Xian Zhang, Jie Song, Bin Liu, Minchen Dai, Binxiang Wang, Xiaowei Cai, Yifan Hu, Yingying Mao, Fan Qu
Background: Observational studies have reported that individuals diagnosed with polycystic ovary syndrome (PCOS) face a heightened vulnerability to developing post-traumatic stress disorder (PTSD). However, it is unclear whether this relationship is causal. Consequently, we implemented a bidirectional Mendelian randomization (MR) analysis to examine the empirical causal association of PCOS and PTSD. Methods: We acquired genetic association data for PCOS through a comprehensive meta-analysis from several large-scale genome-wide association studies (GWASs), which enrolled 10,074 cases and 103,164 controls. For PTSD, we obtained data from a GWAS performed by the Psychiatric Genomics Consortium Posttraumatic Stress Disorder (PGC-PTSD) group. The study included a total of 23,212 cases of PTSD and 151,447 controls of European ancestry. For both PCOS and PTSD, we carefully selected genetic instruments that met the rigorous significance threshold (p < 5 × 10-8, r2 < 0.01). To investigate the causal association between PCOS and PTSD, we conducted bidirectional Mendelian randomization (MR) analyses. The primary analysis employed the inverse-variance weighted (IVW) method, complemented by alternative MR approaches such as the maximum-likelihood method, MR-Egger regression, Mendelian randomization-Robust Adjusted Profile Score (MR-RAPS), and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. Sensitivity analyses were also carried out to verify the robustness of this association. Results: In this study, we identified and utilized 14 genetic variants as instruments for PCOS, while 2 genetic variants were selected as instruments for PTSD. Our findings demonstrated that a genetic predisposition to PCOS was significantly associated with an elevated risk of developing PTSD (odds ratio (OR) = 1.11, 95% confidence interval (CI): 1.03–1.19, p = 7.27 × 10-3 for IVW). MR-Egger regression analysis was performed, and the results did not provide evidence of directional pleiotropy (p intercept = 0.187). Sensitivity analyses utilizing alternative MR methods consistently yielded similar results, supporting the robustness of our findings. Furthermore, in the reverse MR analysis, we observed no significant association between genetic predisposition to PTSD and the risk of developing PCOS (OR = 1.15, 95% CI: 0.69–1.91, p = 0.586 for IVW). Comparable null associations were also observed when alternative MR methods were employed. Conclusions: Through a genetic epidemiological approach, we found that genetic predisposition to PCOS was associated with an increased risk of PTSD, suggesting a potential causal relationship between PCOS and PTSD. Nonetheless, further investigation is necessary to elucidate the underlying mechanism through which PCOS contributes to the development of PTSD.
{"title":"Assessing the Potential Causal Relationship between Polycystic Ovary Syndrome and Post-Traumatic Stress Disorder: A Bidirectional Mendelian Randomization Study","authors":"Xian Zhang, Jie Song, Bin Liu, Minchen Dai, Binxiang Wang, Xiaowei Cai, Yifan Hu, Yingying Mao, Fan Qu","doi":"10.31083/j.ceog5009193","DOIUrl":"https://doi.org/10.31083/j.ceog5009193","url":null,"abstract":"Background: Observational studies have reported that individuals diagnosed with polycystic ovary syndrome (PCOS) face a heightened vulnerability to developing post-traumatic stress disorder (PTSD). However, it is unclear whether this relationship is causal. Consequently, we implemented a bidirectional Mendelian randomization (MR) analysis to examine the empirical causal association of PCOS and PTSD. Methods: We acquired genetic association data for PCOS through a comprehensive meta-analysis from several large-scale genome-wide association studies (GWASs), which enrolled 10,074 cases and 103,164 controls. For PTSD, we obtained data from a GWAS performed by the Psychiatric Genomics Consortium Posttraumatic Stress Disorder (PGC-PTSD) group. The study included a total of 23,212 cases of PTSD and 151,447 controls of European ancestry. For both PCOS and PTSD, we carefully selected genetic instruments that met the rigorous significance threshold (p < 5 × 10-8, r2 < 0.01). To investigate the causal association between PCOS and PTSD, we conducted bidirectional Mendelian randomization (MR) analyses. The primary analysis employed the inverse-variance weighted (IVW) method, complemented by alternative MR approaches such as the maximum-likelihood method, MR-Egger regression, Mendelian randomization-Robust Adjusted Profile Score (MR-RAPS), and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. Sensitivity analyses were also carried out to verify the robustness of this association. Results: In this study, we identified and utilized 14 genetic variants as instruments for PCOS, while 2 genetic variants were selected as instruments for PTSD. Our findings