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Gestational diabetes mellitus poses a substantial threat to the short- and long-term health of women and their offspring. Previous studies have identified a number of genetic risk factors for gestational diabetes through candidate gene strategy and whole genome studies. Many of these identified genetic variations have also been proved to be associated with type 2 diabetes, abnormal glycometabolism as well as insulin secretion and resistance. This article reviews the recent progress in the genetic epidemiology of gestational diabetes mellitus.
ABSTRACT
In recent years, recommendations for delayed cord clamping at birth have been made by the World Health Organization and academic organizations in several countries. A consensus is yet to be reached regarding the timing of delayed cord clamping. Previous studies indicated that delayed cord clamping could decrease the risk of anemia, intraventricular hemorrhage, necrotizing enterocolitis, and hypotension, and improve neurodevelopment for infants, with no increased risk of postpartum hemorrhage. This article reviews the effect of delayed cord clamping on maternal and neonatal outcomes worldwide over the past five years.
ABSTRACT
In recent years,recommendations for delayed cord clamping at birth have been made by the World Health Organization and academic organizations in several countries.A consensus is yet to be reached regarding the timing of delayed cord clamping.Previous studies indicated that delayed cord clamping could decrease the risk of anemia,intraventricular hemorrhage,necrotizing enterocolitis,and hypotension,and improve neurodevelopment for infants,with no increased risk of postpartum hemorrhage.This article reviews the effect of delayed cord clamping on maternal and neonatal outcomes worldwide over the past five years.
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Objective To evaluate the maternal age at delivery in Beijing and the effect of maternal age on pregnancy outcomes.Methods A retrospective analysis was conducted on 14 970 singleton pregnancies from 15 hospitals in Beijing from June 20th to November 30th in 2013.These hospitals were sorted by the numbers of delivery and chosen as clusters by systemic cluster sampling method.The data of age,diagnosis with gestational diabetes mellitus (GDM) and pre-eclampsia (PE),neonatal birth weight,gestational age at delivery,postpartum hemorrhage and infants admitted to the neonatal ICU (NICU) were collected.The 14 970 women were divided into 5 groups according to their ages at delivery:(1) less than 20 years (n=205),(2)20-＜30 years (n=9 228),(3)30-＜35 years (n=4 365),(4)35-＜40 years (n=1 017),and (5) 40 years and older (n=155).T-test and x2 test were used for between-group comparison,and logistic regression analysis was used to examine the association between age and the risk of adverse pregnancy outcomes.Results (1) The mean maternal age at delivery in 2013 in Beijing was (28±4) years old.Among them,205 (1.4％,205/14 970) delivered under 20 years of age;1 172 (7.8％,1 172/14 970) ≥35 years;and 155 (1.O％,155/14 970) at 40 years and older.(2) The prevalence of diabetes,hypertension,overweight and obesity increased with age,and the incidence of these conditions were 3.4％,4.3％ and 31.4％ in women with advanced age,respectively.(3) Compared with 20-＜30 years group,less than 20 years was associated with significantly lower incidence of GDM [adjust OR (aOR)=0.393,95％ CI:0.222-0.696] and cesarean section rate (aOR=0.549,95％CI:0.391-0.771),and higher incidence of preterm birth (aOR=2.144,95％CI:1.256-3.662).Moreover,30-＜35 years,35-＜40 years and 40 years and older groups all had significantly higher risk of GDM (30-34 years,aOR=1.513,95％CI:1.374-1.666;35-＜40 years,aOR=2.094,95％CI:1.786-2.455;≥40 years,aOR=2.174,95％CI:1.492-3.167),preterm birth (aOR=1.219,95％CI:1.021-1.455;aOR=1.644,95％CI:1.251-2.161;aOR=2.141,95％CI:1.209-3.792),cesarean section (aOR=1.373,95％ CI:1.268-1.486;aOR=2.960,95％ CI:2.550-3.435;aOR=4.332,95％CI:2.920-6.426) and NICU admission rate (aOR=1.236,95％CI:1.059-1.443;aOR=1.337,95％CI:1.018-1.756;aOR=2.389,95％CI:1.385-4.121),when compared to the 20-＜30 years of age group.Higher incidence of PE (aOR=1.292,95％CI:1.007-1.659) and postpartum hemorrhage (aOR=1.224,95％CI:1.048-1.429) were also noted in women of 30-＜35 years,compared to 20-＜30 years group respectively.Conclusion Both advanced maternal age and adolescent pregnancy are associated with increasing risk of adverse pregnancy outcomes.
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Objective To explore the effect of TNF related apoptosis inducing ligand (TRAIL) in apoptosis induced by LPS. Methods After LPS injected mice blocking TRAIL with soluble death receptor 5 (sDRS), detecting ALT, AST and LDH of mice serum at different times, apoptotic effects of LPS to mice hepatocyte were detected by HE and flow eytometry (FCM) with Annexin V-FITC/PI staining. The expres-sion of DR5 in mice hepatocyte was assayed with immunohistochemistry and FCM. Results Apoptotic effect was promoted by up-regulated DR5 expression on hepatocyte. Blocking TRAIL with sDR5 markedly amelio-rated the hepatocyte damage and reduced apoptosis. Conclusion These results establish a critical role for TRAIL in apoptosis during disease process of LPS.