Study on the normal value of cervical elasticity parameters of primiparas during pregnancy by transvaginal ultrasound / 中华超声影像学杂志

Objective:To investigate the normal parameter values of transvaginal E-Cervix cervical elastography of primipara and explore the correlation between E-Cervix parameters and gestational age.Methods:A total of 301 primiparas underwent E-Cervix by transvaginal ultrasound in Henan Provincial People′s Hospital from March 2019 to January 2021, they were divided into 6 groups according to generational weeks: group A (11-13 + 6W), group B (14-17 + 6W), group C (18-21 + 6W), group D (22-25 + 6W), group E (26-29 + 6W), group F (30-33 + 6W). Real-time E-Cervix parameters were obtained, including elasticity contrast index (ECI), hardness ratio (HR), internal ostium (IOS), and external ostium (EOS), strain ratio of the internal and external cervical ostium (IOS/EOS), and the correlations between E-Cervix parameters and the gestational week were analyzed. Results:The normal reference ranges of parameters ECI, IOS, EOS, HR and IOS/EOS were obtained, their 95% reference values in groups A to F were as follows: ECI (1.84-3.38, 2.13-4.50, 2.25-4.12, 2.06-3.96, 2.04-5.15, 2.36-5.53), HR (85.85%-88.72%, 77.31%-80.92%, 74.41%-78.50%, 71.13%-74.35%, 64.49%-68.56%, 63.57%-68.23%), IOS (0.12-0.21, 0.14-0.34, 0.14-0.31, 0.19-0.40, 0.19-0.56, 0.21-0.49), EOS (0.12-0.30, 0.14-0.34, 0.16-0.41, 0.20-0.39, 0.22-0.58, 0.22-0.54), IOS/EOS (0.55-1.12, 0.52-1.45, 0.56-1.26, 0.54-1.38, 0.54-1.52, 0.65-1.46). The differences of ECI, HR, IOS and EOS in different groups were statistically significant (all P<0.05). Spearman correlation analysis results showed that ECI, IOS, and EOS were positively correlated with gestational week( rs=0.524, 0.689, 0.609; all P<0.01). HR was negatively correlated with gestational week ( rs=-0.755, P<0.01). The regression equations of ECI, HR, IOS and EOS were Y=0.06X+ 52.214, Y=99.25-1.07X, Y=8.63E-3X+ 0.05, Y=7.94E-3X+ 0.1, respectively. Conclusions:The normal parameters values of E-TVES are summarized.It provides effective support in data for cervical evaluation in the preterm prediction and success of labor induction.

Association between daily average temperature and premature birth in Ningbo City: A time-series analysis / 环境与职业医学

Background Research on the relationship between ambient temperature and preterm birth has received increasing attention, but the conclusions of the previous literature are inconsistent. Objective To explore the impact of environmental temperature exposure in Ningbo on premature delivery of pregnant women. Methods The birth information, preterm birth data, and age of pregnant women from January 2016 to September 2020 were collected by the electronic medical record system of Ningbo Women’s and Children’s Hospital. Meteorological data for the same period were obtained through Ningbo Meteorological Bureau, including daily average temperature, daily average relative humidity, and daily average air pressure. Daily concentrations of SO2, NO2, and PM10 were derived through the air quality real-time release system on the website of Ningbo Environmental Protection Bureau. A distributed lag nonlinear model was used to analyze the impact of environmental temperature on preterm birth by stratifying pregnant women’s age and birth delivery mode. Results The incidence rate of preterm birth in Ningbo from 2016 to 2020 was 5.91%. The exposure-response curve between environmental temperature and preterm birth presented a “U” shape. Taking 22.5 ℃ as a reference, the cumulative effect of 31 ℃ (the 95th percentile) and 32 ℃ (the 99th percentile) over a 21-day lag on preterm delivery was statistically significant, and the related RR (95%CI) values were 1.67 (1.05-2.65) and 1.85 (1.09-3.14) respectively. The results of stratified analysis showed that among pregnant women ≥30 years old, the 21-day cumulative effects of 31 ℃ and 32 ℃ on preterm delivery were statistically significant, and the related RR (95%CI) values were 2.09 (1.08-4.05) and 2.36 (1.11-5.03) respectively; among pregnant women with natural delivery, the 21-day cumulative effect of 32 ℃ on preterm delivery was statistically significant, and the RR (95%CI) was 1.95 (1.02-3.74). Conclusion Exposure of pregnant women to high temperature during pregnancy could increase the risk of preterm birth, and there is a delayed cumulative effect.

