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Is There Any Relationship between Maternal Vitamin D Levels and Asymptomatic Bacteriuria? A Preliminary Study

Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1677-1685页

作者： Emel Kurtoglu Ozdes Bahattin Avci Samettin Celik Gokhan Ocal Serap Polat Feyza Munevver Yaran Taskin Ozdes Migraci Tosun Arif Kokcu Department of Obstetrics and Gynecology Memorial Hizmet Hospital Istanbul Turkey Department of Biochemistry Faculty of Medicine Ondokuz Mayis University Samsun Turkey Maternity Hospital Samsun Training and Research Hospital Samsun Turkey Department of Obstetrics and Gynecology Buyuk Anadolu Hospital Samsun Turkey Department of Obstetrics and Gynecology Private Meditech Hospital Ordu Turkey Obstetrics and Gynecology Independent researcher Istanbul Turkey Forensic Medicine Independent researcher Istanbul Turkey Department of Obstetrics and Gynecology Faculty of Medicine Ondokuz Mayis University Samsun Turkey Department of Obstetrics and Gynecology Medical Park Samsun Hospital Samsun Turkey

Hypothesis: Vitamin D has been considered to play important roles in maintaining pregnancy. Also, this vitamin is considered to regulate immune response and thus may be important for pregnant women also to maintain no-infection of which preterm delivery is especially important. Since vitamin D regulates maternal anti-infection function and since Asymptomatic bacteriuria (ASB) causes various adverse outcomes in pregnancy, we hypothesized that maternal serum vitamin D level may be related with the presence/absence of ASB. The present study was an effort to determine this. The study included 215 pregnant women, attended the Ondokuz Mayis University Hospital antenatal care polyclinic, Samsun, Turkey, in the summer for initial visits between 6- and 14-weeks’ gestation. Women with symptoms suggestive of urinary tract infection, a history of antibiotic use within the previous two weeks, ongoing antibiotic therapy or urinary system instrumentation, a diagnosis of vitamin D insufficiency or deficiency, and those taking vitamin D supplements were excluded. Demographic data features of the sampled women were analyzed retrospectively. 10 ml maternal peripheral venous blood samples were collected and the concentrations of 25(OH)D3 in the serum were analyzed. Mid-stream morning urine samples were obtained and analyzed at the microbiology laboratory according to established procedures. ASB was reported if bacteria were present at specified quantitative counts (≥105

关键词： Pregnancy Asymptomatic Bacteriuria Vitamin D perinatal Complication Supplementation

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Metabolic Syndrome and Pregnancy, Its Prevalence, Obstetrical and Newborns Complications

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Open Journal of Obstetrics and Gynecology 2015年第11期5卷 618-625页

作者： Hamilton dos Prazeres Tavares Mariana Alvarez Arantes Suelma Beatriz Marques Prata Tavares Joelcio Francisco Abbade D. C. D. Meirelles dosDébora Cristina Damasceno Meirelles dos Santos Iracema de Mattos Paranhos Calderon Marilza Vieira Cunha Rudge PhD Student in Gynecology Obstetrics and Mastology at the Botucatu Medical School Unesp Paulista State University Botucatu SP Brazil Medical Specialist in Gynaecology and Obstetrics and Boss of Department of Gynecology and Obstetrics of the Municipal Hospital of Huambo Huambo Angola Assistant Professor of Obstetrics Botucatu Medical School Unesp Paulista State University Botucatu SP Brazil PhD Department of Gynecology and Obstetrics Laboratory of Experimental Research on Gynecology and Obstetrics Botucatu Medical School Unesp Paulista State University Botucatu SP Brazil Full Professor of Obstetrics in Botucatu Medical School Unesp Paulista State University Botucatu SP Brazil

Background: The metabolic syndrome affects more and more global people. Although it shows increasing prevalence in general population, the syndrome affects more women than men, what makes its risk of being developed during pregnancy period. Also, possible perinatal adverse effects are always lurking. Objective: the objective was demonstrated what’s new in literature on metabolic syndrome and pregnancy. Methods: A literature review was performed to extract the articles published on metabolic syndrome and pregnancy, its prevalence, obstetrical complications and its perinatal adverse effects. This review was conducted by online researching in PubMed, Lilacs, Medline, Embase, Scopus, Medscape, Libertas Academica and CINAHL database, Science database and also by researches in books. 27 selected articles on metabolic syndrome after this research were all published between 1988 and 2015. Results: Among those 27 articles and two books studied, SM rate in obstetric population ranged from 3% to 42% depending on the previously manifested components of the syndrome, age and region. Women with previously manifested components showed more adverse perinatal effects. Conclusion: Women with pregestational DM or SM and SM develop more during pregnancy, obstetric complications and adverse perinatal outcomes.

