Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 551
Filtrar
1.
Medicine (Baltimore) ; 100(21): e26106, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032751

RESUMO

BACKGROUND: There is limited study that has conducted a review investigating the clinical effects of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with gestational diabetes mellitus (GDM). Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness and safety of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with GDM. METHODS: This protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. We will conduct systematic reviews and meta-analyses to identify relevant randomized controlled trials (RCTs) involving vitamin and omega-3 fatty acid co-supplementation on GDM in electronic databases including PubMed, Web of Science, Embase, and the Cochrane Library up to June 2021. Exclusion criteria include observational studies, non-RCTs, review articles, studies with a sample size <50, and studies with insufficient outcome data. The primary outcomes include fasting glucose and insulin. Secondary outcomes are evaluated in a homeostasis model of insulin resistance, total antioxidant capacity, triglycerides, total cholesterol, low-density lipoprotein cholesterol, preterm birth and macrosomia over 4 kg. RESULTS: The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. REGISTRATION NUMBER: 10.17605/OSF.IO/NSW54.


Assuntos
Diabetes Gestacional/dietoterapia , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Vitaminas/administração & dosagem , Glicemia/análise , Diabetes Gestacional/sangue , Diabetes Gestacional/diagnóstico , Feminino , Macrossomia Fetal/sangue , Macrossomia Fetal/epidemiologia , Macrossomia Fetal/etiologia , Macrossomia Fetal/prevenção & controle , Humanos , Recém-Nascido , Insulina/sangue , Metanálise como Assunto , Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Nascimento Prematuro/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Resultado do Tratamento
2.
Ecotoxicol Environ Saf ; 217: 112228, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33892343

RESUMO

The relationship between maternal mercury (Hg) intake and the risk of spontaneous preterm birth (SPB) remains unclear. We conducted a nested case-control study from a prospective cohort in Shanxi Province, China, to explore their associations. In total, 126 pregnant women with SPB (cases) and 348 controls with term delivery were included. We measured the Hg concentrations in their serum (Hgs) and blood cell (Hgc) fractions and calculated the concentration ratio of Hg in serum to Hg in blood cells (Hgs/c). We found that only the Hgs/c in the case group was slightly higher than that in control group. The OR of Hgs/c associated with SPB risk was 1.57 [95%CI: 0.99-2.46] with adjusting confounders. After stratification by sampling time, the association above was only statistically significant in the first trimester. High Hgs/c may increase the risk of SPB in the first trimester among women with relatively low Hg exposure.


Assuntos
Poluentes Ambientais/sangue , Exposição Materna/estatística & dados numéricos , Mercúrio/sangue , Nascimento Prematuro/sangue , Adulto , Células Sanguíneas , Estudos de Casos e Controles , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Prospectivos
3.
Int J Mol Sci ; 22(3)2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33572712

RESUMO

Adiponectin is an adipocyte-derived hormone that plays a critical role in energy homeostasis, mainly attributed to its insulin-sensitizing properties. Accumulating studies have reported that adiponectin concentrations are decreased during metabolic diseases, such as obesity and type 2 diabetes, with an emerging body of evidence providing support for its use as a biomarker for pregnancy complications. The identification of maternal factors that could predict the outcome of compromised pregnancies could act as valuable tools that allow the early recognition of high-risk pregnancies, facilitating close follow-up and prevention of pregnancy complications in mother and child. In this review we consider the role of adiponectin as a potential biomarker of disorders associated with pregnancy. We discuss common disorders associated with pregnancy (gestational diabetes mellitus, preeclampsia, preterm birth and abnormal intrauterine growth) and highlight studies that have investigated the potential of adiponectin to serve as biomarkers for these disorders. We conclude the review by recommending strategies to consider for future research.


Assuntos
Adiponectina/sangue , Complicações na Gravidez/sangue , Adiponectina/metabolismo , Animais , Biomarcadores/sangue , Biomarcadores/metabolismo , Diabetes Gestacional/sangue , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/metabolismo , Feminino , Humanos , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/metabolismo , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/metabolismo , Resultado da Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/metabolismo , Transdução de Sinais
4.
Zhonghua Fu Chan Ke Za Zhi ; 56(1): 58-63, 2021 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-33486929

RESUMO

Objective: To conduct a systematic review of the association of levothyroxine treatment with pregnancy outcomes in euthyroid women who are thyroid autoantibody positive. Methods: Medline, Excerpta Medica (EMBASE), Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wanfang data and VIP database were searched from inception until Jan. 28, 2020. All published randomized controlled trials assessing the association of levothyroxine treatment with pregnancy outcomes in euthyroid women with thyroid autoantibody-positive were included. STATA 11.0 and RevMan 5.3 softwares were used to perform this Meta-analysis. Results: A total of 6 studies met the inclusion criteria, with 2 188 women randomized. Meta-analysis showed that there was no significantly association between miscarriage (OR=0.85, 95%CI: 0.65-1.11, P=0.234) and preterm birth (OR=0.79, 95%CI: 0.54-1.16, P=0.224) with levothyroxine treatment. Conclusions: Levothyroxine therapy could not reduce the risk of miscarriage and preterm birth in euthyroid women with thyroid autoantibody-positive. Therefore, levothyroxine should be used with caution for these pregnant women.


