Prevalence and Rapid Screen Method of Diagnostic Criteria for Psychosomatic Research Syndromes in Human Papillomavirus-Infected Patients.

INTRODUCTION: The early and rapid identification of psychosomatic symptoms is crucial to prevent harmful outcomes in patients with human papillomavirus (HPV) infection in busy comprehensive clinics. This study aimed to explore the prevalence and rapid screening method of the Diagnostic Criteria for Psychosomatic Research-revised (DCPR) syndromes in patients with HPV infection. METHODS: A total of 504 participants underwent a clinical assessment that included DCPR, Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the Social Support Rating Scale (SSRS), the Simplified Coping Style Questionnaire (SCSQ), fear of disease, sociodemographic and clinical characteristics. The prevalence of DCPR syndromes and DSM-5 diagnoses were compared between the HPV-positive and negative patients using χ2 tests. We explored the rapid screen indicator through multiple logistic regression analyses of the participants' psychosocial factors, sociodemographic and clinical characteristics. RESULTS: The incidence of DCPR syndromes in HPV-positive patients (56.6%) was significantly greater than that in HPV-negative patients (17.3%) and DSM-5 diagnoses (8.5%) in the HPV-positive group. Health anxiety, irritable mood, type A behavior, and demoralization were the most common psychosomatic syndromes in HPV-positive patients. As the degree of fear increased from 0 to 5 to 10, the risk of DCPR increased from 1.27 (95% CI: 0.21-7.63) to 3.24 (score range: 1-5, 95% CI: 1.01-10.39) to 9.91 (score range: 6-10, 95% CI: 3.21-30.62) in the HPV-positive group. CONCLUSION: The degree of fear, as an independent risk factor, could be used to quickly screen outpatients with a high risk of DCPR syndrome among women with HPV infection.

Maternal fibrinogen/fibrin degradation products to high density lipoprotein cholesterol ratio for predicting delivery of small and large for gestational age infants: a pilot study.

BACKGROUND: The purpose of this pilot study was to investigate associations between fibrinogen/fibrin degradation products (FDP) to high density lipoprotein-cholesterol (HDL-C) ratio (FHR) of mothers and the risk of delivering large/small for gestational age (LGA/SGA) infants and to evaluate the predictive power of FHR on LGA/SGA. METHODS: This study retrospectively reviewed 11,657 consecutive women whose lipid profiles and FDP levels were investigated at the time of admission for delivery at a specialized hospital. The FHR was calculated, and perinatal outcomes, including clinical parameters, were analyzed. RESULTS: The prevalence of SGA was 9% (n = 1034), and that of LGA was 15% (n = 1806) in this cohort study. FHR was significantly lower in women who delivered SGA infants (4.0 ± 3.2 vs. 4.7 ± 3.3 mg/mmol, P < 0.01) and higher in women who delivered LGA infants (5.7 ± 3.8 vs. 4.7 ± 3.3 mg/mmol, P < 0.01) compared with those who delivered infants of normal size for their gestational age. Women in the top quartile for FHR (> 5.9 mg/mmol) had a 2.9-fold higher risk of delivering LGA infants [adjusted odds ratio (OR) = 2.9, P < 0.01] and a 47% lower risk of delivering SGA infants (adjusted OR = 0.47, P < 0.01) than those in the bottom quartile (< 2.7 mg/mmol). In addition, adding FHR to the conventional models significantly improved the area under the curve for the prediction of delivering LGA (0.725 vs. 0.739, P < 0.01) and SGA (0.717 vs. 0.727, P < 0.01) infants. CONCLUSION: These findings suggest that the FHR calculated in late pregnancy is an innovative predictor of delivering LGA and SGA infants. Combining FHR with perinatal parameters could thus enhance the predictive ability for predicting the delivery of LGA/SGA infants.

Platelet counts affect the association between hyperhomocysteinemia and pregnancy complications.