demonstrated that a genetic predisposition to PCOS was significantly associated with an elevated risk of developing PTSD (odds ratio (OR) = 1.11, 95% confidence interval (CI): 1.03–1.19, p = 7.27 × 10-3 for IVW). MR-Egger regression analysis was performed, and the results did not provide evidence of directional pleiotropy (p intercept = 0.187). Sensitivity analyses utilizing alternative MR methods consistently yielded similar results, supporting the robustness of our findings. Furthermore, in the reverse MR analysis, we observed no significant association between genetic predisposition to PTSD and the risk of developing PCOS (OR = 1.15, 95% CI: 0.69–1.91, p = 0.586 for IVW). Comparable null associations were also observed when alternative MR methods were employed. Conclusions: Through a genetic epidemiological approach, we found that genetic predisposition to PCOS was associated with an increased risk of PTSD, suggesting a potential causal relationship between PCOS and PTSD. Nonetheless, further investigation is necessary to elucidate the underlying mechanism through which PCOS contributes to the development of PTSD.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136313513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We aimed to investigate the association of free thyroxin (FT4), free triiodothyronine (FT3), subclinical hypothyroidism (SCH), and thyroid peroxidase antibody (TPOab) in the first trimester with gestational diabetes mellitus (GDM). Methods: We recruited 110 pregnant women with GDM and 100 pregnant women without GDM who had normal 75 g oral glucose tolerance test (OGTT) results between June 2019 and June 2021. We collected basic data from all participants and compared serum FT3 and FT4 levels, SCH, and TPOab (+) incidences in the first trimester between the two groups. We used logistic regression to identify factors that influence the development of GDM. Results: Serum FT3 levels were 4.58 ± 0.78 and 4.61 ±1.42 pmol/L in the GDM group and Control group, while FT4 levels were 9.32 ± 2.54 and 10.24 ± 2.77 pmol/L. The incidence of SCH were 25.5% and 14.0%, while TPO (+) were 20.0% and 10.0%. The GDM group’s FT4 levels were significantly lower than the control group’s, whereas the GDM group’s age, incidence of SCH, and TPOab (+) were significantly higher (p < 0.05). Logistic regression analysis demonstrated that age, SCH and TPO (+) were risk factors for GDM (p < 0.05), the regression equation: logit p = –3.484 + 0.105 (age) + 1.128 (SCH) + 1.294 (TPOab (+)). Conclusions: Our findings suggest that monitoring the changes in FT4 levels, SCH, and TPOab (+) incidence in the first trimester may be useful in predicting the occurrence and development of GDM.
{"title":"Association Analysis of Free Thyroid Hormones, Subclinical Hypothyroidism, and Thyroid Peroxidase Antibody in the First Trimester with Gestational Diabetes Mellitus","authors":"Yi Zhou, Yang Dong","doi":"10.31083/j.ceog5009192","DOIUrl":"https://doi.org/10.31083/j.ceog5009192","url":null,"abstract":"Background: We aimed to investigate the association of free thyroxin (FT4), free triiodothyronine (FT3), subclinical hypothyroidism (SCH), and thyroid peroxidase antibody (TPOab) in the first trimester with gestational diabetes mellitus (GDM). Methods: We recruited 110 pregnant women with GDM and 100 pregnant women without GDM who had normal 75 g oral glucose tolerance test (OGTT) results between June 2019 and June 2021. We collected basic data from all participants and compared serum FT3 and FT4 levels, SCH, and TPOab (+) incidences in the first trimester between the two groups. We used logistic regression to identify factors that influence the development of GDM. Results: Serum FT3 levels were 4.58 ± 0.78 and 4.61 ±1.42 pmol/L in the GDM group and Control group, while FT4 levels were 9.32 ± 2.54 and 10.24 ± 2.77 pmol/L. The incidence of SCH were 25.5% and 14.0%, while TPO (+) were 20.0% and 10.0%. The GDM group’s FT4 levels were significantly lower than the control group’s, whereas the GDM group’s age, incidence of SCH, and TPOab (+) were significantly higher (p < 0.05). Logistic regression analysis demonstrated that age, SCH and TPO (+) were risk factors for GDM (p < 0.05), the regression equation: logit p = –3.484 + 0.105 (age) + 1.128 (SCH) + 1.294 (TPOab (+)). Conclusions: Our findings suggest that monitoring the changes in FT4 levels, SCH, and TPOab (+) incidence in the first trimester may be useful in predicting the occurrence and development of GDM.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136313526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luigi Marino, Maria Antonietta Castaldi, Caterina Fulgione, Salvatore Giovanni Castaldi, Paola Manzo, Valentina Giudice, Francesca Picone, Maria Rosaria Campitiello, Mario Polichetti, Maurizio Guida, Carmine Selleri, Bianca Serio
