ABSTRACT
Objective:To investigate the risk factors of hyperglycemia during pregnancy and its correlation with adverse pregnancy outcomes based on the retrospective analysis of glucose metabolism of pregnant women in Chongming area.Methods:A total of 604 singleton pregnant women who underwent prenatal examination and delivered normally in the Chongming branch of Xinhua Hospital from September 2019 to May 2021 were enrolled in the study. All subjects were divided into normal glucose tolerance gestation (NGTG) group and gestational diabetes mellitus (GDM) group. Pregnant women whose blood glucose exceeded normal but did not meet the diagnostic criteria of GDM were classified into the intermediate state gestational blood glucose (ISGBG) group. Questionnaire, physical examination, and relevant laboratory tests were completed. Data were analyzed using the Statistical Product and Service Solutions 13.0 (SPSS, Chicago, IL).Results:The incidence rate of GDM was 20.86% (126/604), ISGBG was 40.39% (244/604), and NGTG was 38.74% (234/604) in 604 pregnant women. Multivariate logistic regression analysis showed that gestational age ( OR=1.092, P<0.001), serum triglyceride ( OR=1.625, P=0.001) and free T 3 levels ( OR=1.995, P=0.002) were independent risk factors for GDM. The incidence of pregnancy-induced hypertension, cesarean section, macrosomia, the total incidence of adverse pregnancy outcomes and fetal birth weight in ISGBG and GDM were significantly higher than those in NGTG ( P<0.05 or P<0.01). Conclusion:The incidence of GDM in Chongming area is high, especially higher in that of ISGBG. As both GDM and ISGBG lead to increased adverse pregnancy outcomes, early monitoring should be paid more attention to pregnant women in ISGBG in addition to the early intervention of GDM.
ABSTRACT
Objective:To explore the relationship between soft markers found in the first trimester (11-13 + 6 gestational weeks) ultrasound screening and fetal adverse pregnancy outcomes. Methods:Single pregnancy fetuses were selected from the Multicenter Clinical Study of First Trimester Screening in China during August 2017 to August 2020. The types and detection rate of soft markers during the first trimester were compared. The correlation between positive soft markers and adverse pregnancy outcomes was analyzed by binary Logistics regression.Results:A total of 16 625 fetuses with complete follow-up outcomes were included in the group. Six hundred and seven ultrasonic soft markers were detected in 556 fetuses with positive soft markers during the first trimester, and the first four most frequently occurred were increased nuchal translucency (NT) (2.08%, 345/16 625), echogenic intracardiac focus (EIF) (0.94%, 156/16 625), hypoplasia of fetal nasal bone (0.20%, 34/16 625), single umbilical artery (SUA) (0.19%, 31/16 625). Among 556 fetuses, the incidence of adverse pregnancy outcome in fetuses with two or more positive soft markers was 32.50% (13/40), which was significantly higher than fetuses with single positive soft marker (11.05%, 57/516), and the difference was statistically significant (χ 2=5.055, P<0.001). The incidence of adverse pregnancy outcome in positive soft markers fetus associated with structural abnormalities was 80.77% (21/26), which was significantly higher than fetuses with isolated positive soft marker (12.08%, 64/530), and the difference was statistically significant (χ 2=90.310, P<0.001). Binary logistic regression analysis showed choroid plexus cyst (CPC), SUA, echogenic bowel (EB), absent/reversed a-wave of ductus venosus, hypoplasia of fetal nasal bone, increased NT, and EIF were closely related to the adverse pregnancy outcomes (all P<0.05). However, there were no significant correlations between tricuspid regurgitation (TR), pyelectasis (PYE) and fetal adverse pregnancy outcomes (all P>0.05). Conclusions:The ultrasonic soft markers during the first trimester are of great significance in predicting fetal adverse pregnancy outcomes. For multiple positive soft markers or positive soft markers combined with structural abnormalities, more attention should be paid to them and comprehensive evaluation is required to be carried out.
