Search

BACKGROUND: Pregnancy is an important process in women's life, which is widely concerned by women. In recent years, the incidence of premature delivery (PTD) becomes more and more higher due to the development of auxiliary reproduction and ovulation induction technologies and the changes of pregnant women's lifestyle and physical quality. PTD not only affects postpartum recovery and causes great physical pains, but it also has adverse effects on the birth state of neonates and even leads to neonatal death OBJECTIVE: The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination of placenta for premature delivery (PTD) were investigated and the correlation between PTD and infection was analyzed. METHODS: 120 pregnant women with PTD or high-risk factors for PTD admitted to The Affiliated Hospital of Southwest Medical University between February 2020 and March 2022 were included as the subjects and underwent pathological examination of placenta and TVUS for CL measurement. The final gestational age was set as the standard for the evaluation on the predictive values of pathological examination of placenta and TVUS. What's more, 36 subjects in PTD group and 84 in normal delivery group (control group) underwent pathological examination of placenta for the analysis of the correlation between PTD and infection. RESULTS: The joint inspection method showed significantly better sensitivity, specificity, PPV, and NPV compared to single CL or pathological examination of the placenta (P < 0.05). Among pregnant women, those with CL ⩽ 30 mm and positive placental pathology had a higher proportion compared to those with CL > 30 mm and negative placental pathology (P < 0.05). Furthermore, the incidence of Ureaplasma Urealyticum (UU), Chlamydia Trachomatis (CT), and Chorioamnionitis (CA) in vaginal discharge of the preterm delivery (PTD) group was significantly higher than that of the control group (P < 0.05). CONCLUSION: The combination of CL ⩽ 30 mm and positive placental pathology could effectively predict PTD and placental infection was notably correlated with the occurrence of PTD. [ABSTRACT FROM AUTHOR]

Abstract Background Preterm birth (PTB) contributes to nearly 11% of all deliveries in the world. The majority of spontaneous preterm birth (sPTB) remains unexplained. Risk factors include abnormal body mass index (BMI), short cervical length, comorbidities and many more. However, there is limited study on the association between body mass index, cervical length and preterm birth in Malaysia among low-risk women. Hence, we aim to examine the relationship between body mass index, cervical length and the risk of spontaneous preterm birth. Method In this prospective cohort study, pregnant women between 16 and 24 weeks who fulfilled the criteria were recruited. Women with history of preterm birth were excluded. Demographic and clinical data (age, BMI, ethnicity, education level and parity) were obtained. Cervical length was measured using transvaginal scan. Patients were then followed up till delivery to determine their delivery gestation and outcome of delivery. Results Out of 153 women who participated in this study, 146 women had cervical length of more than 30 mm, six had cervical length between 25 mm and 30 mm and one had cervical length of 24 mm. There were nine (9) cases of sPTB, with all of them being late preterm with normal midtrimester cervical length. Almost half of them (44%) were overweight/obese. A significant association was found between age, cervical length, and parity compared to BMI. Nevertheless, no significant association was seen between the BMI and risk of sPTB. Conclusion This study demonstrates a higher BMI is associated with longer cervical length, but it is not necessarily protective against sPTB. Hence, we concluded there is a limited role in cervical length screening among low-risk women regardless of their BMI in predicting sPTB.

Purpose: We utilized a population database to address the paucity of data around pregnancy outcomes in women with Down syndrome (DS). Methods: We conducted a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database over 11 years, from 2004 to 2014. A delivery cohort was created using ICD-9 codes. ICD-9 code 758.0 was used to extract the cases of maternal DS. Pregnant women with DS (study group) were matched based on age, race, income, and health insurance type to women without DS (control) at a ratio of 1:20. Results: There were a total of 9,096,788 deliveries during the study period. Of those, 184 pregnant women were found to have DS. The matched control group was 3680. After matching, most of the pregnancy and delivery outcomes, such as pregnancy-induced hypertension, gestational diabetes, preterm premature rupture of membrane, chorioamnionitis, cesarean section, operative vaginal delivery, or blood transfusion were similar between participants with and without DS. However, patients with DS were at increased risk of giving birth prematurely (aOR 3.09, 95% CI 2.06–4.62), and having adverse neonatal outcomes such as small for gestational age (aOR 2.70, 95% CI 1.54–4.73), intrauterine fetal demise (aOR 22.45, 95% CI 12.02–41.93), congenital anomalies (aOR 7.92, 95% CI 4.11–15.24), and fetal chromosomal abnormalities. Conclusion: Neonates to mothers with DS are at increased risk of prematurity and other neonatal adverse outcomes. Hence, counseling patients with DS about these risks and increased antenatal surveillance is advised. [ABSTRACT FROM AUTHOR]

Background: Preterm birth (PTB) contributes to nearly 11% of all deliveries in the world. The majority of spontaneous preterm birth (sPTB) remains unexplained. Risk factors include abnormal body mass index (BMI), short cervical length, comorbidities and many more. However, there is limited study on the association between body mass index, cervical length and preterm birth in Malaysia among low-risk women. Hence, we aim to examine the relationship between body mass index, cervical length and the risk of spontaneous preterm birth. Method: In this prospective cohort study, pregnant women between 16 and 24 weeks who fulfilled the criteria were recruited. Women with history of preterm birth were excluded. Demographic and clinical data (age, BMI, ethnicity, education level and parity) were obtained. Cervical length was measured using transvaginal scan. Patients were then followed up till delivery to determine their delivery gestation and outcome of delivery. Results: Out of 153 women who participated in this study, 146 women had cervical length of more than 30 mm, six had cervical length between 25 mm and 30 mm and one had cervical length of 24 mm. There were nine (9) cases of sPTB, with all of them being late preterm with normal midtrimester cervical length. Almost half of them (44%) were overweight/obese. A significant association was found between age, cervical length, and parity compared to BMI. Nevertheless, no significant association was seen between the BMI and risk of sPTB. Conclusion: This study demonstrates a higher BMI is associated with longer cervical length, but it is not necessarily protective against sPTB. Hence, we concluded there is a limited role in cervical length screening among low-risk women regardless of their BMI in predicting sPTB. [ABSTRACT FROM AUTHOR]

Background: Although cervical cerclage has improved with the rapid development of medical technology, there remains a distinct probability of adverse pregnancy outcomes. To investigate the associations of changes in the high mobility group box 1 (HMGB1), soluble tumor necrosis factor receptor 1 (sTNFR-1) and peripheral blood neutrophil-to-lymphocyte ratio (NLR) with premature delivery secondary to infection in pregnant patients undergoing cervical cerclage. Methods: Sixty-seven pregnant patients with premature delivery after cervical cerclage, who were treated at the Affiliated Matern & Child Care Hospital of Nantong University from January 2022 to October 2023, were enrolled, including 43 with premature delivery secondary to infection (infectious group) and 24 with idiopathic premature delivery (non-infectious group). The pre-delivery serum levels of HMGB1, sTNFR-1 and the peripheral blood level of NLR were compared between the 2 groups. Further, the clinical value of these 3 indicators in predicting premature delivery secondary to infection among pregnant patients undergoing cervical cerclage was assessed by receiver operating characteristic (ROC) curve analysis. Results: The infectious group exhibited significantly higher serum levels of HMGB1, sTNFR-1 and peripheral blood level of NLR compared to those in the non-infectious group, demonstrating significant differences (p < 0.05). Logistic regression analysis revealed that HMGB1 and NLR were independent influencing factors for premature delivery (p < 0.05). According to the ROC curve analysis results, the changes in HMGB1, sTNFR-1 and NLR levels may reflect the risk of premature delivery secondary to infection among pregnant patients undergoing cervical cerclage. The area under the curve (AUC), sensitivity and specificity of combined detection were all markedly higher than those of independent detection. Conclusions: HMGB1, sTNFR-1 and NLR levels are risk factors for third-trimester premature delivery among pregnant patients undergoing cervical cerclage. Timely combined detection of serum HMGB1, sTNFR-1 and peripheral blood NLR during the third trimester can improve the clinical diagnostic acumen, which enables early prevention to help lower the risk of premature delivery.