Assuntos
Autoanticorpos/sangue , Hipotireoidismo/tratamento farmacológico , Nascimento Prematuro/prevenção & controle , Tireotropina/sangue , Tiroxina/uso terapêutico , Autoanticorpos/fisiologia , China , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez , Resultado da Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/epidemiologia , Tiroxina/administração & dosagem , Tiroxina/efeitos adversos , Tiroxina/sangue , Resultado do Tratamento
5.
Int J Mol Sci ; 22(2)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429954

RESUMO

Previous studies have described increased circulating cell-free DNA (cfDNA) in hypertensive disorders of pregnancy (HDP). Here, we aimed first to confirm this information using a simple, but sensible fluorescent assay, and second to investigate whether total cfDNA is associated with circulating factors known to be linked to the pathophysiology of HDP as well as with poor maternal-fetal outcomes. We studied 98 women with healthy pregnancies (HP), 88 with gestational hypertension (GH), and 91 with preeclampsia (PE). Total DNA was extracted from plasma using the QIAamp DNA blood mini kit and quantified using Quant-iT™ PicoGreen® dsDNA fluorescent detection kit. We found higher total cfDNA levels in GH and PE (197.0 and 174.2 ng/mL, respectively) than in HP (140.5 ng/mL; both p < 0.0001). Interestingly, total cfDNA levels were elevated in both male and female-bearing pregnancies diagnosed with either HDP, and in more severe versus less severe HDP cases, as classified according to responsiveness to antihypertensive therapy. In addition, total cfDNA was independently associated with HDP, and a cutoff concentration of 160 ng/mL provided appropriate sensitivity and specificity values for diagnosing GH and PE compared to HP (70-85%, both p < 0.0001). Moreover, high total cfDNA was associated with adverse clinical outcomes (high blood pressure, low platelet count, preterm delivery, fetal growth restriction) and high prohypertensive factors (sFLT-1, sEndoglin, MMP-2). These findings represent a step towards to the establishment of cfDNA as a diagnostic tool and the need to understand its role in HDP.


Assuntos
Ácidos Nucleicos Livres/sangue , DNA/sangue , Hipertensão Induzida pela Gravidez/sangue , Hipertensão/sangue , Adulto , Endoglina/sangue , Feminino , Retardo do Crescimento Fetal/sangue , Retardo do Crescimento Fetal/patologia , Humanos , Hipertensão/patologia , Hipertensão Induzida pela Gravidez/patologia , Metaloproteinase 2 da Matriz/sangue , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/patologia , Gravidez , Primeiro Trimestre da Gravidez/sangue , Nascimento Prematuro/sangue , Nascimento Prematuro/patologia , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue
7.
PLoS One ; 15(6): e0235162, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584913

RESUMO

BACKGROUND: Preterm birth is the leading cause of neonatal and child mortality worldwide. Maternal HIV infection and antiretroviral treatment (ART) increase the rate of preterm birth, but the underlying mechanisms remain unknown, limiting progress in prediction, prevention and treatment. While overall γδ T cell levels remain constant, acute HIV infection is associated with a depletion of the Vδ2 subset and an increase in the Vδ1 subset, which do not return to baseline with ART. γδ T cells have also been implicated in adverse pregnancy outcomes and we therefore investigated the potential association between maternal HIV infection, peripheral γδ T cell frequencies and preterm birth. METHODS: Study participants were HIV positive (n = 47) and HIV negative (n = 45) women enrolled in a prospective pregnancy cohort study at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa. Women were enrolled in early pregnancy and gestational age was accurately determined by first trimester ultrasound scan. Peripheral blood samples were collected in each trimester and peripheral blood mononuclear cells isolated. Frequencies of γδ T cells, Vδ1+ and Vδ2+ γδ T cell subsets, and CCR6 chemokine receptor expression were determined by flow cytometry. RESULTS: Total γδ T cell levels were similar between HIV positive and HIV negative women throughout pregnancy. However, in each trimester maternal HIV infection was associated with reduced levels of the Vδ2+ subset and increased levels of the Vδ1+ subset, leading to a reversal of the Vδ1/Vδ2 ratio. Timing of ART initiation among HIV positive women did not affect levels of γδ T cells, the Vδ1+ and Vδ2+ subsets, or the Vδ1/Vδ2 ratio. Importantly, preterm birth was associated with lower total γδ T cell levels in early pregnancy and γδ T cell frequencies were lowest in HIV positive women who delivered preterm. Moreover, in the first trimester the proportion of Vδ1+ T cells that were CCR6+ was significantly reduced in HIV+ women and women who delivered preterm, resulting in the lowest proportion of CCR6+ Vδ1 T cells in HIV positive women who delivered preterm. CONCLUSIONS: Our findings suggest that altered γδ T cell frequencies may link maternal HIV infection and preterm birth. γδ T cell frequencies in early pregnancy may serve as predictive biomarkers to identify women at risk of delivering preterm.