ABSTRACT
Ambient air pollution has become a widespread global public health problem. As one of the main components of ambient air pollution, fine particulate matter (PM2.5), with its small diameter and large surface area, can carry a variety of toxic substances and enter the blood circulation directly through the blood-air barrier, damaging various tissues and organs of human body. Studies have shown that PM2.5 exposure during pregnancy can disrupt the mother's and child's thyroid function. Since the fetal thyroid gland does not begin to develop until around the sixth week of pregnancy, the fetal thyroid hormone is almost entirely dependent on the mother during early stages of pregnancy, and maternal thyroid hormone level play a crucial role in the growth and development of fetus. When a mother is exposed to PM2.5 during pregnancy, placenta, the "bridge" between mother and fetus, is also affected to some extent, including changes in placental iodine uptake and oxidative stress, inflammation, and DNA methylation in placental tissue. Exposure to PM2.5 during pregnancy also alters maternal thyroid hormone level and normal placental function, which can have a detrimental effect on pregnancy outcomes, such as preterm birth, low birth weight, and neurological abnormalities. This paper reviewed the effects of PM2.5 exposure during different trimesters on maternal and infant thyroid function, placental function, and pregnancy outcomes, aiming to provide more accurate protection of maternal and fetal health.
ABSTRACT
Background: Hyperemesis gravidarum (HG) is associated with maternal weight loss, nutritional deficiencies, fluid and electrolyte abnormalities, which may lead to adverse fetal and maternal outcomes. The purpose of this study was to evaluate the relationship of hyperemesis gravidarum to maternal and foetal outcomes.Methods: A hospital-based prospective observational study was carried out. All patients with singleton pregnancy diagnosed as / history of hyperemesis gravidarum the current pregnancy was included in the study. The pregnant women with multiple pregnancy, molar pregnancy, presence of pre-gestational diabetes, pre-gestational hypertension, and other causes of nausea such as appendicitis and pyelonephritis were excluded from the study.Results: 36 pregnant women with prevalence rate of 3.28% have been found to be suffering from HG. Almost half (17, 47.22%) of the pregnant women with HG had age less than 25 years. The significant association (p-value: 0.0099) has been found between parity and smoking with HG. HG was significantly associated with low birth weight (p-value: 0.0133); small for gestational age (SGA) (p-value: 0.0316); APGAR score < 7 after 1 minute (p-value: 0.0060); and APGAR score <7 after 5 minutes (p-value: 0.0006). There is no association found between mode of delivery, gestational diabetes, and pregnancy-induced hypertension with HG.Conclusions: HG can adversely affect fetal as well as maternal, though not significant, pregnancy outcomes.
ABSTRACT
Objective To explore risk factors of congenital malformations (CMs) and to evaluate its impacts on adverse pregnancy outcomes (APOs). Methods A prospective cohort study was conducted among pregnant women who received the first antenatal care from March 2013 to February 2016 in the reproductive center, obstetrics clinics, infertility clinics and ultrasound department of Hunan Provincial Maternal and Child Health Hospital. Corresponding information from pregnant women and their spouses were collected. Univariate and multivariate Logistic regression were used to screen possible risk factors of CMs and evaluate the impacts of CMs on other APOs. Results The study showed that women had history of non-standard BMI, smoking, hepatitis, pregnancy-related complications, gestational diabetes mellitus, infertility and using assisted reproductive technology before pregnancy; had no folic acid taking, active and passive smoking, drinking, uneven diet, high intensity physical activity during pregnancy increased the risk of CMs in offspring. Furthermore, the history of spouse smoking and eating betel nut also increased the risk of CMs in offspring. CMs might increase the risk of preterm birth, very preterm birth, low birth weight, very low birth weight, and perinatal mortality. Conclusions There are many risk factors of CMs. Knowing these risk factors, and giving them optimal prevention strategies and effective intervention measures are important measures in preventing the occurrence of CMs and other APOs.
