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1.
BMC Pregnancy Childbirth ; 21(1): 688, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627184

RESUMO

BACKGROUND: Fetal growth velocity standards have yet to be established for the Chinese population. This study aimed to establish such standards suitable for the Chinese population. METHODS: We performed a multicenter, population-based longitudinal cohort study including 9075 low-risk singleton pregnant women. Data were collected from the clinical records of 24 hospitals in 18 provinces of China. Demographic characteristics, reproductive history, fetal ultrasound measurements, and perinatal outcome data were collected. The fetal ultrasound measurements included biparietal diameter (BPD), abdominal circumference (AC), head circumference (HC), and femur diaphysis length (FDL). We used linear mixed models with cubic splines to model the trajectory of four ultrasound parameters and estimate fetal weight. Fetal growth velocity was determined by calculating the first derivative of fetal size curves. We also used logistic regression to estimate the association between fetal growth velocities in the bottom 10th percentile and adverse perinatal outcomes. RESULTS: Fetal growth velocity was not consistent over time or among individuals. The estimated fetal weight (EFW) steadily increased beginning at 12 gestational weeks and peaked at 35 gestational weeks. The maximum velocity was 211.71 g/week, and there was a steady decrease in velocity from 35 to 40 gestational weeks. The four ultrasound measurements increased in the early second trimester; BPD and HC peaked at 13 gestational weeks, AC at 14 gestational weeks, and FDL at 15 gestational weeks. BPD and HC also increased from 19 to 24 and 19 to 21 gestational weeks, respectively. EFW velocity in the bottom 10th percentile indicated higher risks of neonatal complications (odds ratio [OR] = 2.23, 95% confidence interval [CI]: 1.79-2.78) and preterm birth < 37 weeks (OR = 3.68, 95% CI: 2.64-5.14). Sensitivity analyses showed that EFW velocity in the bottom 10th percentile was significantly associated with more adverse pregnancy outcomes for appropriate-for-gestational age neonates. CONCLUSIONS: We established fetal growth velocity curves for the Chinese population based on real-world clinical data. Our findings demonstrated that Chinese fetal growth patterns are somewhat different from those of other populations. Fetal growth velocity could provide more information to understand the risk of adverse perinatal outcomes, especially for appropriate-for-gestational age neonates.

3.
Adv Sci (Weinh) ; 8(18): e2101462, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34337898

RESUMO

Alzheimer's disease (AD) is a progressive neurodegenerative disease with no cure. Huge efforts have been made to develop anti-AD drugs in the past decades. However, all drug development programs for disease-modifying therapies have failed. Possible reasons for the high failure rate include incomplete understanding of complex pathophysiology of AD, especially sporadic AD (sAD), and species difference between humans and animal models used in preclinical studies. In this study, sAD is modeled using human induced pluripotent stem cell (hiPSC)-derived 3D brain organoids. Because the blood-brain barrier (BBB) leakage is a well-known risk factor for AD, brain organoids are exposed to human serum to mimic the serum exposure consequence of BBB breakdown in AD patient brains. The serum-exposed brain organoids are able to recapitulate AD-like pathologies, including increased amyloid beta (Aß) aggregates and phosphorylated microtubule-associated tau protein (p-Tau) level, synaptic loss, and impaired neural network. Serum exposure increases Aß and p-Tau levels through inducing beta-secretase 1 (BACE) and glycogen synthase kinase-3 alpha / beta (GSK3α/ß) levels, respectively. In addition, single-cell transcriptomic analysis of brain organoids reveals that serum exposure reduced synaptic function in both neurons and astrocytes and induced immune response in astrocytes. The human brain organoid-based sAD model established in this study can provide a powerful platform for both mechanistic study and therapeutic development in the future.

