Pub Date : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.001
Bo-lai Li, M. Liang, M. Zhai, Yang Zhang, Jian‐liu Wang, Xiao-hui Zhang
Objective To analyze the maternal and fetal outcomes of pregnancies complicated by aplastic anemia (AA) and to investigate the underlying risk factors. Methods In this retrospective case control study, we retrieved medical records of 85 singleton gravidas with AA (AA group) who were admitted to Peking University People's Hospital from January 2003 to January 2016, and another 340 singleton gravidas (case∶control=1∶4) without blood system or immune system diseases who gave birth at the same period were selected as the control group. Differences in general condition and the incidence of maternal and neonatal complications were compared between the two groups. AA group were further divided into adverse outcome subgroup (n=33) and non-adverse outcome subgroup (n=52), and relevant factors were also analyzed. Statistical analysis was performed using t-test, Chi-square test and logistic regression. Results No maternal deaths occurred in all 85 cases of AA group, 81 of them gave live birth [one neonate died and the others survived with a mean gestational age of 36+5 weeks (30+2-40+5 weeks)], and 45 developed maternal or fetal adverse outcomes. Compared with the control group, AA group had higher incidences of hypertensive disorders of pregnancy [20.0% (17/85) vs 6.2% (21/340)], acute heart failure [7.1% (6/85) vs 0.0% (0/340)], postpartum hemorrhage [5.9% (5/85) vs 0.9% (3/340)], puerperal infection [2.4% (2/85) vs 0.0% (0/340)], preterm birth [22.3% (19/85) vs 5.6% (19/340)], small for gestational age [11.7% (10/85) vs 0.9% (3/340)], fetal growth restriction [8.2% (7/85) vs 1.2% (4/340)], intrauterine fetal death [4.7% (4/85) vs 0.0% (0/340)] and neonatal death [1.2% (1/85) vs 0.0% (0/340)] (all P<0.05). After adjusting for age, pregnancy history and the time of diagnosis, we found that low median (OR=0.88, 95%CI: 0.83-0.95), mean (OR=0.85, 95%CI: 0.79-0.93) and minimal (OR=0.87, 95%CI: 0.82-0.93) values of hemoglobin concentration during pregnancy, and low median (OR=0.96, 95%CI: 0.92-1.00), mean (OR=0.96, 95%CI: 0.92-1.00) and minimal (OR=0.95, 95%CI: 0.90-0.99) values of platelet counts during pregnancy were risk factors for adverse maternal and fetal outcomes of gravidas with AA (all P<0.05). Conclusions Maternal and fetal complications are more common in pregnant women with AA and maintain hemoglobin and platelet counts at a certain level may improve the outcomes. Key words: Pregnancy complications, hematologic; Anemia, aplastic; Pregnancy outcome
{"title":"Maternal and fetal outcomes and related risk factors of 85 cases with aplastic anemia in pregnancy: a retrospective case control study","authors":"Bo-lai Li, M. Liang, M. Zhai, Yang Zhang, Jian‐liu Wang, Xiao-hui Zhang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.001","url":null,"abstract":"Objective \u0000To analyze the maternal and fetal outcomes of pregnancies complicated by aplastic anemia (AA) and to investigate the underlying risk factors. \u0000 \u0000 \u0000Methods \u0000In this retrospective case control study, we retrieved medical records of 85 singleton gravidas with AA (AA group) who were admitted to Peking University People's Hospital from January 2003 to January 2016, and another 340 singleton gravidas (case∶control=1∶4) without blood system or immune system diseases who gave birth at the same period were selected as the control group. Differences in general condition and the incidence of maternal and neonatal complications were compared between the two groups. AA group were further divided into adverse outcome subgroup (n=33) and non-adverse outcome subgroup (n=52), and relevant factors were also analyzed. Statistical analysis was performed using t-test, Chi-square test and logistic regression. \u0000 \u0000 \u0000Results \u0000No maternal deaths occurred in all 85 cases of AA group, 81 of them gave live birth [one neonate died and the others survived with a mean gestational age of 36+5 weeks (30+2-40+5 weeks)], and 45 developed maternal or fetal adverse outcomes. Compared with the control group, AA group had higher incidences of hypertensive disorders of pregnancy [20.0% (17/85) vs 