ABSTRACT
Objective To examine the association between maternal syphilis treatmentand the adverse pregnancy outcomes.Methods Syphilis-infected pregnant women retrieved from Information System of Prevention Mother-to-child Transmission of Human Immunodeficiency Virus (HIV),Syphilis,and Hepatitis B Management in Hu'nan Province between January 2012 and December 2017 were retrospectively studied.Information of demographic characteristics,pregnancy history,and syphilis infection/treatment history among these syphilis-infected pregnant women were collected and analyzed.According to the anti-syphilis treatment situation during pregnancy,syphilis-infected pregnant women were divided into three groups:non-treatment group,non-standardized treatment group and standardized treatment group.The incidences of adverse pregnancy outcomes among the three groups were calculated.Multivariate logistic regression was used to control confounding factors and analyze the association between maternal syphilis treatment and the adverse pregnancy outcomes.The adjusted odds ratios (aOR) and 95％ confidence interval (CI) were calculated.Results Among 9 059 syphilis-infected pregnant women,13.9％ (1 262),31.3％ (2 834),and 54.8％ (4 963)were untreated,non-standardized treated and standardized treated patients,respectively.The incidences of total adverse pregnancy outcomes in the non-treatment,non-standardized treatment and standardized treatment groups were 25.5％ (322),20.8％ (589),and 16.2％ (806),respectively.The incidences of stillbirth in the three groups were 2.3％ (29),1.3％ (38),and 0.6％ (28),respectively;those of preterm birth were 12.6％(159),10.5％ (297),and 6.0％ (299),respectively;those of low birth weight were 6.4％ (81),6.2％(175),and 3.3 ％ (162),respectively;those of small for gestational age were 10.9％ (138),8.4％ (237),and 8.0％ (399),respectively;those of neonatal death were 1.3％ (17),1.0％ (28) and 0.3％ (15),respectively;those of neonatal asphyxia were 1.9％ (24),0.9％ (25),and 0.9％ (46),respectively;those of neonatal pneumonia were 0.6％ (8),0.9％ (26),and 0.6％ (32),respectively;those of birth defects were 2.8％(35),1.3％ (37),and 1.1％ (57),respectively;those of neonatal congenital syphilis were 2.5％ (31),2.4％ (69),and 0.8％ (42),respectively.Compared with standardized treatment group,maternal syphilis without treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.73),stillbirth (aOR =4.82),preterm birth (aOR =2.52),low birth weight (aOR =1.88),neonatal death (aOR =3.29),neonatal asphyxia (aOR =2.42) and birth defects (aOR =3.26) all P ＜ 0.01;maternal syphilis with non-standardized treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.34),stillbirth (aOR =2.54),preterm birth (aOR =1.98),low birth weight (aOR =1.84),neonatal death (aOR =2.49) and neonatal congenital syphilis (aOR =1.70,P ＜ 0.05 or 0.01).Conclusions Maternal syphilis without treatment or with non-standardized treatment would increase the risks of adverse pregnancy outcomes.It is necessary to further strengthen the early screening and early treatment for syphilis-infected pregnant women,and improve the rate of standardized treatment to reduce the occurrence of adverse pregnancy outcomes.
ABSTRACT
Fetal movement counting is one of the common methods for fetal prenatal monitoring. The changes of the normal pattern of fetal movements(FM)indicate abnormal fetal status in uterus.Studies have found that reduced fetal movement is the primary sign of fetal distress,which is associated with adverse pregnancy outcomes such as stillbirth,placental insufficiency,and fetal growth restriction.Increased fetal movement after 32 week's gestation is regular,but a single episode of vigorous FM increases risk of stillbirth.Clinically,fetal safety is preliminarily evaluated by counting numbers of FM to find abnormalities of fetus early and decrease adverse pregnancy outcomes,which is economical,convenient,and simple.However,this method is subjective,due to the different sensitiveness of pregnant women.
ABSTRACT
Early life nutrition plays an important role in determining the pregnancy outcomes and offspring lifelong health. Carotenoids deficiency is associated with adverse pregnancy outcomes such as preeclampsia, premature delivery and intrauterine growth restriction. Carotenoids possess antioxidant, inflammation modulating and immune-enhancing properties and promote visual, cognitive and respiratory health in offsprings. Among carotenoids, α-carotene, β-carotene and β-cryptoxanthin can be transformed into vitamin A in vivo, and their conversion rates are affected by the nutritional status of vitamin A. Lutein and zeaxanthin are highly enriched in the brain and retina of infants and young children, which are closely related to the development of visual acuity and cognitive function. Breast milk contains an adequate level of lutein and its absorption rate is significantly higher than that of infant formulas. Consequently lutein supplementation is necessary for artificially fed infants, especially premature infants. In this paper, the functional research progresses of carotenoids related to adverse pregnancy outcomes and offspring development, as well as the present situation of carotenoids supplementation in formula were reviewed.
