Normal Pregnancy Group Research Articles

Serum Vitamin D Biomarkers in Pregnant Women with Preeclampsia: A Prospective Pilot Study

Background: It has been suggested that hypovitaminosis D is associated with the development of preeclampsia. This study aimed to study the relationship between preeclampsia and various vitamin D serum biomarkers including 25-hydroxyl vitamin D [25(OH)D], vitamin D-binding protein (VDBP), and bioavailable and free 25(OH)D. Methods: This prospective study was conducted with 17 patients with preeclampsia and 38 normal pregnant women as the control group. Total serum 25(OH)D and VDBP concentrations were measured. The levels of bioavailable 25(OH)D and free 25(OH)D were also calculated. Two single nucleotide polymorphisms (rs4588 and rs7041) of the GC gene encoding VDBP were analyzed. Results: VDBP was significantly increased in the preeclampsia group compared to the normal pregnancy group (454.2 vs. 403.4 ng/mL; p = 0.036). When the preeclampsia patients were analyzed by dividing them into early-onset and late-onset, there was no significant difference in the serum vitamin D biomarkers levels. Also, when preeclampsia patients were classified into three subgroups of <2 days, 2–7 days, and >7 days from diagnosis to delivery, free 25(OH)D concentrations were significantly increased in the 2–7 days subgroup compared to the other subgroups (3.5 vs. 6.6 vs. 3.1 pg/mL; p = 0.032). The GC genotype and allele frequency showed no statistically significant different distribution between the preeclampsia and normal pregnancy groups. Conclusions: In the present study, the serum VDBP levels were significantly higher in the patients with preeclampsia than in the normal pregnancy group. Thus, among various serum vitamin D biomarkers, increased VDBP could be associated with the onset and pathogenesis of preeclampsia.

Evaluation of Urinary Calcium–Creatinine Ratio for Early Prediction of Preeclampsia

Background: Preeclampsia (PE) is one of the most important hypertensive disorders in pregnancy. It is one of the fatal complications with significant mortality and morbidity. Incidence of preeclampsia is around 5-10% of all pregnancies, and in developing countries like Bangladesh it is around 4-18%. Objective: The objective of this study was to determine the efficacy of urinary calcium-creatinine ratio in a spot urine sample for early prediction of preeclampsia in pregnant women. Methods: It's a cross sectional type of analytical study, done in the department of Obstetrics & Gynaecology, Sir Salimuilah Medical College Mitford Hospital, Dhaka. After fulfilling inclusion and exclusion criteria total 100 pregnant women with risk factors of preeclampsia were enrolled as the study population. Results: Among different parameters serum calcium concentration of normal pregnancy and preeclampsia group varied significantly (p<0.05). Women with preeclampsia showed reduced excretion of calcium in comparison to normal pregnant women when spot urinary calcium concentration was evaluated. In this study comparison of spot urinary calcium-creatinine ratio in normal pregnant woman and in preeclamptic women was done and the result was highly significant (p <0.001). Conclusion: This study is intended to identify at risk patients and put selection criteria for primary prevention to reduce morbidity and mortality in patients of preeclampsia. It showed lower urinary calcium excretion and calcium-creatinine ratio in preeclamptic women than normotensive pregnant women. Therefore, a single random urinary calcium-creatinine may be an effective tool for the early diagnosis of preeclampsia.

Comparison of Perinatal, Newborn, and Audiometry Results of COVID-19 Pregnant Women

Objective There are studies on the perinatal outcomes of COVID-19, but the audiometric effects of the maternal immune system against COVID-19 in the newborn are not clear. In this study, we aimed to investigate the relationship between the perinatal outcomes of COVID-19 positive pregnant women and the audiological outcomes of newborns. Materials and Methods This retrospective, single-center cohort study was conducted with 65 polymerase chain reaction (PCR) positive pregnant women and newborns and 66 normal pregnant women and newborns who were admitted between January 2020–December 2021. Pregnancy data, perinatal outcomes, and newborn hearing test results of pregnant women and newborns were recorded and compared. Results A total of 131 patients were enrolled in the study. The number of normal pregnant women was 66 (50.4%) and the number of pregnant women who had COVID-19 disease was 65 (49.6%). In general, gestational week, age, parity, biochemical parameters, duration of hospital stay, week of delivery, fetal weight, and apgar scores were compared between pregnant women with COVID-19 and normal. White blood cell (WBC), neutrophil, aspartate aminotransferase (AST), and C-reactive protein (CRP) parameters were found to be significantly higher, and lymphocyte and neutrophil/lymphocyte (N/L) ratios were significantly lower (p < 0.05). There was no statistically significant difference between the two groups (χ2=0.001; p = 1,000). The normal delivery status, the normal delivery rate in patients with COVID-19 was found to be statistically significantly higher than the cesarean section delivery status (p = 0.012). In the statistical comparison between the COVID-19 and normal pregnant groups in the cesarean section group, the gestational week, delivery week, and apgar1 scores of the pregnant women with COVID-19 were found to be significantly higher. There was no statistically significant difference between the distributions of the rate of infants with hearing impairment in the comparison with hearing tests in pregnant women with COVID-19 (n=1) and normal pregnant women (n=1) (χ2=0.001; p = 1,000). Conclusion Although the negative effects of COVID-19 on pregnancy outcomes are rare, it was determined that there was no increased audiological risk factor, and the most important predictor of COVID-19 was lymphopenia.