Cuidados imediatos aos recém-nascidos pré-termos em um hospital de ensino / Immediate care for premature infants in a teaching hospital / Atención inmediata a los recién nacidos prematuros en un hospital universitário

Objetivo: descrever os cuidados imediatos realizados em recém-nascidos pré-termos na sala de parto. Método: estudo observacional, retrospectivo de abordagem quantitativa, realizado em um hospital de ensino. Os dados foram coletados de 144 prontuários de recém-nascidos pré-termos, no período de janeiro de 2019 a janeiro de 2020, e submetidos à análise descritiva e ao teste Qui-quadrado. A pesquisa recebeu aprovação do Comitê de Ética em Pesquisa. Resultados: sobre os cuidados imediatos aos recém-nascidos pré-termo, 52,1% tiveram clampeamento do cordão umbilical antes do primeiro minuto, 22,2% realizaram contato pele a pele precoce, 34,7% iniciaram aleitamento materno precoce, 66,4% realizaram aspiração de vias aéreas na sala de parto. Conclusão: evidenciou-se que o clampeamento precoce do cordão umbilical, a aspiração de vias aéreas e a utilização de oxigênio inalatório para estabilização clínica são cuidados frequentes realizados nos recém-nascidos pré-termo na sala de parto.

Objective: to describe the immediate care provided to preterm newborns in the delivery room. Method: this quantitative, retrospective, observational study was conducted at a teaching hospital. Data collected from 144 medical records of preterm newborns, between January 2019 and January 2020, were submitted to descriptive analysis and the Chi-square test. The study was approved by the research ethics committee. Results: immediate care for preterm newborns included the following: 52.1% had their umbilical cord clamped before the first minute, 22.2% had early skin-to-skin contact, 34.7% started breastfeeding within the first hour, and 66.4% underwent airway aspiration in the delivery room. Conclusion: early umbilical cord clamping, airway aspiration and inhaled oxygen for clinical stabilization were found to be provided in the delivery room frequently in preterm newborns.

Objetivo: describir la atención inmediata realizada a los recién nacidos prematuros en la sala de partos. Método: estudio observacional, retrospectivo, de enfoque cuantitativo, realizado en un hospital universitario. Se colectaron datos de 144 historias clínicas de recién nacidos prematuros, de enero de 2019 a enero de 2020, y se sometieron a análisis descriptivo y prueba de Chi-cuadrado. El estudio fue aprobado por el Comité de Ética en Investigación. Resultados: en cuanto a la atención inmediata a los recién nacidos prematuros, el 52,1% tuvo pinzamiento del cordón umbilical antes del primer minuto, el 22,2% tuvo contacto precoz piel a piel, el 34,7% inició la lactancia materna precoz, el 66,4% realizó aspiración de la vía aérea en sala de parto. Conclusión: se demostró que el pinzamiento precoz del cordón umbilical, aspiración de las vías respiratorias y el uso de oxígeno inhalado para la estabilización clínica son cuidados frecuentes en los recién nacidos prematuros en la sala de partos.

Severe polyhydramnios as neonatal presentation of Bartter's syndrome type IV / Polihidrâmnios grave como manifestação neonatal da síndrome de Bartter tipo IV

Abstract Introduction: Bartter's syndrome comprises a heterogeneous group of inherited salt-losing tubulopathies. There are two forms of clinical presentation: classical and neonatal, the most severe type. Types I and II account for most of the neonatal cases. Types III and V are usually less severe. Characteristically Bartter's syndrome type IV is a saltlosing nephropathy with mild to severe neonatal symptoms, with a specific feature - sensorineural deafness. Bartter's syndrome type IV is the least common of all recessive types of the disease. Description: the first reported case of a Portuguese child with neurosensorial deafness, polyuria, polydipsia and failure to thrive, born prematurely due to severe polyhydramnios, with the G47R mutation in the BSND gene that causes Bartter's syndrome type IV. Discussion: there are few published cases of BS type IV due to this mutation and those reported mostly have moderate clinical manifestations which begin later in life. The poor phenotype-genotype relationship combined with the rarity of this syndrome usually precludes an antenatal diagnosis. In the presence of a severe polyhydramnios case, with no fetal malformation detected, normal karyotype and after maternal disease exclusion, autosomal recessive diseases, including tubulopathies, should always be suspected.

