BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recogn...BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recognized in family-centered clinical practice.Concurrently,against the backdrop of rising rates of delayed marriage and China’s Maternity Incentive Policy,the proportion of women giving birth at an advanced maternal age is increasing.Nevertheless,research specifically examining PPD among spouses of older mothers remains critically scarce,both in China and globally.AIM To investigate PPD and its influencing factors in Chinese advanced maternal age families.METHODS This cross-sectional study included 358 participants;it was conducted among fathers of pregnant women of advanced maternal age at five hospitals in the Pearl River Delta region of China from September 2023 to June 2024.Data were collected via a general information questionnaire,the Social Support Rating Scale,and the Edinburgh Postnatal Depression Scale.Latent profile analysis and regression mixture models(RMMs)were adopted to analyze the latent PPD types and factors that influenced PPD.RESULTS The incidence of PPD was 16.48%,and three profiles were identified:Low-symptomatic(175 cases,48.89%),monophasic(140 cases,39.10%),and high-symptomatic(43 cases,12.01%).The RMM analysis revealed that first pregnancy,low income(<¥3000/month),part-time work,and a history of abnormal pregnancy were positively associated with the high-symptomatic type(P<0.05).Conversely,high subjective support and support utilization were negatively associated with the high-symptomatic type compared with the low-symptomatic type(P<0.05).Good couple relationships,high objective and subjective support,and high support utilization were negatively associated with monophasic disorder(P<0.05).CONCLUSION PPD incidence is high among Chinese fathers with advanced maternal age partners,and the characteristics of depression are varied.Healthcare practitioners should prioritize individuals with low levels of social support.展开更多
Purpose To investigate the perinatal risk factors for conductive hearing loss(CHL)in infancy and develop an initial prediction model to facilitate accurate diagnosis and early detection of CHL.Method This retrospectiv...Purpose To investigate the perinatal risk factors for conductive hearing loss(CHL)in infancy and develop an initial prediction model to facilitate accurate diagnosis and early detection of CHL.Method This retrospective study utilized data from the Newborn Cohort Study of Hearing Loss(ChiCTR2100049765).Infants who underwent diagnostic audiological assessments at our hospital between January 2003 and June 2024 were included.Data analysis was conducted using R(version 4.4.1)to construct an initial prediction model for CHL in infancy,applying the LASSO regression technique.Results A total of 661 infants(1322 ears)were included,with 1253 ears in the normal hearing group and 69 ears in the CHL group.Statistically significant differences were observed between the groups in the following factors:parent-reported infant response to sound,craniofacial deformities,neonatal hemolysis,jaundice treatment,and neonatal hypoglycemia.A multivariate prediction model and nomogram for CHL in infancy were developed and validated,achieving an accuracy of 92.5%and a specificity of 91.3%.Conclusions This study identified key risk factors for CHL in infancy and developed a preliminary predictive model,improving the diagnostic accuracy for CHL.Improved diagnostic precision can decrease misdiagnoses,reduce delays in treatment,and limit unnecessary antimicrobial prescriptions for infants.展开更多
Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-y...Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality.展开更多
BACKGROUND Pharmacological treatments are commonly used in individuals experiencing perinatal depression(PPD);however,a debate regarding the reproductive safety of antidepressants is ongoing.Many pregnant women opt to...BACKGROUND Pharmacological treatments are commonly used in individuals experiencing perinatal depression(PPD);however,a debate regarding the reproductive safety of antidepressants is ongoing.Many pregnant women opt to discontinue antidepressant out of concern about potential negative effects on the developing fetus,while slow and ineffective antidepressant medications hinder improved outcomes in women with PPD.In recent years,bright light therapy(BLT)has gained traction as a treatment option for PPD;however,clinical trials findings examining the efficacy of BLT in this population have been inconclusive.AIM To validate the feasibility and safety of BLT for the treatment of PPD.METHODS We performed a meta-analysis of randomized controlled trials of patients with PPD treated with BLT vs placebo following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.We searched PubMed,Embase,the Cochrane Library,and Web of Science for randomized controlled studies published up to December 2023.The results were evaluated using the standardized mean difference of improvement for depression scores and odds ratios(ORs)for remission rate,response rate,incidence of adverse events,and dropout rate.RESULTS The BLT group had higher PPD response rate[50.68%vs 33.08%;OR=2.05;95% confidence interval(CI):1.25-3.35;P=0.004;I^(2)=35%]and remission rate(54.10%vs 18.52%;OR=5.00;95%CI:2.09-11.99;P=0.0003;I^(2)=0%)than the placebo group.Improvements in depression scores were higher in the BLT group than the placebo group for the overall efficacy(standardized mean difference=-0.47;95%CI:-0.80 to-0.13;P=0.007).No significant differences between the two groups in drop-outs(21.84%vs 29.63%;OR=0.63;95%CI:0.31-1.29;P=0.21;I^(2)=0%)or adverse events(17.89%vs 9.68%;OR=2.01;95%CI:0.95-4.25;P=0.07;I^(2)=0%)were observed.CONCLUSION BLT can potentially treat PPD,showing better results than the control group in this study.BLT is effective and safe and could increase the available therapeutic options for PPD.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
