Functional testing is a complementary tool for the diagnosis of vaginitis.

OBJECTIVE: Vaginal microbiota evaluation is a methodology widely used in China to diagnose various vaginal inflammatory diseases. Although vaginal microbiota evaluation has many advantages, it is time-consuming and requires highly skilled and experienced operators. Here, we investigated a six-index functional test that analyzed pH, hydrogen peroxide (H2O2), leukocyte esterase (LEU), sialidase (SNA), ß-glucuronidase (GUS), and acetylglucossidase (NAG), and determined its diagnostic value by comparing it with morphological tests of vaginal microbiota. MATERIALS AND METHODS: The research was conducted using data extracted from the Laboratory Information System of Women and Children's Hospital. A total of 4902 subjects, ranging in age from 35.4 ± 9.7 years, were analyzed. During the consultation, a minimum of two vaginal swab specimens per patient were collected for both functional and morphological testing. Fisher's exact was used to analyze data using SPSS. RESULTS: Of the 4,902 patients, 2,454 were considered to have normal Lactobacillus morphotypes and 3,334 were considered to have normal dominant microbiota. The sensitivity and specificity of H2O2-indicating Lactobacillus morphotypes were 91.3% and 25.28%, respectively, while those of pH-indicating Lactobacillus morphotypes were 88.09% and 59.52%, respectively. The sensitivity and specificity of H2O2-indicating dominant microbiota were 91.3% and 25.3%, respectively, while those of pH-indicating dominant microbiota were 86.27% and 64.45%, respectively. The sensitivity and specificity of NAG for vulvovaginal candidiasis were 40.64% and 84.8%, respectively. For aerobic vaginitis, GUS sensitivity was low at 0.52%, while its specificity was high at 99.93%; the LEU sensitivity and specificity values were 94.73% and 27.49%, respectively. Finally, SNA sensitivity and specificity for bacterial vaginosis were 80.72% and 96.78%, respectively. CONCLUSION: Functional tests (pH, SNA, H2O2, LEU) showed satisfactory sensitivity for the detection of vaginal inflammatory diseases. However, these tests lacked specificity, making it difficult to accurately identify specific pathologies. By contrast, NAG and GUS showed excellent specificity in identifying vaginal inflammatory diseases, but their sensitivity was limited. Therefore, functional tests alone are not sufficient to diagnose various vaginal inflammatory diseases. When functional and morphological tests are inconsistent, morphological tests are currently considered the preferred reference method.

Maternal Physiological Variations Induced by Chronic Gestational Hypoxia: 1H NMR-Based Metabolomics Study.

Metabolomics have been widely used in pregnancy-related diseases. However, physiological variations induced by chronic hypoxia during pregnancy are not well characterized. We aimed to investigate physiological variations induced by chronic hypoxia during pregnancy. A Sprague-Dawley (SD) pregnant rat model of chronic hypoxia was established. Plasma and urine metabolite profiles at different stages of the pregnancy were detected by 1H NMR (nuclear magnetic resonance). Multivariate statistical analysis was used to analyze changes in plasma and urine metabolic trajectories at different time-points. We identified hypoxia-induced changes in the levels of 30 metabolites in plasma and 29 metabolites in urine during different stages of pregnancy; the prominently affected metabolites included acetic acid, acetone, choline, citric acid, glutamine, isoleucine, lysine, and serine. Most significant hypoxia-induced changes in plasma and urine sample metabolites were observed on the 11th day of gestation. In summary, chronic hypoxia has a significant effect on pregnant rats, and may cause metabolic disorders involving glucose, lipids, amino acids, and tricarboxylic acid cycle. Metabolomics study of the effect of hypoxia during pregnancy may provide insights into the pathogenesis of obstetric disorders.

[Effect of Mobile Health for Standardized Management on Women with Gestational Diabetes Mellitus].

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)% vs.(60.69±21.28)%,P=0.004].The incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit demonstrated no significant differences between groups(all P > 0.05). Conclusions Mobile health applied in standardized management is conducive to the glycemic control of GDM women,whereas it does not significantly improve the pregnancy outcomes.Due to the short time of intervention,the effects of mobile health on pregnancy outcomes need further study.