Resumo Introdução: a síndrome de Bartter inclui um grupo heterogéneo de tubulopatias hereditárias perdedoras de sal. Existem duas formas de apresentação clínica: clássica e neonatal, a forma mais grave. Os tipo I e II representam a maioria dos casos neonatais. Os tipos III e V são geralmente menos graves. Caracteristicamente, a síndrome de Bartter tipo IV é uma nefropatia perdedora de sal com sintomas neonatais ligeiros a graves, com um aspeto especí- fico - surdez neurossensorial. A síndrome de Bartter tipo IV é o tipo menos comum das formas recessivas da doença. Descrição: relatamos o primeiro caso de uma criança portuguesa, com surdez neurossensorial, poliúria, polidipsia e restrição de crescimento, nascida prematuramente devido a polihidrâmnios grave, homozigótica para a mutação G47R do gene BSND, responsável pela síndrome de Bartter tipo IV. Discussão: são raros os casos publicados sobre síndrome de Bartter tipo IV atribuída a esta mutação, e a maioria referem-se a diagnósticos mais tardios, com manifestações clínicas ligeiras. A fraca correlação fenótipo-genótipo combinada com a raridade desta síndrome tornam o diagnóstico pré-natal desafiante. Perante um caso de polihidrâmnios grave em um feto sem malformações aparentes, cariótipo normal e após exclusão de patologia materna, as doenças autossómicas recessivas, incluindo as tubulopatias, devem ser sempre consideradas.

Advances in the role of silence information regulator family in pathological pregnancy / 浙江大学学报·医学版

Aberrant maternal inflammation and oxidative stress are the two main mechanisms of pathological pregnancy. The silence information regulator (sirtuin) family is a highly conserved family of nicotinamide adenine dinucleotide (NAD)-dependent deacylases. By regulating the post-translational modification of proteins, sirtuin is involved in various biological processes including oxidative stress and inflammation. Nowadays, emerging evidence indicates that sirtuin may be closely related to the occurrence and development of pathological pregnancy. The down-regulation of sirtuin can cause spontaneous preterm delivery by promoting uterine contraction and rupture of fetal membranes, cause gestational diabetes mellitus through promoting oxidative stress and affecting the activity of key enzymes in glucose metabolism, cause preeclampsia by reducing the proliferation and invasion ability of trophoblasts, cause intrahepatic cholestasis of pregnancy by promoting the production of bile acids and T helper 1 cell (Th1) cytokines, and cause intrauterine growth restriction through inducing mitochondrial dysfunction. Moreover, the expression and activation of sirtuin can be modulated through dietary interventions, thus sirtuin is expected to become a new target for the prevention and treatment of pregnancy complications. This article reviews the role of the sirtuin family in the occurrence and development of pathological pregnancy and its influence on the development of the offspring.

El parto pretérmino desde los registros del nacido vivo en Colombia, período 2008 - 2017 / Preterm birth from live-born registry in the period between 2008 - 2017 in Colombia

Resumen. Introducción: El parto pretérmino es uno de los principales problemas de la salud infantil. Es la principal causa de mortalidad infantil en los países en vía de desarrollo. Los últimos 20 años ha venido en aumento en el mundo por diferentes causas. Conocer su tendencia y características poblacionales es un elemento útil para su atención. Objetivo: Describir las características poblacionales asociados al parto pretérmino en Colombia desde los datos del Registro del Nacido Vivo en la década 2008 - 2017. Métodos: Estudio descriptivo ecológico a partir de fuentes segundarias: microdatos de Estadísticas Vitales del DANE; información almacenada en el programa Excel de Microsoft Office®. Análisis de las variables tiempo/lugar/persona en el programa estadístico SPSS™ mediante estadística descriptiva, análisis de asociación utilizando el estadístico Ji-cuadrado y el coeficiente de correlación Phi para la asociación estadística entre variables. Resultados. Fueron analizados 6.705.385 registros de nacidos vivos, 1.277.839 correspondientes a parto hasta las 37 semanas de gestación. Prevalencia del 19% de todos los años. Departamentos con mayor tasa de prematuros: Atlántico, Bogotá, Antioquía y Santander. No se encontró una asociación fuerte con los datos del registro del nacido vivo. Conclusiones: Existe déficit de información acerca del parto pretérmino en aspectos de datos completos y accesibles a los investigadores. La información no es homogénea ni sigue parámetros específicos. El registro de nacido vivo, sin embargo, es un excelente instrumento de recolección de datos poblacionales y base de aproximación al evento.