The purpose of this experiment was to investigate the effect and mechanism of quercetin on reproductive performance in perinatal sows.According to the similar principle of parity and body weight,24 perinatal sows were...The purpose of this experiment was to investigate the effect and mechanism of quercetin on reproductive performance in perinatal sows.According to the similar principle of parity and body weight,24 perinatal sows were randomly divided into four treatments with six replicates,including normal control and three treatments fed by a basal diet supplemented with 0,0.025%,0.050%,and 0.075%quercetin,respectively.The feeding trial was conducted from 100 days of gestation to 28 days post-partum.Reproductive performance,colostrum composition,serum indexes of antioxidation,inflammation,hormones,and the diversity and relative abundance of fecal microflora were determined in perinatal sows.Compared with the control,quercetin significantly reduced the rate of constipation,serum content of malondialdehyde(MDA),prolactin(PRL),and progesterone(PROG),and significantly increased the content of serum estradiol(E2)and insulin-like growth factor-1(IGF-1)in colostrum of perinatal sows(P<0.05).Meanwhile,0.025%quercetin significantly increased glutathione(GSH)content in serum(P<0.05),0.050%quercetin significantly reduced the rate of backfat loss(P<0.05),and 0.075%quercetin significantly increased immunoglobulin M(IgM)content in colostrum of perinatal sows(P<0.05).In addition,0.050%and 0.075%quercetin significantly shortened estrus interval(P<0.05)and significantly increased the content of IgA and IgG in colostrum(P<0.05)and dopamine(DA)content in serum of perinatal sows(P<0.05).Quercetin significantly decreased the content of nitric oxide(NO),IL-1β,IL-6,TNF-α,and MCP-1 in serum(P<0.05)and significantly improved microflora abundance and diversity in feces of perinatal sows(P<0.05).In conclusion,dietary supplementation of quercetin reduced oxidative stress and inflammatory responses and regulated intestinal microflora in perinatal sows,thus improved reproductive performance in perinatal sows.Under this experimental condition,the optimal supplementation with dietary quercetin was 0.075%in perinatal sows.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is one of the most prevalent metabolic disorders of pregnancy.Advanced glycation end-products(AGEs)are a complex and highly heterogeneous group of compounds formed from ami...BACKGROUND Gestational diabetes mellitus(GDM)is one of the most prevalent metabolic disorders of pregnancy.Advanced glycation end-products(AGEs)are a complex and highly heterogeneous group of compounds formed from amino acids and reducing sugars.High-AGE diet exposure during pregnancy may cause adverse effects.AIM To investigate the expression levels of AGE and AGE receptor(RAGE)in the serum and placenta of pregnant women with GDM and to assess the association of their mediated oxidative stress response with perinatal outcomes.METHODS This study retrospectively analyzed the clinical data of 126 pregnant women with GDM who gave birth in the Obstetrics Department of Obstetrics and Gynecology Hospital of Fudan University from January 2023 to January 2024.A total of 85 pregnant women of similar age without GDM during the same period were selected as the control group.Fasting blood glucose,glycated hemoglobin,AGEs,soluble RAGE(sRAGE),and oxidative stress were compared in both groups.Postpartum placental tissue was collected to identify RAGE protein expression.Participants with GDM were categorized based on perinatal outcomes into normal(n=89)and adverse perinatal outcome groups(n=37),and differences in serum AGE–RAGE levels and oxidative stress were analyzed.The influencing factors of adverse perinatal outcomes were analyzed using logistic regression.RESULTS The GDM group demonstrated notably higher serum AGE(t=8.955)and malondialdehyde(MDA)levels(t=14.14)and lower sRAGE(t=16.37)and superoxide dismutase(SOD)levels(t=18.50)than the control group at 24-28 weeks of gestation and before delivery(P<0.0001).Serum AGE levels were positively correlated with MDA and negatively related to SOD at 24-28 weeks of pregnancy(SOD:r=0.393,MDA:r=0.424,P<0.0001)and before delivery(SOD:r=0.443,MDA:r=0.492,P<0.0001),whereas AGE was inversely associated with sRAGE in the GDM group(r=-0.495,P<0.0001).Serum AGE levels were significantly higher(t=9.225,P<0.0001)and the sRAGE level(r=3.563,P<0.0001)was significantly lower in participants with adverse perinatal outcomes than those with normal perinatal outcomes in the GDM group.Logistic regression analysis revealed AGE level as a risk factor(OR=1.056,P<0.0001)and sRAGE level(OR=0.949,P<0.0001)as a protective factor for adverse perinatal outcomes in GDM.CONCLUSION High serum AGE level is a risk factor for adverse perinatal outcomes in GDM,whereas high sRAGE levels are protective.AGEs and RAGE may be associated with oxidative stress in pregnant women with GDM.展开更多
BACKGROUND Perinatal anxiety disorder is the main problem affecting mother-infant bonding.Though the impact of perinatal anxiety in primiparous women on the motherinfant relationship is well established,appropriate in...BACKGROUND Perinatal anxiety disorder is the main problem affecting mother-infant bonding.Though the impact of perinatal anxiety in primiparous women on the motherinfant relationship is well established,appropriate interventions need to be explored.AIM To explore the synergistic intervention effect of mindfulness-based stress reduction combined with cognitive behavioral therapy(CBT)on perinatal anxiety disorders and mother-infant bonding in primiparas.METHODS A total of 150 primiparas with perinatal anxiety disorders admitted to the hospital from January 2020 to October 2024 were selected and divided into two groups according to the random number method.The control group(n=75)received CBT,and the observation group(n=75)received mindfulness-based stress reduction combined with CBT.The anxiety and depressive emotions,as well as the mother-infant emotional bonding situation,were compared between the two groups.RESULTS After the intervention,the anxiety and depressive states in the observation group were lower than those in the control group(P<0.05).The mother-infant bonding(sense of pleasure,recognition,understanding,and love)in the observation group was higher than that in the control group,and the role adaptation ability was also higher than in the control group(P<0.05).CONCLUSION Mindfulness-based stress reduction combined with CBT can reduce perinatal anxiety disorders in primiparas,promote mother-infant bonding,and improve their ability to adapt to the mother role.展开更多
Describe the content and current situation of maternal information needs and support,providing a basis for building maternal information needs assessment tools and improving information support systems.Retrieve articl...Describe the content and current situation of maternal information needs and support,providing a basis for building maternal information needs assessment tools and improving information support systems.Retrieve articles related to the topic from domestic and foreign databases,and ultimately include 54 articles.Summarize from the aspects of information demand content,influencing factors,evaluation tools,and information support channels.We found that the information needs of pregnant women are rich in content,but the existing information support content is limited and the form is single.There is an urgent need to establish scientific and effective information needs assessment tools,as well as diverse information support systems.展开更多
