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Frontiers in Endocrinology 2021To evaluate the small intestinal bacterial overgrowth (SIBO) of subclinical hypothyroidism of pregnant women, and explore their possible relevance.
OBJECTIVE
To evaluate the small intestinal bacterial overgrowth (SIBO) of subclinical hypothyroidism of pregnant women, and explore their possible relevance.
METHODS
In total, 224 pregnant women with subclinical hypothyroidism during pregnancy (study group) and 196 pregnant women whose thyroid function was normal (control group) were enrolled in this study. Lactulose-based hydrogen and methane breath test was performed to evaluate the growth of intestinal bacteria. The serum-free thyroid hormone (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), body mass index (BMI) and gastrointestinal symptoms were detected and recorded.
RESULTS
The positive rates of SIBO were 56.7% and 31.6% in study group and control group, respectively. The levels of C response protein (CRP), abdominal distension and constipation in study group were higher than those in the control group. The risk of abdominal distension and constipation in SIBO-positive pregnant women were higher than that in SIBO-negative pregnant women, and the BMI of SIBO-positive patients in the two groups was lower than that of SIBO-negative patients in each group. In addition, the TPOAb-positive rate and TSH levels were higher but the FT4 level was lower in SIBO-positive patients compared to SIBO-negative patients in study group.
CONCLUSION
The occurrence of subclinical hypothyroidism is related to SIBO, and the excessive growth of small intestinal bacteria may affect gastrointestinal symptoms.
CLINICAL TRIAL
http://www.chictr.org.cn/index.aspx, identifier ChiCTR1900026326.
Topics: Abdominal Pain; Adult; Asymptomatic Diseases; Breath Tests; Case-Control Studies; China; Dysbiosis; Female; Humans; Hypothyroidism; Incidence; Intestine, Small; Pregnancy; Pregnancy Complications
PubMed: 34108932
DOI: 10.3389/fendo.2021.604070 -
Malaria Journal Feb 2023Rapid diagnostic tests (RDTs) are effective tools to diagnose and inform the treatment of malaria in adults and children. The recent development of a highly sensitive... (Review)
Review
BACKGROUND
Rapid diagnostic tests (RDTs) are effective tools to diagnose and inform the treatment of malaria in adults and children. The recent development of a highly sensitive rapid diagnostic test (HS-RDT) for Plasmodium falciparum has prompted questions over whether it could improve the diagnosis of malaria in pregnancy and pregnancy outcomes in malaria endemic areas.
METHODS
This landscape review collates studies addressing the clinical performance of the HS-RDT. Thirteen studies were identified comparing the HS-RDT and conventional RDT (co-RDT) to molecular methods to detect malaria in pregnancy. Using data from five completed studies, the association of epidemiological and pregnancy-related factors on the sensitivity of HS-RDT, and comparisons with co-RDT were investigated. The studies were conducted in 4 countries over a range of transmission intensities in largely asymptomatic women.
RESULTS
Sensitivity of both RDTs varied widely (HS-RDT range 19.6 to 85.7%, co-RDT range 22.8 to 82.8% compared to molecular testing) yet HS-RDT detected individuals with similar parasite densities across all the studies including different geographies and transmission areas [geometric mean parasitaemia around 100 parasites per µL (p/µL)]. HS-RDTs were capable of detecting low-density parasitaemias and in one study detected around 30% of infections with parasite densities of 0-2 p/µL compared to the co-RDT in the same study which detected around 15%.
CONCLUSION
The HS-RDT has a slightly higher analytical sensitivity to detect malaria infections in pregnancy than co-RDT but this mostly translates to only fractional and not statistically significant improvement in clinical performance by gravidity, trimester, geography or transmission intensity. The analysis presented here highlights the need for larger and more studies to evaluate incremental improvements in RDTs. The HS-RDT could be used in any situation where co-RDT are currently used for P. falciparum diagnosis, if storage conditions can be adhered to.
Topics: Adult; Pregnancy; Child; Humans; Female; Plasmodium falciparum; Rapid Diagnostic Tests; Sensitivity and Specificity; Malaria; Malaria, Falciparum; Diagnostic Tests, Routine; Antigens, Protozoan
PubMed: 36803858
DOI: 10.1186/s12936-023-04445-1 -
Frontiers in Endocrinology 2021Maternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb)...
BACKGROUND
Maternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.
OBJECTIVE
To identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.
METHODS
This study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden's index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.
RESULTS
45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 ( = 0.955 > 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.
CONCLUSIONS
We identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.
