Pub Date : 2020-03-02DOI: 10.3760/CMA.J.CN113903-20200221-00143
L. Yao, Jing Wang, Jingjing Zhao, Jing Cui, Zhihang Hu
We report a case of asymptomatic COVID-19 infection in a pregnant woman in the third trimester with good maternal and infant outcomes. The patient was admitted to the Second People's Hospital of Hefei on February 11, 2020, because of a "positive novel coronavirus nucleic acid test result for one day" at 38 weeks of gestation. No abnormality was observed during her previous regular prenatal examinations. A throat swab sample was obtained from the patient four days before admission due to the diagnosis of COVID-19 infection in her husband and sister on the 14th and 7th day before her admission, and the new coronavirus nucleic acid test showed positive. The patient reported no discomfort before admission. Chest CT on the 3rd after admission showed a small amount of bilateral pleural effusion. Irregular contractions occurred three days after admission and labor was considered to be imminent. An emergency cesarean section was performed and the patient delivered a live baby girl. No tests were performed on amniotic fluid, cord blood or placenta for new coronavirus nuclei acid. The patient was isolated from the infant without breastfeeding after surgery. All medical staff involved in the cesarean section were isolated after surgery. Neonatal peripheral blood and nasopharyngeal swabs were collected for the new coronavirus nucleic acid tests on the day of birth and one day of age respectively, and nasopharyngeal swabs and anal suabs were taken at nine days after birth. All test results were negative. The patient recovered well after surgery with stable vital signs. Chest CT on the 8th after operation showed a small amount of bilateral pleural effusion, while the new coronavirus nucleic acid test results of the pharyngeal swabs were positive on the 11th and 12th day after operation. The throat swabs of all medical staff involved in the operation were negative 14 days after the operation. The mother and baby were discharged 14 days after the Cesarean section.
{"title":"Asymptomatic COVID-19 infection in pregnant woman in the third trimester: a case report/ 中华围产医学杂志","authors":"L. Yao, Jing Wang, Jingjing Zhao, Jing Cui, Zhihang Hu","doi":"10.3760/CMA.J.CN113903-20200221-00143","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200221-00143","url":null,"abstract":"We report a case of asymptomatic COVID-19 infection in a pregnant woman in the third trimester with good maternal and infant outcomes. The patient was admitted to the Second People's Hospital of Hefei on February 11, 2020, because of a \"positive novel coronavirus nucleic acid test result for one day\" at 38 weeks of gestation. No abnormality was observed during her previous regular prenatal examinations. A throat swab sample was obtained from the patient four days before admission due to the diagnosis of COVID-19 infection in her husband and sister on the 14th and 7th day before her admission, and the new coronavirus nucleic acid test showed positive. The patient reported no discomfort before admission. Chest CT on the 3rd after admission showed a small amount of bilateral pleural effusion. Irregular contractions occurred three days after admission and labor was considered to be imminent. An emergency cesarean section was performed and the patient delivered a live baby girl. No tests were performed on amniotic fluid, cord blood or placenta for new coronavirus nuclei acid. The patient was isolated from the infant without breastfeeding after surgery. All medical staff involved in the cesarean section were isolated after surgery. Neonatal peripheral blood and nasopharyngeal swabs were collected for the new coronavirus nucleic acid tests on the day of birth and one day of age respectively, and nasopharyngeal swabs and anal suabs were taken at nine days after birth. All test results were negative. The patient recovered well after surgery with stable vital signs. Chest CT on the 8th after operation showed a small amount of bilateral pleural effusion, while the new coronavirus nucleic acid test results of the pharyngeal swabs were positive on the 11th and 12th day after operation. The throat swabs of all medical staff involved in the operation were negative 14 days after the operation. The mother and baby were discharged 14 days after the Cesarean section.","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"229-231"},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42997780","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.010
Heng-jun Liu, Chang Chen, Fei Li, Lin Zhang, Jun Zhang