4.
Signal Transduct Target Ther ; 6(1): 289, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34326311

RESUMO

Pregnant women are generally more susceptible to viral infection. Although the impact of SARS-CoV-2 in pregnancy remains to be determined, evidence indicates that the risk factors for severe COVID-19 are similar in pregnancy to the general population. Here we systemically analyzed the clinical characteristics of pregnant and non-pregnant female COVID-19 patients who were hospitalized during the same period and found that pregnant patients developed marked lymphopenia and higher inflammation evident by higher C-reactive protein and IL-6. To elucidate the pathways that might contribute to immunopathology or protective immunity against COVID-19 during pregnancy, we applied single-cell mRNA sequencing to profile peripheral blood mononuclear cells from four pregnant and six non-pregnant female patients after recovery along with four pregnant and three non-pregnant healthy donors. We found normal clonal expansion of T cells in the pregnant patients, heightened activation and chemotaxis in NK, NKT, and MAIT cells, and differential interferon responses in the monocyte compartment. Our data present a unique feature in both innate and adaptive immune responses in pregnant patients recovered from COVID-19.


Assuntos
Imunidade Adaptativa , COVID-19/imunologia , Imunidade Inata , Linfócitos/imunologia , Complicações Infecciosas na Gravidez/imunologia , SARS-CoV-2/imunologia , Adulto , Proteína C-Reativa/imunologia , Feminino , Humanos , Interleucina-6/imunologia , Gravidez , Estudos Retrospectivos , Análise de Sequência de RNA , Análise de Célula Única
5.
BMC Psychiatry ; 21(1): 327, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215220

RESUMO

BACKGROUND: The COVID-19 pandemic and relevant prevention and control measures may affect the mental health and induce depressive symptoms in fathers with concurrent partner delivery exposure. This study aims to investigate the prevalence of depression in fathers with simultaneous exposure to COVID-19 pandemic and the effects of family functions on paternal perinatal depression (PPD) risk. METHODS: A cross-sectional study was conducted among the perinatal fathers recruited in a large tertiary hospital in Wuhan across the whole pandemic period from 31 December 2019 to 11 April 2020. Edinburgh Postnatal Depression Scale (EPDS) and APGAR family function scale were used to evaluate PPD and family function, respectively. Chi-square test and multivariable-adjusted logistic regression model were applied for data analysis. RESULTS: Among the 1187 participants, the prevalence of PPD was 13.82% throughout the COVID-19 pandemic. Compared with that in the time period before the announcement of human-to-human transmission on 19 January 2020, the depression risk was significantly lower during the traffic restriction (OR = 0.54, 95% CI: 0.34, 0.86) and public transportation reopening periods (OR = 0.29, 95% CI: 0.14, 0.59). Poor/fair family functions was associated with elevated depression risk (OR = 2.93, 95% CI: 1.90, 4.52). Individuals reporting a low family income and smoking had high depression risks. CONCLUSIONS: A declined risk of PPD was observed over the traffic restriction period of the COVID-19 pandemic. An improved family function may help alleviate the risk of PPD during the pandemic. Health authorities are recommended to formulate targeted prevention and control strategies to handle PPD.


Assuntos
COVID-19 , Depressão Pós-Parto , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão Pós-Parto/epidemiologia , Pai , Feminino , Humanos , Masculino , Pandemias , Gravidez , Prevalência , Medição de Risco , Fatores de Risco , SARS-CoV-2
6.
Artigo em Inglês | MEDLINE | ID: mdl-34110053

