-
Turkish Journal of Medical Sciences 2023To evaluate whether there is a relationship between serum myosin-binding protein C (MyBP-C) levels measured in the first trimester and the timing of delivery, and, if a...
BACKGROUND/AIM
To evaluate whether there is a relationship between serum myosin-binding protein C (MyBP-C) levels measured in the first trimester and the timing of delivery, and, if a relationship is detected, the potential of this relationship in distinguishing between preterm and term labor.
MATERIALS AND METHODS
This prospective case-control study was conducted with 701 pregnant women who applied to the Obstetrics Outpatient Clinic of Gaziosmanpaşa Training and Research Hospital in the first trimester, between 11 and 14 gestational weeks. MyBP-C serum samples from the first trimester were stored under appropriate conditions until the time of delivery. Of these pregnant women, 628 completed the study. According to the delivery time, the pregnant women were divided into two groups, as those who delivered prematurely before 37 weeks and those who gave birth at term. The case group comprised 45 women who gave birth prematurely, while 583 women gave birth at term. A control group was formed with 45 pregnant women of the same age, who were selected by randomization using a simple random sampling method from the 583 pregnant women. The MyBP-C levels were measured and compared from the first-trimester serum materials of both groups.
RESULTS
The MyBP-C levels of the preterm delivery group were significantly higher than those of the term delivery control group (4.51 ± 1.69 vs. 3.09 ± 1.44 pg/mL, respectively; p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the MyBP-C levels in the first trimester with a cut-off value of 4.76 ng/dL indicated women with preterm delivery with a sensitivity of 42.22% and specificity of 95.56% (AUC: 0.734, 95% CI: 0.630-0.822). The overall differential diagnosis performance of the MyBP-C level for preterm delivery was determined as 73.4% (p < 0.001). The MyBP-C levels were found to be significantly higher both in the early preterm group compared with the late preterm group (p < 0.001), and in those with premature rupture of membranes (PROM) compared with those without (p < 0.001).
CONCLUSION
The preterm delivery group exhibited high serum MyBP-C levels in the serum samples taken in the first trimester. First-trimester serum MyBP-C levels seem to be a simple and easy way to exclude preterm delivery risk in a significant manner. In addition, levels are significantly higher for early preterm compared with late preterm and early PROM compared with intact membranes.
Topics: Humans; Female; Pregnancy; Premature Birth; Prospective Studies; Biomarkers; Adult; Case-Control Studies; Carrier Proteins; Pregnancy Trimester, First; ROC Curve
PubMed: 38813022
DOI: 10.55730/1300-0144.5717 -
Medical Science Monitor : International... May 2024BACKGROUND Exposure to air pollution (AP) during pregnancy is associated with pre-labor rupture of membranes (PROM). However, there is limited research on this topic,...
BACKGROUND Exposure to air pollution (AP) during pregnancy is associated with pre-labor rupture of membranes (PROM). However, there is limited research on this topic, and the sensitive exposure windows remain unclear. The present study assessed the association between AP exposure and the risk of PROM, as well as seeking to identify the sensitive time windows. MATERIAL AND METHODS This retrospective study analyzed 4276 pregnant women's data from Tongling Maternal and Child Health Hospital from 2020 to 2022. We obtained air pollution data, including particulate matter (PM) with an aerodynamic diameter of ≤2.5 μm (PM₂․₅), particulate matter with an aerodynamic diameter of ≤10 μm (PM₁₀), nitrogen dioxide (NO₂), and ozone (O₃), from the Tongling Ecology and Environment Bureau. Demographic information was extracted from medical records. We employed a distributed lag model to identify the sensitive exposure windows of prenatal AP affecting the risk of PROM. We conducted a sensitivity analysis based on pre-pregnancy BMI. RESULTS We found a significant association between prenatal exposure to AP and increased PROM risk after adjusting for confounders, and the critical exposure windows of AP were the 6th to 7th months of pregnancy. In the underweight group, an increase of 10 µg/m³ in PM₂․₅ was associated with a risk of PROM, with an odds ratio (OR) of 1.48 (95% CI: 1.16, 1.89). Similarly, a 10 µg/m³ increase in PM₁₀ was associated with a risk of PROM, with an OR of 1.45 (95% CI: 1.05, 1.77). CONCLUSIONS Prenatal exposure to AP, particularly during months 6-7 of pregnancy, is associated with an increased risk of PROM. This study extends and strengthens the evidence on the association between prenatal exposure to AP and the risk of PROM, specifically identifying the critical exposure windows.
