of the cervical samples, irrespective of whether the samples were obtained by brush or lavage. However, an average of 17,236 ± 7490 foetal cells per sample were detected in the uterine lavage samples. Foetal cells accounted for approximately 0.14% ± 0.10% of the total cell population in these samples. The presence of EVTs in these samples was confirmed by their expression of both HLA-G and GATA-3. CONCLUSION The detection of foetal cells in uterine cavity samples based on hypermethylation of RASSF1A and quantification of foetal cells can be used to prenatal screening. GATA-3 can be used to label EVTs.
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Affiliation(s)
- Yulin Sha
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Wei Liu
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Jiongzhi Hong
- Triplex International Biosciences (China) Co., LTD, Xiamen, Fujian, China
| | - Yan Yang
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Jian Yu
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Xiaodong Fu
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Chen X, Hong L, Mo M, Xiao S, Yin T, Liu S. Contributing factors for pregnancy outcomes in women with PCOS after their first FET treatment: a retrospective cohort study. Gynecol Endocrinol 2024; 40:2314607. [PMID: 38349325 DOI: 10.1080/09513590.2024.2314607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE We aim to explore the contributing factors of clinical pregnancy outcomes in PCOS patients undergoing their first FET treatment. METHODS A retrospective analysis was conducted on 574 PCOS patients undergoing their first FET treatment at a private fertility center from January 2018 to December 2021. RESULTS During the first FET cycle of PCOS patients, progesterone levels (aOR 0.109, 95% CI 0.018-0.670) and endometrial thickness (EMT) (aOR 1.126, 95% CI 1.043-1.419) on the hCG trigger day were associated with the clinical pregnancy rate. Similarly, progesterone levels (aOR 0.055, 95% CI 0.007-0.420) and EMT (aOR 1.179, 95% CI 1.011-1.376) on the hCG trigger day were associated with the live birth rate. In addition, AFC (aOR 1.179, 95% CI 1.011-1.376) was found to be a risk factor for preterm delivery. CONCLUSIONS In women with PCOS undergoing their first FET, lower progesterone levels and higher EMT on hCG trigger day were associated with clinical pregnancy and live birth, and AFC was a risk factor for preterm delivery. During FET treatment, paying attention to the patient's endocrine indicators and follicle status may have a positive effect on predicting and improving the pregnancy outcome of PCOS patients.
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Affiliation(s)
- Xi Chen
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Hong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Meilan Mo
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Shan Xiao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Tailang Yin
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
| | - Su Liu
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
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J-P NA, Watanabe T, Eitoku M, Yamasaki K, Mitsuda N, Maeda N, Fujieda M, Suganuma N. Association of a low chest-to-head circumference ratio with breech or transverse lie: the Japan Environment and Children's Study. J Matern Fetal Neonatal Med 2024; 37:2305678. [PMID: 38290835 DOI: 10.1080/14767058.2024.2305678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE We examined whether the chest-to-head circumference ratio at birth was associated with breech presentation and transverse lie. We also described the obstetric management of such pregnancies in the Japan Environment and Children's Study (JECS). METHODS We performed a cross-sectional evaluation of data collected between January 2011 and March 2014 in a nationwide prospective birth cohort study, the JECS. We analyzed 83,822 non-anomalous singletons born at 34-41 weeks' gestation to mothers with no history of previous cesareans or uterine surgery. We defined low, normal (reference group), and high chest-to-head circumference ratios as <10th percentile, 10th to 90th percentiles, and >90th percentile, respectively. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for breech presentation and transverse lie. The timing and mode of delivery of such pregnancies were examined. RESULTS Breech presentation was recorded in 2.6% and transverse lie in 0.2%. A low chest-to-head circumference ratio was associated with increased rate of breech presentation (5.2%; adjusted OR 2.36, 95% CI: 2.10-2.65) and transverse lie (0.3%; adjusted OR 2.33, 95% CI: 1.50-3.60), whereas a high ratio was linked to reduced breech presentation (1.1%; adjusted OR 0.51, 95% CI: 0.39-0.66). Subgroup analysis of children delivered by cesarean (n = 7971) showed a similar association, albeit with slightly reduced strength for breech presentation. Eighty-three percent of breech births and 46.3% of transverse lie births occurred at 37-38 weeks' gestation. Cesarean section was performed in 96.8% of breech presentations and 63.4% of transverse-lie ones. CONCLUSIONS These findings imply that the fetal chest-to-head circumference ratio may influence presentation at birth.