As an oral antidiabetic drugs, metformin has been widely used to treat various diseases such as gestational diabetes mellitus, polycystic ovary syndrome and obesity in pregnant women. Current literature suggests that intrauterine metformin exposure has no significant impact on perinatal outcomes of the offspring, such as neonatal hypoglycemia, neonatal respiratory distress syndrome, premature delivery and others. However, considering the possible transfer of metformin across the placental barrier, intrauterine metformin exposure may potentially influence the development of placenta and the fetus, cell metabolism, and hormone levels. According to the "Developmental Origins of Health and Diseases"theory, the long-term effect of intrauterine metformin exposure on the growth, metabolism, reproductive function and neuropsychological development of offspring reviewed here still need continuous attention. Key words: Metformin; Prenatal exposure delayed effects; Growth and development; Child development
{"title":"Long-term effects of intrauterine exposure to metformin on offspring","authors":"Heng-jun Liu, Chang Chen, Fei Li, Lin Zhang, Jun Zhang","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.010","url":null,"abstract":"As an oral antidiabetic drugs, metformin has been widely used to treat various diseases such as gestational diabetes mellitus, polycystic ovary syndrome and obesity in pregnant women. Current literature suggests that intrauterine metformin exposure has no significant impact on perinatal outcomes of the offspring, such as neonatal hypoglycemia, neonatal respiratory distress syndrome, premature delivery and others. However, considering the possible transfer of metformin across the placental barrier, intrauterine metformin exposure may potentially influence the development of placenta and the fetus, cell metabolism, and hormone levels. According to the \"Developmental Origins of Health and Diseases\"theory, the long-term effect of intrauterine metformin exposure on the growth, metabolism, reproductive function and neuropsychological development of offspring reviewed here still need continuous attention. \u0000 \u0000Key words: \u0000Metformin; Prenatal exposure delayed effects; Growth and development; Child development","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49226999","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.009
Ye Feng, Huixia Yang
The efficacy as well as short- and long-term safety of metformin in women with gestational diabetes mellitus have been constantly confirmed in recent years. Metformin could decrease the weight gain during pregnancy and the incidence of hypoglycemia compared with insulin, without increasing the incidence of adverse pregnant outcomes. Moreover, no significant adverse outcome has been found in the offspring of women treated with metformin in pregnancy. This article reviews the evidence for efficacy and safety of using metformin during pregnancy, summarizes the latest guidelines and recommendations, and describes the specific medication regimen. Key words: Metformin; Diabetes, gestational; Validation studies; Clinical protocols
{"title":"Progress in use of metformin in pregnancy with diabetes","authors":"Ye Feng, Huixia Yang","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.009","url":null,"abstract":"The efficacy as well as short- and long-term safety of metformin in women with gestational diabetes mellitus have been constantly confirmed in recent years. Metformin could decrease the weight gain during pregnancy and the incidence of hypoglycemia compared with insulin, without increasing the incidence of adverse pregnant outcomes. Moreover, no significant adverse outcome has been found in the offspring of women treated with metformin in pregnancy. This article reviews the evidence for efficacy and safety of using metformin during pregnancy, summarizes the latest guidelines and recommendations, and describes the specific medication regimen. \u0000 \u0000Key words: \u0000Metformin; Diabetes, gestational; Validation studies; Clinical protocols","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41721561","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.004
J. Juan, Yiying Sun, C. Ye, Huixia Yang
Objective To analyze insulin resistance (IR) level and pregnancy outcomes in women with gestational diabetes mellitus (GDM) complicated by chronic hypertension (CHT). Methods This is a retrospective case-control study involving 2 457 singleton pregnant women complicated by GDM who received regular prenatal examinations and participated in the one-day-care clinic of GDM in Peking University First Hospital from January 1, 2014 to December 31, 2016. Clinical data were collected and homeostasis model assessment insulin resistance (HOMA-IR) was calculated. All subjects were divided into two groups: GDM with CHT group (CHT group, n=47) and GDM without CHT group (non-CHT group, n=2 410). Based on their pre-pregnancy body mass index (BMI), they were also grouped into normal pre-pregnancy BMI group (n=1 590) and overweight