Depression is the most common mental disorder among perinatal women,with its incidence showing an annual increasing trend.Depression poses severe harms to the health of mothers and infants,thus requiring high attentio...Depression is the most common mental disorder among perinatal women,with its incidence showing an annual increasing trend.Depression poses severe harms to the health of mothers and infants,thus requiring high attention from perinatal women themselves,their families,and society.Studies have shown that there are numerous influencing factors for depression in perinatal women,the most common of which include place of residence,monthly family income,recent appetite,mother-in-law and daughter-in-law relationship,personal history of anxiety and depression,obstetric complications during pregnancy,fear of childbirth,utilization of support,positive coping,and susceptible personality.Based on empirical research,this paper conducts an in-depth study and discussion on the current status of depression and its influencing factors in perinatal women,aiming to provide a basis for formulating scientific and effective preventive and intervention measures,and to contribute modestly to effectively reducing the adverse impact of depression on the physical and mental health of mothers and infants.展开更多
Nutrition during perinatal period is more critical for the developme nt of the immune system than during adulthood, and the relationship between earl y nutrition and diseases in later life has been established. In hum...Nutrition during perinatal period is more critical for the developme nt of the immune system than during adulthood, and the relationship between earl y nutrition and diseases in later life has been established. In humans and labor atory animals, the plasticity of metabolic function in foetuses or neonates enab les them to adapt to malnutrition for survival; however, such an adaptation, as usually evidenced by retarded growth, stunted development of lymphoid organs and impaired immunocompetence, can maintain and persist into later life even when n utrition is improved. Early nutrition may thus programme' the immune system of a nimals. Limited experimental studies have also revealed that long-term immunity against nematode parasites in sheep can be enhanced by a short-term protein su pplementation shortly after weaning, a form of 'nutritional programming', but su ch an effect appears to vanish if the nutritional status of young animals alread y meets at least the requirement for maintenance.展开更多
Mesenchymal stromal/stem cells(MSCs)are currently applied in regenerative medicine and tissue engineering.Numerous clinical studies have indicated that MSCs from different tissue sources can provide therapeutic benefi...Mesenchymal stromal/stem cells(MSCs)are currently applied in regenerative medicine and tissue engineering.Numerous clinical studies have indicated that MSCs from different tissue sources can provide therapeutic benefits for patients.MSCs derived from either human adult or perinatal tissues have their own unique advantages in their medical practices.Usually,clinical studies are conducted by using of cultured MSCs after thawing or short-term cryopreserved-then-thawed MSCs prior to administration for the treatment of a wide range of diseases and medical disorders.Currently,cryogenically banking perinatal MSCs for potential personalized medicine for later use in lifetime has raised growing interest in China as well as in many other countries.Meanwhile,this has led to questions regarding the availability,stability,consistency,multipotency,and therapeutic efficiency of the potential perinatal MSC-derived therapeutic products after longterm cryostorage.This opinion review does not minimize any therapeutic benefit of perinatal MSCs in many diseases after short-term cryopreservation.This article mainly describes what is known about banking perinatal MSCs in China and,importantly,it is to recognize the limitation and uncertainty of the perinatal MSCs stored in cryobanks for stem cell medical treatments in whole life.This article also provides several recommendations for banking of perinatal MSCs for potentially future personalized medicine,albeit it is impossible to anticipate whether the donor will benefit from banked MSCs during her/his lifetime.展开更多
Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the...Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.展开更多
Cell-based regenerative medicine is of growing interest in biomedical research. The role of stem cells in this context is under intense scrutiny and may help to define principles of organ regeneration and develop inno...Cell-based regenerative medicine is of growing interest in biomedical research. The role of stem cells in this context is under intense scrutiny and may help to define principles of organ regeneration and develop innovative therapeutics for organ failure. Utilizing stem and progenitor cells for organ replacement has been conducted for many years when performing hematopoietic stem cell transplantation. Since the first successful transplantation of umbilical cord blood to treat hematological malignancies, non-hematopoietic stem and progenitor cell populations have recently been identified within umbilical cord blood and other perinatal and fetal tissues. A cell population entitled mesenchymal stromal cells (MSCs) emerged as one of the most intensely studied as it subsumes a variety of capacities: MSCs can differentiate into various subtypes of the mesodermal lineage, they secrete a large array of trophic factors suitable of recruiting endogenous repair processes and they are immunomodulatory.Focusing on perinatal tissues to isolate MSCs, we will discuss some of the challenges associated with these cell types concentrating on concepts of isolation and expansion, the comparison with cells derived from other tissue sources, regarding phenotype and differentiation capacity and finally their therapeutic potential.展开更多
