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JACC. Advances Jul 2023
PubMed: 38938998
DOI: 10.1016/j.jacadv.2023.100406 -
Frontiers in Cellular and Infection... 2024In recent years, a growing body of research has confirmed that the gut microbiota plays a major role in the maintenance of human health and disease. A gut microbiota... (Review)
Review
In recent years, a growing body of research has confirmed that the gut microbiota plays a major role in the maintenance of human health and disease. A gut microbiota imbalance can lead to the development of many diseases, such as pregnancy complications, adverse pregnancy outcomes, polycystic ovary syndrome, endometriosis, and cancer. Short-chain fatty acids are metabolites of specific intestinal bacteria and are crucial for maintaining intestinal homeostasis and regulating metabolism and immunity. Endometriosis is the result of cell proliferation, escape from immune surveillance, and invasive metastasis. There is a strong correlation between the anti-proliferative and anti-inflammatory effects of short-chain fatty acids produced by gut microbes and the development of endometriosis. Given that the mechanism of action of gut microbiota and Short-chain fatty acids in endometriosis remain unclear, this paper aims to provide a comprehensive review of the complex interactions between intestinal flora, short-chain fatty acids and endometriosis. In addition, we explored potential microbial-based treatment strategies for endometriosis, providing new insights into the future development of diagnostic tests and prevention and treatment methods for endometriosis.
Topics: Endometriosis; Humans; Female; Gastrointestinal Microbiome; Fatty Acids, Volatile; Animals; Bacteria; Probiotics
PubMed: 38938880
DOI: 10.3389/fcimb.2024.1373004 -
JACC. Advances Jun 2024Tragically, preeclampsia is a leading cause of pregnancy-related complications and is linked to a heightened risk for morbid and fatal cardiovascular disease (CVD)... (Review)
Review
Tragically, preeclampsia is a leading cause of pregnancy-related complications and is linked to a heightened risk for morbid and fatal cardiovascular disease (CVD) outcomes. Although the mechanism connecting preeclampsia to CVD risk has yet to be fully elucidated, evidence suggests distinct pathways of early and late preeclampsia with shared CV risk factors but with profound differences in perinatal and postpartum risk to the mother and infant. In early preeclampsia, <34 weeks of gestation, systemic vascular dysfunction contributes to near-term subclinical myocardial damage. Hypertrophy and diastolic abnormalities persist postpartum and contribute to early onset heart failure (HF). This HF risk remains elevated decades later and contributes to premature death. Black women are at the highest risk of preeclampsia and HF. These findings support closer monitoring of women postpartum, especially for those with early and severe preeclampsia to control chronic hypertension and reduce the potentially preventable sequelae of heightened CVD and HF risk.
PubMed: 38938863
DOI: 10.1016/j.jacadv.2024.100980 -
JACC. Advances Mar 2024Hypertensive disorders of pregnancy (HDP) complicate 13% to 15% of pregnancies in the United States. Historically marginalized communities are at increased risk, with... (Review)
Review
Hypertensive disorders of pregnancy (HDP) complicate 13% to 15% of pregnancies in the United States. Historically marginalized communities are at increased risk, with preeclampsia and eclampsia being the leading cause of death in this population. Pregnant individuals with HDP require more frequent and intensive monitoring throughout the antepartum period outside of routine standard of care prenatal visits. Additionally, acute rises in blood pressure often occur 3 to 6 days postpartum and are challenging to identify and treat, as most postpartum individuals are usually scheduled for their first visit 6 weeks after delivery. Thus, a multifaceted approach is necessary to improve recognition and treatment of HDP throughout the peripartum course. There are limited studies investigating interventions for the management of HDP, especially within the United States, where maternal mortality is rising, and in higher-risk groups. We review the state of current management of HDP and innovative strategies such as blood pressure self-monitoring, telemedicine, and community health worker intervention.
PubMed: 38938826
DOI: 10.1016/j.jacadv.2024.100864 -
JACC. Advances Nov 2023
PubMed: 38938734
DOI: 10.1016/j.jacadv.2023.100665 -
PeerJ 2024Ongoing military conflict in Sudan has had significant repercussions on the health and well-being of the population, particularly among women of reproductive age. This...
OBJECTIVES
Ongoing military conflict in Sudan has had significant repercussions on the health and well-being of the population, particularly among women of reproductive age. This study aimed to investigate the impact of conflict on maternal health by employing a mixed qualitative and quantitative research approach.