and obese group (n=863). Two-sample independent t test and Chi-square test were used to compared the age, HOMA-IR, pre-pregnancy BMI, weight gain during pregnancy and glucose levels between groups, and logistic regression model was used to analyze the effects of HOMA-IR on pregnancy outcomes. Results HOMA-IR (3.5±1.8 vs 2.6±1.5, t=-3.290), fasting plasma glucose [(5.4±0.5) vs (5.2±0.5) mmol/L, t=-3.005], pre-pregnancy BMI [(26.7±4.7) vs (23.3±3.4) kg/m2, t=-4.842] and the incidence of preeclampsia [14.9% (7/47) vs 2.5% (61/2 410), χ2=21.790] were significantly higher in GDM women with CHT than those without (all P 0.05). For pregnant women with normal pre-pregnancy BMI, HOMA-IR (3.0±1.5 vs 2.3±1.2, t=-2.217), fasting plasma glucose [(5.4±0.5) vs (5.1±0.5) mmol/L, t=-2.299] and the incidence of preeclampsia [2/14 vs 1.6% (26/1 576), χ2=6.545] were higher in the CHT group than the non-CHT group (all P 0.05). After adjusting for age, fasting plasma glucose, pre-pregnancy BMI and weight gain during pregnancy, the elevated HOMA-IR level increased the risk of preterm birth (OR=1.223, 95%CI: 1.093-1.369, P<0.001) in GDM women without CHT. Conclusions GDM gravida complicated by CHT have severe insulin resistance and a higher incidence of preeclampsia, but the risk of other pregnancy outcomes are not increased. Key words: Diabetes, gestational; Hypertension; Insulin resistance; Pregnancy outcome
目的分析妊娠期糖尿病(GDM)合并慢性高血压(CHT)患者胰岛素抵抗(IR)水平与妊娠结局的关系。方法对2014年1月1日至2016年12月31日在北京大学第一医院GDM一日门诊接受常规产前检查并合并GDM的2 457例单胎孕妇进行回顾性病例对照研究。收集临床资料，计算胰岛素抵抗稳态模型(HOMA-IR)。所有受试者分为两组:GDM合并CHT组(n =47)和GDM不合并CHT组(n = 2410)。根据孕妇孕前体重指数(BMI)分为孕前体重指数正常组(n= 1590)和超重肥胖组(n=863)。采用两样本独立t检验和卡方检验比较各组年龄、HOMA-IR、孕前BMI、孕期体重增加及血糖水平，采用logistic回归模型分析HOMA-IR对妊娠结局的影响。结果GDM合并CHT组HOMA-IR(3.5±1.8 vs 2.6±1.5,t=-3.290)、空腹血糖[(5.4±0.5)vs(5.2±0.5)mmol/L, t=-3.005]、孕前BMI[(26.7±4.7)vs(23.3±3.4)kg/m2, t=-4.842]、先兆子痫发生率[14.9% (7/47)vs 2.5% (61/2 410)， χ2=21.790]均显著高于未合并CHT组(P均为0.05)。孕前BMI正常的孕妇，CHT组HOMA-IR(3.0±1.5 vs 2.3±1.2,t=-2.217)、空腹血糖[(5.4±0.5)vs(5.1±0.5)mmol/L, t=-2.299]、先兆子痫发生率[2/14 vs 1.6% (26/1 576)， χ2=6.545]均高于非CHT组(P均为0.05)。在调整了年龄、空腹血糖、孕前BMI和孕期体重增加等因素后，在没有CHT的GDM女性中，HOMA-IR水平升高增加了早产的风险(OR=1.223, 95%CI: 1.093-1.369, P<0.001)。结论GDM妊娠合并CHT患者胰岛素抵抗严重，子痫前期发生率较高，但其他妊娠结局风险未增加。关键词:糖尿病;妊娠期;高血压;胰岛素抵抗;怀孕的结果
{"title":"Insulin resistance and pregnancy outcomes in gestational diabetes mellitus gravida complicated by chronic hypertension","authors":"J. Juan, Yiying Sun, C. Ye, Huixia Yang","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.004","url":null,"abstract":"Objective \u0000To analyze insulin resistance (IR) level and pregnancy outcomes in women with gestational diabetes mellitus (GDM) complicated by chronic hypertension (CHT). \u0000 \u0000 \u0000Methods \u0000This is a retrospective case-control study involving 2 457 singleton pregnant women complicated by GDM who received regular prenatal examinations and participated in the one-day-care clinic of GDM in Peking University First Hospital from January 1, 2014 to December 31, 2016. Clinical data were collected and homeostasis model assessment insulin resistance (HOMA-IR) was calculated. All subjects were divided into two groups: GDM with CHT group (CHT group, n=47) and GDM without CHT group (non-CHT group, n=2 410). Based on their pre-pregnancy body mass index (BMI), they were also grouped into normal pre-pregnancy BMI group (n=1 590) and overweight and obese group (n=863). Two-sample independent t test and Chi-square test were used to compared the age, HOMA-IR, pre-pregnancy BMI, weight gain during pregnancy and glucose levels between groups, and logistic regression model was used to analyze the effects of HOMA-IR on pregnancy outcomes. \u0000 \u0000 \u0000Results \u0000HOMA-IR (3.5±1.8 vs 2.6±1.5, t=-3.290), fasting plasma glucose [(5.4±0.5) vs (5.2±0.5) mmol/L, t=-3.005], pre-pregnancy BMI [(26.7±4.7) vs (23.3±3.4) kg/m2, t=-4.842] and the incidence of preeclampsia [14.9% (7/47) vs 2.5% (61/2 410), χ2=21.790] were significantly higher in GDM women with CHT than those without (all P 0.05). For pregnant women with normal pre-pregnancy BMI, HOMA-IR (3.0±1.5 vs 2.3±1.2, t=-2.217), fasting plasma glucose [(5.4±0.5) vs (5.1±0.5) mmol/L, t=-2.299] and the incidence of preeclampsia [2/14 vs 1.6% (26/1 576), χ2=6.545] were higher in the CHT group than the non-CHT group (all P 0.05). After adjusting for age, fasting plasma glucose, pre-pregnancy BMI and weight gain during pregnancy, the elevated HOMA-IR level increased the risk of preterm birth (OR=1.223, 95%CI: 1.093-1.369, P<0.001) in GDM women without CHT. \u0000 \u0000 \u0000Conclusions \u0000GDM gravida complicated by CHT have severe insulin resistance and a higher incidence of preeclampsia, but the risk of other pregnancy outcomes are not increased. \u0000 \u0000 \u0000Key words: \u0000Diabetes, gestational; Hypertension; Insulin resistance; Pregnancy outcome","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"91-97"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42228715","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.005