BACKGROUND: The joint effect of platelet and other modifiers on the risk of pregnancy complications is unknown. This study investigated whether platelet count (PC) and total homocysteine (tHcy) level have a synergistic effect on the incidence of pregnancy complications in a Chinese population. METHODS: Total 11,553 consecutive pregnant women who received whole blood cell and biochemical tests at the time of admission for labor in Changzhou Maternal and Child Health Care Hospital were analyzed. The primary outcome was the prevalence of pregnancy complications: gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), pre-eclampsia (PE), and pregnancy induced hypertension (PIH). RESULTS: The prevalence of GDM, ICP, PE, and PIH was 8.4%, 6.2%, 3.4%, and 2.1%, respectively. The highest rate of ICP (28.6%) was observed in women with high tHcy (> 15 µmol/L) and low PC (quartile 1); and the lowest rate of GDM (0.6%) was found in women with high tHcy and high PC (quartiles 2 to 4). In low PC group, the prevalence of ICP in women with high tHcy was significantly higher than that in women with low tHcy (≤ 15 µmol/L) (28.6% vs. 8.4%), representing an absolute risk increment of 20.2% and a relative risk increment of 3.3-fold (OR: 3.34; 95% CI: 1.55, 7.17; P = 0.002), whereas no joint effect was observed among high PC group. CONCLUSIONS: Among Chinese pregnant women, one subgroup (high tHcy and low PC) has the highest risk of ICP and another (high tHcy and high PC) has the lowest risk of GDM; tHcy and platelet could be used as indicators to identify the women with high risk of ICP or low risk of GDM.

A Word-Granular Adversarial Attacks Framework for Causal Event Extraction.

As a data augmentation method, masking word is commonly used in many natural language processing tasks. However, most mask methods are based on rules and are not related to downstream tasks. In this paper, we propose a novel masking word generator, named Actor-Critic Mask Model (ACMM), which can adaptively adjust the mask strategy according to the performance of downstream tasks. In order to demonstrate the effectiveness of the method, we conducted experiments on two causal event extraction datasets. Experiment results show that, compared with various rule-based masking methods, the masked sentences generated by our proposed method can significantly enhance the generalization of the model and improve the model performance.

Impact of maternal thyroid hormone in late pregnancy on adverse birth outcomes: A retrospective cohort study in China.

The purpose of this study was to explore the impact of maternal thyroid hormone dysfunction in late pregnancy on birth outcomes in a Chinese population. We retrospectively examined hospitalisation records and laboratory data between April 2016 and March 2017 and obtained results from 11,564 consecutive pregnant women with singleton births in which serum thyroid hormone had been examined together with birth outcomes. We assessed the association between maternal thyroid level and dysfunction with adverse birth outcomes based on regression analysis. Hyperthyroidism was associated with an increased risk of preterm birth (PTB, adjusted OR: 2.41, 95% CI: 1.83-3.17) and hypothyroidism was associated with an increased risk of small for gestational age (SGA, adjusted OR: 1.56, 95% CI: 1.10-2.22), while hyperthyroxinaemia was associated with a decreased risk of large for gestational age (LGA, adjusted OR: 0.64, 95% CI: 0.45-0.90). In addition, compared to women with normal FT3 and TSH (≥the 5th and ≤the 95th percentiles), women with high free triiodothyronine (FT3 >the 95th percentile) and low thyroid-stimulating hormone (TSH

Increased secreted frizzled-related protein 4 and ficolin-3 levels in gestational diabetes mellitus women.

By biochemical and epidemiological similarity with type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM) has some overlap between prediction markers and risk factors of T2DM. The present study aimed to establish that secreted frizzled-related protein 4 (SFRP4) and ficolin-3 levels, which have been linked to insulin resistance and the development of T2DM, are elevated in GDM women. A longitudinal prospective cohort study of 86 GDM and 273 normal glucose tolerant (NGT) pregnant women was performed. The clinical parameters, lipid profiles, and serum SFRP4 and ficolin-3 levels were tested during the early and late second-trimester and third-trimester of pregnancy. Both SFRP4 and ficolin-3 levels were significantly higher in GDM women as compared to the NGT participants at three test points (p < 0.01). Spearman's correlation analysis showed that serum SFRP4 levels were significantly positively correlated with ficolin-3 during the early and late second-trimester and third-trimester of pregnancy. The elevated SFRP4 and ficolin-3 concentrations at 16-18 weeks gestation significantly associated with GDM were conformed using binary logistic regression analysis after controlling for other variables [odds ratios (OR) with 95% confidence intervals (CI) for SFRP4: 2.84 (1.78-4.53), p < 0.01; for ficolin-3: 2.45 (1.55-3.88), p < 0.01]. In Conclusions, increased SFRP4 and ficolin-3 levels are significantly associated with GDM development and might be important risk factors for this pregnancy complication.

