The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians最新文献

{"title":"The effects of placental transfusion on mothers.","authors":"Arpitha Chiruvolu,&nbsp;Emily Estes,&nbsp;Karen C Stanzo,&nbsp;Sujata Desai,&nbsp;Brandon C Cornelius","doi":"10.1080/14767058.2022.2032636","DOIUrl":"https://doi.org/10.1080/14767058.2022.2032636","url":null,"abstract":"<p><strong>Objective: </strong>While there is ample evidence supporting delayed cord clamping (DCC) in neonates, the data on the maternal outcomes related to DCC are relatively sparse. Moreover, the outcomes, such as postpartum hemorrhage (PPH), were mostly reported for uncomplicated term vaginal deliveries. The objective of this study was to present the two primary maternal outcomes, incidence of PPH and change in hematocrit pre- and post-delivery in complex situations of preterm deliveries and term cesarean sections.</p><p><strong>Study design: </strong>Maternal data were collected prospectively since the placental transfusion process was implemented in a step-wise fashion in our delivery hospitals, starting August, 2013. These data on very preterm singleton, moderate preterm, very preterm twin gestation, late preterm deliveries and term cesarean sections with DCC or umbilical cord milking (UCM) were compared with respective retrospective cohorts of deliveries in which immediate cord clamping (ICC) was performed.</p><p><strong>Results: </strong>Comparing very preterm singleton deliveries, the incidence of PPH was similar between the ICC and DCC groups (2.3% vs. 1.7%). There was no significant difference in mean hematocrit change pre- and postdelivery (3.06 ± 1.32 vs. 3.47 ± 1.52). When 45 s DCC cohort was compared with 60 s DCC cohort, there were no significant differences in the incidence of PPH (1.7% vs. 4.8%) or the hematocrit change pre- and postdelivery (3.47 ± 1.52 vs. 4.32 ± 1.88). PPH was not observed in either group when comparing retrospective ICC cohort with prospective DCC cohort with 60 s delay in very preterm twin gestation deliveries. There was no significant difference between the mean hematocrit change pre- and postdelivery (5.5 ± 3.3 vs. 5.8 ± 3.9). When moderate and early late preterm deliveries between 32° to 34⁶ weeks of gestation were compared, there were no differences between the incidence of PPH (0.9% vs. 0%) or hematocrit change pre- and postdelivery (4.2 ± 2.3 vs. 4.8 ± 2.9). Comparing late preterm deliveries between 35° and 36⁶ weeks of gestation, there was no significant difference in the incidence of PPH (13% vs. 11.4%) or the mean hematocrit change pre- and postdelivery (5.0 ± 3.0 vs. 5.1 ± 2.8). In term cesarean deliveries, the incidence of PPH was 2.2% in the retrospective ICC group and 1.4% in the prospective UCM group. There was no difference in mean hematocrit change pre- and postdelivery (5.9 ± 3.7 vs. 6.2 ± 2.8).</p><p><strong>Conclusion: </strong>DCC or UCM was not associated with the increased risk for PPH or significant change in maternal hematocrit pre- and postdelivery in very preterm singleton, moderate preterm, very preterm twin gestation, late preterm deliveries and term cesarean sections.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9356-9361"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39574311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytokines and parturition: investigating adiponectin, TNF-α, and IL-6 in mother-newborn pairs.","authors":"A Flöck,&nbsp;N Ferrari,&nbsp;C Joisten,&nbsp;M T Puth,&nbsp;B Strizek,&nbsp;U Gembruch,&nbsp;W M Merz","doi":"10.1080/14767058.2021.2025356","DOIUrl":"https://doi.org/10.1080/14767058.2021.2025356","url":null,"abstract":"<p><strong>Objective: </strong>Cytokines are reported to be associated with various pregnancy complications and health outcomes of the offspring. However, reference values during pregnancy have not been established, effects of clinical and obstetric factors have not been examined, and interactions between different cytokines have not yet been reported.</p><p><strong>Methods: </strong>In this cross-sectional study, we recruited 120 mother-newborn pairs. Maternal venous blood samples (6 mL) were taken on admission to the labor ward; newborn venous blood samples (6 mL) were drawn from the placental part of the umbilical cord (UC). Adiponectin, TNF-α, and IL-6 serum concentrations were measured by commercial immunoassays. Clinical and obstetric variables were analyzed for their association with maternal and UC cytokine concentrations.</p><p><strong>Results: </strong>Forty-six adiponectin pairs, 55 TNF-α pairs, and 14 IL-6 pairs were available for analysis. Correlation between UC and maternal adiponectin-, IL-6-, and TNF-α levels was low. We found a significant correlation of UC adiponectin with maternal brain-derived neurotrophic factor (BDNF) and maternal adiponectin, and between maternal leptin and maternal TNF-α.