Yu Liu, Jing-mei Ma, S. Qin, B. Zhu, Fei Liu, Huixia Yang
Objective To investigate the gut microbial profiles of gestational mellitus diabetes (GDM) patients before and after treatment, and the relationship between gut microbiota and blood glucose level measured in 75 g oral glucose tolerance test (OGTT). Methods A prospective cohort-based nested case-control study was conducted in Peking University First Hospital from October 2016 to December 2017. Forty-five pregnancies at 24-28 gestational weeks with GDM (GDM group) and 45 healthy gravidas (control group) matched for age and pre-pregnancy body mass index (BMI) were involved. Stool samples of all participants were collected before (24-28 gestational weeks) and after (36-40 gestational weeks) treatment. The V3-V4 region of the 16S rRNA gene was sequenced on the Illumina Hiseq 2500 platform, and the results were analyzed. QIIME software was used for bioinformatics analysis. Student's t-test, Mann-Whitney U test, and Chi-square test were used for statistical analysis. Results (1) Before treatment, the Alpha diversity of the GDM group was significantly reduced compared with that of the control group (Chao1 index: 443.9±72.9 vs 474.0±63.3, t=2.104, P<0.05; Shannon index: 5.6±0.5 vs 6.0±0.5, t=2.002, P<0.05), and a significant difference in Beta diversity was also observed between the two groups (R2=0.04, P<0.05). However, a significant difference was shown in neither Alpha nor Beta diversity between the two groups after the treatment. (2) Before treatment, the relative abundances of Blautia and Faecalibacterium of the GDM group were significantly higher than those of the control group [M (P25-P75): 0.016 (0.009-0.022) vs 0.011 (0.007-0.016), U=782.000; 0.114 (0.076-0.141) vs 0.091 (0.061-0.126), U=752.000; both P<0.05], but the relative abundances of Akkermansia, Odoribacter and Butyricimonas were significantly lower [0.001 (0.000-0.002) vs 0.001 (0.000-0.005), U=745.000; 0.001 (0.000-0.004) vs 0.004 (0.001-0.006), U=766.500; 0.001 (0.000-0.003) vs 0.003 (0.001-0.005), U=710.000; all P<0.05]. (3) A negative relationship was found between the fasting glucose level of OGTT and the relative abundances of Akkermansia, Odoribacter and Butyricimonas (r=-0.325, -0.273 and -0.284; all P<0.05), and between the one-hour-OGTT glucose level and the relative abundances of Akkermansia and Butyricimonas (r=-0.285 and -0.265, both P<0.05). The two-hour-OGTT glucose level was positively related to the relative abundance of Faecalibacterium (r=0.278, P<0.05), but negatively related to the relative abundance of Akkermansia (r=-0.245, P<0.05). The area under the OGTT time-glucose curve was negatively related to the relative abundances of Akkermansia and Butyricimonas (r=-0.321 and -0.264, both P<0.05). Conclusions There are significant differences in gut microbial composition and structure between GDM and healthy pregnant women, which are significantly associated with OGTT blood glucose level. Euglycemia achieved after GDM management could improve gut micro
目的了解妊娠期糖尿病（GDM）患者治疗前后肠道微生物特征，以及肠道微生物群与75g口服葡萄糖耐量试验（OGTT）血糖水平的关系。方法2016年10月至2017年12月在北京大学第一医院进行前瞻性队列嵌套病例对照研究。涉及45例妊娠24-28周的GDM妊娠（GDM组）和45例年龄和孕前体重指数（BMI）匹配的健康孕妇（对照组）。在治疗前（24-28孕周）和治疗后（36-40孕周）采集所有参与者的粪便样本。在Illumina Hiseq 2500平台上对16S rRNA基因的V3-V4区域进行测序，并对结果进行分析。QIME软件用于生物信息学分析。采用Student t检验、Mann-Whitney U检验和卡方检验进行统计分析。结果（1）治疗前，GDM组的α多样性与对照组相比显著降低（Chao1指数：443.9±72.9 vs 474.0±63.3，t=2.104，P<0.05；Shannon指数：5.6±0.5 vs 6.0±0.5，t=2.002，P<0.05），β多样性在两组之间也有显著差异（R2=0.04，P<0.05），治疗后两组之间的Alpha和Beta多样性均未显示出显著差异。（2） 治疗前，GDM组的Blautia和Faecalibacterium的相对丰度显著高于对照组[M（P25-P75）：0.016（0.009-0.022）vs 0.011（0.007-0.016），U=720.000；0.114（0.076-0.141）vs 0.091（0.061-0.126），U=752.000；均P<0.05]，但Akkermansia的相对丰度，Odoribacter和Butyricimonas显著降低[0001（0.000-0.002）vs 0.001（0.000-0.005），U=745.000；0.001（0.000=0.004）vs 0.004（0.001-0.006），U=766.500；0.001（0.001-0.003）vs 0.003（0.001-0.005）；U=710.000；均P<0.05。（3）OGTT的空腹血糖水平与阿克曼菌的相对丰度呈负相关，Odoribacter和Butyricimonas（r=-0.325、-0.273和-0.284；均P<0.05），以及1小时OGTT葡萄糖水平与Akkermansia和Butyrcimonas的相对丰度之间（r=-0.285和-0.265，均P<0.05）。2小时OGTT血糖水平与Faecalibacterium的相对丰度呈正相关（r=0.278，P<0.05），但与阿克曼菌的相对丰度呈负相关（r=-0.245，P<0.05）。OGTT时间-葡萄糖曲线下面积与阿克曼氏菌和丁酸杆菌的相对丰度呈正相关（r=-0.1321和-0.264，均P<0.05），其与OGTT血糖水平显著相关。GDM治疗后血糖升高可改善肠道微生物群紊乱。关键词：糖尿病，妊娠期；胃肠道微生物组；葡萄糖耐量试验；血糖