An age matched case-control study on the risk factors for the gestational diabetes mellitus among primiparous women. / å¹´é¾„åŒ¹é è®¾è®¡çš„åˆäº§å­•å¦‡å¦Šå¨ æœŸç³–å°¿ç— å‘ç— å±é™©å› ç´ çš„ç— ä¾‹å¯¹ç §ç ”ç©¶.

OBJECTIVES: Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. It is associated with a wide range of short and long term adverse health consequences for both mother and offspring. As we know, the risk factors of the GDM are complex and diverse, and the incidence of GDM is directly correlated with the age and the times of women delivery. In the process of exploring the risk factors of GDM, if the 2 known independent risk factors are unevenly distributed among groups, the effects of other risk factors may be concealed. To avoid the influence of the 2 factors on the research results, we collected primiparous women as the participants through the method of the case-control study of age 1꞉1 paired design. Through this way, we want to provide early intervention for the pregnant women with the high risk factors so as to reduce the possibility of the GDM during the pregnancy and promote the maternal and infant's health. METHODS: This study was a retrospective study. A total of 2 425 pregnant women were collected as the participants, who accepted the regular prenatal examination or nutrition health guidance in the Department of Obstetrics or Nutrition in the Women and Children's Hospital, School of Medicine, Xiamen University from August 2018 to October 2019. According to the inclusion and exclusion criteria, 2 287 pregnant women were included in the study. Among them, 231 pregnant women with the complete information were collected as a case group because of the abnormal results of the oral glucose tolerance test (OGTT) that executed between the 24th and 28th weeks during the pregnancy. Meanwhile, among the participants with the normal results of the OGTT, 231 pregnant women with the complete information were selected randomly as a control group through the method of the age 1꞉1 paired with the case group. The age range of the all subjects was 22 to 45 (28.82±4.03) years old. We collected their clinical and basic data retrospectively, including the BMI before pregnancy, the level of uric acid, fasting blood glucose, serum lipid index, and glycosylated hemoglobin (HbA1c) in the early pregnancy, the body weight gain before the 13th and 24th weeks during the pregnancy, the times of the abortions, the positive of HBsAg, the family history of diabetes or hypertension etc. The differences in these indexes were compared between the 2 groups. The logistic regression analysis was used to explore the risk factors for GDM and the stratified analysis was used to explore the difference of the body weight gain before the 24th week during the pregnancy between the 2 groups. RESULTS: The BMI before pregnancy, the uric acid, the fasting blood glucose, the body weight gain before the 13th and 24th weeks during the pregnancy in the GDM group were higher than those in the control group, and the differences were significant (all P<0.05). The LDL level in the early pregnancy of the GDM group was higher than that of the control group, however, the HDL level in the early pregnancy of the GDM group was lower than that of the control group, and the differences were significant (both P<0.05). The rates of the pregnant women in the GDM group with more than 2 abortions, obesity or overweight before pregnancy, the fasting blood glucose in the early pregnancy over 5.1 mmol/L were significantly higher than those in the control group (all P<0.05). With the uptrend of the cut-off point of the body weight gain before the 24th week during the pregnancy, the risk of the GDM was gradually increasing. When the cut-off point reached at 10 kg, the difference was significant (OR=1.988, P=0.004). The level of HDL in the early pregnancy over 1.6 mmol/L was the protective factor for GDM (OR=0.460, P=0.016). Meanwhile, the body weight gain over 10 kg before the 24th week during the pregnancy (OR=1.743, P=0.032), the fasting blood glucose in the early pregnancy over 5.1 mmol/L (OR=3.488, P=0.001), the LDL in the early pregnancy over 2.5 mmol/L (OR=2.179, P=0.032) were the risk factors for the GDM. Among them, the fasting blood glucose in the early pregnancy over 5.1 mmol/L had the greatest impact on the increase of risk for the GDM. CONCLUSIONS: After excluding the influence of the age, for primiparous women, the higher level of the LDL and the fasting blood glucose in the early pregnancy, the higher possibility to be the GDM. Meanwhile, the pregnant women should control their diet as soon as possible to control the body weight gain within 10 kg before the 24th week during the pregnancy so as to reduce the possibility of being GDM.

