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BACKGROUND: At present, there are several studies on abortion history and perinatal outcomes, but there is no unified conclusion whether the history of abortion and different types of abortion are related to perinatal complications of subsequent pregnancy. We aim to study the impact of different types of abortion history on perinatal outcomes of singleton pregnancies. METHODS: This was a retrospective study from a maternity and infant hospital in Shanghai, China from 2016 to 2020. Pregnant women who gave birth to live singleton infant were included (n = 75,773). We classified abortion into spontaneous abortion (SAB) and induced abortion (IA). We compared the perinatal outcomes of singleton pregnancies with different abortion histories and used Logistic regression analysis to evaluate the associations between pre-pregnancy abortion history with perinatal outcomes. RESULTS: We observed that pregnant women with a history of abortion were more likely to have a premature delivery (0.99% VS 0.45%), gestational diabetes mellitus (GDM) (13.40% VS 10.29%), placenta abnormality (8.16% VS 5.06%), placenta previa (5.65% VS 3.75%), placenta accreta (0.18% VS 0.04%), and placenta adhesion (2.79% VS 1.03%) than those who obtained singleton pregnancies without a history of abortion. When confounding factors were adjusted, differences in placenta abnormality still existed (excluding placenta abruption). The odds ratios and 95% confidence interval of placenta previa, placenta accreta, and placenta adhesion in pregnant women with only SAB history, only IA history, and both abortion history were 1.294(1.174-1.427), 1.272(1.159-1.396), and 1.390(1.188-1.625), 2.688(1.344-5.374), 2.549(1.268-5.125), and 5.041(2.232-11.386), 2.170(1.872-2.515), 2.028(1.738-2.366), and 3.580(2.917-4.395), respectively. CONCLUSIONS: Our research showed that pregnant women who have a history of abortion before pregnancy were more likely to have premature birth, GDM, placenta previa, placenta accreta, and placenta adhesion. After adjusting for confounding factors, we found that the history of SAB, IA, and both SAB and IA history were related to the increased risk of placenta previa, placenta accreta, and placenta adhesion.
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Aborto Inducido , Aborto Espontáneo , Diabetes Gestacional , Placenta Accreta , Placenta Previa , Nacimiento Prematuro , Embarazo , Femenino , Humanos , Aborto Espontáneo/epidemiología , Placenta Previa/epidemiología , Placenta Previa/etiología , Estudios Retrospectivos , Factores de Riesgo , China/epidemiología , Nacimiento Prematuro/epidemiologíaRESUMEN
Phosphorus species are the sum of naturally evolved phosphorus elements with diverse forms of existence and unique properties. The detection and analysis of the optical properties of unknown phosphorus species via direct or indirect strategies offers unique advantages in understanding the growth processes and existence characteristics of various chemicals and microorganisms in water environments. This review highlights recent advances and future trends in methods of detection of total phosphorus in water, including photoelectric strategies, spectroscopy techniques, and modeling algorithms. These methods effectively explore the dynamic changes of total phosphorus content in complex water environments to reveal important signals in water, which is of great guiding significance for achieving accurate detection of water quality and promoting social development. We also discuss some extended strategies for its measurement and prediction via rational design and cross-combination, which may help inspire future design of more accurate and intelligent detection models or systems. The strategies based on these types of total phosphorus detection methods provide a versatile platform for novel sensors and thereby show great potential in the development of future water quality detection applications.
