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Analytical Cellular Pathology... 2024Premature rupture of membrane (PROM) refers to the rupture of membranes before the onset of labor which increases the risk of perinatal morbidity and mortality....
Premature rupture of membrane (PROM) refers to the rupture of membranes before the onset of labor which increases the risk of perinatal morbidity and mortality. Recently, circular RNAs (circRNAs) have emerged as promising regulators of diverse diseases. However, the circRNA expression profiles and potential circRNA-miRNA-mRNA regulatory mechanisms in PROM remain enigmatic. In this study, we displayed the expression profiles of circRNAs and mRNAs in plasma and fetal membranes of PROM and normal control (NC) groups based on circRNA microarray, the Gene Expression Omnibus database, and NCBI's Sequence Read Archive. A total of 1,459 differentially expressed circRNAs (DECs) in PROM were identified, with 406 upregulated and 1,053 downregulated. Then, we constructed the circRNA-miRNA-mRNA network in PROM, encompassing 22 circRNA-miRNA pairs and 128 miRNA-mRNA pairs. Based on the analysis of gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and gene set enrichment analysis (GSEA), DECs were implicated in immune-related pathways, with certain alterations persisting even postpartum. Notably, 11 host genes shared by DECs of fetal membrane tissue and prenatal plasma in PROM were significantly implicated in inflammatory processes and extracellular matrix regulation. Our results suggest that structurally stable circRNAs may predispose to PROM by mediating systemic immune imbalances, including peripheral leukocyte disorganization, local immune imbalance at the maternal-fetal interface, and local collagen disruption. This is the first time to decipher a landscape on circRNAs of PROM, reveals the pathogenic cause of PROM from the perspective of circRNA, and opens up a new direction for the diagnosis and treatment of PROM.
Topics: RNA, Circular; Humans; Pregnancy; Fetal Membranes, Premature Rupture; Female; RNA, Messenger; Gene Expression Profiling; Gene Regulatory Networks; MicroRNAs; Gene Ontology; Adult; Gene Expression Regulation; Transcriptome
PubMed: 38803428
DOI: 10.1155/2024/6724914 -
Women & Health May 2024Post-partum quality of life is an inadequately studied and poorly understood outcome of delivery care, especially in low- and middle-income countries. Hence, we...
Post-partum quality of life is an inadequately studied and poorly understood outcome of delivery care, especially in low- and middle-income countries. Hence, we evaluated the postpartum quality of life and its clinic-demographic context as part of a 3-stage cluster randomized community survey (DECLARE; covered quality of care as primary outcome) conducted in 2009-2011 in Delhi. In stage 1 of participant selection(sampling), 20 wards (of 150; geographically defined administrative units) were selected using a probability-proportionate-to-size systematic method. In stage 2, one from each income stratum (high, middle, and low; multiple colonies within each ward) was selected from each ward by simple random sampling (total 60 colonies of 2311). In stage 3, a house-to-house survey was conducted to recruit ~1800 recently delivered women for the multidimensional work, which included quality-of-care, cost-of-care, and PPQOL. Among the participants, those with high school or above education were invited to administer the Mother-Generated Index and calculate the primary and secondary index scores (PIS and SIS). A total of 794 (of 857 eligible; 118846 households) women were administered MGI. The mean PIS was 4.6[95 percent CI 4.4-4.7] while the average SIS was 4.0[95 percent CI 3.8-4.2]. The PIS was worse for primiparous vs. multiparous mothers. On multivariate analysis, poorer psychological state, obstetric complications, and premature delivery correlated with poorer QOL scores, while better gestational weight gain, higher age, and labor-pain relief correlated with better QOL scores. The study benchmarks the poor status of post-partum quality-of-life and documents the spectrum, severity, and complexity of its key social, psychological, physical, and demographic determinants.
PubMed: 38803047
DOI: 10.1080/03630242.2024.2360427 -
Microbiome May 2024Vaginal microbiota composition is associated with spontaneous preterm birth (sPTB), depending on ethnicity. Host-microbiota interactions are thought to play an important...
BACKGROUND
Vaginal microbiota composition is associated with spontaneous preterm birth (sPTB), depending on ethnicity. Host-microbiota interactions are thought to play an important underlying role in this association between ethnicity, vaginal microbiota and sPTB.