Glycemic qualification rate and frequency of self-monitoring blood glucose glycemic qualification rate and frequency of self-monitoring blood glucose (SMBG) in women with gestational diabetes mellitus (GDM).

AIMS: To explore the relationship between blood glucose (BG) control rate and self-monitoring blood glucose (SMBG) compliance of women with gestational diabetes mellitus (GDM). METHODS: Women with GDM (n = 309) were randomized to receive routine clinical prenatal care or additional online management. Follow-up visits were conducted every two weeks (noted here as T) from enrollment to delivery. SMBG records were used for the analysis. RESULTS: Both the intervention group and the control group had an increasing BG control rate and decreasing SMBG compliance during the whole follow-up period. Detailed data analysis on separate follow-up periods showed that the SMBG frequency was negatively correlated with the BG control rate in most Ts and that the BG control rate of Tn-1 was negatively correlated with the SMBG frequency of Tn in the adjacent T. Only in the intervention group was T2 SMBG compliance not under the influence of the T1 BG control rate. CONCLUSIONS: Our data suggested that regardless of management approach, the BG control rate increased, and the SMBG frequency decreased as gestational weeks increased in women with GDM. Even in separate follow-up periods, the SMBG frequency was negatively correlated with the BG control rate both within one follow-up period and between two adjacent follow-up periods.

Maternal exposure to the water soluble fraction of crude oil, lead and their mixture induces autism-like behavioral deficits in zebrafish (Danio rerio) larvae.

Autism spectrum disorder (ASD) is a serious debilitating mental illness with complex symptoms and multi-factorial pathogenesis. Although the pathogenesis of ASD remains unclear, etiology is thought to involve complex, multigenic interactions and possible environmental contributions. In the present study, we used zebrafish (Danio rerio) as a model to investigate whether maternal exposure to the water soluble fraction of crude oil (WSF, 5µg/L), lead (Pb, 20µg/L) and their mixture (5 µg/L WSF+20 µg/L Pb) could induce autism-like behavior in larvae. Our results showed that isolated and combined WSF/Pb exposure altered the behavioral pattern of fish swimming. WSF significantly increased anxiety and locomotor activity, decreased repetitive behavior in the open field test, and reduced the level of serotonin. However, co-exposure to WSF/Pb decreased behavioral activity and shoaling behavior, and increased cycle swimming and edge preference. Significant changes in the expression level of the multiple genes potentially critical for regulating environmental factor induced autism-like behavior were found. A gene network regulating ASD disturbed by WSF/Pb exposure was established using computational analysis. The information from the network could provide a clue for further mechanistic studies explaining molecular events regulating WSF/Pb mediated ASD.

Levels of heavy metals and trace elements in umbilical cord blood and the risk of adverse pregnancy outcomes: a population-based study.

To better understand the relationship between prenatal exposure to heavy metals and trace elements and the risk of adverse pregnancy outcomes, we investigated the status of heavy metals and trace elements level in a Chinese population by collecting umbilical cord blood. Umbilical cord blood heavy metals and trace elements concentrations were determined by inductively coupled plasma-mass spectrometry. No differences with statistical significance in the median arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), strontium (Sr), thallium (Tl), vanadium (V), and zinc (Zn) concentrations were observed between the adverse pregnancy outcome group and the reference group. Titanium (Ti) and antimony (Sb) were found at higher levels with statistical significance in the cord blood samples with adverse pregnancy group when compared to the ones in the reference group. The association between Ti levels and the risk of adverse pregnancy outcomes remained significant after adjusting for potential confounding factors, including newborn weight. These results indicated that environmental exposure to Ti may increase the risk of adverse pregnancy outcomes in Chinese women without occupational exposure.