RESUMO

The objectives of this study were to investigate the relationship between the in vitro ruminal ammonia nitrogen (NH3 -N) concentration and the Cornell Net Carbohydrate and Protein System (CNCPS) N-fractions of feeds for cattle and further compare the performance of developing multiple linear regression (MLR) and artificial neural network (ANN) models in estimating the NH3 -N concentration in rumen fermentation. Two data sets were established, of which the training data set containing forty-five rations for cattle with concentrate/roughage ratios of 50:50, 40:60, 30:70, 20:80 and 10:90 used for developing models and the test data set containing ten other rations with the same concentrate/roughage ratios with the training data set were used for validating of models. The NH3 -N concentrations of feed samples were measured using an in vitro incubation technique. The CNCPS N-fractions (g), for example PB1 (rapidly degraded true protein), PB2 (neutral detergent soluble nitrogen), PB3 (acid detergent soluble nitrogen) of rations, were calculated based on chemical analysis. Statistical analysis indicated that the NH3 -N concentration (mg) was significantly correlated with the CNCPS N-fractions (g) PB1 , PB2 and PB3 in a multiple linear pattern: NH3 -N = (130.70±33.80) PB1  + (155.83±17.89) PB2 - (85.44±37.69) PB3  + (42.43±1.05), R2  = 0.77, p < 0.0001, n = 45. The results indicated that both MLR and ANN models were suitable for predicting in vitro NH3 -N concentration of rations using CNCPS N-fractions PB1 , PB2 , and PB3 as independent variables while the neural network model showed better performance in terms of greater r2 , CCC and lower RMSPE between the observed and predicted values.

7.
Am J Clin Nutr ; 114(3): 1100-1106, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34019623

RESUMO

BACKGROUND: The association between iron supplementation and gestational diabetes mellitus (GDM) is still inconclusive, and this association has not been extensively studied in relation to plasma ferritin in the early second trimester. OBJECTIVES: We aimed to prospectively examine the independent and combined associations of plasma ferritin concentrations and iron supplement use with GDM. METHODS: We studied 2117 women from the Tongji Maternal and Child Health Cohort in Wuhan, China. Plasma ferritin around 16 weeks' gestation was measured by ELISA kits and information on iron supplement use was collected by questionnaires. GDM was diagnosed by a 75-g oral-glucose-tolerance test (OGTT) at 24-28 weeks' gestation. A log-Poisson regression model was used to estimate the RR of GDM associated with plasma ferritin and iron supplementation. RESULTS: The median and IQR of plasma ferritin was 52.1 (29.6-89.9) ng/mL, and 863 (40.8%) participants reported use of iron supplements during the second trimester. A total of 219 (10.3%) participants developed GDM. Adjusted RRs (95% CIs) for GDM across increasing quartiles of plasma ferritin were 1.00 (reference), 2.14 (1.37, 3.34), 2.03 (1.30, 3.19), and 2.72 (1.76, 4.21), respectively. After adjustment, supplemental iron ≥60 mg/d during the second trimester was associated with an increased risk of GDM compared with nonusers (RR: 1.37; 95% CI: 1.02, 1.84). CONCLUSIONS: Both elevated plasma ferritin concentrations in the early second trimester and use of ≥60 mg/d of supplemental iron during pregnancy are independently associated with increased risk of GDM. Further clinical trials with precision nutrition approaches considering both baseline iron status and supplement use are needed to evaluate the benefits and risks of iron supplementation during pregnancy.


Assuntos
Diabetes Gestacional/prevenção & controle , Suplementos Nutricionais/efeitos adversos , Ferritinas/sangue , Ferro/administração & dosagem , Fenômenos Fisiológicos da Nutrição Pré-Natal , Adulto , Estudos de Coortes , Feminino , Humanos , Ferro/efeitos adversos , Gravidez , Estudos Prospectivos
8.
Biomed Pharmacother ; 140: 111706, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34004512

RESUMO

Circular RNA (circRNA) is a general term for a type of single-stranded RNAs, they are primarily generated via exon back-splice process in precursor mRNAs (pre-mRNAs). circRNAs refer to an emerging type of endogeneity-correlated closed molecules of RNA in a covalent manner. They mainly function as microRNA sponges, protein brackets, and regulatory element in transcription and splicing process. Recently, it has also starting been noticed that they serve as extraordinary models involved in polypeptides producing process. Although circRNAs have been extensively studied, their function in thyroid carcinoma is still lacking. Thus, we present the latest advances in circRNA research and summarize their fundamental rules of regulating process as well as the mechanism. More importantly, We mainly review the role and mechanism of circRNA in thyroid cancer, which provides an emerging perspective and theoretically supports the treatment of thyroid cancer.