METHODS
In a prospective cohort of nulliparous pregnant women, we assessed vaginal microbiota composition, vaginal immunoglobulins (Igs), and local inflammatory markers. We performed a nested case-control study with 19 sPTB cases, matched based on ethnicity and midwifery practice to 19 term controls.
RESULTS
Of the 294 included participants, 23 pregnancies ended in sPTB. We demonstrated that Lactobacillus iners-dominated microbiota, diverse microbiota, and ethnicity were all independently associated with sPTB. Microbial Ig coating was associated with both microbiota composition and ethnicity, but a direct association with sPTB was lacking. Microbial IgA and IgG coating were lowest in diverse microbiota, especially in women of any ethnic minority. When correcting for microbiota composition, increased microbial Ig coating correlated with increased inflammation.
CONCLUSION
In these nulliparous pregnant women, vaginal microbiota composition is strongly associated with sPTB. Our results support that vaginal mucosal Igs might play a pivotal role in microbiota composition, microbiota-related inflammation, and vaginal community disparity within and between ethnicities. This study provides insight in host-microbe interaction, suggesting that vaginal mucosal Igs play an immunomodulatory role similar to that in the intestinal tract. Video Abstract.
Topics: Humans; Female; Vagina; Pregnancy; Adult; Premature Birth; Case-Control Studies; Prospective Studies; Microbiota; Ethnicity; Lactobacillus; Host Microbial Interactions; Immunoglobulins; Immunoglobulin A; Young Adult
PubMed: 38802950
DOI: 10.1186/s40168-024-01787-z -
BMC Public Health May 2024Preterm birth (PTB) is an important predictor of perinatal morbidity and mortality. Previous researches have reported a correlation between air pollution and an...
BACKGROUND
Preterm birth (PTB) is an important predictor of perinatal morbidity and mortality. Previous researches have reported a correlation between air pollution and an increased risk of preterm birth. However, the specific relationship between short-term and long-term exposure to carbon monoxide (CO) and preterm birth remains less explored.
METHODS
A population-based study was conducted among 515,498 pregnant women in Chongqing, China, to assess short-term and long-term effects of CO on preterm and very preterm births. Generalized additive models (GAM) were applied to evaluate short-term effects, and exposure-response correlation curves were plotted after adjusting for confounding factors. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using COX proportional hazard models to estimate the long-term effect.
RESULTS
The daily incidence of preterm and very preterm birth was 5.99% and 0.41%, respectively. A positive association between a 100 µg/m³ increase in CO and PTB was observed at lag 0-3 days and 12-21 days, with a maximum relative risk (RR) of 1.021(95%CI: 1.001-1.043). The exposure-response curves (lag 0 day) revealed a rapid increase in PTB due to CO. Regarding long-term exposure, positive associations were found between a 100 µg/m CO increase for each trimester(Model 2 for trimester 1: HR = 1.054, 95%CI: 1.048-1.060; Model 2 for trimester 2: HR = 1.066, 95%CI: 1.060-1.073; Model 2 for trimester 3: HR = 1.007, 95%CI: 1.001-1.013; Model 2 for entire pregnancy: HR = 1.080, 95%CI: 1.073-1.088) and higher HRs of very preterm birth. Multiplicative interactions between air pollution and CO on the risk of preterm and very preterm birth were detected (P- interaction<0.05).
CONCLUSIONS
Our findings suggest that short-term exposure to low levels of CO may have protective effects against preterm birth, while long-term exposure to low concentrations of CO may reduce the risk of both preterm and very preterm birth. Moreover, our study indicated that very preterm birth is more susceptible to the influence of long-term exposure to CO during pregnancy, with acute CO exposure exhibiting a greater impact on preterm birth. It is imperative for pregnant women to minimize exposure to ambient air pollutants.
Topics: Humans; Female; Pregnancy; Premature Birth; China; Carbon Monoxide; Adult; Air Pollutants; Air Pollution; Infant, Newborn; Maternal Exposure; Time Factors; Young Adult; Risk Factors
PubMed: 38802825
DOI: 10.1186/s12889-024-18913-z -
BMC Pregnancy and Childbirth May 2024The rising number of women giving birth at advanced maternal age has posed significant challenges in obstetric care in recent years, resulting in increased incidence of...