METHODS
Through in-depth interviews and survey questionnaires (388 women), this study examined the experiences and challenges faced by pregnant women and new mothers and the availability and accessibility of maternal healthcare services in conflict-affected areas. Using a qualitative approach, in-depth interviews were conducted with 35 women who had recently given birth or were pregnant in regions affected by the Khartoum State-Sudan conflict. Thematic analysis was used to analyze the data collected from the interviews.
RESULT
Most women did not have access to healthcare services (86.6%), and out of the total sample, 93 (24%) experienced adverse outcomes. The factors associated with adverse effects were parity (OR 1.78, CI [1.15-2.75], -value 0.010), gestational age (OR 2.10, CI [1.36-3.25], -value 0.002), access to healthcare (OR 2.35, CI [1.48-3.72], -value 0.001), and delivery mode (OR 1.68, CI [1.05-2.69], = 0.030). Factors significantly associated with accessibility to maternal healthcare services included age (OR, 1.28; = 0.042) and higher conflict levels (1.52 times higher odds, = 0.021). The narratives and experiences shared by women exposed the multifaceted ways in which the conflict-affected maternal health outcomes.
CONCLUSION
The significance of this study lies in its potential to contribute to the existing literature on maternal health in conflict-affected areas, especially in Sudan, and to help us understand how women can receive maternal health services.
Topics: Humans; Female; Sudan; Pregnancy; Adult; Health Services Accessibility; Maternal Health; Maternal Health Services; Qualitative Research; Young Adult; Armed Conflicts; Surveys and Questionnaires; Interviews as Topic; Adolescent
PubMed: 38938615
DOI: 10.7717/peerj.17484 -
PeerJ 2024To determine the association between lipid metabolism and intrahepatic cholestasis of pregnancy (ICP), and explore the value of maternal alanine...
Evaluation of alanine aminotransferase/aspartate aminotransferase ratio and high-density lipoprotein for predicting neonatal adverse outcomes associated with intrahepatic cholestasis of pregnancy.
BACKGROUND
To determine the association between lipid metabolism and intrahepatic cholestasis of pregnancy (ICP), and explore the value of maternal alanine aminotransferase/aspartate aminotransferase (ALT/AST) and high-density lipoprotein (HDL) in predicting adverse neonatal outcomes in women with ICP.
METHODS
A total of 147 pregnant women with ICP admitted to The Fourth Hospital of Shijiazhuang and 120 normal pregnant women in the same period were selected in this study. The Mann-Whitney U test and Chi-square tests were used to compare the differences in clinical data. Multivariate logistic regression was used to analyze the relationship between ALT/AST and the occurrence of adverse pregnancy outcomes in patients with ICP. The combined predictive value of ALT/AST and HDL was determined by receiver operating characteristic (ROC) curve analysis.
RESULTS
Among 147 women with ICP, 122 women had total bile acid (TBA) levels of 10-39.9 µmol/L, and 25 had TBA ≥ 40 µmol/L. There was significantly lower gestational age in patients with severe ICP than in those with mild and control groups (all < 0.05), and the weight of newborns in the maternal ICP group was significantly lower than in the control group ( < 0.05). Increasing TBA levels was associated with higher AST, ALT, ALT/AST, and lower HDL level (all < 0.05). Meanwhile, higher levels of ALT/AST was positively associated with neonatal hyperbilirubinemia [adjusted odds ratio (AOR) = 4.019, 95% CI [1.757-9.194, = 0.001] and cardiac injury [AOR = 3.500, 95% CI [1.535-7.987], = 0.003]. HDL was a significant protective factor for neonatal hyperbilirubinemia and cardiac injury [AOR = 0.315, 95% CI [0.126-0.788], = 0.014; AOR = 0.134 (0.039-0.461), = 0.001]. The area under the ROC curve (AUC) for prediction of neonatal hyperbilirubinemia by ALT/AST combined with HDL was 0.668 [95% CI [56.3-77.3%], = 0.002], and the sensitivity and specificity were 47.1% and 84.0%, respectively. To predict neonatal cardiac injury, the AUC value was 0.668 [95% CI [56.4-77.1%], = 0.002], with sensitivity and specificity were 41.2% and 87.1%, respectively.
CONCLUSIONS
The levels of higher ALT/AST and lower HDL were significantly associated with the risk of ICP-related adverse neonatal outcomes. Moreover, ALT/AST combined with HDL has moderate clinical value in predicting the adverse outcomes of neonatal hyperbilirubinemia and cardiac injury.
Topics: Humans; Female; Pregnancy; Cholestasis, Intrahepatic; Pregnancy Complications; Alanine Transaminase; Adult; Aspartate Aminotransferases; Infant, Newborn; Lipoproteins, HDL; Pregnancy Outcome; ROC Curve; Predictive Value of Tests; Biomarkers; Case-Control Studies
PubMed: 38938614
DOI: 10.7717/peerj.17613 -
Frontiers in Endocrinology 2024Endocannabinoids and their -acyl-ethanolamines (NAEs) and 2monoacyl-glycerols (2-MAGs) congeners are involved in the central and peripheral regulation of energy...
