Abnormal Pregnancy History Research Articles

Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR)

ObjectiveThis study aimed at developing an available predictive model of singleton pregnancies with fetal growth restriction (FGR) for accurate and individualised prognosis assessment.MethodsThe prediction nomogram was developed by using multivariable...

Role of continuing regular follow-up of serial B-human chorionic gonadotropin measurements with health education following initial surgical management of complete molar pregnancy cases

Objective: Our goal to confirm complete cure, early detection of persistent gestational trophoblastic disease and more effective and less complex treatment. Methods: Fifty-one patients from 12,960 were admitted to the Department of Obstetrics and Gynecology at Tobruk Medical Center between August 2018 and July 2021 with complete molar pregnancy, the diagnosis was confirmed with histopathology after initial surgical management. Following identification of these patients, due to lack of registration centers, the patient's telephone was required to complete the data for continuing regular follow-ups over a period of time these patients were evaluated prospectively according to their age, number of deliveries, history of normal and abnormal pregnancy, the quantity of beta-human chorionic gonadotropin (B-HCG) at the time of diagnosis and follow-up and treatment type. Persistent gestational trophoblast disease was diagnosed on the basis of a rise of B-HCG after initial evacuation, and just one patient in our study diagnosed with invasive mole and underwent second evacuation and none of these patients developed choriocarcinoma during the follow-up period. Analysis was conducted by using the social package of statistical science (SPSS) version 25 software. Results: 51 patients (0.39%) were diagnosed with complete molar pregnancy (CMP), the mean age was 31.90 (8.169) years range (17-47 years). Among 51 patients with CMP over three years, seventeen patients (33.3%) were diagnosed with persistent gestational trophoblast disease (PGTD), the incidence is about 1.3 per 1000 per deliveries, thirty-four patients (66.7%) reached spontaneous remission of molar gestation in a median time of 61 days and had a total follow-up time of 24 months. Conclusion: Follow-up women with complete molar pregnancy especially after initial management is challenging task as the incidence of molar pregnancy increasing and exposed to the risk of developing persistent gestational trophoblastic disease, and there are no specialist centres for documentation and surveillance programme. And due to wide geographical area in Libya and difficulty in the follow-up patients with molar pregnancies, especially after initial treatment has been performed. Therefore, we must create multiple centers throughout the country to cover all cases as much as possible and the communication between the patients and centers via internet, to ensure early detection of pregnancy complications.

Characteristics and clinical evaluation of X chromosome translocations

BackgroundIndividuals with X chromosomal translocations, variable phenotypes, and a high risk of live birth defects are of interest for scientific study. These characteristics are related to differential breakpoints and various types of chromosomal abnormalities. To investigate the effects of X chromosome translocation on clinical phenotype, a retrospective analysis of clinical data for patients with X chromosome translocation was conducted. Karyotype analysis plus endocrine evaluation was utilized for all the patients. Additional semen analysis and Y chromosome microdeletions were assessed in male patients.ResultsX chromosome translocations were detected in ten cases, including seven females and three males. Infantile uterus and no ovaries were detected in case 1 (FSH: 114 IU/L, LH: 30.90 mIU/mL, E2: < 5.00 pg/ml), and the karyotype was confirmed as 46,X,t(X;22)(q25;q11.2) in case 1. Infantile uterus and small ovaries were both visible in two cases (FSH: 34.80 IU/L, LH: 17.06 mIU/mL, E2: 15.37 pg/ml in case 2; FISH: 6.60 IU/L, LH: 1.69 mIU/mL, E2: 23.70 pg/ml in case 3). The karyotype was detected as 46,X,t(X;8)(q13;q11.2) in case 2 and 46,X,der(X)t(X;5)(q21;q31) in case 3. Normal reproductive hormone levels and fertility abilities were found for cases 4, 6 and 7. The karyotype were detected as 46,X,t(X;5)(p22.3;q22) in case 4 and 46,X,der(X)t(X;Y)(p22.3;q11.2) in cases 6 and 7. These patients exhibited unremarkable clinical manifestations but experienced a history of abnormal chromosomal pregnancy. Normal phenotype and a complex reciprocal translocation as 46,X,t(X;14;4)(q24;q22;q33) were observed in case 5 with a history of spontaneous abortions. In the three male patients, multiple semen analyses confirmed the absence of sperm. Y chromosome microdeletion and hormonal analyses were normal. The karyotypes were detected as 46,Y,t(X;8)(q26;q22), 46,Y,t(X;1)(q26;q23), 46,Y,t(X;3)(q26;p24), respectively.ConclusionsOur study provides insights into individuals with X chromosome translocations. The clinical phenotypes are variable and unpredictable due to differences in breakpoints and X chromosome inactivation (XCI) patterns. Our results suggest that physicians should focus on the characteristics of the X chromosome translocations and provide personalized clinical evaluations in genetic counselling.