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Affiliation(s)
- Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Takafumi Watanabe
- Department of Obstetrics, Kochi Health Sciences Center, Kochi, Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Keiko Yamasaki
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Naomi Mitsuda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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Cai M, Lin J, Que Y, Xu L, Lin N, Huang H. Fetal congenital talipes equinovarus: genomic abnormalities and obstetric follow-up results. J Matern Fetal Neonatal Med 2024; 37:2299113. [PMID: 38151241 DOI: 10.1080/14767058.2023.2299113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE The etiology of congenital talipes equinovarus (CTEV) is unknown, and the relationship between chromosome microdeletion/microduplication and fetal CTEV is rarely reported. In this study, we retrospectively analyzed fetal CTEV to explore the relationship among the CTEV phenotype, chromosome microdeletion/microduplication, and obstetric outcomes. METHODS Chromosome karyotype analysis and single nucleotide polymorphism (SNP) array were performed for the 68 fetuses with CTEV. RESULTS An SNP array was performed for 68 fetuses with CTEV; pathogenic copy number variations (CNVs) were detected in eight cases (11.8%, 8/68). In addition to one case consistent with karyotype analysis, the SNP array revealed seven additional pathogenic CNVs, including three with 22q11.21 microdeletions, two with 17p12p11.2 microduplications, one with 15q11.2 microdeletions, and one with 7q11.23 microduplications. Of the seven cases carrying pathogenic CNVs, three were tested for family genetics; of these, one was de novo, and two were inherited from either the father or mother. In total, 68 fetuses with CTEV were initially identified, of which 66 cases successfully followed-up. Of these, 9 were terminated, 2 died in utero, and 55 were live births. In 9 cases, no clinical manifestations of CTEV were found at birth; the false-positive rate of prenatal ultrasound CTEVdiagnosis was thus 13.6% (9/66). CONCLUSION CTEV was associated with chromosome microdeletion/microduplication, the most common of which was 22q11.21 microdeletion, followed by 17p12p11.2 microduplication. Thus, further genomic detection is recommended for fetuses with CTEV showing no abnormalities on conventional karyotype analysis.
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Affiliation(s)
- Meiying Cai
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Jiansong Lin
- Department of Pathology, Fujian Maternal and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Yanting Que
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Liangpu Xu
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Na Lin
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Hailong Huang
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
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Acikgöz AS, Gök K, Tüten A, Kaya B, Hamzaoğlu K, Kolomuç Gayretli T, Malik E, Güralp O. Evaluation of serum levels of soluble vascular endothelial (sVE)-Cadherin in early- and late-onset preeclampsia serum sVE-Cadherin levels in preeclampsia. J Matern Fetal Neonatal Med 2024; 37:2326304. [PMID: 38499386 DOI: 10.1080/14767058.2024.2326304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVE Endothelial dysfunction is a major feature of preeclampsia. sVE-cadherin plays a role in the preservation and regulation of the endothelial barrier. For that reason, to evaluation of sVE-cadherin may help elucidate the disease pathophysiology of preeclampsia. METHODS The sample size was calculated as a minimum of 46 pregnant women for each group based on serum sVE-Cadherin levels in a pilot study of 10 preeclamptic and 10 control groups. Hundred-twenty pregnancies complicated with early-onset (n = 60) and late-onset (n = 60) preeclampsia were compared with 120 gestational-age (GA)-matched (±1 week) uncomplicated pregnancies. The venous blood sampling was performed upon preeclampsia diagnosis prior to the onset of the labor in the preeclampsia group and the matching (±1 week) pregnancy week in the control group. Demographic and biochemical parameters were evaluated. RESULTS Mean serum sVE-Cadherin was significantly higher in women with EOPE compared to that of the GA-matched control group (5.86 ± 1.57 ng/mL vs. 2.28 ± 0.80 ng/mL, p < 0.001), in women with LOPE compared to that of the GA-matched control group (3.11 ± 0.97 ng/mL vs. 1.69 ± 0.87 ng/mL, p < 0.001), and in women with EOPE compared to that of LOPE group (5.86 ± 1.57 ng/mL vs. 3.11 ± 0.97 ng/mL, p < 0.001) after correction for GA. Serum sVE-Cadherin positively correlated with systolic and diastolic blood pressure and a negative correlation with gestational age at sampling. CONCLUSION The serum level of sVE-Cadherin was higher in women with preeclampsia than that of GA-matched healthy pregnant women, in women with EOPE compared to that of LOPE. sVE-Cadherin is an important marker in early-onset pre-eclampsia with severe clinical findings.