Fetuses and neonates are known to be high-risk groups for Methylmercury（MeHg）exposure.MeHg can be transferred to the fetus through the placenta and to newborn offspring through breast milk.The aim of the present stu...Fetuses and neonates are known to be high-risk groups for Methylmercury（MeHg）exposure.MeHg can be transferred to the fetus through the placenta and to newborn offspring through breast milk.The aim of the present study was to investigate the neurotoxic effects of low doses of MeHg（1 and 5 μg/m L in drinking water） administration,from gestational day 1 to postnatal day（PND） 21,on the neurobehavioral development of rats.The results showed that the no-observed-effect level of MeHg is somewhere in the range of 1-4 μg/mL.Neurobehavioral development analysis revealed a delayed appearance of cliff drop and negative geotaxis reflexes in the 5 μg/mL MeHg exposure group.Developmental exposure to MeHg affected locomotor activity functions for the females,but not for the males,implying that the female pups were more vulnerable than the male pups.All pups exposed to 5 μg/mL of MeHg showed a significant deficit in motor coordination in the rotarod test compared with controls,and the highest accumulated concentrations of Hg were found in the cerebellum,followed by the hippocampus and cerebral cortex,indicating that the cerebellum is a possible target for MeHg toxicity.We demonstrated adverse effects of developmental exposure to MeHg associated with tissue concentrations very close to the current human body burden of this persistent and bioaccumulative compound.展开更多
Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy(NE) and r...Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy(NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy(HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. Outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and longterm outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing novel markers.展开更多
Data indicate that perinatal nutritional insults not onlyhave short-term consequences on the growth velocity of the fetus/neonate but also sensitize to the development of metabolic adult diseases.The pathophysiologica...Data indicate that perinatal nutritional insults not onlyhave short-term consequences on the growth velocity of the fetus/neonate but also sensitize to the development of metabolic adult diseases.The pathophysiological mechanisms involved in the so-called "Developmental Origin of Health and Adult Diseases" are still largely unknown and depend on the type of alteration (nutritional,psychological,endocrine disruptors,etc.),its intensity and duration,species,sex and the time during which it is applied.Perinatal stress,via disturbances of both hy-pothalamo-pituitary-adrenal (HPA) axis and sympathoadrenal-system (SAS),as well as brain-adipose axis and pancreas alterations could play a crucial role.Interestingly,it has been demonstrated that perinatal insults may be transmitted transgenerationally,suggesting that these long-term consequences may be inherited via epigenetic mechanisms.Finally,since the placenta has been demonstrated to be sensitive to perinatal nutritional manipulations,the identification of placental markers may thus represent an important new avenue to identify the more susceptible babies prone to developing meta-bolic diseases.展开更多
AIM:To investigate associations between perinatal risk factors and subsequent inflammatory bowel disease (IBD) in children and young adults.METHODS:Record linked abstracts of birth registrations,maternity,day case and...AIM:To investigate associations between perinatal risk factors and subsequent inflammatory bowel disease (IBD) in children and young adults.METHODS:Record linked abstracts of birth registrations,maternity,day case and inpatient admissions in a defined population of southern England.Investigation of 20 perinatal factors relating to the maternity or the birth:maternal age,Crohn's disease (CD) or ulcerative colitis (UC) in the mother,maternal social class,marital status,smoking in pregnancy,ABO blood group and rhesus status,pre-eclampsia,parity,the infant's presentation at birth,caesarean delivery,forceps delivery,sex,number of babies delivered,gestational age,birthweight,head circumference,breastfeeding and Apgar scores at one and five minutes.RESULTS:Maternity records were present for 180 children who subsequently developed IBD.Univariate analysis showed increased risks of CD among children of mothers with CD (P=0.011,based on two cases of CD in both mother and child) and children of mothers who smoked during pregnancy.Multivariate analysis confirmed increased risks of CD among children of mothers who smoked (odds ratio=2.04,95% CI=1.06-3.92) and for older mothers aged 35+ years (4.81,2.32-9.98).Multivariate analysis showed that there were no significant associations between CD and 17 other perinatal risk factors investigated.It also showed that,for UC,there were no significant associations with the perinatal factors studied.CONCLUSION:This study shows an association between CD in mother and child;and elevated risks of CD in children of older mothers and of mothers who smoked.展开更多
Background:Intrahepatic cholestasis of pregnancy(ICP)increases the risk of adverse pregnancy outcomes.This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinata...Background:Intrahepatic cholestasis of pregnancy(ICP)increases the risk of adverse pregnancy outcomes.This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinatal outcome as well as the responses to the treatment of ursodeoxycholic acid(UDCA).Methods:This prospective,case control study included 88 pregnant women(44 women with ICP and 44 healthy controls).The primary end points were the perinatal outcome and the response to UDCA therapy.A logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes and reduced response to UDCA therapy.Results:Women with ICP had significantly higher serum syndecan-1(1.27±0.36 ng/m L vs.0.98±0.50 ng/m L;P=0.003),glypican-3(1.78±0.13 ng/m L vs.1.69±0.16 ng/m L;P=0.004),AST(128.59±1.44 vs.13.29±1.32 U/L;P<0.001),and ALT(129.84±1.53 vs.8.00±3.67 U/L;P<0.001)levels compared with the controls.The increased levels of syndecan-1(OR=4.715,95%CI:1.554–14.310;P=0.006),glypican-3(OR=8.465,95%CI:3.372–21.248;P=0.007),ALT(OR=1.382,95%CI:1.131–1.690;P=0.002),and postprandial bile acid(PBA)(OR=3.392,95%CI:1.003–12.869;P=0.026)were correlated to ICP.The adverse neonatal outcome was related to increased glypican-3(OR=4.275,95%CI:2.726–5.635;P=0.039),and PBA(OR=3.026,95%CI:1.069–13.569;P=0.037).Increases of syndecan-1(OR=7.464,95%CI:2.130–26.153,P=0.017)and glypican-3(OR=6.194,95%CI:2.951–13.002;P=0.025)were the risk factors of decreased response to UDCA treatment.Conclusion:Syndecan-1 and glypican-3 might be powerful determinants in predicting adverse perinatal outcome in patients with ICP,and they can be used to predict the response to the UDCA treatment.展开更多