Effects of Vitamin E in Hypertensive Disorder of Pregnancy and Its Outcomes

Objective: To investigate the effects of vitamin E in Hypertensive Disorder of Pregnancy and the effects of vitamin E in Pregnancy Outcomes in Hypertensive Disorder of Pregnancy. Study Design: Prospective Cohort Study Materials and Method Data source: A total of 1910 pregnant women visited to the OPD and admitted in the Obstetrics and Gynecology Department of the First Affiliated Hospital of Dali University in Yunnan Province from June 2017 to May 2018 fulfilling the inclusion criteria were included in our study group. Case selection: All the pregnant women between the ages 23 to 35 years were included in the study and were divided into four groups: Normal pregnant group, gestational hypertension group, Pre-eclampsia group, and severe Pre-eclampsia group. Control group: Normal pregnant women were included in this group. Statistical Method: This study was performed prospectively and collected data were statistically analyzed using SPSS software (version 20.0) using independent t-test, Pearson Chi-square test, and one-way ANOVA test. The P values considered significant at value P&lt;0.05. The descriptive data were presented using frequency and percentage. Multivariate Logistic regression analysis was conducted to examine the effect of vitamin E in HDP and Pregnancy outcomes including PPH, HIE, Neonatal rescue and 1≤Apgar Score≤7. Results: 1. There was no statistically significant difference in the results of all studies on BMI, WOG in the third trimester, parity, and maternal age (P&gt;0.05). 2. Analysis between the effect of vitamin E and Hypertensive Disorder of Pregnancy: 2.1.1. There was no significant difference between the hypertensive group and control group during pregnancy in vitamin E level (t=1.665 P=0.096) (P&gt;0.05). 2.1.2. The difference between pre-eclampsia and severe pre-eclampsia group was statistically significant in vitamin E level (t=27.692 P=0.000) (P&lt;0.05). 2.2. Analysis between the effect of vitamin E levels and Hypertensive Disorders of pregnancy: 2.2.1. When vitamin E was excess, there was no significant difference between the control group, the gestational HTN group, pre-eclampsia group and severe pre-eclampsia group (X2 =0.164, P=0.983) (P&gt;0.05). 2.2.2. When vitamin E was deficient, the difference between the control group and the hypertensive group during pregnancy was statistically significant (X2 =20.580, P=0.00) (P &lt;0.05). 2.2.3. When vitamin E was deficient, there was no significant difference between the pre-eclampsia group and severe pre-eclampsia group (X2 =0.827, P=0.399) (P&gt;0.05). 3. Effects of vitamin E in Pregnancy Outcomes in Hypertensive Disorders of pregnancy: When vitamin E level was deficient ： In Gestational Hypertension group there is 8.3% occurrence of PPH, 8.3% newborn has HIE. In pre-eclampsia group, there is 10% occurrence of PPH, 5% newborn has HIE, 5% newborn needed neonatal rescue and 5% newborn has 1≤Apgar Score≤7. In severe pre-eclampsia groups there is 5.7% occurrence of PPH, 5.7% newborn has HIE, 5.7% newborn needed neonatal rescue and 2.9% newborn has 1≤Apgar Score≤7. (X2 =2.325, P=0.887) (P&gt; 0.05) There was no significant difference in the incidence of 1≤Apgar Score≤7 and Neonatal rescue between the pre-eclampsia and the severe pre-eclampsia. Conclusion: 1. Vitamin E contents are related to the hypertensive disorder of pregnancy. 2. Vitamin E deficiency is related to the occurrence of hypertensive disorders of pregnancy and has effects on maternal health and fetal outcomes. 3. Serum levels of vitamin E detection during pregnancy can help in the prediction of HOP; hence, it can help to reduce the risk of Pre-eclampsia.