</p><p><strong>Conclusions: </strong>Clinical and obstetric variables as well as interactions between cytokines may have an impact on serum concentrations of the respective cytokines in maternal and UC blood. Further studies are required to confirm our findings.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9249-9256"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39613210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrahepatic cholestasis of pregnancy: dilemma in diagnosis and management.","authors":"Deepali Mathur,&nbsp;Marielle Morgan,&nbsp;Jessica McKenzie,&nbsp;Dorothy Wakefield,&nbsp;Mary Beth Janicki,&nbsp;Reinaldo Figueroa","doi":"10.1080/14767058.2021.2008896","DOIUrl":"https://doi.org/10.1080/14767058.2021.2008896","url":null,"abstract":"<p><strong>Objective: </strong>To determine the obstetrical outcomes of women delivered for the diagnosis of intrahepatic cholestasis of pregnancy (ICP).</p><p><strong>Methods: </strong>Retrospective study of singleton pregnancies diagnosed with ICP between 1 May 2014 and 31 December 2017. Population was analyzed based on bile acids: normal (<10 µmol/L), mild (10 to 40 µmol/L), moderate-severe (>40 µmol/L), and not obtained. Receiver operating characteristic curves established critical values for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) to predict elevated bile acids. Statistical analyses included χ² for categorical variables and ANOVA for continuous variables. All tests used a 2-sided α level of significance of .05.</p><p><strong>Results: </strong>Bile acids were normal in 39 (45.9%) women, 30 (35.3%) had mild cholestasis, 10 (11.8%) had moderate-severe cholestasis and not obtained for six (7%) women. Gestational diabetes was more common in mild cholestasis (<i>p</i> = .03). There were no differences in demographics, clinical presentation, obstetric interventions and neonatal outcomes. Bile acids took 5-6 days to result. Rate of labor inductions was high in all groups. Postpartum complications occurred in four women in the normal group and in one woman in the mild cholestasis group. Five (12.8%) neonates in the normal group, six (20%) in the mild group, and one (10%) in the severe group were admitted to the NICU. There was no fetal asphyxia, no 5-minute Apgar score <7, and no perinatal deaths. An AST of 27.5 IU/L (<i>p</i> = .002) with sensitivity of 81% and specificity of 76%, and an ALT of 26.7 IU/L (<i>p</i> = .004) with sensitivity of 78% and specificity of 68% predicted elevated bile acids. Improving the sensitivity of AST and ALT to 95%, the ROC curve identified an AST of 62 IU/L with a specificity, positive and negative predictive values of 32, 58 and 86%, respectively; and an ALT of 106 IU/L with a specificity, positive and negative predictive values of 27, 57 and 83%, respectively.</p><p><strong>Conclusions: </strong>ICP should not be presumed in patients with pruritus. This practice may lead to early term delivery and associated complications.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8975-8981"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39658529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European guidelines on perinatal care- Peripartum care Episiotomy.","authors":"Katariina Laine,&nbsp;Branka M Yli,&nbsp;Vanessa Cole,&nbsp;Christiane Schwarz,&nbsp;Anneke Kwee,&nbsp;Diogo Ayres-de-Campos,&nbsp;Christophe Vayssiere,&nbsp;Emmanuel Roth,&nbsp;Elko Gliozheni,&nbsp;Yuliya Savochkina,&nbsp;Marina Ivanisevic,&nbsp;Vladimir Kalis,&nbsp;Susanna Timonen,&nbsp;Eric Verspyck,&nbsp;Panos Anstaklis,&nbsp;Artur Beke,&nbsp;Beate Horsberg Eriksen,&nbsp;Susana Santo,&nbsp;Gorazd Kavsek,&nbsp;Hans Duvekot,&nbsp;Christian Dadak","doi":"10.1080/14767058.2021.2005022","DOIUrl":"https://doi.org/10.1080/14767058.2021.2005022","url":null,"abstract":"<p><p>OF RECOMMENDATIONS1. Episiotomy should be performed by indication only, and not routinely (<b>Moderate quality evidence +++-; Strong recommendation)</b>. Accepted indications for episiotomy are to shorten the second stage of labor when there is suspected fetal hypoxia <b>(Low quality evidence ++-; Weak recommendation)</b>; to prevent obstetric anal sphincter injury in vaginal operative deliveries, or when obstetric sphincter injury occurred in previous deliveries (<b>Moderate quality evidence +++-; Strong recommendation)</b>2. Mediolateral or lateral episiotomy technique should be used (<b>Moderate quality evidence +++-; Strong recommendation)</b>. Labor ward staff should be offered regular training in correct episiotomy techniques (<b>Moderate quality evidence +++-; Strong recommendation)</b>.3. Pain relief needs to be considered before episiotomy is performed, and epidural analgesia may be insufficient. The perineal skin needs to be tested for pain before an episiotomy is performed, even when an epidural is in place. Local anesthetics or pudendal block need to be considered as isolated or additional pain relief methods (<b>Low quality evidence ++-; Strong recommendation)</b>.4. After childbirth the perineum should be carefully inspected, and the anal sphincter palpated to identify possible injury (<b>Moderate quality evidence +++-; Strong recommendation)</b>. Primary suturing immediately after childbirth should be offered and a continuous suturing technique should be used when repairing an uncomplicated episiotomy <b>(High quality evidence ++++; Strong recommendation)</b>.