Development and validation of a prenatal predictive nomogram for the risk of NICU admission in infants born to Chinese mothers over 35 years of age: a retrospective cohort study.
BACKGROUND
The rising number of women giving birth at advanced maternal age has posed significant challenges in obstetric care in recent years, resulting in increased incidence of neonatal transfer to the Neonatal Intensive Care Unit (NICU). Therefore, identifying fetuses requiring NICU transfer before delivery is essential for guiding targeted preventive measures.
OBJECTIVE
This study aims to construct and validate a nomogram for predicting the prenatal risk of NICU admission in neonates born to mothers over 35 years of age.
STUDY DESIGN
Clinical data of 4218 mothers aged ≥ 35 years who gave birth at the Department of Obstetrics of the Second Hospital of Shandong University between January 1, 2017 and December 31, 2021 were reviewed. Independent predictors were identified by multivariable logistic regression, and a predictive nomogram was subsequently constructed for the risk of neonatal NICU admission.
RESULTS
Multivariate logistic regression demonstrated that the method of prenatal screening, number of implanted embryos, preterm premature rupture of the membranes, preeclampsia, HELLP syndrome, fetal distress, premature birth, and cause of preterm birth are independent predictors of neonatal NICU admission. Analysis of the nomogram decision curve based on these 8 independent predictors showed that the prediction model has good net benefit and clinical utility.
CONCLUSION
The nomogram demonstrates favorable performance in predicting the risk of neonatal NICU transfer after delivery by mothers older than 35 years. The model serves as an accurate and effective tool for clinicians to predict NICU admission in a timely manner.
Topics: Humans; Female; Nomograms; Pregnancy; Retrospective Studies; Intensive Care Units, Neonatal; Adult; Infant, Newborn; Maternal Age; China; Risk Assessment; Logistic Models; Risk Factors; Premature Birth; Patient Admission; Prenatal Diagnosis; East Asian People
PubMed: 38802735
DOI: 10.1186/s12884-024-06582-0 -
Taiwanese Journal of Obstetrics &... May 2024Endometriosis is associated with higher risk of ectopic pregnancy, premature delivery, miscarriage, and other adverse maternal and fetal complications. This study aimed... (Observational Study)
Observational Study
OBJECTIVE
Endometriosis is associated with higher risk of ectopic pregnancy, premature delivery, miscarriage, and other adverse maternal and fetal complications. This study aimed to assess the impact of endometriosis on maternal and fetal outcomes of singleton pregnancies in a large nationally representative database.
MATERIALS AND METHODS
This population-based, retrospective observational study extracted the data of women aged 20-49 years with singleton, spontaneously conceived pregnancies from the US Nationwide Inpatient Sample (NIS) database from 2005 to 2018. Included subjects were divided into those with ICD codes for endometriosis and those without (non-endometriosis group). Data of maternal and fetal outcomes were compared between groups and analyzed using regression analysis.
RESULTS
After excluding 17,124 women who conceived with assisted reproductive technology (ART), 162,155 women with multiple pregnancies, and 27,847 with abnormal trend weight values (TRENDWT), a total of 8,584,269 women were eligible. After propensity score matching (PMS) case-control 1:4 by age, 45,560 remained (9112 (0.1%) with endometriosis, 36,448 without) and were included in the analysis. The mean age of women before matching was 28.7 years, and 30.5 years after matching. The most common comorbidity was chronic pulmonary disease (3.6%). Smoking frequency was higher in women with endometriosis compared to those without (4.8% vs. 2.4%). Multivariable analysis adjusted for confounders revealed that endometriosis was associated with significantly higher risk of maternal complications, including pre-eclampsia and eclampsia, antepartum hemorrhage, placenta previa, Cesarean delivery, post-partum hemorrhage, disseminated intravascular coagulation (DIC), transfusion, hemoperitoneum, and hospital stays ≥6 days. For fetal outcomes, endometriosis was associated with higher risk of intrauterine growth restriction (IUGR), premature birth, birth defects and abortion.