Topics: Adolescent; Adult; Autoantibodies; China; Clinical Decision Rules; Diabetes, Gestational; Female; Humans; Iodide Peroxidase; Logistic Models; Middle Aged; Multivariate Analysis; Nomograms; Pre-Eclampsia; Pregnancy; Premature Birth; Reference Values; Retrospective Studies; Risk Factors; Thyroid Function Tests; Thyrotropin; Thyroxine; Young Adult
PubMed: 35082756
DOI: 10.3389/fendo.2021.793650 -
Analytical Sciences : the International... Aug 2019This review summarizes the development of whole-cell biosensors with a special focus on device development and cell immobilization. Integration of biosensor functions in... (Review)
Review
This review summarizes the development of whole-cell biosensors with a special focus on device development and cell immobilization. Integration of biosensor functions in a device will pave the way for field applications in remote areas and resource-limited settings. Firstly, an introduction to the field of whole-cell biosensors is provided, followed by examples of genetic engineering of cells in order to fulfill sensor functions. A framework of requirements to enable future field applications of biosensors is elaborated. A special focus is on different cell immobilization techniques ranging from polymers, to microfluidic devices, immobilization on paper and combinations of these methods. Looking at globally successfully implemented point of care devices such as a home pregnancy test or a blood glucose meter, we conclude the review with thoughts on long-term stability, portability, ease of use and user safety design guidelines for whole-cell biosensor devices.
Topics: Bacteria; Biosensing Techniques; Cells, Immobilized; Chemistry Techniques, Analytical; Genetic Engineering
PubMed: 31204371
DOI: 10.2116/analsci.19R004 -
The Lancet. Digital Health Feb 2022The impact of maternal SARS-CoV-2 infection remains unclear. In this study, we evaluated the risk of maternal SARS-CoV-2 infection on birth outcomes and how this is...
BACKGROUND
The impact of maternal SARS-CoV-2 infection remains unclear. In this study, we evaluated the risk of maternal SARS-CoV-2 infection on birth outcomes and how this is modulated by the pregnancy trimester in which the infection occurs. We also developed models to predict gestational age at delivery for people following a SARS-CoV-2 infection during pregnancy.
METHODS
We did a retrospective cohort study of the impact of maternal SARS-CoV-2 infection on birth outcomes. We used clinical data from Providence St Joseph Health electronic health records for pregnant people who delivered in the USA at the Providence, Swedish, or Kadlec sites in Alaska, California, Montana, Oregon, or Washington. The SARS-CoV-2 positive cohort included people who had a positive SARS-CoV-2 PCR-based test during pregnancy, subdivided by trimester of infection. No one in this cohort had been vaccinated for COVID-19 at time of infection. The SARS-CoV-2 negative cohort were people with at least one negative SARS-CoV-2 PCR-based test and no positive tests during pregnancy. Cohorts were matched on common covariates impacting birth outcomes, and univariate and multivariate analysis were done to investigate risk factors and predict outcomes. The primary outcome was gestational age at delivery with annotation of preterm birth classification. We trained multiple supervised learning models on 24 features of the SARS-CoV-2 positive cohort to evaluate performance and feature importance for each model and discuss the impact of SARS-CoV-2 infection on gestational age at delivery.
FINDINGS
Between March 5, 2020, and July 4, 2021, 73 666 pregnant people delivered, 18 335 of whom had at least one SARS-CoV-2 test during pregnancy before Feb 14, 2021. We observed 882 people infected with SARS-CoV-2 during their pregnancy (first trimester n=85; second trimester n=226; and third trimester n=571) and 19 769 people who have never tested positive for SARS-CoV-2 and received at least one negative SARS-CoV-2 test during their pregnancy. SARS-CoV-2 infection indicated an increased risk of preterm delivery (p<0·05) and stillbirth (p<0·05), accounted for primarily by first and second trimester SARS-CoV-2 infections. Gestational age at SARS-CoV-2 infection was correlated with gestational age at delivery (p<0·01) and had the greatest impact on predicting gestational age at delivery. The people in this study had mild or moderate SARS-CoV-2 infections and acute COVID-19 severity was not correlated with gestational age at delivery (p=0·31).
INTERPRETATION
These results suggest that pregnant people would benefit from increased monitoring and enhanced prenatal care after first or second trimester SARS-CoV-2 infection, regardless of acute COVID-19 severity.
FUNDING
US National Institutes of Health.
Topics: Adult; COVID-19; Cohort Studies; Female; Gestational Age; Humans; Models, Statistical; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Pregnancy Trimesters; Premature Birth; Retrospective Studies; Risk Factors; SARS-CoV-2; United States
PubMed: 35034863
DOI: 10.1016/S2589-7500(21)00250-8 -
Reproductive Biomedicine Online Feb 2022Is measurement of hyperglycosylated HCG (hHCG) superior to beta-HCG (HCG+β) for early pregnancy detection after IVF and embryo transfer?