Background: Current evidence shows subclinical hypothyroidism (SCH) is associated with increased risk of adverse pregnancy outcomes, though some controversies exist. However, little is known on the impacts and effectiveness of levothyroxine (LT4) therapy on pregnancy outcomes in women with SCH. Present study aims to investigate the associations between SCH and adverse pregnancy outcomes and clinical effects of levothyroxine (LT4) replacement therapy in patients with SCH. Methods: The clinical data of pregnant women (n = 635) with SCH who referred to Huai'an Maternal and Child Health Care Hospital, Huaian, China from June 2018 to December 2018 were retrospectively analyzed. Among them, 147 cases received standard thyroxine replacement therapy, 292 cases did not receive treatment and 150 cases who received irregular treatment or did not achieve the target or were lost to follow-up. 46 cases whose thyroid peroxidase antibody (TPOAb) was not checked during pregnancy were not included in the study. According to the TPOAb test results patients were divided into positive treatment (n = 14), negative treatment (n = 133), positive untreated (n = 19), or negative untreated (n = 273) subgroups. A total of 1876 pregnant women with normal thyroid function (TPOAb positive = 59; TPOAb negative = 1817) who delivered during the same period were selected as the control group. Pregnancy outcomes were assessed and compared between treated and control group, untreated and control group, TPOAb positive treatment subgroup and TPOAb positive and untreated subgroup, TPOAb negative treatment subgroup and TPOAb negative subgroup, and TPOAb positive and TPOAb negative subgroup. Results: Our data showed that the incidences of hypertensive disease, premature delivery, fetal growth restriction and fetal death during pregnancy in the untreated group were significantly higher than in the control group (p < 0.05). The incidence of preterm delivery in the treatment group was significantly lower compared to the untreated group and the control group (p < 0.05). Moreover, the incidence of premature birth in TPOAb positive treatment subgroup was significantly lower than their peers in TPOAb positive and untreated subgroup. The incidence of premature delivery in TPOAb negative treatment subgroup was significantly lower than TPOAb negative untreated subgroup and the difference was statistically significant (p < 0.05). There was no significant difference in the incidence of adverse pregnancy outcomes between TPOAb positive subgroup and TPOAb negative subgroup in the control group (p > 0.05). Conclusions: SCH during pregnancy is a risk factor for hypertensive disease during pregnancy, fetal growth restriction, premature delivery and fetal death. L-T4 replacement therapy improves maternal and infant outcomes in patients with SCH during pregnancy, regardless of whether or not TPOAb is positive.

Abstract We report two children with hepatoblastoma (HB) with a history of neonatal necrotizing enterocolitis (NEC). Case 1 was diagnosed with HB at 5 months of age. Liver enlargement was found during the NEC operation at 3 months of age and then was clinically diagnosed by imaging. After six chemotherapy courses, a partial hepatectomy was performed. Three months after ceasing the chemotherapy, a chest computed tomography scan suggested that distant metastasis of the tumor should be considered, and the lesion was removed. However, 9 months after the operation, alpha‐fetoprotein concentrations were increased, and abdominal imaging showed a recurrence of the tumor in situ, resulting in a hepatectomy. Case 2 was diagnosed with NEC shortly after birth and underwent an intestinal resection and anastomosis 1 month later. He was diagnosed with HB at 3 years of age. Hepatectomy was performed after five courses of chemotherapy. Chemotherapy was stopped after 10 courses, and alpha‐fetoprotein concentrations were normal. At present, both children have survived and are in a healthy condition. Physicians should be aware of the possibility of HB and a history of NEC in children. Premature birth and low birth weight are common factors leading to the pathogenesis of HB and NEC. The association between these two diseases requires further study.

Abstract Introduction The aim of this work was to investigate the pregnancy outcomes in infertile patients with primary Sjögren’s syndrome (pSS) undergoing assisted reproductive therapy (ART). Methods A multi-center retrospective study was performed in pregnant women with pSS and ART from five tertiary hospitals from Guangdong Province from 2013 to 2022. Natural planned pregnancy in pSS and healthy people undergoing ART were selected as controls. Pregnancy outcomes were collected from medical records and compared among groups. Results Twenty-four pregnancies in pSS with ART, 70 natural planned pregnancies in pSS, and 96 pregnancies in healthy people with ART were analyzed. More than half of the pSS mothers undergoing ART have a past history of adverse pregnancy and spontaneous abortion was the most common (10/24, 41.7%). Primary infertility (25.0%) and recurrent spontaneous abortion (16.7%) were the leading causes of infertility in pSS. The major maternal adverse pregnancy outcome (APO) in pSS patients with ART was premature delivery (11/24, 45.8%), likely attributed to twin gestation (4/11, 36.4%) and fetal distress (3/11, 27.3%). Twenty-seven live infants were born from 22 successful deliveries. The live birth rate was 93.1% (27/29). The average delivery time was 36.1 ± 3.3 weeks of gestation. The average birthweight was 2434.4 ± 722.1 g, compared with 2844.9 g in natural planned pregnancy in pSS, and 3072.1 g from healthy mothers with ART (P

Abstract Background and aims Domestic violence (DV) are one of the important risk factors for women’s health outcomes. The aim of this study was explored the risk of DV association with the poor pregnancy outcomes (PPOs), including premature delivery, abortion, and stillbirth. Methods A nested case–control study was applied. Data from the Taiwan National Health Insurance Research Database were collected from 2000 to 2015. A total of 41,730 participants were included in this study, including 8,346 participants in the case group and 33,384 age- and index year-matched control group. Assessments of DA and PPOs were determined according to the International Classification of Diseases, 9th Revision. We conducted a conditional logistic regression analysis to estimate the effect of DV on PPOs. Results The mean age was 35.53 in the 41,730 female participants. The overall incidence rate of PPOs of the participants, who had experienced DV, was 84.05 per 100,000 person-years. which was significantly higher than that for the controls (18.19 per 100,000 person-years). The risk of PPOs was higher in the participants who had experienced DV than in the controls (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] [95% CI]: 2.83–3.86), including for premature delivery (AOR = 3.57; 95% CI: 3.05–4.17), abortion (AOR = 3.31; 95% CI: 2.83–3.86) and stillbirth (AOR = 2.98; 95% CI: 2.55–3.47). The results showed that the longer a participant has been suffering DV, the risk of PPOs was higher. Conclusions Present results reaved the risk of PPOs associated with DV. Especially, the longer a woman has been experiencing DV, the risk of PPOs was higher, showed a dose–response effect.

This review examines the international role of perinatal protection of a fetus in preservation of the health of the nation. Historical perspectives, present-day developments, and future priorities of perinatal medical science are given. The etiology of decompensated placental insufficiency and intrauterine growth restriction is considered. The authors also considered the epidemiology of premature delivery and perinatal outcomes, the problem of development, diagnosis and obstetric management in critical fetal condition is covered in detail. The current review of literature was conducted in order to advance the theoretical knowledge of specialists on modern complex issues of perinatal medicine. The considered practical aspects will contribute to the improvement of interdisciplinary interaction between clinicians of various specialties in the field of perinatal protection of a fetus and, through this, to the preservation of the health of the nation and the multiplication of future generations.