Construction of machine learning tools to predict threatened miscarriage in the first trimester based on AEA, progesterone and β-hCG in China: a multicentre, observational, case-control study

BackgroundEndocannabinoid anandamide (AEA), progesterone (P4) and β-human chorionic gonadotrophin (β-hCG) are associated with the threatened miscarriage in the early stage. However, no study has investigated whether combing these three hormones could predict threatened miscarriage. Thus, we aim to establish machine learning models utilizing these three hormones to predict threatened miscarriage risk.MethodsThis is a multicentre, observational, case-control study involving 215 pregnant women. We recruited 119 normal pregnant women and 96 threatened miscarriage pregnant women including 58 women with ongoing pregnancy and 38 women with inevitable miscarriage. P4 and β-hCG levels were detected by chemiluminescence immunoassay assay. The level of AEA was tested by ultra-high-performance liquid chromatography-tandem mass spectrometry. Six predictive machine learning models were established and evaluated by the confusion matrix, area under the receiver operating characteristic (ROC) curve (AUC), accuracy and precision.ResultsThe median concentration of AEA was significantly lower in the healthy pregnant women group than that in the threatened miscarriage group, while the median concentration of P4 was significantly higher in the normal pregnancy group than that in the threatened miscarriage group. Only the median level of P4 was significantly lower in the inevitable miscarriage group than that in the ongoing pregnancy group. Moreover, AEA is strongly positively correlated with threatened miscarriage, while P4 is negatively correlated with both threatened miscarriage and inevitable miscarriage. Interestingly, AEA and P4 are negatively correlated with each other. Among six models, logistic regression (LR), support vector machine (SVM) and multilayer perceptron (MLP) models obtained the AUC values of 0.75, 0.70 and 0.70, respectively; and their accuracy and precision were all above 0.60. Among these three models, the LR model showed the highest accuracy (0.65) and precision (0.70) to predict threatened miscarriage.ConclusionsThe LR model showed the highest overall predictive power, thus machine learning combined with the level of AEA, P4 and β-hCG might be a new approach to predict the threatened miscarriage risk in the near feature.

THE ASSOCIATION IN SERUM VITAMIN D3 LEVELS IN PATIENTS WITH EARLY PREGNANCY LOSS

AIM: To nd out the association between vitamin D levels in normal pregnancy and pregnancy loss in the rst trimester. METHODOLOGY: -The present study was a hospital based comparative study conducted in 40 pregnant (7-9 weeks) women having pregnancy loss (Group I) and 40 pregnant (7-9 weeks) women having normal pregnancy coming to department of Obstetrics and Gynaecology, SMS medical college and associated hospitals, Jaipur, Rajasthan. The mean Vitamin D3 level in pregnancy loss cases RESULTS: was 17.77±6.56 ng/ml and in normal pregnancy group was 24.85±7.55 ng/ml. So the results showed that the mean Vitamin D3 level was signicantly higher in normal pregnancy group compare to early pregnancy loss cases. Pre CONCLUSION: sent study concluded that vitamin D has a signicant role during pregnancy started from early implantation and decidulization phase till late pregnancy

IRF2BP2 attenuates gestational diabetes mellitus by activating AMPK signaling

Purpose: To investigate the role of interferon regulatory factor 2 binding protein 2 (IRF2BP2) in gestational diabetes mellitus (GDM).&#x0D; Methods: Mice were injected intraperitoneally with streptozotocin to establish a model of GDM and then subjected to intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test (IPITT) to determine glucose and insulin tolerances. Lipid metabolism was evaluated by enzyme-linked immunosorbent assay (ELISA). The histomorphology of pancreatic islets was assessed by hematoxylin and eosin staining.&#x0D; Results: IRF2BP2 was downregulated in pancreatic tissues of mice with GDM (p &lt; 0.001). Mice in GDM group showed higher blood glucose levels than those in normal pregnancy group. However, overexpression of IRF2BP2 reduced glucose and insulin levels in mice with GDM. Overexpression of IRF2BP2 increased the level of high-density lipoprotein (HDL) and reduced triglyceride (TG), total cholesterol (TC), and low-density lipoprotein (LDL) levels in mice with GDM (p &lt; 0.001). The histopathological changes in the islets of mice with GDM were also ameliorated by overexpression of IRF2BP2. Overexpression of IRF2BP2 reduced IL-6, IL-1β, and TNF-α levels and increased protein expression of p-AMPK in mice with GDM.&#x0D; Conclusion: IRF2BP2 ameliorates the outcomes of GDM and suppressed inflammation in mice with GDM through activation of AMPK signaling. Thus, IRF2BP2 is a potential therapeutic strategy for the management of GDM.&#x0D; Keywords: IRF2BP2; inflammation; gestational diabetes mellitus; AMPK; mice; insulin tolerance

