Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically...Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.展开更多
Objective Electronic cigarettes(ECs)differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling.Pulmonary hypertension(PH),characterized by pulmonary artery and right ventricle remodeling,po...Objective Electronic cigarettes(ECs)differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling.Pulmonary hypertension(PH),characterized by pulmonary artery and right ventricle remodeling,poses a significant risk of mortality in infants,children,and adolescents.However,the impact of maternal EC exposure on PH development in offspring remains unclear.To address this,we established a PH rat model with maternal EC exposure.Methods Maternal EC exposure was initiated on gestation day 12 via electronic nicotine delivery systems.Offspring were administered monocrotaline(MCT)at 6 weeks of age(6-wo)to induce PH.Mechanistic experiments were conducted at 10-week-old(10-wo).Protein expression of NADPH oxidases,DNA methyltransferases,and autophagy-related markers was analyzed by Western blot.Morphological changes and the severity of PH were evaluated via hematoxylin and eosin(HE)staining and echocardiography,respectively.Furthermore,the involvement of the oxidative stress/DNA methylation/autophagy axis in response to maternal EC exposure was confirmed through a combination of ELISA,Western blot,HE staining,and echocardiography.Additionally,ATG5 mRNA expression was measured by qRT-PCR.Results Compared with control conditions,maternal EC exposure significantly worsened MCT-induced PH in male offspring.This was associated with increased oxidative stress,DNA hypomethylation,and anomalous autophagy in the offspring.In vivo treatment with chloroquine inhibited autophagy and ameliorated PH development in offspring exposed to maternal EC.Furthermore,N-acetylcysteine(NAC),an antioxidant,attenuated maternal EC exposure-induced oxidative stress,DNA hypomethylation,and excessive autophagy,thereby improving PH.DNA hypermethylation also reversed PH development,accompanied by reduced oxidative stress and suppressed autophagy.ATG5,a key regulator of autophagy,was identified as a potential therapeutic target,as its repression mitigated PH in maternal EC-exposed offspring.Conclusion Maternal EC exposure induces oxidative stress and DNA hypomethylation in offspring,leading to anomalous autophagy and exacerbation of PH development.Targeting ATG5-mediated autophagy may represent a novel therapeutic approach for improving PH outcomes in offspring exposed to maternal EC.Graphical Abstract Pregnant rats were exposed to either EC vapor or standard air from gestation day 12 until 2 days before delivery,with all offspring undergoing PH induction at 6-wo.Offspring exposed to maternal EC presented increased oxidative stress,which in turn affected DNA methylation patterns.The decreased DNA methylation in male offspring led to the activation of autophagy,exacerbating the development of PH.Treatment with ATG5 siRNA inhibited autophagy and alleviated heightened PH in male offspring with maternal EC exposure.展开更多
Background: Maternal mortality remains a major public health problem worldwide. Objectives: Our study aims to present the results of an analysis of reviews of maternal deaths at HGOPY. Methodology: This was a descript...Background: Maternal mortality remains a major public health problem worldwide. Objectives: Our study aims to present the results of an analysis of reviews of maternal deaths at HGOPY. Methodology: This was a descriptive cross-sectional study with retrospective data collection from archived records and reviewed maternal death reports. Our study lasted 8 months, from October 1, 2023 to May 31, 2024. The study covered maternal death files at the HGOPY over an 8-year period, from 1st of January 2016 to the 31st of December 2023. Data were processed and analyzed using Statitical Paquage for Social Science (SPSS) version 26.0. Results: We counted a total of 160 maternal deaths, of which 97 had been reviewed. We excluded 61 deceased women reviewed and retained 33. We recorded a cumulative total of 160 maternal deaths and 19,651 live births. The peak in the proportion of maternal deaths at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital was in 2021, with a proportion of 0.013. No maternal deaths had been reviewed between 2016 to 2017. Most deaths (64%) occurred between 37 and 40 weeks. The majority (30.5%) were aged between 30 and 35. The data show that 80.6% of maternal deaths were due to direct obstetric causes, while 19.4% were due to indirect causes. Most deaths (69.4%) were preventable. Only 8.3% were not preventable. Conclusion: Concerted efforts must be made to adapt maternal death prevention and management strategies to local contexts in order to significantly reduce these alarming figures.展开更多
Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal ant...Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.展开更多
Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 an...Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.展开更多
Background:Maternal viral infection during pregnancy can lead to maternal immune activation(MIA),increasing the risk of neurodevelopmental disorders in offspring.Amantadine(AMA)exhibits antiviral activity and is widel...Background:Maternal viral infection during pregnancy can lead to maternal immune activation(MIA),increasing the risk of neurodevelopmental disorders in offspring.Amantadine(AMA)exhibits antiviral activity and is widely employed in the management of neurologic conditions.Nevertheless,the efficacy of AMA in treating MIA is currently not established.Methods:MIA was induced by polyinosinic acid-polycytidylic acid(poly(I:C));AMA was administered from embryonic(E)day 11.5 for 3 days.BV-2 cells were stimulated using poly(I:C)and treated with AMA.Behavior was assessed via open field test,elevated plus maze test,three-chamber sociability test,and marble burying test.Neuronal morphology was vizualized using Nissl stain;apoptosis via TUNEL(terminal deoxynucleotidyl transferase dUTP nick-end labeling)stain;protein expression(Iba1,NeuN,CD68,TNF-α[tumor necrosis factor-alpha],IL-1β[interleukin-1β])using immunofluorescence(IF);interleukin-6(IL-6)levels using enzyme-linked immunosorbent assay;reactive oxygen species using staining;Iba1,NeuN,Bcl-2,Bax,and cleaved caspase 3 using Western blot;and gene expression changes using RNA-seq.Results:AMA treatment reduced the levels of IL-6 in maternal blood,improved autism-like behaviors in MIA offspring,and effectively prevented neuronal damage and neuroinflammation.In vitro cellular studies have demonstrated that AMA effectively downregulates the expression levels of pro-inflammatory cytokines,including IL-6,TNF-α,and IL-1β.RNA-seq analysis indicated that AMA mitigates abnormal activation of microglia by modulating inflammatory pathways associated with IL-6.Conclusion:AMA can prevent the development of neuropsychiatric disorders in MIA offspring.This effect may be related to its ability to attenuate neuronal damage,reduce neuronal apoptosis,and inhibit neuroinflammation,indicating that the antiviral drug AMA may be a potential treatment for MIA.展开更多