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The majority of broadband cavity-enhanced systems are used to detect trace gas species in the visible spectral range. We demonstrated a broadband cavity-enhanced sensor system in combination with a Fourier-transform spectrometer (FTS) in the near-infrared (near-IR) region for methane (CH4) detection. Light from a tungsten-halogen lamp was coupled into a high-finesse cavity and the light leaking from the cavity was imaged onto the FTS. An optimal incident beam diameter of 2.25 cm was required in the condition of a 40 cm-long cavity of a 2.5 cm diameter and a 100 cm radius of curvature (RoC) mirror. The CH4 sensor system was capable of operating at a temperature of 300 K and 1 atm gas pressure. Based on an Allan variance analysis, a minimum detectable absorption coefficient of 4.6 × 10-7 cm-1 was achieved. A wavelet denoising (WD) method was introduced in the retrieval of the gas concentration, which improved the measurement precision from 10.2 parts-per-million in volume (ppmv) to 5.3 ppmv with an enhancement factor of 2 for a 20 min averaging time. The near-IR broadband cavity-enhanced sensor system can also be used to measure high-resolution absorption spectra of other atmospheric trace gas species.
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A multi-gas sensor system was developed that uses a single broadband light source and multiple carbon monoxide (CO), carbon dioxide (CO2) and methane (CH4) pyroelectric detectors by use of the time division multiplexing (TDM) technique. A stepper motor-based rotating system and a single-reflection spherical optical mirror were designed and adopted to realize and enhance multi-gas detection. Detailed measurements under static detection mode (without rotation) and dynamic mode (with rotation) were performed to study the performance of the sensor system for the three gas species. Effects of the motor rotating period on sensor performances were also investigated and a rotation speed of 0.4π rad/s was required to obtain a stable sensing performance, corresponding to a detection period of ~10 s to realize one round of detection. Based on an Allan deviation analysis, the 1σ detection limits under static operation are 2.96, 4.54 and 2.84 parts per million in volume (ppmv) for CO, CO2 and CH4, respectively and the 1σ detection limits under dynamic operations are 8.83, 8.69 and 10.29 ppmv for the three gas species, respectively. The reported sensor has potential applications in various fields requiring CO, CO2 and CH4 detection such as in coal mines.
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AIM: To investigate tumor necrosis factor (TNF)-α expression and its relationship with serum bile acids in placental trophoblasts from patients with intrahepatic cholestasis of pregnancy (ICP). METHODS: Human placenta, including normal pregnancies (n = 10) and patients with ICP (n = 10), were collected at term and subject to TNF-α measurements. Bile acid-induced TNF-α expression and cell apoptosis were evaluated in cultured syncytiotrophoblasts in vitro. RESULTS: ICP placental trophoblasts displayed apoptotic histological abnormalities. TNF-α levels in ICP tissue were significantly greater than those of controls as measured by quantitative polymerase chain reaction and western blot. Levels of placental TNF-α mRNA were positively correlated with serum bile acid concentration in ICP patients. In vitro, lithocholic acid (LCA) significantly enhanced TNF-α mRNA at both doses, by 2.07-fold at 15 µm and by 3.41-fold at 30 µm, whereas deoxycholic acid mildly increased TNF-α mRNA by 1.41-fold at 100 µm only. LCA treatment produced significantly higher percentage of caspase-3 positive cells than vehicle treatment, rescuable by the addition of a TNF-α inhibitor, indicative of apoptosis induced by LCA-TNF-α pathway. CONCLUSION: This study shows that the increase of TNF-α expression in placental trophoblasts is strongly associated with ICP pathology and is inducible by LCAâ in vitro, suggesting its potential value in the clinical prevention, diagnosis and treatment of ICP.
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Detection of viable Vibrio parahaemolyticus (V. parahaemolyticus) is a major challenge due to its significant risk to food safety and human health. Herein, we developed a phagomagnetic separation-ATP bioluminescence (PhMS-BL) assay based on phage VPHZ6 for rapid and sensitive detection of viable V. parahaemolyticus. Phage as a recognition element was coupled to magnetic beads to capture and enrich V. parahaemolyticus, shortening detection time and improving method sensitivity. The intracellular ATP released by chemical lysis using CTAB was quantified using firefly fluorescein-adenosine triphosphate bioluminescence system to detect viable bacteria. So, PhMS-BL method was able to detect V. parahaemolyticus in a linear range of 2.3 × 102 to 1.3 × 107 CFU mL-1, with a detection limit of 78 CFU mL-1 within 15 min. It is successfully applied to detect V. parahaemolyticus in spiked lake water, lobster tail meat, and clam meat. The developed detection strategy can rapidly and sensitively detect viable V. parahaemolyticus in food matrixes.