OBJECTIVE
Endocannabinoids and their -acyl-ethanolamines (NAEs) and 2monoacyl-glycerols (2-MAGs) congeners are involved in the central and peripheral regulation of energy homeostasis, they are present in human milk and are associated with obesity. Infants exposed to gestational diabetes mellitus (GDM) are more likely to develop obesity. The objective of this cross-sectional study is to compare the profile of eCBome mediators in milk of women with gestational diabetes (GDM+) and without (GDM-) and to assess the association with offspring growth. The hypothesis is that the eCBome of GDM+ human milk is altered and associated with a difference in infant growth.
METHODS
Circulating eCBome mediators were measured by LC-MS/MS in human milk obtained at 2 months postpartum from GDM+ (n=24) and GDM- (n=29) women. Infant weight and height at 2 months were obtained from the child health record. Z-scores were calculated.
RESULTS
Circulating Npalmitoylethanolamine (PEA) was higher in human milk of GDM+ women than in GDM- women (4.9 ± 3.2 vs. 3.3 ± 1.7, p=0.04). Higher levels were also found for several 2monoacyl-glycerols (2-MAGs) (p<0.05). The levels of NAEs (β=-4.6, p=0.04) and especially non-omega-3 NAEs (B=-5.6, p=0.004) in human milk were negatively correlated with weight-for-age z-score of GDM+ offspring.
CONCLUSION
The profile of eCBome mediators in human milk at 2 months postpartum was different in GDM+ compared to GDM- women and was associated with GDM+ offspring growth at 2 months.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier (NCT04263675 and NCT02872402).
Topics: Humans; Endocannabinoids; Milk, Human; Female; Pregnancy; Diabetes, Gestational; Infant, Newborn; Adult; Cross-Sectional Studies; Male; Infant; Child Development
PubMed: 38938519
DOI: 10.3389/fendo.2024.1415630 -
JACC. Advances Dec 2023Recent evidence has shown that reproductive factors are associated with an increased risk of heart failure with preserved ejection fraction in women. However, the...
BACKGROUND
Recent evidence has shown that reproductive factors are associated with an increased risk of heart failure with preserved ejection fraction in women. However, the pathogenic pathways underlying this relationship are unclear. Subclinical myocardial fibrosis has been found to be a common pathway in a large proportion of patients with heart failure with preserved ejection fraction.
OBJECTIVES
This study examined the relationship between vital reproductive factors (parity, pregnancy, age at menopause, and use of hormone replacement therapy [HRT]) with interstitial myocardial fibrosis (IMF) and myocardial scar measured by cardiac magnetic resonance imaging (CMR) T1 mapping and late gadolinium enhancement, respectively.
METHODS
There were 596 female participants (mean age 67 ± 8 years) enrolled in MESA (Multi-Ethnic Study of Atherosclerosis) who had complete parity data and underwent CMR. Parity was categorized as 0 live births, 1 to 2, 3 to 4, and ≥5 live births. Multivariable regression models were constructed to assess the associations of parity status, history of null gravidity, age at menopause and HRT with CMR obtained measures of IMF (extracellular volume [ECV], native-T1 time) and myocardial scar.
RESULTS
Women with a history of nulliparity had greater ECV% (β = 0.95 ± 0.28, = 0.001) and native-T1 ms (β = 10.6 ± 4.9, = 0.03) than those who had 1 to 2 live births. These associations were independent of age, traditional cardiovascular risk factors, and interim cardiovascular events. Similar associations were found for women with a history of null gravidity compared to those with a history of pregnancy (ECV% [β = 0.7 ± 0.3, = 0.02] and native-T1 ms [β = 10.6 ± 5.2, = 0.04]). There was no association between age at menopause and HRT with markers of IMF. There were no associations between parity status, null gravidity, and age of menopause with the presence of myocardial scar; however, those who used HRT were independently associated with a lesser risk of myocardial scar (OR: 0.20; 95% CI: 0.05-0.82).
CONCLUSIONS
In a multiethnic cohort, women with a history of nulliparity or null gravidity had greater IMF defined by CMR, while those who used HRT were less likely to have myocardial scar.
PubMed: 38938498
DOI: 10.1016/j.jacadv.2023.100703 -
JACC. Advances Dec 2023
PubMed: 38938492
DOI: 10.1016/j.jacadv.2023.100698