The oviduct epithelium is the initial maternal contact site for embryos after fertilization,offering the microenviron-ment before implantation.This early gestation period is particularly sensitive to stress,which can ...The oviduct epithelium is the initial maternal contact site for embryos after fertilization,offering the microenviron-ment before implantation.This early gestation period is particularly sensitive to stress,which can cause reduced fertil-ity and reproductive disorders in mammals.Nevertheless,the local impact of elevated stress hormones on the ovi-duct epithelium has received limited attention to date,except for a few reports on polyovulatory species like mice and pigs.In this study,we focused on the effects of chronic maternal stress on cattle,given its association with infertil-ity issues in this monoovulatory species.Bovine oviduct epithelial cells(BOEC)differentiated at the air–liquid interface(ALI)were stimulated with 250 nmol/L cortisol for 1 or 3 weeks.Subsequently,they were assessed for morphology,bioelectrical properties,and gene expression related to oviduct function,glucocorticoid pathway,cortisol metabo-lism,inflammation,and apoptosis.Results revealed adverse effects of cortisol on epithelium structure,featured by deciliation,vacuole formation,and multilayering.Additionally,cortisol exposure led to an increase in transepithelial potential difference,downregulated mRNA expression of the major glucocorticoid receptor(NR3C1),upregulated the expression of cortisol-responsive genes(FKBP5,TSC22D3),and significant downregulation of oviductal glycopro-tein 1(OVGP1)and steroid receptors PGR and ESR1.The systematic comparison to a similar experiment previously performed by us in porcine oviduct epithelial cells,indicated that bovine cultures were more susceptible to elevated cortisol levels than porcine.The distinct responses between both species are likely linked to their divergence in the cortisol-induced expression changes of HSD11B2,an enzyme controlling the cellular capacity to metabolise cortisol.These findings provide insights into the species-specific reactions and reproductive consequences triggered by maternal stress.展开更多
BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both...BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both mother and baby.AIM To investigate the relationships between FI and pregnancy outcomes,particularly GDM and PIH,while also examining the mediating role of the dietary diversity score(DDS).METHODS A cross-sectional study was undertaken to examine this relationship,involving 600 pregnant women.Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes.The FI was measured via the Household Food Security Survey Module,with GDM defined as fasting plasma glucose levels of≥5.1 mmol/L or a 2-hour oral glucose tolerance test value of≥8.5 mmol/L.The DDS is determined by evaluating one's food consumption based on nine distinct food groups.A logistic regression model was used to explore the relationship between FI and PIH,and GDM.RESULTS Seventeen percent of participants reported experiencing FI during pregnancy.The study found a significant association between FI and an elevated risk of GDM[odds ratio(OR)=3.32,95%CI:1.2-5.4].Once more,food-insecure pregnant women had higher rates of PIH(OR=0.10,95%CI:0.02-0.45)and they also faced a higher likelihood of neonatal complications,such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight.The FI wasfurther linked to metabolic disruptions,such as elevated fasting blood sugar(FBS),low-density lipoprotein cholesterol,and triglyceride levels.Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM.In particular,the mediation analysis showed that approximately 65%of the effect was mediated through DDS(P=0.002).CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health.Additionally,the study explored how DDS mediates the relationship between FI and the incidence of GDM.展开更多
Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women ...Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.展开更多
To promote sustainable aquaculture,plant-based ingredients are increasingly replacing fish meal(FM)and fish oil(FO)in aquafeeds,altering broodstock diets and reducing omega-3 long-chain polyunsaturated fatty acids(ω-...To promote sustainable aquaculture,plant-based ingredients are increasingly replacing fish meal(FM)and fish oil(FO)in aquafeeds,altering broodstock diets and reducing omega-3 long-chain polyunsaturated fatty acids(ω-3 LC-PUFAs),essential for reproductive success and progeny growth.Despite the critical role ofω-3 LC-PUFAs,particularly docosahexaenoic acid(DHA)in brain function,data on how fry cope with FM/FO-free diets during early development remain limited.To address this,we conducted a 2-year experiment comparing three broodstock diets:a commercial diet(C diet),a total plant-based diet(V1 diet),and a plant-based diet supplemented with DHA-rich Schizochytrium sp.microalgae oil(V2 diet).After reproduc-tion,progeny were fed either a C diet or a plant-based diet(V).Six groups(C-C,C-V,V1-C,V1-V,V2-C,V2-V)were analyzed for survival,feed intake,and growth,as well as neuropeptide,neurotransmitter,and intestinal hormone expres-sion.Results showed enhanced robustness in fry-fed V diets,particularly from V1 and V2-fed broodstock,with improved survival and feed intake.Fry from DHA-supplemented broodstock(V2-V)compensated for initial growth delays,achieving growth comparable to fry from commercial-fed mothers(C-V)within 30 days.Neurophysiological and gut-brain adapta-tions revealed complex compensatory mechanisms enabling fish to thrive on sustainable diets.These findings highlight the potential of DHA supplementation in plant-based diets to support sustainable aquaculture and warrant further validation under diverse nutritional and environmental conditions.展开更多