Association Between ESR1 PvuII, XbaI, and P325P Polymorphisms and Breast Cancer Susceptibility: A Meta-Analysis.

BACKGROUND: Breast cancer is one of the leading causes of cancer-related deaths for women. Numerous studies have shown that single-nucleotide polymorphisms (SNPs) on the ESR1 gene are associated to this disease. However, data and conclusions are inconsistent and controversial. MATERIAL AND METHODS: To investigate the association between PvuII (rs2234693), XbaI (rs9340799) and P325P (rs1801132) polymorphisms of ESR1 gene with the risk of breast cancer under different population categorizations, we searched multiple databases for data collection, and performed the meta-analysis on a total of 25 case-control studies. Three different comparison models - dominant model, recessive model, and homozygote comparison model - were applied to evaluate the association. RESULTS: Our results indicated that people with TT+TC or TT genotype were at a greater risk of developing breast cancer than those with CC genotype in the PvuII polymorphism. While for XbaI and P325P polymorphisms, no significance was found using any of the 3 models. Furthermore, the data were also stratified into different subgroups according to the ethnicity (white or Asian) and source of controls (hospital-based or population-based), and separate analyses were conducted to assess the association. The ethnicity subgroup assessment showed that the higher risk of breast cancer for TT genotype of PvuII polymorphism than CC genotype only occurred in Asian people, but not in white populations. For the source-stratified subgroup analysis, significant association suggested that people with TT + TC genotype were at a greater risk of developing breast cancer than those with CC genotype in the hospital-based subgroup. CONCLUSIONS: Thus, this meta-analysis clarified the inconsistent conclusions from previous studies, conducted analyses for the entire population as well as for different subgroups using diverse population categorization strategies, and has the potential to help provide a personalized risk estimate for breast cancer susceptibility.

Impact of Maternal Monocyte to High-density Lipoprotein Cholesterol Ratio on the Incidence of Large-for-gestational-age Newborns: An Observational Cohort Study.

BACKGROUND AND OBJECTIVES: Monocyte to high-density lipoprotein cholesterol ratio (MHR) has recently been identified as a new marker of inflammation and oxidative stress. However, it is unknown whether maternal MHR is associated with fetal weight at birth. Therefore, our objective was to analyze the association between maternal MHR and the frequency of small/large for gestational age (SGA/LGA) newborns in this retrospective cohort study. METHODS: We retrospectively analyzed hospitalization records and laboratory data and obtained results from consecutive pregnant women in whom the blood lipid level had been investigated along with the blood cell count. Linear regression and logistic regression analyses were performed to estimate the associations of maternal MHR with birth weight and SGA/LGA. RESULTS: Monocyte counts and MHR were positively associated with birth weight/LGA risk (monocyte [1-109/L increase] for birth weight: ß: 170.24, 95% confidence interval [CI]: 41.72-298.76, LGA: odds ratio [OR]: 7.67; 95% CI: 2.56-22.98; MHR [1-109/mmol increase] for birth weight: ß: 294.84, 95% CI: 170.23-419.44, LGA: OR: 7.97; 95% CI: 3.06-20.70), whereas high-density lipoprotein cholesterol (HDL-C) levels were negatively associated with birth weight/LGA risk [1 mmol/L increase for birth weight (ß: -99.83, 95% CI: -130.47 to -69.19), for LGA: (OR: 0.57, 95% CI: 0.45-0.73). Obese pregnant women (body mass index [BMI] ≥30 kg/m2) with higher MHR (tertile 3: >0.33 109/mmol) significantly increased LGA risk by 6.39 fold (95% CI: 4.81, 8.49) compared to those with low MHR (tertile 1-2: ≤0.33 109/mmol) and normal weight (BMI <25 kg/m2). CONCLUSION: Maternal MHR is associated with LGA risk, and this association might be further modified by BMI.