Background: Pathophysiology of placental syndromes is still unclear, and umbilical cord-derived mesenchymal stem cells (UC-MSCs) might play a role in the development of these syndromes. In this prospective cohort study, we evaluated proliferative abilities of two types of UC-MSCs, Wharton’s Jelly MSCs (WJ-MSCs) and cord blood MSCs (CB-MSCs), in placental syndromes. Methods: A total of 16 cord blood and umbilical cord samples were seeded and cultured until MSC growth potential exhaustion. Cumulative population doublings were employed for studying growth potential, and flow cytometry immunophenotyping for verification of mesenchymal markers. Results: In our prospective cohort study, on one hand CB-MSCs from pathological pregnancies showed a significant reduction of growth potential, on the other hand WJ-MSCs showed a trend toward higher growth potential. This trend is consistent with the well-known faster-growing phenotype of WJ-MSCs under low oxygen atmosphere. Moreover, it’s well understood that chronic hypoxia is a main feature of both intrauterine growth restriction (IUGR) and preeclampsia, thus, our data perfectly match with the well-known clinical characteristics. Conclusions: Growth potential of CB-MSCs obtained from placental syndromes tended to be reduced compared to that of MSCs from healthy pregnancies. Our results need to be confirmed in larger in vitro studies, as a higher number of CB- and WJ-MSC would better clarify pathophysiology of placental syndromes.
{"title":"Reduced Proliferative Potential with Conserved Stem/Stromal Phenotype of Human Umbilical Cord Mesenchymal Stem Cells in Placental Syndromes: A Prospective Cohort Study","authors":"Luigi Marino, Maria Antonietta Castaldi, Caterina Fulgione, Salvatore Giovanni Castaldi, Paola Manzo, Valentina Giudice, Francesca Picone, Maria Rosaria Campitiello, Mario Polichetti, Maurizio Guida, Carmine Selleri, Bianca Serio","doi":"10.31083/j.ceog5009196","DOIUrl":"https://doi.org/10.31083/j.ceog5009196","url":null,"abstract":"Background: Pathophysiology of placental syndromes is still unclear, and umbilical cord-derived mesenchymal stem cells (UC-MSCs) might play a role in the development of these syndromes. In this prospective cohort study, we evaluated proliferative abilities of two types of UC-MSCs, Wharton’s Jelly MSCs (WJ-MSCs) and cord blood MSCs (CB-MSCs), in placental syndromes. Methods: A total of 16 cord blood and umbilical cord samples were seeded and cultured until MSC growth potential exhaustion. Cumulative population doublings were employed for studying growth potential, and flow cytometry immunophenotyping for verification of mesenchymal markers. Results: In our prospective cohort study, on one hand CB-MSCs from pathological pregnancies showed a significant reduction of growth potential, on the other hand WJ-MSCs showed a trend toward higher growth potential. This trend is consistent with the well-known faster-growing phenotype of WJ-MSCs under low oxygen atmosphere. Moreover, it’s well understood that chronic hypoxia is a main feature of both intrauterine growth restriction (IUGR) and preeclampsia, thus, our data perfectly match with the well-known clinical characteristics. Conclusions: Growth potential of CB-MSCs obtained from placental syndromes tended to be reduced compared to that of MSCs from healthy pregnancies. Our results need to be confirmed in larger in vitro studies, as a higher number of CB- and WJ-MSC would better clarify pathophysiology of placental syndromes.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136378208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Tairy, Ohad Gluck, Yakira Izaik, Jacob Bar, Eran Weiner, Giulia Barda
Background: In recent years a trend towards childbearing at older maternal age is evident. Most of the current literature investigated the association between advanced maternal age and neonatal outcome at term. We aimed to study the outcomes of the mother and the neonate among preterm births of women of advanced maternal age. Methods: This retrospective study between 2009 to 2017, comprised 494 singleton preterm births between 24 and 34 weeks gestation, of which 116 (23%) were of 35 years old or older (advanced maternal age) and 378 (77%) were of younger women. The medical records were reviewed and the outcomes of the mother and the neonate were compared between advanced maternal age (≥35 years) and younger women. Results: The rate of severe intra-ventricular hemorrhage (IVH) and of composite adverse neonatal outcome was lower among advanced maternal age women compared to younger women (p = 0.02 and p = 0.05 respectively). In multivariate regression analysis, composite adverse neonatal outcome was found to be independently inversely associated only with advanced maternal age (adjusted odds ratio (aOR) 0.45 95% confidence interval (CI) 0.23–0.86). Conclusions: Advanced maternal age was not found to be a risk factor for adverse neonatal outcome among preterm births before 34 weeks, and might be a protective factor from early neonatal complications.