The characteristics of antigenic specificity of memory regulatory t cells in women with unexplained recurrent pregnancy loss

Regulatory T cells (Tregs) proliferate after encountering the fetal antigen, which plays an important role in maintaining maternal-fetal tolerance. Activated Tregs increase number and function after antigen encounter and develop memory. Upon subsequent antigen exposure, Treg cells re-expand more rapidly. However, the characteristics of memory regulatory T cells (mTregs) during normal pregnancy and unexplained recurrent pregnancy loss (URPL) have not been elucidated well. In this study, we analyzed the proportion of Tregs and mTregs in the peripheral blood and their surface expression of PD-1, CCR6, and HLA-G in normal non-pregnant (n = 20) and pregnant (n = 20) women, and non-pregnant (n = 20) and pregnant URPL (n = 20) women. We found that the proportions of mTregs in lymphocytes, CD3+ T cells, CD4+ T cells, and Tregs were lower in pregnant URPL patients than in normal pregnant women. The proportions of CD4+CD45RO+ Th cells in lymphocytes, CD3+ T, and CD4+ T cells in the pregnant URPL group were the highest among the four groups (P < 0.05). There were no significant differences among the other three groups (P > 0.05). The proportions of CD4+/CCR6+/mTregs, CD4+/PD-1+/mTregs, CD4+/HLA-G+/mTregs were significantly lower in the non-pregnant normal group and non-pregnant URPL group than in normal pregnant group and pregnant URPL group (P < 0.05, respectively). The proportions of CD4+/CCR6+ mTregs, CD4+/PD-1+/mTregs, CD4+/HLA-G+/mTregs were lower in pregnant URPL group than in normal pregnant group (P < 0.05, respectively). These findings indicate that fetal antigen-specific mTregs play an important role in pregnancy maintenance, and the dysregulation of mTreg may contribute to URPL.

A comparative study on the maternal and foetal outcome between normal and high risk pregnancy patient

Background Pregnancies and deliveries are potentially at risk. Well supervised antenatal, intranatal and postnatal care can reduce this risk to a minimal acceptable level.&#x0D; Objective To find out perinatal outcome of high-risk pregnant patients in comparison with the normal pregnant women and to evaluate the utility of numerical scoring system in identifying high-risk pregnancy.&#x0D; Methods 200 patients were selected from the admitted patients in the obstetric ward of Bangabandhu Sheikh Mujib Medical University, Dhaka. Study patients were divided into three groups: 100 patients (control group) were normal pregnancy (score 0-2), 85 patients were high-risk ( score 3 – 6), and 15 patients were severe-risk (score 7 or more). Both case and control subjects were followed intranatally and postnatally up to the discharge from the above institutions. All types of abnormalities or complications like prolonged ist stage, 2nd stage, APH, PPH and all types of operative and non operative interventions were recorded in order to correlate with perinatal mortality, morbidity and maternal morbidity. Each patient was followed up to discharge from the hospital and abnormalities important for the study were recorded. Neonatal morbidity was defined for surviving newborn by Apgar score &lt;7 at 5 minutes or birth weight &lt; 2.5 kg.&#x0D; Results In normal pregnancy group, 43% needed to be delivered by caesarean section in comparison to 63 (74.1%) and 14 (93.33%) patients respectively in high-risk and severe-risk group (P &lt;0.001). Maternal complication following normal vaginal delivery was highest (100%) in severe-risk group, followed by highrisk group (36.36%) and normal pregnancy (19.30%). Complications following caesarean section were also highest in severe-risk group (28.47%), followed by normal pregnancy (25.59%) and high-risk pregnancy (20.63%). Neonatal complications in normal pregnancy group was 30.23% in comparison 38.46% in high risk group. 6 (6%) of neonates in the normal pregnancy group had Apgar score &lt; 7 at 5 minutes and in high risk and severe-risk groups, 10 (11.76%) and 7 (43.75%) of the neonates respectively had Apgar score &lt;7 at 5 minutes (P &lt; 0.001). In the severe-risk group, 8 (50%) of the babies had birth weight &lt;2.5kg, which is higher than high and normal pregnancy group, i.e. 25 (28.41%) and 3 (3%), respectively(P&lt;0.001). Higher perinatal deaths also occurred in high-risk and severe risk groups.&#x0D; Conclusion It can be concluded that the perinatal morbidity, mortality and maternal morbidity are significantly higher in high-risk pregnancies. This group, though represent only 20-30 percent of all pregnant patients, is responsible for 70-80 percent of the perinatal morbidity and mortality.&#x0D; JBSA 2012; 25(2): 59-65