Low Fetal Fraction of Cell Free DNA at Non-Invasive Prenatal Screening Increases the Subsequent Risk of Preterm Birth in Uncomplicated Singleton Pregnancy.

Objective: To examine the association between low fetal fraction (FF) of cell free DNA determined at non-invasive prenatal screening (NIPS) and the subsequent risk of preterm birth in uncomplicated singleton pregnancy. Methods: We retrospectively interrogated NIPS System and hospitalization records from April 2018 to August 2019 and obtained results from 1521 consecutive and uncomplicated women with singleton pregnancy in which plasma FF of cell free DNA at NIPS had been investigated together with birth outcomes. We examined the association between FF and preterm birth (PTB) by regression analysis. Results: The incidence of preterm birth, low birthweight, and macrosomia in the study population was 5.06%, 2.89%, and 7.17%, respectively. FF at NIPS in the second to fourth quartiles (8.40-11.07, 11.08-13.70, and >13.70%, respectively) was associated with higher gestational age at delivery relative to the lowest quartile (<8.40%), with estimated mean increases of 0.27 weeks (95% CI: 0.05-0.49), 0.29 weeks (95% CI: 0.06-0.51), and 0.28 weeks (95% CI: 0.05-0.51), respectively (P for trend = 0.027). Low FF (< the 5th percentile) was associated with an increased risk of PTB (adjusted OR: 2.23, 95% CI: 1.01-4.98, P = 0.047) compared to normal FF (≥ the 5th and ≤ the 95th percentiles). In addition, when compared to women with normal FF and body mass index (BMI) <25 at NIPS, the risk of early PTB (< 34 weeks gestation) was remarkably significantly higher among those with low FF and BMI ≥25 (adjusted OR: 6.29, 95% CI: 1.71-23.15, P = 0.006). Conclusion: Our study supports the association of low FF at NIPS with PTB (especially early PTB) for uncomplicated singleton pregnancy.

Association of Maternal Serum Uric Acid and Cystatin C Levels in Late Pregnancy with Adverse Birth Outcomes: An Observational Cohort Study in China.

OBJECTIVE: To investigate the associations between serum uric acid (UA) and cystatin C (CysC) levels in late pregnancy with major unfavorable birth outcomes. METHODS: We retrospectively analyzed the maternal UA and CysC levels during late pregnancy and their relationship with unfavorable birth outcomes in a Chinese population (n = 11,580). RESULTS: Women with the highest quartile of UA had higher risks of low birth weight (LBW) and small for gestational age (SGA) babies and a lower risk of preterm birth (PTB) compared to women with the lowest quartile [for LBW, adjusted-odds ratio (OR) = 2.63, 95% CI: 1.76, 3.95; for SGA, adjusted-OR = 2.11, 95% CI: 1.73, 2.57; for PTB, adjusted-OR = 0.55, 95% CI: 0.45, 0.69; all P for trend <0.001]. Compared to women in the lowest quartile of CysC, higher risks of macrosomia and large for gestational age (LGA) and lower risks of PTB and SGA were observed for those in the highest quartile (for macrosomia, adjusted-OR = 2.01, 95% CI: 1.60, 2.51; for LGA, adjusted-OR = 1.97, 95% CI: 1.67, 2.32; for PTB, adjusted-OR = 0.32, 95% CI: 0.26, 0.41; all P for trend <0.001; for SGA, adjusted-OR = 0.78, 95% CI: 0.64, 0.96; P for trend <0.05). CONCLUSION: This study reports the associations of maternal UA and CysC with adverse birth outcomes, and suggests that routine determination of maternal UA and CysC in late pregnancy is beneficial for assessing the risks of these outcomes.

Investigation and Application of Risk Factors of Macrosomia Based on 10,396 Chinese Pregnant Women.