6.2% (21/340)], acute heart failure [7.1% (6/85) vs 0.0% (0/340)], postpartum hemorrhage [5.9% (5/85) vs 0.9% (3/340)], puerperal infection [2.4% (2/85) vs 0.0% (0/340)], preterm birth [22.3% (19/85) vs 5.6% (19/340)], small for gestational age [11.7% (10/85) vs 0.9% (3/340)], fetal growth restriction [8.2% (7/85) vs 1.2% (4/340)], intrauterine fetal death [4.7% (4/85) vs 0.0% (0/340)] and neonatal death [1.2% (1/85) vs 0.0% (0/340)] (all P<0.05). After adjusting for age, pregnancy history and the time of diagnosis, we found that low median (OR=0.88, 95%CI: 0.83-0.95), mean (OR=0.85, 95%CI: 0.79-0.93) and minimal (OR=0.87, 95%CI: 0.82-0.93) values of hemoglobin concentration during pregnancy, and low median (OR=0.96, 95%CI: 0.92-1.00), mean (OR=0.96, 95%CI: 0.92-1.00) and minimal (OR=0.95, 95%CI: 0.90-0.99) values of platelet counts during pregnancy were risk factors for adverse maternal and fetal outcomes of gravidas with AA (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Maternal and fetal complications are more common in pregnant women with AA and maintain hemoglobin and platelet counts at a certain level may improve the outcomes. \u0000 \u0000 \u0000Key words: \u0000Pregnancy complications, hematologic; Anemia, aplastic; Pregnancy outcome","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"761-766"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44491084","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.004
Zhong Junyan, Zong Haifeng, Ye Nan, H. Mei, Yu Yurong, Zhang Sue, Zhang Wanfang, Zhuo-Ting Lin, Zhang Shujuan, Hu Zhifeng, Shi Yuping, Yang Chuanzhong
Objective To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O2 (FiO2) and ratio of partial pressure of oxygen (PO2) over FiO2 were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis. Results There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO2), FiO2 and PO2/FiO2 at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO2: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO2: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO2/FiO2: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P 0.05). Conclusions SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO2 without causing significant complications. Key words: Respiratory distress syndrome, newborn; Continuous positive airway pressure; Pulmonary surfactants; Treatment outcome
目的探讨持续性肺充气（SLI）联合肺表面活性物质（PS）治疗新生儿呼吸窘迫综合征（NRDS）的疗效及不良反应。方法采用前瞻性随机对照试验，纳入2016年7月1日至2018年10月31日在南方医科大学附属深圳妇幼保健院就诊的124名诊断为NRDS、需要PS治疗的早产儿（胎龄<34周，出生体重<2000g）。他们被随机分为实验组和对照组，每组62例。实验组的婴儿使用T型片和气管内PS进行SLI治疗，而对照组的婴儿仅接受PS治疗。在PS注射前和注射后1小时进行血气分析和吸气O2分数（FiO2）和氧分压（PO2）与FiO2的比率的测量。比较两种治疗方法的疗效和并发症的发生率。采用配对样本t检验、两个独立样本t检验，秩和检验和卡方检验进行统计分析。结果实验组有56名参与者，对照组有54名参与者最终接受了分析。实验组的pH值、二氧化碳分压（PCO2），与治疗前相比，PS注射后1小时的FiO2和PO2/FiO2均有所改善[pH值：7.26±0.09 vs 7.19±0.09，t=3.814；PCO2:（51.5±12.6）vs（59.8±16.3）mmHg（1mmHg=0.133kPa），t=2.610；FiO2:26.0（21.0-31.5）%vs 40.5（38.5-51.5）%，U=392.000；PO2/FiO2:（284.6±117.9）vs（173.4±59.7）mmHg，t=6.427；结论SLI联合PS治疗NRDS患儿可提高24 h内拔管率，促进FiO2的下调，不会引起明显的并发症。关键词：呼吸窘迫综合征，新生儿；持续气道正压；肺表面活性剂；治疗结果
{"title":"Effects of sustained lung inflation combined with pulmonary surfactant on neonatal respiratory distress syndrome: a prospective randomized controlled trial","authors":"Zhong Junyan, Zong Haifeng, Ye Nan, H. Mei, Yu Yurong, Zhang Sue, Zhang Wanfang, Zhuo-Ting Lin, Zhang Shujuan, Hu Zhifeng, Shi Yuping, Yang Chuanzhong","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.004","url":null,"abstract":"Objective \u0000To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). \u0000 \u0000 \u0000Methods \u0000This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O2 (FiO2) and ratio of partial pressure of oxygen (PO2) over FiO2 were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO2), FiO2 and PO2/FiO2 at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO2: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO2: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO2/FiO2: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO2 without causing significant complications. \u0000 \u0000 \u0000Key words: \u0000Respiratory distress syndrome, newborn; Continuous positive airway pressure; Pulmonary surfactants; Treatment outcome","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"781-786"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45406993","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.009