Topics: Humans; Female; Pregnancy; China; Fetal Membranes, Premature Rupture; Maternal Exposure; Air Pollution; Particulate Matter; Adult; Retrospective Studies; Air Pollutants; Risk Factors; Ozone; Nitrogen Dioxide
PubMed: 38812259
DOI: 10.12659/MSM.943601 -
Georgian Medical News Mar 2024Preterm birth (PTB) is defined as birth before 37 completed weeks of gestation. It is generally agreed, preterm delivery is the most important obstetrical complication... (Observational Study)
Observational Study
Preterm birth (PTB) is defined as birth before 37 completed weeks of gestation. It is generally agreed, preterm delivery is the most important obstetrical complication leading to perinatal morbidity and mortality. The aim of this study is to assess the prevalence of progesterone prescription, the route of administration, the prevalence of PTB, and the route of delivery as well as to look at the rates of PTB among those who received progesterone and those who did not. An observational cross-sectional study among postpartum women was done between April and September 2023. A convenience sample of 300 women were interviewed at maternity hospitals and primary health centers in Duhok. A survey of postpartum women up to 1 year postpartum was completed. Patients were questioned about basic pregnancy information, risk factors, and complications, as well as the use (if any) of progesterone. The preterm birth (<37 week) rate is 12%. From the 300 patients in the sample, 114 (38%) women had history of single or multiple progesterone therapies. The most common single route of progesterone therapy was the parenteral route (29.8%), but more patients received progesterone via multiple routes (32.4%). Pre-term birth was reported in 19 women who received progesterone treatment compared to 17 women among those who did not receive progesterone treatment. No statistically significant variations were found between the two groups (P=0.08). There were no statistically significant differences in prevalence of PTB or route of delivery between women who received progesterone supplementation and those who did not receive progesterone (P=0.08 and P= 0.14 respectively). Prior research has shown that the clearest evidence of benefit for progesterone in pregnancy is among those with short cervix. Perhaps the lack of significant difference found in this study was because of prescriptions outside of established indications. More randomized controlled trials are needed to assess the effects of progesterone supplementation during pregnancy.
Topics: Humans; Female; Pregnancy; Progesterone; Premature Birth; Cross-Sectional Studies; Adult; Prevalence; Young Adult; Progestins; Risk Factors
PubMed: 38807387
DOI: No ID Found -
Journal of Neuroinflammation May 2024Intrauterine inflammation is considered a major cause of brain injury in preterm infants, leading to long-term neurodevelopmental deficits. A potential contributor to...
BACKGROUND
Intrauterine inflammation is considered a major cause of brain injury in preterm infants, leading to long-term neurodevelopmental deficits. A potential contributor to this brain injury is dysregulation of neurovascular coupling. We have shown that intrauterine inflammation induced by intra-amniotic lipopolysaccharide (LPS) in preterm lambs, and postnatal dopamine administration, disrupts neurovascular coupling and the functional cerebral haemodynamic responses, potentially leading to impaired brain development. In this study, we aimed to characterise the structural changes of the neurovascular unit following intrauterine LPS exposure and postnatal dopamine administration in the brain of preterm lambs using cellular and molecular analyses.
METHODS
At 119-120 days of gestation (term = 147 days), LPS was administered into the amniotic sac in pregnant ewes. At 126-7 days of gestation, the LPS-exposed lambs were delivered, ventilated and given either a continuous intravenous infusion of dopamine at 10 µg/kg/min or isovolumetric vehicle solution for 90 min (LPS, n = 6; LPS, n = 6). Control preterm lambs not exposed to LPS were also administered vehicle or dopamine (CTL, n = 9; CTL, n = 7). Post-mortem brain tissue was collected 3-4 h after birth for immunohistochemistry and RT-qPCR analysis of components of the neurovascular unit.
