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Objective: To investigate the serum lipid and apolipoprotein levels in pregnancy-induced hypertension (PIH or pre-eclampsia), normotensive pregnant women and non-pregnant women., Methods: Twenty-eight women with PIH, 31 normatensive and 24 non-pregnant ones were studied, from whom maternal blood samples were collected. Serum lipid levels were measured by enzymatic method and apolipoproteins AI, B100, C II, CIII and E levels by radial immunodiffusion kits developed by our Lab., Results: 1. Serum TG, apoC II and apoC III were highly increased in normotensive pregnant women by 3.5, 2.4 and 2.8 times respectively, when compared with those in non-pregnant ones (P < 0.001); serum TC, nHDL-C and apoAI, B100 and E were also increased in normotensive pregnant women by 21%, 33%, 55%, 79% and 77% respectively, when compared with those in non-pregnant ones (P < 0.001). TG/HDL-C in normotensive pregnant women was also significantly, higher than that in non-pregnant ones(P < 0.01). Serum HDL-C levels remained unchanged in both groups. 2. Serum TG, apoC II and apoC III were highly increased in PIH patients by 2.3, 4.0 and 2.8 times respectively, when compared with those in non-pregnant ones (P < 0.001); serum TC, nHDL-C and apoAI, B100 and E were also increased in PIH patients by 27%, 26%, 52%, 90% and 67% respectively, when compared with those in non-pregnant ones (P < 0.001) TG/HDL-C in PIH patients was also significantly higher than that in non-pregnant ones (P < 0.01). Serum HDL-C levels were increased in PIH patients by 29%, when compared with non-pregnant women. Only serum HDL-C level in PIH patients was higher than that in normotensive pregnant women. No significant differences were seen in other lipid and apolipoprotein levels between PIH patients and normotensive pregnant ones. 3. There was no significant difference in the levels of serum lipid and apolipoprotein between the subgroups of PIH patients according to the severity of the disease., Conclusion: The increase of serum lipid and apolipoprotein levels in PIH is probably not the predictor for pre-eclampsia.

Background: The current evidence about anemia and iron deficiency anemia (IDA) during pregnancy remains elusive in China. The purpose of this study is to investigate the prevalence of anemia and IDA and their risk factors in Chinese pregnant women.Methods: A nationwide cross-sectional survey of pregnant women was conducted during their antenatal visits. Using a multi-stage sampling method, 24 hospitals from 16 provinces across China were selected. Structured questionnaires were administered to collect information from participants and to extract clinical data from electronic medical records. Mixed-effects logistic regression models were performed to determine the risk factors associated with anemia and IDA.Results: In total, 12,403 pregnant women were enrolled, including 1018 (8.2%) at the first trimester, 3487 (28.1%) at the second, and 7898 (63.7%) at the third. Overall, 19.8% of women were diagnosed with anemia and 13.9% were diagnosed with IDA. The prevalence of anemia and IDA varied among regions and increased by gestational month, peaking at the eighth gestational month (24.0% for anemia and 17.8% for IDA). Pregnant women at advanced stage of gestation, non-local residents, multiple gestations, multiparity, pre-pregnancy underweight, and those experiencing severe nausea or vomiting during pregnancy, were associated with higher risks of anemia and IDA.Conclusions: The prevalence of anemia and IDA during pregnancy are similar to those from developed countries and vary across regions in China. [ABSTRACT FROM AUTHOR]

Introduction: Studies using voxel-based morphometry report variable and inconsistent abnormalities of gray matter volume (GMV) and white matter volume (WMV) in brains of preterm-born adolescents (PBA). In such circumstances a meta-analysis can help identify the most prominent and consistent abnormalities. Method: We identified 9 eligible studies by systematic search of the literature up to October 2017. We used Seed-based d Mapping to analyze GMV and WMV alterations between PBA and healthy controls. Results: In the GMV meta-analysis, PBA compared to healthy controls showed: increased GMV in left cuneus cortex, left superior frontal gyrus, and right anterior cingulate cortex; decreased GMV in bilateral inferior temporal gyrus (ITG), left superior frontal gyrus, and right caudate nucleus. In the WMV meta-analysis, PBA showed: increased WMV in right fusiform gyrus and precuneus; decreased WMV in bilateral ITG, and right inferior frontal gyrus. In meta-regression analysis, the percentage of male PBA negatively correlated with decreased GMV of bilateral ITG. Interpretation: PBA show widespread GMV and WMV alterations in the default mode network, visual recognition network, and salience network. These changes may be causally relevant to socialization difficulties and cognitive impairments. The meta-regression results perhaps reveal the structural underpinning of the cognition-related sex differences in PBA. [ABSTRACT FROM AUTHOR]