Maternal isolated hypothyroxinemia in the first trimester is not associated with adverse pregnancy outcomes, except for macrosomia: a prospective cohort study in China.

Insufficient thyroid hormone levels during pregnancy, especially in the first trimester, adversely affect maternal and fetal health. However, the impact of isolated hypothyroxinemia (IH) on adverse pregnancy outcomes remains controversial. Therefore, this study aimed to investigate the association between IH during the first trimester and adverse pregnancy outcomes. This prospective cohort study included 1236 pregnant women. Thyroid-stimulating hormone and free thyroxine levels were measured before 13 weeks of gestation. Logistic regression analysis and the Cochran-Armitage trend test were used to assess the association between IH in the first trimester and adverse pregnancy outcomes. IH during the first trimester was associated with an increased risk of macrosomia. After adjusting for confounding factors, including age, body mass index, parity, abnormal pregnancy history, fasting blood glucose, and total cholesterol, multivariate logistic regression analysis showed that IH in the first trimester remained an independent risk factor for macrosomia. In addition, the risk of macrosomia increased with IH severity. However, no significant relationship was found between IH during the first trimester and gestational diabetes mellitus, hypertensive disorders of pregnancy, spontaneous abortion, premature rupture of membranes, placental abruption, oligohydramnios, premature delivery, fetal distress, or low birth weight. IH during the first trimester did not increase the risk of adverse pregnancy outcomes, except for macrosomia.

A nomogram prediction model for early death in patients with persistent pulmonary hypertension of the newborn.

Persistent pulmonary hypertension of the newborn (PPHN) is a major lethal disorder in neonates that leads to an extremely high mortality rate. Thus, the early identification of adverse outcomes in PPHN is critical for clinical practice. This research attempted to develop a nomogram prediction system for assessing the mortality of newborns with PPHN. Two hundred and three newborns with PPHN diagnosed from January 2015 to March 2022 were involved in the study. The clinical features of these newborns and pregnancy details were compared between newborns in the survival and lethal groups. Univariable and multivariate analyses were established in sequence to demonstrate the essential risk factors. The nomogram prediction model was built. A total of 203 newborns were included in the analysis. 136 (67.0%) newborns represented the hospital survival group. Plasma pH value (OR = 0.606, p = 0.000, 95% CI 0.45715-0.80315), septicemia (OR = 3.544, p = 0.000, 95% CI 1.85160-6.78300), and abnormal pregnancy history (OR = 3.331, p = 0.008, 95% CI 1.37550-8.06680) were identified as independent risk factors for neonatal death in newborns associated with PPHN. Finally, the nomogram predictive model was established based on multivariate analysis results, indicating the efficacies of prediction and calibration. This study generated an applicable risk score formula using the plasma pH value, septicemia, and abnormal pregnancy history to recognize neonatal death in newborns with PPHN, presenting a sufficient predictive value and calibration.