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Affiliation(s)
- Abdullah Serdar Acikgöz
- Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Koray Gök
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Abdullah Tüten
- Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Barış Kaya
- Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Kübra Hamzaoğlu
- Department of Obstetrics and Gynecology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Tuğba Kolomuç Gayretli
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Eduard Malik
- Carl von Ossietzky Oldenburg University, University Hospital for Gynecology and Obstetrics, Oldenburg, Germany
| | - Onur Güralp
- Carl von Ossietzky Oldenburg University, University Hospital for Gynecology and Obstetrics, Oldenburg, Germany
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van Vliet MM, Schoenmakers S, Gribnau J, Steegers-Theunissen RP. The one-carbon metabolism as an underlying pathway for placental DNA methylation - a systematic review. Epigenetics 2024; 19:2318516. [PMID: 38484284 PMCID: PMC10950272 DOI: 10.1080/15592294.2024.2318516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/07/2024] [Indexed: 03/19/2024] Open
Abstract
Epigenetic modifications, including DNA methylation, are proposed mechanisms explaining the impact of parental exposures to foetal development and lifelong health. Micronutrients including folate, choline, and vitamin B12 provide methyl groups for the one-carbon metabolism and subsequent DNA methylation processes. Placental DNA methylation changes in response to one-carbon moieties hold potential targets to improve obstetrical care. We conducted a systematic review on the associations between one-carbon metabolism and human placental DNA methylation. We included 22 studies. Findings from clinical studies with minimal ErasmusAGE quality score 5/10 (n = 15) and in vitro studies (n = 3) are summarized for different one-carbon moieties. Next, results are discussed per study approach: (1) global DNA methylation (n = 9), (2) genome-wide analyses (n = 4), and (3) gene specific (n = 14). Generally, one-carbon moieties were not associated with global methylation, although conflicting outcomes were reported specifically for choline. Using genome-wide approaches, few differentially methylated sites associated with S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), or dietary patterns. Most studies taking a gene-specific approach indicated site-specific relationships depending on studied moiety and genomic region, specifically in genes involved in growth and development including LEP, NR3C1, CRH, and PlGF; however, overlap between studies was low. Therefore, we recommend to further investigate the impact of an optimized one-carbon metabolism on DNA methylation and lifelong health.
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Affiliation(s)
- Marjolein M van Vliet
- Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, the Netherlands
- Department of Developmental Biology, Erasmus MC, Rotterdam, the Netherlands
| | - Sam Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, the Netherlands
| | - Joost Gribnau
- Department of Developmental Biology, Erasmus MC, Rotterdam, the Netherlands
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Tsibizova V, Al-Sannan B, Fedorova A, Govorov I, Meyyazhagan A, Di Renzo GC. Can we improve the outcome of pregnancies with low serum PAPP-A in the first trimester? J Matern Fetal Neonatal Med 2024; 37:2326303. [PMID: 38503546 DOI: 10.1080/14767058.2024.2326303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE This study aimed to assess the impact of micronized progesterone (VMP4) supplementation on pregnancies with low serum pregnancy-associated plasma protein-A (PAPP-A) multiples of the median (MoM) values during first-trimester screening. METHODS Out of 8933 patients evaluated, 116 pregnant women with low PAPP-A concentrations in their blood and no fetal chromosomal anomalies (CAs) were included. Three groups were formed: group 1 received VMP4 from 11 to 16 weeks (29 women, 25%), group 2 received VMP4 from 11 to 36 weeks (25 women, 21.5%), and group 3 (62 women, 53.5%) served as controls without receiving progesterone. RESULTS Results indicated that group 3 had higher rates of complications, including miscarriages (16.37%), preterm delivery (17.8%), and fetal developmental abnormalities (19.4%). Birthweight variations were elevated in pregnancies without progesterone, contrasting with lower variations in VMP4 groups. Group 2, receiving VMP4 until 36 weeks, reported the lowest incidence of abortion and preterm birth (PB), along with the highest mean birth weight. CONCLUSIONS The conclusion suggests that 200 mg per day of VMP4 up to 36 weeks of supplementation led to fewer placental-related complications in women with very low PAPP-A at first-trimester screening (0.399 MoM). By reporting lower rates of miscarriages, PBs, and fetal developmental abnormalities in the micronized progesterone-treated groups, the study suggests a potential reduction in complications.