ABSTRACT
[Objective]To explore the adverse pregnancy outcomes(APO)and examine the predictive value of umbil-ical artery Doppler in systemic lupus erythematosus(SLE)pregnancies.[Methods]Data of 273 pregnancies from 2010 to 2016 were analyzed retrospectively. Pulsatility index(PI),resistance index(RI),and systolic/diastolic ratio(S/D)of the umbilical artery flow velocity data were monitored by Doppler ultrasound.[Results]One or more APO occurred in 61.9% of patients with SLE,among which pregnancy loss occurred in 60 cases;preterm birth in 56 cases;intrauterine growth retardation occurred in 20 cases;and fetal distress occurred in 21 cases.Twelve of pregnancies resulted in neona-tal Lupus. In total,118 patients underwent fetal umbilical artery Doppler during 28~34 gestational weeks. Doppler PI, RI,and S/D were significantly higher in the APO groups than in the patients without APO.[Conclusion]Pregnancies in lupus still had an increased risk of APO.Umbilical artery Doppler was useful in predicting APO in lupus pregnancies.
ABSTRACT
Objective To investigate the outpatient visitor′s B19 infection in Fuzhou area, study the correlation between B19 virus infection and clinical diseases.Methods The infection status of B19V IgM and IgG in 22 089 outpatient visitors in Fuzhou area from 2011 to 2016 has been retrospectively analyzed.The patients were divided into different groups according to sex,age,different pregnant outcomes, healthy people and hematopoietic system diseases.Results The positive rate in 22 089 patients of B19V IgM was 4.5%(998/22 089)and the IgG positive rate was 36.9%(8 155/22 089); The positive rate of B19V IgM in female patients(4.8%,546/11 374)was higher than male patients(4.2%,452/10 715)(χ2=4.333,P<0.05); The middle-aged and elderly patients IgG positive rate(53.6%,3 629/6 772;54.3%,1 542/2 838)were significantly higher than infants,children and young people(36.0%,989/2 747;25.4%,237/934;20.0%,1 758/8 797); The positive rate of IgM in adverse pregnancy outcomes (8.2%,20/245)was higher than normal pregnant women(3.3%,23/688)(χ2=9.548,P<0.05).In pancytopenia,thrombocytopenia and anemia patients, the positive rates of B19V IgG were 39.8%(165/415),38.1%(297/780)and 35.4%(81/226)respectively, all of which were higher than that in the healthy people(14.4%,78/543)(χ2=80.127,88.626,43.461; P<0.05).Conclusions The outpatient visitor′s infection rate of B19V in Fuzhou is high.B19V is a common virus who can lead to adverse pregnancy outcomes.What′s more, it also can lead to pancytopenia, thrombocytopenia, anemia or other related hematopoietic diseases.
ABSTRACT
Both HIV and HBV infection have become major health problems,of global concern,due to the high prevalence in the past few decades.Data from cumulated epidemiological surveys have shown the links between maternal HIV or HBV infection and adverse outcomes on pregnancy.Maternal HIV or HBV infection may also increase the mother-to-child (MTCT) transmission of the two diseases.However,association between HIV-HBV co-infection and adverse pregnancy is still inconclusive.Does maternal HIV-HBV co-infection have an impact on mother-to-child transmission on either HIV or HBV? Study on effective precautionary measures to promote both maternal and child's health is deemed necessary.