Chemical exposure during prenatal development has significant implications for both maternal and child health.Compared to blood,saliva is a non-invasive and less resource-intensive,alternative.Given the temporal varia...Chemical exposure during prenatal development has significant implications for both maternal and child health.Compared to blood,saliva is a non-invasive and less resource-intensive,alternative.Given the temporal variability of xenobiotic metabolites(XM),repeated sampling is essential.Therefore,saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes.Despite its potential,no studies have explored saliva for XM measurement.This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women.Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24–34 weeks gestation.Metabolomes and exposomes were annotated using the Human Metabolome and U.S.Environmental Protection Agency databases.Metabolome-XM associations were clustered using Glay community clustering.Linear regression models,adjusted for age,estimated associations between catecholamines and XMs.XM levels were validated in a cohort of women(n=14)with and without preeclampsia.Our study identified 582 metabolomes and 125 XM in saliva,demonstrating its potential as a matrix for exposure measurement.After false discovery rate correction,18109 significant metabolome-XM associations were identified.Community clustering revealed 37 connected clusters,with the largest cluster(238 nodes)enriched in tyrosine and catecholamine metabolism.Food-contactchemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels.Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls.This study demonstrates that saliva contains valuable molecular data for measuring exposomes.Food-related chemicals were associated with higher catecholamine levels,which may be relevant to the prevalence of hypertensive crises in pregnancy.展开更多
Maternal consumption of a high-fat diet has been linked to increased risks of obesity and impaired glucose metabolism in offspring.However,the precise epigenetic mechanisms governing these intergenerational effects,pa...Maternal consumption of a high-fat diet has been linked to increased risks of obesity and impaired glucose metabolism in offspring.However,the precise epigenetic mechanisms governing these intergenerational effects,particularly during the early stages of offspring development,remain poorly understood.In this study,female C57BL/6J mice were randomly assigned to either a high-fat diet or normal chow diet throughout gestation and lactation.Methylated DNA immunoprecipitation(MeDIP)coupled with microarray analysis was employed to identify differentially methylated genes in the livers of offspring at weaning age.We found that maternal high-fat diet feeding predisposes offspring to obesity and impaired glucose metabolism as early as the weaning period.DNA methylation profile analysis unveiled a significant enrichment of differentially methylated genes within the natural killer(NK)cell-mediated cytotoxicity pathway.MeDIP-PCR validated reduced methylation levels of specific genes within this pathway,including tumour necrosis factorα(TNF-α),phosphoinositide 3-kinase(PI3K),and SHC adaptor protein 1(SHC1).Consistently,the expressions of TNF-α,PI3K,and SHC1 were significantly upregulated,accompanied by elevated serum TNF-αand interleukin-6(IL-6)levels in offspring from dams fed with high-fat diet.Moreover,we assessed the expressions of genes associated with NK cell activities,uncovering a notable rise in hepatic granzyme B levels and a trend towards increased CD107a expression in offspring from dams fed a high-fat diet.In addition,methylation levels of TNF-α,PI3K,and SHC1 promoters were inversely correlated with glucose response during glucose tolerance testing.In conclusion,our findings underscore the critical role of the NK cell-mediated cytotoxicity signaling pathway in mediating DNA methylation patterns,thereby contributing to the programming effects of maternal high-fat diet consumption on offspring glucose metabolism as early as the weaning period.展开更多
Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or force...Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.展开更多
Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with ...Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.展开更多
Irritable bowel syndrome-diarrhea(IBS-D)is a prevalent functional bowel disease severely impairs the quality of life of patients.Visceral hypersensitivity(VH)is the main symptom of IBS-D.Probiotics have been found to ...Irritable bowel syndrome-diarrhea(IBS-D)is a prevalent functional bowel disease severely impairs the quality of life of patients.Visceral hypersensitivity(VH)is the main symptom of IBS-D.Probiotics have been found to effectively alleviate VH.In this study,neonatal maternal separation(NMS)was used to induce VH in 72 rats and investigated the effects of daily gavage of 3×10^(9) CFU of Lactobacillus and Bifidobacterium on alleviating the symptoms of IBS-D and behavioral interventions,as well as exploring potential mechanisms.The results demonstrated that L.acidophilus and B.breve could alleviate the symptoms of IBS-D such as VH and increased frequency of bowel movements,as well as improving non-spatial memory in NMS rats.These effects were achieved by modulating the composition of gut microbiota and metabolites(including short-chain fatty acids,deoxycholic acid and adenosine),and by regulating the expression of genes and proteins associated with the NGF/TrkA signaling pathway,tryptophan metabolism,and inflammatory factors in the hippocampus.This finding suggests that L.acidophilus and B.breve have promising potential for the alleviation of IBS.展开更多
This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with...This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with sleep disturbances recruited from Zouping County Traditional Chinese Medicine Hospital.Participants were divided into control and experimental groups,and sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before and after the intervention.The experimental group received Chinese herbal foot bath therapy,while the control group did not.Post-intervention results showed a significant improvement in sleep quality for the experimental group,with a mean PSQI score of 7.79(SD=2.90),compared to 13.45(SD=2.57)in the control group,indicating continued poor sleep.Statistical analysis confirmed that the therapy led to significant improvements across overall and component PSQI scores.The study concludes that Chinese herbal foot bath therapy is a safe,non-invasive,and cost-effective method to enhance sleep quality among postpartum women,especially those of advanced maternal age.It holds promise as a complementary treatment option and could be integrated into standard postpartum care practices to address sleep disturbances without relying on pharmacological interventions.展开更多