{"title":"The Impact of Advanced Maternal Age on Neonatal Outcome in Preterm Births before 34 Weeks","authors":"Daniel Tairy, Ohad Gluck, Yakira Izaik, Jacob Bar, Eran Weiner, Giulia Barda","doi":"10.31083/j.ceog5009191","DOIUrl":"https://doi.org/10.31083/j.ceog5009191","url":null,"abstract":"Background: In recent years a trend towards childbearing at older maternal age is evident. Most of the current literature investigated the association between advanced maternal age and neonatal outcome at term. We aimed to study the outcomes of the mother and the neonate among preterm births of women of advanced maternal age. Methods: This retrospective study between 2009 to 2017, comprised 494 singleton preterm births between 24 and 34 weeks gestation, of which 116 (23%) were of 35 years old or older (advanced maternal age) and 378 (77%) were of younger women. The medical records were reviewed and the outcomes of the mother and the neonate were compared between advanced maternal age (≥35 years) and younger women. Results: The rate of severe intra-ventricular hemorrhage (IVH) and of composite adverse neonatal outcome was lower among advanced maternal age women compared to younger women (p = 0.02 and p = 0.05 respectively). In multivariate regression analysis, composite adverse neonatal outcome was found to be independently inversely associated only with advanced maternal age (adjusted odds ratio (aOR) 0.45 95% confidence interval (CI) 0.23–0.86). Conclusions: Advanced maternal age was not found to be a risk factor for adverse neonatal outcome among preterm births before 34 weeks, and might be a protective factor from early neonatal complications.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136313757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iwona Gawron, Rafał Baran, Kamil Derbisz, Andrzej Zmaczyński, Robert Jach, Miłosz Pietrus
Background: Pain accompanying office hysteroscopy, possibly aggravated by urogenital atrophy, is the most common reason for its discontinuation. The aim was to evaluate the effectiveness of vaginal estriol and hyaluronic acid to facilitate the office hysteroscopy in peri and postmenopausal women. Methods: A prospective cohort study involved women aged 45–90 years subjected to office hysteroscopy. Women were assigned to three study arms: (A) 0.5 mg of estriol in vaginal cream twice daily for 10 days pre-procedure, (B) 5 mg of hyaluronic acid in vaginal gel twice daily for 10 days pre-procedure, (C) no medication. The following endpoints were compared: pain accompanying the procedure, need for cervical dilation, time of cervical passage, incidence of severe urogenital atrophy, and vaso-vagal reaction. Results: There were no significant differences between the arms in terms of pain intensity during (p = 0.93) and after the procedure (p = 0.17), need for cervical dilation (p = 0.5), cervical passage time (p = 0.1), severe urogenital atrophy (p = 0.15), and vaso-vagal reaction (p = 0.29). Conclusions: Despite unfavorable conditions in peri and postmenopausal women, cervical preparation in the above regimens did not seem to bring clinically significant benefits. Clinical Trial Registration: The study was registered under the number NCT05783479 in the Protocol Registration and Results System database (https://clinicaltrials.gov/). The database used for the study was made available in Harvard Dataverse (https://doi.org/10.7910/DVN/HSWURD).
