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
Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the cou...Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the country has a 6.5%prevalence of small-for-gestational-age(SGA),ranking fifth globally in total SGA birth numbers^([1,2]).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
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
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
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
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
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
BACKGROUND Perinatal depression affects 10%-20%of pregnant women and subsequently influences maternal health and fetal development.Concerns over the safety of antidepressants during pregnancy have prompted the explora...BACKGROUND Perinatal depression affects 10%-20%of pregnant women and subsequently influences maternal health and fetal development.Concerns over the safety of antidepressants during pregnancy have prompted the exploration of nutritional interventions as adjunct therapies.This study evaluated the impact of combining preconception and prenatal supplementation with myo-inositol,probiotics,and trace elements on mood,quality of life,and fetal development in depressed mothers.This retrospective cohort study included 314 pregnant women who were diag-nosed with mild to moderate depression,as determined by a Zung self-rating depression scale score of less than 69.The participants were divided into an intervention group(n=161)receiving myo-inositol,probiotics,and trace elements and a control group(n=153)without supplementation.Supplementation comm-enced 3 months before conception and continued through pregnancy.Psychiatric symptoms and quality of life were evaluated using the positive and negative affect schedule-now,state-trait anxiety inventory,Patient Health Ques-tionnaire-8,and World Health Organization Quality of life Assessment:Brief Version scales preconception and postpartum.Fetal development metrics were assessed via ultrasound,and neonatal outcomes were recorded.RESULTS The intervention group presented significant reductions in gestational diabetes mellitus(13.04%vs 23.53%,P=0.016)and gestational hypertension(3.73%vs 9.15%,P=0.049).Higher levels of inositol,iron,zinc,and probiotics were observed near term in the intervention group.Postpartum mood assessments indicated lower anxiety and depression scores for the intervention group,with significant improvements in the positive and negative affect schedule-now(P=0.002),trait anxiety(P=0.002),and Patient Health Questionnaire-8(P=0.018)scores.The World Health Organization Quality of life Assessment:Brief Version scores improved in the psychological(P=0.041)and environmental(P=0.009)domains postpartum.Fetal biparietal diameter and femoral length were greater in the intervention group alongside better neonatal body length and reduced neonatal unit admissions(2.48%vs 7.84%,P=0.031).CONCLUSION Combined supplementation with myo-inositol,probiotics,and trace elements from preconception through pregnancy may reduce pregnancy-related complications,enhance mood and quality of life,and improve fetal growth metrics.展开更多
Background Relative energy deficiency in sport(REDs)results from exposure to problematic low energy availability.It is a serious condition affecting the health and athletic performance of up to 80%of elite female athl...Background Relative energy deficiency in sport(REDs)results from exposure to problematic low energy availability.It is a serious condition affecting the health and athletic performance of up to 80%of elite female athletes.REDs is established to have negative short-term effects on reproductive function,but the long-term impact of this condition is unknown.Therefore,we examined the impact of secondary amenorrhea with or without a concurrent diagnosis of REDs on perinatal health outcomes.Methods Postpartum individuals(≥18 years of age)completed an online questionnaire that covered demographics,reproductive history(including a diagnosis of REDs or secondary amenorrhea),and maternal/fetal health outcomes.Logistic regression was used to determine the relationship between previously diagnosed REDs or secondary amenorrhea with perinatal health outcomes.Results A total of 1025 previously pregnant participants completed the survey(33.1±3.4 years,mean±SD).Prior to pregnancy,6.1%had been previously diagnosed with REDs and 20.5%had a history with secondary amenorrhea.Individuals diagnosed with REDs had 3.5-times higher odds of having premature labor(odds ratio,(OR)=3.52,95%confidence interval(95%CI):1.26–9.81)and 2.6-times higher odds of preterm delivery(OR=2.62,95%CI:1.05–6.58)compared to those who had not experienced REDs or secondary amenorrhea.However,in individuals who did not have a history of REDs,secondary amenorrhea did not increase the odds of adverse pregnancy or delivery outcomes.Conclusion A history of REDs,but not secondary amenorrhea,may increase the odds of premature labor and preterm delivery.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
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
AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to Sep...AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.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
In the epidemiologic context of maternal obesity and type 2 diabetes(T2D),the incidence of gestational diabetes has significantly increased in the last decades.Infants of diabetic mothers are prone to various neonatal...In the epidemiologic context of maternal obesity and type 2 diabetes(T2D),the incidence of gestational diabetes has significantly increased in the last decades.Infants of diabetic mothers are prone to various neonatal adverse outcomes,including metabolic and hematologic disorders,respiratory distress,cardiac disorders and neurologic impairment due to perinatal asphyxia and birth traumas,among others.Macrosomia is the most constant consequence of diabetes and its severity is mainly influenced by maternal blood glucose level.Neonatal hypoglycemia is the main metabolic disorder that should be prevented as soon as possible after birth.The severity of macrosomia and the maternal health condition have a strong impact on the frequency and the severity of adverse neonatal outcomes.Pregestational T2 D and maternal obesity significantly increase the risk of perinatal death and birth defects.The high incidence of maternal hyperglycemia in developing countries,associated with the scarcity of maternal and neonatal care,seriously increase the burden of neonatal complications in these countries.展开更多
Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Orga...Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Organization estimates that approximately 3% of the world population have been infected with HCVand the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children.Following the introduction of blood product screening,vertical transmission becomes the leading cause of childhood HCV infection.The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world.All children born to women with antiHCV antibodies should be checked for HCV infection.Though universal screening is controversial,selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably.Multiple risk factors were shown to increase the possibility of HCV vertical transmission,including coinfections with human immunodeficiency virus,intravenous drug use and elevated maternal HCV viral load,while breastfeeding and HCV genotypes have been studied to have little impact.At present,no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk.Cesarean section should not be recommended as a procedure to prevent vertical transmission,however,breastfeeding is generally not forbidden.The high prevalence of global HCV infection necessitates renewed efforts in primary prevention,including vaccine development,as well as new approaches to reduce the burden of chronic liver disease.Future researches should focus on the interruption of vertical transmission,developments of HCV vaccine and directacting antivirals in infancy and early childhood.展开更多
Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous ca...Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.展开更多
AIM To systematically review the literature on women with both diabetes in pregnancy(DIP)and depression during or after pregnancy.METHODS In this systematic literature review,PubM ed/MEDLINE and EMBASE were searched(1...AIM To systematically review the literature on women with both diabetes in pregnancy(DIP)and depression during or after pregnancy.METHODS In this systematic literature review,PubM ed/MEDLINE and EMBASE were searched(13 November 2015)using terms for diabetes(type 1,type 2,or gestational),depression,and pregnancy(no language or date restrictions).Publications that reported on women who had both DIP(any type)and depression or depressive symptoms before,during,or within one year after pregnancy were considered for inclusion.All study types were eligible for inclusion;conference abstracts,narrative reviews,nonclinical letters,editorials,and commentaries were excluded,unless they provided treatment guidance.RESULTS Of 1189 articles identified,48 articles describing women with both DIP and depression were included(sample sizes 36 to>32 million).Overall study quality was poor;most studies were observational,and only 12 studies(mostly retrospective database studies)required clinical depression diagnosis.The prevalence of concurrent DIP(any type)and depression in general populations of pregnant women ranged from 0%to 1.6%(median 0.61%;12 studies).The prevalence of depression among women with gestational diabetes ranged from 4.1%to 80%(median 14.7%;16 studies).Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP.However,there was no clear consensus for either relationship.Importantly,we found limited guidance on the management of women with both DIP and depression.CONCLUSION Given the increasing prevalence of diabetes and depression,high-quality research and specific guidance for management of pregnant women with both conditions are warranted.展开更多
BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 ...BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.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funded by the Natural Science Foundation of Hunan Province(grant number 2024JJ5283 to XH)。
文摘Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the country has a 6.5%prevalence of small-for-gestational-age(SGA),ranking fifth globally in total SGA birth numbers^([1,2]).
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.
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.
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 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.
文摘BACKGROUND Perinatal depression affects 10%-20%of pregnant women and subsequently influences maternal health and fetal development.Concerns over the safety of antidepressants during pregnancy have prompted the exploration of nutritional interventions as adjunct therapies.This study evaluated the impact of combining preconception and prenatal supplementation with myo-inositol,probiotics,and trace elements on mood,quality of life,and fetal development in depressed mothers.This retrospective cohort study included 314 pregnant women who were diag-nosed with mild to moderate depression,as determined by a Zung self-rating depression scale score of less than 69.The participants were divided into an intervention group(n=161)receiving myo-inositol,probiotics,and trace elements and a control group(n=153)without supplementation.Supplementation comm-enced 3 months before conception and continued through pregnancy.Psychiatric symptoms and quality of life were evaluated using the positive and negative affect schedule-now,state-trait anxiety inventory,Patient Health Ques-tionnaire-8,and World Health Organization Quality of life Assessment:Brief Version scales preconception and postpartum.Fetal development metrics were assessed via ultrasound,and neonatal outcomes were recorded.RESULTS The intervention group presented significant reductions in gestational diabetes mellitus(13.04%vs 23.53%,P=0.016)and gestational hypertension(3.73%vs 9.15%,P=0.049).Higher levels of inositol,iron,zinc,and probiotics were observed near term in the intervention group.Postpartum mood assessments indicated lower anxiety and depression scores for the intervention group,with significant improvements in the positive and negative affect schedule-now(P=0.002),trait anxiety(P=0.002),and Patient Health Questionnaire-8(P=0.018)scores.The World Health Organization Quality of life Assessment:Brief Version scores improved in the psychological(P=0.041)and environmental(P=0.009)domains postpartum.Fetal biparietal diameter and femoral length were greater in the intervention group alongside better neonatal body length and reduced neonatal unit admissions(2.48%vs 7.84%,P=0.031).CONCLUSION Combined supplementation with myo-inositol,probiotics,and trace elements from preconception through pregnancy may reduce pregnancy-related complications,enhance mood and quality of life,and improve fetal growth metrics.