{"title":"Different characteristics of gut microbiota before and after management of women with gestational diabetes mellitus and the association with blood glucose level","authors":"Yu Liu, Jing-mei Ma, S. Qin, B. Zhu, Fei Liu, Huixia Yang","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.005","url":null,"abstract":"Objective \u0000To investigate the gut microbial profiles of gestational mellitus diabetes (GDM) patients before and after treatment, and the relationship between gut microbiota and blood glucose level measured in 75 g oral glucose tolerance test (OGTT). \u0000 \u0000 \u0000Methods \u0000A prospective cohort-based nested case-control study was conducted in Peking University First Hospital from October 2016 to December 2017. Forty-five pregnancies at 24-28 gestational weeks with GDM (GDM group) and 45 healthy gravidas (control group) matched for age and pre-pregnancy body mass index (BMI) were involved. Stool samples of all participants were collected before (24-28 gestational weeks) and after (36-40 gestational weeks) treatment. The V3-V4 region of the 16S rRNA gene was sequenced on the Illumina Hiseq 2500 platform, and the results were analyzed. QIIME software was used for bioinformatics analysis. Student's t-test, Mann-Whitney U test, and Chi-square test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000(1) Before treatment, the Alpha diversity of the GDM group was significantly reduced compared with that of the control group (Chao1 index: 443.9±72.9 vs 474.0±63.3, t=2.104, P<0.05; Shannon index: 5.6±0.5 vs 6.0±0.5, t=2.002, P<0.05), and a significant difference in Beta diversity was also observed between the two groups (R2=0.04, P<0.05). However, a significant difference was shown in neither Alpha nor Beta diversity between the two groups after the treatment. (2) Before treatment, the relative abundances of Blautia and Faecalibacterium of the GDM group were significantly higher than those of the control group [M (P25-P75): 0.016 (0.009-0.022) vs 0.011 (0.007-0.016), U=782.000; 0.114 (0.076-0.141) vs 0.091 (0.061-0.126), U=752.000; both P<0.05], but the relative abundances of Akkermansia, Odoribacter and Butyricimonas were significantly lower [0.001 (0.000-0.002) vs 0.001 (0.000-0.005), U=745.000; 0.001 (0.000-0.004) vs 0.004 (0.001-0.006), U=766.500; 0.001 (0.000-0.003) vs 0.003 (0.001-0.005), U=710.000; all P<0.05]. (3) A negative relationship was found between the fasting glucose level of OGTT and the relative abundances of Akkermansia, Odoribacter and Butyricimonas (r=-0.325, -0.273 and -0.284; all P<0.05), and between the one-hour-OGTT glucose level and the relative abundances of Akkermansia and Butyricimonas (r=-0.285 and -0.265, both P<0.05). The two-hour-OGTT glucose level was positively related to the relative abundance of Faecalibacterium (r=0.278, P<0.05), but negatively related to the relative abundance of Akkermansia (r=-0.245, P<0.05). The area under the OGTT time-glucose curve was negatively related to the relative abundances of Akkermansia and Butyricimonas (r=-0.321 and -0.264, both P<0.05). \u0000 \u0000 \u0000Conclusions \u0000There are significant differences in gut microbial composition and structure between GDM and healthy pregnant women, which are significantly associated with OGTT blood glucose level. Euglycemia achieved after GDM management could improve gut micro","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"98-104"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44734499","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}
Gestational diabetes mellitus (GDM) refers to the carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. In recent years, the growing prevalence of obesity and GDM has been of long-standing interest. Maternal obesity is an independent risk factor of GDM, which can lead to adverse pregnancy outcomes. This review describes the relationship between maternal obesity and GDM from the aspects of the evaluation index and the management of obesity during pregnancy. Key words: Diabetes, gestational; Obesity; Body mass index
{"title":"Maternal obesity and gestational diabetes mellitus","authors":"Zhimin Song, Yan-hi Cheng, Qingying Zhang, Haidong Cheng","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.011","url":null,"abstract":"Gestational diabetes mellitus (GDM) refers to the carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. In recent years, the growing prevalence of obesity and GDM has been of long-standing interest. Maternal obesity is an independent risk factor of GDM, which can lead to adverse pregnancy outcomes. This review describes the relationship between maternal obesity and GDM from the aspects of the evaluation index and the management of obesity during pregnancy. \u0000 \u0000Key words: \u0000Diabetes, gestational; Obesity; Body mass index","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"131-134"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47029474","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.012
Shujuan Li, Yi Yang, Yun Cao