RESULTS
LPS exposure increased vascular leakage in the presence of increased vascular density and remodelling with increased astrocyte "end feet" vessel coverage, together with downregulated mRNA levels of the tight junction proteins Claudin-1 and Occludin. Dopamine administration decreased vessel density and size, decreased endothelial glucose transporter, reduced neuronal dendritic coverage, increased cell proliferation within vessel walls, and increased pericyte vascular coverage particularly within the cortical and deep grey matter. Dopamine also downregulated VEGFA and Occludin tight junction mRNA, and upregulated dopamine receptor DRD1 and oxidative protein (NOX1, SOD3) mRNA levels. Dopamine administration following LPS exposure did not exacerbate any effects induced by LPS.
CONCLUSION
LPS exposure and dopamine administration independently alters the neurovascular unit in the preterm brain. Alterations to the neurovascular unit may predispose the developing brain to further injury.
Topics: Animals; Dopamine; Sheep; Female; Animals, Newborn; Lipopolysaccharides; Pregnancy; Brain; Inflammation; Blood-Brain Barrier; Premature Birth
PubMed: 38807204
DOI: 10.1186/s12974-024-03137-0 -
BMC Public Health May 2024Although the coronavirus disease 2019 (COVID-19) pandemic affected trends of multiple health outcomes in Japan, there is a paucity of studies investigating the effect of...
BACKGROUND
Although the coronavirus disease 2019 (COVID-19) pandemic affected trends of multiple health outcomes in Japan, there is a paucity of studies investigating the effect of the pandemic on adverse birth outcomes and fetal mortality. This study aimed to investigate the effect of the onset of the pandemic on the trends in adverse birth outcomes and fetal mortality using national data in Japan.
METHODS
We used the 2010-2022 birth and fetal mortality data from the Vital Statistics in Japan. We defined the starting time of the effect of the pandemic as April 2020, and the period from January 2010 to March 2020 and that from April 2020 to December 2022 were defined as the pre- and post- pandemic period, respectively. The rates of preterm birth, term low birth weight (TLBW), small-for-gestational-age (SGA), large-for-gestational-age (LGA), spontaneous fetal mortality, and artificial fetal mortality were used as outcomes. An interrupted time series analysis was conducted using monthly time series data of the outcomes to evaluate the effects of the pandemic. In addition, a modified Poisson regression model was used to evaluate the effects of the pandemic on these outcomes using individual-level data, and the adjusted risk ratio of the effect was calculated.
RESULTS
The adverse birth and fetal mortality outcomes showed a decreasing trend over the years, except for preterm birth and LGA birth rates, and SGA birth rates tended to reach their lowest values after the onset of the pandemic. The interrupted time series analysis revealed that the pandemic decreased preterm birth, TLBW, and SGA birth rates. In addition, the regression analysis revealed that the pandemic decreased the TLBW, SGA, and artificial fetal mortality rates.
CONCLUSIONS
Analyses performed using national data suggested that the pandemic decreased the TLBW and SGA rates in Japan.
Topics: Humans; COVID-19; Japan; Female; Pregnancy; Infant, Newborn; Fetal Mortality; Premature Birth; Pregnancy Outcome; Pandemics; Interrupted Time Series Analysis; Adult; SARS-CoV-2; Infant, Low Birth Weight; Infant, Small for Gestational Age
PubMed: 38807097
DOI: 10.1186/s12889-024-18905-z -
Archives of Gynecology and Obstetrics Jul 2024The prevalence of benzodiazepines and related drugs (BZRDs) use during pregnancy increased sharply in recent years. Thus, there are concerns regarding the pregnancy... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The prevalence of benzodiazepines and related drugs (BZRDs) use during pregnancy increased sharply in recent years. Thus, there are concerns regarding the pregnancy outcomes following exposure to BZRDs.
METHODS
Two electronic databases were thoroughly searched to identify related clinical studies published from inception until June 2023. English-language cohort studies with high-quality comparing antenatal BZRDs exposure to an unexposed group on any delivery outcome were included.
RESULTS
Ten cohort studies that estimated adverse neonatal outcomes associated with exposure to BZRDs during pregnancy were included. Exposure to BZRDs during pregnancy was associated with an increased risk of congenital malformation [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.05-1.13, p < 0.001], heart malformation (OR 1.13, 95% CI 1.04-1.22, p = 0.003), preterm birth (OR 1.45, 95% CI 1.23-1.7, p < 0.001), SGA (OR 1.18, 95% CI 1.08-1.29, P < 0.001), LBW (OR 1.42, 95% CI 1.25-1.6, p = 0.001) or low Apgar score (OR 1.42, 95% CI 1.08-1.87, p = 0.011),compared with no exposure. Further analyses limited to the first trimester exposure yielded consistent results.
