Search

Background Prior prediction models used for screening preeclampsia (PE) in twin pregnancies were found to be inadequate. In singleton pregnancies, various maternal biomarkers have been shown to be correlated with negative pregnancy outcomes. However, the impact of these biomarkers in twin pregnancies remained uncertain. Methods A retrospective cohort study was carried out on 736 twin pregnancies at a tertiary hospital in Hangzhou, China. Multivariable logistic models were employed to examine the association between levels of serological markers and the likelihood of adverse pregnancy outcomes. The final logistic model was formulated as a user-friendly nomogram. The primary outcome assessed was the occurrence of PE. Results were presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Results The prevalence of PE in the study was 10.3%. When comparing women diagnosed with PE to those without, it was evident that the former group experienced a significantly higher risk of unfavorable maternal and neonatal outcomes. A multivariable logistic regression analysis revealed notable associations between various factors including maternal age, parity, gestational weight gain, a family history of hypertension, as well as levels of cholesterol, albumin, and creatinine and the risk of developing PE, with a significance level of P < 0.05. The concordance index for the constructed nomogram was determined to be 0.792 (95% CI: [0.739–0.844]). Furthermore, an increment of 1 * 1012/L in red blood cell (RBC) count was associated with more than a two-fold increase in the odds of experiencing adverse maternal outcomes (OR 2.247, 95% CI: [1.229–4.107]). However, no significant correlations were identified between any of the examined variables and neonatal outcomes. Conclusions In this study, we developed a user-friendly predictive model that achieves notable detection rates by incorporating maternal serum biomarker levels alongside maternal characteristics and medical history. Our findings indicate that the probability of adverse maternal outcomes increases with elevated levels of RBCs. Obstetricians should consider intensifying surveillance for these women in clinical practice.

Abstract Background This study analyzed the pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy (ICP) in Hangzhou, China. Methods Cases of pregnant women monitored by antepartum testing at Hangzhou Women’s Hospital from January 2018 to December 2020 were reviewed. Subjects were classified into two groups according to whether they had ICP: 688 cases of ICP were assigned to an exposure group while 38,556 cases of non-ICP were assigned to a non-exposed group. Univariate analysis was performed on qualitative or quantitative data using the Chi-Squared test or Mann–Whitney U test, and the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the two groups of related variables were calculated by multivariate binary logistic regression analysis. Results The incidence rate of ICP was 1.75%. Pregnant women with hepatitis B virus were correlated with ICP. Hepatitis B carriers (aOR = 3.873), preeclampsia (PE, aOR = 3.712), thrombocytopenia (aOR = 1.992), gestational hypertension (GH, aOR = 1.627), hyperlipidemia (aOR = 1.602) and gestational diabetes mellitus (GDM, aOR = 1.265) were all risk factors for ICP. In contrast, Body Mass Index (BMI) ≥ 30 kg/m2 (aOR = 0.446), 25 m2

Background To investigate the effects of down’s screening markers and maternal characteristics on preeclampsia (PE) pregnancy outcome during early and middle pregnancy. Methods A retrospective study of a cohort of 246 PE and 18,709 No-PE pregnant women who participated in Down’s screening during early and middle pregnancy was performed. Clinical data of pregnancy-related were collected. Multivariate binary logistic regression was used to analyze the adjusted odds ratio (aOR) and 95% confidence interval (CI) of Down’s screening markers, maternal characteristics, pregnancy outcome, and other related variables, and to evaluate the influencing factors of each indicator on PE. P

Abstract This paper aimed to investigate the characteristics of female HPV infection in the Shangcheng District, Hangzhou city, China. The retrospective study was designed to analyze the HPV prevalence rate of 22,382 women receiving physical examinations from 2016 to 2020 in the Shangcheng District of Hangzhou city in China. A commercial kit was designed to detect the HPV genotypes. Trends were examined for age-specific groups (≤ 30 years, 31–44 years, 45–54 years, 55–64 years, ≥ 65 years). A receiver operating characteristic (ROC) analysis was used to assess the correlation of age classification in high risk HPV (HR-HPV) infection. 22.41% (5015/22,382) of samples were HPV positive, 91.28% (4578/5015) of HPV positive women were infected by HR-HPV. The most prevalent HR-HPV genotypes were 16, 52, 18, 58, 56, and 51. The trend of HPV prevalence showed the significant differences in age-specific groups (χ2 = 164.70, P