Recent studies have revealed that human milk harbors stem cells at various stages of differentiation, including pluripotent stem cells, hematopoietic stem cells and mesenchymal stem cells. The stem cellular components of human milk with high interindividual variability are affected by gestational age and lactation stages. The maternal stem cells which pass to the infant through human milk could help boost offspring growth and development. Human milk stem cell with multi-directional differentiation potential may be a new source of stem cell replacement therapy in the future. We hereby review the latest progress in human milk stem cells from these aspects. Key words: Milk, human; Stem cells; Child development
{"title":"Advances in human milk stem cells","authors":"Shujuan Li, Yi Yang, Yun Cao","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.012","url":null,"abstract":"Recent studies have revealed that human milk harbors stem cells at various stages of differentiation, including pluripotent stem cells, hematopoietic stem cells and mesenchymal stem cells. The stem cellular components of human milk with high interindividual variability are affected by gestational age and lactation stages. The maternal stem cells which pass to the infant through human milk could help boost offspring growth and development. Human milk stem cell with multi-directional differentiation potential may be a new source of stem cell replacement therapy in the future. We hereby review the latest progress in human milk stem cells from these aspects. \u0000 \u0000Key words: \u0000Milk, human; Stem cells; Child development","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"135-138"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48509217","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}
We reported a women with ornithine carbamoyltransferase deficiency who delivered a healthy boy after two pregnancies with adverse outcome with the help of a multidiscipline team. The woman was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine with an acute prenatal hyperammonemic episode at 28 gestational weeks of her first pregnancy in 2013 and was diagnosed with ornithine transcarbamylase deficiency. Her hyperammonemic complications were controlled under a well-planned multidisciplinary management including a low-protein diet and appropriate medications assisting nitrogen removal. A boy was delivered by cesarean section at 32 weeks of gestation but died three days later. Mutation analysis revealed a hemizygous c.583G>A (G195R) mutation in the neonatal ornithine carbamyltransferase gene and his mother was a heterozygous carrier with the same mutation. Two years later in 2015, the patient was pregnant spontaneously. However, she received an induced abortion at 21 weeks of gestation because amniocentesis and DNA analysis showed that the male fetus had the same ornithine transcarbamylase gene mutation. The index pregnancy was assisted by in vitro fertilization-embryo transfer and preimplantation genetic diagnosis in 2017 and the woman delivered a healthy boy with the management of a multidisciplinary team. Key words: Ornithine carbamoyltransferase deficiency disease; Gravidity; Peripartum period; Patient care management
{"title":"A healthy neonate born at the third pregnancy of a woman with ornithine carbamoyltransferase deficiency under multidisciplinary management","authors":"Yan Zeng, Yuelin Wu, Huaxiang Shen, Mengnan Yang, Shengyi Gu, Zhengqian Mou, Xiaolin Hua","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.007","url":null,"abstract":"We reported a women with ornithine carbamoyltransferase deficiency who delivered a healthy boy after two pregnancies with adverse outcome with the help of a multidiscipline team. The woman was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine with an acute prenatal hyperammonemic episode at 28 gestational weeks of her first pregnancy in 2013 and was diagnosed with ornithine transcarbamylase deficiency. Her hyperammonemic complications were controlled under a well-planned multidisciplinary management including a low-protein diet and appropriate medications assisting nitrogen removal. A boy was delivered by cesarean section at 32 weeks of gestation but died three days later. Mutation analysis revealed a hemizygous c.583G>A (G195R) mutation in the neonatal ornithine carbamyltransferase gene and his mother was a heterozygous carrier with the same mutation. Two years later in 2015, the patient was pregnant spontaneously. However, she received an induced abortion at 21 weeks of gestation because amniocentesis and DNA analysis showed that the male fetus had the same ornithine transcarbamylase gene mutation. The index pregnancy was assisted by in vitro fertilization-embryo transfer and preimplantation genetic diagnosis in 2017 and the woman delivered a healthy boy with the management of a multidisciplinary team. \u0000 \u0000Key words: \u0000Ornithine carbamoyltransferase deficiency disease; Gravidity; Peripartum period; Patient care management","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"111-113"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49049657","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.006
