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Objective:To study the risk factors for abnormal glucose metabolism in pregnant women with a history of gestational diabetes mellitus (GDM).Methods:A retrospective analysis was performed on pregnant women who had two consecutive deliveries and were was complicated by GDM in the previous pregnancy at the First Affiliated Hospital of Sun Yat-sen University from January 2011 to May 2019. Clinical data of both pregnancies were collected, including general information, fasting blood glucose in early pregnancy and 75 g oral glucose tolerance test (OGTT) results, glycosylated hemoglobin A1c and blood lipid profile at 24-28 gestational weeks. The incidence and risk factors of abnormal glucose metabolism in these cases during the present pregnancy were analyzed. Analysis of variance, Kruskal-Wallis test, SNK- q or LSD- t-test, and Chi-square test were used for data analysis. Single-factor logistic regression analysis was used to analyze the high-risk factors, and multifactor logistic regression analysis was performed to fit the model. Variable collinearity diagnosis was performed using the coldiag2 command. Results:(1) A total of 455 cases were enrolled in the study. According to the fasting glucose level in the first trimester and the OGTT results in the present pregnancy, they were divided into three groups: normal OGTT group ( n=240), GDM group ( n=189), and pre-gestational diabetes mellitus group (PGDM, n=26). The incidence of abnormal glucose metabolism in these patients during the present pregnancy was 47.2% (215/455). (2) Those with a history of GDM had higher pre-pregnancy weight, lower weight gain, higher cesarean section rate, smaller gestational age at delivery, and higher neonatal birth weight in the present pregnancy than those in the previous pregnancy [(55.6±8.5) vs (53.3±7.9) kg, t=-4.059; (11.2±4.2) vs (12.5±4.4) kg, t=4.435; 47.9% (218/455) vs 33.0% (150/455), χ2=20.481; (38.6±1.3) vs (38.8±1.3) weeks, t=2.288; (3 177±463) and (3 114±460) g, t=-2.044; all P<0.05]. (3) In the PGDM group, the 2-h plasma glucose level after 75 g OGTT was higher than that in the previous pregnancy [(11.4±1.1) vs (9.9±1.7) mmol/L, t=-3.299, P=0.002]. (4) In the present pregnancy, the PGDM group had the highest fasting blood glucose in early pregnancy, followed by the GDM group and the normal OGTT group [4.6 mmol/L (4.2-7.6 mmol/L), 4.3 mmol/L (4.0-4.6 mmol/L) and 4.1 mmol/L (3.8-4.4 mmol/L), χ2=34.498, P<0.001]. The PGDM group had the least postpartum weight retention, followed by the normal OGTT group and the GDM group [(1.2±3.9), (1.6±3.9), and (2.6±4.9) kg, F=3.086, P<0.05]. (5) Multivariate logistic regression analysis showed postpartum weight retention and the 1-h and 2-h plasma glucose levels after 75 g OGTT in the previous pregnancy were independent risk factors for abnormal glucose metabolism in pregnant women with a history of GDM (postpartum weight retention: OR=1.054, 95% CI: 1.005-1.106; 1-h plasma glucose: OR=1.284, 95% CI: 1.087-1.516; 2-h plasma glucose: OR=1.272, 95% CI: 1.071-1.511). Conclusions:The incidence of abnormal glucose metabolism is higher in subsequent pregnancy in women with GDM history, which may be related to various factors, such as postpartum weight retention and plasma glucose after 75 g OGTT in the previous pregnancy.
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Objective To analyze labor progression characteristics among nulliparas and provide reference to labor progress management. Methods A retrospective study was conducted on 1089 women who went for vaginal delivery at the First Affiliated Hospital, Sun Yet-San University from January 1st, 2015 to May 31th, 2016. The duration of cervical dilation from 1.0 cm to the next and the process of initial cervical dilation (2.0 cm or 3.0 cm) to full cervical dilation of nulliparas were analyzed. Results The cervical dilation speed was accelerating with the progress of labor. The rate of cervical dilation changed fastest between 5.0-6.0 cm dilation, which was more than 3.0 cm/hour. With regard to labor curves, at admission of 2.0 cm cervical dilation, it rose dramatically from 5.0 cm dilation. At admission of 3.0 cm dilation, it presented approximately linear rising before 5.5 cm dilation, then became steeper. Conclusions The cervical dilation speed is fast. Both labor curves of initial cervical dilation (2.0 cm or 3.0 cm) to full cervical dilation show obvious acceleration stage with steep slope.