Fetal umbilical artery thrombosis: prenatal diagnosis, treatment and follow-up

BackgroundTo analyze the ultrasound imaging and clinical characteristics of fetuses with umbilical artery thrombosis (UAT), explore the potential causes of UAT and construct a prognostic prediction model to guide clinical practice.MethodsThis was a retrospective cohort study of fetal UAT cases examined at two academic tertiary referral care centers from 2014 to 2020. The basic information of the participants was obtained by interview during follow-up, and data on clinical treatment, delivery conditions, diagnosis and confirmation were obtained through medical records. Probable causes of thrombosis were explored by comparative analysis of the UAT group to the control group and by further regression analysis. Multivariable logistic regression models were used to evaluate risk factors for adverse pregnancy outcomes. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of the prognostic prediction model.ResultsThirty fetuses with UAT were included in this study. UAT occurred mostly in the third trimester of pregnancy, and there was an obvious predominance of right UAT. An abnormal pregnancy history (53.3%) was the most common comorbidity, followed by gestational diabetes mellitus (GDM) (20.0%). GDM and umbilical cord (UC) abnormalities were found to be independent risk factors for the development of UAT. After comprehensive decision-making, over two-thirds of the patients with UAT received urgent treatment, and less than one-third received expectant management. Surprisingly, there were no significant differences in fetal outcomes between the urgent treatment and expectant management groups. Multivariate logistic regression analysis showed that gestational age (GA) at clinical diagnosis and UC abnormalities were independent risk factors for adverse pregnancy outcomes (OR 0.781, p = 0.042; OR 16.779, p = 0.023, respectively). Based on this, we constructed a comprehensive prognostic prediction model. The area under the ROC curve (AUC) was 0.877 (95% CI 0.698–0.970; p < 0.001), which suggested that the combination of GA and UC abnormalities was a better predictor for fetal outcomes in our setting.ConclusionIn summary, maternal GDM and fetal UC abnormalities are independent risk factors for UAT. UAT is more frequently observed on the right side. Moreover, poor clinical outcomes for fetuses with UAT are ascribed mainly to GA and UC abnormalities, which should be comprehensively evaluated to choose the appropriate treatment.

Preventive effect of one-day outpatient health management on adverse pregnancy outcomes in patients with gestational diabetes mellitus: a retrospective cohort study.

BackgroundOne-day outpatient health management has been applied to treat gestational diabetes mellitus (GDM) and prevent further complications. However, the relationships between one-day outpatient health management and adverse pregnancy outcomes remain ambiguous, because of limited evidence. We analyzed the effects of one-day outpatient health management on premature birth, macrosomia and low-birth-weight infants in patients with GDM.MethodsWe retrospectively enrolled pregnant women with GDM who delivered at Guiyang Maternal and Child Health Hospital between 2019 and 2021. Patients could voluntarily choose to participate in either the general outpatient health education or a one-day outpatient health management. Data on demographic and clinical characteristics were collected and pregnancy outcomes ascertained. Logistic regression analysis was used to detect the potential relationship between one-day outpatient health management and adverse pregnancy outcomes including preterm birth, macrosomia, and low-birth-weight infants. GDM, preterm birth, low birth weight and macrosomia was diagnosed according to the criteria established by Obstetrics and Gynecology (9th edition).ResultsA total of 3,249 patients with GDM were included, and 798 (24.56%) patients participated in the one-day outpatient health management. Statistically significant differences were observed in the maternal age (P<0.05) and gravidity (P<0.001) between the study and control groups. The incidences of premature birth, low-birth-weight infant, and macrosomia in patients attending the one-day outpatient service were 9.6%, 8.1%, and 4.5%, while the incidences of those who did not attend the one-day outpatient service were 12.4%, 11.1%, and 7.5%. After adjusting for maternal age, ethnic groups, body mass index (BMI) before pregnancy, family history of diabetes, history of abnormal pregnancy, history of polycystic ovary syndrome, gravidity, hyperthyroidism and hypothyroidism, multivariate logistic regression analyses showed that this one-day outpatient health management was a protective factor for premature birth [odds ratio (OR) 0.751, 95% confidence interval (CI): 0.576–0.981], macrosomia (OR 0.567, 95% CI: 0.385–0.834) and low-birth-weight infants (OR 0.699, 95% CI: 0.522–0.937).ConclusionsThe degree of acceptance of patients with GDM to a one-day outpatient health management is still low. This one-day outpatient health management may reduce the incidence of adverse pregnancy outcomes in women with GDM to a certain extent.

Application of thromboelastography in diagnosing normal pregnancies and pregnancies with complications.