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Vibrio parahaemolyticus , Humanos , Alimentos Marinos/microbiología , Inocuidad de los Alimentos , Separación Inmunomagnética , Sensibilidad y EspecificidadRESUMEN
Objective: The objective of this study was to investigate the influence of pre-pregnancy body mass index (BMI) on the incidence of premature rupture of membranes (PROM) among Chinese women. Methods: This was a hospital-based retrospective cohort study of 75,760 Chinese women who had live singleton births between 2016 and 2020. In this study, we utilized logistic regression analysis to estimate the association between pre-pregnancy BMI and PROM based on gestational age. Results: Prior to pregnancy, being overweight or obese was found to be significantly associated with an increased risk of preterm premature rupture of membranes (PPROM), as evidenced by adjusted odds ratios and 95 % confidence intervals of 1.336 (1.173-1.522) and 1.411 (1.064-1.872), respectively. Those with PPROM were divided into three groups according to gestational age: 22-27, 28-31, and 32-36 weeks. Women who were overweight or obese prior to pregnancy had a higher likelihood of experiencing PROM between 22 and 27 weeks of gestation. This finding remained consistent even after controlling for potential confounding factors, such as gestational diabetes mellitus (GDM), gestational hypertension, preeclampsia, hydramnios, cervical abnormalities, and a history of preterm birth. Conclusion: Our research findings indicate that being overweight or obese before pregnancy is linked to a higher likelihood of experiencing PPROM. Therefore, achieving optimal weight before pregnancy is important to prevent PPROM and its associated complications.
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Previous research has demonstrated significant differences in intestinal flora between pregnant women with intrahepatic cholestasis of pregnancy (ICP) and healthy pregnant women. The objective of our study is to identify the key bacteria involved in ICP rats and explore the underlying mechanism. We established an ICP rat model and collected rat feces for metagenomic sequencing and found that Roseburia intestinalis (R.I) is the key bacteria in ICP. Transplantation of R.I improved phenotypes associated with ICP through the bile acid/farnesoid X receptor-fibroblast growth factor 15 (FXR-FGF15) signaling pathway. We used the FXR antagonist Z-Guggulsterone (Z-Gu) to verify the key role of FXR in ICP and found that Z-Gu reversed the benefits of R.I on ICP rats. Our research highlights the important role of intestinal flora in the pathogenesis of ICP and provides a novel approach for its treatment.
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This study aimed to explore potential biomarkers and molecular mechanisms in preeclampsia (PE) progression. Gene expression profiles of GSE147776 and GSE96984 were downloaded, followed by the identification of common differentially expressed genes (co-DEGs) and common differentially expressed lncRNAs (co-DElncRNAs) in PE patients between the two datasets. Key genes were identified using gene set enrichment analysis (GSEA), followed by functional enrichment analyses. Subsequently, the miRNAs of key genes and miRNA-related lncRNAs were predicted, followed by the construction of the lncRNA-miRNA-gene ceRNA network. Furthermore, the key genes associated with different gestational stages were identified. As a result, 192 co-DEGs and 16 co-DElncRNAs were revealed from the two datasets. Based on two outstanding PE-associated pathways, including glaucoma and PE, identified by GSEA, ten key genes, including IGFBP1, CORIN, and C3, were revealed. Key genes, including IL1A and IL1B, were enriched in the developmental process involved in reproduction. Furthermore, ceRNAs, such as LINC00473-miR-4476-IL1A, LINC00473-miR-1291-IL1B, and NAV2-AS4-miR-6131-REN, were identified. Moreover, REN expression was significantly upregulated in the first- and second-trimester placentae compared to C-section-term placentae. In conclusion, these key genes may serve as novel biomarkers for PE. The detection of REN expression may help in the early prediction of PE and the initiation of prophylactic medical treatment.