Objective: The objective of this study was to examine the association of fetal macrosomia with maternal D-dimer and blood lipid levels, and explore whether D-dimer and blood lipids, either alone or in combination with traditional risk factors at hospital birth, could be used to predict subsequent delivery of macrosomia. Methods: From April 2016 to March 2017, 10,396 women with singleton pregnancy giving birth at around 28-41 weeks of gestation were recruited into the present study. D-dimer and blood lipid levels were measured at hospital admission; and data on birth outcomes were obtained from hospital records. Results: Multivariate logistic regression analysis showed that D-dimer, triglyceride and HDL-C levels were significantly associated with risk of macrosomia independent of traditional risk factors (for D-dimer: adjusted OR: 1.33, 95% CI, 1.23-1.43; for triglyceride: adjusted OR: 1.14, 95% CI, 1.05-1.23; for HDL-C: adjusted OR: 0.35, 95% CI, 0.24-0.51, all P <0.01). More importantly, incorporating D-dimer and blood lipids into the traditional model significantly increased the area under curve (AUC) for prediction of macrosomia (0.783 vs. 0.811; P <0.01). Conclusion: Our study demonstrates that maternal D-dimer, triglyceride, and HDL-C levels before hospital birth could be significant and independent of risk factors of fetal macrosomia. Therefore, combining D-dimer and blood lipid levels with traditional risk factors might improve the ability to predict macrosomia in gestational diabetes mellitus and normal pregnancies.

Association of folate and vitamin B12 imbalance with adverse pregnancy outcomes among 11,549 pregnant women: An observational cohort study.

Objective: This study aimed to evaluate maternal serum levels of folate, vitamin B12, and their ratio on admission for labor and determine whether an imbalance between folate and vitamin B12, represented by a higher or lower serum folate to vitamin B12 ratio (SFVB12R), was associated with adverse pregnancy outcomes. Methods: A retrospective cohort study of 11,549 pregnant women attending a district specialized hospital and who had serum folate (SF) and serum vitamin B12 (SVB12) levels measured at delivery was performed. The levels of SF, SVB12, and SFVB12R were defined as high (>95th percentile), normal (5-95th percentile), and low (<5th percentile). Information on pregnancy outcomes was retrieved from medical records. Linear regression was performed to examine the association of abnormal SF, SVB12, and SFVB12R levels with fetal growth indicators. Logistic regression was applied to estimate the association between abnormal SF, SVB12, and SFVB12R levels and pregnancy outcomes. Results: Lower SF levels were associated with higher risks of intrahepatic cholestasis of pregnancy (ICP, OR 1.58; 95% CI 1.15-2.17), pre-eclampsia (PE, OR 1.89; 95% CI 1.28-2.81), and a lower risk of gestational diabetes mellitus (GDM, OR 0.40; 95% CI 0.23-0.70), whereas higher SVB12 levels were associated with a higher risk of ICP (OR 2.22; 95% CI 1.67-2.96), PE (OR 1.69; 95% CI 1.04-2.74), and GDM (OR 1.62; 95% CI 1.24-2.11). A higher SFVB12R increased birthweight (ß 60.99; 95% CI 29.52-92.45) and was associated with a higher risk of large-for-gestational-age (LGA) newborns (OR 3.08; 95% CI 1.63-5.83); a lower SFVB12R decreased birthweight (ß -43.81; 95% CI -75.62, -12.00) and was associated with a lower risk of LGA newborns (OR 0.75; 95% CI 0.56-1.00), and with higher risks of ICP (OR 2.03; 95% CI 1.54-2.67) and pregnancy-induced hypertension (PIH, OR 1.81; 95% CI 1.09-3.00). Conclusion: An imbalance between folate and vitamin B12, represented by a higher or lower SFVB12R before delivery, was significantly associated with adverse pregnancy outcomes (ICP/PIH/LGA).

Association between low fetal fraction of cell free DNA at the early second-trimester and adverse pregnancy outcomes.