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Affiliation(s)
- Valentina Tsibizova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- PREIS International School, Firenze, Italy
| | - Baydaa Al-Sannan
- Obstetrics and Gynecology Department, Faculty of Medicine, University of Kuwait, Kuwait City, Kuwait
| | | | - Igor Govorov
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Arun Meyyazhagan
- PREIS International School, Firenze, Italy
- Department of Life Sciences, CHRIST (Deemed to be University), Bengaluru, India
- Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Gian Carlo Di Renzo
- PREIS International School, Firenze, Italy
- Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
- Department of Obstetrics, Gynecology and Perinatal Medicine, First Moscow Medical University, Sechenov University, Moscow, Russia
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Han N, Yuan Z, Zhao H, Chang X, Chen Y, Zhang M, Wang Y. Relationship between serum NLRP3 along with its effector molecules and pregnancy outcomes in women with hyperglycemia. J Matern Fetal Neonatal Med 2024; 37:2312447. [PMID: 38350233 DOI: 10.1080/14767058.2024.2312447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE The study aims to investigate the levels of serum NLRP3 along with its effector molecules (Caspase-1, IL-1β, and IL-18) in the mid-pregnancy in pregnant women with hyperglycemia, and explore the relationship between NLRP3, along with its effector molecules (Caspase-1, IL-1β, and IL-18) and insulin resistance, as well as pregnancy outcomes. METHODS The levels of serum NLRP3 along with its effector molecules (Caspase-1, IL-1β, and IL-18) in three groups of pregnant women with gestational diabetes mellitus (GDM), pregestational diabetes mellitus (PGDM) and normal glucose tolerance (NGT) were measured in mid-pregnancy, and their relationship with insulin resistance and pregnancy outcomes was analyzed. The ROC curve was also used to evaluate the predictive value of serum NLRP3 inflammasome and its effector molecules for pregnancy outcomes. RESULTS There were no statistical differences in the general clinical data of the three groups, and the concentrations of serum NLRP3 along with its effector molecules were higher in the GDM and PGDM groups than in the NGT group, and NLRP3 along with its effector molecules were positively correlated with fasting blood glucose, fasting insulin, and insulin resistance index in both groups (r > 0, p < .05). The incidence of preterm delivery, hypertensive disorders of pregnancy, premature rupture of membranes, neonatal hypoglycemia and macrosomia was significantly higher in both groups than in the NGT group (p < .05). The value of the combined serum NLRP3 and its effector molecules in mid-pregnancy to predict adverse pregnancy outcomes was highest, and the AUCs for the combined prediction of late hypertensive disorders of pregnancy, premature rupture of membranes, preterm delivery, neonatal hypoglycemia and macrosomia were 0.84 (95% CI 0.79-0.88, p < .001), 0.81 (95% CI 0.75-0.85, p < .001), 0.76 (95% CI 0.70-0.81, p < .001), 0.76 (95% CI 0.70-0.81, p < .001) and 0.72 (95% CI 0.63-0.81, p < .001), respectively. CONCLUSIONS Increased serum NLRP3 along with its effector molecules in pregnant women with hyperglycemia are associated with the levels of insulin resistance and the subsequent development of adverse pregnancy outcomes.