关键词： Metabolic Syndrome Pregnancy Adverse perinatal Outcomes

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母亲高血压与小于胎龄儿预后的关系

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世界核心医学期刊文摘（妇产科学分册） 2005年第12期1卷 61-61页

作者： Von Dadelszen P. Magee L.A. Taylor E.L. 党慧敏 BC Women's Hospital and Health centre 4500 Oak Street Vancouver BC V6H 3N1 Canada Dr

Objective: To determine whether maternal hypertension might improve perinatal outcome among small for gestational age (SCA) infants (< 10th percentile). Methods: Our prospective cohort comprised 17 Canadian neonatal intensive care units (NICUs) and 3,244 SGA singletons. Multivariable regression was used to analyze the relation between maternal hypertension and each of the following: SNAP-II (Score of Neonatal Acute Physiology; ordinal regression) and neonatal survival and survival without severe intraventricular hemorrhage (logistic regression), adjusting for potential confounders. Results: There were 698 (21.5% ) neonates born to hypertensive mothers. Inversely associated with lower SNAP-II scores (healthier infant) were antenatal steroids (complete course: odds ratio [OR] 0.67, 95% confidence interval [CI] 0.54- 0.83; incomplete: OR 0.71, 95% CI 0.56- 0.88), lower gestational age (< 27 weeks: OR 0.06, 95% CI 0.05- 0.08; 27- 28 weeks: OR 0.11, 95% CI 0.07- 0.17; 29- 32 weeks: OR 0.28, 95% CI 0.23- 0.35), 5- minute Apgar < 7 (OR 0.30, 95% CI 0.25- 0.36), male gender (OR 0.80, 95% CI 0.70- 0.92), and anomalies (OR 0.49, 95% CI 0.41- 0.58). Maternal hypertension was associated with lower SNAP-II (healthier infant) (7.54 ± 11.16 [hypertensive] versus 7.21 ± 11.85 [normotensive]) on multivariable regression analysis (adjusted OR 1.25, 95% CI 1.05- 1.49), as well as higher neonatal survival (93.0% versus 91.2% , and adjusted OR 1.9, 95% CI 1.2- 3.0), but not survival without severe intraventricular hemorrhage (91.4% versus 87.0% , and adjusted OR 1.4, 95% CI 1.0- 2.0), respectively. Conclusion: Among SCA neonates in NICU, maternal hypertension is associated with improved admission neonatal physiology and survival.

关键词：小于胎龄儿新生儿存活率急性生理学评分血压正常者脑室内出血多元回归孕母队列研究出生前混杂因素

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晚育对围生期的影响

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世界核心医学期刊文摘（妇产科学分册） 2005年第10期1卷 49-49页

作者： Joseph K.S Allen A.C Dodds L 高雪莲 Joseph Division of Neonatal Pediatrics IWK Health Centre 5980 University Avenue Halifax NS B3K 6R8 Canada.Dr

OBJECTIVE: To determine if the rates of pregnancy complications, preterm birth, small for gestational age, perinatal mortality, and serious neonatal morbidity are higher among mothers aged 35- 39 years or 40 years or older, compared with mothers 20- 24 years. METHODS: We performed a population- based study of all women in Nova Scotia, Canada, who delivered a singleton fetus between 1988 and 2002 (N = 157,445). Family income of women who delivered between 1988 and 1995 was obtained through a confidential linkage with tax records (n = 76,300). The primary outcome was perinatal death (excluding congenital anomalies) or serious neonatal morbidity. Analysis was based on logistic models. RESULTS: Older women were more likely to be married, affluent, weigh 70 kg or more, attend prenatal classes, and have a bad obstetric history but less likely to be nulliparous and to smoke. They were more likely to have hypertension, diabetes mellitus, placental abruption, or placenta previa. Preterm birth and small- for- gestational age rates were also higher; compared with women aged 20- 24 years, adjusted rate ratios for preterm birth among women aged 35- 39 years and 40 years or older were 1.61 (95% confidence interval [CI] 1.42- 1.82; P perinatal mortality/morbidity were 1.46 (95% CI 1.11- 1.92; P = .007) among women 35- 39 years and 1.95 (95% CI 1.13- 3.35; P = .02) among women 40 years or older. perinatal mortality rates were low at all ages, especially in recent years. CONCLUSION: Older maternal age is associated with relatively higher risks of perinatal mortality/morbidity, although the absolute rate of such outcomes is low.