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8797-8802"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39717060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on the mental health of women seeking treatment for postpartum depression.","authors":"Oswin Chang,&nbsp;Haley Layton,&nbsp;Bahar Amani,&nbsp;Donya Merza,&nbsp;Sawayra Owais,&nbsp;Ryan J Van Lieshout","doi":"10.1080/14767058.2021.2014810","DOIUrl":"https://doi.org/10.1080/14767058.2021.2014810","url":null,"abstract":"<p><strong>Background: </strong>While research has examined the mental health of general population samples of postpartum women during the COVID-19 pandemic, the pandemic's impact on women seeking treatment for postpartum depression (PPD) is not well known. This study compared levels of depression and anxiety, the quality of social relationships, and the temperament of infants of treatment-seeking mothers in Ontario, Canada prior to and during the pandemic.</p><p><strong>Methods: </strong>Mothers with Edinburgh Postnatal Depression Scale scores ≥10 and seeking treatment for PPD prior to COVID-19 (<i>n</i> = 100) were compared to those who sought treatment during the pandemic (<i>n</i> = 120). Mothers self-reported symptoms of depression, worry/anxiety, partner relationship quality, social support, as well as aspects of the mother-infant relationship and infant temperament.</p><p><strong>Results: </strong>There were no statistically significant differences in symptoms of depression, anxiety, or the quality of social relationships between women seeking treatment for PPD before or during the pandemic. However, mothers reported poorer relationships with their infants, and there was evidence of more negative emotionality in their infants during COVID-19.</p><p><strong>Conclusions: </strong>The pandemic may not have worsened depression, anxiety, relationships with partners, or social support in mothers seeking treatment for PPD, but appears to have contributed to poorer mother-infant interactions and maternal reports of more negative emotionality in their infants. These findings highlight the importance of identifying women with possible PPD, supporting mother-infant interactions, and monitoring their infants during COVID-19 and beyond.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9086-9092"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39794951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 16-week sonographic findings in fetuses with increased nuchal translucency and a normal array.","authors":"Li Zhen,&nbsp;Min Pan,&nbsp;Yan-Ting Li,&nbsp;Qun Cao,&nbsp;Li-Li Xu,&nbsp;Dong-Zhi Li","doi":"10.1080/14767058.2022.2040477","DOIUrl":"https://doi.org/10.1080/14767058.2022.2040477","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this prospective study is to evaluate the performance of the intermediate 16-week ultrasound in fetuses with increased nuchal translucency (NT) and a normal chromosomal microarray analysis (CMA).</p><p><strong>Methods: </strong>During a one-year period, a detailed ultrasound was performed at 16 week' gestation for patients with an increased NT (≥3.5 mm) and normal CMA. Pregnancy work-up included a traditional 22-week ultrasound scan, an echocardiography, and the option of a 10-gene Rasopathy panel after a normal 16-week scan. Abnormal findings and pregnancy outcomes were collected and analyzed.</p><p><strong>Results: </strong>In 52 fetuses with an isolated increased NT and normal CMA, 14 (26.5%) were noted to have structural defects on the 16-week ultrasound. Intrauterine fetal death occurred in one (1.9%) case identified by the 16-week scan. Of the remaining 37 cases, six opted for a RASopathy panel. In this group, one case of Noonan syndrome was detected. One case of unilateral duplex kidney had not been found until the 22-week scan. One case of fetal growth restriction was identified in the third trimester. The remaining 34 cases proceeded with normal ultrasound to term.</p><p><strong>Conclusion: </strong>The 16-week ultrasound scan performed on fetuses with increased NT and normal CMA could detect the majority of structural abnormalities that are expected to be identified traditionally at 20-24 weeks.