An Investigation into the Correlation of Intestinal Flora with Obesity and Gestational Diabetes Mellitus.

Method Thirty-two pregnant women aged 25-35 who were hospitalized in Shanxi Maternal and Child Health Hospital from January 2019 to December 2019 were included for evaluation, including 15 normal pregnant women (NG_NO group), 6 pregnant women with GDM alone (G_NO group), and 7 pregnant women with overweight alone (NG_O group). Stools were collected from pregnant women at 24 and 37 weeks of gestation and newborns' first meconium. The v3-v4 variable region of the gut flora 16s rRNA was double-ended sequenced and bioinformatically analyzed using the Illumina MiSeq PE300 sequencing platform. Results In the third trimester of pregnancy, there were significant differences in the composition of intestinal flora between the simple overweight group, simple GDM group, and normal pregnant group. From the second trimester to the third trimester, there was no significant change in the relative distribution of intestinal flora at the phyla classification level in normal pregnant women. The relative distribution of intestinal flora at the phylum level of newborns was significantly different from that of their mothers. The characteristic intestinal microbes of newborns in simple GDM group were g_Diaphorobacter, while the simple recombinant neonates were Nocardiaceae (f_Nocardioidaceae). In addition, the results showed significant differences in intestinal flora among the normal pregnant women group, simple GDM group, simple overweight group, and GDM overweight group. The results of β diversity analysis showed a significant difference in intestinal microflora species composition structure between the simple overweight group and the normal pregnant group in the second trimester of pregnancy. The species composition structure of intestinal flora was similar between the simple GDM group and the normal pregnant group. In the third trimester of pregnancy, there was no significant difference in the β diversity index among the groups, and the composition and structure of intestinal flora were similar. There were significant differences in the composition structure (β diversity) of intestinal flora between pregnant women and their newborns in each group (P < 0.05). Correlation analysis showed that the blood glucose values of oral glucose tolerance test (OGTT)_1 h and OGTT_2 h were positively correlated with Bacteroides (Bacteroides) and negatively correlated with Proteus (Prevotella), prepregnancy BMI was negatively correlated with Bacteroides, and weight gain during pregnancy was negatively correlated with Vibrio (Desulfovibrio) in Proteus. The birth weight of newborns was positively correlated with Actinomycetes (Actinomyces), Bacteroides (Faecalibacterium), and microbacilli (Dialister) and negatively correlated with Rolston (Ralstonia). Conclusion Gut microbiota is strongly linked to obesity and gestational diabetes.

PERBANDINGAN KADAR INTERLEUKIN 6 PADA PERSALINAN PRETERM DAN KEHAMILAN NORMAL

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Preterm labor occurs between 20 weeks and before 37 weeks of pregnancy. It is indicated by regular contractions of the uterus and it may cause the thinning and flattening of the cervix. Preterm labor also causes the high rates of perinatal morbidity and mortality. Increasing levels of interleukin 6 during pregnancy can stimulate the preterm labor. The design of this reseacrh was a comparative cross sectional study. It was conducted in Rasidin District Hospital, Siti Rahmah Hospital and Biomedical Laboratory, Faculty of Medicine, Andalas University, Padang on March to June 2018. There were 50 samples in this reseach. It was selected by consecutive sampling. The samples were divided into two groups: preterm labor and normal pregnancy. The interleukin 6 levels were examined by the ELISA method. Then, the data were analyzed by using the t test. The results of this reseach showed that the mean level of IL-6 in the preterm labor group was 90.22 ± 21.41ng / L. Then, 75.57 ± 14.01 ng / L for the mean level of IL-6 in the normal pregnancy group with p= 0.006. Moreover, statistical test inffered that there were significant differences between IL-6 levels in preterm labor and normal pregnancy. In short, it can be concluded that IL-6 levels in the preterm labor group were higher than normal pregnancy group.&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: IL-6 levels, preterm labor&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Gebeliğin Sonunda Uygulanan Enerji Eksikliğinin Koyun ve Kuzu Doğum Ağırlıkları Üzerine Etkisi