{"title":"Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study","authors":"Iwona Gawron, Rafał Baran, Kamil Derbisz, Andrzej Zmaczyński, Robert Jach, Miłosz Pietrus","doi":"10.31083/j.ceog5009194","DOIUrl":"https://doi.org/10.31083/j.ceog5009194","url":null,"abstract":"Background: Pain accompanying office hysteroscopy, possibly aggravated by urogenital atrophy, is the most common reason for its discontinuation. The aim was to evaluate the effectiveness of vaginal estriol and hyaluronic acid to facilitate the office hysteroscopy in peri and postmenopausal women. Methods: A prospective cohort study involved women aged 45–90 years subjected to office hysteroscopy. Women were assigned to three study arms: (A) 0.5 mg of estriol in vaginal cream twice daily for 10 days pre-procedure, (B) 5 mg of hyaluronic acid in vaginal gel twice daily for 10 days pre-procedure, (C) no medication. The following endpoints were compared: pain accompanying the procedure, need for cervical dilation, time of cervical passage, incidence of severe urogenital atrophy, and vaso-vagal reaction. Results: There were no significant differences between the arms in terms of pain intensity during (p = 0.93) and after the procedure (p = 0.17), need for cervical dilation (p = 0.5), cervical passage time (p = 0.1), severe urogenital atrophy (p = 0.15), and vaso-vagal reaction (p = 0.29). Conclusions: Despite unfavorable conditions in peri and postmenopausal women, cervical preparation in the above regimens did not seem to bring clinically significant benefits. Clinical Trial Registration: The study was registered under the number NCT05783479 in the Protocol Registration and Results System database (https://clinicaltrials.gov/). The database used for the study was made available in Harvard Dataverse (https://doi.org/10.7910/DVN/HSWURD).","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136313234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To investigate the diagnostic value of serum transthyretin (TTR), placental protein 13 (PP13) and placental growth factor (PLGF) in preeclampsia patients. Methods: Sixty cases of pregnant women with preeclampsia who were examined in our hospital from January 2020 to February 2022 were retrospectively selected as the preeclampsia group, and 40 cases of healthy pregnant women who received regular physical examination in our hospital during the same period were selected as the control group. Based on the severity of the disease, the patients were allocated into two groups: mild preeclampsia group (n = 35) and severe preeclampsia group (n = 25). The levels of Serum TTR, PP13 and PLGF were compared between the groups. The correlation between serum TTR, PP13, PLGF and the patients was also analyzed by Spearman method, and receiver operating characteristic curve (ROC) and area under the curve (AUC) was adopted to analyze the clinical value of the separate and combined detection of serum TTR, PP13, PLGF in the diagnosis of preeclampsia. Results: The levels of serum TTR, PP13, PLGF in preeclampsia group were evidently lower versus the control group (p < 0.05), and those of patients in mild preeclampsia group were markedly lower versus the control group (p < 0.05), while those in severe preeclampsia group were markedly lower versus the mild preeclampsia group and control group (p < 0.05). Serum TTR, PP13, PLGF levels in preeclampsia patients were negatively correlated with the disease progression (r = –0.332, –0.315, –0.391, p < 0.05). The AUC values of TTR, PP13, PLGF in the single diagnosis of preeclampsia and their joint diagnosis were 0.812, 0.759, 0.867, and 0.887, respectively. The area under the ROC curve of TTR, PP13, and PLGF joint diagnosis of preeclampsia was higher than that of PP13 alone (p < 0.05). Conclusions: Serum TTR, PP13, and PLGF levels of preeclampsia patients were decreased compared with those of the control group, and the decrease was more significant with the aggravation of the disease, suggesting that TTR, PP13, and PLGF could be used as indicators to predict the onset and severity of preeclampsia. The combination of the three indicators could improve the diagnostic efficiency.