ABSTRACT
Objective To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China.Methods Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis.A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled.Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires,with related outcomes on pregnancy recorded by doctors.Results Among all the 248 501 participants,1 806 (0.74％) women and 2 653 (1.09％) men reported to have been exposed to pesticide before pregnancy,with 505 (0.21％) reported of having been exposed to pesticide during the period of pregnancy.Maternal exposure to pesticide was found a risk factor related to stillbirth (OR=3.37,95 ％ CI:2.05-5.55),peculiar smell pregnancy (OR =3.17,95％CI:1.18-8.55) and low birth weight (OR=7.56,95％ CI:5.36-10.66).Paternal exposure to pesticide was also found related to miscarriage (OR=1.37,95％ CI:1.03-1.80),low birth weight (OR=3.65,95％ CI:1.51-8.84),or giant infant (OR?=0.64,95％ CI:0.44-0.93).Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage (OR=4.65,95％ CI:3.47-6.24).Other adverse outcomes on pregnancy would include premature birth and high birth weight.Conclusion Parental pesticide exposure appeared a risk factor on stillbirth,peculiar smell pregnancy,low birth weight and miscarriage.
ABSTRACT
Objective@#To investigate the reproductive health status of female workers in a railway system and possible influencing factors.@*Methods@#From January to June, 2016, a cross-sectional epidemiological investigation was performed to collect 2 165 female workers aged 17-55 years. A women’s health questionnaire was used to collect the data on their occupation and health, and their reproductive health status was analyzed.@*Results@#The female workers exposed to occupational hazards had significantly higher incidence rates of gynecological diseases, abnormal menstruation, and infertility than those not exposed to such hazards (χ2=32.29, 12.42, and 4.23, respectively, all P<0.05) . There were significant differences in the incidence rates of gynecological diseases, abnormal menstruation, adverse pregnancy outcomes, and pregnancy complications between the female workers with different working forms and states (χ2=17.19, 23.03, 200.65, and 21.28, respectively, all P<0.05) . There were significant differences in the incidence rates of gynecological diseases, abnormal menstruation, and pregnancy complications between the female workers with different behavioral habits (χ2=15.65, 36.23, and 25.35, respectively, all P<0.05) . The logistic regression analysis showed that exposure to occupational hazards, married state, medium-grade professional title or above, work in shifts, sitting for a long time, standing for a long time, and video operation were risk factors for gynecological diseases, and the prevalence rate of gynecological diseases increased with age. Exposure to occupational hazards, night shifts, staying up late, and sitting for a long time were risk factors for abnormal menstruation. Exposure to occupational hazards was a risk factor for infertility. Medium-grade professional title or above was a risk factor for adverse pregnancy outcomes. Married state, medium-grade professional title or above, standing for a long time, and high mobility in job form and state were risk factors for pregnancy complications.@*Conclusion@#Exposure to occupational hazards, job form and state, and unhealthy behavioral habits may affect reproductive health status in female workers in the railway system.
ABSTRACT
Both HIV and HBV infection have become major health problems,of global concern,due to the high prevalence in the past few decades.Data from cumulated epidemiological surveys have shown the links between maternal HIV or HBV infection and adverse outcomes on pregnancy.Maternal HIV or HBV infection may also increase the mother-to-child (MTCT) transmission of the two diseases.However,association between HIV-HBV co-infection and adverse pregnancy is still inconclusive.Does maternal HIV-HBV co-infection have an impact on mother-to-child transmission on either HIV or HBV? Study on effective precautionary measures to promote both maternal and child's health is deemed necessary.
ABSTRACT
Objective To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China.Methods Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis.A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled.Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires,with related outcomes on pregnancy recorded by doctors.Results Among all the 248 501 participants,1 806 (0.74％) women and 2 653 (1.09％) men reported to have been exposed to pesticide before pregnancy,with 505 (0.21％) reported of having been exposed to pesticide during the period of pregnancy.Maternal exposure to pesticide was found a risk factor related to stillbirth (OR=3.37,95 ％ CI:2.05-5.55),peculiar smell pregnancy (OR =3.17,95％CI:1.18-8.55) and low birth weight (OR=7.56,95％ CI:5.36-10.66).Paternal exposure to pesticide was also found related to miscarriage (OR=1.37,95％ CI:1.03-1.80),low birth weight (OR=3.65,95％ CI:1.51-8.84),or giant infant (OR?=0.64,95％ CI:0.44-0.93).Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage (OR=4.65,95％ CI:3.47-6.24).Other adverse outcomes on pregnancy would include premature birth and high birth weight.Conclusion Parental pesticide exposure appeared a risk factor on stillbirth,peculiar smell pregnancy,low birth weight and miscarriage.