Objective:To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.Methods:A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from ...Objective:To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.Methods:A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire.Results:Sixty-two respondents were included and most of them were working mothers (77.4%).The mean age of the respondents was (31.0±5.6) years and a majority of the subjects aged between 20-34 years (77.4%).According to the EPDS score,53.2% of the respondents had a psychosocial impact with a total score of >9,out of 30.There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019).However,there were no significant differences between psychosocial impact and history of previous perinatal loss,ethnicity,occupation,educational level,age or total income.Conclusion:Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed.Family and friends should continue to provide emotional support.People who have experienced similar problem before will be able to provide better support than those who have not.展开更多
基金Supported by High-level Professional Groups in Gangdong Province,No.GSPZYQ2020101Guangdong Province Educational Research Planning Project,No.2024GXJK742。
文摘BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recognized in family-centered clinical practice.Concurrently,against the backdrop of rising rates of delayed marriage and China’s Maternity Incentive Policy,the proportion of women giving birth at an advanced maternal age is increasing.Nevertheless,research specifically examining PPD among spouses of older mothers remains critically scarce,both in China and globally.AIM To investigate PPD and its influencing factors in Chinese advanced maternal age families.METHODS This cross-sectional study included 358 participants;it was conducted among fathers of pregnant women of advanced maternal age at five hospitals in the Pearl River Delta region of China from September 2023 to June 2024.Data were collected via a general information questionnaire,the Social Support Rating Scale,and the Edinburgh Postnatal Depression Scale.Latent profile analysis and regression mixture models(RMMs)were adopted to analyze the latent PPD types and factors that influenced PPD.RESULTS The incidence of PPD was 16.48%,and three profiles were identified:Low-symptomatic(175 cases,48.89%),monophasic(140 cases,39.10%),and high-symptomatic(43 cases,12.01%).The RMM analysis revealed that first pregnancy,low income(<¥3000/month),part-time work,and a history of abnormal pregnancy were positively associated with the high-symptomatic type(P<0.05).Conversely,high subjective support and support utilization were negatively associated with the high-symptomatic type compared with the low-symptomatic type(P<0.05).Good couple relationships,high objective and subjective support,and high support utilization were negatively associated with monophasic disorder(P<0.05).CONCLUSION PPD incidence is high among Chinese fathers with advanced maternal age partners,and the characteristics of depression are varied.Healthcare practitioners should prioritize individuals with low levels of social support.
基金supported by the grants of the National Key Research and Development Program of China(Grant No.2023YFC2508400)the National Natural Science Foundation of China(Grant No.82350005).
文摘Purpose To investigate the perinatal risk factors for conductive hearing loss(CHL)in infancy and develop an initial prediction model to facilitate accurate diagnosis and early detection of CHL.Method This retrospective study utilized data from the Newborn Cohort Study of Hearing Loss(ChiCTR2100049765).Infants who underwent diagnostic audiological assessments at our hospital between January 2003 and June 2024 were included.Data analysis was conducted using R(version 4.4.1)to construct an initial prediction model for CHL in infancy,applying the LASSO regression technique.Results A total of 661 infants(1322 ears)were included,with 1253 ears in the normal hearing group and 69 ears in the CHL group.Statistically significant differences were observed between the groups in the following factors:parent-reported infant response to sound,craniofacial deformities,neonatal hemolysis,jaundice treatment,and neonatal hypoglycemia.A multivariate prediction model and nomogram for CHL in infancy were developed and validated,achieving an accuracy of 92.5%and a specificity of 91.3%.Conclusions This study identified key risk factors for CHL in infancy and developed a preliminary predictive model,improving the diagnostic accuracy for CHL.Improved diagnostic precision can decrease misdiagnoses,reduce delays in treatment,and limit unnecessary antimicrobial prescriptions for infants.
文摘Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality.
基金Supported by the Hebei Province Natural Science Foundation,No.H2018206034 and No.H2022206544Hebei Province clinical medicine outstanding personnel training project,No.ZF2024135.
文摘BACKGROUND Pharmacological treatments are commonly used in individuals experiencing perinatal depression(PPD);however,a debate regarding the reproductive safety of antidepressants is ongoing.Many pregnant women opt to discontinue antidepressant out of concern about potential negative effects on the developing fetus,while slow and ineffective antidepressant medications hinder improved outcomes in women with PPD.In recent years,bright light therapy(BLT)has gained traction as a treatment option for PPD;however,clinical trials findings examining the efficacy of BLT in this population have been inconclusive.AIM To validate the feasibility and safety of BLT for the treatment of PPD.METHODS We performed a meta-analysis of randomized controlled trials of patients with PPD treated with BLT vs placebo following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.We searched PubMed,Embase,the Cochrane Library,and Web of Science for randomized controlled studies published up to December 2023.The results were evaluated using the standardized mean difference of improvement for depression scores and odds ratios(ORs)for remission rate,response rate,incidence of adverse events,and dropout rate.RESULTS The BLT group had higher PPD response rate[50.68%vs 33.08%;OR=2.05;95% confidence interval(CI):1.25-3.35;P=0.004;I^(2)=35%]and remission rate(54.10%vs 18.52%;OR=5.00;95%CI:2.09-11.99;P=0.0003;I^(2)=0%)than the placebo group.Improvements in depression scores were higher in the BLT group than the placebo group for the overall efficacy(standardized mean difference=-0.47;95%CI:-0.80 to-0.13;P=0.007).No significant differences between the two groups in drop-outs(21.84%vs 29.63%;OR=0.63;95%CI:0.31-1.29;P=0.21;I^(2)=0%)or adverse events(17.89%vs 9.68%;OR=2.01;95%CI:0.95-4.25;P=0.07;I^(2)=0%)were observed.CONCLUSION BLT can potentially treat PPD,showing better results than the control group in this study.BLT is effective and safe and could increase the available therapeutic options for PPD.