Background: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience.Methods: This was a retrospective study for consecutive 12 pregnancies in women with MVSA, who delivered at a tertiary care center in west China between May 2008 and March 2015.Results: All patients with MVSA delivered via caesarian section. One patient with severe pulmonary arterial hypertension expired from pulmonary infection and heart failure after delivery. One patient terminated pregnancy in the second trimester- necessitated by cardiogenic shock. The other mothers had varying degrees of cardiac morbidity, but survived. Ten of thirteen newborns survived. Congenital heart disease and small-for-gestational-age (SGA) of newborn occurred in two cases (one twin and one single gestation). Two of these babies expired.Conclusions: Maternal and neonatal risk appeared associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmia. Accurate diagnosis and care by a multidisciplinary team is recommended for pregnant woman with MVSA. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of maternal hepatitis B surface antigen (HBsAg) carrier status on neonatal outcomes. Methods: A retrospective cohort study was conducted using data from medical records database of six hospitals in China. Information on maternal characteristics and selected neonatal outcomes was retrieved for all women who delivered singleton infants between 1 January 2009 and 31 December 2010. Results: A total of 21 947 singleton newborns and their mothers were included. The prevalence of maternal HBsAg positivity was 4.2% (95% confidence interval (CI) 3.9–4.5%). Compared with infants born to HBsAg-negative women, infants born to HBsAg-positive mothers were more than twice more likely to have a malformation before (adjusted odds ratio (aOR) 2.23, 95% CI 1.15–4.30) and at birth (aOR 2.66, 95% CI 1.38–5.14), but were less likely to be macrosomia (aOR 0.67, 95% CI 0.47–0.96). No statistically significant association was found between maternal HBsAg positivity and preterm birth (aOR 1.20, 95% CI 0.95–1.51), low birth weight (aOR 1.24, 95% CI 0.91–1.69), and Apgar scores at 1 min (aOR 0.88, 95% CI 0.49–1.57) and 5 min (aOR 1.84, 95% CI 0.89–3.81). Conclusion: Maternal HBsAg positivity may be associated with a higher risk of congenital malformation. [ABSTRACT FROM PUBLISHER]

Introduction: microRNAs (miRs) have been shown to play critical roles in the regulation of trophoblast and endothelial cell functions, and one significant finding concerning the miR-15/16 family is that most members of this family are highly expressed in endothelial cells and contribute to functions, such as tube formation. The interaction between trophoblast and endothelial cell play an important role in normal placentation process. Therefore, the aims of this study were to investigate the expression of miR-15b in human placenta and to uncover the potential role of miR-15b as well as its target functional loop in trophoblast and endothelial cells. Whether inflammation could modulate the expression of miR-15b and its down-stream target was further investigated. Additionally, the potential link between miR-15b deregulation and preeclampsia was also explored in the placenta of patients diagnosed with preeclampsia.Methods: The expression of miR-15b was studied in the placental tissue of a normal pregnancy using in situ hybridization, and the effects of miR-15b on proliferation, invasion, and angiogenesis were further explored in vitro using HTR-8/SVneo and HUVEC cell line models. A Lipopolysaccharides (LPS) treatment model in HTR-8/SVneo cell was utilized to explore the mechanism of how LPS treatment could lead to the activation of miR-15b expression. Western blot was used to detect the expression of proteins related to miR-15b mediated pathway in preeclamptic placentas.Results: miR-15b inhibits trophoblast cell invasion and endothelial cell tube formation by suppressing the expression of Argonaute 2 (AGO2), a major miRNA effecter protein. AGO2 is specifically localized to human placenta cytotrophoblast and endothelial cells, and it plays important roles in trophoblast cell invasion and endothelial cell tube formation. LPS treatment may lead to the overexpression of miR-15b and down-regulation of AGO2, which may be involved in shallow trophoblast cell invasion associated with the pathogenesis of preeclampsia. Chromatin immunoprecipitation assay indicates that increased occupancy of AGO2 to miR-15b promoter is responsible for the increased expression of miR-15b under the condition of LPS treatment. Furthermore, preeclamptic placentas have decreased expression of AGO2, but increased expression of miR-15b and TLR-4 compared to normal controls.Discussion: This is the first report about the function of AGO2 in human trophoblast and endothelial cells in the placenta. The data indicates that the aberrant expression of miR-15b contributes to abnormal placentation by targeting AGO2 mRNA. This study provides insight into the potential role of the miR-15b and AGO2 functional loop in the placentation process. [ABSTRACT FROM AUTHOR]