N. Liu, Yu Guo, Chaofeng Zhu, Yin Feng, X. Kong
We hereby reported a case of false negative non-invasive prenatal screening (NIPS) for trisomy 18. The fetus with increased nuchal translucency (3.2 mm) detected by ultrasound scan at 13+4 gestational weeks received NIPS and the result was negative in chromosomes 21, 18 and 13. A routine ultrasound examination at 22 weeks of gestation revealed multiple anomalies and a second NIPS was offered, which showed a negative result again. The pregnancy was terminated at 22+3 weeks. Multiple fetal and placental biopsies were collected for chromosome analysis using copy number variation sequencing based on high-throughput sequencing and fluorescence in situ hybridization. The fetal karyotype was shown to be 47,XY,+18 in fetal tissues (skin and liver) and umbilical cord, while no chromosomal abnormalities was detected at or near the center of the fetal and maternal surface of the placenta. Results of the chromosomal analysis along the edges of the fetal and maternal surfaces of the placenta were Chr18:47,XY,+18[60]/46,XY[40] and Chr18:47,XY,+18[35]/46,XY[65], respectively. We inferred that placental mosaicism was the cause of the false negative NIPS result. Therefore, genetic counseling before and after NIPS is necessary. Follow-up ultrasound is important for NIPS-negative patients. Invasive prenatal diagnosis is recommended when abnormal ultrasound markers with possible genetic etiology were recognized. Key words: Trisomy 18 syndrome; Ultrasonography, prenatal; False negative reactions; Nuchal translucency measurement
{"title":"False negative non-invasive prenatal screening result for trisomy 18: a case report","authors":"N. Liu, Yu Guo, Chaofeng Zhu, Yin Feng, X. Kong","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.009","url":null,"abstract":"We hereby reported a case of false negative non-invasive prenatal screening (NIPS) for trisomy 18. The fetus with increased nuchal translucency (3.2 mm) detected by ultrasound scan at 13+4 gestational weeks received NIPS and the result was negative in chromosomes 21, 18 and 13. A routine ultrasound examination at 22 weeks of gestation revealed multiple anomalies and a second NIPS was offered, which showed a negative result again. The pregnancy was terminated at 22+3 weeks. Multiple fetal and placental biopsies were collected for chromosome analysis using copy number variation sequencing based on high-throughput sequencing and fluorescence in situ hybridization. The fetal karyotype was shown to be 47,XY,+18 in fetal tissues (skin and liver) and umbilical cord, while no chromosomal abnormalities was detected at or near the center of the fetal and maternal surface of the placenta. Results of the chromosomal analysis along the edges of the fetal and maternal surfaces of the placenta were Chr18:47,XY,+18[60]/46,XY[40] and Chr18:47,XY,+18[35]/46,XY[65], respectively. We inferred that placental mosaicism was the cause of the false negative NIPS result. Therefore, genetic counseling before and after NIPS is necessary. Follow-up ultrasound is important for NIPS-negative patients. Invasive prenatal diagnosis is recommended when abnormal ultrasound markers with possible genetic etiology were recognized. \u0000 \u0000 \u0000Key words: \u0000Trisomy 18 syndrome; Ultrasonography, prenatal; False negative reactions; Nuchal translucency measurement","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"808-811"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41349138","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.010
D. Jie, Y. Jianying, Zhang Qinjian
Iron plays an important role in maintaining normal physiological functions of oxygen transportation and electron transfer in the body. However, excessive iron intake will induce the generation of oxygen radicals through Fenton reaction and result in free radical chain reactions, causing lipid peroxidation and DNA damage. Oxidative stress is also known as one of the causes of preeclampsia. Therefore, the correlation between iron overload and preeclampsia has attracted more attention. Relevant publications were reviewed to discuss the potential mechanisms of iron overload under oxidative stress in the pathogenesis of preeclampsia. Key words: Pre-eclampsia; Iron; Oxidative stress