Luan-ying Tian, H. Li, Zhen Wang
Objective To investigate the influence of early skin-to-skin contact (SSC) after cesarean section on maternal psychological status and the rate of exclusive breastfeeding. Methods This was a prospective randomized controlled study enrolling 221 singleton pregnant women who underwent elected caesarean section at term in Shenzhen Nanshan Maternity and Child Healthcare Hospital from August 1 to December 31, 2017. They were randomly divided into SSC group and control group. In the SSC group, naked infants were placed on the mothers' chests within 1 h after delivery for 1-2 h, while those in the control group received standard care. Clinical outcomes were compared between two groups, including the rate of exclusive breastfeeding and score of Breastfeeding Self-Efficacy Scale (BSES) and Edinburgh Postnatal Depression Scale (EPDS) at 72 h and 42 d after delivery, scores of Breastfeeding Assessment Tool (BAT) for the first breastfeeding, time to lactogenesis and successful rate of first breastfeeding. Two-independent sample t test, Chi-square test and binary logistic regression analysis were used as statistical methods. Results Eventually, 210 puerperae were analyzed with 105 in each group. Twenty in the SSC group and 17 in the control group were lost to follow-up 42 d after delivery. The successful rate of first breastfeeding [77.1% (81/105) vs 59.1% (62/105), χ2=7.913, P=0.005], BAT scores (9.5±1.7 vs 8.6±1.4, t=4.115, P<0.001), the rate of lactation initiation ≤24 h after birth [41.0% (43/105) vs 12.4% (13/105), χ2=23.205, P<0.001], and exclusive breastfeeding rates [36.2% (38/105) vs 22.9% (24/105), χ2=4.486, P=0.034; 76.5% (65/85) vs 60.2% (63/88), χ2=5.261, P =0.022] and BESE scores (117.5±12.0 vs 111.8±22.3, t=2.100, P=0.037; 124.3±11.6 vs 113.1±19.0, t=4.710, P<0.001) at 72 h and 42 d after delivery were all higher in the SSC group than those in the control group. However, no statistically significant difference in EPDS scores was observed between the two groups at either 72 h or 42 d after delivery (5.4±3.5 vs 5.9±4.0, t=0.937, P=0.350; 7.0±3.7 vs 8.1±4.0, t=0.905, P=0.058). Binary logistic regression analysis showed early SSC was a protective factor for successful exclusive breastfeeding 42 d after delivery (OR=2.359, 95%CI: 1.173-4.743, P=0.016). Conclusions Early SSC after caesarean should be recommended as a usual clinical practice because it can improve maternal confidence on breastfeeding, shorten the time to lactogenesis and increase the successful rate of first breastfeeding and exclusive breastfeeding rate during puerperium. Key words: Breast feeding; Postpartum period; Self efficacy; Self-assessment; Assertiveness; Randomized controlled trial
目的探讨剖宫产术后早期皮肤接触对产妇心理状态和纯母乳喂养率的影响。方法采用前瞻性随机对照研究，纳入2017年8月1日至12月31日在深圳南山妇幼保健院接受择期剖宫产手术的221例单胎孕妇。随机分为SSC组和对照组。SSC组在分娩后1小时内将裸体婴儿放在母亲的胸部，持续1-2小时，而对照组则接受标准护理。比较两组的临床结果，包括纯母乳喂养率、产后72小时和42天的母乳喂养自我效能量表（BSES）和爱丁堡产后抑郁量表（EPDS）评分、首次母乳喂养的母乳喂养评估工具（BAT）评分、产乳时间和首次母乳喂养成功率。采用两个独立样本t检验、卡方检验和二元逻辑回归分析作为统计方法。结果分析210例产妇，每组105例。SSC组有20例和对照组有17例在分娩后42天失访。首次母乳喂养的成功率[77.1%（81/105）vs 59.1%（62/105），χ2=7.913，P=0.005]，BAT评分（9.5±1.7 vs 8.6±1.4，t=4.115，P<0.001），出生后≤24 h开始泌乳率[41.0%（43/105）vs12.4%（13/105），χ=23.205，P<0.001]，SSC组产后72小时和42天的纯母乳喂养率[36.2%（38/105）vs 22.9%（24/105），χ2=4.486，P=0.034；76.5%（65/85）vs 60.2%（63/88），χ0=5.261，P=0.022]和BESE评分（117.5±12.0 vs 111.8±22.3，t=2.100，P=0.037；124.3±11.6 vs 113.1±19.0，t=4.710，P<0.001）均高于对照组。然而两组在产后72小时或42天的EPDS评分均无统计学显著差异（5.4±3.5 vs 5.9±4.0，t=0.937，P=0.350；7.0±3.7 vs 8.1±4.0，t=0.905，P=0.058）。二元逻辑回归分析显示，早期SSC是产后42天成功纯母乳喂养的保护因素（or=2.359，95%CI:1.173-4.743，P=0.016）。结论剖宫产术后早期SSC可提高产妇对母乳喂养的信心，缩短产乳时间，提高首次母乳喂养成功率和产褥期纯母乳喂养率，因此应推荐将其作为临床常规做法。关键词：母乳喂养；产后；自我效能；自我评估；自信；随机对照试验
{"title":"Influence of early skin-to-skin contact after cesarean section on maternal psychological status and exclusive breastfeeding rate: a prospective randomized controlled study","authors":"Luan-ying Tian, H. Li, Zhen Wang","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.006","url":null,"abstract":"Objective \u0000To investigate the influence of early skin-to-skin contact (SSC) after cesarean section on maternal psychological status and the rate of exclusive breastfeeding. \u0000 \u0000 \u0000Methods \u0000This was a prospective randomized controlled study enrolling 221 singleton pregnant women who underwent elected caesarean section at term in Shenzhen Nanshan Maternity and Child Healthcare Hospital from August 1 to December 31, 2017. They were randomly divided into SSC group and control group. In the SSC group, naked infants were placed on the mothers' chests within 1 h after delivery for 1-2 