ABSTRACT
OBJECTIVE: To investigate the relationship between serum leptin,resistin and adiponectin levels and preeclampsia.METHODS: The study was a case-control study.All enrolled pregnant women were selected from January2013 to June 2015 in Peking Union Medical College Hospital,Peking Union Medical College Peking Union Medical College Hospital.In the case group,74 patients were further divided into early-onset and late-onset subgroups(51 cases and 23 cases respectively).The control group enrolled 79 uncomplicated pregnant women who delivered full-term babies during the study period.Three adipokines were measured by enzyme linked immunosorbent assay.RESULTS: Leptin level8.98)μg/L,P<0.001).Positive correlation between leptin level and BMI was observed in normotensive pregnancies(r=0.651,P<0.001),but the correlation disappeared in preeclampsia patients.The serum resistin level in the case group was significantly higher than that in the control group(14.08±6.10)vs.(9.99±8.33)μg/L,P<0.001),and there was no correlation between serum resistin level and BMI.There was no significant difference in adiponectin level between the case group and the control group.CONCLUSION: Serum resistin and leptin in preeclampsia population are significantly higher than those in normotensive pregnancies,and the underlying mechanism of their elevation needs to be further investigated.The correlation between adiponectin and preeclampsia is not clear.
ABSTRACT
Objective To investigate the changes in preterm birth rate,its gestational age distribution,and possible contributors in Peking Union Medical College Hospital (PUMCH) over the last 25-year period. Methods The clinical data of premature deliveries,both singleton and twins,in PUMCH from January 1,1990 to December 31,2014 were retrospectively analyzed. We counted the number of premature fetuses and assessed the changes of preterm birth rate and its gestational age distribution (including extremely preterm birth,early preterm birth,and late preterm birth) over time. The etiologies (including spontaneous and iatrogenic) of preterm birth were also surveyed. Results The overall preterm birth rate was 7.8% in PUMCH,showing a slightly up-trend in both singletons and twins. Twin prematurity accounted for 23.8% of total preterm births,increased from 15.1% to 28.5%. Preterm births subgrouped by gestational age included 26 cases (0.7%) of extreme prematurity (<28 weeks),1199 cases (33.9%) of early preterm birth (28- 33weeks),and 2310 cases (65.3%) of late preterm birth (34- 36weeks). The gestational age distribution in singletons and twins showed no significant difference(z=0.844,P=0.398). Changes in the proportion of preterm birth before 28 weeks was little,gradually increased in the 28- 33weeks group (from 23.8% to 36.1%) and gradually decreased in the 34- 36weeks group (from 75.5% to 63.3%). Trends of gestational age distribution of singleton and twins were similar to that of the total. Spontaneous preterm labor,preterm premature rupture of membrane,and medically indicated (iatrogenic) preterm birth accounted for 20.2%,38.9%,and 40.9% respectively. There was no difference in singletons and twins(χ=1.071,P=0.301).The proportion of iatrogenic preterm was increased. Common reasons for iatrogenic preterm birth included gestational hypertension,fetal indications (including fetal distress,fetal growth restriction),placenta previa,and pregnancy complicated by heart disease. Conclusions The overall preterm birth rate shows an upward trend in the general hospital as a result of more multifetal gestations and more medically indicated preterm births. Reducing multifetal gestations and effective control of pregnancy complications should be the priorieties in preterm birth intervention.