{"title":"Progress in role of iron in pathogenesis of preeclampsia","authors":"D. Jie, Y. Jianying, Zhang Qinjian","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.010","url":null,"abstract":"Iron plays an important role in maintaining normal physiological functions of oxygen transportation and electron transfer in the body. However, excessive iron intake will induce the generation of oxygen radicals through Fenton reaction and result in free radical chain reactions, causing lipid peroxidation and DNA damage. Oxidative stress is also known as one of the causes of preeclampsia. Therefore, the correlation between iron overload and preeclampsia has attracted more attention. Relevant publications were reviewed to discuss the potential mechanisms of iron overload under oxidative stress in the pathogenesis of preeclampsia. \u0000 \u0000 \u0000Key words: \u0000Pre-eclampsia; Iron; Oxidative stress","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"812-816"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42001241","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.013
Jing Xu
Gravidas receiving epidural labor analgesia are at an increased risk for intrapartum fever due to unknown mechanism, which may be related to thermoregulation, non-infectious inflammatory, continued use of local anesthetic agents and trauma from epidural catheter insertion. Epidural labor analgesia-related intrapartum fever is associated with excessive obstetric interventions, higher rates of cesarean and assisted vaginal deliveries, unnecessary maternal and neonatal exposure to antibiotics, and adverse neonatal outcomes. Hence it is imperative to explore its etiology and shorten the labor with a safe and effective measure to reduce the occurrence of intrapartum fever. Key words: Analgesia, epidural; Analgesia, obstetrical; Fever
{"title":"Progress in epidural labor analgesia-related intrapartum fever","authors":"Jing Xu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.013","url":null,"abstract":"Gravidas receiving epidural labor analgesia are at an increased risk for intrapartum fever due to unknown mechanism, which may be related to thermoregulation, non-infectious inflammatory, continued use of local anesthetic agents and trauma from epidural catheter insertion. Epidural labor analgesia-related intrapartum fever is associated with excessive obstetric interventions, higher rates of cesarean and assisted vaginal deliveries, unnecessary maternal and neonatal exposure to antibiotics, and adverse neonatal outcomes. Hence it is imperative to explore its etiology and shorten the labor with a safe and effective measure to reduce the occurrence of intrapartum fever. \u0000 \u0000 \u0000Key words: \u0000Analgesia, epidural; Analgesia, obstetrical; Fever","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"829-832"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43017513","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.011
Qiaoqiao Zhang, Yan Liu
Premature infants are at high risk of vitamin D deficiency, thereby commonly treated with vitamin D supplementation after birth. However, the nutritional status of vitamin D in premature infants is not optimistic due to the fact of high incidence of vitamin D deficiency. Studies have found that vitamin D is associated with a variety of diseases in premature infants, including metabolic bone disease, respiratory distress syndrome, bronchopulmonary dysplasia, neonatal necrotizing enterocolitis and infection. Clinicians should be aware of the importance of vitamin D for premature infants and prescribe vitamin D supplementation as early as possible with the dose reference of serum 25-hydroxyvitamin D level. Key words: Infant, premature, diseases; Vitamin D; Nutritional status; Vitamin D deficiency