In recent years, it has become evident that early-life intestinal flora plays a pivotal role in determining human health. Consequently, it is imperative to explore the establishment of neonatal intestinal flora and its influencing factors. Early neonatal intestinal flora is influenced by a multitude of factors, including maternal and infant-related factors, as well as external environment. This review summarizes the colonization mechanism of intestinal flora in the early life of newborns and discussed their influence on the establishment of neonatal intestinal flora, taking into account factors such as delivery mode, gestational age and feeding mode. Additionally, this review delves into the natural or artificial reconstruction of intestinal flora colonization defects in infants born via cesarean section and premature infants, with the goal of establishing a theoretical foundation for preventing and treating issues related to neonatal intestinal flora colonization and associated diseases. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this work was to investigate the pregnancy outcomes in infertile patients with primary Sjögren's syndrome (pSS) undergoing assisted reproductive therapy (ART). Methods: A multi-center retrospective study was performed in pregnant women with pSS and ART from five tertiary hospitals from Guangdong Province from 2013 to 2022. Natural planned pregnancy in pSS and healthy people undergoing ART were selected as controls. Pregnancy outcomes were collected from medical records and compared among groups. Results: Twenty-four pregnancies in pSS with ART, 70 natural planned pregnancies in pSS, and 96 pregnancies in healthy people with ART were analyzed. More than half of the pSS mothers undergoing ART have a past history of adverse pregnancy and spontaneous abortion was the most common (10/24, 41.7%). Primary infertility (25.0%) and recurrent spontaneous abortion (16.7%) were the leading causes of infertility in pSS. The major maternal adverse pregnancy outcome (APO) in pSS patients with ART was premature delivery (11/24, 45.8%), likely attributed to twin gestation (4/11, 36.4%) and fetal distress (3/11, 27.3%). Twenty-seven live infants were born from 22 successful deliveries. The live birth rate was 93.1% (27/29). The average delivery time was 36.1 ± 3.3 weeks of gestation. The average birthweight was 2434.4 ± 722.1 g, compared with 2844.9 g in natural planned pregnancy in pSS, and 3072.1 g from healthy mothers with ART (P < 0.001). Seven (25.9%) low-birthweight (LBW) infants were born, and the incidence was comparable to the other two groups (22.2% in natural pregnancy, 13.0% in healthy people, P = 0.09). No infants developed congenital heart block (CHB). Conclusions: ART is an effective method for infertility in patients with pSS. Premature delivery is the leading maternal APOs. The incidence of fetal APOs does not increase, while birthweight is lower in offspring from pSS mothers with ART. [ABSTRACT FROM AUTHOR]

We report two children with hepatoblastoma (HB) with a history of neonatal necrotizing enterocolitis (NEC). Case 1 was diagnosed with HB at 5 months of age. Liver enlargement was found during the NEC operation at 3 months of age and then was clinically diagnosed by imaging. After six chemotherapy courses, a partial hepatectomy was performed. Three months after ceasing the chemotherapy, a chest computed tomography scan suggested that distant metastasis of the tumor should be considered, and the lesion was removed. However, 9 months after the operation, alpha‐fetoprotein concentrations were increased, and abdominal imaging showed a recurrence of the tumor in situ, resulting in a hepatectomy. Case 2 was diagnosed with NEC shortly after birth and underwent an intestinal resection and anastomosis 1 month later. He was diagnosed with HB at 3 years of age. Hepatectomy was performed after five courses of chemotherapy. Chemotherapy was stopped after 10 courses, and alpha‐fetoprotein concentrations were normal. At present, both children have survived and are in a healthy condition. Physicians should be aware of the possibility of HB and a history of NEC in children. Premature birth and low birth weight are common factors leading to the pathogenesis of HB and NEC. The association between these two diseases requires further study. [ABSTRACT FROM AUTHOR]

We evaluated the impact of cervical cerclage combined with one or more uterine contraction inhibitors in persistent inhibition of uterine contraction for the treatment of late abortion and premature delivery. This retrospective case series study analysed the medical data of 58 patients who underwent cervical cerclage for cervical insufficiency and simultaneously received one or more uterine contraction inhibitors (indomethacin, ritodrine, and atosiban) and magnesium sulphate at the Zibo Maternal and Child Health Hospital between January 2019 and December 2020. Patients are normal pregnancy who received cervical cerclage without complications. The rate of successful treatment was 74.14% (43/58). The prolonged gestation duration was 16.42 ± 7.84 weeks, and the average delivery gestational age was 35.91 ± 5.16 weeks. The longest duration of treatment with a uterine contraction inhibitor or inhibitors in combination or with magnesium sulphate alone was 15.34 ± 13.16 days, and nine cases developed adverse reactions. Persistent uterine contraction inhibition after cervical cerclage could prolong pregnancy and improve pregnancy outcomes. What is already known on this subject? A crucial reason for treatment failure of cervical cerclage is that uterine contraction was not effectively inhibited. What do the results of this study add? Persistent inhibition of uterine contraction after cervical cerclage prolonged pregnancy duration, increased gestational age at delivery, and improved pregnancy outcomes. What are the implications of these findings for clinical practice and/or further research? This study may provide a clinical basis for prolonging gestational age, preventing late abortion and premature delivery, and improving the survival rate and quality of life of premature infants. [ABSTRACT FROM AUTHOR]

Vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) serve key roles in the regulation of vascular development, revascularization and vasopermeability in the endometrium, decidua and trophoblasts. Furthermore, both VEGF and PlGF are modulators of embryonic vascular development. Thus, the present study aimed to investigate the serum levels of VEGF and PlGF in female patients with early threatened abortion (TA) who experienced preterm delivery. The present case-control study included 130 pregnant patients with or without TA that were admitted to The Maternal and Childcare Hospital of Nantong University from January 2019 to January 2022. Patients were divided into two groups: i) Group A, which included 55 patients diagnosed with TA with slight vaginal bleeding and closed cervical internal os within the first 6-12 weeks of pregnancy; and ii) group B, which included 75 patients with healthy asymptomatic pregnancy. Blood samples were obtained from all patients and VEGF and PlGF levels were examined prior to treatment, and the chi-squared, Student's t-test and two-way ANOVA followed by Bonferroni's post hoc analysis were used to analyze statistical differences between the two patient groups. Results of the present study demonstrated that patients with TA had significantly lower levels of VEGF and PlGF, compared with the controls. In patients with or without TA, the levels of serum PlGF in the preterm delivery group were significantly decreased compared with patients that did not experience preterm delivery. However, there was no signifi- cant difference in the levels of VEGF between patients with or without preterm delivery. In addition, lower levels of PlGF, compared with those in patients without TA, may be associated with an increased risk of preterm delivery in patients without early TA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination of placenta for premature delivery (PTD) were investigated, and the correlation between PTD and infection was analyzed. PATIENTS AND METHODS: A total of 120 pregnant women with PTD or high-risk factors for PTD admitted to Hengyang Maternal and Child Health Hospital, between February 2020 and March 2022 were included in this retrospective study. There were 36 subjects in the PTD group and 84 in the normal delivery group (control group). They underwent pathological examination of the placenta and TVUS for CL measurement. The final gestational age was set as the standard for the evaluation of the predictive values of pathological examination of the placenta and TVUS. Moreover, a pathological examination of the placenta was used to analyze the correlation between PTD and infection. RESULTS: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of joint inspection were remarkably superior to those of single CL or pathological examination of the placenta (p<0.05). The proportion of pregnant women with CL =30 mm and positive placental pathology was higher than that of pregnant women with CL >30 mm and negative placental pathology (p<0.05). In addition, the incidence of Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), and chorioamnionitis (CA) in the vaginal discharge of the PTD group was markedly superior to that of the control group (p<0.05). CONCLUSIONS: The combination of CL =30 mm and positive placental pathology could effectively predict PTD, and placental infection was notably correlated with the occurrence of PTD. [ABSTRACT FROM AUTHOR]

Background and objectives: UTI is one of the most common bacterial infections in pregnant women. E. coli is the most frequent urinary pathogen isolated from 40-60% of all uncomplicated UTI. Untreated UTI in pregnancy leads to low-birthweight, premature delivery, pre-eclampsia, postpartum endometritis, pyelonephritis etc. Historically, the measurement of virulence has led to measurable outcomes like morbidity and mortality of the host. Therefore, screening for UTI and determining their virulence in pregnancy is important to prevent these complications. The objectives are to isolate E. coli species from the pregnant women suffering from urinary tract infection, to determine the urovirulence factors and to study the antimicrobial susceptibility pattern of the E. coli isolates. Material and methods: Inclusion criteria: Pregnant women suspected of UTI. Exclusion criteria: Cases who are on antibiotic therapy. Virulence tests like Mannose Resistant Haemagglutination test (MRHA), Cell Surface Hydrophobicity (CSH), ⍺ Haemolysin Production, Serum Resistance (SR) test and Gelatinase test (GT) were done on E. coli isolates. AST was performed by Kirby-Bauer’s disk diffusion method. Results: Out of 683 urine samples tested, 405 samples exhibited significant growth. Among 405 isolates, all the 285 E. coli isolates exhibited virulence markers, and 50% of E. coli isolates exhibited more than one virulence marker. Serum resistance is the commonest and Gelatinase production is the least common virulence marker. The overall sensitivity of E. coli is 89.8% to Cefotaxime, 83.8% to Nitrofurantoin, 56.1% to Amoxiclav, 52.2% to Netilmicin, 42.4% to Cotrimoxazole, and 41% to Gentamicin. Conclusion: Virulence markers such as serum resistance, ⍺ - haemolysin production and MRHA contributed to highest virulence. This study reflects the importance of identifying virulence markers, to prevent mortality and morbidity in pregnant women. The highest prevalence of resistance in UTI, calls for stringent policies for rational drug use and infection control measures in hospital practices. [ABSTRACT FROM AUTHOR]