Abstract Background: Preterm birth is one of the main problems in infant health and it is the leading cause of infant mortality in developing countries. During the last 20 years this particularity has been increasing in the world for different reasons. Knowing its trend and population characteristics is a useful element for its attention. Objectives: To describe the population characteristics associated with preterm birth in Colombia from the data of the Live Birth Registry in the decade 2008 - 2017. Methods: Descriptive ecological study using secondary sources such us Vital Statistics microdata from DANE; information stored in the Microsoft Office® Excel program. Also, the analysis of the time/place/person variables in the SPSS ™ statistical program through descriptive statistics, and association analysis using the Chi-square statistic and the Phi correlation coefficient for the statistical association between variables was implemented. Results: 6,705,385 records from live-born registry were analyzed. 1,277,839 corresponded to preterm birth up to 37 weeks of gestation with 19% of prevalence all years. The departments with the highest rate of premature infants were Atlántico, Bogotá, Antioquia, and Santander. No strong association was found with live birth registry data. Conclusions: There is lack of complete and accessible information to researchers related to preterm birth. The data is not homogeneous and does not follow specific parameters. However, the live-born registry is an excellent instrument for collecting population data and a useful basis for approaching this event.

Parto prematuro en pacientes COVID-19 en Hospital San Juan de Dios / Premature delivery in COVID-19 patients at San Juan de Dios Hospital

INTRODUCCIÓN Y OBJETIVO: La pandemia por SARS-CoV-2 afecta a las embarazadas con diferentes manifestaciones clínicas; una de ellas es el parto prematuro. El objetivo del presente estudio es caracterizar a las embarazadas con COVID-19 que tuvieron su parto y determinar la razón de aumento de parto prematuro en este grupo en comparación con aquellas que no presentaban la enfermedad. MÉTODOS: Estudio observacional de cohorte retrospectivo donde se incluyeron pacientes embarazadas entre abril y junio del año 2020 en la Maternidad del Hospital San Juan de Dios. Se seleccionaron aquellas que tuvieron su parto y se evaluaron los datos demográficos y médicos, antecedentes obstétricos, información respecto al parto, antecedentes del recién nacido y características de la enfermedad por COVID-19. RESULTADOS: Entre las pacientes COVID-19 un 16.9% tuvo parto prematuro, alcanzando un OR de 1,79 (0,76-3,84 IC 95%) respecto a aquellas sin la enfermedad que, aunque no significativo, evidencia tendencia. Entre las que cursaron con COVID-19 severo todas tuvieron parto prematuro, con un OR significativo (>= 7.84 IC 95%) en comparación con aquellas con cuadro leve o negativas a COVID-19. Un 10.1% de los recién nacidos de madres COVID-19 requirió reanimación neonatal, mientras que en las negativas fue de un 5.5%. CONCLUSIONES: Entre las pacientes COVID-19 se observo una tendencia a aumento del riesgo de parto prematuro respecto a aquellas sin la enfermedad, siendo significativo el aumento del riesgo en aquellas que cursaban con síntomas y aún más significativo si presentaban enfermedad severa.

INTRODUCTION AND OBJECTIVES: The SARS-CoV-2 pandemic has affected pregnant women with different clinical manifestations, one of them premature labor. The objective of this study is to characterize the pregnant patients with COVID-19 who had their delivery and to determine the risk of preterm delivery in this group compared to those who did not have the disease at the Maternity Department in San Juan de Dios Hospital, and determine what the rate of premature delivery is. METHODS: Retrospective observational cohort study where pregnant patients were included between April and June of 2020 at the Maternity Department in San Juan de Dios Hospital. Patients who had their delivery were selected and demographic and medical data, obstetric history, information regarding delivery, newborn history and characteristics of COVID-19 disease were evaluated. RESULTS: Among COVID-19 positives, a 16.9% had premature labor, reaching a nonsignificant OR 1.79 (0.76-3.84 95% CI) compared to those COVID-19 negative. Among those with severe COVID-19, all had preterm birth, with a significant OR (>=7.84 95% CI) compared to those with mild symptoms or COVID-19 negative. 10.1% of newborns of COVID-19 mothers required neonatal resuscitation, while, in the negative ones it was 5.5%. CONCLUSIONS: Among COVID-19 patients, a trend towards increased risk of preterm birth was observed compared to those without the disease, with the increased risk being significant in those with symptoms and even more significant if they had severe disease.