Abstract: This study was carried out in Chios breed pregnant sheep which created experimentally energy deficiency. To determine the effect of low energy feeding on the birth weights of sheep and lambs in the last period of pregnancy. 38 Chios breed sheep, 4-6 years old, were used in the study. The live weight weights of the ewes before the pregnancy were done on the zero day and the other weight weights on the days 120, 127, 134, 141 and 148 of the pregnancy. On the 105th day of pregnancy, pregnant and non-pregnant sheep were divided into 3 groups as normal energy pregnant group (PNE), deficient energy pregnant group (PLE) and non-pregnant normal energy group (N-PNE). From the 106th day of pregnancy to delivery; The pregnant sheep in the PNE group were fed with the ration containing 13% HP and 10 MJ / kg ME, the pregnant sheep in the PLE group were fed with ration containing 13% HP and 8.0 MJ / kg ME. The sheep in the N-PNE group were fed with ration containing 11% HP and 8.8 MJ / kg ME. PLE and N-PNE groups were found to have lower body weight than the PNE group. However, there was no statistical difference between these groups. In all pregnant sheep, body weight was higher than 120 days of pregnancy, it was found to be higher than day 0 (p

Evaluation of placental oxygenation in fetal growth restriction using blood oxygen level-dependent magnetic resonance imaging

IntroductionAbnormalities in placental function can lead to fetal growth restriction (FGR), but there is no consensus on their evaluation. Using blood oxygen level-dependent magnetic resonance imaging (BOLD MRI), we compared placental oxygenation between FGR cases and previously reported normal pregnancies. MethodsEight singleton pregnant women (>32 weeks of gestation) diagnosed with fetal growth failure during pregnancy were recruited. BOLD MRI was consecutively performed under normoxia (21% O2), hyperoxia (100% O2), and normoxia for 4 min each. Each placental time-activity curve was evaluated to calculate the peak score (peakΔR2*) and the time from the start of maternal oxygen administration to the time of peakΔR2* (time to peakΔR2*). In six of the eight FGR cases, placental FGR-related pathological findings were evaluated after delivery. ResultsThe parameter peakΔR2* was significantly decreased in the FGR group (8 ± 3 vs 6 ± 1, p < 0.001), but there was no significant difference in time to peakΔR2* (458 ± 74 s vs 468 ± 57 s, p = 0.750). The findings in the six FGR cases assessed for placental pathologies included chorangiosis in two cases, avascular chorions in two cases, placental infarction in two cases, and syncytial knot formation in one case. DiscussionThe peakΔR2* values were lower in the FGR group than in the normal pregnancy group. This suggests that oxygenation of the placenta is decreased in the FGR group compared to the normal group, and this may be related to FGR. Placental pathology also revealed findings possibly related to FGR, suggesting that low peakΔR2* values in the FGR group may reflect placental dysfunction.

Clinical Application of a Multiparameter-Based Nomogram Model in Predicting Preeclampsia.

Based on single-center data, the related predictive factors of preeclampsia (PE) were investigated, and a nomogram prediction model was established and validated. A retrospective collection of 93 PE patients admitted to our hospital from January 2019 to January 2021 were included in the PE group. In addition, non-PE pregnant women were selected for physical examination during the same period for matching, and 170 normal pregnant women who met the matching conditions were found as the normal pregnancy group. Clinical data of the selected candidates were collected. The risk factors of PE were screened by logistic regression analysis, and the lipopograph prediction model was constructed and verified. Logistic analysis results showed that age (OR = 3.069, 95% CI = 1.233–7.638), prepregnancy BMI (OR = 2.896, 95% CI = 1.193–7.029), vitamin E deficiency (OR = 2.803, 95% CI = 1.134–6.928), 25-(OH)D (OR = 0.944, 95% CI = 0.903∼9.988), PLGF (OR = 0.887, 95% CI = 0.851∼0.924), PAPP-A (OR = 1.240, 95% CI = 1.131∼1.360), and PI (OR = 6.376, 95% CI = 1.163∼34.967) were the independent risk factors for PE prediction (P < 0.05). The ROC curve showed that the AUC of the model for predicting the risk of PE was 0.957 (95% CI: 0.935–0.979), and the specificity and sensitivity were 0.912 and 0.892, respectively. H-L goodness of the fit test showed that there was no statistical significance in the deviation between the actual observed value and the predicted value of the risk in the line graph model (χ2 = 7.001, P=0.536). The bootstrap test was used for internal verification, and the original data were repeatedly sampled 1000 times. The average absolute error of the calibration curve is 0.014, and the fitting degree between the calibration curve and the ideal curve is good. Age, prepregnancy BMI, lack of vitamin E, 25-(OH)D, PLGF, PAPP-A, and PI are independent risk factors for predicting PE. The establishment of a nomogram prediction model based on the above parameters can help identify PE high-risk groups in the early clinical stage and provide a reference for individualized clinical diagnosis and treatment.