Background In recent years, the number of neonatal surgeries has been on the rise despite the decline in the number of births, and we examined the actual trends and problems at Tottori University Hospital located in the Sanin region. Methods Medical records were retrospectively searched for patients who underwent major surgery during the neonatal period (within 30 days of age) at the Tottori University Hospital over the past 10 years (Jan. 2011 to Dec. 2020). Results Sixty-five cases were included. Early birth infants (< 37 gestational weeks) comprised 15 cases (23%) and low birth weight (< 2500 g) infants involved 27 cases (42%). In the latter half (2016--2020), early birth and low birth weight infants were significantly less than in the first half (2011--2015). The common diseases were anorectal malformation (14 cases), esophageal atresia (10), duodenal atresia (10), and diaphragmatic hernia (9). Prenatal diagnosis was obtained in 26 cases (40%), with high diagnostic rate obtained in duodenal atresia (100%), abdominal wall defect (100%), ileal atresia (75%), meconium peritonitis (67%), and diaphragmatic hernia (67%). Fifty-five cases (85%) were operated on within 7 days of age. Other major malformations were associated in 23 cases (35%). There were 6 deaths (9%), of which 3 cases were low birth weight infants with gastrointestinal perforation, 2 cases with severe chromosomal abnormalities (esophageal atresia, omphalocele), and 1 case with diaphragmatic hernia with severe pulmonary hypertension. Home medical care has been required with gastrostomy tube in 2 cases. Conclusion Neonatal surgery at Tottori University has been well performed as required with acceptable results along with the progression of other perinatal care. However, further investigation for improvements in premature delivery or organ hypoplasia may be required. [ABSTRACT FROM AUTHOR]

We evaluated the impact of cervical cerclage combined with one or more uterine contraction inhibitors in persistent inhibition of uterine contraction for the treatment of late abortion and premature delivery. This retrospective case series study analysed the medical data of 58 patients who underwent cervical cerclage for cervical insufficiency and simultaneously received one or more uterine contraction inhibitors (indomethacin, ritodrine, and atosiban) and magnesium sulphate at the Zibo Maternal and Child Health Hospital between January 2019 and December 2020.Patients are normal pregnancy who received cervical cerclage without complications. The rate of successful treatment was 74.14% (43/58). The prolonged gestation duration was 16.42 ± 7.84 weeks, and the average delivery gestational age was 35.91 ± 5.16 weeks. The longest duration of treatment with a uterine contraction inhibitor or inhibitors in combination or with magnesium sulphate alone was 15.34 ± 13.16 days, and nine cases developed adverse reactions. Persistent uterine contraction inhibition after cervical cerclage could prolong pregnancy and improve pregnancy outcomes.Impact statement What is already known on this subject? A crucial reason for treatment failure of cervical cerclage is that uterine contraction was not effectively inhibited. What do the results of this study add? Persistent inhibition of uterine contraction after cervical cerclage prolonged pregnancy duration, increased gestational age at delivery, and improved pregnancy outcomes. What are the implications of these findings for clinical practice and/or further research? This study may provide a clinical basis for prolonging gestational age, preventing late abortion and premature delivery, and improving the survival rate and quality of life of premature infants.

Background and aims: Domestic violence (DV) are one of the important risk factors for women's health outcomes. The aim of this study was explored the risk of DV association with the poor pregnancy outcomes (PPOs), including premature delivery, abortion, and stillbirth. Methods: A nested case–control study was applied. Data from the Taiwan National Health Insurance Research Database were collected from 2000 to 2015. A total of 41,730 participants were included in this study, including 8,346 participants in the case group and 33,384 age- and index year-matched control group. Assessments of DA and PPOs were determined according to the International Classification of Diseases, 9th Revision. We conducted a conditional logistic regression analysis to estimate the effect of DV on PPOs. Results: The mean age was 35.53 in the 41,730 female participants. The overall incidence rate of PPOs of the participants, who had experienced DV, was 84.05 per 100,000 person-years. which was significantly higher than that for the controls (18.19 per 100,000 person-years). The risk of PPOs was higher in the participants who had experienced DV than in the controls (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] [95% CI]: 2.83–3.86), including for premature delivery (AOR = 3.57; 95% CI: 3.05–4.17), abortion (AOR = 3.31; 95% CI: 2.83–3.86) and stillbirth (AOR = 2.98; 95% CI: 2.55–3.47). The results showed that the longer a participant has been suffering DV, the risk of PPOs was higher. Conclusions: Present results reaved the risk of PPOs associated with DV. Especially, the longer a woman has been experiencing DV, the risk of PPOs was higher, showed a dose–response effect. [ABSTRACT FROM AUTHOR]

Objective: To understand and analyze the incidence of premature delivery and its influencing factors in Qujing city, Yunnan province, so as to provide the scientific basis for the early intervention. Methods: Based on Qujing Maternal and Child Health Hospital, we selected the pregnant women who met the inclusion criteria from September 1, 2020 to October 31, 2021 as the research objective, followed up the basic situation and delivery outcome of pregnant women, and analyzed the epidemiological characteristics and influencing factors of premature delivery by chi-square test and logistic regression model. Results: Among 7 302 pregnant women, 477 cases were premature, with an incidence of 6.53%. Among them, late preterm labor, middle preterm labor and early preterm labor accounted for 77.15%, 12.79% and 10.06% respectively. Multivariate analysis showed that the risk factors of premature delivery were: low education level (i.e. primary school or below, junior high school and senior high school), pregnancy ≥3 times, parity ≥3 times, placenta previa, twin or multiple pregnancy, history of cesarean section, history of abortion, number of check-ups ≤8 times, gestational hypertension, gestational diabetes, premature rupture of membranes, fetal or uterine malformation ( all P-value < 0.05). Conclusion: The incidence of premature delivery is high, which may be influenced by the education level of pregnant women, placenta previa during pregnancy, twin or multiple pregnancies, the number of prenatal checkups, pregnancy-induced hypertension, gestational diabetes, premature rupture of membranes, fetal or uterine malformation, and previous history of cesarean section and abortion. Therefore, we should strengthen the ability to accurately identify the risk factors of premature delivery at an early stage, so as to achieve the early detection, early prevention and early treatment, reduce its impact on mother and fetus, and promote the health of mother and baby. [ABSTRACT FROM AUTHOR]