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Supported by the National Natural Science Foundation of China(32072749)。
文摘The purpose of this experiment was to investigate the effect and mechanism of quercetin on reproductive performance in perinatal sows.According to the similar principle of parity and body weight,24 perinatal sows were randomly divided into four treatments with six replicates,including normal control and three treatments fed by a basal diet supplemented with 0,0.025%,0.050%,and 0.075%quercetin,respectively.The feeding trial was conducted from 100 days of gestation to 28 days post-partum.Reproductive performance,colostrum composition,serum indexes of antioxidation,inflammation,hormones,and the diversity and relative abundance of fecal microflora were determined in perinatal sows.Compared with the control,quercetin significantly reduced the rate of constipation,serum content of malondialdehyde(MDA),prolactin(PRL),and progesterone(PROG),and significantly increased the content of serum estradiol(E2)and insulin-like growth factor-1(IGF-1)in colostrum of perinatal sows(P<0.05).Meanwhile,0.025%quercetin significantly increased glutathione(GSH)content in serum(P<0.05),0.050%quercetin significantly reduced the rate of backfat loss(P<0.05),and 0.075%quercetin significantly increased immunoglobulin M(IgM)content in colostrum of perinatal sows(P<0.05).In addition,0.050%and 0.075%quercetin significantly shortened estrus interval(P<0.05)and significantly increased the content of IgA and IgG in colostrum(P<0.05)and dopamine(DA)content in serum of perinatal sows(P<0.05).Quercetin significantly decreased the content of nitric oxide(NO),IL-1β,IL-6,TNF-α,and MCP-1 in serum(P<0.05)and significantly improved microflora abundance and diversity in feces of perinatal sows(P<0.05).In conclusion,dietary supplementation of quercetin reduced oxidative stress and inflammatory responses and regulated intestinal microflora in perinatal sows,thus improved reproductive performance in perinatal sows.Under this experimental condition,the optimal supplementation with dietary quercetin was 0.075%in perinatal sows.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is one of the most prevalent metabolic disorders of pregnancy.Advanced glycation end-products(AGEs)are a complex and highly heterogeneous group of compounds formed from amino acids and reducing sugars.High-AGE diet exposure during pregnancy may cause adverse effects.AIM To investigate the expression levels of AGE and AGE receptor(RAGE)in the serum and placenta of pregnant women with GDM and to assess the association of their mediated oxidative stress response with perinatal outcomes.METHODS This study retrospectively analyzed the clinical data of 126 pregnant women with GDM who gave birth in the Obstetrics Department of Obstetrics and Gynecology Hospital of Fudan University from January 2023 to January 2024.A total of 85 pregnant women of similar age without GDM during the same period were selected as the control group.Fasting blood glucose,glycated hemoglobin,AGEs,soluble RAGE(sRAGE),and oxidative stress were compared in both groups.Postpartum placental tissue was collected to identify RAGE protein expression.Participants with GDM were categorized based on perinatal outcomes into normal(n=89)and adverse perinatal outcome groups(n=37),and differences in serum AGE–RAGE levels and oxidative stress were analyzed.The influencing factors of adverse perinatal outcomes were analyzed using logistic regression.RESULTS The GDM group demonstrated notably higher serum AGE(t=8.955)and malondialdehyde(MDA)levels(t=14.14)and lower sRAGE(t=16.37)and superoxide dismutase(SOD)levels(t=18.50)than the control group at 24-28 weeks of gestation and before delivery(P<0.0001).Serum AGE levels were positively correlated with MDA and negatively related to SOD at 24-28 weeks of pregnancy(SOD:r=0.393,MDA:r=0.424,P<0.0001)and before delivery(SOD:r=0.443,MDA:r=0.492,P<0.0001),whereas AGE was inversely associated with sRAGE in the GDM group(r=-0.495,P<0.0001).Serum AGE levels were significantly higher(t=9.225,P<0.0001)and the sRAGE level(r=3.563,P<0.0001)was significantly lower in participants with adverse perinatal outcomes than those with normal perinatal outcomes in the GDM group.Logistic regression analysis revealed AGE level as a risk factor(OR=1.056,P<0.0001)and sRAGE level(OR=0.949,P<0.0001)as a protective factor for adverse perinatal outcomes in GDM.CONCLUSION High serum AGE level is a risk factor for adverse perinatal outcomes in GDM,whereas high sRAGE levels are protective.AGEs and RAGE may be associated with oxidative stress in pregnant women with GDM.
文摘BACKGROUND Perinatal anxiety disorder is the main problem affecting mother-infant bonding.Though the impact of perinatal anxiety in primiparous women on the motherinfant relationship is well established,appropriate interventions need to be explored.AIM To explore the synergistic intervention effect of mindfulness-based stress reduction combined with cognitive behavioral therapy(CBT)on perinatal anxiety disorders and mother-infant bonding in primiparas.METHODS A total of 150 primiparas with perinatal anxiety disorders admitted to the hospital from January 2020 to October 2024 were selected and divided into two groups according to the random number method.The control group(n=75)received CBT,and the observation group(n=75)received mindfulness-based stress reduction combined with CBT.The anxiety and depressive emotions,as well as the mother-infant emotional bonding situation,were compared between the two groups.RESULTS After the intervention,the anxiety and depressive states in the observation group were lower than those in the control group(P<0.05).The mother-infant bonding(sense of pleasure,recognition,understanding,and love)in the observation group was higher than that in the control group,and the role adaptation ability was also higher than in the control group(P<0.05).CONCLUSION Mindfulness-based stress reduction combined with CBT can reduce perinatal anxiety disorders in primiparas,promote mother-infant bonding,and improve their ability to adapt to the mother role.