Fetal Cerebral Hemodynamic Changes in Preeclampsia Patients by Ultrasonic Imaging under Intelligent Algorithm.

This study was aimed at evaluating the adoption value of ultrasound imaging features on fetal cerebral hemodynamics in preeclampsia patients based on the partial difference algorithm and the hybrid segmentation network (HSegNet) algorithm. Forty pregnant women with preeclampsia diagnosed by ultrasound examination were selected as the research objects, and another forty normal pregnant women were selected as the control. Then, by using the partial differential algorithm, the imaging of fetal cerebral hemodynamics in preeclampsia patients was enhanced and optimized, and the general clinical data and experimental results were collected. The results showed that the automatic labeling of fetal cerebral artery in fetal middle cerebral artery (MCA) hemodynamic images was realized by HSegNet algorithm model, and the final accuracy was 97.3%, which had a good consistency with the manual annotation of doctors. Education level was a protective factor for preeclampsia (odds ratio (OR) = 0.535). Body mass index (BMI) and family history of hypertension during pregnancy were independent risk factors for preeclampsia (OR = 1.286, and 2.774, respectively). MCA end-diastolic volume (EDV) of preeclampsia fetuses was higher than that of normal fetuses. The MCA systolic-diastolic ratio (S/D), the pulsatility index (PI), and the resistive index (RI) in the preeclampsia group were significantly lower than those in the normal pregnancy group. The results showed that MCA PI, MCA RI, and MCA S/D had certain predictive values for the occurrence of adverse pregnancy outcomes (P < 0.05). In summary, the intelligent algorithm-based fetal MCA hemodynamic ultrasound image in the study could effectively predict pregnancy outcomes of patients and provide certain theoretical support for the subsequent reduction of adverse pregnancy outcomes in patients with preeclampsia.

Comparison of Serum Vitamin D Level between Normal Pregnancy and Abortion in Outpatient Settings

Background: Abortion is pregnancy termination or loss before 20 weeks gestation or with a fetus delivered weighing &lt;500 grams. One of the pathogenic mechanisms associated with abortion was immunological factors. The human fetus represents a semi-allograft, which cannot survive without maternal immune tolerance. Vitamin D may be implicated in the risk of miscarriage due to its function as an immune modulator and its potential importance for the maternal-fetal immunologic response&#x0D; Objective: This study aimed to compare the level of serum vitamin D in abortion patients and normal pregnant women.&#x0D; Methods: This is a cross-sectional study using primary data from a private maternity clinic in October 2020-February 2021. The subjects recruited in this study were 98 women at first-trimester pregnancy with either viable gestation (46 subjects) or abortion (52 subjects). Demographic data (maternal age, gestational age, BMI, parity level, history of miscarriage, and occupation) and their association to abortion were determined. The serum 25(OH)D level was measured and then compared using statistical analysis.&#x0D; Results: Mean age of the subjects was 30.45 ± 4.56 years and the mean gestational age of the recruitment was 58.31 ± 17.89 days. Abortion group has lower serum 25(OH)D level (16.95 ± 5,51 mg/L) than normal pregnant group (17.89 ± 4,74 mg/L), although it was not statistically significant (P = 0.527). The results also showed there was no statistically significant association between the classification of vitamin D deficiency, BMI, parity level, history of miscarriage, occupation, and abortion (P &gt; 0.05).&#x0D; Conclusion: In our study, we found that abortion patients had lower vitamin D levels than normal pregnant women, but it was not statistically significant. Abortion also was not associated with BMI, parity level, history of miscarriage, and occupation

Plasma Levels of Vitamin A in Early Pregnancy and Correlationship with Hypertensive Disorder.