BackgroundThis observational study aimed to compare the potential application of thromboelastography (TEG) in diagnosing women with normal pregnancy (NP) and women with threatened abortion (TA), missed abortion (MA), embryo arrest (EA), fetal death (FD), history of abnormal pregnancy (HAP), and antiphospholipid antibody syndrome (AA).MethodsAccording to the relevant clinical criteria, patients were divided into groups, and their blood samples were subjected to TEG. Next, the parameters R, K, α‐angle, MA, LY‐30, G, and coagulation index (CI) were analyzed. Partial correlation analysis was used to analyze correlation between groups of data. LSD‐t test and Dunnett's T3 test were used to analyze continuous variables. Ordinal categorical variables were compared using ordinal logistic regression analysis and estimate odds ratio of risk factors. A receiver operating characteristic (ROC) curve was constructed to detect the ability of TEG to recognize various parameters, and areas under the curve were compared using Delong's test for diagnosing pregnancy‐related diseases.ResultsMA had a negative effect on the MA parameter in TEG; EA had a negative effect on the MA and G parameters; HAP had a negative effect on the CI parameter and a positive effect on the R parameter; AA had a negative effect on the CI parameter. Compared with that of the NP group, the G of the EA (p = 0.014) group and the CI of the TA (p = 0.036) MA (p = 0.08) EA (p = 0.026) HAP (p = 0.000004) and AA (p = 0.002) groups were reduced. In the ordinal logistic regression analysis, compared with that of the NP group, the high R value of the HAP group accounted for more than that of the NP group (OR = 48.76, p = 0.001); the high K value of the AA group accounted for more than that of the NP group (OR = 17.00, p = 0.023); the angle value distributions of the TA and AA groups were different from that of the NP group (OR = 3.30, p = 0.039; OR = 0.14, p = 0.029); the low MA value of the MA, EA, and HAP groups accounted for more than that of the NP group (OR = 0.16, p = 0.03; OR = 0.26, p = 0.005; OR = 0.11, p = 0.008); and the low CI value of the HAP group accounted for more than that of the NP group (OR = 0.09, p = 0.005). In the ROC analysis, there were no significant differences in the TEG parameters of pregnant women belonging to the NP and TA, NP and MA, NP and EA, NP and FD, NP and HAP, and NP and AA groups (p > 0.05).

Predicting the Risk of Microtia From Prenatal Factors: A Hospital-Based Case-Control Study

BackgroundAlthough a wide range of risk factors for microtia were identified, the limitation of these studies, however, is that risk factors were not estimated in comparison with one another or from different domains. Our study aimed to uncover which factors should be prioritized for the prevention and intervention of non-syndromic microtia via tranditonal and meachine-learning statistical methods.Methods293 pairs of 1:1 matched non-syndromic microtia cases and controls who visited Shanghai Ninth People's Hospital were enrolled in the current study during 2017-2019. Thirty-nine risk factors across four domains were measured (i.e., parental sociodemographic characteristics, maternal pregnancy history, parental health conditions and lifestyles, and parental environmental and occupational exposures). Lasso regression model and multivariate conditional logistic regression model were performed to identify the leading predictors of microtia across the four domains. The area under the curve (AUC) was used to calculate the predictive probabilities.ResultsEight predictors were identified by the lasso regression, including abnormal pregnancy history, genital system infection, teratogenic drugs usage, folic acid supplementation, paternal chronic conditions history, parental exposure to indoor decoration, paternal occupational exposure to noise and maternal acute respiratory infection. The additional predictors identified by the multivariate conditional logistic regression model were maternal age and maternal occupational exposure to heavy metal. Predictors selected from the conditional logistic regression and lasso regression both yielded AUCs (95% CIs) of 0.83 (0.79–0.86).ConclusionThe findings from this study suggest some factors across multiple domains are key drivers of non-syndromic microtia regardless of the applied statistical methods. These factors could be used to generate hypotheses for further observational and clinical studies on microtia and guide the prevention and intervention strategies for microtia.

An Analysis on the Factors for Cervical Insufficiency Causing Adverse Emotions Among Pregnant Women at Different Gestation Phases.