Introduction:Diabetes mellitus(DM),a metabolic disorder,leads to organ damage due to chronic hyperglycemia with multiple pathogenic processes.Gestational diabetes mellitus(GDM)poses risks to mothers and offspring,incr...Introduction:Diabetes mellitus(DM),a metabolic disorder,leads to organ damage due to chronic hyperglycemia with multiple pathogenic processes.Gestational diabetes mellitus(GDM)poses risks to mothers and offspring,increasing the incidence of structural congenital heart disease(CHD)and myocardial hypertrophy in newborns.Objective:This review aimed to examine the association between maternal diabetes mellitus and CHD.Methods:This systematic review used the STROBE and TRIPOD checklists registered in PROSPERO(CRD42024513858).It focused on diagnostic test accuracy using the Munn et al.protocol for systematic assessment,emphasizing the“PIRD”:Population,Index Test,Reference Test,Diagnosis of Interest.This review aimed the following PIRD model question:‘Does diabetic pregnant woman inffuence in fetal cardiac malformation?’using PRISMA 2020 statement.A systematic review was conducted on 19 October 2023 in the following databases:PubMed/MEDLINE,Embase(Elsevier),CINAHL(EBSCO),Scopus(Elsevier),Web of Science(Clarivate Analytics),LILACS,and SciELO.Only articles in English,Spanish,and Portuguese languages were selected.Results:Seven studies between 2018 and 2023 were selected.The studies differed in terms of the cardiac ultrasound parameters used to assess CHD and diagnose diabetes mellitus in pregnancy.They highlight the importance of fetal echocardiography in detecting CHD prenatally and assessing the impact of diabetes mellitus on fetal cardiac health,recommending proactive care planning and early intervention for better outcomes.Conclusions:The studies highlight the impact of maternal diabetes mellitus,particularly GDM,on fetal cardiac development and support early detection by fetal echocardiography.Standardization and collaboration are essential to reffne management and outcomes in high-risk pregnancies.展开更多
BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on mater...BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on maternal processes,maternal and infant outcomes,and anxiety during pregnancy.METHODS A total of 100 singleton term pregnancies with cervical maturity induction and anxiety were selected using a lottery method;50 women were included.Cervical balloons were used for all participants.In the control group,80 mL of fluid was injected into both balloons;in the observation group,80 and 100 mL were injected into the vaginal and cervical balloons,respectively.The two groups were compared for cervical maturity,labor duration,anxiety,maternal and infant outcomes,and effects on cervical ripening.RESULTS After treatment,the cervical maturity test(Bishop)score was significantly higher in the observation group(9.76±1.19)than in the control group(7.62±0.83),and the Hamilton Anxiety Scale score was lower in the observation group(7.32±0.85)than in the control group(13.05±1.12).The observation group showed higher rates of natural delivery and lower rates of cesarean section than the control group.The first and total stages of labor were shorter in the observation than in the control group;no significant differences were found in the second and third stages.The incidence of complications was lower in the observation group[1(2.00%)vs 9(18.00%)for complications;49(98.00%)vs 41(82.00%)for non-complications].CONCLUSION The selected fluid volumes to promote cervical maturity and induce labor stabilize maternal mood,increase the natural delivery rate,shorten labor,and improve maternal and infant outcomes.展开更多
Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was e...Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was employed, involving 60 pregnant women with GDM who were purposively selected and randomly allocated into experimental and control groups, each comprising 30 participants. The experimental group received comprehensive nursing interventions and pregnancy monitoring, while the control group received standard nursing care. Data collection was conducted using demographic questionnaires, pregnancy indicators, and maternal-infant outcome measurement tools. The collected data were analyzed using Microsoft Excel and the Statistical Package for Social Sciences (SPSS). Results: The findings indicated significant improvements in fasting blood glucose, postprandial blood glucose, amniotic fluid index, and neonatal birth weight in the experimental group compared to the control group. However, no statistically significant differences were observed in body mass index (BMI) or pregnancy weight gain. Comprehensive nursing interventions were associated with a significant reduction in maternal complications, including polyhydramnios, postpartum hemorrhage, and preeclampsia, as well as neonatal complications such as neonatal pneumonia, macrosomia, and hypoglycemia. Conclusion: Comprehensive nursing interventions have a positive impact on maternal and neonatal outcomes in pregnant women with GDM.展开更多
Theincreasing prevalence of gestational diabetesmellitus(GDM)is associated with an array of pregnancy complications and enduring health challenges in bothmothers and their offspring.Studies have indicated that exposur...Theincreasing prevalence of gestational diabetesmellitus(GDM)is associated with an array of pregnancy complications and enduring health challenges in bothmothers and their offspring.Studies have indicated that exposure to the intrauterine environment can prompt adaptations in the offspring,thereby programming transgenerational inheritance.Physical activity during pregnancy,as a non-pharmacological intervention,mitigates metabolic risks through epigenetic modifications,mediating placental adaptations,the action of exercise factors,and gut microbiota.Here,we provide a review summarizing how regular exercise can reduce the risk of GDM and positively influence pregnancy outcomes.It also discusses the exercise-induced reduction in obesity,insulin resistance,and fatty liver disease in the offspring of GDM,outlining the mechanisms that underpin these health benefits.This review underscores the importance of exercise in safeguarding the health of GDM mothers and their offspring.展开更多
文摘Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.
基金supported by National Natural Science Foundation of China(No.82300268)Guangzhou Municipal Science and Technology Project(No.2023B03J1255).