{"title":"Advances in correlation between vitamin D nutritional status and diseases in premature infants","authors":"Qiaoqiao Zhang, Yan Liu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.011","url":null,"abstract":"Premature infants are at high risk of vitamin D deficiency, thereby commonly treated with vitamin D supplementation after birth. However, the nutritional status of vitamin D in premature infants is not optimistic due to the fact of high incidence of vitamin D deficiency. Studies have found that vitamin D is associated with a variety of diseases in premature infants, including metabolic bone disease, respiratory distress syndrome, bronchopulmonary dysplasia, neonatal necrotizing enterocolitis and infection. Clinicians should be aware of the importance of vitamin D for premature infants and prescribe vitamin D supplementation as early as possible with the dose reference of serum 25-hydroxyvitamin D level. \u0000 \u0000 \u0000Key words: \u0000Infant, premature, diseases; Vitamin D; Nutritional status; Vitamin D deficiency","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"817-821"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44261199","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.006
Yayin Lin, Xinzhu Lin, Ji-dong Lai
Objective To analyze clinical features, treatment, prognosis and risk factors for death of capillary leak syndrome (CLS) in neonates. Methods This retrospective study involved 68 neonates with CLS treated in the Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University from January 2013 to December 2017. Clinical data, including features, causes, treatment and outcomes of those CLS cases were analyzed. Chi-square test and multivariate logistic regression analysis were performed. Results Among the 68 cases consisting of 49 males and 19 females, 86.7% (59/68) were born at ≥ 35 gestational weeks. Fifty-three neonates (77.9%) developed symptoms within three days after admission. Forty-two cases (61.8%) had respiratory distress syndrome and 35 (51.5%) had septicemia. The mortality rate was 23.5% (16/68). Among the survivors, 38.5% (20/52) showed abnormal cranial MRI. Univariate analysis with Chi-square test showed that neonatal death due to CLS was associated with the lactic acid level >10 mmol/L, oliguria lasting for 12 h or anuria for 8 h, no negative fluid balance occured within seven days, adrenaline infusion >0.6 μg/(kg·min) and administration of 3% sodium chloride. Multivariate logistic regression analysis showed that lactic acid level, oliguria/anuria duration and the time achieve negative fluid balance were independent risk factors for neonatal death of CLS. Conclusions Neonatal CLS is a condition with high fatality rate and poor prognosis. Respiratory distress syndrome and septicemia are the common causes. The prognosis of CLS might be improved by treatment with 3% sodium chloride. Lactic acid level, oliguria/anuria duration and the time achieve negative fluid balance are independent risk factors for neonatal death due to CLS. Key words: Capillary leak syndrome; Death; Risk factors; Infant, newborn
{"title":"Neonatal capillary leak syndrome: analysis of 68 cases","authors":"Yayin Lin, Xinzhu Lin, Ji-dong Lai","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.006","url":null,"abstract":"Objective \u0000To analyze clinical features, treatment, prognosis and risk factors for death of capillary leak syndrome (CLS) in neonates. \u0000 \u0000 \u0000Methods \u0000This retrospective study involved 68 neonates with CLS treated in the Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University from January 2013 to December 2017. Clinical data, including features, causes, treatment and outcomes of those CLS cases were analyzed. Chi-square test and multivariate logistic regression analysis were performed. \u0000 \u0000 \u0000Results \u0000Among the 68 cases consisting of 49 males and 19 females, 86.7% (59/68) were born at ≥ 35 gestational weeks. Fifty-three neonates (77.9%) developed symptoms within three days after admission. Forty-two cases (61.8%) had respiratory distress syndrome and 35 (51.5%) had septicemia. The mortality rate was 23.5% (16/68). Among the survivors, 38.5% (20/52) showed abnormal cranial MRI. Univariate analysis with Chi-square test showed that neonatal death due to CLS was associated with the lactic acid level >10 mmol/L, oliguria lasting for 12 h or anuria for 8 h, no negative fluid balance occured within seven days, adrenaline infusion >0.6 μg/(kg·min) and administration of 3% sodium chloride. Multivariate logistic regression analysis showed that lactic