Determination of maternal risk factors of preterm delivery: adjusted for sparse data bias; results from a population-based case-control study in Iran

OBJECTIVE: To determine the maternal risk factors associated with preterm delivery in Iran.METHODS: A population-based case-control study was conducted including 48 women having preterm delivery (case group) and 100 women having term delivery (control group) between March 2007 and March 2012 in the maternity hospitals of the Selseleh County, Lorestan province, Iran. Information regarding maternal risk factors was collected by structured interview and reviewing the medical records. The maternal risk factors associated with preterm delivery were identified using univariate and multivariable logistic regression analysis after adjusting the sparse data bias. The area under the receiver operating characteristic (ROC) curves was estimated to evaluate the discrimination power of the statistical models.RESULTS: Multivariable analysis demonstrated that multiparty (odds ratio [OR], 14.23; 95% confidence interval [CI], 1.60–127.05), history of gestational diabetes (OR, 0.10; 95% CI, 0.01–0.99), thyroid dysfunction (OR, 97.32; 95% CI, 5.78–1,637.80), urinary tract infection (OR, 16.60; 95% CI, 3.20–85.92), and taking care during pregnancy (OR, 0.12; 95% CI, 0.03–0.50) had significant impact on preterm delivery after adjusting the potential confounders. The area under the ROC curve for the aforementioned maternal risk factors was 0.86 (95% CI, 0.80–0.92).CONCLUSION: Our study provides evidence for the associations between multiparty, history of gestational diabetes, thyroid dysfunction, urinary tract infection, as well as taking care during pregnancy, and preterm delivery.

Investigation on the influence of periodontal disease in gestation on small for gestational age / 口腔疾病防治

Objective @#The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery.@*Methods@# A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups.@*Results @#The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05).@*Conclusion@#Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.

Maternal exposure to benzene and toluene and preterm birth. A longitudinal study

ABSTRACT BACKGROUND: Exposure to air pollutants has several effects on human health, including during pregnancy. OBJECTIVE: To identify whether exposure to benzene and toluene among pregnant women contributes to preterm delivery. DESIGN AND SETTING: Longitudinal study using data on newborns from mothers living in São José dos Campos (SP) in 2016, who had been exposed to benzene and toluene. METHODS: A logistic regression model with three hierarchical levels was constructed using maternal variables relating to newborns, and using benzene and toluene concentrations in quartiles. Occurrences of cesarean births, twins or malformations were excluded. Maternal exposure windows of 5, 10, 15, 30, 60 and 90 days prior to delivery were considered. RESULTS: Out of the 9,562 live births, 3,671 newborns were included and 343 newborns were born at less than 37 weeks of gestation (9.3%). The average birth weight was 3,167.2 g. Exposure to benzene and toluene was significantly associated (P = 0.04) with preterm delivery in the five-day window. There was no association in any of the other exposure windows. CONCLUSIONS: It was possible to identify that maternal exposure to benzene and toluene has an acute effect on preterm delivery.

Neutrophil-to-lymphocyte ratio as a prognostic biomarker for patients with preterm labor in late stage of pregnancy / 实用医学杂志

Objective The aim of this study was to investigate the association between maternal serum lev-el of neutrophil-lymphocyte ratio(NLR)and preterm labor in late stage of pregnancy. Methods In this retrospec-tive analysis of 200 pregnant women who underwent routine prenatal examination and delivered from January 12016 to December 312016 in the Maternal and Child Health family planning services,Xinhui District,Jiangmen city. The patients were divided into the PIR group(n = 100)and the control group(n = 100). The levels of leuko-cytes,neutrophils,lymphocytes,CRP and NLR of the two groups were compared. Multivariate analysis was per-formed to identify independent risk factor. Logistic regression model was established and the area under the receiver operating characteristic curve(ROC)was recorded for analysis of the prognostic value of different serum inflamma-tory makers in late stage of pregnancy. Results The NLR predict premature occurrence of AUC,the sensitivity and specificity of which were higher than those of peripheral blood leukocyte,neutrophil count,lymphocyte count and CRP. Conclusion Increased NLR in late stage of pregnancy could serve as an effective factor to predict the risk of preterm labor.

Relationship between gestational weight gain and pregnancy outcomes in Songjiang District, Shanghai / 上海交通大学学报（医学版）

