Maternal-fetal medicine (Wolters Kluwer Health, Inc.)最新文献

Objective: To compare the analgesic effects of ibuprofen administered orally via two modes combined with a conventional, patient-controlled intravenous analgesia pump on maternal pain after cesarean section (CS).

Methods: This prospective, randomized, controlled study enrolled females who underwent CS from August 2022 to August 2023 at Peking University First Hospital, Beijing, China. Participants were randomly assigned to either an as-needed ibuprofen group (300 mg orally upon request) or a scheduled ibuprofen group (300 mg every 12 hours for 48 hours). The primary outcomes assessed were postoperative pain levels using the Wong-Baker Faces Pain Scale-Revised and cumulative oxycodone consumption at multiple time points up to 48 hours post-delivery. Secondary outcomes included recovery parameters (time to first flatus, ambulation, and lactation initiation), patient satisfaction with pain control, and postpartum depression scores evaluated by the Edinburgh Postnatal Depression Scale on postoperative day 3. Normally distributed data analyzed with t-tests; non-normal data with Mann-Whitney U tests; categorical variables with chi-square or Fisher's exact tests (SPSS 26.0, P < 0.05).

Results: After excluding 61 non-eligible cases, 339 patients were included (171 as-needed vs. 168 scheduled). The scheduled group showed significantly better pain control at 12 hours (4.00 (2.00-5.50) vs. 4.00 (4.00-6.00), P < 0.001), 24 hours (4.00 (2.00-4.00) vs. 4.00 (2.00-6.00), P < 0.001), and 36 hours (2.00 (2.00-4.00) vs. 4.00 (2.00-4.00), P < 0.001), and 48 hours (2.00 (2.00-4.00) vs. 2.00 (2.00-4.00), P = 0.004) post-delivery and lower levels of oxycodone consumption at 36 hours (10.20 (8.20-13.35) vs. 11.00 (8.80-14.40), P = 0.042) and 48 hours (12.40 (10.40-15.95) vs. 13.80 (11.00-16.00), P = 0.020) postpartum compared with those in the as-needed group. Additionally, the time to the return of bowel movements was shorter in the scheduled group than in the as-needed group (23.50 (16.94, 31.47) vs. 27.00 (19.88, 35.97), P = 0.004). Differences in post-delivery ambulation, lactation initiation, satisfaction levels, and depression scores were not significantly different between the two groups.

Conclusion: The results of this study promote the use of ibuprofen (scheduled oral administration) combined with a conventional, patient-controlled intravenous analgesia pump for achieving better post-CS pain control than an as-needed dosage regimen.

Registration: Chinese Clinical Trial Registry, ChiCTR2400082474.

Objective: To assess the adverse maternal and neonatal outcomes of anemia among pregnant women in primary hospitals in Southern Ethiopia.

Methods: This institution-based prospective cohort study was conducted from March 1 to October 30, 2022, in three primary hospitals in the Hadiya zone of Southern Ethiopia. Participants were categorized into exposed (Hb < 11 g/dL) and non-exposed (Hb ≥ 11 g/dL) groups based on hemoglobin levels measured before delivery. Baseline characteristics were comparable between groups. Maternal and neonatal complications were considered as outcomes. Data were analyzed using STATA version 15. Descriptive statistics summarized baseline characteristics, and Chi-square tests assessed associations. Generalized linear models with a log link calculated adjusted relative risks (aRRs) with 95% CIs. Statistical significance was set at P < 0.05. Multivariable models adjusted for confounders, and sensitivity analyses evaluated robustness using multiple imputations for missing data.

Results: A total of 490 participants were enrolled in the study, with 245 in each of the exposed and non-exposed groups. Due to loss to follow-up, 220 participants in the exposed group and 239 in the non-exposed group were assessed for outcomes. Prolonged labor (adjusted RR (aRR) = 3.235; 95% CI: 1.658, 6.312; P = 0.003) and postpartum hemorrhage (aRR = 2.901; 95% CI: 1.202, 7.910; P = 0.045) were identified as adverse maternal pregnancy outcomes of anemia. We observed low birth weight (aRR = 3.020; 95% CI: 1.233, 6.010; P = 0.002) and respiratory distress syndrome (aRR = 4.820; 95% CI: 2.901, 9.012; P = 0.001) as neonatal complications. Furthermore, having no previous history of anemia reduced the risk of prolonged labor (aRR = 0.078; 95% CI: 0.033, 0.188; P = 0.015) and low birth weight (aRR = 0.480; 95% CI: 0.370, 0.592; P = 0.001).

Conclusion: Mothers who have experienced maternal anemia in the past or present face serious consequences for both themselves and their children. Preventing anemia should thus start before conception and continue through pregnancy.

Alternative splicing (AS) is a crucial process that produces functionally distinct proteins from a single gene, depending on the developmental or physiological state of cells in multicellular organisms. It plays a significant role in cellular proliferation, survival, and differentiation, including embryonic development, spermatogenesis, and a broad spectrum of diseases. However, the precise involvement of AS in embryo implantation is still unclear. In this review, we summarize the potential roles of AS in regulating mesenchymal-epithelial transitions during embryo implantation, specifically in epithelium regeneration and decidualization initiation via the mesenchymal-epithelial transformation process. Overall, this review emphasizes the impact of AS and splicing variants on embryo implantation and offers novel insights into the potential application of alternative splicing in the treatment of female infertility.