acid level, oliguria/anuria duration and the time achieve negative fluid balance were independent risk factors for neonatal death of CLS. \u0000 \u0000 \u0000Conclusions \u0000Neonatal CLS is a condition with high fatality rate and poor prognosis. Respiratory distress syndrome and septicemia are the common causes. The prognosis of CLS might be improved by treatment with 3% sodium chloride. Lactic acid level, oliguria/anuria duration and the time achieve negative fluid balance are independent risk factors for neonatal death due to CLS. \u0000 \u0000 \u0000Key words: \u0000Capillary leak syndrome; Death; Risk factors; Infant, newborn","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"793-796"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45634634","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.006
Bin Tan, C. Tong, Yu Yuan, Li Lin
Objective To investigate the mechanism of wild-type p53-induced phosphatase (Wip1) in regulating p53-dependent apoptosis of trophoblasts for further understanding the etiology of preeclampsia (PE). Methods Placenta tissues were collected from normal (n=15) and PE (n=13) gravidas who underwent caesarean section in the First Affiliated Hospital of Chongqing Medical University from June 2017 to December 2018. Chorionic villus and decidua tissues were collected from another 10 women who aborted in early pregnancy. Two in vitro trophoblastic hypoxia cultures were established by subjecting human chorionic trophoblast cells (HTR8/SVneo) to either hypoxia intervention in incubator (HII) or simulated ischemic buffer (SIB). Wip1 expressions at the transcriptional and protein levels were determined by real-time quantitative polymerase chain reaction and Western blotting, respectively. The localization of Wip1 in placental tissues and HTR8/SVneo cells was determined by immunohistochemistry and immunofluorescence. Cell apoptosis was assessed by flow cytometry after viral infection and hypoxia. And the changes of pathway-related molecules including p53, phospho-p53 (p-p53), mouse double minute 2 homolog (Mdm2) and cleaved caspase3 (cl-cas3) were measured by Western blotting. The impact of Wip1 on Mdm2-p53 interaction was examined by co-immunoprecipitation. NVP-CGM097, an Mdm2-p53 specific inhibitor, was administered in PE cell models to verify the regulation of Wip1 on trophoblastic apoptosis through Mdm2-p53 pathway. Independent student's t-test, Welch's t-test and one-way analysis of variance were used as statistical methods. Results (1) Wip1 expression, which was mainly in trophoblast cells, was significantly elevated in human PE placentas (mRNA: 1.711±0.141 vs 0.860±0.126, t=4.496; protein: 0.449±0.027 vs 0.192±0.019, t=7.902) and in both in vitro trophoblastic PE models (protein in HII: 1.376±0.086 vs 0.977±0.114, t=2.792; SIB: 1.243±0.057 vs 0.381±0.045, t=11.910) compared with the corresponding control groups (all P<0.05). (2) Compared with corresponding control groups, overexpression of Wip1 suppressed the hypoxia-induced upregulation of p53 (HII: 0.185±0.024 vs 0.572±0.072; SIB: 0.400±0.067 vs 0.803±0.064), cl-cas3 (HII: 0.243±0.034 vs 0.529±0.072; SIB: 0.179±0.011 vs 0.368±0.025) and p-p53/p53 protein expression (HII: 1.326±0.129 vs 2.100±0.187; SIB: 0.473±0.028 vs 0.925±0.036) and also reduced the apoptosis rate [HII: (8.925±1.092)% vs (17.610±1.980)%; SIB: (13.910±1.886)% vs (24.650±1.622)%], which in turn promoted Mdm2-p53 binding (all P<0.05). However, knockdown of Wip1 gene expression in HTR8/SVneo cells brought about opposite effects (all P<0.05). (3) Neither overexpression nor knockdown of Wip1 influenced p53 or cl-cas3 expression when Mdm2-p53 interaction was blocked by NVP-CGM097. Conclusions Mdm2-p53 interaction promoted by Wip1 upregulation could compensate for the trophoblastic p53 accumulation in response to hypoxia, w
