ABSTRACT
<p><b>OBJECTIVE</b>To study the efficacy of metformin intervention on insulin resistance during catch-up growth in mice with fetal growth restriction (FGR).</p><p><b>METHODS</b>Mouse models of FGR were established by low protein diet feeding of the pregnant mice. Both the newborn female mice with FGR and normal control (NC) mice were randomized for feeding with a standard diet (SF) or a high-fat diet (HF) after weaning and treatment with gavage of either metformin or normal saline. The mice were examined for vaginal opening time and the estrous cycle at the age of 8 weeks. At the age of 12 weeks, 6 mice in anestrus from each group were fasted for 12 h for measurement of body weight, height, poundera index (PI), fasting blood glucose (FBG), fasting insulin (Fins), follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH), and the HOMA-IR was calculated. The reproductive capacity of female mice was assessed by mixing them with male mice at the ratio of 2:1. The 3 × 2 factorial analysis was conducted to determine the interactions between FGR, high-fat feeding and metformin.</p><p><b>RESULTS</b>Factorial analysis showed that FGR and high-fat feeding had significant effects on the PI index, Fins, HOMA-IR, vaginal opening time, and AMH (P<0.05). Metformin significantly affected the factors related to high-fat feeding including weight, PI, FPG, Fins, HOMA-IR and estrous cycle (P<0.05) and the factors related to FGR with the exception of height and FSH (P<0.05). FGR significantly affected the factors tested except for body weight (P<0.05); high-fat feeding affected all the factors but the FSH (P<0.05); metformin affected all the factors but the height and FSH (P<0.05). In the female mice treated with saline, the pregnancy rates differed significantly between FGR mice with high-fat feeding and control mice with standard feeding, and between FGR mice with standard feeding and high-fat feeding (P<0.05).</p><p><b>CONCLUSION</b>FGR mice can present with delayed puberty with rare ovulation and adulthood insulin resistance, and high-fat feeding after birth can promote the catch-up growth of FGR mice. Metformin intervention is effective for improving insulin resistance and reproductive-endocrine disorders in FGR mice during catch-up growth.</p>
ABSTRACT
Objective To analyse incidence of the severe complications of hypertensive disorder complicating pregnancy and the influence on the outcome of pregnancy.Methods A retrospective study of 4107 cases among 71 020 cases who delivered in hospitals from 1995 to 2004 in Guangzhou was conducted. Results The morbidity of hypertensive disorder complicating pregnancy was 5.78%,in which the morbidity of severe pre-eclampsia was 27.78% (1141/4107),of mitis pre-eclampsia was 72.22% (2966/4107). Maternal mortality rate was 0.19% (8/4107),and the specific mortality rate was 11.26/100 000.The proportion of severe complications of hypertensive disorder complicating pregnancy from high to low was as follows:placental abruption 1.68% (69/4107),DIC 1.36% (56/4107),hypertensive disorder complicating pregnancy induced cardiopathy(induced cardiopathy) 1.05% (43/4107),renal failure 0.97% (40/4107),cerebrovascular accident 0.58% (24/4107),and hemolysis,elevated liver enzymes and low platelet (HELLP) syndrome 0.51% (21/4107).Mortality caused by severe complications of hypertensive disorder complicating pregnancy were as follows:cerebrovascular accident 17% (4/24),HELLP syndrome 10% (2/21),DIC 5% (3/56) and induced cardiopathy 2% (1/43).The proportion of perinatal mortality from severe complications were as follows:placental abruption 43% (33/77),HELLP syndrome 42% (10/ 24),DIC 34% (22/64),renal failure 25% (11/44),cerebro vascular accident 24% (6/25)and induced cardiopathy 16% (8/49).Conclusions (1) The morbidity of severe complications from high to low are: placental abruption,DIC,induced eardiopathy,renal failure,eerebro vascular accident and HELLP syndrome.(2) The main causes of mortality for gravida and puerperant are:cerebro vascular accident, HELLP syndrome,DIC and induced cardiopathy.(3) The major complications harmful to perinatal newborns are in the order of:placental abruption,HELLP syndrome,DIC,renal failure,eerebro vascular accident and induced cardiopathy.