CONCLUSION
Endometriosis during pregnancy is associated with maternal and fetal complications. Study findings may serve as a benchmark for expanding medical assistance for endometriosis-affected pregnant women.
Topics: Humans; Female; Pregnancy; Endometriosis; Adult; Retrospective Studies; United States; Pregnancy Complications; Middle Aged; Young Adult; Pregnancy Outcome; Databases, Factual; Premature Birth; Risk Factors; Case-Control Studies; Cesarean Section
PubMed: 38802198
DOI: 10.1016/j.tjog.2023.06.005 -
Zhonghua Fu Chan Ke Za Zhi May 2024To investigate the relationship between sleep status in the first trimester and preterm birth. Clinical data of pregnant women who received regular prenatal...
To investigate the relationship between sleep status in the first trimester and preterm birth. Clinical data of pregnant women who received regular prenatal examination and delivered in Peking University Third Hospital from September 1, 2019 to June 10, 2020 were collected. The Pittsburgh sleep quality index (PSQI) was used to investigate their sleep status during 8-12 weeks of gestation, and the delivery outcomes were followed up. According to the gestational age at delivery and the cause of preterm birth, they were divided into full-term delivery group (204 cases), preterm birth group (13 cases) and spontaneous preterm birth group (9 cases). The correlation between the sleep status in the first trimester and preterm birth or spontaneous preterm birth was analyzed. The median PSQI score of full-term delivery group was 4.0 points (3.0, 6.0 points), which was lower than those of preterm delivery group [6.0 points (4.0, 8.0 points)] and spontaneous preterm delivery group [7.0 points (4.0, 8.0 points)], and the differences were statistically significant (all <0.05). The proportion of pregnant women with poor sleep quality (PSQI score>7 points) in full-term delivery group [14.2% (29/204)] was lower than those in preterm delivery group (5/13) and spontaneous preterm delivery group (4/9), and the differences were statistically significant (all <0.05). Compared with the full-term delivery group [8.0 hours (7.0, 9.0 hours)], the preterm birth group [7.0 hours (7.0, 8.0 hours)] and spontaneous preterm birth group [7.0 hours (7.0, 8.0 hours)] had significantly shorter sleep duration at night (all <0.05). Multivariate analysis showed that PSQI score in the first trimester was an independent risk factor for preterm birth (a=1.22, 95%: 1.02-1.45; =0.026). Pregnancy with assisted reproductive technology (a=5.55, 95%: 1.22-25.31; =0.027), gestational diabetes mellitus (a=9.27, 95%: 1.96-43.82; =0.005), PSQI score in the first trimester (a=1.27, 95%: 1.01-1.58; =0.039) were independent risk factors for spontaneous preterm birth. Attention should be paid to the decreased sleep quality in the first trimester, which might significantly increase the risk of preterm birth and spontaneous preterm birth.
Topics: Humans; Female; Pregnancy; Premature Birth; Pregnancy Trimester, First; Adult; Gestational Age; Risk Factors; Sleep; Sleep Quality; Infant, Newborn; Sleep Wake Disorders; Surveys and Questionnaires
PubMed: 38797566
DOI: 10.3760/cma.j.cn112141-20231016-00150 -
Environmental Research Sep 2024Adverse pregnancy outcomes (APOs) include stillbirth, preterm birth, and low birthweight (LBW). Studies exploring the impact of weather factors and air pollution on APOs...
Linking weather and health outcomes: Examining the potential influences of weather factors and particulate matter pollution on adverse pregnancy outcomes in the Kavre district, Nepal.
INTRODUCTION
Adverse pregnancy outcomes (APOs) include stillbirth, preterm birth, and low birthweight (LBW). Studies exploring the impact of weather factors and air pollution on APOs are scarce in Nepal. We examined the impacts of prenatal exposure to temperature, precipitation, and air pollution (PM) on APOs among women living in Kavre, Nepal.
METHODS
We conducted a hospital and rural health centers-based historical cohort study that included health facility birth records (n = 1716) from the Nepali fiscal year 2017/18 through 2019/20. We linked health records to temperature, precipitation, and PM data for Kavre for the six months preceding each birth. A random intercept model was used to analyze birthweight, while a composite APO variable, was analyzed using multivariable logistic regression in relation to environmental exposures.