目的探讨野生型p53诱导的磷酸酶（Wip1）调节p53依赖性滋养层细胞凋亡的机制，以进一步了解子痫前期（PE）的病因。方法收集2017年6月至2018年12月在重庆医科大学第一附属医院剖腹产的正常（n=15）和PE（n=13）孕妇的胎盘组织。从另外10名早孕流产妇女身上采集绒毛和蜕膜组织。通过在培养箱中对人绒毛膜滋养层细胞（HTR8/SVneo）进行缺氧干预（HII）或模拟缺血缓冲液（SIB），建立了两种体外滋养层缺氧培养物。分别通过实时定量聚合酶链反应和蛋白质印迹测定转录和蛋白质水平上的Wip1表达。通过免疫组织化学和免疫荧光测定Wip1在胎盘组织和HTR8/SVneo细胞中的定位。通过流式细胞术评估病毒感染和缺氧后的细胞凋亡。Western印迹法检测p53、磷酸化p53（p-p53）、小鼠双分钟2同源物（Mdm2）和裂解caspase3（cl-cas3）等通路相关分子的变化。通过共免疫沉淀检测Wip1对Mdm2-p53相互作用的影响。NVP-CGM097，一种Mdm2-p53特异性抑制剂，在PE细胞模型中给药，以验证Wip1通过Mdm2-p53途径对滋养层细胞凋亡的调节。采用独立学生t检验、韦尔奇t检验和单因素方差分析作为统计方法。结果（1）Wip1主要在滋养层细胞中表达，与相应的对照组相比，在人PE胎盘中显著升高（mRNA：1.711±0.141 vs 0.860±0.126，t=4.496；蛋白质：0.449±0.027 vs 0.192±0.019，t=7.902），在两种体外滋养层PE模型中（HII:1.376±0.086 vs 0.977±0.114，t=2.792；SIB:1.243±0.057 vs 0.381±0.045，t=11.910）（均P<0.05），Wip1的过表达抑制了缺氧诱导的p53的上调（HII:0.185±0.024 vs 0.572±0.072；SIB:0.400±0.067 vs 0.803±0.064），cl-cas3（HII:0.243±0.034 vs 0.529±0.072；SIB:0.179±0.011 vs 0.368±0.025）和p-p53/p53蛋白表达（HII:1.326±0.129 vs 2.100±0.187；SIB:0.473±0.028 vs 0.925±0.036），还降低了细胞凋亡率[HII:（8.925±1.092）%vs（17.610±1.980）%；SIB:（13.910±1.886）%vs，（3）NVP-CGM097阻断Mdm2-p53相互作用时，Wip1的过表达和敲低均不影响p53和cl-cas3的表达。结论Wip1上调所促进的Mdm2-p53相互作用可以补偿滋养层细胞缺氧时p53的积累，而Wip1在滋养层中的外源性上调可能逆转缺氧诱导的细胞凋亡。因此，这可能为PE提供一个新的治疗靶点；细胞缺氧；滋养层；蛋白磷酸酶2C；细胞凋亡
{"title":"Compensatory role of wild-type p53-induced phosphatase in trophoblastic apoptosis in response to hypoxia","authors":"Bin Tan, C. Tong, Yu Yuan, Li Lin","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.006","url":null,"abstract":"Objective \u0000To investigate the mechanism of wild-type p53-induced phosphatase (Wip1) in regulating p53-dependent apoptosis of trophoblasts for further understanding the etiology of preeclampsia (PE). \u0000 \u0000 \u0000Methods \u0000Placenta tissues were collected from normal (n=15) and PE (n=13) gravidas who underwent caesarean section in the First Affiliated Hospital of Chongqing Medical University from June 2017 to December 2018. Chorionic villus and decidua tissues were collected from another 10 women who aborted in early pregnancy. Two in vitro trophoblastic hypoxia cultures were established by subjecting human chorionic trophoblast cells (HTR8/SVneo) to either hypoxia intervention in incubator (HII) or simulated ischemic buffer (SIB). Wip1 expressions at the transcriptional and protein levels were determined by real-time quantitative polymerase chain reaction and Western blotting, respectively. The localization of Wip1 in placental tissues and HTR8/SVneo cells was determined by immunohistochemistry and immunofluorescence. Cell apoptosis was assessed by flow cytometry after viral infection and hypoxia. And the changes of pathway-related molecules including p53, phospho-p53 (p-p53), mouse double minute 2 homolog (Mdm2) and cleaved caspase3 (cl-cas3) were measured by Western blotting. The impact of Wip1 on Mdm2-p53 interaction was examined by co-immunoprecipitation. NVP-CGM097, an Mdm2-p53 specific inhibitor, was administered in PE cell models to verify the regulation of Wip1 on trophoblastic apoptosis through Mdm2-p53 pathway. Independent student's t-test, Welch's t-test and one-way analysis of variance were used as statistical methods. \u0000 \u0000 \u0000Results \u0000(1) Wip1 expression, which was mainly in trophoblast cells, was significantly elevated in human PE placentas (mRNA: 1.711±0.141 vs 0.860±0.126, t=4.496; protein: 0.449±0.027 vs 0.192±0.019, t=7.902) and in both in vitro trophoblastic PE models (protein in HII: 1.376±0.086 vs 0.977±0.114, t=2.792; SIB: 1.243±0.057 vs 0.381±0.045, t=11.910) compared with the corresponding control groups (all P<0.05). (2) Compared with corresponding control groups, overexpression of Wip1 suppressed the hypoxia-induced upregulation of p53 (HII: 0.185±0.024 vs 0.572±0.072; SIB: 0.400±0.067 vs 0.803±0.064), cl-cas3 (HII: 0.243±0.034 vs 0.529±0.072; SIB: 0.179±0.011 vs 0.368±0.025) and p-p53/p53 protein expression (HII: 1.326±0.129 vs 2.100±0.187; SIB: 0.473±0.028 vs 0.925±0.036) and also reduced the apoptosis rate [HII: (8.925±1.092)% vs (17.610±1.980)%; SIB: (13.910±1.886)% vs (24.650±1.622)%], which in turn promoted Mdm2-p53 binding (all P<0.05). However, knockdown of Wip1 gene expression in HTR8/SVneo cells brought about opposite effects (all P<0.05). (3) Neither overexpression nor knockdown of Wip1 influenced p53 or cl-cas3 expression when Mdm2-p53 interaction was blocked by NVP-CGM097. \u0000 \u0000 \u0000Conclusions \u0000Mdm2-p53 interaction promoted by Wip1 upregulation could compensate for the trophoblastic p53 accumulation in response to hypoxia, w","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"712-721"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41692565","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.004