{"title":"Diagnostic Value of Combined Detection of Serum TTR, PP13 and PLGF in Preeclampsia Patients","authors":"Ying Jiang, Caifeng Deng, Xuehua Cheng, Xiaofeng Chen","doi":"10.31083/j.ceog5009195","DOIUrl":"https://doi.org/10.31083/j.ceog5009195","url":null,"abstract":"Background: To investigate the diagnostic value of serum transthyretin (TTR), placental protein 13 (PP13) and placental growth factor (PLGF) in preeclampsia patients. Methods: Sixty cases of pregnant women with preeclampsia who were examined in our hospital from January 2020 to February 2022 were retrospectively selected as the preeclampsia group, and 40 cases of healthy pregnant women who received regular physical examination in our hospital during the same period were selected as the control group. Based on the severity of the disease, the patients were allocated into two groups: mild preeclampsia group (n = 35) and severe preeclampsia group (n = 25). The levels of Serum TTR, PP13 and PLGF were compared between the groups. The correlation between serum TTR, PP13, PLGF and the patients was also analyzed by Spearman method, and receiver operating characteristic curve (ROC) and area under the curve (AUC) was adopted to analyze the clinical value of the separate and combined detection of serum TTR, PP13, PLGF in the diagnosis of preeclampsia. Results: The levels of serum TTR, PP13, PLGF in preeclampsia group were evidently lower versus the control group (p < 0.05), and those of patients in mild preeclampsia group were markedly lower versus the control group (p < 0.05), while those in severe preeclampsia group were markedly lower versus the mild preeclampsia group and control group (p < 0.05). Serum TTR, PP13, PLGF levels in preeclampsia patients were negatively correlated with the disease progression (r = –0.332, –0.315, –0.391, p < 0.05). The AUC values of TTR, PP13, PLGF in the single diagnosis of preeclampsia and their joint diagnosis were 0.812, 0.759, 0.867, and 0.887, respectively. The area under the ROC curve of TTR, PP13, and PLGF joint diagnosis of preeclampsia was higher than that of PP13 alone (p < 0.05). Conclusions: Serum TTR, PP13, and PLGF levels of preeclampsia patients were decreased compared with those of the control group, and the decrease was more significant with the aggravation of the disease, suggesting that TTR, PP13, and PLGF could be used as indicators to predict the onset and severity of preeclampsia. The combination of the three indicators could improve the diagnostic efficiency.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136378207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Postoperative recurrence remains a problem for endometriosis. The study aimed to study whether baseline serum vascular endothelial growth factor (VEGF) levels can predict postoperative endometriosis recurrence. Methods: We included 147 patients with ovarian endometriosis who received laparoscopic endometrioma excision and postoperative gonadotropin-releasing hormone agonist treatment with hormonal add-back therapy between 2017 and 2019 in a tertiary hospital. According to endometriosis recurrence within 2 years, the patients were divided into two groups and baseline serum VEGF level measured before the surgery were compared. Logistic regression was used to examine the association between baseline serum VEGF level and endometriosis recurrence, and the area under the receiver operating characteristic curve (AUC) was calculated to examine its predictive performance. Results: The mean age of the patients was 30.1 ± 6.0 years with a duration of dysmenorrhea of 60.3 ± 35.0 months before surgery, and the majority (88.4%) were with revised American Fertility Society (rAFS) stage III or IV. Eight (5.44%) patients had endometriosis recurrence within 2 years. Compared with patients without recurrence, patients with recurrence were significantly younger (25.9 ± 4.3 vs. 30.3 ± 6.0 years, p = 0.040) and had higher baseline serum VEGF levels (689.67 ± 127.38 vs. 547.87 ± 171.31 pg/mL, p = 0.023), but there was no difference in other baseline characteristics. Serum VEGF levels were significantly associated with endometriosis recurrence (odds ratio 1.008 per pg/mL increase, 95% confidence interval 1.001–1.014) after adjusting for other baseline characteristics. The AUC of serum VEGF levels for predicting postoperative endometriosis recurrence was 0.741 (95% confidence interval 0.594–0.887). Conclusions: Baseline serum VEGF level is an independent risk factor of postoperative endometriosis recurrence and might be useful for predicting endometriosis recurrence.