RESULTS
The proportion of LBW (<2500 gm), preterm birth (babies born alive before 37 weeks of gestation), and stillbirth was 13%, 4.3%, and 1.5%, respectively, in this study. Overall, around 16% of the study participants had one or more APOs. Total precipitation (β: 0.17, 95% CI 0.01 to 0.33, p = 0.03) had a positive effect on birthweight in the wetter season. Negative effects for mean maximum (β: 33.37, 95% CI -56.68 to -10.06, p = 0.005), mean (β: 32.35, 95% CI -54.44 to -10.27, p = 0.004), and mean minimum temperature (β: 29.28, 95% CI -49.58 to -8.98, p = 0.005) on birthweight was also observed in the wetter season.
CONCLUSION
A positive effect of temperature (mean maximum, mean, and mean minimum) and total precipitation on birthweight was found in the wetter season. This study emphasizes the need for future research using larger cohorts to elucidate these complex relationships in Nepal.
Topics: Nepal; Humans; Female; Pregnancy; Particulate Matter; Adult; Pregnancy Outcome; Weather; Air Pollution; Young Adult; Premature Birth; Air Pollutants; Cohort Studies; Infant, Newborn; Infant, Low Birth Weight; Stillbirth; Maternal Exposure
PubMed: 38797462
DOI: 10.1016/j.envres.2024.119212 -
Transcervical side by side Foley balloons for preterm breech birth: A new concept to enhance safety.European Journal of Obstetrics,... Jul 2024Preterm breech birth risks head entrapment. Three side-by-side Foley balloons as previously described for labour induction/augmentation may prevent breech expulsion...
Preterm breech birth risks head entrapment. Three side-by-side Foley balloons as previously described for labour induction/augmentation may prevent breech expulsion until adequate cervical dilation. We present an illustrative case.
Topics: Humans; Female; Pregnancy; Breech Presentation; Premature Birth; Adult
PubMed: 38796409
DOI: 10.1016/j.ejogrb.2024.05.025 -
F&S Science May 2024To investigate potential differences in pregnancy, delivery, and neonatal outcomes between 2 hyperandrogenic conditions in reproductive-aged women: polycystic ovary...
OBJECTIVE
To investigate potential differences in pregnancy, delivery, and neonatal outcomes between 2 hyperandrogenic conditions in reproductive-aged women: polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia (CAH).
DESIGN
Retrospective population-based study with data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database from 2004-2014.
SETTING
Not applicable.
PATIENT(S)
A total of 14,881 women with PCOS and 298 women with CAH.
INTERVENTION(S)
Not applicable.
MAIN OUTCOME MEASURE(S)
Gestational diabetes mellitus, placenta previa, pregnancy-induced hypertension (HTN), gestational HTN, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on HTN, preterm birth, preterm premature rupture of membrane, abruptio placenta, chorioamnionitis, mode of delivery, maternal infection, hysterectomy, blood transfusion, venous thromboembolism (deep vein thrombosis and pulmonary embolism during pregnancy, intrapartum, or postpartum), maternal death, chorioamnionitis, septicemia during labor, postpartum endometritis, septic pelvic, peritonitis, small for gestational age, congenital anomalies, and intrauterine fetal demise.
RESULT(S)
After adjusting for potential confounders, we found that women with PCOS were at increased risk of developing pregnancy-induced HTN (adjusted odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.12-2.77) and gestational diabetes (adjusted OR = 1.68; 95% CI: 1.12-2.52) when compared with women with CAH. Contrary women with CAH were at increased risk for delivery via cesarean section (adjusted OR = 0.59; 95% CI: 0.44-0.80) and small for gestational age neonates (adjusted OR = 0.32; 95% CI: 0.20-0.52).
CONCLUSION(S)
To our knowledge, this study is the first to directly compare obstetric and neonatal outcomes between patients with PCOS and CAH. Despite the similar phenotypes and some common hormonal and biochemical profiles, such as insulin resistance, hyperinsulinemia, and hyperandrogenism, our results suggest the existence of additional metabolic pathways implicated in the pathogenesis of pregnancy complications.
PubMed: 38795844
DOI: 10.1016/j.xfss.2024.05.001