The purpose of the study is to investigate the expression of epithelial sodium channel (ENaC) in normal pregnancy and severe preeclampsia placenta and to explore the underlying mechanism of the relationship between the altered ENaC expression and onset of preeclampsia. Reverse transcription polymerase chain reaction (RT-PCR) and Western blot were used to check epithelial sodium channel subunits expression in mRNA and protein level in first term and full term placental tissue. ENaCα specific RNAi were used to knockdown ENaC expression and cell invasion and migration assay were used to check whether reduced expression of ENaC can compromise trophoblast cell function. The result showed that ENaCα was highly expressed in first term placental trophoblast cells; while EnaCβ was highly expressed in full term placenta. Knockdown ENaCα expression by using small interfering RNA reduced the invasive and migration abilities of HTR-8/SVneo cell. Real time-PCR and Western blot analysis showed that the expression levels of ENaCβ were also significantly lower in severe preeclampsia compared with normal pregnancy. It is concluded that the ENaC played an important role in trophoblast cell invasion and migration. Reduced expression and activity of epithelial sodium channel in trophoblast cells may be involved in the pathogenesis of preeclampsia. [ABSTRACT FROM AUTHOR]

Abnormal placenta trophoblast proliferation and apoptosis is related to the pathogenesis of preeclampsia. Emerging evidence has also indicated that key pregnancy-associated hormones, such as hCG, progesterone, are found in high concentration at the maternal-fetal interface. The purpose of this study was to investigate the expression of CYP11A, a key enzyme in steroid hormone synthesis and metabolism, in normal pregnancy and severe preeclampsia placenta and to explore the underlying mechanism of the relationship between the altered CYP11A expression and onset of preeclampsia. Immunohistochemistry method was used to study the localization of CYP11A-encoded protein P450scc in the placenta; reverse transcription polymerase chain reaction (RT-PCR) and Western blotting were used to examine CYP11A expression at mRNA and protein levels in patients with severe preeclampsia and normal placental tissue. CYP11A overexpression in trophoblastic cells was used to evaluate the effect on viability. TUNEL staining was used to determine whether overexpression of CYP11A could affect trophoblastic cell apoptosis. The results showed that CYP11A was selectively expressed in the cytoplasm of the placental trophoblastic cells. CYP11A expression were significantly increased in severe preeclampsia compared with normal pregnancy in both mRNA and protein levels. Multiple regression analysis indicated that CYP11A gene expression was positively correlated to ALT level and Plt, while negatively correlated to INR. Overexpression of CYP11A reduced trophoblastic cell proliferation and induced HTR8/SVneo cells apoptosis through activation of activated caspase-3 expression. These results suggest that abnormally high expression of CYP11A inhibits trophoblastic proliferation and increases apoptosis and therefore could be involved in the pathogenesis of preeclampsia. [ABSTRACT FROM AUTHOR]

Objective: Data on the prevention of preterm birth in twin pregnancies with cervical cerclage remain inconsistent. Thus, this study aimed to comprehensively evaluate the value of cervical cerclage as a treatment strategy to prevent preterm birth in twin pregnancies with regard to both maternal and neonatal outcomes.Study Design: In this systematic review and meta-analysis, the PubMed, Cochrane Library, Medline, EMBASE, and Web of Science databases were searched for relevant studies and trials from their inception up to December 2020. Outcomes were expressed as risk ratios and standardized mean differences in a meta-analysis model using STATA 15.0 software.Results: The search included 944 studies, 15 of which were eligible for inclusion, representing 726 patients treated with cervical cerclage and 8578 non-cerclage treatment controls. When the cervical length was <15 mm, the risk ratio of preterm birth at <37 weeks (0.77, p = 0.01), <34 weeks (0.58, p = 0.002), and <32 weeks (0.61, p = 0.024) of gestation in the cerclage group was significantly lower than that in the non-cerclage group.Conclusion: For twin pregnancies with a cervical length <15 mm, cervical cerclage was associated with significant reduction in preterm birth. [ABSTRACT FROM AUTHOR]