RESEARCH QUESTION
Is measurement of hyperglycosylated HCG (hHCG) superior to beta-HCG (HCG+β) for early pregnancy detection after IVF and embryo transfer?
DESIGN
Blood samples were collected on day 4 (+1), 7 (+1) and 11 (+2) after embryo transfer from women aged 18-45 years undergoing first or second fresh or frozen IVF embryo transfer cycles. Biochemical pregnancy was assessed on-site by HCG determination on day 11; clinical pregnancy was assessed by ultrasound on day 21 (+4/-3). Serum hHCG (immunochemiluminometric assay) and HCG+β (Elecsys® HCG+β assay) concentrations were measured. Performance of hHCG and HCG+β for predicting pregnancy was evaluated and cut-offs selected.
RESULTS
In total, 155 women were enrolled and underwent IVF and embryo transfer. Area under the curve (AUC) (95% CI) on day 4 was not significantly different for hHCG (AUC 0.88; 95% CI 0.83 to 0.94) and HCG+β (AUC 0.90; 95% CI 0.84 to 0.95), as was predictive performance on day 7 and 11, with higher AUC estimates compared with day 4. Applying cut-offs derived according to Youden's index on day 4 (hHCG, 100 pg/ml; HCG+β, 1.30 mIU/ml), both biomarkers demonstrated high negative predictive values for ruling out pregnancy (hHCG, 83.8%; HCG+β, 82.8%) and high positive predictive values for ruling in pregnancy (hHCG, 89.0%; HCG+β, 84.9%) on day 21. Diagnostic performance improved from day 4 to day 11.
CONCLUSIONS
Predictive performance for early pregnancy post-IVF embryo transfer of day-5 blastocysts was not significantly different for hHCG and HCG+β; hHCG superiority over HCG+β was not shown.
Topics: Area Under Curve; Blastocyst; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Embryo Transfer; Female; Fertilization in Vitro; Humans; Male; Pregnancy; Pregnancy Outcome; Retrospective Studies
PubMed: 34924288
DOI: 10.1016/j.rbmo.2021.10.007 -
Journal of Clinical Microbiology Dec 2022Early-onset neonatal sepsis due to Streptococcus agalactiae (group B Streptococcus [GBS]) infection is one of the leading causes of newborn mortality and morbidity. The...
Early-onset neonatal sepsis due to Streptococcus agalactiae (group B Streptococcus [GBS]) infection is one of the leading causes of newborn mortality and morbidity. The latest guidelines published in 2019 recommended universal screening of GBS colonization among all pregnant women and intrapartum antibiotic prophylaxis for positive GBS. The updated procedures allow rapid molecular-based GBS screening using nutrient broth-enriched rectovaginal samples. Commercially available molecular assays for GBS diagnosis target mainly the gene, which encodes a hemolysin protein responsible for producing the Christie-Atkins-Munch-Petersen (CAMP) factor. is considered a conserved gene in essentially all GBS isolates. However, false-negative GBS results on Cepheid Xpert GBS and GBS LB tests due to deletions in or near the region that encodes were reported recently. Therefore, the new Xpert GBS LB XC test was developed. This study is a multicenter evaluation of the new test for GBS identification from nutrient broth-enriched rectal/vaginal samples from antepartum women. A total of 621 samples were prospectively enrolled. The samples were tested with the Xpert GBS LB XC test, the composite comparator method, which included the Hologic Panther Fusion GBS test combined with bacterial culture, followed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) identification, and bacterial culture alone, followed by MALDI-TOF MS identification. The respective sensitivity and specificity of the Xpert GBS LB XC test were 99.3% and 98.7% compared to the composite comparator method and 99.1% and 91.8% compared to bacterial culture alone with MALDI-TOF MS identification. Overall, the Xpert GBS LB XC test performed comparatively to the composite comparator method and is equivalent to traditional bacterial culture followed by MALDI-TOF MS.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Pregnancy Complications, Infectious; Vagina; Streptococcus agalactiae; Streptococcal Infections; Sensitivity and Specificity
PubMed: 36472424
DOI: 10.1128/jcm.01356-22 -
Journal of Health Monitoring Jun 2021Gestational diabetes mellitus (GDM) is an important risk factor for pregnancy complications. Since 2012, the Federal Joint Committee's maternity directive recommends a...