BACKGROUND Reproductive tract infection is an important factor leading to male and female infertility. Among female infertility factors, microbial and viral infections are the main factors affecting female reproductive health and causing tubal infertility, ectopic tubal pregnancy and premature delivery. Among male infertility factors, 13–15% of male infertility is related to infection. Defensins are cationic antibacterial and antiviral peptides, classified into α-defensins, β-defensins and θ-defensins. Humans only have α-defensins and β-defensins. Apart from their direct antimicrobial functions, defensins have an immunomodulatory function and are involved in many physiological processes. Studies have shown that defensins are widely distributed in the female reproductive tract (FRT) and male reproductive tract (MRT), playing a dual role of host defence and fertility protection. However, to our knowledge, the distribution, regulation and function of defensins in the reproductive tract and their relation to reproduction have not been reviewed. OBJECTIVE AND RATIONALE This review summarizes the expression, distribution and regulation of defensins in the reproductive tracts to reveal the updated research on the dual role of defensins in host defence and the protection of fertility. SEARCH METHODS A systematic search was conducted in PubMed using the related keywords through April 2022. Related data from original researches and reviews were integrated to comprehensively review the current findings and understanding of defensins in the human reproductive system. Meanwhile, female and male transcriptome data in the GEO database were screened to analyze defensins in the human reproductive tracts. OUTCOMES Two transcriptome databases from the GEO database (GSE7307 and GSE150852) combined with existing researches reveal the expression levels and role of the defensins in the reproductive tracts. In the FRT, a high expression level of α-defensin is found, and the expression levels of defensins in the vulva and vagina are higher than those in other organs. The expression of defensins in the endometrium varies with menstrual cycle stages and with microbial invasion. Defensins also participate in the local immune response to regulate the risk of spontaneous preterm birth. In the MRT, a high expression level of β-defensins is also found. It is mainly highly expressed in the epididymal caput and corpus, indicating that defensins play an important role in sperm maturation. The expression of defensins in the MRT varies with androgen levels, age and the status of microbial invasion. They protect the male reproductive system from bacterial infections by neutralizing lipopolysaccharide and downregulating pro-inflammatory cytokines. In addition, animal and clinical studies have shown that defensins play an important role in sperm maturation, motility and fertilization. WIDER IMPLICATIONS As a broad-spectrum antimicrobial peptide without drug resistance, defensin has great potential for developing new natural antimicrobial treatments for reproductive tract infections. However, increasing evidence has shown that defensins can not only inhibit microbial invasion but can also promote the invasion and adhesion of some microorganisms in certain biological environments, such as human immunodeficiency virus. Therefore, the safety of defensins as reproductive tract anti-infective drugs needs more in-depth research. In addition, the modulatory role of defensins in fertility requires more in-depth research since the current conclusions are based on small-size samples. At present, scientists have made many attempts at the clinical transformation of defensins. However, defensins have problems such as poor stability, low bioavailability and difficulties in their synthesis. Therefore, the production of safe, effective and low-cost drugs remains a challenge. [ABSTRACT FROM AUTHOR]

BackgroundResearch on the relationship between ambient temperature and preterm birth has received increasing attention, but the conclusions of the previous literature are inconsistent.ObjectiveTo explore the impact of environmental temperature exposure in Ningbo on premature delivery of pregnant women.MethodsThe birth information, preterm birth data, and age of pregnant women from January 2016 to September 2020 were collected by the electronic medical record system of Ningbo Women’s and Children’s Hospital. Meteorological data for the same period were obtained through Ningbo Meteorological Bureau, including daily average temperature, daily average relative humidity, and daily average air pressure. Daily concentrations of SO2, NO2, and PM10 were derived through the air quality real-time release system on the website of Ningbo Environmental Protection Bureau. A distributed lag nonlinear model was used to analyze the impact of environmental temperature on preterm birth by stratifying pregnant women’s age and birth delivery mode.ResultsThe incidence rate of preterm birth in Ningbo from 2016 to 2020 was 5.91%. The exposure-response curve between environmental temperature and preterm birth presented a “U” shape. Taking 22.5 ℃ as a reference, the cumulative effect of 31 ℃ (the 95th percentile) and 32 ℃ (the 99th percentile) over a 21-day lag on preterm delivery was statistically significant, and the related RR (95%CI) values were 1.67 (1.05-2.65) and 1.85 (1.09-3.14) respectively. The results of stratified analysis showed that among pregnant women ≥30 years old, the 21-day cumulative effects of 31 ℃ and 32 ℃ on preterm delivery were statistically significant, and the related RR (95%CI) values were 2.09 (1.08-4.05) and 2.36 (1.11-5.03) respectively; among pregnant women with natural delivery, the 21-day cumulative effect of 32 ℃ on preterm delivery was statistically significant, and the RR (95%CI) was 1.95 (1.02-3.74).ConclusionExposure of pregnant women to high temperature during pregnancy could increase the risk of preterm birth, and there is a delayed cumulative effect.

Background and Objective: Zinc deficiency has been suggested as a risk factor for adverse pregnancy outcomes. Since dealing with zinc deficiency is an easy and inexpensive method, this study was conducted with the aim of investigating the relationship between adverse pregnancy outcomes and zinc concentration of amniotic fluid and maternal plasma in the second trimester and biomarkers of the first and second trimester. Methods: This cross-sectional study was conducted on 102 pregnant mothers who were candidates for amniocentesis in Mousavi Hospital in Zanjan in 2018 through convenience sampling. Women with normal amniocentesis results were followed up until delivery in terms of adverse pregnancy outcomes (incidence of preeclampsia, intrauterine growth retardation, premature delivery, fetal death, and low birth weight) and were divided into two groups with adverse pregnancy outcomes (first group) and without adverse pregnancy outcomes (second group) and were compared in terms of zinc concentration in plasma and amniotic fluid. Findings: The concentration of zinc in the plasma of the mothers of the first group (59.53±15.88 µg/dl) was significantly lower than that of the mothers of the second group (71.44±19.25 µg/dl) (p=0.02). However, there was no significant difference in the concentration of zinc in the amniotic fluid of the two study groups. In this study, the best cutoff point to determine people at risk of adverse pregnancy outcomes was determined to be 60.5 µg/dl. Conclusion: Based on the results of this study, there seems to be a relationship between low zinc concentration of plasma in pregnant women and adverse outcomes.

Objectives: This study aimed to investigate whether a history of loop electrosurgical excision procedure (i.e., conisation) affects obstetric and neonatal outcomes. Methods: A retrospective cohort study was carried out in Västernorrland county, Sweden. 57 nulliparous women with singleton pregnancies and previous conisation were compared with 100 age-matched pregnant controls without history of conisation. Results: There was significantly lower gestational age by delivery (p = 0.036), however, the premature delivery rate was not different. Caesarean section was also less frequent (OR: 0.29, 95% CI: 0.081–1.04, p = 0.047) in the conisation group than those in the control group. There were no differences in neonatal outcomes. Conclusions: Previous conisation does not affect the risk of prematurity or cervical dilatation during the first stage of labour. Women with history of conisation had a lower rate of caesarean section, and lower gestational age by delivery.

Diabetic retinopathy is a common microvascular complication of diabetes. Despite that, there are few studies in the literature to address pregnancy, delivery, or neonatal outcomes among women with diabetic retinopathy. We conducted a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database over 11 years from 2004 to 2014. A delivery cohort was created using ICD-9 codes. ICD-9 code 250 or 249 was used to extract the cases of maternal diabetic retinopathy. A multivariant logistic regression model was used to adjust for statistically significant variables (p-value ≤.05). There were a total of 9,096,788 deliveries during the study period. Of those, 86 615 pregnant women were found to have Diabetes Mellites (DM). Diabetic retinopathy was present in 1233 of the patients with DM. Diabetic retinopathy increased the likelihood of developing pregnancy-induced HTN (p <.0001), Preeclampsia (p <.0001), and Preeclampsia and eclampsia superimposed on preexisting HTN (p <.0001). In addition, in women with DM, the presence of diabetic retinopathy increased the risk of Preterm delivery (p =.002), cesarean section (p <.0001), requiring transfusion (p <.0001), and undergoing hysterectomy (p =.001), and were less likely to have a spontaneous vaginal delivery (p <.0001). However, the presence of diabetic retinopathy in women with DM did not increase the risk of the fetus being small at delivery, having intrauterine fetal demise, or congenital anomalies. Women with diabetic retinopathy should be counseled about their increased risk of pregnancy-induced HTN, preeclampsia, premature delivery, cesarean section, transfusion, and hysterectomy. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus disease 2019 (COVID-19) pandemic has become worldwide, posing particularly severe challenges. Pregnancy brings changes that might make individuals more vulnerable to this viral infection. To date, the impact of COVID-19 infection on pregnancy outcomes remains controversial. Method: We performed a meta-analysis to address the impact of COVID-19 infection on pregnancy outcomes. We searched the PubMed and China National Knowledge infrastructure (CNKI) databases for related articles. The odds ratio (OR) corresponding to the 95% confidence interval (95% CI) was used to define the impact of INFECTION and severity of COVID-19 on pregnancy outcomes. The statistical heterogeneity among studies was batched with the Q-test and I² statistics. Results: We collected 38 studies including 127,805 pregnancy women. Our meta-analysis revealed that pregnant women with COVID-19 have been linked to an increased risk of premature birth (OR = 1.66, 95% CI = 1.41–1.96), stillbirth (OR = 1.98, 95% CI = 1.22–3.21), preeclampsia (OR = 1.46, 95% CI = 1.18–1.80), and PROM (OR = 1.39, 95% CI = 1.07–1.81). Conclusions: Our meta-analysis showed that infection with COVID-19 increases the risk of preterm birth, stillbirth, pre-eclampsia, and PROM. Screening and early care for pregnant women to intervene with COVID-19 is important, given the increased risk of adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Human norovirus (HuNoV) is the leading cause of acute gastroenteritis. The varying severity of chronic infection in patients with underlying immune deficiencies poses additional burdens on public health. However, the potential effects of HuNoV infection during pregnancy, a specific immune perturbed state, have been rarely reported. Recently, four cases of HuNoV-infected patients in the late stages of pregnancy were admitted to the Guangzhou Women and Children's Medical Center, and premature rupture of membranes as primary adverse outcome was observed in these cases. Samples of fetal accessory tissue were collected from two of these cases at delivery to explore the potential pathogenesis. Pathological analysis showed placental malperfusion in both maternal and fetal vascular, while a decrease in vessels was not observed in villi of placenta. There was obvious pathological change in the chorion of fetal membrane, accompanied by a tendency of Th-1 immune bias. Notably, aggregation of M2 macrophages was observed in the chorion of the fetal membrane, potentially recruited for tissue repair. Next-generation sequencing showed minimal changes in immune pathways within placenta tissue. A gene panel associated with immunosuppression was identified in the fetal membrane of HuNoV-infected women compared to those of normal parturient. Taken together, this study provides clues for the association between the HuNoV and premature delivery, which requires the attention of the clinicians., Competing Interests: Conflict of interest Prof. Jing An is an editorial board member for Virologica Sinica and was not involved in the editorial review or the decision to publish this article. Authors declare no competing interests., (Copyright © 2024 The Authors. Publishing services by Elsevier B.V. All rights reserved.)