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9435-9439"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39802789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal outcomes of abnormally invasive placenta in China and their association with use of abdominal aortic balloon occlusion.","authors":"Xueyin Wang,&nbsp;Jie Yan,&nbsp;Xianlan Zhao,&nbsp;Weiran Zheng,&nbsp;Huijing Zhang,&nbsp;Hong Xin,&nbsp;Weishe Zhang,&nbsp;Yali Hu,&nbsp;Huixia Yang","doi":"10.1080/14767058.2022.2035355","DOIUrl":"https://doi.org/10.1080/14767058.2022.2035355","url":null,"abstract":"<p><strong>Objective: </strong>To compare maternal outcomes of abnormally invasive placenta in China in 2012, 2015, and 2018, and further examine the association between use of abdominal aortic balloon occlusion (AABO) and the risk of maternal outcomes.</p><p><strong>Materials and methods: </strong>A retrospective analysis included 830 women diagnosed as abnormally invasive placenta from 5 tertiary care centers in China in 2012, 2015 and 2018. Participants were divided into AABO group and non-AABO group according to whether they were treated with AABO or not. Logistic regression models were used to assess the association of use of AABO with postpartum hemorrhage, blood transfusion, hysterectomy and repeated surgery.</p><p><strong>Results: </strong>Among 830 participants, 66.0% (548/830) and 34.0% (282/830) of women were diagnosed with placenta increta and percreta, respectively; 33.3% (276/830) of women with abnormally invasive placenta were treated with AABO. In 2012, 2015, and 2018, the rate of blood transfusion was 83.1, 59.8, and 56.2%; the rate of hysterectomy was 50.8, 11.2, and 2.4%; and the rate of repeated surgery was 10.2, 9.4, and 0.9%. Use of AABO was associated with lower risk of postpartum hemorrhage (OR = 0.59, 95% CI: 0.35-0.99), blood transfusion (OR = 0.72, 95% CI: 0.52-0.99), hysterectomy (OR = 0.04, 95% CI: 0.01-0.14) and repeated surgery (OR = 0.14, 95% CI: 0.05-0.41) after adjustment for potential confounders.</p><p><strong>Conclusion: </strong>The rates of blood transfusion, hysterectomy and repeated surgery progressively decreased from 2012 to 2018 in Chinese women with abnormally invasive placenta. Use of AABO was associated with lower risk of postpartum hemorrhage, blood transfusion, hysterectomy and repeated surgery.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9376-9382"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39879017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should we target insomnia to treat and prevent postpartum depression?","authors":"Verinder Sharma,&nbsp;Laura Palagini,&nbsp;Dieter Riemann","doi":"10.1080/14767058.2021.2005021","DOIUrl":"https://doi.org/10.1080/14767058.2021.2005021","url":null,"abstract":"<p><p>Postpartum depression (PPD) is a major public health problem that affects approximately 12-18% of women and is associated adverse maternal and infant outcome. Given that untreated maternal depression has negative consequences for both the mother and her child, it is important to deploy effective measures to treat or prevent PPD. Antidepressant treatment after delivery has been proposed for prophylaxis, however, this is not firmly established. Since insomnia is an early sign and a common symptom of PPD in this contribution we argue that management of insomnia may play a key role in the treatment and prevention of PPD. To this aim we by discussed the current evidence about the potential prophylactic role of antidepressants compared to that of insomnia treatment in PPD. We concluded that insomnia symptoms may be a better therapeutic target to prevent or treat PPD which is heterogeneous entity and may be more responsive to interventions addressing a common and early symptom such as insomnia.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8794-8796"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39929460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exosomal mRNA and lncRNA profiles in cord blood of preeclampsia patients.","authors":"Lingmin Hu,&nbsp;Jinqi Ma,&nbsp;Minkai Cao,&nbsp;Yu Lin,&nbsp;Wei Long,&nbsp;Zhonghua Shi,&nbsp;Juan Wen","doi":"10.1080/14767058.2021.1966413","DOIUrl":"https://doi.org/10.1080/14767058.2021.1966413","url":null,"abstract":"<p><strong>Background: </strong>Exosomes are endosome-derived membrane vesicles that contain numerous RNAs and allow intercellular communication. The roles of mRNAs and lncRNAs from umbilical cord blood exosomes in the development of preeclampsia (PE) remain unclear.</p><p><strong>Methods: </strong>In the study, microarray technology was used to construct the differential mRNA and lncRNA expression profiles in umbilical cord blood exosomes between PE patients and normal controls.