Assuntos
RNA Circular , Neoplasias da Glândula Tireoide/genética , Animais , Humanos
9.
Diabetes Res Clin Pract ; 176: 108853, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33961900

RESUMO

AIMS: Iron supplementation has been recommended for healthy pregnancy, but concerns have been raised regarding the potential adverse effects. We sought to examine the impact of periconceptional iron supplement use on subsequent gestational diabetes mellitus (GDM) risk. METHODS: Participants (N = 5101) with information on periconceptional micronutrient supplementation and diagnosis of GDM were involved. Information on iron supplementation and general characteristics were collected at enrollment and follow-up visits. GDM was diagnosed by oral glucose tolerance tests (OGTT) conducted at 24-28 weeks of gestation. Robust Poisson regression model was used to estimate the relative risks (RRs) and 95% confidence intervals (CI) for the effect of iron supplement use on GDM. RESULTS: 10.5% of the participants were diagnosed with GDM and the incidence was significantly higher in users with iron >30 mg/d for more than 3 months (Iron >30-L) than in nonusers. Adjusted RRs (95% CI) were 1.53 (1.21, 1.93) in Iron >30-L group, 1.14 (0.80, 1.61) in users with iron >30 mg/d for<3 months (Iron > 30-S) and 1.15 (0.86, 1.54) in users with iron ≤30 mg/d for any duration (Iron ≤30) respectively, compared to nonusers. This link in Iron >30-L group was even stronger (adjusted RR: 1.70, 95% CI: 1.25, 2.31) when restricting the analysis among primiparous and iron-replete participants without family history of diabetes. There were no significant differences in birth outcomes among groups. CONCLUSIONS: Periconceptional iron supplementation >30 mg/d for long-term was associated with increased GDM risk. The need and safety of prophylactic iron supplement in iron-replete pregnant women should be reconsidered.


Assuntos
Anemia Ferropriva/prevenção & controle , Diabetes Gestacional/epidemiologia , Ferro/uso terapêutico , Complicações Hematológicas na Gravidez/prevenção & controle , Adulto , Anemia Ferropriva/epidemiologia , Quimioprevenção/métodos , Quimioprevenção/estatística & dados numéricos , China/epidemiologia , Estudos de Coortes , Diabetes Gestacional/etiologia , Suplementos Nutricionais , Feminino , Teste de Tolerância a Glucose , Humanos , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/estatística & dados numéricos , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
10.
Biochem Pharmacol ; 190: 114594, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33964281

RESUMO

Hippocampal neurogenesis is known to be related to depressive symptoms. Increasing evidence indicates that Wnt/ß-catenin signaling regulates multiple aspects of adult hippocampal neurogenesis. Baicalin is a major flavonoid compound with multiple pharmacological effects such as anti-inflammatory, anti-apoptotic, and neuroprotective effects. The current study aimed to explore the antidepressant effects of baicalin and its possible molecular mechanisms affecting hippocampal neurogenesis via the regulation of the Wnt/ß-catenin signaling pathway. A chronic mild unpredictable stress (CUMS) model of depression was used in the study. The CUMS-induced mice were treated with baicalin (50 and 100 mg/kg) for 21 days, orally, and the fluoxetine was used as positive control drug. The results indicated that baicalin alleviated CUMS-induced depression-like behaviour, and improved the nerve cells' survival of the hippocampal dentate gyrus (DG) in CUMS-induced depression of model mice and increased Ki-67- and doublecortin (DCX)-positive cells to restore CUMS-induced suppression of hippocampal neurogenesis. The related proteins in the Wnt/ß-catenin signaling pathway, which declined in the CUMS-induced depression model of mice, were upregulated after baicalin treatment, including Wingless3a (Wnt3a), dishevelled2 (DVL2), and ß-catenin. Further study found that the phosphorylation rate of glycogen synthase kinase-3ß (GSK3ß) and ß-catenin nuclear translocation increased, as the levels of the ß-catenin target genes cyclinD1, c-myc, NeuroD1, and Ngn2 upregulated after baicalin treatment. In conclusion, these findings suggest that baicalin may promote hippocampal neurogenesis, thereby exerting the antidepressant effect via regulation of the Wnt/ß-catenin signaling pathway.