文摘Objective Electronic cigarettes(ECs)differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling.Pulmonary hypertension(PH),characterized by pulmonary artery and right ventricle remodeling,poses a significant risk of mortality in infants,children,and adolescents.However,the impact of maternal EC exposure on PH development in offspring remains unclear.To address this,we established a PH rat model with maternal EC exposure.Methods Maternal EC exposure was initiated on gestation day 12 via electronic nicotine delivery systems.Offspring were administered monocrotaline(MCT)at 6 weeks of age(6-wo)to induce PH.Mechanistic experiments were conducted at 10-week-old(10-wo).Protein expression of NADPH oxidases,DNA methyltransferases,and autophagy-related markers was analyzed by Western blot.Morphological changes and the severity of PH were evaluated via hematoxylin and eosin(HE)staining and echocardiography,respectively.Furthermore,the involvement of the oxidative stress/DNA methylation/autophagy axis in response to maternal EC exposure was confirmed through a combination of ELISA,Western blot,HE staining,and echocardiography.Additionally,ATG5 mRNA expression was measured by qRT-PCR.Results Compared with control conditions,maternal EC exposure significantly worsened MCT-induced PH in male offspring.This was associated with increased oxidative stress,DNA hypomethylation,and anomalous autophagy in the offspring.In vivo treatment with chloroquine inhibited autophagy and ameliorated PH development in offspring exposed to maternal EC.Furthermore,N-acetylcysteine(NAC),an antioxidant,attenuated maternal EC exposure-induced oxidative stress,DNA hypomethylation,and excessive autophagy,thereby improving PH.DNA hypermethylation also reversed PH development,accompanied by reduced oxidative stress and suppressed autophagy.ATG5,a key regulator of autophagy,was identified as a potential therapeutic target,as its repression mitigated PH in maternal EC-exposed offspring.Conclusion Maternal EC exposure induces oxidative stress and DNA hypomethylation in offspring,leading to anomalous autophagy and exacerbation of PH development.Targeting ATG5-mediated autophagy may represent a novel therapeutic approach for improving PH outcomes in offspring exposed to maternal EC.Graphical Abstract Pregnant rats were exposed to either EC vapor or standard air from gestation day 12 until 2 days before delivery,with all offspring undergoing PH induction at 6-wo.Offspring exposed to maternal EC presented increased oxidative stress,which in turn affected DNA methylation patterns.The decreased DNA methylation in male offspring led to the activation of autophagy,exacerbating the development of PH.Treatment with ATG5 siRNA inhibited autophagy and alleviated heightened PH in male offspring with maternal EC exposure.
文摘Background: Maternal mortality remains a major public health problem worldwide. Objectives: Our study aims to present the results of an analysis of reviews of maternal deaths at HGOPY. Methodology: This was a descriptive cross-sectional study with retrospective data collection from archived records and reviewed maternal death reports. Our study lasted 8 months, from October 1, 2023 to May 31, 2024. The study covered maternal death files at the HGOPY over an 8-year period, from 1st of January 2016 to the 31st of December 2023. Data were processed and analyzed using Statitical Paquage for Social Science (SPSS) version 26.0. Results: We counted a total of 160 maternal deaths, of which 97 had been reviewed. We excluded 61 deceased women reviewed and retained 33. We recorded a cumulative total of 160 maternal deaths and 19,651 live births. The peak in the proportion of maternal deaths at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital was in 2021, with a proportion of 0.013. No maternal deaths had been reviewed between 2016 to 2017. Most deaths (64%) occurred between 37 and 40 weeks. The majority (30.5%) were aged between 30 and 35. The data show that 80.6% of maternal deaths were due to direct obstetric causes, while 19.4% were due to indirect causes. Most deaths (69.4%) were preventable. Only 8.3% were not preventable. Conclusion: Concerted efforts must be made to adapt maternal death prevention and management strategies to local contexts in order to significantly reduce these alarming figures.
文摘Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.
文摘Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.
基金Collaborative Innovation Project of Zigong Medical Big Data and Artificial Intelligence Research Institute,Grant/Award Number:2023-YGY-1-02 and 2024-YGY-02-04National Natural Science Foundation of China,Grant/Award Number:31900950+4 种基金Project Supported by the Natural Science Basic Research Plan in Shaanxi Province of China,Grant/Award Number:2024JCYBMS-706National Key Research and Development Program of China,Grant/Award Number:2022YFC2009900Zigong Science and Technology Program,Grant/Award Number:2023YKY11Scientific Research Project of Zigong Health Commission,Grant/Award Number:22yb001 and 24zd008Key Science and Technology Plan Projects in Zigong,Grant/Award Number:2022ZCNKY07,2023-NKY-01-02,2023-NKY-02-13 and 2023-NKY-02-14。
文摘Background:Maternal viral infection during pregnancy can lead to maternal immune activation(MIA),increasing the risk of neurodevelopmental disorders in offspring.Amantadine(AMA)exhibits antiviral activity and is widely employed in the management of neurologic conditions.Nevertheless,the efficacy of AMA in treating MIA is currently not established.Methods:MIA was induced by polyinosinic acid-polycytidylic acid(poly(I:C));AMA was administered from embryonic(E)day 11.5 for 3 days.BV-2 cells were stimulated using poly(I:C)and treated with AMA.Behavior was assessed via open field test,elevated plus maze test,three-chamber sociability test,and marble burying test.Neuronal morphology was vizualized using Nissl stain;apoptosis via TUNEL(terminal deoxynucleotidyl transferase dUTP nick-end labeling)stain;protein expression(Iba1,NeuN,CD68,TNF-α[tumor necrosis factor-alpha],IL-1β[interleukin-1β])using immunofluorescence(IF);interleukin-6(IL-6)levels using enzyme-linked immunosorbent assay;reactive oxygen species using staining;Iba1,NeuN,Bcl-2,Bax,and cleaved caspase 3 using Western blot;and gene expression changes using RNA-seq.Results:AMA treatment reduced the levels of IL-6 in maternal blood,improved autism-like behaviors in MIA offspring,and effectively prevented neuronal damage and neuroinflammation.In vitro cellular studies have demonstrated that AMA effectively downregulates the expression levels of pro-inflammatory cytokines,including IL-6,TNF-α,and IL-1β.RNA-seq analysis indicated that AMA mitigates abnormal activation of microglia by modulating inflammatory pathways associated with IL-6.Conclusion:AMA can prevent the development of neuropsychiatric disorders in MIA offspring.This effect may be related to its ability to attenuate neuronal damage,reduce neuronal apoptosis,and inhibit neuroinflammation,indicating that the antiviral drug AMA may be a potential treatment for MIA.
