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
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
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
BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model ...BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.展开更多
Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of se...Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.展开更多
Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and ...Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and perinatal prognosis. Patients and Method: Preliminary longitudinal and analytical survey at the Owendo University Hospital (OHU) over 6 months. It focused on prenatal surveillance. The study population consisted of parturients who gave birth within 24 hours and we studied sociodemographic characteristics, variables related to antenatal contact, those of delivery as well as maternal and newborn outcomes. Results: 2485 deliveries were recorded and 1300 patients were retained according to the inclusion criteria. No prenatal contact (ANC0) was performed in 93 (7.15%), insufficient (ANCI) in 943 patients (72.5%), and sufficient (ANCS) in 264 patients (20.30%). Patients with low school level were significantly found when the NPC was not performed or insufficient and the same was true for the group of patients who were not employed and those who were single (p < 0.005). The caesarean section rate and perinatal mortality are high in this case. Conclusion: The quality of prenatal contact is insufficient in our context. The absence or inadequacy of the latter has a strong negative impact on maternal and perinatal morbidity and mortality.展开更多
Introduction: The association of diabetes and pregnancy is associated with a significantly higher risk of perinatal morbidity and mortality. The aim of this study was to investigate the perinatal morbidity and mortali...Introduction: The association of diabetes and pregnancy is associated with a significantly higher risk of perinatal morbidity and mortality. The aim of this study was to investigate the perinatal morbidity and mortality associated with maternal diabetes at the Issaka Gazoby Maternity Hospital in Niamey. Methodology: This was a prospective case-control study conducted from April to September 2021 at the Issaka Gazoby Maternity Hospital in Niamey. “Cases” were neonates born to diabetic mothers, and “controls” were neonates born to non-diabetic mothers. The main dependent variable was the occurrence of perinatal complications. Analysis was performed using Epi info software 7.2.1. Pearson’s Chi2 test or Fisher’s exact test were used (p Results: Of the 2,225 admissions during the study period, 31 newborns were born to diabetic mothers (1.4%). Diabetic mothers were 2.8 times more likely to have a history of abortion (67.7% vs. 28.6%;OR = 2.82;p = 0.001). Similarly, a history of macrosomia was found in 29.0% of diabetic mothers versus 9.5% of controls (OR = 2.15;p = 0.01). Macrosomia was also more common in newborns of diabetic mothers (38.7% vs. 9.5%;OR = 2.63;p Conclusion: The risks of ante- and perinatal complications such as abortion, fetal macrosomia and stillbirth, as well as neonatal pathological events (macrosomia and malformations) were greater in newborns of diabetic mothers.展开更多
Objective: This study aimed to assess perinatal morbidity, mortality rates, and neurodevelopmental outcomes in the management of fetal growth restriction (FGR) at a single tertiary institute. Methods: Among 2465 deliv...Objective: This study aimed to assess perinatal morbidity, mortality rates, and neurodevelopmental outcomes in the management of fetal growth restriction (FGR) at a single tertiary institute. Methods: Among 2465 deliveries between 2013 and 2019, 109 cases of FGR were reviewed retrospectively for causes, indications for pregnancy termination, perinatal death, overall neonatal outcomes, and long-term prognosis. Results: Excluding FGR due to congenital anomalies (n = 17), the mortality rate was 3.3% (3/92). One neonate delivered at 23 weeks developed cerebral palsy (1.1%). Retinopathy of prematurity occurred in four neonates (4.3%). Neurodevelopmental disorders were present in six neonates (6.5%), all of whom were delivered at 32 - 38 weeks. Significantly lower gestational age at delivery, lower birth weight, and higher umbilical artery resistance indices were observed in neonates with neurodevelopmental disorders. Conclusions: Intact survival before 27 weeks of gestation at delivery with FGR is uncommon. Neurodevelopmental disorders may still develop after delivery at 32 - 38 weeks;consideration should be given to the timing of delivery usingfetal ductus venosus Doppler waveforms measurements to reduce neurodevelopmental disorders.展开更多
The perinatal period,defined as 28 weeks of gestation to one week postpartum,is a time when women are particularly vulnerable to re-traumatization or the formation of new trauma,significantly impacting their health an...The perinatal period,defined as 28 weeks of gestation to one week postpartum,is a time when women are particularly vulnerable to re-traumatization or the formation of new trauma,significantly impacting their health and well-being as well as that of their families.This article outlines the forms and risk factors associated with trauma,examines the connection between trauma-informed care(TIC)principles and trauma,and reviews the implementation methods and application outcomes of TIC in perinatal care.The aim is to provide a reference for healthcare professionals to advance research related to TIC in perinatal women.展开更多
Objective:To involve stakeholders in Jiangsu Province,China,to identify barriers for nonspecialist-delivered perinatal depression(PND)management to guide management in maternity and child health care institutions.Meth...Objective:To involve stakeholders in Jiangsu Province,China,to identify barriers for nonspecialist-delivered perinatal depression(PND)management to guide management in maternity and child health care institutions.Methods:In this qualitative study,semi-structured face-to-face individual interviews were used,guided by the Consolidated Framework for Implementation Research(CFIR).Thematic analysis was done to categorize data using the CFIR framework's domains.Results:There were a total of 20 interviewees.Barriers coded under the CFIR framework included:needs and resources of those served by the organization,cosmopolitanism,available resources,structural characteristics,access to knowledge and information,and knowledge and beliefs.Conclusions:Implementing nonspecialist-delivered PND management poses varying obstacles in different situations.Overcoming these barriers can be accomplished by simplifying interventions based on local conditions,changing women's and families'attitudes and help-seeking behaviors toward PND,establishing linkages with psychiatry,strengthening policymakers'capacity and improving mental health care systems,developing detailed intervention manuals,enhancing clinicians'mental health literacy,and improving the operation of psychologically appropriate approaches to build self-efficacy.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
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
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.