{"title":"Predictive Value of Serum Vascular Endothelial Growth Factor Level for Postoperative Endometriosis Recurrence in Patients with Ovarian Endometriosis","authors":"Yanfen Zou, Yuan Ding","doi":"10.31083/j.ceog5009187","DOIUrl":"https://doi.org/10.31083/j.ceog5009187","url":null,"abstract":"Background: Postoperative recurrence remains a problem for endometriosis. The study aimed to study whether baseline serum vascular endothelial growth factor (VEGF) levels can predict postoperative endometriosis recurrence. Methods: We included 147 patients with ovarian endometriosis who received laparoscopic endometrioma excision and postoperative gonadotropin-releasing hormone agonist treatment with hormonal add-back therapy between 2017 and 2019 in a tertiary hospital. According to endometriosis recurrence within 2 years, the patients were divided into two groups and baseline serum VEGF level measured before the surgery were compared. Logistic regression was used to examine the association between baseline serum VEGF level and endometriosis recurrence, and the area under the receiver operating characteristic curve (AUC) was calculated to examine its predictive performance. Results: The mean age of the patients was 30.1 ± 6.0 years with a duration of dysmenorrhea of 60.3 ± 35.0 months before surgery, and the majority (88.4%) were with revised American Fertility Society (rAFS) stage III or IV. Eight (5.44%) patients had endometriosis recurrence within 2 years. Compared with patients without recurrence, patients with recurrence were significantly younger (25.9 ± 4.3 vs. 30.3 ± 6.0 years, p = 0.040) and had higher baseline serum VEGF levels (689.67 ± 127.38 vs. 547.87 ± 171.31 pg/mL, p = 0.023), but there was no difference in other baseline characteristics. Serum VEGF levels were significantly associated with endometriosis recurrence (odds ratio 1.008 per pg/mL increase, 95% confidence interval 1.001–1.014) after adjusting for other baseline characteristics. The AUC of serum VEGF levels for predicting postoperative endometriosis recurrence was 0.741 (95% confidence interval 0.594–0.887). Conclusions: Baseline serum VEGF level is an independent risk factor of postoperative endometriosis recurrence and might be useful for predicting endometriosis recurrence.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135107477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Backgrounds: To investigate the use of vascular ligation in the treatment of pernicious placenta previa. Methods: Clinical data from 199 patients with pernicious placenta previa were collected and divided into groups according to placenta location, placenta accretion and vessel ligation, the pregnancy outcome of each group was compared. Results: The unplanned reoperation rate was lower for the internal iliac artery ligation group than the group without internal iliac artery ligation (p < 0.05). The intraoperative bleeding volume, blood transfusion volume, and intensive care unit (ICU) admission rate were lower for the prophylactic internal iliac artery ligation group than the therapeutic ligation group (p < 0.05), and in the hysterectomy patients, intraoperative bleeding was lower in the prophylactic internal iliac artery ligation group than the therapeutic ligation group (p < 0.05). The hysterectomy rate was lower for the uterine artery ligation group than the group without uterine artery ligation (p < 0.05); and for superficial and deep placental accreta, the operation time of uterine artery ligation group was shorter than internal iliac artery ligation group, intraoperative bleeding volume, blood transfusion volume, and ICU admission rate have no significant difference, when placental penetrating implantation was performed, patients with internal iliac artery ligation were statistically more severely ill, but there was no difference in prognosis. Conclusions: Vascular ligation is an effective means of managing high-risk obstetric bleeding and helps to avoid hysterectomy and unplanned reoperation, but surgeons need to choose the appropriate ligation method to improve patient prognosis, considering the patient’s condition and his or her skills.
{"title":"Application of Ligation of Internal Iliac Artery and Uterine Artery in Pernicious Placenta Previa","authors":"Lijuan Bai, Jie Lin, Qiuni Shen, Xiaodong Fu","doi":"10.31083/j.ceog5009190","DOIUrl":"https://doi.org/10.31083/j.ceog5009190","url":null,"abstract":"Backgrounds: To investigate the use of vascular ligation in the treatment of pernicious placenta previa. Methods: Clinical data from 199 patients with pernicious placenta previa were collected and divided into groups according to placenta location, placenta accretion and vessel ligation, the pregnancy outcome of each group was compared. Results: The unplanned reoperation rate was lower for the internal iliac artery ligation group than the group without internal iliac artery ligation (p < 0.05). The intraoperative bleeding volume, blood transfusion volume, and intensive care unit (ICU) admission rate were lower for the prophylactic internal iliac artery ligation group than the therapeutic ligation group (p < 0.05), and in the hysterectomy patients, intraoperative bleeding was lower in the prophylactic internal iliac artery ligation group than the therapeutic ligation group (p < 0.05). The hysterectomy rate was lower for the uterine artery ligation group than the group without uterine artery ligation (p < 0.05); and for superficial and deep placental accreta, the operation time of uterine artery ligation group was shorter than internal iliac artery ligation group, intraoperative bleeding volume, blood transfusion volume, and ICU admission rate have no significant difference, when placental penetrating implantation was performed, patients with internal iliac artery ligation were statistically more severely ill, but there was no difference in prognosis. Conclusions: Vascular ligation is an effective means of managing high-risk obstetric bleeding and helps to avoid hysterectomy and unplanned reoperation, but surgeons need to choose the appropriate ligation method to improve patient prognosis, considering the patient’s condition and his or her skills.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135107676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study introduced the Perinatal Grief Intensity Scale (PGIS) and applied it to assess the reliability and validity of perinatal loss in Chinese mothers. Methods: To sinicize PGIS and cultural debugging of the scale, reliability validity was assessed in this prospective cross-sectional study. Results: The Chinese version of the PGIS contained 14 items in three dimensions: reality, confront others, and congruence. The content validity index (CVI) at the total scale level, mean scale level, and item level was 0.92, 0.909, and 0.860–1.000. Exploratory factors were identified as three metric factors with a cumulative variance contribution rate of 66.627%. The Chinese version of the Perinatal Grief Scale (PGS) was used as a calibration standard, and the correlation coefficient was 0.759. The total Cronbach’s alpha coefficient for the Chinese version of the PGIS was 0.768, with a fold-half reliability of 0.749. The scale showed good reliability and validity. Conclusions: The Chinese version of the PGIS was used as a calibration standard by exploratory factor testing, and the correlation coefficient was good, and the scale had good reliability and validity for application in China.