Wangsheng Wang
The fetal membranes, consisting of amnion and chorion, cover approximately 70% of the uterine cavity. Accumulating evidence indicates that the fetal membranes are not mere degenerating tissues covering the amniotic fluid and the fetus, but one of the most important functional tissues during pregnancy. The fetal membranes not only protect the fetus, but also secrets a series of hormones and cytokines involved in pregnancy maintenance and fetal development as well as the initiation of labor. Early activation of fetal membranes such as chorioamnionitis will lead to preterm birth. Key words: Fetal membranes; Pregnancy; Premature birth
{"title":"Fetal membranes: degenerative or functional tissues?","authors":"Wangsheng Wang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.004","url":null,"abstract":"The fetal membranes, consisting of amnion and chorion, cover approximately 70% of the uterine cavity. Accumulating evidence indicates that the fetal membranes are not mere degenerating tissues covering the amniotic fluid and the fetus, but one of the most important functional tissues during pregnancy. The fetal membranes not only protect the fetus, but also secrets a series of hormones and cytokines involved in pregnancy maintenance and fetal development as well as the initiation of labor. Early activation of fetal membranes such as chorioamnionitis will lead to preterm birth. \u0000 \u0000 \u0000Key words: \u0000Fetal membranes; Pregnancy; Premature birth","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"698-703"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48357831","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.009
Chanjuan Zeng, Weishe Zhang
Placenta-mediated pregnancy complication (PMPC), including preeclampsia, fetal growth restriction and recurrent pregnancy loss, is caused by inadequate trophoblast invasion and abnormal remodeling of maternal spiral arteries in early pregnancy, resulting in adverse perinatal outcomes and affecting the long-term maternal and child health. However, the molecular mechanisms of PMPC remain unclear. Endocrine gland-derived vascular endothelial growth factor (EG-VEGF) is highly expressed in human placenta and plays an important role in the development of a normal placenta through promoting placental angiogenesis and inhibiting trophoblast migration and invasion. EG-VEGF dysregulation is closely related to the pathogenesis of PMPC. This review described recent advances in EG-VEGF for better understanding of the underlying mechanism of PMPC and providing a potential biomarker for early diagnosis of PMPC. Key words: Pregnancy complications; Placenta diseases; Vascular endothelial growth factor, endocrine-gland-derived
{"title":"Endocrine gland-derived vascular endothelial growth factor and placenta-mediated pregnancy complication","authors":"Chanjuan Zeng, Weishe Zhang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.009","url":null,"abstract":"Placenta-mediated pregnancy complication (PMPC), including preeclampsia, fetal growth restriction and recurrent pregnancy loss, is caused by inadequate trophoblast invasion and abnormal remodeling of maternal spiral arteries in early pregnancy, resulting in adverse perinatal outcomes and affecting the long-term maternal and child health. However, the molecular mechanisms of PMPC remain unclear. Endocrine gland-derived vascular endothelial growth factor (EG-VEGF) is highly expressed in human placenta and plays an important role in the development of a normal placenta through promoting placental angiogenesis and inhibiting trophoblast migration and invasion. EG-VEGF dysregulation is closely related to the pathogenesis of PMPC. This review described recent advances in EG-VEGF for better understanding of the underlying mechanism of PMPC and providing a potential biomarker for early diagnosis of PMPC. \u0000 \u0000 \u0000Key words: \u0000Pregnancy complications; Placenta diseases; Vascular endothelial growth factor, endocrine-gland-derived","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"735-739"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44329620","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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