Assuntos
Infecções por HIV/sangue , HIV-1 , Nascimento Prematuro/sangue , Receptores de Antígenos de Linfócitos T gama-delta/sangue , Linfócitos T/metabolismo , Adulto , Biomarcadores/sangue , Feminino , Citometria de Fluxo , Infecções por HIV/tratamento farmacológico , Humanos , Imunossupressão , Gravidez , Complicações Infecciosas na Gravidez , Receptores CCR6/sangue , África do Sul
8.
Nat Commun ; 11(1): 2111, 2020 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-32355283

RESUMO

Preterm birth (PTB) is the leading cause of perinatal mortality and newborn complications. Bile acids are recognized as signaling molecules regulating a myriad of cellular and metabolic activities but have not been etiologically linked to PTB. In this study, a hospital-based cohort study with 36,755 pregnant women is conducted. We find that serum total bile acid levels directly correlate with the PTB rates regardless of the characteristics of the subjects and etiologies of liver disorders. Consistent with the findings from pregnant women, PTB is successfully reproduced in mice with liver injuries and dysregulated bile acids. More importantly, bile acids dose-dependently induce PTB with minimal hepatotoxicity. Furthermore, restoring bile acid homeostasis by farnesoid X receptor activation markedly reduces PTB and dramatically improves newborn survival rates. The findings thus establish an etiologic link between bile acids and PTB, and open an avenue for developing etiology-based therapies to prevent or delay PTB.


Assuntos
Ácidos e Sais Biliares/sangue , Nascimento Prematuro/epidemiologia , Adolescente , Adulto , Animais , Tetracloreto de Carbono , Ácido Cólico/metabolismo , Modelos Animais de Doenças , Feminino , Hospitais , Humanos , Recém-Nascido , Hepatopatias/epidemiologia , Masculino , Camundongos , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Gravidez , Resultado da Gravidez , Prenhez , Nascimento Prematuro/sangue , Estudos Prospectivos , Transdução de Sinais , Adulto Jovem
9.
PLoS One ; 15(5): e0232634, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469905

RESUMO

OBJECTIVE: During pregnancy, inhibin A is mainly derived from the placenta and regulates the implantation and differentiation of embryos. Our aim was to assess whether second trimester serum inhibin A was associated with an increased risk of adverse pregnancy outcomes. METHODS: We investigated the serum levels of Inhibin A during the second trimester in pregnancy, and analyzed associations between the Inhibin A and the risk of adverse pregnancy outcome. 12,124 pregnant women were enrolled in this study between January 2017 and July 2019 at the Obstetrics & Gynecology Hospital of Fudan University. Multivariate logistic regression analysis was conducted to estimate the relative risk between Inhibin A and adverse pregnancy outcome. RESULTS: Compared with the group without adverse pregnancy outcome, during the second trimester of pregnancy, age and Inhibin A were risk factors for pre-eclampsia, gestational diabetes mellitus and preterm delivery; Inhibin A was risk factors for low birth weight. Gravidity and Inhibin A were risk factors for macrosomia; while parity was a protective factor against pre-eclampsia, gestational hypertension and low birth weight. CONCLUSION: Elevated Inhibin A levels in pregnancy are significantly associated with pre-eclampsia, GDM, macrosomia, low birth weight and preterm delivery.


Assuntos
Inibinas/sangue , Complicações na Gravidez/epidemiologia , Segundo Trimestre da Gravidez/sangue , Adulto , China/epidemiologia , Diabetes Gestacional/sangue , Diabetes Gestacional/epidemiologia , Feminino , Macrossomia Fetal/sangue , Macrossomia Fetal/epidemiologia , Humanos , Recém-Nascido de Baixo Peso/sangue , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/epidemiologia , Gravidez , Complicações na Gravidez/sangue , Resultado da Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/epidemiologia , Fatores de Risco
10.
Medicine (Baltimore) ; 99(17): e19663, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332610