11.
Clin Nutr ESPEN ; 42: 307-312, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33745597

RESUMO

BACKGROUND: Gestational diabetes mellitus (GDM), body mass index (BMI) and gestational weight gain (GWG) are salient predictors of pregnancy-outcomes. However, findings on the association between GDM, BMI, and GWG with fetal growth measures are limited. OBJECTIVE: The aim of this study was to investigate the effect of GDM on fetal growth measures and birth outcomes. METHODS: All participants came from Tongji Maternal and Child health cohort, in which pregnant women were enrolled before 16 weeks of gestation and had their weights measured regularly during antenatal visits. GDM was diagnosed by oral glucose tolerance test (OGTT) during 24-28 weeks of gestation. Ultrasound measurements of fetal bi-parietal diameters (BPD), head circumferences (HC), abdominal circumferences (AC) and femur length (FL) before birth were collected and neonate outcomes were obtained from the hospital records. Odds ratios were calculated using logistic regression to assess the association of GDM, pre-pregnancy BMI, and GWG with fetal growth measures of ultrasound and birth outcomes, while controlling confounding. RESULTS: Of 3253 singleton pregnant women, 293 (9.0%) were diagnosed with GDM, 357 (11.0%) were overweight before pregnancy, and 1995 (61.3%) had excessive GWG. GDM was associated with decreased intrauterine fetal growth measurements including BPD and AC. Maternal pre-pregnancy overweight was associated with increased fetal HC and neonatal birth weight and length, women gained excessive GWG had increased fetal growth measurements of BPD, HC, AC, FL, neonatal birth weight and length. Offspring of GDM women had increased odds of cesarean section 1.31 (1.03, 1.66) and preterm birth 2.02 (1.05, 3.91) in unadjusted models, but these associations disappeared after adjustment. Compared with neonate born to mothers with normal pre-pregnancy weight, those born to underweight mother had higher risk of SGA, and lower risk of cesarean section, LGA and macrosamia, whereas those born to overweight mother had increased risk of cesarean section, LGA and macrosamia. Compared with neonate born to mothers of adequate GWG, neonate of women with excessive GWG had elevated risk of cesarean section, LGA and macrosamia, but lower risk of preterm birth and SGA. CONCLUSION: Pre-pregnancy BMI, GWG and GDM all associated with fetal growth and birth outcomes. The effect of GDM decreased after adjusting pre-pregnancy BMI and GWG. Early screening and management of GDM, preventing excessive GWG could help protect fetuses of GDM mothers from adverse birth outcomes.


Assuntos
Diabetes Gestacional , Ganho de Peso na Gestação , Nascimento Prematuro , Índice de Massa Corporal , Cesárea , Diabetes Gestacional/epidemiologia , Feminino , Desenvolvimento Fetal , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez
12.
J Electrocardiol ; 65: 66-68, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33549988

RESUMO

Atrial fibrillation (AF) is rarely found in newborns and infants. It is usually associated with some underlying diseases and presents as tachyarrhythmia. Here, we describe a case of AF in a preterm neonate. Paroxysmal AF and multifocal atrial tachycardia had been observed in the postnatal dynamic electrocardiogram. Further investigations revealed patent foramen ovale, pulmonary disease, heart failure and potential viral myocarditis. After receiving antiarrhythmic therapy and supportive treatment, the neonate underwent successful cardioversion and showed favorable outcomes without any recurrence.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Taquicardia Supraventricular , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/cirurgia , Cardioversão Elétrica , Eletrocardiografia , Humanos , Lactente , Recém-Nascido , Recidiva , Taquicardia Supraventricular/tratamento farmacológico , Resultado do Tratamento
13.
Environ Sci Pollut Res Int ; 28(21): 27230-27237, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33506423