ABSTRACT
Introduction@#Locally, there is no unified set of diagnostic criteria for gestational diabetes mellitus (GDM) and this can lead to potential confusion on the part of the physician and the patient as well. Moreover, whether the adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) threshold values for GDM diagnosis among Filipino women is appropriate is still unclear. This study serves to give a clinically important insight whether utilizing the abovementioned diagnostic criteria is appropriate in the local setting or not. The study aims to determine the association of the threshold values set up by the IADPSG to diagnose GDM with adverse pregnancy outcomes among a cohort of Filipino women.@*Methods@#A retrospective analysis of medical files of the women diagnosed with GDM using the IADPSG criteria from January 2013 to March 2016 was done. The results of seventyfive gram oral glucose tolerance test (75-g OGTT) were recorded. The association between each IADPSG threshold values (fasting blood glucose of ≥92 mg/dL, one-hour post glucose load of ≥180 mg/dL, two-hour post glucose load of ≥153 mg/dL) used to define GDM and maternal and perinatal outcomes were determined. @*Results@#One hundred twenty women with GDM were included in the analysis. Each of IADPSG-defined cut-off values was not significantly associated with increased likelihood of having adverse maternal outcomes namely: hypertensive disorders of pregnancy, miscarriage, primary cesarean section, operative vaginal delivery, and maternal death. Similarly, the likelihood of perinatal outcomes namely: macrosomia, perinatal death, prematurity, birth injuries, congenital anomalies, neonatal hypoglycemia, jaundice, low APGAR score, acute respiratory distress syndrome, and infection were not significantly higher even if these cut-off values were met. Of note, high odds ratio was noted for neonatal hypoglycemia at FBS >92 mg/dL and <92 mg/dL and the low Apgar Score in first minute at >153 mg/dL and <153 mg/dL even though they were statistically not significant. @*Conclusion@#We did not find a statistically significant positive association between IADPSG threshold values and specified adverse maternal and perinatal outcomes.
Subject(s)
Diabetes, GestationalABSTRACT
Objective To understand the incidence and epidemiological characteristics of adverse pregnancy outcome in Shaanxi province.Methods General information of the study was derived from the prevalence and risk factors of birth defects in Shaanxi province in 2010-2013.Descriptive epidemiological method was used to analyze the data of adverse pregnancy outcome.Results The overall incidence of adverse pregnancy outcome was 25.45％ during 2010-2013 (26.84％ in 2010,26.11％ in 2011,24.96％ in 2012 and 24.80％ in 2013,respectively).Fetal macrosomia and low birth weight accounted for 31.91％ and 23.42％,spontaneous abortion and premature delivery accounted for 18.94％ and 16.65％,while birth defects and embryo death in the palace accounted for 7.38％ and 1.70％,respectively.There were significant differences in distribution of adverse pregnancy outcome among different age groups (P＜0.001) and different years (P＜0.05).Age was positively associated with risk on adverse pregnancy outcomes (P＜0.001).The incidence of adverse pregnancy outcome were high in Liquan (37.49％),Wugong (35.50％) and Qianxian counties (35.13％).Conclusions The overall incidence of adverse pregnancy outcome was 25.45％ in Shaanxi.Fetal macrosomia,low birth weight and spontaneous abortion were the three major types of adverse pregnancy outcome,while age and area were related factors.Targeted strategies should be taken to reduce the incidence of adverse pregnancy outcome in Shaanxi.