基金German research Foundation(DFG,grant numbers:CH2321/1–1 and SCHO1231/7–1)JH has received a scholarship from the Chinese Scholarship Council(CSC No.:201908350115).
文摘The oviduct epithelium is the initial maternal contact site for embryos after fertilization,offering the microenviron-ment before implantation.This early gestation period is particularly sensitive to stress,which can cause reduced fertil-ity and reproductive disorders in mammals.Nevertheless,the local impact of elevated stress hormones on the ovi-duct epithelium has received limited attention to date,except for a few reports on polyovulatory species like mice and pigs.In this study,we focused on the effects of chronic maternal stress on cattle,given its association with infertil-ity issues in this monoovulatory species.Bovine oviduct epithelial cells(BOEC)differentiated at the air–liquid interface(ALI)were stimulated with 250 nmol/L cortisol for 1 or 3 weeks.Subsequently,they were assessed for morphology,bioelectrical properties,and gene expression related to oviduct function,glucocorticoid pathway,cortisol metabo-lism,inflammation,and apoptosis.Results revealed adverse effects of cortisol on epithelium structure,featured by deciliation,vacuole formation,and multilayering.Additionally,cortisol exposure led to an increase in transepithelial potential difference,downregulated mRNA expression of the major glucocorticoid receptor(NR3C1),upregulated the expression of cortisol-responsive genes(FKBP5,TSC22D3),and significant downregulation of oviductal glycopro-tein 1(OVGP1)and steroid receptors PGR and ESR1.The systematic comparison to a similar experiment previously performed by us in porcine oviduct epithelial cells,indicated that bovine cultures were more susceptible to elevated cortisol levels than porcine.The distinct responses between both species are likely linked to their divergence in the cortisol-induced expression changes of HSD11B2,an enzyme controlling the cellular capacity to metabolise cortisol.These findings provide insights into the species-specific reactions and reproductive consequences triggered by maternal stress.
基金The research received approval from Children’s Hospital of Shanxi Committee (Approval Number:KLT6230511).
文摘BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both mother and baby.AIM To investigate the relationships between FI and pregnancy outcomes,particularly GDM and PIH,while also examining the mediating role of the dietary diversity score(DDS).METHODS A cross-sectional study was undertaken to examine this relationship,involving 600 pregnant women.Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes.The FI was measured via the Household Food Security Survey Module,with GDM defined as fasting plasma glucose levels of≥5.1 mmol/L or a 2-hour oral glucose tolerance test value of≥8.5 mmol/L.The DDS is determined by evaluating one's food consumption based on nine distinct food groups.A logistic regression model was used to explore the relationship between FI and PIH,and GDM.RESULTS Seventeen percent of participants reported experiencing FI during pregnancy.The study found a significant association between FI and an elevated risk of GDM[odds ratio(OR)=3.32,95%CI:1.2-5.4].Once more,food-insecure pregnant women had higher rates of PIH(OR=0.10,95%CI:0.02-0.45)and they also faced a higher likelihood of neonatal complications,such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight.The FI wasfurther linked to metabolic disruptions,such as elevated fasting blood sugar(FBS),low-density lipoprotein cholesterol,and triglyceride levels.Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM.In particular,the mediation analysis showed that approximately 65%of the effect was mediated through DDS(P=0.002).CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health.Additionally,the study explored how DDS mediates the relationship between FI and the incidence of GDM.
文摘Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.
基金funded by the French National Research Agency(grant no.ANR-21-CE20-0009-01“FEEDOMEGA”).
文摘To promote sustainable aquaculture,plant-based ingredients are increasingly replacing fish meal(FM)and fish oil(FO)in aquafeeds,altering broodstock diets and reducing omega-3 long-chain polyunsaturated fatty acids(ω-3 LC-PUFAs),essential for reproductive success and progeny growth.Despite the critical role ofω-3 LC-PUFAs,particularly docosahexaenoic acid(DHA)in brain function,data on how fry cope with FM/FO-free diets during early development remain limited.To address this,we conducted a 2-year experiment comparing three broodstock diets:a commercial diet(C diet),a total plant-based diet(V1 diet),and a plant-based diet supplemented with DHA-rich Schizochytrium sp.microalgae oil(V2 diet).After reproduc-tion,progeny were fed either a C diet or a plant-based diet(V).Six groups(C-C,C-V,V1-C,V1-V,V2-C,V2-V)were analyzed for survival,feed intake,and growth,as well as neuropeptide,neurotransmitter,and intestinal hormone expres-sion.Results showed enhanced robustness in fry-fed V diets,particularly from V1 and V2-fed broodstock,with improved survival and feed intake.Fry from DHA-supplemented broodstock(V2-V)compensated for initial growth delays,achieving growth comparable to fry from commercial-fed mothers(C-V)within 30 days.Neurophysiological and gut-brain adapta-tions revealed complex compensatory mechanisms enabling fish to thrive on sustainable diets.These findings highlight the potential of DHA supplementation in plant-based diets to support sustainable aquaculture and warrant further validation under diverse nutritional and environmental conditions.
