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OBJECTIVE: To investigate the reasons and prevention and treatment measures of acute third-and fourthdegree obstetric lacerations.METHODS: A retrospective analysis of 83 cases of acute third-and fourth-degree obstetric lacerations in the First Affiliated Hospital of Kunming Medical University from 2010 to 2016 was performed.RESULTS:(1)The incidence of 3 rd or 4 th degree laceration was 0.394%(83/21 083),which was 0.433%(72/16 620)in primiparas and 0.246%(11/4463)in multiparous women,there being a statistical difference(P<0.05).(2)The incidence of 3 rd or 4 th degree laceration was significantly increased in the group with episiotomy than without episiotomy[0.583%(48/8229)vs.0.272%(35/12 854),P<0.05].(3)The incidence of 3 rd or 4 th degree laceration was significantly increased in the group with Forceps delivery than without Forceps deliery[3.120%(37/1186)vs.0.231%(46/19 897),P<0.05].(4)In patients with forceps delivery,the incidence of 3 rd or 4 th degree laceration was 2.911%(28/962)in episiotomy group and 4.018%(9/224)in without episiotomy group,there being a significant difference(P<0.05).(5)The incidence of 3 rd or 4 th degree laceration was significantly increased in the macrosomia group than in the non-macrosomia group[1.225%(11/898)vs.0.357%(72/20 185),P<0.05].(6)The incidence of 3 rd or 4 th degree laceration was significantly increased in the prolonged second stage group than in the normal second stage group[2.381%(24/1008)vs.0.294%(59/20 075),P<0.05].CONCLUSION: The incidence of third-and fourth-degree obstetric lacerations is increased in primiparous women,episiotomy,forceps delivery,forceps delivery without episiotomy,big fetal weight and prolonged second stage.
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<p><b>OBJECTIVE</b>To investigate the relationship of serum omentin-1 and chemerin with gestational diabetes mellitus (GDM).</p><p><b>METHODS</b>Serum levels of omentin-1 chemerin, glycolipids biochemical index, inflammation index, fasting insulin (FINS), and insulin resistance indexes (HOMA-IR) were determined in 85 women with GDM and 85 pregnant women with normal glucose tolerance (NGT).</p><p><b>RESULTS</b>BMI, FPG, hs-CRP, blood lipids, blood glucose, FINS, HOMA-IR and serum chemerin level were all significantly higher while serum omentin-1 significantly lower in GDM group than in NGT group (P<0.05). In both groups, serum omentin-1 level was significantly lower and serum chemerin was significantly higher in obese subjects than in the non-obese subjects (P<0.05). Obesity before delivery and/or HOMA-IR ≥2 was associated with a significantly decreased serum omentin-1 level; serum chemerin increased significantly in obese women before delivery but was not associated with HOMA-IR. Serum omentin-1 level was positively correlated with HDL but inversely with BMI (at pregnancy and before delivery), FPG, FINS and HOMA-IR; Chemerin was positively correlated with TC, TG, hs-CRP and FPG; serum omentin-1 and chemerin levels were not significant correlated (P=0.301). In women with GDM, BMI at pregnancy, TG, FPG, and FINS were all independent factors affecting serum omentin-1; TG, LDL, and hs-CRP were independent factors affecting serum chemerin.</p><p><b>CONCLUSION</b>An decreased serum omentin-1 can be indicative of glucose and lipid metabolism disorder and insulin resistance, and an increased serum chemerin level indicates hyperlipidemia and chronic inflammation in pregnant women. Both of the adipokines are closed associated with GDM and probably participate in the occurrence and development of GDM.</p>
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Objective To investigate the relationship between children's body mass index (BMI)at 5 to 6 years old and glucose concentrations of mothers without pre-existing diabetes or a gestational diabetes mellitus(GDM) diagnosis during pregnancy.Methods A prospective observational study was performed in offspring whose mother had no pre-existing diabetes or a GDM diagnosis during pregnancy in the First Affiliated Hospital of Kunming Medical Uni versity from Jan.2006 to Dec.2007.The data of maternal glucose concentrations of oral glucose tolerance test(OGTT)were acquired through referring to clinical records.Weight and height at 5 to 6 years old were measured and used to calculate BMI.Multivariable linear regression models were used to examine the association between children's BMI and maternal glucose concentrations.The influence of maternal glucose concentrations on the risk of overweight of offspring was analyzed by Logistic regression.Results There were 860 cases of children were followed-up,including 459 male cases and 401 female cases.The average BMI of children was(15.6 ± 2.7) kg/m2.There were 78 cases of overweight (9.06％) and 50 cases of obesity(5.81％).The mean maternal fasting glucose level of the OGTT was (3.8 ± 0.6) mmol/L and 2 h glucose level of the OGTT was (6.0 ± 0.9) mmol/L.After adjusting for progestation BMI,maternal weight gain during pregnancy,sex,birth weight,age and paternal weight,at the 5 to 6 years old,BMI of offspring of mothers whose fasting glucose level of the OGTT≥5.51 mmol/L were significantly higher than those of mothers whose average blood glucose level ＜5.51 mmol/L(β =0.45,95％ CI:0.15-0.80).Maternal fasting glucose level of the OGTT≥5.51 mmoL/L was associated with an greater risk of children's overweight(OR =2.32,95％ CI:1.30-3.96).Conclusions Even though the mother was in the absence of pre-existing diabetes or GDM during pregnancy,fetal exposure to high maternal glucose concentration may also promote the development of overweight in the offspring at 5 to 6 years old.
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<p><b>OBJECTIVE</b>To investigate whether breastfeeding can reduce the risk of childhood overweight in the offspring of mothers with gestational diabetes mellitus (GDM).</p><p><b>METHODS</b>Follow-up was performed on 1189 offspring of mothers with GDM between January 2003 and December 2009. The influence of the manner and duration of breastfeeding between 0 to 3 months after birth on the risk of childhood overweight in the offspring of mothers with GDM was analyzed by logistic regression.</p><p><b>RESULTS</b>After correcting confounding factors such as pre-pregnancy BMI, gestational weight gain, gestational blood sugar, sex, birth weight, age and farther's body weight, it was found that the risk of childhood overweight in the offspring who received exclusive breastfeeding during the first 3 months after birth was lower than in the artificial feeding group (OR: 0.479, 95%CI: 0.256-0.897). Offspring who were breastfed for 0 to 3 months, 4 to 6 months and over 6 months had a lower risk of childhood overweight than the artificial feeding group (OR: 0.456, 95%CI: 0.233-0.827; OR: 0.29, 95%CI: 0.103-0.817; OR: 0.534, 95%CI: 0.280-0.970), offspring who were breastfed for 4 to 6 months had a lower risk of childhood overweight than those who were breastfed for 0 to 3 months (OR: 0.372, 95%CI: 0.129-0.874), and offspring who were breastfed for more than 6 months did not show significantly lower risk of overweight than those who were breastfed for less than 6 months (OR: 0.769, 95%CI: 0.470-1.258).</p><p><b>CONCLUSIONS</b>Within 3 months of birth, breastfeeding, especially exclusively, may reduce the risk of childhood overweight in the offspring of mothers with GDM. Within 6 months of birth, the risk of childhood overweight decreases as the duration of breastfeeding increases, but prolonging the duration of breastfeeding cannot necessarily reduce the risk of childhood overweight after postnatal six months.</p>