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Affiliation(s)
- Ning Han
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zili Yuan
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongyang Zhao
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyuan Chang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Chen
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Miao Zhang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yizhan Wang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Kim O, Hong S, Park IY, Ko HS. Association between placental location and cord insertion site with pre-eclampsia: a retrospective cohort study. J Matern Fetal Neonatal Med 2024; 37:2306189. [PMID: 38272651 DOI: 10.1080/14767058.2024.2306189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE The relationship between placental location in pregnancies without previa and adverse pregnancy outcomes has not been well studied. Additionally, the impact of abnormal cord insertion sites remains controversial. Therefore, the objective of this study was to explore the adverse outcomes associated with placental location and abnormal cord insertion in nulliparous women and to assess their impact on pregnancy outcomes. METHODS This retrospective cohort study was conducted at a single tertiary hospital between January 2019 and June 2022. The study included nulliparous women with singleton pregnancies who delivered live infants and had available data on placental location and umbilical cord insertion site from a second- or third-trimester ultrasound. Placental location was categorized as anterior or posterior using transabdominal ultrasonography. The association between placental location/cord insertion site and pre-eclampsia was evaluated using multivariate logistic regression analysis. We compared the area under the curve to evaluate the impact of placental location and cord insertion site on pre-eclampsia. RESULTS A total of 2219 pregnancies were included in the study. Pre-eclampsia occurred significantly more frequently in the anterior group than in the posterior group (8.21% vs. 3.04%, p < .001). In multivariate analysis investigating the association between placental location and pre-eclampsia, anterior placenta and marginal cord insertion showed increased odds ratios for pre-eclampsia of 3.05 (95% confidence interval [CI] 1.68-6.58) and 3.64 (95% CI 1.90-6.97), respectively. Receiver operating characteristic (ROC) curves were constructed to predict pre-eclampsia using independent factors from multivariate analyses. Model I, including maternal age, pre-pregnancy body mass index, in vitro fertilization, chronic hypertension, overt diabetes, kidney disease, and hematologic diseases, achieved an area under the ROC curve of 0.70 (95% CI 0.65-0.75). Adding cord insertion site and placental location to the model (Model II) improved its predictive performance, resulting in an area under the ROC curve of 0.749 (95% CI 0.70-0.79, p = .02). CONCLUSIONS Anterior placenta and marginal cord insertion were associated with an increased risk of pre-eclampsia. Further studies on prospective cohorts are necessary to validate these findings.
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Affiliation(s)
- Oyoung Kim
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Subeen Hong
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Yang Park
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Sun Ko
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Pirš B, Vengušt E, Bokal Vrtačnik E. Characterising umbilical abdominal wall endometriosis as a distinct subgroup of abdominal wall endometriosis - retrospective cohort study. HUM FERTIL 2024; 27:2309389. [PMID: 38321838 DOI: 10.1080/14647273.2024.2309389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/17/2024] [Indexed: 02/08/2024]
Abstract
Abdominal wall endometriosis (AWE) is one of the rarest forms of endometriosis. Little is known about differences between umbilical AWE (U-AWE) and non-umbilical AWE (non-U-AWE) patients. This retrospective cohort study included patients treated for AWE at tertiary endometriosis centre between 2012 and 2020. Patients were divided into two groups - umbilical AWE and non-umbilical AWE.We identified 14 U-AWE and 45 non-U-AWE patients who mostly had lesions in caesarean section scar (38, 64.4%), rarely at other locations (7, 11.9%). Infertility rates for U-AWE patients and non-U-AWE patients were 57.1% and 17.8%, respectively. Concurrent or previous peritoneal endometriosis was noted in 85.7% of U-AWE and 24.4% of non-U- AWE patients. In addition, U-AWE patients and non-UAWE patients significantly differed in following: parity, number of previous caesarean sections, lesion size, prevalence of concurrent or previous deep infiltrating endometriosis, bleeding from abdominal wall, cyclic pain, continuous pain.Infertility and pelvic endometriosis were more prevalent in U-AWE patients. Our data suggests that U-AWE may be a specific marker for a patient highly prone to pelvic endometriosis and subsequent infertility. Findings suggests that clinician should consider comprehensive evaluation of U-AWE patients.
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Affiliation(s)
- Boštjan Pirš
- Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Eva Vengušt
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Eda Bokal Vrtačnik
- Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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