基金funded by a Christenson Professorship in Active Healthy Livingfunded by the Health Sciences TD Bank Undergraduate Research Awardsupport from the FIFA Female Athlete Project
文摘Background Relative energy deficiency in sport(REDs)results from exposure to problematic low energy availability.It is a serious condition affecting the health and athletic performance of up to 80%of elite female athletes.REDs is established to have negative short-term effects on reproductive function,but the long-term impact of this condition is unknown.Therefore,we examined the impact of secondary amenorrhea with or without a concurrent diagnosis of REDs on perinatal health outcomes.Methods Postpartum individuals(≥18 years of age)completed an online questionnaire that covered demographics,reproductive history(including a diagnosis of REDs or secondary amenorrhea),and maternal/fetal health outcomes.Logistic regression was used to determine the relationship between previously diagnosed REDs or secondary amenorrhea with perinatal health outcomes.Results A total of 1025 previously pregnant participants completed the survey(33.1±3.4 years,mean±SD).Prior to pregnancy,6.1%had been previously diagnosed with REDs and 20.5%had a history with secondary amenorrhea.Individuals diagnosed with REDs had 3.5-times higher odds of having premature labor(odds ratio,(OR)=3.52,95%confidence interval(95%CI):1.26–9.81)and 2.6-times higher odds of preterm delivery(OR=2.62,95%CI:1.05–6.58)compared to those who had not experienced REDs or secondary amenorrhea.However,in individuals who did not have a history of REDs,secondary amenorrhea did not increase the odds of adverse pregnancy or delivery outcomes.Conclusion A history of REDs,but not secondary amenorrhea,may increase the odds of premature labor and preterm delivery.
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.
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 Hunan Ministry of Science and Technology,No.06FJ3177,China
文摘AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.
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.
文摘In the epidemiologic context of maternal obesity and type 2 diabetes(T2D),the incidence of gestational diabetes has significantly increased in the last decades.Infants of diabetic mothers are prone to various neonatal adverse outcomes,including metabolic and hematologic disorders,respiratory distress,cardiac disorders and neurologic impairment due to perinatal asphyxia and birth traumas,among others.Macrosomia is the most constant consequence of diabetes and its severity is mainly influenced by maternal blood glucose level.Neonatal hypoglycemia is the main metabolic disorder that should be prevented as soon as possible after birth.The severity of macrosomia and the maternal health condition have a strong impact on the frequency and the severity of adverse neonatal outcomes.Pregestational T2 D and maternal obesity significantly increase the risk of perinatal death and birth defects.The high incidence of maternal hyperglycemia in developing countries,associated with the scarcity of maternal and neonatal care,seriously increase the burden of neonatal complications in these countries.
文摘Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Organization estimates that approximately 3% of the world population have been infected with HCVand the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children.Following the introduction of blood product screening,vertical transmission becomes the leading cause of childhood HCV infection.The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world.All children born to women with antiHCV antibodies should be checked for HCV infection.Though universal screening is controversial,selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably.Multiple risk factors were shown to increase the possibility of HCV vertical transmission,including coinfections with human immunodeficiency virus,intravenous drug use and elevated maternal HCV viral load,while breastfeeding and HCV genotypes have been studied to have little impact.At present,no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk.Cesarean section should not be recommended as a procedure to prevent vertical transmission,however,breastfeeding is generally not forbidden.The high prevalence of global HCV infection necessitates renewed efforts in primary prevention,including vaccine development,as well as new approaches to reduce the burden of chronic liver disease.Future researches should focus on the interruption of vertical transmission,developments of HCV vaccine and directacting antivirals in infancy and early childhood.
基金Supported by Beijing Clinical Study(Z111107058811025)Beijing Government Excellent Person Sponsor Program
文摘Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.
文摘AIM To systematically review the literature on women with both diabetes in pregnancy(DIP)and depression during or after pregnancy.METHODS In this systematic literature review,PubM ed/MEDLINE and EMBASE were searched(13 November 2015)using terms for diabetes(type 1,type 2,or gestational),depression,and pregnancy(no language or date restrictions).Publications that reported on women who had both DIP(any type)and depression or depressive symptoms before,during,or within one year after pregnancy were considered for inclusion.All study types were eligible for inclusion;conference abstracts,narrative reviews,nonclinical letters,editorials,and commentaries were excluded,unless they provided treatment guidance.RESULTS Of 1189 articles identified,48 articles describing women with both DIP and depression were included(sample sizes 36 to>32 million).Overall study quality was poor;most studies were observational,and only 12 studies(mostly retrospective database studies)required clinical depression diagnosis.The prevalence of concurrent DIP(any type)and depression in general populations of pregnant women ranged from 0%to 1.6%(median 0.61%;12 studies).The prevalence of depression among women with gestational diabetes ranged from 4.1%to 80%(median 14.7%;16 studies).Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP.However,there was no clear consensus for either relationship.Importantly,we found limited guidance on the management of women with both DIP and depression.CONCLUSION Given the increasing prevalence of diabetes and depression,high-quality research and specific guidance for management of pregnant women with both conditions are warranted.
文摘BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.