Objective • To understand the status of gestational weight gain (GWG) during pregnancy among women in Songjiang District, Shanghai, and to explore the relationship between GWG and birth outcomes. Methods • 4 884 cases were collected in Maternal and Child Health Hospital of Songjiang District, Shanghai from July to December 2016. According to the range of GWG formulated by the Institute of Medicine (IOM) in 2009, the subjects were divided into the insufficient GWG group, the normal GWG group, and the excessive GWG group. The relationship between GWG and the birth outcome of the newborn, mainly including the neonatal weight, the birth gestational week, the neonatal score, and the bad birth outcome such as premature delivery, small-for-gestational age (SGA), large-for-gestational age (LGA), and macrosomia were analyzed. Results • 25.7% of pregnant women gained underweight during pregnancy. 33.3% of pregnant women gained overweight during pregnancy. The GWG was positively correlated with birth weight (β=24.17, 95% CI 21.90-26.45, P=0.000). GWG was a protective factor for SGA (OR=0.89, 95% CI 0.87-0.91, P=0.000). GWG was a risk factor for LGA (OR=1.12, 95% CI 1.09-1.14, P=0.000) and macrosomia (OR=1.14, 95% CI 1.11-1.16, P=0.000). The GWG was positively associated with gestational age (β=0.03, 95% CI 0.03-0.04, P=0.000). The incidence of the premature delivery decreased with the increasing of GWG (OR=0.91, 95% CI 0.88-0.95, P=0.000). Women with insufficient GWG exhibited increased risks of SGA infants (OR=1.54, 95% CI 1.22-1.94, P=0.000) and premature delivery (OR=1.53, 95% CI 1.03-2.26, P=0.034), whereas women with excessive GWG exhibited increased risk of LGA (OR=2.20, 95% CI 1.71-2.84, P=0.000) and macrosomia (OR=2.41, 95% CI 1.86-3.11, P=0.000), when compared with women who had normal GWG. Conclusion • It is of great significance to maintain proper GWG and to improve the outcome of birth. Attention should be paid to the management of weight during pregnancy.

Meningitis neonatal precoz causada por transmisión vertical de Escherichia coli productora de beta-lactamasa de espectro extendido en parto prematuro con rotura prematura de membranas / Early neonatal meningitis caused by vertical transmission of extended-spectrum beta-lactamase-producing Escherichia coli in premature labor with premature rupture of membranes

Se comunica el caso de un recién nacido producto de un parto prematuro con rotura prematura de membranas, que desarrolló precozmente meningitis neonatal por Escherichia coli productora de beta-lactamasa de espectro extendido. Los cultivos en líquido céfalo raquídeo y sangre neonatal fueron tempranamente positivos para esta bacteria. No obstante no aislarse este microorganismo en la madre, los hallazgos de la biopsia placentaria y la precocidad de la infección neonatal son determinantes en señalar que se trató de infección intraamniótica con transmisión vertical al neonato. La meningitis neonatal fue tratada con meropenem y el niño se dio de alta en buenas condiciones después de 41 días de hospitalización. Las guías perinatales actuales, preconizan el tamizaje de muestras vaginales para la prevención del parto prematuro y de los resultados adversos asociados a infección bacteriana ascendente durante el embarazo.

We report the case of a newborn resultant of premature delivery with premature rupture of membranes, which developed early-onset neonatal meningitis caused by transmission of Escherichia coli producer of betalactamasa of spectrum extended. Cultures in cerebrospinal fluid and neonatal blood were early positive for this bacterium. Although this microorganism is not isolated in the mother, the findings of the placenta biopsy and the precocity of the neonatal infection are determinant in indicating that it was an intraamniotic infection with vertical transmission to the neonate. Neonatal meningitis was treated with meropenem and the child was discharged in good condition after 41 days of hospitalization. The current perinatal guidelines support the screening of vaginal samples for the prevention of preterm birth and the adverse outcomes associated with ascending bacterial infection during pregnancy.

Relationship between optimal cutoff value of serum homocysteine and risk factors of premature delivery and its logistic regression analysis / 实用医学杂志

Objective To investigate the relationship between the optimal cutoff point of serum homocyste-ine(Hcy)and premature delivery in pregnant women ,and to analyze the influence of Hcy levels on the outcome of preterm infants. Methods Totally 114 cases of pregnant women were chosen as observation group and 103 cases of normal as control group. Hcy,D-D and hypersensitive C reactive protein were detected;analysis of the ROC curve was conducted by using the SPSS 13 software and the risk factors for preterm delivery were analyzed using logistic multivariate regression analysis. Results (1)The levels of Hcy,HS-CRP and D-D in preterm pregnant women were higher than those in control group and the difference was statistically significant (P < 0.05). (2) Logistic regression analysis showed that the relative risk coefficient(OR)of Hcy was 9.736,and the regression equation of premature birth probability was obtained.(3)ROC curve to evaluate the predictive value of Hcy in risk factors of preterm birth was 0.931;when Hcy was 13.8μmol/L,the Youden index was 0.784.(4)Elevated levels of Hcy in preterm women led to a marked increase in the likelihood of SGA. Conclusion When predicting risk factors for preterm birth,the best predictive cutoff value for Hcy is 13.8μmol/L,which is one of the independent risk factors for preterm birth.