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IMPORTANCE: At present, few people have studied the associations between abortion history before pregnancy on the outcomes of women and their infants after assisted reproductive technology (ART). OBJECTIVE: To explore the association between the history of abortion and the outcomes of singleton pregnancies after ART. DESIGN: This was a retrospective study in a hospital from 2015 to 2020 in Shanghai, China. Pregnant women with live singleton births through ART were included (n = 3043). Abortion was classified into spontaneous abortion (SAB) and induced abortion. We compared the maternal and fetal outcomes of singleton pregnancies obtained through ART with different abortion histories. Logistic regression analysis was used to evaluate the associations between the history of pre-pregnancy abortion with perinatal complications and neonatal outcomes. RESULTS: We observed that compared with those who had no abortion history and obtained singleton pregnancies through ART, women who had an abortion history before pregnancy (including SAB or induced abortion history) and only SAB history were more likely to have gestational diabetes mellitus (GDM), thyroid-related diseases, and placenta-related diseases. After adjusting the potential confounding factors, these differences still existed. The adjusted odds ratios (ORs) and 95% confidence interval (CI) of GDM, thyroid-related diseases, and placenta-related diseases in women with a history of abortion and only a history of SAB were 1.239 (1.030-1.492) and 1.240 (1.010-1.522), 1.589 (1.261-2.002) and 1.724 (1.344-2.213), 1.465 (1.183-1.815) and 1.433 (1.132-1.814), respectively. However, we did not observe the association between the history of induced abortion and GDM and thyroid-related diseases. CONCLUSIONS AND RELEVANCE: Our research showed that pregnant women with singleton pregnancies through ART who had a history of abortion or only a history of SAB were more likely to have GDM, thyroid-related diseases, and placenta-related diseases. Pregnant women who had both SAB and induced abortion before pregnancy had a higher risk of thyroid-related diseases and placenta-related diseases, while women who had only a history of induced abortion had a higher risk of placenta-related diseases. Further research is needed to explore the biological mechanism of different types of abortion related to subsequent pregnancy.
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Objective: We aimed to determine the association between maternal characteristics and isolated maternal hypothyroxinemia (IMH). Methods: Pregnancies registered at Shanghai First Maternity and Infant Hospital between January 2014 and September 2020 were included in this cross-sectional study. IMH was defined as free thyroxine (FT4) levels below the 10th percentile with TSH within the normal reference range. Multivariate logistic regression models were used to identify potential risk factors for IMH, including demographic information, anthropometric measurements and nutritional status. Results: A total of 54586 singleton pregnancies were included, involving 6084 women with IMH and 48502 euthyroid women. Multivariate logistic regression analyses showed that the variables for women with ages ≥35 (adjusted OR = 1.30, 95% CI:1.20-1.40), non-local residence (adjusted OR = 1.16, 95% CI:1.09-1.23), multiparas (adjusted OR = 1.11, 95% CI:1.03-1.21), pre-pregnancy overweight (adjusted OR = 1.37, 95% CI:1.27-1.49) or obesity (adjusted OR = 1.35, 95% CI:1.18-1.54), and iron deficiency (adjusted OR = 1.27, 95% CI:1.20-1.35) were independent risk factors for IMH in the overall study population, which were identical to those in the first trimester subgroup. Conclusions: Maternal characteristics were associated with the onset of IMH. Maternal age, residence of origin, parity, pre-pregnancy body mass index (BMI) and iron status should be comprehensively considered to evaluate the risk of IMH, according to which obstetricians could determine an optimal assessment time for thyroid function.