Preterm birth (PTB) is the main cause of perinatal incidence rate and mortality worldwide and seriously threatens lives of newborns. In order to improve the understanding of PTB etiology, this study aimed to investigate associations between vaginal microbiome and PTB. We conducted an in-depth meta-analysis on publicly available shotgun metagenomics datasets of vaginal microbiome, including comparisons of microbial composition, metabolic pathways, biosynthetic gene clusters (BGCs), and virulence factors (VFs) between PTB and Healthy groups. Our results showed that 113 species existed in PTB group and 161 species in Healthy group, and their species compositions were significantly different. PTB group was associated with six species, namely Lactobacillus crispatus, Atopobium vaginae, Prevotella bivia, Neisseria subflava, Corynebacterium sp. HMSC078H07 and Capnocytophaga leadbetteri. Between the two groups exhibited 314 significantly different KEGG orthologys. The distribution of BGCs in PTB group were significantly different from that in Healthy group. The total amount of BGCs in PTB group was 95 and they were divided into 12 types, in Healthy group 300 BGCs into 16 types. We also obtained 7080 types of VF genes in PTB group, and 10,748 in Healthy group. The virulence gene with the highest proportion in both groups was ssrA. To conclude, this meta-analysis indicated that significant differences of microbial relative abundance were observed between PTB and Healthy groups. PTB group carried less total amount and types of BGCs, and less types of VFs than those in Healthy group, and PTB group showed significantly different metabolic pathways from Healthy group. We also provided new hypotheses related to vaginal microbiome and PTB.

Introduction: The prevalence of preterm labor (PTL) is growing, and annually one in ten babies is born prematurely. Various studies have examined the effect of oral or vaginal probiotics on the prevention of preterm labor, which has yielded contrasting results. This study aimed to compare the impact of vaginal and oral probiotics on the prevention of preterm delivery. Methods: This clinical trial was performed among 185 pregnant women with a gestational age greater than or equal to 25 weeks visiting Kamali Hospital, Karaj, Iran in 2020. The participants were divided into three groups; intervention group 1 receiving Oral probiotic pill once a day until 37 weeks of pregnancy, intervention group 2 receiving probiotic vaginal suppository once a day until 37 weeks of pregnancy, and control group not receiving any intervention. Patients were then followed up until the end of pregnancy. Results: Demographic characteristics and gestational age at the time of intervention were not significantly different among the three groups. Overall, 26.7 % in the control group, 30 % in intervention group 1 %, and 22.5 % in intervention group 2 had deliveries less than 37 weeks. There was no significant difference in the frequency of preterm labor and the duration of pregnancy among the groups (all p > 0.05). Conclusion: Probiotics use does not increase the rate of preterm delivery or reduce the duration of pregnancy, but the rate of preterm delivery was lower in the oral probiotic group. Further clinical studies on the impact of probiotics on PTL can yield valuable results.

ObjectiveThe purpose of this study was to explore the association of cervical disorders on obstetric outcomes of singleton pregnancies in China.MethodsThis hospital-based retrospective cohort study of women with live singleton births included 71,097 Chinese women. We compared the risk of adverse obstetric outcomes in different types of pregnancies with cervical disorders with those with normal cervix. Logistic regression model was used to estimate the association between cervical disorders and adverse obstetric outcomes.ResultsWomen with cervical disorders had a higher risk of premature delivery (10.98 vs. 4.41%), preterm premature rupture of membranes (PPROM) (3.48 vs. 1.62%), low birth weight (LBW) (7.62 vs. 2.92%) and very low birth weight (VLBW) (2.01 vs. 0.28%) than women with normal cervix. After adjusting for confounding factors, compared with women with normal cervix, women with high-grade abnormal cervical cytology are at greater risk of premature birth (adjusted OR 1.971, 95% CI: 1.302–2.983), premature rupture of membranes (PROM) (adjusted OR 1.379, 95% CI: 1.047–1.815), LBW (adjusted OR 1.790, 95% CI: 1.059–3.025), and VLBW (adjusted OR 4.519, 95% CI: 1.662–12.292) than women with low-grade abnormal cervical cytology, and women with abnormal cervical cytology after treatment had a higher risk of premature birth (adjusted OR 2.060, 95% CI: 1.348–3.147), PROM (adjusted OR 1.381, 95% CI: 1.038–1.839), PPROM (adjusted OR 1.995, 95% CI: 1.022–3.892), LBW (adjusted OR 1.801, 95% CI: 1.046–3.102), and VLBW (adjusted OR 4.868, 95% CI: 1.788–13.255) than untreated women.ConclusionsOur research showed that pregnant women with cervical disorders were more likely to have premature delivery, PPROM, LBW, and VLBW. Moreover, pregnant women with high-grade abnormal cervical cytology and abnormal cervical cytology after treatment had a higher risk of premature birth, PROM, LBW, and VLBW.

Objective　To investigate the relationships of matrix metalloproteinase-1 （MMP-1）, matrix metalloproteinase-3 （ MMP-3）, matrix metalloproteinase-9 （ MMP-9） and serum amyloid A （ SAA） with the premature rupture of membranes. Methods　 Thirty cases of premature rupture of fetal membranes，30 cases of fullterm premature rupture of fetal membranes and 30 cases of full-term pregnancies were chosen as controls. The levels of MMP-1, MMP-3, MMP-9 and SAA in the peripheral blood of the three groups of pregnant women were measured by ELISA. The placental tissues of the three groups of pregnant women were examined pathologically to determine the presence of histological chorioamnionitis. Results （1） The levels of MMP-1 and SAA of PPROM and PROM groups were significantly higher than those of the control group （P < 0.05）. After the comparison，MMP1 and SAA of the PPROM group were significantly more than those of the PROM group （P < 0.05）. However，the content of MMP-3 in PPROM group was significantly higher than that in PROM group and the control group （P < 0.05），but there was no significant difference in the concentration between PROM group and the control group （P＞0.05）. There was no significant difference in the concentration of MMP-9 among the three groups （P > 0.05）. （2） 70% （21/30） in the PROM group，33.3% （10/30） in the PROM group and 33.3% （10/30） in the control group. The histological positivity rate of placenta in the PPROM group was elevated compaired with that in the PROM and control groups，and the difference was statistically significant （ χ2 = 10.841，P < 0.05）. There was no significant difference between the PROM and control groups （P > 0.05）. Conclusion　 Serum MMP-1，MMP-3 and SAA are closely associated with the premature rupture of membranes complicated by early chorioamnionitis. [ABSTRACT FROM AUTHOR]