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Objective To investigate the morbidity, diagnostic profile and perinatal outcome of pregestational diabetes mellitus (PGDM) in 15 hospitals in Guangdong province. Methods A total of 41338 women delivered in the 15 hospitals during the 6 months,195 women with PGDM(PGDM group) and 195 women with normal glucose test result(control group)were recruited from these tertiary hospitals in Guangdong province from January 2016 to June 2016. The morbidity and diagnostic profile of PGDM were analyzed. The complications during pregnancy and perinatal outcomes were compared between the two groups. In the PGDM group, pregnancy outcomes were analyzed in women who used insulin treatment (n=91) and women who did not (n=104). Results (1)The incidence of PGDM was 0.472%(195/41338). Diabetes mellitus were diagnosed in 59 women (30.3%, 59/195) before pregnancy, and 136 women (69.7%,136/195) were diagnosed as PGDM after conceptions. Forty-six women (33.8%) were diagnosed by fasting glucose and glycohemoglobin (HbA1c) screening. (2) The maternal age, pre-pregnancy body mass index (BMI), prenatal BMI, percentage of family history of diabetes, incidence of macrosomia, concentration of low density lipoprotein were significantly higher in PGDM group than those in control group (all P<0.05). Women in PGDM group had significantly higher HbA1c concentration((6.3±1.3)% vs (5.2±0.4)%), fasting glucose [(6.3±2.3) vs (4.8±1.1) mmol/L], oral glucose tolerance test(OGTT)-1 h glucose((12.6±2.9) vs (7.1± 1.3) mmol/L)and OGTT-2 h glucose [(12.0±3.0) vs (6.4±1.0) mmol/L] than those in control group (P<0.01). (3)The morbidity of preterm births was significantly higher (11.3% vs 1.0%, P<0.01), and the gestational age at delivery in PGDM group was significantly smaller [(37.6±2.3) vs (39.2±1.2) weeks, P<0.01]. Cesarean delivery rate in the PGDM group (70.8% vs 29.7%) was significantly higher than the control group (P<0.01). There was significantly difference between PGDM group and control in the neonatal male/female ratio (98/97 vs 111/84, P=0.033). The neonatal birth weight in PGDM group was significantly higher((3159±700) vs (3451±423) g, P<0.01). And the incidence of neonatal hypoglycemia in the PGDM group was higher than the control group (7.7% vs 2.6%, P=0.036).(4)In the PGDM group, women who were treated with insulin had a smaller gestational age at delivery [(36.9±2.9) vs (37.9±2.5) weeks, P<0.01], and the neonates had a higher neonatal ICU(NICU)admission rate (24.2% vs 9.6% , P<0.01). Conclusions The morbidity of PGDM in the 15 hospitals in Guangdong province is 0.472%. The majority of PGDM was diagnosed during pregnancy; HbA1c and fasting glucose are reliable parameters for PGDM screening. Women with PGDM have obvious family history of diabetes and repeated pregnancy may accelerate the process of diabetes mellitus. Women with PGDM have higher risk for preterm delivery and neonatal hypoglycemia. Unsatisfied glucose control followed by insulin treatment may increase the need for NICU admission.
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[Objective]To investigate associations between the functional polymorphisms of signal transducer and activator of transcription 4 (STAT4) gene and preeclampsia.[Methods]PCR-restriction fragment length polymorphism was used to genotype rs10181656 and rs16833431 local polymorphism in 228 preeclampsia cases and 179 normal controls.[Results](1)The frequencies of rs10181656C/G were 35.96%,46.37%in genotype C/C,47.81%,44.69%in genotype C/G and 16.23%,8.94%in genotype G/G between preeclampsia patients and normal controls. They reached statistical difference (P = 0.031). There was different distribution in two alleles(C and G)between preeclampsia patients and normal controls(P=0.009).(2)There was no different distribution in 3 genotypes(C/C,C/T,T/T)and 2 alleles(C and T)of rs16833431 C/T between preeclampsia patients and normal controls(P =0.508,0.461).[Conclusions]Functional polymorphisms of the rs10181656 locus could associate with the preeclampsia. The polymor-phisms of the rs16833431 locus could not associate with the preeclampsia.