文摘Describe the content and current situation of maternal information needs and support,providing a basis for building maternal information needs assessment tools and improving information support systems.Retrieve articles related to the topic from domestic and foreign databases,and ultimately include 54 articles.Summarize from the aspects of information demand content,influencing factors,evaluation tools,and information support channels.We found that the information needs of pregnant women are rich in content,but the existing information support content is limited and the form is single.There is an urgent need to establish scientific and effective information needs assessment tools,as well as diverse information support systems.
基金Study on the Construction of a Perinatal Depression Risk Prediction Model Based on Artificial Neural Network,2023 Xiangjiao Tong(Project No.:361-23c0467)。
文摘Depression is the most common mental disorder among perinatal women,with its incidence showing an annual increasing trend.Depression poses severe harms to the health of mothers and infants,thus requiring high attention from perinatal women themselves,their families,and society.Studies have shown that there are numerous influencing factors for depression in perinatal women,the most common of which include place of residence,monthly family income,recent appetite,mother-in-law and daughter-in-law relationship,personal history of anxiety and depression,obstetric complications during pregnancy,fear of childbirth,utilization of support,positive coping,and susceptible personality.Based on empirical research,this paper conducts an in-depth study and discussion on the current status of depression and its influencing factors in perinatal women,aiming to provide a basis for formulating scientific and effective preventive and intervention measures,and to contribute modestly to effectively reducing the adverse impact of depression on the physical and mental health of mothers and infants.
文摘Nutrition during perinatal period is more critical for the developme nt of the immune system than during adulthood, and the relationship between earl y nutrition and diseases in later life has been established. In humans and labor atory animals, the plasticity of metabolic function in foetuses or neonates enab les them to adapt to malnutrition for survival; however, such an adaptation, as usually evidenced by retarded growth, stunted development of lymphoid organs and impaired immunocompetence, can maintain and persist into later life even when n utrition is improved. Early nutrition may thus programme' the immune system of a nimals. Limited experimental studies have also revealed that long-term immunity against nematode parasites in sheep can be enhanced by a short-term protein su pplementation shortly after weaning, a form of 'nutritional programming', but su ch an effect appears to vanish if the nutritional status of young animals alread y meets at least the requirement for maintenance.
基金Supported by the Henan Province Science and Technique Bureau R&D Project,No.222102310228.
文摘Mesenchymal stromal/stem cells(MSCs)are currently applied in regenerative medicine and tissue engineering.Numerous clinical studies have indicated that MSCs from different tissue sources can provide therapeutic benefits for patients.MSCs derived from either human adult or perinatal tissues have their own unique advantages in their medical practices.Usually,clinical studies are conducted by using of cultured MSCs after thawing or short-term cryopreserved-then-thawed MSCs prior to administration for the treatment of a wide range of diseases and medical disorders.Currently,cryogenically banking perinatal MSCs for potential personalized medicine for later use in lifetime has raised growing interest in China as well as in many other countries.Meanwhile,this has led to questions regarding the availability,stability,consistency,multipotency,and therapeutic efficiency of the potential perinatal MSC-derived therapeutic products after longterm cryostorage.This opinion review does not minimize any therapeutic benefit of perinatal MSCs in many diseases after short-term cryopreservation.This article mainly describes what is known about banking perinatal MSCs in China and,importantly,it is to recognize the limitation and uncertainty of the perinatal MSCs stored in cryobanks for stem cell medical treatments in whole life.This article also provides several recommendations for banking of perinatal MSCs for potentially future personalized medicine,albeit it is impossible to anticipate whether the donor will benefit from banked MSCs during her/his lifetime.
文摘Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.
基金Supported by Research Funds of the German Federal Ministry of Education and Research (01GN0531 and 01GN0939)Proj-ect Commissioned by the European Community ("CASCADE"HEALTH-F5-2009-223236).
文摘Cell-based regenerative medicine is of growing interest in biomedical research. The role of stem cells in this context is under intense scrutiny and may help to define principles of organ regeneration and develop innovative therapeutics for organ failure. Utilizing stem and progenitor cells for organ replacement has been conducted for many years when performing hematopoietic stem cell transplantation. Since the first successful transplantation of umbilical cord blood to treat hematological malignancies, non-hematopoietic stem and progenitor cell populations have recently been identified within umbilical cord blood and other perinatal and fetal tissues. A cell population entitled mesenchymal stromal cells (MSCs) emerged as one of the most intensely studied as it subsumes a variety of capacities: MSCs can differentiate into various subtypes of the mesodermal lineage, they secrete a large array of trophic factors suitable of recruiting endogenous repair processes and they are immunomodulatory.Focusing on perinatal tissues to isolate MSCs, we will discuss some of the challenges associated with these cell types concentrating on concepts of isolation and expansion, the comparison with cells derived from other tissue sources, regarding phenotype and differentiation capacity and finally their therapeutic potential.
基金financially supported by the National Natural Science Foundation of China (No.21177087)the National Program on Key Basic Research Project of China (973 Program) (No.2013CB430005)
文摘Fetuses and neonates are known to be high-risk groups for Methylmercury（MeHg）exposure.MeHg can be transferred to the fetus through the placenta and to newborn offspring through breast milk.The aim of the present study was to investigate the neurotoxic effects of low doses of MeHg（1 and 5 μg/m L in drinking water） administration,from gestational day 1 to postnatal day（PND） 21,on the neurobehavioral development of rats.The results showed that the no-observed-effect level of MeHg is somewhere in the range of 1-4 μg/mL.Neurobehavioral development analysis revealed a delayed appearance of cliff drop and negative geotaxis reflexes in the 5 μg/mL MeHg exposure group.Developmental exposure to MeHg affected locomotor activity functions for the females,but not for the males,implying that the female pups were more vulnerable than the male pups.All pups exposed to 5 μg/mL of MeHg showed a significant deficit in motor coordination in the rotarod test compared with controls,and the highest accumulated concentrations of Hg were found in the cerebellum,followed by the hippocampus and cerebral cortex,indicating that the cerebellum is a possible target for MeHg toxicity.We demonstrated adverse effects of developmental exposure to MeHg associated with tissue concentrations very close to the current human body burden of this persistent and bioaccumulative compound.