BackgroundTo analyze the anxiety, depression, and related factors among pregnant women with cervical insufficiency, so as to provide a reference for clinical psychological intervention as an adjuvant therapy.MethodsA total of 101 cases in China with cervical insufficiency were included in the observation group by a convenience sampling method, and 114 normal healthy women of childbearing age were selected as the control group. Participants were investigated and observed for anxiety and depression by SAS and SDS, respectively, to analyze the emotional state and influencing factors of the patients with cervical insufficiency. Stratified by the first, second and third trimesters, our study used whether depressive or not and whether anxiety or not as the dichotomous variables. A multivariate Logistic regression was adopted to analyze the influencing factors. Relevant influencing factors were screened out by the forward stepwise method in combination with professional knowledge and the number of variables.ResultsThere were statistical significant differences in SAS and SDS between observation group and control group and the incidence rate of anxiety and depression was higher in pregnant women with CI. Multivariate Logistic regression demonstrated that history of abnormal pregnancy was the main influencing factor for anxiety and depression in the early and middle gestation phases, and cervical insufficiency was the factor influencing the anxiety in early gestation and both anxiety and depression in the late gestation phase.ConclusionCervical insufficiency may have a negative impact on the emotions of pregnant women. Individualized and targeted mental care should be added into clinic work to prevent negative outcomes.

Determinants for Perinatal Mortality in South China: A Prospective Cohort Study.

ObjectiveTo estimate the association of selected maternal and fetal characteristics with the risk of perinatal mortality in South China.MethodsA prospective cohort study was conducted from March 2013 to December 2019. The exposures of interest were maternal sociodemographic characteristics, lifestyle and habits during early pregnancy, and complications of pregnancy. Their effects on the development of perinatal death were analyzed in our study.ResultsA total of 44,048 eligible pregnant women were included in the analysis. Of these, 596 fetuses were perinatal deaths (perinatal mortality was 13.5 per 1,000 births). After adjustment, maternal obesity, being employed, history of gestational hypertension, taking antidepressants during early pregnancy, history of gestational diabetes mellitus, gestational diabetes mellitus, infertility drug treatment and assisted reproductive techniques, history of neonatal death, preterm birth, and congenital malformations all significantly increased the risk of perinatal death. Ethnic minority, income > 5,000, multiparous women, and cesarean section associated with reduced risk of perinatal death.ConclusionSome factors of maternal sociodemographic characteristics, abnormal pregnancy history, lifestyle and habits during early pregnancy, and complications of pregnancy were associated with the risk of perinatal death.

The pregnancy-related anxiety characteristics in women with gestational diabetes mellitus: why should we care?

BackgroundGestational diabetes mellitus (GDM) is very commonly-seen in clinical settings, and GDM patients may have higher levels of anxiety. It’s necessary to evaluate the anxiety level and potentially influencing factors in patients with GDM, to provide insights for the management of anxiety of GDM patients.MethodsPatients with GDM treated in our hospital from May, 2018 to May, 2020 were included. We evaluated the characteristics of patients and the scores of pregnancy-related anxiety scale for anxiety level, vulnerable personality style questionnaire (VPSQ) for personality, general self-efficacy scale (GSES) for self-efficacy, social support rating scale (SSRS) for social support level. Logistic regression analyses were conducted to identify the potential influencing factors of anxiety in GDM patients.ResultsA total of 386 GDM patients were included, the incidence of anxiety in patients with GDM was 59.07%. Anxiety was positively correlated with the susceptible personality (r = 0.604, p = 0.023), and it was negatively correlated with self-efficacy and social support (r = -0.586 and -0.598 respectively, all p < 0.05). The education level, monthly income, abnormal pregnancy (miscarriage, premature rupture of membranes) and cesarean section history and first pregnancy were the independent influencing factors for the anxiety in the patients with GDM (all p < 0.05).ConclusionsThe anxiety of GDM patients is very common, early care and interventions are warranted for those patients with abnormal pregnancy and cesarean section history, first pregnancy, lower education level, and less monthly income.

Copy number variation sequencing combined with quantitative fluorescence polymerase chain reaction in clinical application of pregnancy loss.