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Pruebas de Función de la Tiroides , Índice de Masa Corporal , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Embarazo , Estudios ProspectivosRESUMEN
Context: Adverse maternal outcomes and perinatal complications are associated with maternal hypothyroidism. However, the utility of levothyroxine (L-T4) in the treatment of pregnant women with hypothyroxinemia is unclear. Objective: This study aimed to evaluate the effects of L-T4 on maternal and perinatal outcomes in pregnant women with hypothyroxinemia. Methods: The nonrandomized interventional study was conducted at Shanghai First Maternity and Infant Hospital, Punan Hospital of Shanghai, and Beicai Community Health Center of Shanghai. The pregnant women with hypothyroxinemia from the first trimester were enrolled and divided into treatment and control groups. 463 taking L-T4 and 501 not administering L-T4 were analyzed in the study. All participants were screened for TPOAB/TGAB antibody status. Main Outcome: The primary outcome of the study was the hypertensive disorder of pregnancy (HDP), measured as the proportion of HDP. In addition to this primary outcome, some secondary outcomes will be measured: miscarriage, gestational diabetes mellitus, premature rupture of membranes, placental abruption, intrahepatic cholestasis of pregnancy, fetal distress, macrosomia, and neonates admitted to the neonatal intensive care unit (NICU). The effects of L-T4 on the incidence of adverse pregnancy outcomes and perinatal complications were compared. Results: Multivariate logistic regression analysis showed that L-T4 treatment (adjusted odds ratio = 1.78 [95% CI = 1.00-3.16], p = 0.04) significantly reduced the incidence of miscarriage. Otherwise, lower neonates admitted to the NICU were strongly associated with the L-T4 group (adjusted odds ratio = 1.36 [95% CI = 1.01 - 1.83], p = 0.04). There were no significant differences in the incidence rates of other adverse maternal outcomes and perinatal complications between pregnant women with hypothyroxinemia receiving and those not receiving L-T4 treatment. Conclusion: The incidence of HDP was not significantly reduced using L-T4 in pregnant women with hypothyroxinemia. The results of this study also showed that L-T4 treatment significantly reduced the miscarriages rate and the proportion of newborns admitted to the NICU.
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Aborto Espontáneo , Complicaciones del Embarazo , China/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Placenta , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Mujeres Embarazadas , Tiroxina/uso terapéuticoRESUMEN
BACKGROUND: The pathogenesis of intrahepatic cholestasis of pregnancy (ICP) is not clear, and some researchers have compared the differences in serum levels of inflammatory cytokines between ICP patients and normal pregnant women, but there are few studies and different conclusions. AIM: To investigate the levels of inflammatory cytokines such as interleukins (IL) -4, IL-6, IL-8, and tumor necrosis factor alpha (TNF-α) in patients with ICP and their potential role in pathophysiology. METHODS: This case-control study was conducted in Shanghai First Maternity and Infant Health Hospital, and we recruited ICP patients and age-matched healthy pregnant women as a control group. Plasma samples from 40 subjects with ICP and 40 subjects without ICP were tested for concentration of the following inflammatory cytokines: interferon-gamma, IL-1 alpha, IL-1 beta, IL-2, IL-4, IL-6, IL-8, IL-10, and TNF-α. Analyzed inflammatory cytokines were then assessed, either individually or in combination with regard to ICP. RESULTS: The cytokine composition of the ICP and CTL group was significantly different. We compared levels of inflammatory cytokines with regard to the presence of ICP symptoms. Levels of IL-4, IL-6, and TNF-α were significantly lower in ICP subjects, and IL-8 were significantly higher in ICP subjects, compared with CTL subjects. The TNF-α showed the best performance for ICP identification (area under the curve [AUC]: 0.829). Performance was increased when TNF-α was combined with IL-4 and IL-8 analysis (AUC, 0.901). Spearman correlation and linear regression analysis revealed that the TNF-α concentrations correlated with IL-4 and IL-6 levels, and inversely correlated to TBA, ALT, AST, and IL-8 levels. CONCLUSION: IL-4, IL-6, and TNF-α were significantly decreased, while IL-8 was significantly increased in the ICP group compared with the healthy control group. TNF showed the best single marker discriminatory potential; however, combining TNF-α, IL-4, and IL-8 analyses increased performance for ICP identification.