基金supported by grants from Singhealth Duke-NUS Academic Medicine Research grant(AM/SU035/2020)NMRC Clinician-Scientist Individual Research Grant New Investigator Grant(CNIG20nov-0003).
文摘Chemical exposure during prenatal development has significant implications for both maternal and child health.Compared to blood,saliva is a non-invasive and less resource-intensive,alternative.Given the temporal variability of xenobiotic metabolites(XM),repeated sampling is essential.Therefore,saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes.Despite its potential,no studies have explored saliva for XM measurement.This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women.Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24–34 weeks gestation.Metabolomes and exposomes were annotated using the Human Metabolome and U.S.Environmental Protection Agency databases.Metabolome-XM associations were clustered using Glay community clustering.Linear regression models,adjusted for age,estimated associations between catecholamines and XMs.XM levels were validated in a cohort of women(n=14)with and without preeclampsia.Our study identified 582 metabolomes and 125 XM in saliva,demonstrating its potential as a matrix for exposure measurement.After false discovery rate correction,18109 significant metabolome-XM associations were identified.Community clustering revealed 37 connected clusters,with the largest cluster(238 nodes)enriched in tyrosine and catecholamine metabolism.Food-contactchemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels.Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls.This study demonstrates that saliva contains valuable molecular data for measuring exposomes.Food-related chemicals were associated with higher catecholamine levels,which may be relevant to the prevalence of hypertensive crises in pregnancy.
基金sponsored by National Natural Science Foundation of China(81800703)Postdoctoral Fellowship Program of China Postdoctoral Science Foundation(GZC20231088)+8 种基金Beijing Nova Program(Z201100006820117 and 20220484181)Beijing Municipal Natural Science Foundation(7184252)the Fundamental Research Funds for the Central Universitiesthe Fundamental Research Funds for the Central Universities(BMU2021MX013)Peking University Clinical Scientist Training Program(BMU2023PYJH022)Peking University Medicine Seed Fund for Interdisciplinary ResearchChina Endocrine and Metabolism Young Scientific Talent Research Project(2022-N-02-01)China Diabetes Young Scientific Talent Research ProjectBethune-Merck Diabetes Research Fund of Bethune Charitable Foundation。
文摘Maternal consumption of a high-fat diet has been linked to increased risks of obesity and impaired glucose metabolism in offspring.However,the precise epigenetic mechanisms governing these intergenerational effects,particularly during the early stages of offspring development,remain poorly understood.In this study,female C57BL/6J mice were randomly assigned to either a high-fat diet or normal chow diet throughout gestation and lactation.Methylated DNA immunoprecipitation(MeDIP)coupled with microarray analysis was employed to identify differentially methylated genes in the livers of offspring at weaning age.We found that maternal high-fat diet feeding predisposes offspring to obesity and impaired glucose metabolism as early as the weaning period.DNA methylation profile analysis unveiled a significant enrichment of differentially methylated genes within the natural killer(NK)cell-mediated cytotoxicity pathway.MeDIP-PCR validated reduced methylation levels of specific genes within this pathway,including tumour necrosis factorα(TNF-α),phosphoinositide 3-kinase(PI3K),and SHC adaptor protein 1(SHC1).Consistently,the expressions of TNF-α,PI3K,and SHC1 were significantly upregulated,accompanied by elevated serum TNF-αand interleukin-6(IL-6)levels in offspring from dams fed with high-fat diet.Moreover,we assessed the expressions of genes associated with NK cell activities,uncovering a notable rise in hepatic granzyme B levels and a trend towards increased CD107a expression in offspring from dams fed a high-fat diet.In addition,methylation levels of TNF-α,PI3K,and SHC1 promoters were inversely correlated with glucose response during glucose tolerance testing.In conclusion,our findings underscore the critical role of the NK cell-mediated cytotoxicity signaling pathway in mediating DNA methylation patterns,thereby contributing to the programming effects of maternal high-fat diet consumption on offspring glucose metabolism as early as the weaning period.
文摘Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.
文摘Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.
基金supported by the National Key Research and Development Program of China(2021YFD2100700)the National Natural Science Foundation of China(32021005)+1 种基金the 111 project(BP0719028)the Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province.
文摘Irritable bowel syndrome-diarrhea(IBS-D)is a prevalent functional bowel disease severely impairs the quality of life of patients.Visceral hypersensitivity(VH)is the main symptom of IBS-D.Probiotics have been found to effectively alleviate VH.In this study,neonatal maternal separation(NMS)was used to induce VH in 72 rats and investigated the effects of daily gavage of 3×10^(9) CFU of Lactobacillus and Bifidobacterium on alleviating the symptoms of IBS-D and behavioral interventions,as well as exploring potential mechanisms.The results demonstrated that L.acidophilus and B.breve could alleviate the symptoms of IBS-D such as VH and increased frequency of bowel movements,as well as improving non-spatial memory in NMS rats.These effects were achieved by modulating the composition of gut microbiota and metabolites(including short-chain fatty acids,deoxycholic acid and adenosine),and by regulating the expression of genes and proteins associated with the NGF/TrkA signaling pathway,tryptophan metabolism,and inflammatory factors in the hippocampus.This finding suggests that L.acidophilus and B.breve have promising potential for the alleviation of IBS.
文摘This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with sleep disturbances recruited from Zouping County Traditional Chinese Medicine Hospital.Participants were divided into control and experimental groups,and sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before and after the intervention.The experimental group received Chinese herbal foot bath therapy,while the control group did not.Post-intervention results showed a significant improvement in sleep quality for the experimental group,with a mean PSQI score of 7.79(SD=2.90),compared to 13.45(SD=2.57)in the control group,indicating continued poor sleep.Statistical analysis confirmed that the therapy led to significant improvements across overall and component PSQI scores.The study concludes that Chinese herbal foot bath therapy is a safe,non-invasive,and cost-effective method to enhance sleep quality among postpartum women,especially those of advanced maternal age.It holds promise as a complementary treatment option and could be integrated into standard postpartum care practices to address sleep disturbances without relying on pharmacological interventions.