Objective. Analyzing the vitamin A content in early pregnancy and finding out the relationship between the serum levels of vitamin A of pregnant women and hypertensive disorder. Method. A total of 4,188 pregnant women who had took part in vitamin A testing in Miyun District Hospital from November 2016 to March 2020 were collected. The serum levels of vitamin A were determined by high performance liquid chromatography, and clinical and testing data were collected for statistical analysis. The original data outcome was finally analyzed with the SPSS. Results. 266 Hypertensive disorder cases and 2836 normal pregnancy cases were analyzed with 27 cases of twin pregnancy, 315 cases without follow-up and 744 of diabetic pregnancies excluded. The 266 women were divided into four groups: 110 women were diagnosed gestational hypertension, 65 women were diagnosed preeclampsia, 78 women were diagnosed pregnancy with chronic hypertension, and 13 women were diagnosed chronic hypertension with preeclampsia. The results shows that vitamin A level of the hypertensive group was 0.46(±0.08) mg/L, 0.47 (±0.012) mg/L, 0.47 (±0.09) mg/L, and 0.52 (±0.012) mg/L, respectively, while the level of normal group was 0.44 (±0.09) mg/L. We found that there were differences between the normal pregnant group and the preeclampsia group with statistical significance (P < 0.05). The difference between the pregnancy with chronic hypertension group and the normal group was statistically significant (P < 0.05). The difference between the chronic hypertension with preeclampsia group and the normal group was also statistically significant (P < 0.05). Conclusion. Serum levels of vitamin A in early pregnant women have a certain correlation with the hypertensive disorder.

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).

TNFα-induced abnormal activation of TNFR/NF-κB/FTH1 in endometrium is involved in the pathogenesis of early spontaneous abortion.

Early spontaneous abortion (ESA) is one of the most common complications during pregnancy and the inflammation condition in uterine environment such as long‐term exposure to high TNFα plays an essential role in the aetiology. Ferritin heavy chain (FTH1) is considered to be closely associated with inflammation and very important in normal pregnancy, yet the underlying mechanism of how TNFα induced abortion and its relationship with FTH1 remain elusive. In this study, we found that TNFα and FTH1 were positively expressed in decidual stromal cells and increased significantly in the ESA group compared with the normal pregnancy group (NP group). Besides, TNFα expression was positively correlated with FTH1 expression. Furthermore, in vitro cell model demonstrated that high TNFα could induce the abnormal signals of TNFR/NF‐κB/FTH1 and activate apoptosis both in human endometrium stromal cells (hESCs) and in local decidual tissues. Taken together, the present findings suggest that the excessive apoptosis in response to TNFα‐induced upregulation of FTH1 may be responsible for the occurrence of ESA, and thus provide a possible therapeutic target for the treatment of ESA.

Levothyroxine treatment for subclinical hypothyroidism improves the rate of live births in pregnant women with recurrent pregnancy loss: a randomized clinical trial

Objective: This study aimed to assess whether the use of levothyroxine was beneficial in pregnant women with subclinical hypothyroidism (SCH) or women who were positive for thyroid peroxidase antibody (TPOAb+). Study design: This was a randomized clinical trial involving 1736 populations of pregnant women. Our study was conducted into two groups: normal pregnant group and recurrent pregnancy loss (RPL) pregnant group. Both patients were divided into SCH and TPOAb+ groups, respectively; the patients of four groups were randomized into either the L-T4 treatment or control groups. Results: There was no significant difference between the two groups in the prevalence of SCH and TPOAb+ (p > .05); The live births rate of normal pregnant group was higher than that of the RPL pregnant Group (79.5% vs. 70.8%, p < .05); Considering normal pregnant women, whether women who were TPOAb + or SCH, there was no significant difference between the treatment and control group in the live birth rate and the pregnancy loss rate. In RPL group, whether women who were TPOAb + or SCH, L-T4 treatment can obtain higher live birth rate and lower abortion rate compared to the control. Conclusion: There was no significant difference between normal and RPL pregnant women in the prevalence of SCH and TPOAb+.Treatment with L-T4 decreased the risk of pregnancy loss and increased the live birth rate in RPL pregnant women who were positive for TPOAb or subclinical hypothyroidism. Levothyroxine therapy is recommended for SCH and TPOAb + women in pregnant women with recurrent pregnancy loss.