RESUMO

Associations between environmental tobacco smoke (ETS) and the risk of adverse birth outcomes may be confounded. We aimed to clarify the associations of ETS before and during pregnancy with the risk of adverse birth outcomes and determine whether the associations were modified by key potential confounders. A total of 7147 non-smoking mothers from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China, were included in the final analyses. ETS status was self-reported by pregnant women at their first antenatal care visit before 16 gestational weeks. Information on birth outcomes was extracted from delivery records. Poisson regression was used to identify the association between ETS before and during pregnancy and the risk of adverse birth outcomes. Exposures to ETS before and during pregnancy were reported by 645 (9.0%) and 464 (6.5%) mothers, respectively. Compared with no ETS, continued ETS during pregnancy was associated with an increased risk of preterm birth (PTB) (RR: 1.55, 95% CI: 1.07, 2.25) after adjustment for potential confounders. The association remained consistent in medically indicated PTB and late PTB. The risk of PTB associated with continued ETS during pregnancy was significantly increased in mothers more educated (P for interaction < 0.05). However, the increased risk of low birth weight (LBW) or small for gestational age (SGA) births by ETS during pregnancy was not observed. Exposure to ETS during pregnancy was associated with a higher risk of PTB, but not LBW or SGA births in a Chinese birth cohort.


Assuntos
Nascimento Prematuro , Poluição por Fumaça de Tabaco , Criança , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Fatores de Risco , Poluição por Fumaça de Tabaco/efeitos adversos
15.
Clin Nutr ; 40(2): 550-559, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32593522

RESUMO

BACKGROUND & AIMS: Emerging evidence has shown the inverse association between dietary polyphenols intake and type 2 diabetes mellitus risk, however, few studies focus on the prospective effects of polyphenols on gestational diabetes mellitus (GDM). Thus, the aim was to evaluate whether higher polyphenols intake and the intake from fruits and vegetables was correlated to a lower risk of GDM. METHODS: Dietary intake of polyphenols of women with a singleton pregnancy and without any history of diabetes were obtained by a validated food frequency questionnaire from Tongji Maternal and Child Health Cohort study. Oral glucose tolerance tests were conducted at 24-28 weeks to screen for GDM. Logistic regression models were used to evaluate the association between dietary intake of polyphenols, and the results were presented as odds ratios (ORs) with 95% confidence interval (CIs). Generalized linear models were adopted to determine the association of polyphenols intake with blood glucose concentrations, and the results were presented as coefficients (ß) with 95% CIs. RESULTS: 185 (8.3%) of 2231 pregnant women were diagnosed with GDM. The intake of total polyphenols was 319.9 (217.8-427.0) mg/d, and the intake from fruits and vegetables was 201.6 (115.3-281.8) mg/d and 63.2 (41.1-92.7) mg/d, respectively. Compared with the lowest quartile, the adjusted ORs (95% CIs) of GDM risk for women with the highest quartile of total polyphenols and flavonoids intake was 0.55 (0.30, 0.99), and 0.57 (0.32, 0.99). The adjusted ORs (95% CIs) of GDM risk was 0.55 0.51 (0.30, 0.87) (Pfor trend = 0.017) for polyphenols from fruits, 0.58 (0.34, 0.99) (Pfor trend = 0.038) for flavonoids from fruits, and 0.62 (0.38, 1.00) (Pfor trend = 0.065) for anthocyanidins from fruits comparing the highest versus lowest quartile. In addition, each 100 mg increase of total polyphenols and polyphenols from fruits was associated with 0.054 (0.008, 0.096) (P = 0.021) and 0.061 (0.012, 0.109) (P = 0.015) decrease in 2-h post-load blood glucose. No significant association was found between total polyphenols from vegetables intake and the risk of GDM. CONCLUSIONS: Higher dietary intake of total polyphenols and flavonoids and the intake from fruits was associated with lower GDM risk. This study was registered at clinicaltrials.gov as NCT03099837.