CONCLUSIONS
Exposure to BZRDs during pregnancy may be associated with several adverse neonatal outcomes. However, we could not rule out the potential indication confounding factor, further studies with high-quality that control for important confounders are still needed to verify our findings.
Topics: Humans; Pregnancy; Female; Benzodiazepines; Pregnancy Outcome; Infant, Newborn; Premature Birth; Abnormalities, Drug-Induced; Cohort Studies; Pregnancy Complications
PubMed: 38806942
DOI: 10.1007/s00404-024-07557-4 -
Scientific Reports May 2024Intrahepatic cholestasis of pregnancy (ICP) can lead to many adverse pregnancy outcomes, and the influencing factors remain unclear at present. This study...
Intrahepatic cholestasis of pregnancy (ICP) can lead to many adverse pregnancy outcomes, and the influencing factors remain unclear at present. This study retrospectively analyzed clinical data from 1815 pregnant women with ICP and evaluated the relationship between ICP subtypes, gestational age at onset, and pregnancy outcomes. The results of this study show that during pregnancy, the levels of biochemical indicators (TBA, DBIL and ALT) in the serum of pregnant women initially diagnosed with subtypes of ICP were noted to constantly change, and the subtype of ICP and its severity also changed. The incidence of adverse pregnancy outcomes [meconium-stained amniotic fluid (MSAF), NICU transfer, Apgar score ≤ 7 at 1 min, and preterm birth] in patients with ICP1 (icteric type) was significantly higher than for patients with ICP2, ICP3 or ICP4. The preterm birth rate of early-onset ICP was higher than that of late-onset ICP in ICP1 and ICP3 subtypes. In conclusion, the outcome of pregnancy in women with ICP is closely related to the serum TBA level and ICP subtype, which should be recognized in the clinic.
Topics: Humans; Female; Pregnancy; Cholestasis, Intrahepatic; Pregnancy Complications; Bile Acids and Salts; Adult; Pregnancy Outcome; Retrospective Studies; Premature Birth; Gestational Age; Infant, Newborn
PubMed: 38806569
DOI: 10.1038/s41598-024-63183-9 -
Reproductive Biology May 2024Preterm birth affects approximately 15 million women worldwide, of which 30 % is due to preterm premature rupture of membranes (PPROM). The reasons for shortening the... (Review)
Review
Preterm birth affects approximately 15 million women worldwide, of which 30 % is due to preterm premature rupture of membranes (PPROM). The reasons for shortening the duration of pregnancy are seen in genetic, hormonal, immunological and socio-economic conditions. Recent years have provided a lot of evidence on the impact of the microbiota and whole microbiome on pregnant women, suggesting that the microorganisms inhabiting the vagina significantly affect the risk of preterm delivery. The aim of the study was to review studies evaluating the composition of the vaginal microflora and its role in the occurrence of preterm labor caused by PPROM, and to evaluate the potential beneficial effect of probiotics on preventing the development of preterm labor. Vaginal microbial dysbiosis is observed in PPROM, which, due to its association with a high risk of prematurity and infection, increases neonatal morbidity and mortality. Further research on biomarkers for screening, early prognosis and diagnosis of PPROM seems advisable. Probiotics as a potential intervention can prevent the development of pathological vaginal flora, reducing the risk of infection in women planning pregnancy and pregnant women.
PubMed: 38805904
DOI: 10.1016/j.repbio.2024.100899 -
JAMA Network Open May 2024Understanding the effect of antenatal magnesium sulfate (MgSO4) treatment on functional connectivity will help elucidate the mechanism by which it reduces the risk of... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Understanding the effect of antenatal magnesium sulfate (MgSO4) treatment on functional connectivity will help elucidate the mechanism by which it reduces the risk of cerebral palsy and death.