Application of axillary vein puncture needle technique in premature infants with low birth weight / 中国生化药物杂志

Objective To investigate the clinical effect of axillary vein puncture needle technique in the infusion of low birth weight infants.Methods The study group received axillary venipuncture indwelling needle technique, the control group was given head intravenous indwelling needle technique, compared the related anomalies incidence of two groups of low birth weight infants during intravenous infusion catheter. Results The incidence of abnormal occlusion, phlebitis, oozing of blood in preterm infants with low birth weight infants (2.13%,4.26% and 2.13%) were significantly lower than those in the control group (19.15%,27.66%,17.02%), respectively (P＜0.05). Conclusion The application of axillary vein puncture needle technique can significantly reduce the incidence of adverse reactions associated with infusion of low birth weight infants, and has positive significance in ensuring the efficacy and prognosis.

Relationship between optimal cutoff value of serum homocysteine and risk factors of premature delivery and its logistic regression analysis / 实用医学杂志

Objective To investigate the relationship between the optimal cutoff point of serum homocyste-ine(Hcy)and premature delivery in pregnant women ,and to analyze the influence of Hcy levels on the outcome of preterm infants. Methods Totally 114 cases of pregnant women were chosen as observation group and 103 cases of normal as control group. Hcy,D-D and hypersensitive C reactive protein were detected;analysis of the ROC curve was conducted by using the SPSS 13 software and the risk factors for preterm delivery were analyzed using logistic multivariate regression analysis. Results (1)The levels of Hcy,HS-CRP and D-D in preterm pregnant women were higher than those in control group and the difference was statistically significant (P < 0.05). (2) Logistic regression analysis showed that the relative risk coefficient(OR)of Hcy was 9.736,and the regression equation of premature birth probability was obtained.(3)ROC curve to evaluate the predictive value of Hcy in risk factors of preterm birth was 0.931;when Hcy was 13.8μmol/L,the Youden index was 0.784.(4)Elevated levels of Hcy in preterm women led to a marked increase in the likelihood of SGA. Conclusion When predicting risk factors for preterm birth,the best predictive cutoff value for Hcy is 13.8μmol/L,which is one of the independent risk factors for preterm birth.

Comparison of Efficacy and Safety of Original Ritodrine Injection and Its Generic Formulation / 医薬品情報学

<b>Objective: </b>In Japan, the healthcare authority encourages physicians to prescribe generic drugs in order to reduce the copayments by the patients for pharmaceutical expenses and to improve the financial status of the national medical insurance system.  In accordance with this governmental policy, we have been actively involved in switching original to generic formulations.  Thus, Utemerine® 50 mg injection was replaced with Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.  There have been some reports on adverse events caused by the generic formulations of Ritodrine hydrochloride.  Factors contributing to these adverse effects may include different additives and/or vehicles and the exemption of demonstrating some conditions for approval, including clinical trials.  Therefore, in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation and to decide on its continued use, we carried out a retrospective cohort study.<br><b>Methods: </b>We carried out a retrospective cohort study in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation.<br><b>Results: </b>There were no significant differences in the length of hospital stay, rate of emergency transport to other institutions, gestational week of delivery, rate of stillbirth, rate of abortion, or incidence of adverse events between the two formulations.<br><b>Conclusion: </b>Our results may contribute to the safe and secure use of the generic formulations of Ritodrine hydrochloride in the current situation of the increasing use of generic drugs in health care.  Although there are some limitations in our study, the results suggest that there are no particular problems with the continued use of Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.

Application of axillary vein puncture needle technique in premature infants with low birth weight / 中国生化药物杂志

Objective To investigate the clinical effect of axillary vein puncture needle technique in the infusion of low birth weight infants.Methods The study group received axillary venipuncture indwelling needle technique, the control group was given head intravenous indwelling needle technique, compared the related anomalies incidence of two groups of low birth weight infants during intravenous infusion catheter. Results The incidence of abnormal occlusion, phlebitis, oozing of blood in preterm infants with low birth weight infants (2.13%,4.26% and 2.13%) were significantly lower than those in the control group (19.15%,27.66%,17.02%), respectively (P＜0.05). Conclusion The application of axillary vein puncture needle technique can significantly reduce the incidence of adverse reactions associated with infusion of low birth weight infants, and has positive significance in ensuring the efficacy and prognosis.