16.
BMC Pregnancy Childbirth ; 20(1): 715, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33228631

RESUMO

BACKGROUND: Few studies have focused on cesarean delivery (CD) trends among primipara under the one-child and the two-child policies. This study aimed to explore the trends in CD rates among primipara during 1995-2019 and the associated factors with CD risk. METHODS: This study obtained clinical data on primiparous mothers and newborns from 1995 to 2019 at a large tertiary hospital in Wuhan, China. Trends in CD rates were calculated using the joinpoint regression analysis. The Chi-square tests and log-binomial regression analyses were used to evaluate the associations between primary variables and CD risk. RESULTS: CD rates showed a significant upward trend with an average annual percentage change (APC) of 2.2% (95% CI: 0.6, 3.8%) during the study period. In 1995-2006, the CD rates continued to increase with an APC of 7.8% (95% CI: 4.8, 10.9%). After 2006, the CD rates started to decline by an APC of - 4.1% (95% CI: - 5.5, - 2.6%). The CD rates non-significantly increased from 36.2% in 2016 to 43.2% in 2019. Moreover, the highest CD rate during 2015-2019 was observed on August 30 (59.2%) and the lowest on September 1 (29.7%). Primipara of older age and those with >3pregnancies had higher risks of CD. Furthermore, primipara who gave birth to newborns with low birth weight and macrosomia had higher risks of CD. CONCLUSIONS: Maternal and fetal as well as social and cultural factors may contribute to the rising trend of CD rates. Effective measures should be taken to control CD under the two-child policy, especially for primipara.


Assuntos
Cesárea/tendências , Peso Fetal , Idade Materna , Paridade , Adulto , Distribuição de Qui-Quadrado , China/epidemiologia , Política de Planejamento Familiar , Feminino , Macrossomia Fetal/epidemiologia , Humanos , Recém-Nascido , Masculino , Gravidez , Análise de Regressão , Fatores de Risco , Centros de Atenção Terciária , Adulto Jovem
17.
BMJ Open ; 10(11): e043461, 2020 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-33203639

RESUMO

OBJECTIVES: This study described the needs of pregnant women and the contents of online obstetric consultation in representative areas with various severity of the epidemic in China. DESIGN: This was a cross- sectional study. SETTING: Yue Yi Tong (YYT), a free online communication platform that allows pregnant women to consult professional obstetricians. PARTICIPANTS: All the pregnant women who used the YYT platform. INTERVENTION: From 10 to 23 February, we collected data on online obstetric consultations and participants' satisfaction through the YYT platform in the mild, moderate and severe epidemic areas which were defined according to the local confirmed cases. The primary outcomes were the reasons for online consultations by the severity of the epidemic. All the comparisons were performed using χ2 test. Statistical analysis was performed using SPSS V.24. RESULTS: A total of 2599 pregnant women participated in this study, of whom 448 (17.24%), 1332 (51.25%) and 819 (31.51%) were from the mild, moderate and severe epidemic areas, respectively. The distribution of the amount of online consultations was significantly different not only in different areas (p<0.001) but also in different trimesters (p<0.001). A total of 957 participants completed the satisfaction part of the survey. In this study, 77.95% of the participants used e-health for the first time, and 94.63% of the participants were completely or mostly satisfied with the online consultations. CONCLUSIONS: The distribution of the amount of online consultations was significantly different not only in different areas but also in different trimesters. In any trimester, the amount of consultations on the second category (obstetric care-seeking behaviour) was the highest in the severe epidemic areas. The needs for online consultations were substantial. In order to prevent irreversible obstetric adverse events, an appropriate antenatal care contingency plan with e-health services is highly recommended during the Public Health Emergency of International Concern.