文摘BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.
文摘Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.
文摘Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and perinatal prognosis. Patients and Method: Preliminary longitudinal and analytical survey at the Owendo University Hospital (OHU) over 6 months. It focused on prenatal surveillance. The study population consisted of parturients who gave birth within 24 hours and we studied sociodemographic characteristics, variables related to antenatal contact, those of delivery as well as maternal and newborn outcomes. Results: 2485 deliveries were recorded and 1300 patients were retained according to the inclusion criteria. No prenatal contact (ANC0) was performed in 93 (7.15%), insufficient (ANCI) in 943 patients (72.5%), and sufficient (ANCS) in 264 patients (20.30%). Patients with low school level were significantly found when the NPC was not performed or insufficient and the same was true for the group of patients who were not employed and those who were single (p < 0.005). The caesarean section rate and perinatal mortality are high in this case. Conclusion: The quality of prenatal contact is insufficient in our context. The absence or inadequacy of the latter has a strong negative impact on maternal and perinatal morbidity and mortality.
文摘Introduction: The association of diabetes and pregnancy is associated with a significantly higher risk of perinatal morbidity and mortality. The aim of this study was to investigate the perinatal morbidity and mortality associated with maternal diabetes at the Issaka Gazoby Maternity Hospital in Niamey. Methodology: This was a prospective case-control study conducted from April to September 2021 at the Issaka Gazoby Maternity Hospital in Niamey. “Cases” were neonates born to diabetic mothers, and “controls” were neonates born to non-diabetic mothers. The main dependent variable was the occurrence of perinatal complications. Analysis was performed using Epi info software 7.2.1. Pearson’s Chi2 test or Fisher’s exact test were used (p Results: Of the 2,225 admissions during the study period, 31 newborns were born to diabetic mothers (1.4%). Diabetic mothers were 2.8 times more likely to have a history of abortion (67.7% vs. 28.6%;OR = 2.82;p = 0.001). Similarly, a history of macrosomia was found in 29.0% of diabetic mothers versus 9.5% of controls (OR = 2.15;p = 0.01). Macrosomia was also more common in newborns of diabetic mothers (38.7% vs. 9.5%;OR = 2.63;p Conclusion: The risks of ante- and perinatal complications such as abortion, fetal macrosomia and stillbirth, as well as neonatal pathological events (macrosomia and malformations) were greater in newborns of diabetic mothers.
文摘Objective: This study aimed to assess perinatal morbidity, mortality rates, and neurodevelopmental outcomes in the management of fetal growth restriction (FGR) at a single tertiary institute. Methods: Among 2465 deliveries between 2013 and 2019, 109 cases of FGR were reviewed retrospectively for causes, indications for pregnancy termination, perinatal death, overall neonatal outcomes, and long-term prognosis. Results: Excluding FGR due to congenital anomalies (n = 17), the mortality rate was 3.3% (3/92). One neonate delivered at 23 weeks developed cerebral palsy (1.1%). Retinopathy of prematurity occurred in four neonates (4.3%). Neurodevelopmental disorders were present in six neonates (6.5%), all of whom were delivered at 32 - 38 weeks. Significantly lower gestational age at delivery, lower birth weight, and higher umbilical artery resistance indices were observed in neonates with neurodevelopmental disorders. Conclusions: Intact survival before 27 weeks of gestation at delivery with FGR is uncommon. Neurodevelopmental disorders may still develop after delivery at 32 - 38 weeks;consideration should be given to the timing of delivery usingfetal ductus venosus Doppler waveforms measurements to reduce neurodevelopmental disorders.
基金2024 Zhejiang Provincial Education Science Planning Project“A Study of the Mediating Effect of Spiritual Health on the Sense of Meaning in Life and Death Coping Skills Among Undergraduate Nursing Students”(Project No.2024SCG410)。
文摘The perinatal period,defined as 28 weeks of gestation to one week postpartum,is a time when women are particularly vulnerable to re-traumatization or the formation of new trauma,significantly impacting their health and well-being as well as that of their families.This article outlines the forms and risk factors associated with trauma,examines the connection between trauma-informed care(TIC)principles and trauma,and reviews the implementation methods and application outcomes of TIC in perinatal care.The aim is to provide a reference for healthcare professionals to advance research related to TIC in perinatal women.
基金supported by the Project of Philosophy and Social Science Research in Colleges and Universities of Jiangsu Province(No.22024SJYB0250)。
文摘Objective:To involve stakeholders in Jiangsu Province,China,to identify barriers for nonspecialist-delivered perinatal depression(PND)management to guide management in maternity and child health care institutions.Methods:In this qualitative study,semi-structured face-to-face individual interviews were used,guided by the Consolidated Framework for Implementation Research(CFIR).Thematic analysis was done to categorize data using the CFIR framework's domains.Results:There were a total of 20 interviewees.Barriers coded under the CFIR framework included:needs and resources of those served by the organization,cosmopolitanism,available resources,structural characteristics,access to knowledge and information,and knowledge and beliefs.Conclusions:Implementing nonspecialist-delivered PND management poses varying obstacles in different situations.Overcoming these barriers can be accomplished by simplifying interventions based on local conditions,changing women's and families'attitudes and help-seeking behaviors toward PND,establishing linkages with psychiatry,strengthening policymakers'capacity and improving mental health care systems,developing detailed intervention manuals,enhancing clinicians'mental health literacy,and improving the operation of psychologically appropriate approaches to build self-efficacy.
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.
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.