RESUMO

Hyperglycemia in pregnancy (HIP) is related to adverse pregnancy outcomes. However, women with hyperglycemia in the second and third trimester of pregnancy (HISTTP) were not been observed. We aim to reveal associations between HISTTP and prematurity. To confirm which risk factor is better in predicting preterm delivery.This retrospective study included 660 patients, of which 132 have HISTTP and 528 have euglycemia. Univariate analysis was used to extract risk factors and multivariates logistic regression analysis to obtain odds ratio (OR) for prematurity. Mean decrease gini (MDG) in random forest algorithm was used to rank the risk factors.HISTTP women have higher prepregnancy BMI and a higher percentage of family history of hypertension, maternal adiposity, maternal anemia, gestational diabetes mellitus (GDM), prematurity, neonatal asphyxia in 1-minute (P < .05). Univariate analysis of prematurity showed that preterm women had higher rate of HISTTP (P < .01), second births, elderly pregnancy, hypertention, family history of hypertention and multiple perinatal infant (P < .05). Multivariate logistic regression analysis indicates that HISTTP (OR = 2.984, P = .0017), maternal hypertension (OR = 5.208, P = .001) and multiple perinatal infants (OR = 59.815, P < .0001) are independent risk factors for prematurity. After ranked the MDG, the top 3 risk factors were multiple perinatal infants, maternal hypertension, HISTTP. MDG of HISTTP is higher than that of GDM.Women with HISTTP deserve to be concerned, whose prematurity rate are increased. HISTTP is an independent risk factor and a better predictor of prematurity.


Assuntos
Hiperglicemia/complicações , Adulto , Índice de Massa Corporal , Feminino , Idade Gestacional , Humanos , Hiperglicemia/sangue , Hiperglicemia/fisiopatologia , Recém-Nascido , Modelos Logísticos , Razão de Chances , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/fisiopatologia , Segundo Trimestre da Gravidez/sangue , Segundo Trimestre da Gravidez/metabolismo , Terceiro Trimestre da Gravidez/sangue , Terceiro Trimestre da Gravidez/metabolismo , Nascimento Prematuro/sangue , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas
11.
Sci Rep ; 10(1): 6904, 2020 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-32327682

RESUMO

In the preterm brain, accumulating evidence suggests toll-like receptors (TLRs) are key mediators of the downstream inflammatory pathways triggered by hypoxia-ischemia (HI), which have the potential to exacerbate or ameliorate injury. Recently we demonstrated that central acute administration of the TLR7 agonist Gardiquimod (GDQ) confers neuroprotection in the preterm fetal sheep at 3 days post-asphyxial recovery. However, it is unknown whether GDQ can afford long-term protection. To address this, we examined the long-term effects of GDQ. Briefly, fetal sheep (0.7 gestation) received sham asphyxia or asphyxia induced by umbilical cord occlusion, and were studied for 7 days recovery. Intracerebroventricular (ICV) infusion of GDQ (total dose 3.34 mg) or vehicle was performed from 1-4 hours after asphyxia. GDQ was associated with a robust increase in concentration of tumor necrosis factor-(TNF)-α in the fetal plasma, and interleukin-(IL)-10 in both the fetal plasma and cerebrospinal fluid. GDQ did not significantly change the number of total and immature/mature oligodendrocytes within the periventricular and intragyral white matter. No changes were observed in astroglial and microglial numbers and proliferating cells in both white matter regions. GDQ increased neuronal survival in the CA4 region of the hippocampus, but was associated with exacerbated neuronal injury within the caudate nucleus. In conclusion, our data suggest delayed acute ICV administration of GDQ after severe HI in the developing brain may not support long-term neuroprotection.


Assuntos
Aminoquinolinas/administração & dosagem , Aminoquinolinas/uso terapêutico , Asfixia/embriologia , Encéfalo/patologia , Feto/patologia , Imidazóis/administração & dosagem , Imidazóis/uso terapêutico , Nascimento Prematuro/tratamento farmacológico , Receptor 7 Toll-Like/agonistas , Aminoquinolinas/farmacologia , Animais , Apoptose/efeitos dos fármacos , Pressão Arterial/efeitos dos fármacos , Asfixia/sangue , Asfixia/líquido cefalorraquidiano , Asfixia/fisiopatologia , Gasometria , Peso Corporal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Caspase 3/metabolismo , Polaridade Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Citocinas/sangue , Citocinas/líquido cefalorraquidiano , Feminino , Feto/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Imidazóis/farmacologia , Injeções Intraventriculares , Masculino , Metaboloma/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Neurônios/patologia , Oligodendroglia/efeitos dos fármacos , Oligodendroglia/metabolismo , Oligodendroglia/patologia , Tamanho do Órgão/efeitos dos fármacos , Nascimento Prematuro/sangue , Nascimento Prematuro/líquido cefalorraquidiano , Nascimento Prematuro/fisiopatologia , Ovinos , Fatores de Tempo , Cordão Umbilical/patologia
12.
Pregnancy Hypertens ; 20: 124-130, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32299059