关键词：围生期妇女妊娠新生儿发病率妊娠并发症胎盘早剥前置胎盘小于胎龄儿高龄孕妇先天性异常新斯科舍

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Motivated by a mandate: a university-clinic partnership to develop a perinatal depression registry at a community based hospital in the Midwest

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Social Work and Social Welfare 2019年第1期1卷 7-12页

作者： Karen M Tabb Pamela Samara Shinwoo Choi Aubrey Hudson Linda Donovan Hsiang Huang School of Social Work University of Illinois at Urbana-Champaign Urbana IL 61801 USA Department of Obstetrics and Gynecology Carle Foundation Hospital Urbana IL USA Department of Sociology Anthropology Social Work University of North Florida USA Cambridge Health Alliance and Harvard Medical School Cambridge MA USA Institute of Psychiatry & LIM-23 Faculty of Medicine University of Sao Paulo Brazil Identifying Depression through Early Assessment (IDEA) research Team Urbana IL USA

Disparities in maternal mental health outcomes persist despite the myriad of existing evidence based treatments and recent public health prevention policy efforts. Integrated health care delivery models such as Collaborative Care and patient medical home models have the potential to reduce health disparities in clinic settings. These evidence-based approaches require multidisciplinary teams for successful implementation and to provide quality care to improve specified patient outcomes. However, strategies for successful collaboration and steps for critical reflection are often overlooked in clinical and health services research. Furthermore, a shared vision of social justice is essential in the process of building and sustaining patient-centered care models, but is often understated. The purpose of this paper is to describe the development and implementation of a social justice-informed hospital-based perinatal depression registry to address maternal health disparities. Our partnership is informed by community-based participatory research (CBPR) principles for carrying out health services research. We describe the steps for building a sustainable university-hospital collaboration between traditional and non-traditional researchers using principles from CBPR in a clinic setting.

关键词： community-based participatory research maternal mental health perinatal depression psychosocial screening

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胸壁的间充质细胞错构瘤突入胸腔后导致新生儿呼吸功能不全

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世界核心医学期刊文摘（儿科学分册） 2005年第11期1卷 45-45页

作者： Shimotake T. Fumino S. Aoi S. 贺莉 Division of Surgery Children's Research Hospital Kyoto Pref. University of Medicine Kyoto 602-0841 Japan

The authors describe a newborn patient with mesenchymal hamartoma of the chest wall associated with pulmonary hypoplasia. A massive thoracic tumor was diagnosed by prenatal ultrasonography and magnetic resonance imaging at the 28th week of gestation. She was delivered through cesarean delivery at the 36th gestational week. Respiratory distress because of pulmonary hypoplasia necessitated neonatal intensive care. The tumor extensively involved the left hemithorax including all 12 ribs and the first 10 thoracic vertebrae, resulting inmarked deformity of the thorax. At 5 days of age, she underwent the incisional biopsy through a left thoracotomy. Histopathology of biopsy specimens showed multiple components of mesenchymal origin including premature cartilage, bone, and cystic lesions resembling aneurysmal bone cyst. The tumor then showed a rapid overgrowth, but subsequently exhibited a selflimited growth for months, in which her respiratory condition gradually improved to spontaneous breathing without oxygenation support. The present case advocates perinatal preparations for associated pulmonary hypoplasia and conservative management for the neoplasmin fetuses prenatally diagnosed as having this unique pathological entity.

关键词：错构瘤新生儿重症监护间充质细胞呼吸功能不全肺发育不良出生后呼吸窘迫自限性病理学检查产前诊断

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Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection

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World Journal of Gastroenterology 2013年第48期19卷 9377-9382页

作者： Mustafa Kemal Celen Duygu Mert Müzeyyen Ay Tuba Dal Safak Kaya Necmettin Yildirim Serda Gulsun Tunga Barcin Sevgi Kalkanli Mehmet Sinan Dal Celal Ayaz Department of Infectious Diseases Faculty of Medicine Dicle University 21280 YenisehirDiyarbakir Turkey State Hospital 72000 Merkez Batman Turkey State Hospital Kiziltepe 47500 Mardin Turkey Department of Medical Microbiology Faculty of Medicine Dicle University 21280 Yenisehir Diyarbakir Turkey Department of Infectious Disease Teaching and Research Hospital 21100 Diyarbakir Turkey Department of Infectious Diseases State Hospital 47000 Mardin Turkey Department of Infectious Diseases State Hospital 21100 Diyarbakir Turkey Department of Infectious Diseases Mardin Park Hospital 47000 Mardin Turkey Department of Immunology Faculty of Medicine Dicle University 21280 Yeni?ehir Diyarbakir Turkey Department of Internal Medicine Faculty of Medicine Dicle University 21280 Yenisehir Diyarbakir Turkey