In this study, we evaluated the feasibility of the combining CNV-seq and quantitative fluorescence polymerase chain reaction (QF-PCR) for miscarriage analysis in clinical practice. Over a 35-month period, a total of 389 fetal specimens including 356 chorionic villi and 33 fetal muscle tissues were analyzed by CNV-seq and QF-PCR. Relationships between the risk factors (e.g., advanced maternal age, abnormal pregnancy history, and gestational age) and incidence of these chromosomal abnormalities were further analyzed by subgroup. Clinically significant chromosomal abnormalities were identified in 58.95% cases. Aneuploidy was the most common abnormality (46.84%), followed by polyploidy (8.16%) and structural chromosome anomalies (3.95%). In sub-group analysis, significant differences were found in the total frequency of chromosomal abnormalities between the early abortion and the late abortion group, as well as in the distribution of chromosomal abnormalities between the advanced and the younger maternal age group. Meanwhile, the results of the logistic regression analysis identified a trend suggesting that the percentage of fetal chromosomal abnormalities is significantly higher in advanced maternal age, lesser gestational age, and lesser number of prior miscarriages. Our study suggests that CNV-seq and QF-PCR are efficient and reliable technologies in the fetal chromosome analysis of miscarriages and could be used as a routine selection method for the genetic analysis of spontaneous abortion.

Epidemiology and perinatal risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture

Objective To investigate the incidence and risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture. Methods Live born infants, including those diagnosed with neonatal asphyxia, were recruited from 16 different hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture from January to December of 2016. The 16 hospitals included four grade A tertiary hospitals (three general hospitals and one traditional Chinese medicine hospital) and 12 grade A secondary hospitals (eight general hospitals, one maternal and child health hospital and three traditional Chinese medicine hospitals). A retrospective investigation was conducted using questionnaire to analyze the basic information, perinatal risk factors and prognosis of those infants. Chi-square test was used for statistical analysis. Results Among 22 294 recruited live born infants, 733 (3.29%) were diagnosed with neonatal asphyxia on discharge, including 627 (85.54%) mild cases and 106 (14.46%) severe cases. And neonatal asphyxia resulted in deaths of 27 cases (3.68%). The risk factors for neonatal asphyxia included multiple pregnancy, pregnancy conceived with assisted reproductive technology, premature infant, low birth weight infant, fetal malposition, congenital malformation, male infant, born during transfer, mother of Tujia nationality, low educational level (primary school or lower), living in rural area, the number of antenatal visits ≤3, history of early threatened abortion, anemia in pregnancy, hypertensive disorders of pregnancy, chorioamnionitis, abnormal pregnancy history and abnormality of umbilical cord, amniotic fluid or placenta. Conclusions The incidence of neonatal asphyxia in Enshi area is obviously higher than the national average. The main risk factors for neonatal asphyxia in this area are related to maternal background and the living condition of the mother during pregnancy, delivery as well as the newborn at birth. Key words: Asphyxia neonatorum; Incidence; Risk factors; Minority Groups

Genetic predisposition to gestational glucose metabolism and gestational diabetes mellitus risk in a Chinese population.

Genome-wide association studies (GWAS) have identified several genetic variants affecting gestational glucose metabolism. However, information regarding their known associations with gestational diabetes mellitus (GDM) risk remains scarce. This study examined the associations of 12 gestational glucose metabolism-related variants with GDM risk in a Chinese population (964 GDM cases, 1021 controls). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression analysis. Rs10830963 in melatonin receptor 1B (MTNR1B) was found to be associated with an increased risk of GDM, after adjusting for age, prepregnancy body mass index, parity, abnormal pregnancy history, and family history of diabetes (OR 1.20; 95% CI 1.05-1.36; P = 0.007). Compared with women with a family history of diabetes, there was a significant association of rs7936247 with GDM risk among pregnant women without a family history of diabetes (OR 1.20; 95% CI 1.04-1.38; P = 0.014; Pheterogeneity = 0.035). Further functional annotations showed that rs10830963 and rs7936247 fell in the functional elements of human pancreatic islets. Genotype-phenotype associations indicated that the variants may contribute to GDM risk by affecting the expression of nearby or distant genes. The findings of this study suggest that rs10830963 and rs7936247 may be markers for susceptibility to GDM in a Chinese population. Additional studies are warranted to validate our findings and clarify the underlying mechanism.