RESUMO

OBJECTIVE: To compare characteristics and outcomes of women with chronic hypertension (cHTN) between those with normal and abnormal plasma angiogenic profiles. STUDY DESIGN: This secondary analysis explored associations between angiogenic markers soluble fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF) drawn prior to delivery among women with history of cHTN who were enrolled between 22 and 41 weeks. Patients were divided into two groups based on sFlt1/PlGF ratio, namely low sFlt1/PlGF (<85) and high sFlt1/PlGF (≥85) ratio. RESULTS: Of the 115 patients, 76% were African American. Compared to women with low sFlt1/PlGF (n = 78), patients with high sFlt1/PlGF (n = 37) had higher median antenatal blood pressures (systolic mmHg 179 vs 155; diastolic 106 vs 91), lower gestational age at delivery (34.7 vs 38.2 weeks), lower birthweight (1940 vs 3103 g), and a higher prevalence of preterm delivery <34 (40.5% vs 7.7%) and <37 weeks (64.9% vs 20.5%), all p < 0.001. Importantly, more women with high sFlt1/PlGF had a diagnosis of superimposed preeclampsia (62.2% vs 26.9%, p = 0.003), preeclampsia with severe features (59.5% vs 20.5%, p < 0.0001), maternal adverse outcomes (24.3% vs 3.9%, p = 0.002), neonatal intensive care unit admissions (71.9% vs 40.8%; p = 0.003), severe postpartum hypertension (67.6% vs 38.5%, p = 0.01) and longer hospital stays (median 6.0 vs 4.5 days, p = 0.003). DISCUSSION: In contrast to patients with a low ratio, high sFlt1/PlGF is characterized by an increased risk of maternal adverse outcomes and prematurity. Incorporation of angiogenic biomarkers while managing cHTN may improve accuracy of early identification of adverse outcomes to improve outcomes.


Assuntos
Hipertensão Induzida pela Gravidez/sangue , Obesidade/sangue , Fator de Crescimento Placentário/sangue , Nascimento Prematuro/sangue , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue , Adulto , Afro-Americanos , Biomarcadores/sangue , Peso ao Nascer , Pressão Sanguínea , Chicago/epidemiologia , Doença Crônica , Feminino , Idade Gestacional , Humanos , Hipertensão Induzida pela Gravidez/diagnóstico , Hipertensão Induzida pela Gravidez/etnologia , Hipertensão Induzida pela Gravidez/fisiopatologia , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Obesidade/diagnóstico , Obesidade/etnologia , Obesidade/fisiopatologia , Período Periparto/sangue , Gravidez , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/etnologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Saúde da População Urbana
13.
PLoS One ; 15(2): e0229002, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32059045

RESUMO

BACKGROUND: Although protective associations between dietary antioxidants and pregnancy outcomes have been reported, randomized controlled trials of supplementation have been almost uniformly negative. A possible explanation is that supplementation during pregnancy may be too late to have a beneficial effect. Therefore, we examined the relationship between antioxidant levels prior to pregnancy and birth outcomes. METHODS AND FINDINGS: Serum carotenoids and tocopherols were assayed in fasting specimens at 1985-86 (baseline) and 1992-1993 (year 7) from 1,215 participants in Coronary Artery Risk Development in Young Adults (CARDIA) study. An interviewer-administered quantitative food-frequency questionnaire assessed dietary intake of antioxidants. Pregnancy outcome was self-reported at exams every 2 to 5 years. Linear and logistic regression modeling was used to assess relationships of low birthweight (LBW; <2,500 g), continuous infant birthweight, preterm birth (PTB; <37 weeks) and length of gestation with antioxidant levels adjusted for confounders, as well as interactions with age and race. RESULTS: In adjusted models, lycopene was associated with higher odds of LBW (adjusted odds ratio for top quartile, 2.15, 95% confidence interval 1.14, 3.92) and shorter gestational age (adjusted beta coefficient -0.50 weeks). Dietary intake of antioxidants was associated with lower birthweight, while supplement use of vitamin C was associated with higher gestational age (0.41 weeks, 0.01, 0.81). CONCLUSIONS: Higher preconception antioxidant levels are not associated with better birth outcomes.


Assuntos
Afro-Americanos , Antioxidantes/metabolismo , Ácido Ascórbico/sangue , Carotenoides/sangue , Grupo com Ancestrais do Continente Europeu , Idade Gestacional , Nascimento Prematuro/sangue , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Adulto Jovem
14.
BMC Pregnancy Childbirth ; 20(1): 131, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32106828