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[Objective]Dysregulated long noncoding RNAs(lncRNAs)have been found involved in human diseases,including cancers. Long non-coding RNA growth arrest-specific 5(GAS5)was reported to be dysregulated in different types of cancers. Howev-er,the role of GAS5 in ovarian cancer remains elusive.[Methods]In the present study,the expression of GAS5 was detected in 108 ovarian cancer tissues and compared adjacent normal tissues by quantitative real-time PCR(qRT-PCR).[Results]The results showed that the expression levels of lncRNA GAS5 were significantly decreased in cancer tissues(P=0.0004),and it was negatively correlated with tumor size(5 cm,P<0.0001),invasion depth(T1-T2 vs. T3-T4,P=0.0021),and tumor grade(Ⅰ~Ⅱgrades vsⅢ~Ⅳgrades,P=0.0086)in ovarian cancer patients. Kaplan-Meier analysis demonstrated that decreased lncRNA GAS5 expression contributed to poor disease-free survival and overall survival.[Conclusion]In conclusion ,our study suggested that decreased lncRNA GAS5 expression may beidentified as a potential poor prognostic biomarker in ovarian cancer.
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[Objective] To investigate the relationship of different types of gestational diabetes mellitus (GDM) and thyroid function.[Methods] A Total of 3846 cases,which received prenatal examination,delivered in the Eastern Hospital of the First Affiliated Hospital,Sun Yat-sen University and performed a 75 g oral glucose tolerance test (75 g 0GTT) at 24-28 gestational weeks,from Jan 1st,2014 to Dec 31st,2015,were divided into 2 groups.Normal blood glucose group:the result of OGTT (fasting plasma glucose,1 hour glucose and 2 hour glucose) was normal;Gestational diabetes mellitus group (GDM group):the result of 0GTT was abnormal.GDM group were divided into Ⅰ,Ⅱ,and lⅢ.GDM Ⅰ defined as one abnormal blood glucose of result.GDM Ⅱ:two abnormal blood glucose.GDM Ⅲ:three abnormal blood glucose.1868 cases of healthy pregnant women were reselected as the control group.TSH,FT4 and TPO Ab were detected in two groups.Analysis of Variance,Mann-Whitney U test,Kruskal Wallis rank test or Fisher's test was used for statistical analysis.[Result] There were statistically significant difference in TSH,FT4 between GDM subgroup and control group (P =0.012,P =0.002).TSH median trend to increase in GDM Ⅱ,and FT4 median trend to decrease in GDM Ⅱ.The Prevalence of hypothyroidism in GDM Ⅱ and GDM Ⅲ were higher than those in control group.[Conclusion] The GDM group with two or three abnormal blood glucose had a higher incidence thyroid gland dysfunction,especial with subclinical hypothyroidism.We should fully test the thyroid function,treat diabetes as early as possible and improve the pregnancy outcome as we could.
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Objective To investigate the association between the functional polymorphisms of Foxp3 gene and unexplained recurrent spontaneous abortion (URSA).Methods PCR-restriction fragment length polymorphism (rs3761548,rs2294021 ) and PCR with sequence-specific primers (rs2232365,rs5902434) were used to detect four polymorphisms of Foxp3 in 146 URSA cases and 112 normal controls.Results ( 1 ) The frequencies of rs3761548A/C were 10.3％,22.3％ in genotype C/C,38.4％,40.2％ in genotype A/C and 51.4％,37.5％ in genotype A/A between URSA patients and normal controls; the frequencies of rs2232365A/G were 5.5％,15.2％ in genotype A/A,47.9％,50.0％ in genotype A/G,46.6％,34.8％ in genotype G/G between URSA patients and normal controls; they all reached statistical difference ( P＜0.05 ).The carriers of rs3761548A allele and rs2232365G allele increased the risk of URSA (OR=1.73,1.61 ; all P ＜ 0.05 ).(2) There was no difference in the genotypic distribution of rs5902434del/ArTTpolymorphism between cases and controls ( P =0.10),but the frequency of del allele in URSA was statistically increased than that of controls (71.2％,62.5％ ; OR =1.49,P =0.04 ).(3) There was no different distribution in 3 genotypes (C/C,T/C,T/T) and 2 alleles (T and C) of rs2294021T/C between URSA patients and normal controls (P =0.18 and 0.08 ).(4) Estimated haplotype frequency distribution of rs5902434del/ATT,rs3761548A/C and rs22323565A/G showed haplotype del-A-G conferring the susceptibility to URSA ( OR =2.51,P ＜ 0.01 ) but haplotype del-C-G and ATT-A-A could provide protection on URSA ( OR =0.18,0.22 ; all P ＜ 0.01 ).Conclusion Functional polymorphisms of Foxp3 gene could probably confer the susceptibility to URSA,by altering Foxp3 function and (or) its expression.