Gestational diabetes mellitus (GDM) is an important risk factor for pregnancy complications. Since 2012, the Federal Joint Committee's maternity directive recommends a two-step screening for GDM with a pre-test and subsequent diagnostic test if the pre-test is positive. This study analyses the implementation and development over time of GDM screening participation and prevalence in Germany. The data basis is the external inpatient obstetrics quality assurance documentation, which covers all births in hospital. Women with diabetes before pregnancy were excluded. The study defined women as GDM cases if the condition was documented in maternity records or if the ICD-10 diagnosis O24.4 was coded for inpatients at discharge and figures were determined for the years 2013 to 2018. As the documentation of screening tests has only been included in the data set since 2016, screening participation for the years 2016 to 2018 were estimated and evaluated based on the pre-test and/or diagnostic tests documented in maternity records. In 2018, the majority of all women who gave birth in hospitals had had a pre-test conducted (65.0%) or a pre-test and diagnostic test (18.2%) in line with the two-step procedure. A further 6.7% received a diagnostic test alone. GDM screening participation increased over time from 83.4% in 2016 to 89.9% in 2018. The prevalence of a documented GDM increased from 4.6% to 6.8% between 2013 and 2018. In 2018, this equates to 51,318 women with GDM. Reliably assessing the extent and causes of this development will require continuous analyses of screening implementation, documentation and changes in maternal risk factors.
PubMed: 35146306
DOI: 10.25646/8325 -
Animals : An Open Access Journal From... Jun 2021One of the most recent techniques for the on-farm diagnosis of early pregnancy (EP) in cattle is B-mode ultrasonography. Under field conditions, acceptable results may... (Review)
Review
One of the most recent techniques for the on-farm diagnosis of early pregnancy (EP) in cattle is B-mode ultrasonography. Under field conditions, acceptable results may be achieved with ultrasonography from Days 25 to 30 post-AI. The reliability of the test greatly depends on the frequency of the transducer used, the skill of the examiner, the criterion used for a positive pregnancy diagnosis (PD), and the position of the uterus in the pelvic inlet. Non-pregnant animals can be selected accurately by evaluating blood flow in the corpus luteum around Day 20 after AI, meaning we can substantially improve the reproductive efficiency of our herd. Pregnancy protein assays (PSPB, PAG-1, and PSP60 RIA, commercial ELISA or rapid visual ELISA tests) may provide an alternative method to ultrasonography for determining early pregnancy or late embryonic/early fetal mortality (LEM/EFM) in dairy cows. Although the early pregnancy factor is the earliest specific indicator of fertilization, at present, its detection is entirely dependent on the use of the rosette inhibition test; therefore, its use in the field needs further developments. Recently found biomarkers like interferon-tau stimulated genes or microRNAs may help us diagnose early pregnancy in dairy cows; however, these tests need further developments before their general use in the farms becomes possible.
PubMed: 34204926
DOI: 10.3390/ani11061666 -
International Journal of Pediatric... Jul 2021The current study aimed to investigate possible association of maternal SARS-CoV-2 with newborn hearing loss. We compared hearing screening outcomes in neonates born to...
OBJECTIVE
The current study aimed to investigate possible association of maternal SARS-CoV-2 with newborn hearing loss. We compared hearing screening outcomes in neonates born to women with positive SARS-CoV-2 PCR test results during pregnancy with healthy controls.
METHODS
Neonates born between April and December 2020 in our hospital to mothers with positive SARS-CoV-2 PCR test results during pregnancy were included in this study. Neonates with risk factors for universal newborn hearing screening (NHS) were excluded. Neonates born to mothers with positive SARS-CoV-2 PCR test results during pregnancy were compared with healthy controls in terms of newborn hearing screening results and independent variables.
RESULTS
Neonates in the COVID-19 group were more likely to have a "refer" result in auditory brainstem responses (ABR) compared with the control group (53/118 and 28/118, respectively; p = 0.001). The second ABR test results did not differ significantly between the groups (p = 0.618). Logistic regression revealed that birth week and type of birth were not associated with the "refer" result. PCR positivity in the second trimester was more likely to produce the "refer" result in the first ABR test (p = 0.014).
CONCLUSION
SARS-CoV-2 PCR positivity in pregnancy is significantly associated with an increased risk of abnormal NHS results. Also, the timing of PCR positivity in pregnancy (trimester) may be related to abnormal NHS results.
Topics: COVID-19; Evoked Potentials, Auditory, Brain Stem; Female; Hearing Disorders; Hearing Tests; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Neonatal Screening; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Pregnant Women; SARS-CoV-2
PubMed: 33964672
DOI: 10.1016/j.ijporl.2021.110754