The diagnostic value of high-sensitivity C-reactive protein/albumin ratio in evaluating early-onset infection in premature / 中华危重病急救医学

Objective To observe the diagnostic value of high-sensitivity C-reactive protein/albumin ratio (hs-CRP/ALB) in early-onset infection in premature and its clinical significance. Methods Clinical data of premature patients with high risk factors of intrauterine infection admitted to neonatal intensive care unit (NICU) of Liaocheng People's Hospital in Shandong Province from July 2013 to July 2015 were analyzed retrospectively. They were divided into infection and non-infection groups, as well as survival and death groups according to the outcome of the premature babies. The pre-albumin (PA), ALB, white blood cell count (WBC), platelet count (PLT), and hs-CRP at the moment of NICU admission (0 hour) and 24, 48 and 72 hours after NICU admission were compared. The receiver operating characteristic (ROC) curve was plotted for evaluation of the predictive value of serum hs-CRP/ALB ratio for the babies during hospitalization. Results A total of 214 cases of premature infants were enrolled, with 102 cases in infection group, and 112 in non-infection group. In infection neonates, 97 of them survived, and 5 died. ① The level of hs-CRP after NICU admission was increased in infection and non-infection groups, and it was significantly higher at 48 hours in infection group than that of the non-infection group [mg/L: 22.0 (7.6, 40.4) vs. 18.3 (12.9, 23.4),Z = 5.257, P = 0.038]. Then hs-CRP was decreased in non-infection, but it was persistently increased in infection group, and it was significantly higher at 72 hours in infection group than that of the non-infection group [mg/L: 25.5 (9.8, 43.5) vs. 12.2 (1.9, 22.1), Z = 5.879, P = 0.042]. The levels of ALB and WBC in infection group was significantly lower than those of the non-infection group [ALB (g/L): 27.9±2.7 vs. 29.1±2.9, t = 5.178, P = 0.026; WBC (×109/L): 13.7±7.1 vs. 16.1±7.9, t = 4.368, P = 0.037], and at 48 hours hs-CRP/ALB in infection group was significantly higher than that of non-infection group [0.16 (0.08, 0.57) vs. 0.07 (0.00, 0.23), Z = 3.436, P = 0.042]. There was no significant difference in PA and PLT between infection and non-infection groups. ② In premature patients with infection, ALB in non-survival group was decreased (g/L: 20.4±6.9 vs. 29.6±7.5, t = 7.859, P = 0.003), and 48-hour hs-CRP and hs-CRP/ALB ratio was significantly increased when compared with that of survival group [hs-CRP (mg/L): 25.8 (15.6, 54.8) vs. 18.2 (12.9, 36.2), Z = 4.067, P = 0.043; hs-CRP/ALB: 0.31 (0.28, 0.76) vs. 0.06 (0.00, 0.21), Z = 6.102, P = 0.011].③ It was shown by ROC curve analysis that the area under ROC curve (AUC) of 48-hour hs-CRP/ALB ratio for evaluating infection was 0.765, when the cut-off of 48-hour hs-CRP/ALB ratio was 0.08, the sensitivity was 84.2%, and the specificity was 76.3%. Conclusions The values of hs-CRP and ALB can be used as effective indexes in early diagnosis of intrauterine bacterial infection, and increase in 48-hour hs-CRP/ALB can improve the sensitivity of the diagnosis. Hs-CRP/ALB can be combined to guide rational use of antibiotics.

Delivery peculiarity in pregnant women with sexually transmitted infections / Монголын Анагаах Ухаан

Introduction: Sexually transmitted infections (STIs) are common in the developing countries. Sexually transmitted infections are among the most important causes of spontaneous abortion, premature rupture of membranes, preterm delivery, stillbirth, low birth weight, neonatal infection and postpartum endometritis and a major public health problem in the world.Goal: The goal of this study is to search peculiarity of delivery in women with STI.Materials and Methods: This study is a prospective cohort study which was done 2009-2010. In this study 120 pregnant women were involved. In case group were attended 60 women with STI and 60 women without STI in control group. The 40 pregnant women of case group (I group) were done treatment of STI and 20 pregnant women of case group (II group) were not done treatment of STI. All women were diagnosed with STI including syphilis, gonorrhea, Chlamydia and trichomoniasis. Statistical analysis has been done by SPSS 13.0 programm.Results: Mean gestational age at the first antenatal visit in I group was significantly earlier than in group II (13.5±4.5 weeks and 18.8±7.2 weeks respectively; p=0.005) but was similar to that of control group (13.6±5.2 weeks; P not significant). The frequency of preterm delivery and PROM was significantly lower in group I (12.5%, 17.5% respectively) than group II (30.0%, 40.0% respectively). In terms of II group preterm delivery and PROM were from 4 to 5 times more in comparison to control group. Low birth weight was significantly lower in women of group I (17.5%) than group II (30.0%; p=0.04) and in group II was 3 times more in comparison to control group(11.7%; p=0.008). Conclusions: The frequency of premature delivery, PROM, low birth weight were higher in the pregnant women who untreated STI. The first pprenatal visit is late and prenatal care inadequate were cause untreated in the pregnant women with STI.