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Colestasis Intrahepática , Complicaciones del Embarazo , Femenino , Humanos , Embarazo , Interleucina-4 , Citocinas , Factor de Necrosis Tumoral alfa , Interleucina-6 , Estudios de Casos y Controles , Interleucina-8 , China/epidemiologíaRESUMEN
Objective: The purpose of this study was to explore the association of cervical disorders on obstetric outcomes of singleton pregnancies in China. Methods: This 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. Results: Women 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. Conclusions: Our 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.
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Background: Research indicates that exposure to polychlorinated biphenyls (PCBs) can cause neurobehavioral impairments in neonates and adults, but the way specific PCBs' congeners impact cognition functions at a low exposure level in a real-life co-exposure system remains poorly understood. This study aimed to investigate the association of PCBs burden with cognition function among elderly adults. Methods: Based on the Weitang Geriatric Diseases study (2014−2015), the current study measured the plasma concentrations of six indicator-PCBs by GC-MS/MS and assessed the cognitive dysfunction (CoD) via an Abbreviated Mental Test in 266 participants (ages 61−90). Sequential logistic regression was used to analyze the effects of PCBs on cognition functions. Female participants aged less than or equal to 80 years were selected, and path analysis was used to determine the direct or indirect impacts of co-exposure PCBs on CoD by structural equation modeling. Results: After sequential adjustments to potential confounding factors and correction by the Bonferroni, no statistically significant correlation between PCBs exposure and CoD was found in participants (p > 0.05). However, in the co-exposure system, after controlling for co-exposures and confounders, exposure to PCB28 had a direct effect on CoD in females aged between 61 and 80, with a factor load of 0.670. Conclusions: After adjusting for the co-exposures and confounders, exposure to PCB28 can directly increase the risk of cognitive impairment in older Chinese females.
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Disfunción Cognitiva , Contaminantes Ambientales , Bifenilos Policlorados , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Cognición , Disfunción Cognitiva/inducido químicamente , Disfunción Cognitiva/epidemiología , Contaminantes Ambientales/análisis , Femenino , Humanos , Recién Nacido , Persona de Mediana Edad , Espectrometría de Masas en TándemRESUMEN
Objective: To investigate the association between hypothyroxinemia and the risk of preeclampsia-eclampsia and gestational hypertension. Design: Historical cohort study. Methods: The study included pregnant individuals who delivered live-born singletons and had at least one thyroid function assessment during pregnancy at a tertiary hospital. Hypothyroxinemia was defined as thyroid-stimulating hormone (TSH) levels within the normal reference range and free thyroxine (FT4) levels lower than the tenth percentile. Risk ratios (RRs) with 95% confidence intervals (95% CIs) for preeclampsia-eclampsia and gestational hypertension between women with and without a diagnosis of hypothyroxinemia during pregnancy were estimated using a generalized estimating equation model. Results: A total of 59,463 women with live-born singletons were included in the analysis. Logistic regression models with restricted cubic spline suggested that there was a U-shaped association between FT4 levels and preeclampsia-eclampsia risk. Compared with euthyroid women, those with hypothyroxinemia had an increased risk of preeclampsia-eclampsia (RR = 1.16, 95% CI: 1.02-1.31), and the risk increased with the increasing severity of hypothyroxinemia (p for trend < 0.001). Moreover, persistent hypothyroxinemia from the first to second trimesters was associated with an increased risk of preeclampsia-eclampsia (RR = 1.37, 95% CI: 1.03-1.83), especially for women with severe hypothyroxinemia (RR = 1.70, 95% CI: 1.12-2.58). In contrast, there was no association between hypothyroxinemia and gestational hypertension. Conclusion: Our study suggested that hypothyroxinemia was only associated with an increased risk of preeclampsia-eclampsia, especially in women with persistent hypothyroxinemia in the first half of pregnancy. Analyses of the associated risk of gestational hypertension with hypothyroxinemia were not significant.