Abstract Background This study investigated whether maternal serum D-dimer (DD) alone or DD combined with alpha-fetoprotein (AFP) and free β-subunit of human chorionic gonadotropin (free β-hCG) in the second trimester could be used to predict hypertensive disorders of pregnancy (HDP). Materials and methods In this retrospective case–control study, the data of gravidas patients who delivered at hospital were divided into the following groups: control (n = 136), gestational hypertension (GH, n = 126), preeclampsia (PE, n = 53), and severe preeclampsia (SPE, n = 41). Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic value of maternal serum DD, AFP, and free β-hCG levels for HDP. Results DD levels of the GH, PE, and SPE groups were significantly higher than that of the control group (P DD > DD + AFP > DD + free β-hCG > AFP + free β-hCG > AFP > free β-hCG. For predicting different types of HDP, DD alone had the best diagnostic value for SPE, followed by PE and GH. DD alone had a sensitivity of 100% with a 0% false negative rate and had the highest positive likelihood ratio (+ LR) for SPE. DD alone in combination with AFP alone, free β-hCG alone and AFP + free β-hCG could reduce false positive rate and improve + LR. Conclusion DD is possible the best individual predictive marker for predicting HDP. Levels of DD alone in the second trimester were positively correlated with the progression of elevated blood pressure in the third trimester, demonstrating the predicting the occurrence of HDP. The risk calculation model constructed with DD + free β-hCG + AFP had the greatest diagnostic value for SPE.

Background: With the prevalence of assisted reproductive technology (ART), the incidence of ectopic pregnancy (EP) is increasing, especially in patients with salpingectomy or proximal tubal occlusion. Methods: A total of 11,609 women who were undergoing ART and had undergone salpingectomy or proximal tubal occlusion, and 5388 women who achieved a clinical pregnancy were included in the study. Statistical analysis was used to determine whether the number of embryos transferred was associated with EP. Results: Both the number of embryos transferred and the day of embryo transfer differed significantly between those with and without EP (p < 0.05), while the number of embryos transferred was associated with interstitial pregnancy (IP) (p < 0.05) in those undergoing frozen-thawed embryo transfer (ET) cycles. Following multivariate modeling, the odds of having an EP in women undergoing frozen-thawed ET cycles increased with the number of embryos transferred (odds ratio [OR] 2.003, 95% confidence interval [95% CI] 1.036–3.876). Conclusions: The embryo transfer number was considered a risk factor for EP in patients undergoing frozen-thawed ET who had undergone salpingectomy or proximal tubal occlusion.

Background: To evaluate the feasibility of serum microelements, amino acids and acyl carnitine levels to predict maternal complications and adverse infant outcomes in pregnancies complicated by preeclampsia. Methods: We launched a prospective study including 81 pregnant patients. Serum microelements, amino acids and acyl carnitine levels were tested using external calibration technique or high-performance liquid chromatography tandem mass spectrometry. Concentrations of metabolites were compared between the preeclampsia and control groups. Logistic regression models were used to assess the relevance between the metabolites and pregnancy outcomes in preeclampsia patients without severe features. Results: Concentrations of some microelements, amino acids and acyl carnitines were significantly higher or lower in preeclampsia patients. Women with severe preeclampsia had significantly lower (hexadecanoyl carnitine + octadecenoyl carnitine)/acetyl carnitine [(C16 + C18:1)/C2] compared to mothers without severe features. Lower (C16 + C18:1)/C2 was found in women who developed maternal complications (p = 0.07) or experienced adverse infant outcomes (p < 0.01) compared with those who did not in patients without severe features. Levels of (C16 + C18:1)/C2 at enrollment resulted in moderate prediction rates for maternal outcomes [areas under the curves (AUC) 0.746, 95% Confidence Interval (CI) 0.543, 0.948] and perinatal outcomes (AUC 0.871, 95% CI 0.729, 1.000). Conclusions: Maternal levels of microelements, amino acids and acyl carnitines were associated with preeclampsia. Levels of (C16 + C18:1)/C2 seemed to be a potential biomarker in the prediction of maternal complications and adverse infant outcomes in preeclampsia patients without severe features. Further studies are needed to validate its predictive application.