RESUMO

BACKGROUND: Currently, there are many studies researched the associations between maternal serum inflammatory indicators (i.e. ferritin, C-reactive protein [CRP], C3 and C4) and preterm birth (PTB). The results, however, are inconsistent. Therefore, the aim of this study was to estimate the relationship between maternal serum inflammatory indicators and PTB in a nested case-control (NCC)study. METHODS: A NCC study was conducted by Guangxi Birth Cohort Study which enrolled a total of 6203 pregnant women between 50/7 and 346/7 weeks of gestational age (wGA) from six cities in China between 2015 and 2016. There were 206women who delivered preterm (< 370/7 wGA), and 412 women who delivered term birth, those women were matched by maternal age, birth place, gender of infants, and wGA at blood collection. The inflammatory indicators were quantified by immunoturbidimetric methods. RESULTS: Highest quartile concentrations of all inflammatory indicators were determined versus median. After adjusting for maternal age, high levels of CRP (CRP > 16.60 mg/L) are related to the risk of PTB (OR = 2.16, 95% CI: 1.02-4.56, p = 0.044) in the first trimester. The association of C3 was extremely related to those who delivered PTB (OR = 2.53, 95% CI: 1.14-5.64, p = 0.023) in the first trimester. Moreover, no significant associations were found in C4 (p = 0.079) and ferritin (p = 0.067) between PTB. CONCLUSIONS: Elevated concentrations of CRP and C3 in the first trimester were associated with increased risk of PTB. Inflammatory indicators may act a pivotal part in early diagnosis and prognosis of PTB.


Assuntos
Proteína C-Reativa/metabolismo , Complemento C3/metabolismo , Nascimento Prematuro/sangue , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , China , Estudos de Coortes , Complemento C4/metabolismo , Feminino , Ferritinas/metabolismo , Idade Gestacional , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Gravidez , Primeiro Trimestre da Gravidez , Fatores de Risco , Adulto Jovem
15.
Fertil Steril ; 113(2): 444-452.e1, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31973904

RESUMO

CONTEXT: Antimüllerian hormone (AMH) levels are higher in patients with polycystic ovary syndrome (PCOS). Accumulating evidence indicates that AMH has an impact on the physiology of the female reproductive system. OBJECTIVE: To investigate the association of AMH levels with the risk of preterm delivery in PCOS patients. DESIGN: Retrospective cohort study. SETTING: Academic fertility center. PATIENTS: Women who underwent in vitro fertilization between January 2017 and July 2018 (25,165 cycles). INTERVENTIONS: None. MAIN OUTCOME MEASURES: The primary outcome was preterm delivery. RESULTS: Serum AMH levels were not different between the term delivery and preterm delivery groups in the entire cohort (3.8 vs. 4.1 ng/mL, P>.05). In patients diagnosed with PCOS, those with preterm delivery had higher AMH levels than were found in patients with term delivery (9.3 vs. 6.9 ng/mL, P<.01). Preterm deliveries predominated in PCOS patients with AMH levels above the 75th percentile (9.75 ng/mL) (adjusted P<.0001, adjusted odds ratio [OR] 4.0, 95% confidence interval [CI] 1.94, 8.08)) and frozen-thawed embryo transfer (FET) patients with AMH levels higher than the 90th percentile (10.10 ng/mL) (adjusted P<.05, adjusted OR 2.0, 95% CI 1.16, 3.36). CONCLUSION: Serum AMH levels higher than 75th percentile were associated with an increased risk of preterm delivery in patients with PCOS, and serum AMH levels higher than the 90th percentile were associated with an increased risk of preterm delivery in FET patients.


Assuntos
Hormônio Antimülleriano/sangue , Fertilização In Vitro/efeitos adversos , Infertilidade Feminina/terapia , Síndrome do Ovário Policístico/terapia , Nascimento Prematuro/etiologia , Adulto , Biomarcadores/sangue , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/etiologia , Infertilidade Feminina/fisiopatologia , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/fisiopatologia , Gravidez , Nascimento Prematuro/sangue , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Regulação para Cima
16.
PLoS One ; 15(1): e0227193, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995561

RESUMO

BACKGROUND: We conducted a literature review on the studies that investigated the relationship of preterm birth, including spontaneous preterm birth (sPTB), with vitamin D status. Overall, these studies demonstrated that the incidence of sPTB was associated with maternal vitamin D insufficiency in early pregnancy. However, the potential mechanisms and biological pathways are unknown. OBJECTIVES: To investigate early pregnancy gene expression signatures associated with both vitamin D insufficiency and sPTB. We further constructed a network of these gene signatures and identified the common biological pathways involved. STUDY DESIGN: We conducted peripheral blood transcriptome profiling at 10-18 weeks of gestation in a nested case-control cohort of 24 pregnant women who participated in the Vitamin D Antenatal Asthma Reduction Trial (VDAART). In this cohort, 8 women had spontaneous preterm delivery (21-32 weeks of gestation) and 17 women had vitamin D insufficiency (25-hydroxyvitamin D < 30 ng/mL). We separately identified vitamin D-associated and sPTB gene signatures at 10 to 18 weeks and replicated the overlapping signatures in the mid-pregnancy peripheral blood of an independent cohort with sPTB cases. RESULT: At 10-18 weeks of gestation, 146 differentially expressed genes (25 upregulated) were associated with both vitamin D insufficiency and sPTB in the discovery cohort (FDR < 0.05). Of these genes, 43 (25 upregulated) were replicated in the independent cohort of sPTB cases and controls with normal pregnancies (P < 0.05). Functional enrichment and network analyses of the replicated gene signatures suggested several highly connected nodes related to inflammatory and immune responses. CONCLUSIONS: Our gene expression study and network analyses suggest that the dysregulation of immune response pathways due to early pregnancy vitamin D insufficiency may contribute to the pathobiology of sPTB.