Association of rs10830962 polymorphism with gestational diabetes mellitus risk in a Chinese population

To date, only three polymorphisms (rs10830962, rs7754840 and rs1470579) are included in the genome-wide association study Catalog (www.ebi.ac.uk/gwas). However, the available evidence is limited in pregnant Chinese women. We aimed to explore the associations of three polymorphisms (rs10830962, rs7754840 and rs1470579) with GDM risk in a Chinese population. We conducted a case-control study (964 GDM cases and 1,021 controls) to evaluate the associations of these polymorphisms with GDM risk. A logistic regression model was used to calculate odds ratios (ORs) and their confidence intervals (CIs). After adjustment for age, prepregnancy BMI, parity, abnormal pregnancy history and family history of diabetes, the minor allele of rs10830962 (C > G) demonstrated a significant association with an increased risk of GDM (OR = 1.16, 95% CI = 1.02–1.31, P = 0.029 in the additive model). However, no significant association was observed between the other two polymorphisms and GDM. Subsequent functional annotation shows that rs10830962 is located in the regulatory elements of pancreatic islets, alters the binding affinity of motifs and regulates SNORA8 expression. Our findings demonstrate that rs10830962 is associated with an increased risk of GDM in the Chinese population. Further functional characterization is warranted to uncover the mechanism of the genotype-phenotype association.

Prevalence of chromosomal abnormalities identified by copy number variation sequencing in high-risk pregnancies, spontaneous abortions, and suspected genetic disorders.

ObjectiveHigh-throughput sequencing based on copy number variation (CNV-seq) is commonly used to detect chromosomal abnormalities including aneuploidy. This study provides evidence for the prevalence of chromosomal abnormalities in target populations.MethodsA total of 160 samples, including 83 high-risk pregnancies, 37 spontaneous abortions, and 40 suspected genetic disorders, were analyzed by CNV-seq. Relationships between the incidence of these chromosomal abnormalities and risk factors (e.g. advanced maternal age, abnormal pregnancy history, and family history of congenital disease) were further analyzed by subgroup.ResultsA total of 37 (44.6%) high-risk pregnancies, 25 (67.6%) spontaneous abortions, and 22 (55%) suspected genetic disorders had chromosomal abnormalities including aneuploidy and CNVs. There was an increased risk association between the prevalence of aneuploidy and pathogenic-relevant CNV in the fetus or abortive tissue and advanced maternal age. Moreover, a family history of congenital disease was also positively correlated with fetal chromosomal abnormalities in high-risk pregnancies.ConclusionA relatively high prevalence of chromosomal abnormalities was detected in high-risk pregnancies, spontaneous abortions, and suspected genetic disorders, indicating the importance of CNV detection in such populations.

Prediction of intima partner violence using administrative data on pregnancy

Background Intimate partner violence (IPV) is one of huge problem worldwide, especially IPV during pregnancy need to be prevented because it leads negative health outcome for both the mother and offspring. However, it is hard to find women who suffer from IPV by health practitioner or public health staff due to stigma or hesitation. Thus, it would be useful if we can detect the possibility of IPV using administrative data on pregnancy. The aim of this study is to develop an algorism to predict IPV during pregnancy using administrative data on pregnancy. Methods We used data of pregnancy record registered at Adachi city, Tokyo, in 2016 fiscal year (n = 6008). The administrative pregnancy record include date of registration, location of health center, type of center where pregnancy record submitted, parity, maternal age, BMI, psychiatric disease, lack of insurance or public aid, week of gestation when pregnancy record submitted, marital status, feeling when recognized pregnancy, multiple pregnancy, twin, teenage pregnancy for first baby, existence of social support, having trouble within family, history of abnormal pregnancy or delivery, having smoker within family, drinking, economic situation. IPV was assessed for the first time interview or other opportunity for further assessment by public health nurse. Multiple logistic regression model was used to predict IPV. Results IPV cases were found for 38 (0.65%) cases. Multiple logistic regression analyses showed that weekend registration, location of health center, parity, young maternal age, psychiatric disease, lack of insurance or public aid, late week of gestation when pregnancy record submitted (20 week or later), single marital status, multiple pregnancy (4 or more), lack of social support, having smoker within family, drinking, severe economic situation showed significant association with IPV. These variables predicted IPV with good predictive power (area under receiver operating characteristic curve = 0.95, 95% confidence interval: 0.92 to 0.98). Conclusion We showed strong predictability of IPV during pregnancy using administrative data on pregnancy record. Current study is useful to prevent deterioration of IPV per se, and further adverse health outcome due to IPV during pregnancy, such as postpartum depression, low birth weight or child maltreatment.