h, while those in the control group received standard care. Clinical outcomes were compared between two groups, including the rate of exclusive breastfeeding and score of Breastfeeding Self-Efficacy Scale (BSES) and Edinburgh Postnatal Depression Scale (EPDS) at 72 h and 42 d after delivery, scores of Breastfeeding Assessment Tool (BAT) for the first breastfeeding, time to lactogenesis and successful rate of first breastfeeding. Two-independent sample t test, Chi-square test and binary logistic regression analysis were used as statistical methods. \u0000 \u0000 \u0000Results \u0000Eventually, 210 puerperae were analyzed with 105 in each group. Twenty in the SSC group and 17 in the control group were lost to follow-up 42 d after delivery. The successful rate of first breastfeeding [77.1% (81/105) vs 59.1% (62/105), χ2=7.913, P=0.005], BAT scores (9.5±1.7 vs 8.6±1.4, t=4.115, P<0.001), the rate of lactation initiation ≤24 h after birth [41.0% (43/105) vs 12.4% (13/105), χ2=23.205, P<0.001], and exclusive breastfeeding rates [36.2% (38/105) vs 22.9% (24/105), χ2=4.486, P=0.034; 76.5% (65/85) vs 60.2% (63/88), χ2=5.261, P =0.022] and BESE scores (117.5±12.0 vs 111.8±22.3, t=2.100, P=0.037; 124.3±11.6 vs 113.1±19.0, t=4.710, P<0.001) at 72 h and 42 d after delivery were all higher in the SSC group than those in the control group. However, no statistically significant difference in EPDS scores was observed between the two groups at either 72 h or 42 d after delivery (5.4±3.5 vs 5.9±4.0, t=0.937, P=0.350; 7.0±3.7 vs 8.1±4.0, t=0.905, P=0.058). Binary logistic regression analysis showed early SSC was a protective factor for successful exclusive breastfeeding 42 d after delivery (OR=2.359, 95%CI: 1.173-4.743, P=0.016). \u0000 \u0000 \u0000Conclusions \u0000Early SSC after caesarean should be recommended as a usual clinical practice because it can improve maternal confidence on breastfeeding, shorten the time to lactogenesis and increase the successful rate of first breastfeeding and exclusive breastfeeding rate during puerperium. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Postpartum period; Self efficacy; Self-assessment; Assertiveness; Randomized controlled trial","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"105-110"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46518336","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}
Pub Date : 2020-02-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2020.02.003
Siying Zhuang, Juanjuan Guo, Yuming Cao, Huijun Chen, Dan Xu, J. Li, Yuan-zhen Zhang
We hereby reported the diagnosis, treatment process and perinatal outcome of a patient with novel coronavirus infection in perinatal period. The pregnant woman delivered a boy by cesarean section at 37+2 gestational weeks due to severe liver dysfunction. She subsequently had a high fever 2 days later, and novel coronavirus infection was confirmed by nucleic acid test in a throat swab. After a 12-day isolation and support treatment, her two consecutive throat swab results for novel coronavirus turned negative and she was discharged. The novel coronavirus was tested in the patient's blood, urine, breast milk as well as the neonatal throat swab, and the results were all negative. The neonate had an elevated myocardial enzyme, but was otherwise well and was discharged after 14-day isolation with normal myocardial enzyme. Key words: Novel coronavirus; Pregnancy; Infant, newborn
{"title":"Perinatal novel coronavirus infection: a case report","authors":"Siying Zhuang, Juanjuan Guo, Yuming Cao, Huijun Chen, Dan Xu, J. Li, Yuan-zhen Zhang","doi":"10.3760/CMA.J.ISSN.1007-9408.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2020.02.003","url":null,"abstract":"We hereby reported the diagnosis, treatment process and perinatal outcome of a patient with novel coronavirus infection in perinatal period. The pregnant woman delivered a boy by cesarean section at 37+2 gestational weeks due to severe liver dysfunction. She subsequently had a high fever 2 days later, and novel coronavirus infection was confirmed by nucleic acid test in a throat swab. After a 12-day isolation and support treatment, her two consecutive throat swab results for novel coronavirus turned negative and she was discharged. The novel coronavirus was tested in the patient's blood, urine, breast milk as well as the neonatal throat swab, and the results were all negative. The neonate had an elevated myocardial enzyme, but was otherwise well and was discharged after 14-day isolation with normal myocardial enzyme. \u0000 \u0000Key words: \u0000Novel coronavirus; Pregnancy; Infant, newborn","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2020-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49309351","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}
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