文摘Introduction:Diabetes mellitus(DM),a metabolic disorder,leads to organ damage due to chronic hyperglycemia with multiple pathogenic processes.Gestational diabetes mellitus(GDM)poses risks to mothers and offspring,increasing the incidence of structural congenital heart disease(CHD)and myocardial hypertrophy in newborns.Objective:This review aimed to examine the association between maternal diabetes mellitus and CHD.Methods:This systematic review used the STROBE and TRIPOD checklists registered in PROSPERO(CRD42024513858).It focused on diagnostic test accuracy using the Munn et al.protocol for systematic assessment,emphasizing the“PIRD”:Population,Index Test,Reference Test,Diagnosis of Interest.This review aimed the following PIRD model question:‘Does diabetic pregnant woman inffuence in fetal cardiac malformation?’using PRISMA 2020 statement.A systematic review was conducted on 19 October 2023 in the following databases:PubMed/MEDLINE,Embase(Elsevier),CINAHL(EBSCO),Scopus(Elsevier),Web of Science(Clarivate Analytics),LILACS,and SciELO.Only articles in English,Spanish,and Portuguese languages were selected.Results:Seven studies between 2018 and 2023 were selected.The studies differed in terms of the cardiac ultrasound parameters used to assess CHD and diagnose diabetes mellitus in pregnancy.They highlight the importance of fetal echocardiography in detecting CHD prenatally and assessing the impact of diabetes mellitus on fetal cardiac health,recommending proactive care planning and early intervention for better outcomes.Conclusions:The studies highlight the impact of maternal diabetes mellitus,particularly GDM,on fetal cardiac development and support early detection by fetal echocardiography.Standardization and collaboration are essential to reffne management and outcomes in high-risk pregnancies.
基金Supported by the Wuxi Municipal Health Commission Maternal and Child Health Research Project,No.FYKY202202.
文摘BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on maternal processes,maternal and infant outcomes,and anxiety during pregnancy.METHODS A total of 100 singleton term pregnancies with cervical maturity induction and anxiety were selected using a lottery method;50 women were included.Cervical balloons were used for all participants.In the control group,80 mL of fluid was injected into both balloons;in the observation group,80 and 100 mL were injected into the vaginal and cervical balloons,respectively.The two groups were compared for cervical maturity,labor duration,anxiety,maternal and infant outcomes,and effects on cervical ripening.RESULTS After treatment,the cervical maturity test(Bishop)score was significantly higher in the observation group(9.76±1.19)than in the control group(7.62±0.83),and the Hamilton Anxiety Scale score was lower in the observation group(7.32±0.85)than in the control group(13.05±1.12).The observation group showed higher rates of natural delivery and lower rates of cesarean section than the control group.The first and total stages of labor were shorter in the observation than in the control group;no significant differences were found in the second and third stages.The incidence of complications was lower in the observation group[1(2.00%)vs 9(18.00%)for complications;49(98.00%)vs 41(82.00%)for non-complications].CONCLUSION The selected fluid volumes to promote cervical maturity and induce labor stabilize maternal mood,increase the natural delivery rate,shorten labor,and improve maternal and infant outcomes.
文摘Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was employed, involving 60 pregnant women with GDM who were purposively selected and randomly allocated into experimental and control groups, each comprising 30 participants. The experimental group received comprehensive nursing interventions and pregnancy monitoring, while the control group received standard nursing care. Data collection was conducted using demographic questionnaires, pregnancy indicators, and maternal-infant outcome measurement tools. The collected data were analyzed using Microsoft Excel and the Statistical Package for Social Sciences (SPSS). Results: The findings indicated significant improvements in fasting blood glucose, postprandial blood glucose, amniotic fluid index, and neonatal birth weight in the experimental group compared to the control group. However, no statistically significant differences were observed in body mass index (BMI) or pregnancy weight gain. Comprehensive nursing interventions were associated with a significant reduction in maternal complications, including polyhydramnios, postpartum hemorrhage, and preeclampsia, as well as neonatal complications such as neonatal pneumonia, macrosomia, and hypoglycemia. Conclusion: Comprehensive nursing interventions have a positive impact on maternal and neonatal outcomes in pregnant women with GDM.
基金supported by grants from the National Natural Science Foundation of China(Grant No.82401994)the Top Medical Expert Team of the Wuxi Taihu Talent Plan(Grant Nos.DJTD202106,GDTD202105)+1 种基金the Medical Key Discipline Program of theWuxi Health Commission(Grant Nos.ZDXK2021007,CXTD2021005)Top Talent Support Program for Young and Middle-Aged People of Wuxi Health Committee(Grant No.HB2023079).
文摘Theincreasing prevalence of gestational diabetesmellitus(GDM)is associated with an array of pregnancy complications and enduring health challenges in bothmothers and their offspring.Studies have indicated that exposure to the intrauterine environment can prompt adaptations in the offspring,thereby programming transgenerational inheritance.Physical activity during pregnancy,as a non-pharmacological intervention,mitigates metabolic risks through epigenetic modifications,mediating placental adaptations,the action of exercise factors,and gut microbiota.Here,we provide a review summarizing how regular exercise can reduce the risk of GDM and positively influence pregnancy outcomes.It also discusses the exercise-induced reduction in obesity,insulin resistance,and fatty liver disease in the offspring of GDM,outlining the mechanisms that underpin these health benefits.This review underscores the importance of exercise in safeguarding the health of GDM mothers and their offspring.