OBJECTIVE: The purpose of this study was to examine whether low fetal fraction (FF) of cell free DNA is associated with risks of adverse pregnancy outcomes. METHODS: This was a historical cohort study of 2191 women with singleton pregnancies who had non-invasive prenatal test (NIPT) at 13 to 26 weeks of gestation. Data were collected from prenatal screening system and hospital records. Main outcome was the subsequent diagnosis of gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), preeclampsia (PE), pregnancy induced hypertension (PIH) and preterm birth (PTB). Logistic regression analysis was performed to evaluate the association between LFF and adverse pregnancy outcomes. RESULTS: The prevalence of GDM, ICP, PE, PIH and PTB was 23.87% (523), 4.02% (88), 2.92% (64), 2.83% (62) and 6.85% (150), respectively. Low FF, defined as less than the 10th percentile, was associated with an increased risk of PE (adjusted OR = 2.06, 95% CI: 1.07-3.98) and early PTB (<34 weeks' gestation: adjusted OR = 3.09, 95% CI: 1.21-7.92). In addition, low FF, defined as less than the 5th percentile, was associated with an increased risk of low birth weight babies (<2500 g: adjusted OR = 2.50, 95% CI: 1.01-6.17). However, there was no significant association between low FF and GDM, as well as ICP and PIH. CONCLUSION: Our study provides evidence that low FF is associated with PE and early PTB. Further exploration of the clinical significance of low FF is warranted.

Effect of the inflammatory response on serum indices of iron status in late pregnancy.

BACKGROUND AND AIMS: A systemic inflammatory response complicates the evaluation of iron status during pregnancy. We investigated the magnitude of this effect on indices of iron status in late pregnancy. METHODS: We retrospectively interrogated laboratory data and hospitalisation records from April 2016 to March 2017 and obtained results from pregnant women in which serum high-sensitivity C-reactive protein (hsCRP) or albumin had been examined together with indicators of iron status (serum ferritin [SF] and serum transferrin [ST], n = 11,571). We assessed the association of the inflammatory response, as evidenced by hsCRP and albumin, with iron status indicators by general linear regression analysis. RESULT: Compared to women with an hsCRP of ≤ 5 mg/L, the median SF level in those with an hsCRP of 6-10, 11-20, and > 20 mg/L significantly increased by 2.24 µg/L (95 % confidence interval [CI]: 1.22, 3.26), 4.04 µg/L (95 % CI: 2.05, 6.04), and 13.49 µg/L (95 % CI: 10.44, 16.53); while the ST level decreased by 0.10 g/L (95 % CI: 0.13, 0.06), 0.16 g/L (95 % CI: 0.23, 0.09), and 0.21 g/L (95 % CI: 0.32, 0.11), respectively (all P < 0.001). With regard to the association of inflammation with SF and ST, no significant interaction between albumin (< 35 and ≥ 35 g/L) and hsCRP was observed (SF: P for interaction = 0.426; ST: P for interaction = 0.872). CONCLUSIONS: Measurement of hsCRP in late pregnancy is necessary to correct the levels of SF and ST. The impact of the inflammatory response on indices of iron status in late pregnancy could not be adjusted by albumin.

Fibrin/fibrinogen degradation products in late pregnancy promote macrosomia prediction in normal uncomplicated pregnancy.

OBJECTIVE: The purpose of this study was to explore the association of fibrin/fibrinogen degradation products (FDP) levels with the risk of macrosomia, and determine whether FDP, either alone or combined with traditional factors in late pregnancy, could be used to predict macrosomia at birth in healthy pregnancies. METHODS: A total of 9464 health pregnant women with singleton pregnancy were recruited in this retrospective cohort study. Maternal plasma FDP levels at hospital admission and birth outcomes were obtained from laboratory system and hospital records, respectively. RESULTS: FDP levels in late pregnancy were significant higher in women who delivered macrosomia than those who delivered infants with normal weight [median (interquartile range, IQR): 8.2 (5.8-11.9) vs. 6.6 (4.7-9.6) mg/L; P < 0.001]. Multivariable logistic regression analysis demonstrated that FDP levels were independently associated with macrosomia risk. Pregnant women in the highest quartile of FDP had a 2.99-fold higher risk of delivering macrosomia compared with those in the lowest (adjusted OR: 2.99; 95% CI: 2.27-3.93). In addition, the incorporation of FDP into the crude prediction model significantly improved the area under curve (AUC) for predicting macrosomia (0.774 vs. 0.787; P < 0.001). CONCLUSION: Our findings suggest that maternal plasma FDP levels in late pregnancy are independently and significantly associated with risk of macrosomia. Combination of FDP levels and traditional risk factors could promote the prediction of macrosomia.