Perbedaan Luaran Maternal dan Perinatal pada Ibu Bersalin Usia Reproduksi Sehat dan Usia Berisiko

The old age mother has a risk to get a complication in pregnancy and parturition much higher than reproductive age mother. According to Yensi study (2015), that of the 226 women giving birth over the age of 35 years, as many as 125 people (55.3%) had a history of abnormal pregnancy. In addition, most of the type of labor is by Sectio Caesarea (SC) a total of 119 (51.7%) and suffered complications as much as 44.7%. This study was to identify differences in maternal and perinatal outcomes between healthy reproductive age and risky age maternal in Cempaka Room, Doctor Doris Sylvanus Regional Public Hospital, Palangkaraya. The study design was case-control, data retrieved by conducting interviews at birth mothers in the Cempaka room dr. Doris Sylvanus Palangkaraya. The research sample consisted of 30 samples of mothers of reproductive age (20-35 years) and 30 samples of old-risk maternal age (&gt;35 years). The Data were taken from September to November 2016. Data were analyzed by Chi-Square, Odds ratio, and logistic regression analysis. The results showed that birth weight babies in reproductive age maternal different from risky age maternal (OR=7, 95% CI=1.4 to 35.5). This means that the risky age maternal has seven times greater to give birth a baby with body weight &lt;2500 g or &gt;4000 g. While maternal and perinatal outcomes on the kind of labor, bleeding, gestation, and asphyxia no difference. The difference of perinatal outcomes in the maternal reproductive age between healthy reproductive age and risky age maternal was of infant birth weight. It was recommended that pregnant women and maternity in the age range of 20-35 years.

Prevalence, risk factors, and neurobehavioral comorbidities of epilepsy in Kenyan children

SummaryObjectiveTo investigate the prevalence, risk factors, clinical features, and neurobehavioral comorbidities of epilepsy and acute symptomatic seizures in school‐aged children in Kilifi, Kenya.MethodsRandomly selected children (N = 11,223) were screened for epilepsy and other neurodevelopmental disorders. Those who screened positive were invited for further clinical, electroencephalographic (EEG), and neuropsychological evaluations. Prevalence was measured by dividing cases by screened population, providing Agresti–Coull confidence intervals (CIs). Prevalence ratios were computed using log binomial regression, and odds ratios (ORs) were computed using logistic regression; both were implemented with generalized linear models. Attention‐deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other neurodevelopmental impairments were assessed in cases and controls.ResultsPrevalence of lifetime epilepsy was 20.9 per 1,000 (95% CI = 18.4–23.7), and that of active epilepsy was 11.5 per 1,000 (95% CI = 9.7–13.6). Prevalence of acute symptomatic seizures was 68.8 per 1,000 (95% CI = 64.2–73.6). Acute symptomatic seizures preceded a diagnosis of epilepsy in 8% of children. Of 98 children diagnosed with epilepsy, focal seizures were seen in 79%, abnormal EEG was seen in 39%, and 83% were not receiving antiepileptic drugs. Childhood absence epilepsy and Lennox–Gastaut epilepsy were the most easily identifiable epilepsy syndromes. Perinatal complications, previous hospitalization, geophagia, and snoring were risk factors for epilepsy. Family history of seizures, abnormal pregnancy, previous hospitalization, and snoring were risk factors for acute symptomatic seizures. Neurobehavioral comorbidities were present in 54% of subjects with lifetime epilepsy and in 3% of controls, with associations for individual comorbidities being statistically significant: ADHD (OR = 14.55, 95% CI = 7.54–28.06), ASD (OR = 36.83, 95% CI = 7.97–170.14), and cognitive impairments (OR = 14.55, 95% CI = 3.52–60.14).SignificanceThe burden of seizure disorders in this area is higher than in locations in high‐income countries, and can be reduced by preventing risk factors. A comprehensive management plan for neurobehavioral comorbidities of epilepsy should be incorporated into standard epilepsy care.