</p><p><strong>Results: </strong>Totally, 120 differentially expressed mRNAs and 248 differentially expressed lncRNAs were identified. Pathway analysis showed that the differentially expressed mRNAs were related to glycolysis/gluconeogenesis, PI3K-Akt signaling pathway and JAK-STAT signaling pathway, which are critical in PE development. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were conducted for the differential lncRNA-associated mRNAs. We found several significantly enriched pathways were closely associated with metabolic process, cell proliferation, differentiation, and apoptosis. Moreover, the constructed pathway network revealed key pathways in PE, including apoptosis and TGF-beta signaling pathway. Further analysis of lncRNA/miRNA interactions showed that most of the lncRNAs had miRNA binding sites, and some of them were associated with PE.</p><p><strong>Conclusions: </strong>The study highlights the importance of exosomal mRNAs and lncRNAs in umbilical cord blood, and provides new insight into the development of PE.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8199-8209"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39374667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivery risks and outcomes associated with grand multiparity.","authors":"Kate E Lee,&nbsp;Timothy Wen,&nbsp;Adam S Faye,&nbsp;Yongmei Huang,&nbsp;Chin Hur,&nbsp;Alexander M Friedman","doi":"10.1080/14767058.2021.1960972","DOIUrl":"https://doi.org/10.1080/14767058.2021.1960972","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is limited recent US national data on risk for adverse outcomes associated with grand multiparity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the association between grand multiparity and severe maternal morbidity (SMM) and other adverse outcomes during delivery hospitalizations in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This repeat cross-sectional study evaluated delivery hospitalizations from 2000 through the third quarter of 2015 to women aged 15-54 in the National (Nationwide) Inpatient Sample database. Temporal trends in deliveries to women with grand multiparity were analyzed using the Cochran-Armitage trend test. The primary outcome studied was SMM, a composite of adverse outcomes defined by the Centers for Disease Control and Prevention. The exposure of interest was grand multiparity diagnosis during delivery hospitalization. Other adverse outcomes analyzed included placental abruption, preterm delivery, postpartum hemorrhage, disseminated intravascular coagulation, shock, hysterectomy, pulmonary edema and acute heart failure, transfusion of blood or blood products, hypertensive diseases of pregnancy, cesarean delivery, eclampsia, and acute renal failure. Log linear regression models were performed to determine the relationship between grand multiparity and adverse outcomes with measures of association demonstrated as unadjusted (RR) and adjusted risk ratios (aRR) with 95%CIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 2000 to 2015, there were an estimated 62,672,862 hospital deliveries with 386,019 deliveries in the setting of grand multiparity. The number of deliveries with a grand multiparity diagnosis increased over the study period from 4.2 per 1000 deliveries in 2000 to 8.6 per 1000 in 2015 (&lt;i&gt;p&lt;/i&gt; &lt; .01). Women with grand multiparity were more likely to be older, have comorbidities, be Hispanic or non-Hispanic Black, be from a lower ZIP code income quartile, have Medicaid insurance, and present to an urban teaching hospital for delivery (&lt;i&gt;p&lt;/i&gt; &lt; .01 for all). On univariable analysis, grand multiparity was associated with SMM (RR 1.27, 95%CI 1.23-1.32). However, in adjusted analyses accounting for hospital, clinical, and demographic factors, women with grand multiparity were at lower risk of SMM (aRR 0.93, 95%CI 0.89, 0.96). On analysis of individual adverse outcomes, grand multiparity was associated with a higher risk of placental abruption (RR 1.28, 95%CI 1.24-1.31), preterm delivery (RR 1.17, 95%CI 1.16-1.18), postpartum hemorrhage (RR 1.30, 95%CI 1.28-1.32), disseminated intravascular coagulation (RR 1.23, 95%CI 1.16-1.31), shock (RR 2.50, 95%CI 2.20-2.85), hysterectomy (RR 3.20, 95%CI 3.30, 3.41), pulmonary edema and acute heart failure (RR 1.33, 95%CI 1.24-1.42), and transfusion of blood or blood products (RR 1.74, 95%CI 1.70-1.79). Conversely, grand multiparity was associated with a lower risk of hypertensive diseases of pregnancy (RR 0.85, 95%CI 0.84-0.86), cesarean delivery ","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7708-7716"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39377332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}