Abstract Background Risk perception is based on collective indicators, but it is influenced by the individual’s self-perception of his health-disease process. This study aims to investigate the risk perception of pregnant women who were identified as high-risk for premature birth and to seek strategies for better management of such cases. Methods This is a cross-sectional study where women who had completed their participation in P5 trial were contacted and invited to answer a structured questionnaire with open questions. Data were collected by telephone and analyzed using thematic analysis. The analysis categories were defined, and all the answers were reviewed, categorized, grouped, and a descriptive summary was prepared. Results Two hundred eight Brazilian women have participated. Three categories were identified: (1) Risk perception mediated by health professionals; (2) Self-perception of risk through personal experiences and relationships; (3) Perception of treatment success. After receiving an explanation from a health professional about short cervix and premature birth, women understood the risk of premature delivery, recognizing the importance of early diagnosis to prevent premature birth. Unsuccessful previous experiences in prior pregnancies influenced women’s risk perception. Patients believed in the success of the treatment performed, placing their hopes on the treatment even without research guarantees about benefits. Conclusions Pregnant women’s risk perception regarding prematurity is based partly on personal and family experiences but mainly on information given by health professionals. The risk perception about preterm birth may contribute to healthy pregnancy, guiding necessary interventions and preventing adverse outcomes. Prevention studies on prematurity should thus focus on neonatal outcomes.

Abstract Introduction: Bartter’s syndrome comprises a heterogeneous group of inherited salt-losing tubulopathies. There are two forms of clinical presentation: classical and neonatal, the most severe type. Types I and II account for most of the neonatal cases. Types III and V are usually less severe. Characteristically Bartter’s syndrome type IV is a saltlosing nephropathy with mild to severe neonatal symptoms, with a specific feature - sensorineural deafness. Bartter’s syndrome type IV is the least common of all recessive types of the disease. Description: the first reported case of a Portuguese child with neurosensorial deafness, polyuria, polydipsia and failure to thrive, born prematurely due to severe polyhydramnios, with the G47R mutation in the BSND gene that causes Bartter’s syndrome type IV. Discussion: there are few published cases of BS type IV due to this mutation and those reported mostly have moderate clinical manifestations which begin later in life. The poor phenotype-genotype relationship combined with the rarity of this syndrome usually precludes an antenatal diagnosis. In the presence of a severe polyhydramnios case, with no fetal malformation detected, normal karyotype and after maternal disease exclusion, autosomal recessive diseases, including tubulopathies, should always be suspected.

BACKGROUND AND OBJECTIVE: Caring for hospitalized premature infants, who are exposed to a variety of painful caregiving, exposes mothers to many challenges that lead to anxiety. This study was designed to provide solutions to reduce maternal anxiety and neonatal pain. METHODS: This clinical trial was performed on 90 mothers with preterm infants in three groups of massage intervention, kangaroo care and control group. The interventions of both groups were performed from the time of stabilization of the neonates to the time of discharge from the neonatal intensive care unit. Spielberger overt and covert anxiety questionnaires with a minimum score of 20 and a maximum of 80 were completed before and after the intervention. FINDINGS: There was a significant difference between the levels of overt and covert anxiety of mothers in the massage group (34.43±11.74 and 32.13±9.25) and the kangaroo care group (36.90±10.06 and 38.07±13.10) compared to the control group (57.47±10.86 and 50.10±9.19) (p

Aims Women who deliver pre-term have higher future risks of hypertension and ischaemic heart disease, but long-term risks of heart failure (HF) are unknown. We examined these risks in a large national cohort. Methods and results All 2 201 284 women with a singleton delivery in Sweden during 1973–2015 were followed up for inpatient or outpatient HF diagnoses through 2015. Cox regression was used to compute hazard ratios (HRs) for HF associated with pregnancy duration, adjusting for other maternal factors. Co-sibling analyses assessed for confounding by shared familial (genetic and/or environmental) factors. In 48.2 million person-years of follow-up, 19 922 women were diagnosed with HF (median age: 60.7 years). Within 10 years after delivery, the adjusted HR was 2.96 [95% confidence interval (CI): 2.48–3.53] for HF associated with pre-term (gestational age: <37 weeks) compared with full-term (39–41 weeks) delivery. Stratified HRs were 4.27 (2.54–7.17) for extremely pre-term (22–27 weeks), 3.39 (2.57–4.48) for moderately pre-term (28–33 weeks), 2.70 (2.19–3.32) for late pre-term (34–36 weeks), and 1.70 (1.45–1.98) for early term (37–38 weeks). These HRs declined but remained elevated at 10–19 years (pre-term vs. full term: HR: 2.19; 95% CI: 1.94–2.46), 20–29 years (1.80; 1.67–1.95), and 30–43 years (1.56; 1.47–1.66) after delivery, and were not explained by shared familial factors. Conclusion Pre-term and early term delivery were associated with markedly increased future hazards for HF, which persisted after adjusting for other maternal and familial factors and remained elevated 40 years later. Pre-term and early-term delivery should be recognized as risk factors for HF across the life course. Key Question What are the long-term hazards for heart failure (HF) across the life course in women who deliver preterm? Key Finding Preterm and early term delivery were associated with ∼3- and 1.7-fold adjusted hazards for HF in the next 10 years vs. full-term delivery. These hazards declined but remained elevated 40 years later, and were not explained by shared familial factors. Take Home Message Preterm and early term delivery were associated with increased future hazards for HF, which persisted for 40 years after adjusting for other maternal and familial factors. Preterm and early term delivery should be recognized as lifelong risk factors for HF. [ABSTRACT FROM AUTHOR]

Background: Maternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking. Objective: To identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications. Methods: This study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden's index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis. Results: 45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 > 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement. Conclusions: We identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool. [ABSTRACT FROM AUTHOR]

Background and Objective: Zinc deficiency has been suggested as a risk factor for adverse pregnancy outcomes. Since dealing with zinc deficiency is an easy and inexpensive method, this study was conducted with the aim of investigating the relationship between adverse pregnancy outcomes and zinc concentration of amniotic fluid and maternal plasma in the second trimester and biomarkers of the first and second trimester. Methods: This cross-sectional study was conducted on 102 pregnant mothers who were candidates for amniocentesis in Mousavi Hospital in Zanjan in 2018 through convenience sampling. Women with normal amniocentesis results were followed up until delivery in terms of adverse pregnancy outcomes (incidence of preeclampsia, intrauterine growth retardation, premature delivery, fetal death, and low birth weight) and were divided into two groups with adverse pregnancy outcomes (first group) and without adverse pregnancy outcomes (second group) and were compared in terms of zinc concentration in plasma and amniotic fluid. Findings: The concentration of zinc in the plasma of the mothers of the first group (59.53±15.88 µg/dl) was significantly lower than that of the mothers of the second group (71.44±19.25 µg/dl) (p=0.02). However, there was no significant difference in the concentration of zinc in the amniotic fluid of the two study groups. In this study, the best cutoff point to determine people at risk of adverse pregnancy outcomes was determined to be 60.5 µg/dl. Conclusion: Based on the results of this study, there seems to be a relationship between low zinc concentration of plasma in pregnant women and adverse outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the risk of poor delivery events (PDEs; premature delivery, abortion, and stillbirth) in female subjects with obstructive sleep apnea (OSA). Methods: The study identified 8346 female subjects with PDEs as cases between January 1, 2000 and December 31, 2015 from the Longitudinal Health Insurance Database 2005 in Taiwan. A total of 33,384 controls were also identified based on frequency matching for age and year of index date. Diagnoses of OSA and PDEs were determined according to the International Classification of Diseases, 9th Revision. The risk of PDEs in female subjects with OSA was estimated with conditional logistic regression analyses. Findings: The mean age of the 41,730 female subjects was 35.53 years. The overall incidence rate of PDEs was 506.22 per 100,000 person‐years for subjects with OSA, which was significantly higher than that for the controls (501.95 per 100,000 person‐years). The risk of PDEs was higher in subjects with OSA than in controls (adjusted odds ratio [AOR] = 1.19; 95% confidence interval [CI] [95% CI]: 1.08–1.43), including for premature delivery (AOR = 1.20; 95% CI: 1.16–1.50), and abortion (AOR = 1.19; 95% CI: 1.09–1.47). OSA showed no relation to stillbirth (AOR = 1.04; 95% CI: 0.99–1.31). The findings indicate that the longer a subject has been experiencing OSA, the higher the probability of PDEs. Conclusions: The risk of PDEs associated with OSA was found in this study. In particular, the longer a subject has OSA, the higher the likelihood of PDEs, exhibiting a dose–response effect. Clinical relevance: To effectively promote maternal health in clinical practice, health providers need to recognize OSA as a risk factor associated with negative pregnancy outcomes. Furthermore, OSA symptoms should be assessed and managed in all pregnant women to enable more comprehensive maternal care. [ABSTRACT FROM AUTHOR]