Assuntos
Perfilação da Expressão Gênica , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/genética , Transcriptoma/genética , Vitamina D/análogos & derivados , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Método Duplo-Cego , Feminino , Humanos , Incidência , Recém-Nascido , Saúde Materna , Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/imunologia , Mapas de Interação de Proteínas/genética , Vitamina D/sangue , Vitamina D/imunologia , Vitaminas , Adulto Jovem
17.
Acta Obstet Gynecol Scand ; 99(3): 357-363, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31587255

RESUMO

INTRODUCTION: Preterm birth is a major cause of neonatal morbidity and mortality. There is an urgent need to accurately predict imminent delivery to enable necessary interventions such as tocolytic, glucocorticoid, and magnesium sulfate administration. We aimed to evaluate placental α-macroglobulin-1 as a new diagnostic marker in the prediction of preterm birth. MATERIAL AND METHODS: We performed a prospective observational trial in women with intact membranes between 24+0 and 36+6 weeks of gestation. We included both women with and without threatened preterm labor symptoms. We evaluated the test performance of placental α-macroglobulin-1 measurements in cervicovaginal fluid regarding three different presentation-to-delivery intervals: ≤2, ≤7, ≤14 days. In addition, we calculated placental α-macroglobulin-1 performance in combination with other prognostic factors such as ultrasonographic cervical length measurements. RESULTS: We included 126 women in the study. We detected high specificity (97%-98%) and negative predictive value (89%-97%) for placental α-macroglobulin-1 at all time intervals. We assessed placental α-macroglobulin-1 in combination with cervical length measurements (≤15 mm) in the sub-group of women presenting with threatened preterm labor symptoms (n = 63) and detected high positive predictive values (100%) for 7- and 14-day presentation-to-delivery intervals. CONCLUSIONS: Our study provides evidence that placental α-macroglobulin-1 testing in cervicovaginal fluid, in combination with cervical length measurements, accurately predicts preterm birth in women with preterm labor symptoms. This novel test combination may be used clinically to triage women presenting with threatened preterm labor, avoiding overtreatment and unnecessary hospitalizations.


Assuntos
Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Trabalho de Parto Prematuro , Nascimento Prematuro/diagnóstico , Diagnóstico Pré-Natal , alfa-Macroglobulinas/metabolismo , Adulto , Medida do Comprimento Cervical , Feminino , Humanos , Valor Preditivo dos Testes , Gravidez , Terceiro Trimestre da Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/prevenção & controle , Estudos Prospectivos , Sensibilidade e Especificidade
18.
J Matern Fetal Neonatal Med ; 33(1): 57-61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29860925

RESUMO

Background: The Bilicare™ is a new device that measures transcutaneous bilirubin (TcB) level at the ear pinna. There are only few studies which have evaluated its accuracy in clinical practice.Objective: This study aims to determine the accuracy of Bilicare™ as a predischarge screening tool in late preterm and term neonates and to define the optimal cutoff point for determining the need to measure total serum bilirubin (TSB).Methods: The 35 weeks' gestation or more and healthy neonates who underwent predischarge TSB measurement were enrolled. Bilicare™ TcB was measured within 30 minutes of blood sampling. Paired TcB and TSB data were analyzed.Results: We collected 214 paired samples. Mean age (SD) at TcB measurement was 57.17 (7.47) hours. Mean TSB (SD) was 9.79 (2.83) mg/dL. TcB showed a significant correlation with TSB (r = 0.84, r2 = 0.7). The mean difference (SD) between TcB and TSB was 0.7 (0.21) mg/dL (95%CI 0.49-0.91). TcB tended to overestimate TSB level at the TSB values of <12 mg/dL but underestimate at the higher TSB level. The accuracy of using TcB values to detect neonates who required phototherapy was 92.5%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 78.3, 94.2, 62.1, and 97.3%, respectively. If TcB +3 mg/dL was applied as a cutoff point, the sensitivity, specificity, PPV, and NPV were 100, 53.9, 20.7, and 100%, respectively.Conclusions: Bilicare™ TcB and TSB measurements were well correlated. The TcB level +3 mg/dL could detect all neonates who had significant hyperbilirubinemia requiring phototherapy during their birth hospitalization.