ABSTRACT
Objective To understand the incidence and epidemiological characteristics of adverse pregnancy outcome in Shaanxi province.Methods General information of the study was derived from the prevalence and risk factors of birth defects in Shaanxi province in 2010-2013.Descriptive epidemiological method was used to analyze the data of adverse pregnancy outcome.Results The overall incidence of adverse pregnancy outcome was 25.45％ during 2010-2013 (26.84％ in 2010,26.11％ in 2011,24.96％ in 2012 and 24.80％ in 2013,respectively).Fetal macrosomia and low birth weight accounted for 31.91％ and 23.42％,spontaneous abortion and premature delivery accounted for 18.94％ and 16.65％,while birth defects and embryo death in the palace accounted for 7.38％ and 1.70％,respectively.There were significant differences in distribution of adverse pregnancy outcome among different age groups (P＜0.001) and different years (P＜0.05).Age was positively associated with risk on adverse pregnancy outcomes (P＜0.001).The incidence of adverse pregnancy outcome were high in Liquan (37.49％),Wugong (35.50％) and Qianxian counties (35.13％).Conclusions The overall incidence of adverse pregnancy outcome was 25.45％ in Shaanxi.Fetal macrosomia,low birth weight and spontaneous abortion were the three major types of adverse pregnancy outcome,while age and area were related factors.Targeted strategies should be taken to reduce the incidence of adverse pregnancy outcome in Shaanxi.
ABSTRACT
Ureaplasma species are the most prevalent genital Mycoplasma isolated from the urogenital tract of both men and women. Ureaplasma has 14 known serotypes and is divided into two biovars‑ Ureaplasma parvum and Ureaplasma urealyticum. The organism has several genes coding for surface proteins, the most important being the gene encoding the Multiple Banded Antigen (MBA). The C‑terminal domain of MBA is antigenic and elicits a host antibody response. Other virulence factors include phospholipases A and C, IgA protease and urease. Besides genital tract infections and infertility, Ureaplasma is also associated with adverse pregnancy outcomes and diseases in the newborn (chronic lung disease and retinopathy of prematurity). Infection produces cytokines in the amniotic fluid which initiates preterm labour. They have also been reported from renal stone and suppurative arthritis. Genital infections have also been reported with an increasing frequency in HIV‑infected patients. Ureaplasma may be a candidate ‘co factor’ in the pathogenesis of AIDS. Culture and polymerase chain reaction (PCR) are the mainstay of diagnosis. Commercial assays are available with improved turnaround time. Micro broth dilution is routinely used to test antimicrobial susceptibility of isolates. The organisms are tested against azithromycin, josamycin, ofloxacin and doxycycline. Resistance to macrolides, tetracyclines and fluoroquinolones have been reported. The susceptibility pattern also varies among the biovars with biovar 2 maintaining higher sensitivity rates. Prompt diagnosis and initiation of appropriate antibiotic therapy is essential to prevent long term complications of Ureaplasma infections. After surveying PubMed literature using the terms ‘Ureaplasma’, ‘Ureaplasma urealyticum’ and ‘Ureaplasma parvum’, relevant literature were selected to provide a concise review on the recent developments.
ABSTRACT
Objective To investigate Monilia infection and adverse pregnancy outcomes of pregnant women in labor.Methods Before informed consent,542 cases of pregnant women in labor were collected in Obstetrics Department of Maternity and Child Healthcare of Maoming City from January 2013 to April 2014,and all of these cases were examined by Monilia inspec-tion of vaginal secretions.All of these cases were 20 to 30 years old,without vaginal pathogenic infection symptoms,but in-cluded in a few of formulation of clinical features of vaginal Candida infection.With the two methods of 10% potassium hy-droxide solution wet sheet and Gram staining,if blastospore or pseudohypha of Candida mycoderma were found out in the two methods under microscope,this case was diagnosed as positive result,otherwise as negative result.Respectively choosing positive cases as observation group,and negative cases as control group,the indexes of premature rupture of membranes,per-ineum wound infection,neonatal thrush and neonatal diaper rash of the two groups were recorded.The statistical method:e-numeration data by chi-square test,measurement data using analysis of varianc.Results The positive rate of Monilia was 23.1% (125/542),higher than 19.3% reported in domestic.The incidence rates of neonatal diaper rash,premature rupture of membranes,neonatal thrush and perineum wound infection of the observation group were respectively 19.2%,8.0%, 16.8% and 12.8%,all much higher than the control group respectively was 8.4%,1.2%,3.8% and 1.7%,(χ2 =12.578~29.273,all P <0.01).Conclusion Monilia infection of pregnant women in labor could increase the chance of adverse preg-nancy outcomes.Healthy or clinical doctors should suggest that pregnant women early carry out routine examination and ear-ly treatment,in order to prevent adverse pregnancy outcomes.