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Eclampsia/etiología , Hipertensión Inducida en el Embarazo/etiología , Hipotiroidismo/complicaciones , Preeclampsia/etiología , Adulto , China/epidemiología , Estudios de Cohortes , Eclampsia/sangre , Eclampsia/epidemiología , Femenino , Humanos , Hipertensión Inducida en el Embarazo/sangre , Hipertensión Inducida en el Embarazo/epidemiología , Hipotiroidismo/sangre , Hipotiroidismo/epidemiología , Preeclampsia/sangre , Preeclampsia/epidemiología , Embarazo , Factores de Riesgo , Pruebas de Función de la Tiroides , Tirotropina/sangre , Tiroxina/sangre , Adulto JovenRESUMEN
Objective: To study the association between pre-pregnancy body mass index (BMI) and adverse maternal and neonatal outcomes of singleton pregnancies after assisted reproductive technology (ART). Methods: This hospital-based retrospective cohort study of women with live singleton births through ART in China from January 2015 to August 2020 included 3043 Chinese women. According to the latest BMI classification standard of Asian women, the women included in this study were classified as underweight (BMI <18.5 kg/m2), normal (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2), and obese (BMI ≥27.5 kg/m2). We compared the risk of adverse outcomes of different pre-pregnancy BMI values of women with singleton pregnancies conceived through ART. We used Logistic regression analysis to estimate the associations between pre-pregnancy BMI and adverse perinatal and neonatal outcomes. Results: Our findings showed that women who were overweight or obese before pregnancy through ART are more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia, regardless of whether confounding factors are adjusted. Moreover, pre-pregnancy obesity was more associated with a higher risk of these adverse outcomes than pre-pregnancy overweight. In addition, neonates from women who had obesity before pregnancy through ART were more likely to have macrosomia; adjusted odds ratios and 95% confidence intervals were 3.004 (1.693-5.330). Conclusions: Our research showed that women who had pre-pregnancy overweight or obesity with singleton pregnancies through ART were more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia. Moreover, neonates from women who had obesity before pregnancy were more likely to have macrosomia.
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Cesárea , Resultado del Embarazo , Índice de Masa Corporal , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo/epidemiología , Técnicas Reproductivas Asistidas/efectos adversos , Estudios RetrospectivosRESUMEN
BACKGROUND: Intrahepatic cholestasis in pregnancy (ICP) is the most common liver disease during pregnancy, and its exact etiology and course of progression are still poorly understood. AIM: To investigate the link between the gut microbiota and serum metabolome in ICP patients. METHODS: In this study, a total of 30 patients were recruited, including 15 patients with ICP (disease group) and 15 healthy pregnant patients (healthy group). The serum nontarget metabolomes from both groups were determined. Amplification of the 16S rRNA V3-V4 region was performed using fecal samples from the disease and healthy groups. By comparing the differences in the microbiota and metabolite compositions between the two groups, the relationship between the gut microbiota and serum metabolites was also investigated. RESULTS: The Kyoto Encyclopedia of Genes and Genomes analysis results showed that the primary bile acid biosynthesis, bile secretion and taurine and hypotaurine metabolism pathways were enriched in the ICP patients compared with the healthy controls. In addition, some pathways related to protein metabolism were also enriched in the ICP patients. The principal coordination analysis results showed that there was a distinct difference in the gut microbiota composition (beta diversity) between the ICP patients and healthy controls. At the phylum level, we observed that the relative abundance of Firmicutes was higher in the healthy group, while Bacteroidetes were enriched in the disease group. At the genus level, most of the bacteria depleted in ICP are able to produce short-chain fatty acids (e.g., Faecalibacterium, Blautia and Eubacterium hallii), while the bacteria enriched in ICP are associated with bile acid metabolism (e.g., Parabacteroides and Bilophila). Our results also showed that specific genera were associated with the serum metabolome. CONCLUSION: Our study showed that the serum metabolome was altered in ICP patients compared to healthy controls, with significant differences in the bile, taurine and hypotaurine metabolite pathways. Alterations in the metabolization of these pathways may lead to disturbances in the gut microbiota, which may further affect the course of progression of ICP.