Association of maternal D-dimer level in late pregnancy with birth outcomes in a Chinese cohort.

OBJECTIVE: To investigate the association of D-dimer level during late pregnancy with birth outcomes in a Chinese population. METHODS: A retrospective observational cohort study of 11,570 pregnant women who delivered in a single central hospital was conducted. Maternal plasma D-dimer levels at hospital admission and pregnancy outcomes were abstracted and analyzed from laboratory information system and hospital records, respectively. RESULTS: Maternal plasma D-dimer levels were associated with higher fetal growth indicators for the highest vs. lowest quartile (Q) of D-dimer (mean birth weight: 145.79 g, mean birth length: 0.11 cm, mean gestational age: 0.30 week). Increase in D-dimer quartiles were associated with an decreased risk for small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB) neonates, and with an increased risk for large for gestational age (LGA), and macrosomia infants (SGA: OR = 0.52, 95% CI: 0.43, 0.64; LBW: OR = 0.58, 95% CI: 0.38, 0.86; PTB: OR = 0.44, 95% CI: 0.35, 0.55; LGA: OR = 2.37, 95% CI: 2.01, 2.78; macrosomia: OR = 2.59, 95% CI, 2.06, 3.24; for Q4 vs. Q1). CONCLUSION: Maternal plasma D-dimer levels during late pregnancy were associated with birth outcomes and had risk evaluation value for these outcomes.

Early second-trimester plasma cell free DNA levels with subsequent risk of pregnancy complications.

OBJECTIVE: To investigate the association between cfDNA levels measured during non-invasive prenatal testing (NIPT) and the risk of pregnancy complications in a Chinese population. METHODS: This was a retrospective cohort study of 831 pregnant women who underwent NIPT at 12-22 weeks of gestation. Maternal plasma cfDNA levels and pregnancy outcomes were obtained from NIPT Screening System and hospitalization records, respectively. Logistic regression analysis was performed to investigate the relationship between cfDNA levels and pregnancy complications (after adjusting for confounding factors). RESULTS: Maternal cfDNA levels were significantly higher in women diagnosed with intrahepatic cholestasis of pregnancy (ICP) and preeclampsia (PE) compared to pregnant women with non-pregnancy complications (NPC) (median cfDNA 7.07, 6.42 vs. 5.99 ng/mL). Increase in cfDNA levels were associated with an increased risk for ICP (adjusted-OR = 1.20, 95% CI: 1.07-1.34) and PE (adjusted-OR = 1.14, 95% CI: 1.02-1.26). In addition, increase in cfDNA levels were associated with risk of GDM, and was dependent on maternal age (maternal age ≥ 35 years: adjusted-OR = 1.16, 95% CI: 1.04-1.29; maternal age < 35 years: adjusted-OR = 0.85, 95% CI: 0.73-0.99). CONCLUSION: Maternal plasma cfDNA levels measured during NIPT are associated with pregnancy complications (ICP, PE and GDM). Maternal age may be an important effect modifier for the association between plasma cfDNA levels and GDM.

Iron deficiency in late pregnancy and its associations with birth outcomes in Chinese pregnant women: a retrospective cohort study.