OBJECTIVE
To determine whether MgSO4 administered to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks is associated with increased functional connectivity and measures of functional segregation and integration in infants at term-equivalent age, possibly reflecting a protective mechanism of MgSO4.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study was nested within a randomized placebo-controlled trial performed across 24 tertiary maternity hospitals. Participants included infants born to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks who participated in the MAGENTA (Magnesium Sulphate at 30 to 34 Weeks' Gestational Age) trial and underwent magnetic resonance imaging (MRI) at term-equivalent age. Ineligibility criteria included illness precluding MRI, congenital or genetic disorders likely to affect brain structure, and living more than 1 hour from the MRI center. One hundred and fourteen of 159 eligible infants were excluded due to incomplete or motion-corrupted MRI. Recruitment occurred between October 22, 2014, and October 25, 2017. Participants were followed up to 2 years of age. Analysis was performed from February 1, 2021, to February 27, 2024. Observers were blind to patient groupings during data collection and processing.
EXPOSURES
Women received 4 g of MgSO4 or isotonic sodium chloride solution given intravenously over 30 minutes.
MAIN OUTCOMES AND MEASURES
Prior to data collection, it was hypothesized that infants who were exposed to MgSO4 would show enhanced functional connectivity compared with infants who were not exposed.
RESULTS
A total of 45 infants were included in the analysis: 24 receiving MgSO4 treatment and 21 receiving placebo; 23 (51.1%) were female and 22 (48.9%) were male; and the median gestational age at scan was 40.0 (IQR, 39.1-41.1) weeks. Treatment with MgSO4 was associated with greater voxelwise functional connectivity in the temporal and occipital lobes and deep gray matter structures and with significantly greater clustering coefficients (Hedge g, 0.47 [95% CI, -0.13 to 1.07]), transitivity (Hedge g, 0.51 [95% CI, -0.10 to 1.11]), local efficiency (Hedge g, 0.40 [95% CI, -0.20 to 0.99]), and global efficiency (Hedge g, 0.31 [95% CI, -0.29 to 0.90]), representing enhanced functional segregation and integration.
CONCLUSIONS AND RELEVANCE
In this cohort study, infants exposed to MgSO4 had greater voxelwise functional connectivity and functional segregation, consistent with increased brain maturation. Enhanced functional connectivity is a possible mechanism by which MgSO4 protects against cerebral palsy and death.
Topics: Humans; Magnesium Sulfate; Female; Pregnancy; Infant, Newborn; Magnetic Resonance Imaging; Male; Adult; Gestational Age; Cohort Studies; Premature Birth; Infant; Brain; Prenatal Care; Cerebral Palsy
PubMed: 38805222
DOI: 10.1001/jamanetworkopen.2024.13508 -
Yonsei Medical Journal Jun 2024There are many studies regarding the increased relationship between pregnancy outcomes of singleton with endometriosis. However, there was limited evidence of twin...
PURPOSE
There are many studies regarding the increased relationship between pregnancy outcomes of singleton with endometriosis. However, there was limited evidence of twin pregnancies with endometriosis. This study aimed to compare the pregnancy outcomes and complications in twin pregnancies with or without endometriosis in a single institution.
MATERIALS AND METHODS
From January 2011 to July 2022, a retrospective analysis of twin pregnancies was conducted. The endometriosis group included patient with histological or visual confirmation before pregnancy or during cesarean section. Pregnancy outcomes and complications were compared between the two groups.
RESULTS
Out of 1714 patients examined, 127 (7.4%) were included in the endometriosis group. Maternal body mass index (BMI) was lower in the endometriosis group (<0.001). There were no significant differences in maternal age, mode of conception, chorionicity, and pregnancy outcomes, such as gestational age at delivery (=0.835) and the preterm birth rate (=0.579). The endometriosis group had a significantly higher rate of obstetrical complication: small for gestational age (SGA) <10% (=0.029). However, after adjustment for BMI, the endometriosis group showed no statistical significance in obstetrical complications, including SGA (adjusted odds ratio, 1.568; 95% confidence interval, 0.984-2.499; =0.059).
CONCLUSION
Twin pregnancies with endometriosis were not related to adverse effects on pregnancy outcomes and obstetrical complications. To confirm these outcomes, further large prospective studies are required.
Topics: Humans; Female; Pregnancy; Endometriosis; Pregnancy, Twin; Pregnancy Outcome; Adult; Retrospective Studies; Pregnancy Complications; Body Mass Index; Infant, Small for Gestational Age; Premature Birth; Infant, Newborn; Cesarean Section
PubMed: 38804030
DOI: 10.3349/ymj.2023.0099