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Colestasis Intrahepática , Microbioma Gastrointestinal , Colestasis Intrahepática/diagnóstico , Clostridiales , Femenino , Humanos , Metaboloma , Embarazo , ARN Ribosómico 16SRESUMEN
OBJECTIVE: Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disease which is closely correlated with abnormal placental vascular formation and deficient vascular maturation. This study intends to explore the role of VCAM-1 in the vascular formation in the placenta of ICP. METHODS: Patients with ICP or healthy puerperant were respectively used as ICP group and control group. The umbilical vein endothelial cell Eahy926 was selected as in vitro cell model. Immunohistochemistry and western blot were used for analysis of protein expression. MRNA expression was assayed by real time-PCR and the cell viability was detected by the MTT method. Cell proliferation and cell apoptosis were probed by the flow cytometer. Luciferase report assay was used for the interaction analysis between the microRNA and the 3'UTR of gene VCAM-1. RESULTS: Immunohistochemistry indicated that the expression of VCAM-1 was reduced in the ICP group compared to that in control group. The cell culture and cell behavior assays indicated that the TCA (Taurocholic acid) could reduce the expression of gene VCAM-1 and inhibit the cell proliferation and enhance the cell apoptosis. In order to probe its reduction mechanism, the potential microRNAs were detected and gene VCAM-1 was confirmed to be the target of miR-590-3p by western blot and luciferase report assays. CONCLUSIONS: The expression pattern of gene VCAM-1 was suppressed by TCA through miR-590-3p, which participated in the regulation of cell growth, cell proliferation and cell apoptosis.
Asunto(s)
Colestasis Intrahepática/metabolismo , Células Endoteliales/metabolismo , Complicaciones del Embarazo/metabolismo , Molécula 1 de Adhesión Celular Vascular/metabolismo , Apoptosis/efectos de los fármacos , Línea Celular , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Colestasis Intrahepática/genética , Femenino , Humanos , MicroARNs/genética , Placenta/citología , Embarazo , Complicaciones del Embarazo/genética , ARN Mensajero/metabolismo , Ácido Taurocólico/farmacología , Molécula 1 de Adhesión Celular Vascular/genéticaRESUMEN
Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder with potentially deleterious consequences for fetuses. Although a clear correlation between the elevated levels of maternal serum bile acids and deficient fetal outcome has been established in clinical practice, the underlying mechanisms remain elusive. Herein, we report that bile acids induce NF-κB pathway activation via G protein-coupled bile acid receptor 1 (Gpbar1), with consequent upregulation of inflammatory genes in trophoblasts, leading to aberrant leukocyte infiltration and inflammation in placenta. Ursodeoxycholic acid (UDCA), a drug used clinically to treat ICP, competes with other bile acids for binding with Gpbar1 and thus inhibits bile acid-induced inflammatory response in trophoblasts and improves fetal survival in pregnant rats with obstructive cholestasis. Notably, inhibition of NF-κB by andrographolide is more effective than UDCA in benefiting placentas and fetuses. Thus, anti-inflammation therapy targeting Gpbar1/NF-κB pathway could be effective in suppressing bile acid-induced inflammation and alleviating ICP-associated fetal disorders.