AIM:To evaluate the effects of tenofovir disoproxil fumarate(TDF)use during late pregnancy to reduce hepatitis B virus(HBV)transmission in highly viremic ***:This retrospective study included 45 pregnant patients with hepatitis B e antigen(+)chronic hepatitis B and HBV DNA levels>107copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation(n=21).Untreated pregnant patients served as controls(n =24).All infants received 200 IU of hepatitis B immune globulin(HBIG)within 24 h postpartum and 20μg of recombinant HBV vaccine at 4,8,and 24 *** transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week ***:At week 28,none of the infants of TDFtreated mothers had immunoprophylaxis failure,whereas2(8.3%)of the infants of control mothers had immunoprophylaxis failure(P=0.022).There were no differences between the groups in terms of adverse events in mothers or congenital deformities,gestational age,height,or weight in *** postpartum week 28,significantly more TDF-treated mothers had levels of HBV DNAperinatal transmission rates of HBV and no adverse events were observed in mothers or infants.

关键词： Hepatitis B Tenofovir Reverse transcriptase inhibitors Vertical transmission Chronic

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中国西部贫困农村孕期微营养素补充对出生体重、分娩孕周和围产儿死亡影响的研究：双盲整群随机对照试验

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英国医学杂志中文版 2009年第1期12卷 23-27页

作者： Lingxia Zeng Michael J Dibley Yue Cheng Shaonong Dang Suying Chang Lingzhi Kong Hong Yan 曾令霞(译) Department of Public Health Xi'an Jiaotong University College of Medicine PO Box 46 Xi'an Shaanxl 71(1061 China School of Public Health University of SydneyRoom 307AEdward Ford Building(A27)University of SydneyNSW 2006Australia. George Institute for International Health PO Box M201 Sydney NSW 2050 Australia Chinese centre for Disease Control and Prevention Beijing 100050 China Bureau for Disease Prevention and Control Ministry of Health Beijing 100044 China 西安交通大学医学院公共卫生学系

目的以单纯补充叶酸为对照，评价孕期补充多种微营养素或铁／叶酸对出生体重、分娩孕周和孕晚期血红蛋白的影响。设计采用整群随机双盲对照试验设计。地点中国陕西省的两个贫困县（长武县和彬县）。研究对象5828名孕妇及其分娩的4697名... 详细信息

目的以单纯补充叶酸为对照，评价孕期补充多种微营养素或铁／叶酸对出生体重、分娩孕周和孕晚期血红蛋白的影响。设计采用整群随机双盲对照试验设计。地点中国陕西省的两个贫困县（长武县和彬县）。研究对象5828名孕妇及其分娩的4697名活产新生儿。干预措施以村为单位整群随机化，同一个村的孕妇孕期每天补充叶酸（对照组）、铁／叶酸或多微营养素。多微营养素含15种推荐量的维生素和矿物质。主要结局指标测量出生体重、身长、头围在产后72小时内测量。通过产后42天访视收集新生儿生存情况。结果与单纯补充叶酸比较，多微营养素可显著提高出生体重42g（95％CI7—78g）；孕期补充多微营养素和铁／叶酸均可显著增加分娩孕周（铁／叶酸：0．23周，95％CI0．10～0．36周；多微营养素：0．19周，95％CI0．06～0．32周）。铁／叶酸可显著减少34周以内的早产（RR0．50，95％CI0．27～0．94，P=0．031）。相对于纯叶酸组，多微营养素和铁／叶酸均可显著增加孕妇孕晚期的血红蛋白水平（铁／叶酸：5．0g／L，95％CI2．0～8．0g／L，P=0．001；多微营养素：6．9g／L，95％CI4．1～9．6g／L，P〈0．001）。孕期营养素补充对围产儿死亡没有明显影响，但铁／叶酸可减少54％（RR0．46，95％CI0．21～0．98）的7天内新生儿死亡。结论与对照组（叶酸）比较，在中国贫困农村孕期补充铁／叶酸可延长分娩孕周从而减少早期新生儿死亡；多微营养素可适当增加出生体重，尽管如此，对早期新生儿死亡并无明显影响。在孕期微营养素干预中，剂量充足的铁对于降低发展中国家的新生儿死亡是最关键的。

关键词：随机双盲对照出生体重分娩孕周营养素补充围产儿死亡中国西部贫困农村随机对照试验

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