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Vitamin D is a fat soluble steroid derivative, which is very important to maintain human normal physiological function. It plays an important role in embryogenesis, bone development and calcium homeostasis. Vitamin D deficiency is widespread in the world, and the prevalence of vitamin D deficiency during pregnancy is also significantly increased, accompanied by adverse maternal and neonatal outcomes, such as gestational diabetes mellitus, preeclampsia, premature delivery, and low birth weight. At present, there is no consensus on whether vitamin D supplementation is helpful to improve the prognosis of mothers and infants, and whether vitamin D is the etiology or marker of adverse pregnancy outcome. This paper reviews the latest research progress on the relationship between vitamin D level during pregnancy and maternal and infant outcomes.
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Objective:To investigate the effect of oral glucocorticoid dose on maternal and infant outcomes in female patients with systemic lupus erythematosus(SLE), thus providing reference for clinical work.Methods:Clinical data of pregnant women with SLE admitted to Department of Obstetrics, Peking University People′s Hospital from July 2015 to June 2020 were retrospectively analyzed.According to the daily oral glucocorticoid dose during pregnancy(equivalent converted to Prednisone), pregnant women were divided into 2 groups: ≤7.5 mg group(67 cases) and >7.5 mg group(74 cases). The maternal and fetal outcomes of the 2 groups were analyzed by t-test or χ2 test or Fisher′ s exact probability method. Results:The neonatal birth weight, birth length, white blood cell count and platelet count in ≤7.5 mg group were significantly higher than those in >7.5 mg group[(2 990.69±532.20) g vs.(2 734.57±608.35) g, (48.97±2.34) cm vs.(47.43±3.38) cm, (17.69±6.16)×10 9/L vs.(15.11±6.00)×10 9/L, (276.92±74.51)×10 9/L vs.(240.05±69.29)×10 9/L], while the incidence of low birth weight and neonatal transfer rate were significantly lower(13.85% vs.30.43%, 12.31% vs.33.33%) ( t/ χ2=2.587, 3.068, 2.354, 2.841, 5.301, 8.321, all P<0.05). Meanwhile, the incidence of maternal complications like hypertension disorders in pregnancy and gestational diabetes mellitus in the ≤7.5 mg group were lower than those in the >7.5 mg group, but the incidence of anemia and postpartum hemorrhage increased, although no significant differences were detected (all P>0.05). Conclusions:The overall maternal and fetal outcomes of patients with SLE with oral Prednisone ≤7.5 mg/d were better those medicated >7.5 mg/d, but the incidence of anemia during pregnancy and postpartum hemorrhage was higher.An individual monitoring and treatment should be concerned to improve the maternal and infant outcomes.
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Objective:To investigate the effect of reproduction on maternal and infant outcomes in female patients with systemic lupus erythematosus (SLE).Methods:Clinical data of SLE patients complicated with pregnancy admitted in the Peking University People′s Hospital from July 2015 to December 2019 were analyzed retrospectively.According to the history of live birth, SLE patients complicated with pregnancy were divided into primiparity group (94 cases) and reproduction group (32 cases). Maternal and infant outcomes of the 2 groups were analyzed.Results:A total of 126 SLE patients complicated with pregnancy were included in the present study.The proportion of using immunosuppressants was significantly lower in reproduction group than that of primiparity group [3 cases (9.38%) vs.27 cases (28.72%)] ( χ2=4.927, P=0.026). Complications like lupus nephritis, thyroid disease and postpartum hemorrhage significantly increased in the reproduction group (all P<0.05), and the adverse neonatal outcomes like preterm infants, low birth weight infants and small for gestational age infants in the reproduction group were lower than those in primiparity group, but no significant differences were detected(all P>0.05). There were no significant diffe-rences in the results of the first blood routine examination of newborns and the incidence of neonatal pathological jaundice between the 2 groups (all P>0.05). Conclusions:For SLE patients complicated with reproductive pregnancy, although the incidence of some pregnancy complications increases, the incidence of adverse neonatal outcomes decreases.In addition, reducing the use of immunosuppressants may have positive implications on neonatal outcomes.
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OBJECTIVE: To compare the maternal and infant outcomes of pregnant women infected with human immunodeficiency virus(HIV)treated with different regimens of highly active antiretroviral therapy(HAART).METHODS: For pregnant women infected with the human immunodeficiency virus(HIV)who received antiviral therapy and delivered in the Eighth Peple's Hospital of Guangzhu between May 2015 and June 2018,they will be grouped according to different treatment options. The pregnant women's body weight,CD4+T lymphocytes,white blood cells,hemoglobin,serum albumin,neonatal body weight and adverse pregnancy outcomes were compared and analyzed.RESULTS:(1)There was no significantly statistical difference between the two groups of pregnant women in terms of body weight,white blood cells,hemoglobin or serum albumin(P>0.05).(2)The changes of CD4+T lymphocytes in the two groups of pregnant women before and after treatment were statistically different(P0.05).(4)There was no significantly statistical difference in the incidence of premature birth,premature rupture of fetal membrane,low birth weight,low amniotic fluid,fetal malformation or neonatal asphyxia between the two groups(P>0.05).Until December 2018,there were no positive reports of HIVRNA and HIV antibody detection in two groups of infants.CONCLUSION: The two HAART schemes have no significant difference in the influence on nutritional status,immune status or maternal and infant outcomes of HIV-infected pregnant women,and they are both effective and feasible,and vertical transmission of HIV from mother to child can be blocked.