Assuntos
Bilirrubina/sangue , Hiperbilirrubinemia Neonatal/diagnóstico , Triagem Neonatal/instrumentação , Alta do Paciente , Pele/diagnóstico por imagem , Bilirrubina/análise , Estudos Transversais , Orelha , Feminino , Idade Gestacional , Humanos , Hiperbilirrubinemia Neonatal/sangue , Recém-Nascido , Doenças do Prematuro/sangue , Doenças do Prematuro/diagnóstico , Masculino , Triagem Neonatal/métodos , Triagem Neonatal/normas , Nascimento Prematuro/sangue , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Pele/metabolismo , Nascimento a Termo/sangue , Fatores de Tempo
19.
J Matern Fetal Neonatal Med ; 33(3): 359-367, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29909752

RESUMO

Objectives: To evaluate if midtrimester maternal serum contains microbial DNA and whether it differs between women with spontaneous preterm birth (SPTB) and those delivering at term.Study design: In this retrospective case-control study, we identified 20 healthy nulliparas with SPTB at 24-33 weeks of a nonanomalous singleton in 2014. Each case was matched by race/ethnicity to a control delivering at 39-40 weeks. Serum samples, collected at 15-20 weeks and stored at -80 C, were thawed and DNA extracted. PCR with primers targeting the 16S rDNA V4 region were used to prepare an amplicon library, sequenced using Illumina MiSeq, and analyzed using quantitative insight into microbial ecology (QIIME). Taxonomy was assigned using Ribosomal Database program (RDP) Classifier (threshold 0.8) against a modified Greengenes database. Differences in number of observed species, microbial alpha-diversity and beta-diversity, and taxa level analyses were undertaken.Results: All 40 samples were included. Women with SPTB had more unique observed species (p = .046) and higher mean alpha-diversity by Shannon index (but not Chao1 or Simpson) (p = .024). Microbial composition was different between groups by Bray-Curtis clustering (p = .03) but not by weighted (p = .13) or unweighted Unifrac (p = .11). Numerous taxa in the Firmicutes, Proteobacteria, and Actinobacteria phyla differed between groups (p < .05).Conclusions: SPTB is associated with distinct microbial DNA changes detected in midtrimester maternal serum.


Assuntos
DNA Bacteriano/sangue , Microbiota , Nascimento Prematuro/microbiologia , Adulto , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez , Nascimento Prematuro/sangue , Estudos Retrospectivos , Adulto Jovem
20.
Front Immunol ; 11: 563473, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33552042

RESUMO

Many premature babies who are born with neonatal respiratory distress syndrome (RDS) go on to develop Bronchopulmonary Dysplasia (BPD) and later Post-Prematurity Respiratory Disease (PRD) at one year corrected age, characterized by persistent or recurrent lower respiratory tract symptoms frequently related to inflammation and viral infection. Transcriptomic profiles were generated from sorted peripheral blood CD8+ T cells of preterm and full-term infants enrolled with consent in the NHLBI Prematurity and Respiratory Outcomes Program (PROP) at the University of Rochester and the University at Buffalo. We identified outcome-related gene expression patterns following standard methods to identify markers for oxygen utilization and BPD as outcomes in extremely premature infants. We further identified predictor gene sets for BPD based on transcriptomic data adjusted for gestational age at birth (GAB). RNA-Seq analysis was completed for CD8+ T cells from 145 subjects. Among the subjects with highest risk for BPD (born at <29 weeks gestational age (GA); n=72), 501 genes were associated with oxygen utilization. In the same set of subjects, 571 genes were differentially expressed in subjects with a diagnosis of BPD and 105 genes were different in BPD subjects as defined by physiologic challenge. A set of 92 genes could predict BPD with a moderately high degree of accuracy. We consistently observed dysregulation of TGFB, NRF2, HIPPO, and CD40-associated pathways in BPD. Using gene expression data from both premature and full-term subjects (n=116), we identified a 28 gene set that predicted the PRD status with a moderately high level of accuracy, which also were involved in TGFB signaling. Transcriptomic data from sort-purified peripheral blood CD8+ T cells from 145 preterm and full-term infants identified sets of molecular markers of inflammation associated with independent development of BPD in extremely premature infants at high risk for the disease and of PRD among the preterm and full-term subjects.


Assuntos
Displasia Broncopulmonar/sangue , Displasia Broncopulmonar/genética , Linfócitos T CD8-Positivos/imunologia , Nascimento Prematuro/sangue , Nascimento Prematuro/genética , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/genética , Transcriptoma/genética , Biomarcadores/sangue , Feminino , Idade Gestacional , Humanos , Lactente Extremamente Prematuro/sangue , Recém-Nascido , Ativação Linfocitária , Masculino , Gravidez , Prognóstico , RNA-Seq
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...