基金Supported by The Health Research Board CSA/2012/40a Science Foundation Ireland Research Centre Award(INFANT-12/RC/2272)
文摘Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy(NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy(HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. Outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and longterm outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing novel markers.
文摘Data indicate that perinatal nutritional insults not onlyhave short-term consequences on the growth velocity of the fetus/neonate but also sensitize to the development of metabolic adult diseases.The pathophysiological mechanisms involved in the so-called "Developmental Origin of Health and Adult Diseases" are still largely unknown and depend on the type of alteration (nutritional,psychological,endocrine disruptors,etc.),its intensity and duration,species,sex and the time during which it is applied.Perinatal stress,via disturbances of both hy-pothalamo-pituitary-adrenal (HPA) axis and sympathoadrenal-system (SAS),as well as brain-adipose axis and pancreas alterations could play a crucial role.Interestingly,it has been demonstrated that perinatal insults may be transmitted transgenerationally,suggesting that these long-term consequences may be inherited via epigenetic mechanisms.Finally,since the placenta has been demonstrated to be sensitive to perinatal nutritional manipulations,the identification of placental markers may thus represent an important new avenue to identify the more susceptible babies prone to developing meta-bolic diseases.
基金Supported by (in part) National Institute for Health Research,England,Grant No.NCCRCD ZRC/002/002/026
文摘AIM:To investigate associations between perinatal risk factors and subsequent inflammatory bowel disease (IBD) in children and young adults.METHODS:Record linked abstracts of birth registrations,maternity,day case and inpatient admissions in a defined population of southern England.Investigation of 20 perinatal factors relating to the maternity or the birth:maternal age,Crohn's disease (CD) or ulcerative colitis (UC) in the mother,maternal social class,marital status,smoking in pregnancy,ABO blood group and rhesus status,pre-eclampsia,parity,the infant's presentation at birth,caesarean delivery,forceps delivery,sex,number of babies delivered,gestational age,birthweight,head circumference,breastfeeding and Apgar scores at one and five minutes.RESULTS:Maternity records were present for 180 children who subsequently developed IBD.Univariate analysis showed increased risks of CD among children of mothers with CD (P=0.011,based on two cases of CD in both mother and child) and children of mothers who smoked during pregnancy.Multivariate analysis confirmed increased risks of CD among children of mothers who smoked (odds ratio=2.04,95% CI=1.06-3.92) and for older mothers aged 35+ years (4.81,2.32-9.98).Multivariate analysis showed that there were no significant associations between CD and 17 other perinatal risk factors investigated.It also showed that,for UC,there were no significant associations with the perinatal factors studied.CONCLUSION:This study shows an association between CD in mother and child;and elevated risks of CD in children of older mothers and of mothers who smoked.
基金the Ethics Committee of the Liv Hospital Affiliated to University of I˙stinye,Turkey(2018-003/015).
文摘Background:Intrahepatic cholestasis of pregnancy(ICP)increases the risk of adverse pregnancy outcomes.This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinatal outcome as well as the responses to the treatment of ursodeoxycholic acid(UDCA).Methods:This prospective,case control study included 88 pregnant women(44 women with ICP and 44 healthy controls).The primary end points were the perinatal outcome and the response to UDCA therapy.A logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes and reduced response to UDCA therapy.Results:Women with ICP had significantly higher serum syndecan-1(1.27±0.36 ng/m L vs.0.98±0.50 ng/m L;P=0.003),glypican-3(1.78±0.13 ng/m L vs.1.69±0.16 ng/m L;P=0.004),AST(128.59±1.44 vs.13.29±1.32 U/L;P<0.001),and ALT(129.84±1.53 vs.8.00±3.67 U/L;P<0.001)levels compared with the controls.The increased levels of syndecan-1(OR=4.715,95%CI:1.554–14.310;P=0.006),glypican-3(OR=8.465,95%CI:3.372–21.248;P=0.007),ALT(OR=1.382,95%CI:1.131–1.690;P=0.002),and postprandial bile acid(PBA)(OR=3.392,95%CI:1.003–12.869;P=0.026)were correlated to ICP.The adverse neonatal outcome was related to increased glypican-3(OR=4.275,95%CI:2.726–5.635;P=0.039),and PBA(OR=3.026,95%CI:1.069–13.569;P=0.037).Increases of syndecan-1(OR=7.464,95%CI:2.130–26.153,P=0.017)and glypican-3(OR=6.194,95%CI:2.951–13.002;P=0.025)were the risk factors of decreased response to UDCA treatment.Conclusion:Syndecan-1 and glypican-3 might be powerful determinants in predicting adverse perinatal outcome in patients with ICP,and they can be used to predict the response to the UDCA treatment.
基金Project (No.FF-293-2008) supported by University Kebangsaan Malaysia
文摘Objective:To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.Methods:A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire.Results:Sixty-two respondents were included and most of them were working mothers (77.4%).The mean age of the respondents was (31.0±5.6) years and a majority of the subjects aged between 20-34 years (77.4%).According to the EPDS score,53.2% of the respondents had a psychosocial impact with a total score of >9,out of 30.There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019).However,there were no significant differences between psychosocial impact and history of previous perinatal loss,ethnicity,occupation,educational level,age or total income.Conclusion:Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed.Family and friends should continue to provide emotional support.People who have experienced similar problem before will be able to provide better support than those who have not.