BACKGROUND: Several biomarkers are used to measure iron deficiency (ID) during pregnancy, but the prevalence of ID and its association with adverse birth outcomes shows inconsistent results. The aim of this study was to examine the prevalence of ID in third trimester using multiple indicators of iron status and the relationship with birth outcomes in Chinese population. METHODS: We conducted a retrospective observational cohort study of 11,581 pregnant women between 2016 and 2017 in Changzhou City, Jiangsu Province, China. We obtained the data (maternal characteristics and birth outcomes) and the concentrations of ID biomarkers from our hospitalization information system and laboratory information system, respectively. Using serum ferritin (SF), serum transferrin (ST) and their ratio as criteria of ID, we investigated associations between birth outcomes and late pregnancy ID. RESULTS: The prevalence of ID in our study was 51.82% as defined by low SF (< 12 µg/L), 54.43% as defined by high ST (> 4 g/L) and 53.90% as defined by high ratio of ST/SF (Log 10 transform > 5.52). Maternal ST/SF ratio was associated with higher mean birth weight (97.04 g; 95% CI, 74.28, 119.81 for the highest vs. lowest quartile). Third trimester maternal ID, defined by ST/SF ratio, was associated with lower risks of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) infants, higher risks of macrosomia and large for gestational age (LGA) babies (for PTB: OR = 0.53, 95% CI, 0.36-0.77; for LBW: OR = 0.44, 95% CI, 0.31-0.62; for SGA: OR = 0.69, 95% CI, 0.57-0.83; for macrosomia: OR = 1.39, 95% CI, 1.13-1.70; for LGA: OR = 1.20, 95% CI, 1.04-1.39). CONCLUSIONS: ID in the third-trimester of pregnancy are frequent in Chinese women. Our findings suggest that the ratio of ST/SF measured in late pregnancy could be useful as a significant predictor of unfavorable birth outcomes.

Associations of serum markers screening for Down's syndrome with pregnancy outcomes: A Chinese retrospective cohort study.

BACKGROUND: We examined the associations between Down's serum screening analytes and pregnancy outcomes in Chinese women. METHODS: A retrospective cohort study of 2470 pregnant women was conducted. Maternal serum triple tests (AFP, fß-hCG, uE3), maternal characteristics and pregnancy outcomes were recorded from our prenatal screening and hospitalization information system, respectively. RESULTS: The elevated concentration of uE3 in the early-second trimester was associated with increased risk of LGA infants and macrosomia, decreased risk of PE and small SGA infants (for LGA: OR: 1.34, 95% CI: 1.09-1.65; for macrosomia: OR:1.39, 95% CI: 1.08-1.78; for PE: OR: 0.61, 95% CI: 0.40-0.95; for SGA: OR: 0.35, 95% CI: 0.25-0.49). The increased ratio of AFP/uE3 was associated with reduced risk of GDM in the study populations (BMI ≥ 25; OR: 0.96, 95% CI: 0.0.93-1.00). The higher ratio of AFP/fß-hCG + uE3 associated with increased risk of SGA infants and ICP in these subjects (BMI ≥ 25) was also observed (for SGA: OR: 1.11, 95% CI: 1.03-1.18; for ICP: OR: 1.27, 95% CI: 1.06-1.53). CONCLUSIONS: Down's serum screening analytes were associated with pregnancy outcomes in Chinese population and might provide an alternative tools for risk estimates on these unfavorable outcomes.

Ficolin-3/adiponectin ratio for the prediction of gestational diabetes mellitus in pregnant women.

AIMS/INTRODUCTION: To establish that the ficolin-3/adiponectin ratio is a predictor for gestational diabetes mellitus (GDM) and is eligible for screening tests for GDM. MATERIALS AND METHODS: A prospective cohort study of 86 pregnant women who developed GDM and 273 normal glucose tolerance participants was carried out. Maternal serum ficolin-3, adiponectin levels were investigated at 16-18 weeks of gestation using enzyme-linked immunosorbent assay. RESULTS: Compared with the normal glucose tolerance group, the GDM group showed significantly higher levels of ficolin-3 and the ratio of ficolin-3/adiponectin; and decreased levels of adiponectin between 16-18 weeks of gestation (P < 0.05 or P < 0.01). The cut-off values for the ratio of ficolin-3/adiponectin (≥1.06; sensitivity 90.9%, specificity 96.5%) to discriminate the pregnant women who developed GDM from the non-diabetic cases were identified using receiver operating characteristic analysis. Using binary logistic regression analysis, ficolin-3, retinol-binding protein-4 and adiponectin, but not C-reactive protein, triglyceride and free fatty acids were shown as predictive factors for GDM. CONCLUSIONS: The ratio of ficolin-3/adiponectin at 16-18 weeks of gestation was changed in pregnant women who subsequently developed GDM, and might provide effective early predicting and screening for GDM.