Introduction: Oxidative stress is one of the indicators that changes during preterm labor as well as cardiovascular diseases; several factors are effective on this index. Therefore, this study was performed with aim to evaluate eight weeks of intermittent exercise training on oxidative stress indices in women with preterm labor after coronary artery bypass graft surgery (CABG). Methods: This clinical randomized trial study was performed on 21 women with preterm delivery and a history of coronary artery graft surgery at Tabriz University of Medical Sciences in 2019. After random allocation, blood sample was taken from the samples and then the intervention group performed 24 sessions of intermittent exercise and the control group had her normal life. Serum levels of 8-hydroxy-2-dioxan-guanosine and urinary 8-hydroxy-2-deoxy-guanosine were measured before and after the intervention. Data were analyzed by SPSS software (version 19) and Shapirovilk, Independent t and t-student tests. P< 0.05 was considered statistically significant. Results: The exercise program in the intervention group caused a significant difference compared to pre-exercise in serum (P=0.003) and urinary (P=0.003) concentrations of 8-Hydroxy-2-dioxychuanosine. Intergroup difference of the variables such as weight (P=0.048), body mass index (P=0.004), fat percentage (P=0.002), and serum 8-hydroxy-2-dioxane guanosine (P=0.001) and urinary (P=0.001) were observed between the intervention and control groups. Conclusion: Intermittent exercise in women with a history of preterm labor undergoing coronary artery bypass graft surgery could cause changes in oxidative stress index.

Objective The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery.Methods A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups.Results The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05).Conclusion Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.

Purpose of Investigation: With the advent of fertility treatment the number of twin gestations has increased considerably. These pregnancies are associated with many maternal and perinatal complications, mainly due to prematurity. The aim of this study was to assess the effectiveness of a fully embedded prophylactic vaginal cervical cerclage in reducing the rate of prematurity in twin pregnancies following ART. Materials and Methods: A prophylactic vaginal cervical cerclage was applied in forty three twin pregnancies conceived following fertility treatments. The cerclage suture was fully embedded under the vaginal mucosa in order to minimize the risk of infection. Results: The mean gestational age at delivery was 35+4 weeks and the mean delivery weight was 2,238 grams. No differences between the type of fertility treatment used was noted in the outcome measures studied. Conclusion: Twin pregnancies conceived with the aid of fertility treatment, benefited from the application of a prophylactic vaginal cervical cerclage.

ABSTRACT BACKGROUND: Exposure to air pollutants has several effects on human health, including during pregnancy. OBJECTIVE: To identify whether exposure to benzene and toluene among pregnant women contributes to preterm delivery. DESIGN AND SETTING: Longitudinal study using data on newborns from mothers living in São José dos Campos (SP) in 2016, who had been exposed to benzene and toluene. METHODS: A logistic regression model with three hierarchical levels was constructed using maternal variables relating to newborns, and using benzene and toluene concentrations in quartiles. Occurrences of cesarean births, twins or malformations were excluded. Maternal exposure windows of 5, 10, 15, 30, 60 and 90 days prior to delivery were considered. RESULTS: Out of the 9,562 live births, 3,671 newborns were included and 343 newborns were born at less than 37 weeks of gestation (9.3%). The average birth weight was 3,167.2 g. Exposure to benzene and toluene was significantly associated (P = 0.04) with preterm delivery in the five-day window. There was no association in any of the other exposure windows. CONCLUSIONS: It was possible to identify that maternal exposure to benzene and toluene has an acute effect on preterm delivery.

ObjectiveTo determine the maternal risk factors associated with preterm delivery in Iran.MethodsA population-based case-control study was conducted including 48 women having preterm delivery (case group) and 100 women having term delivery (control group) between March 2007 and March 2012 in the maternity hospitals of the Selseleh County, Lorestan province, Iran. Information regarding maternal risk factors was collected by structured interview and reviewing the medical records. The maternal risk factors associated with preterm delivery were identified using univariate and multivariable logistic regression analysis after adjusting the sparse data bias. The area under the receiver operating characteristic (ROC) curves was estimated to evaluate the discrimination power of the statistical models.ResultsMultivariable analysis demonstrated that multiparty (odds ratio [OR], 14.23; 95% confidence interval [CI], 1.60–127.05), history of gestational diabetes (OR, 0.10; 95% CI, 0.01–0.99), thyroid dysfunction (OR, 97.32; 95% CI, 5.78–1,637.80), urinary tract infection (OR, 16.60; 95% CI, 3.20–85.92), and taking care during pregnancy (OR, 0.12; 95% CI, 0.03–0.50) had significant impact on preterm delivery after adjusting the potential confounders. The area under the ROC curve for the aforementioned maternal risk factors was 0.86 (95% CI, 0.80–0.92).ConclusionOur study provides evidence for the associations between multiparty, history of gestational diabetes, thyroid dysfunction, urinary tract infection, as well as taking care during pregnancy, and preterm delivery.

BackgroundMaternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.ObjectiveTo identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.MethodsThis study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden’s index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.Results45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 > 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.ConclusionsWe identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.

Prematurity is a major health problem and it is an important life-threatening pathology for the children in their perinatal, new-born and infantile period. We have evaluated the epidemiologic factors for prematurity in Obstetrics Clinic of Sibiu city. We have analysed the epidemiology of 649 preterm babies between 2012 and 2019 in a III grade Maternity Clinic concerning general maternal information, pregnancy pathology and delivery. We have found significant differences between single and multiple pregnancies and between natural conceived pregnancies and assisted reproductive techniques conceived pregnancies concerning the maternal age, number of cortisone doses, modality of delivery and significant differences between normal conceived and assisted reproductive technique conceived new born related to maternal age and pregnancy and labor fetal presentations dystocia. As a conclusion, prematurity is induced by high blood pressure, pregnancy bleeding and infectious complications. Prophylactic cortisone is improving fetal outcome and is a routine practice in our clinic. [ABSTRACT FROM AUTHOR]

Copyright of ESPOCH Congresses: The Ecuadorian Journal of S.T.E.A.M. is the property of Knowledge E DMCC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Risk perception is based on collective indicators, but it is influenced by the individual's self-perception of his health-disease process. This study aims to investigate the risk perception of pregnant women who were identified as high-risk for premature birth and to seek strategies for better management of such cases.Methods: This is a cross-sectional study where women who had completed their participation in P5 trial were contacted and invited to answer a structured questionnaire with open questions. Data were collected by telephone and analyzed using thematic analysis. The analysis categories were defined, and all the answers were reviewed, categorized, grouped, and a descriptive summary was prepared.Results: Two hundred eight Brazilian women have participated. Three categories were identified: (1) Risk perception mediated by health professionals; (2) Self-perception of risk through personal experiences and relationships; (3) Perception of treatment success. After receiving an explanation from a health professional about short cervix and premature birth, women understood the risk of premature delivery, recognizing the importance of early diagnosis to prevent premature birth. Unsuccessful previous experiences in prior pregnancies influenced women's risk perception. Patients believed in the success of the treatment performed, placing their hopes on the treatment even without research guarantees about benefits.Conclusions: Pregnant women's risk perception regarding prematurity is based partly on personal and family experiences but mainly on information given by health professionals. The risk perception about preterm birth may contribute to healthy pregnancy, guiding necessary interventions and preventing adverse outcomes. Prevention studies on prematurity should thus focus on neonatal outcomes. [ABSTRACT FROM AUTHOR]