Assuntos
COVID-19/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal/métodos , Saúde Pública , Encaminhamento e Consulta/organização & administração , SARS-CoV-2 , Telemedicina/métodos , Adulto , Estudos Transversais , Feminino , Humanos , Pandemias , Gravidez , Adulto Jovem
18.
J Healthc Eng ; 2020: 9465019, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33149872

RESUMO

Excessive use of mobile phones might bring negative physical and psychological consequences to pregnant women. This study aims to explore the potential determinants of pregnant women's mobile phone use behavior to assist healthcare providers in the development of guideline programs. In order to explain the behavior, we developed a theoretical model based on the widely applied theory of planned behavior (TPB) by incorporating two additional constructs of personal habit and perceived risk. Structural equation modeling technique is employed to estimate the model based on questionnaire survey. Research results clearly show that behavior attitude and perceived behavior control play dominant roles in determining the intention and behavior. It is interesting to find that perceived risk and personal habit are less important in determining pregnant women's behavior of mobile phone use. Finally, suggestions are put forward to reduce the risk of mobile phone use during pregnancy.

19.
Cell Rep Med ; 1(1): 100002, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33205055

RESUMO

Although congenital infection by human cytomegalovirus (HCMV) is well recognized as a leading cause of neurodevelopmental defects, HCMV neuropathogenesis remains poorly understood. A major challenge for investigating HCMV-induced abnormal brain development is the strict CMV species specificity, which prevents the use of animal models to directly study brain defects caused by HCMV. We show that infection of human-induced pluripotent-stem-cell-derived brain organoids by a "clinical-like" HCMV strain results in reduced brain organoid growth, impaired formation of cortical layers, and abnormal calcium signaling and neural network activity. Moreover, we show that the impeded brain organoid development caused by HCMV can be prevented by neutralizing antibodies (NAbs) that recognize the HCMV pentamer complex. These results demonstrate in a three-dimensional cellular biosystem that HCMV can impair the development and function of the human brain and provide insights into the potential capacity of NAbs to mitigate brain defects resulted from HCMV infection.

20.
BMC Pregnancy Childbirth ; 20(1): 580, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008308

RESUMO

BACKGROUND: During the ongoing global outbreak of COVID-19, pregnant women who are susceptible to COVID-19 should be highly concerned. The issue of vertical transmission and the possibility of neonatal infection is a major concern. CASE PRESENTATION: Case 1: A 35-year-old pregnant woman with a gestational age of 37 weeks and 6 days was admitted to our hospital at the point of giving birth. Except for the abnormalities in her chest CT image, she was asymptomatic. She had an uncomplicated spontaneous vaginal delivery, and her infant was discharged home for isolation. Because of the positive result of the maternal swabs for SARS-CoV-2 obtained on the 2nd day after sampling, we transferred the mother to the designated hospital and followed up with her by telephone interviews. Luckily, it was confirmed on February 23 that the newborn did not develop any COVID-19 symptoms after observation for 14 days after birth. Case 2: Another pregnant woman, with a gestational age of 38 weeks and 2 days, was also admitted to our hospital because of spontaneous labor with cervical dilation of 5 cm. Since she had the typical manifestations of COVID-19, including cough, lymphopenia, and abnormal chest CT images, she was highly suspected of having COVID-19. Based on the experience from case 1, we helped the mother deliver a healthy baby by vaginal delivery. On the 2nd day after delivery, the maternal nasopharyngeal swab result was positive, while the infant's result was negative. CONCLUSION: There is still insufficient evidence supporting maternal-fetal vertical transmission for COVID-19-infected mothers in late pregnancy, and vaginal delivery may not increase the possibility of neonatal infection.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/diagnóstico , Parto Obstétrico/métodos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Aleitamento Materno , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/terapia , Tosse , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Idade Gestacional , Humanos , Linfopenia , Máscaras , Oxigenoterapia , Pandemias , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/terapia , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2 , Testes Sorológicos , Tomografia Computadorizada por Raios X
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