{"title":"Validity and Reliability of the Perinatal Grief Intensity Scale in a Chinese Clinical Sample: A Prospective Cross-Sectional Study","authors":"Jianping Xu, Shuiqin Gu, Shuihong Su","doi":"10.31083/j.ceog5009189","DOIUrl":"https://doi.org/10.31083/j.ceog5009189","url":null,"abstract":"Background: This study introduced the Perinatal Grief Intensity Scale (PGIS) and applied it to assess the reliability and validity of perinatal loss in Chinese mothers. Methods: To sinicize PGIS and cultural debugging of the scale, reliability validity was assessed in this prospective cross-sectional study. Results: The Chinese version of the PGIS contained 14 items in three dimensions: reality, confront others, and congruence. The content validity index (CVI) at the total scale level, mean scale level, and item level was 0.92, 0.909, and 0.860–1.000. Exploratory factors were identified as three metric factors with a cumulative variance contribution rate of 66.627%. The Chinese version of the Perinatal Grief Scale (PGS) was used as a calibration standard, and the correlation coefficient was 0.759. The total Cronbach’s alpha coefficient for the Chinese version of the PGIS was 0.768, with a fold-half reliability of 0.749. The scale showed good reliability and validity. Conclusions: The Chinese version of the PGIS was used as a calibration standard by exploratory factor testing, and the correlation coefficient was good, and the scale had good reliability and validity for application in China.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135063098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC.
背景:与其他亚型相比，三阴性乳腺癌(TNBC)更具侵袭性，生存率较低，化疗是唯一公认的全身治疗选择。最近，PD-1/PD-L1(程序性细胞死亡-1和程序性死亡配体1)抑制剂在局部晚期或转移性TNBC患者中显示出生存益处。然而，PD-1/PD-L1抑制剂在新辅助化疗中的作用仍然存在争议。方法:在PubMed、Embase和Cochrane数据库中进行广泛的文献检索。分析合并优势比(OR)和95%置信区间(CI)。结果:纳入7项随机对照试验(N = 1707)。PD-1/PD-L1抑制剂化疗组病理完全缓解(pCR)获益为59.0% vs 40.4% (OR 1.98, 95% CI 1.38-2.82, p <0.001)。血液学不良事件相似。两组在贫血方面无显著差异(OR 1.25, 95% CI 0.93-1.68, p = 0.14;I2 = 0%， p = 0.99)或中性粒细胞减少症(or 1.00, 95% CI 0.82-1.21, p = 0.96;I2 = 0%， p = 0.70)。结论:在新辅助化疗中加入PD-1/PD-L1抑制剂可提高TNBC患者的pCR率，且不会增加血液毒性。数据表明，PD-1/PD-L1抑制剂可能是TNBC患者的可行选择。
{"title":"Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis","authors":"Zhen-Yu Li, Zhen Zhang, Xiao-Zhong Cao, Yun Feng, Sha-Sha Ren","doi":"10.31083/j.ceog5009185","DOIUrl":"https://doi.org/10.31083/j.ceog5009185","url":null,"abstract":"Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135107470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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