Anemia ; epidemiology ; China ; epidemiology ; Female ; Hemoglobins ; analysis ; Humans ; Pregnancy ; Pregnancy Complications, Hematologic ; epidemiology ; Pregnancy Trimesters

Adult ; Extracorporeal Circulation ; Female ; Humans ; Pregnancy ; Pregnancy Complications, Cardiovascular ; surgery ; Pregnancy Trimesters ; Thoracotomy ; methods

OBJECTIVETo study the impact of maternal weight gain during pregnancy on the risk of infant obesity within 1 year old.

METHODSA total of 785 infants who were born in Hefei and participated children medical care in one district health center and their mothers were chosen as the research subjects from September 2010 to September 2011. Three groups were classified by weight gain during pregnancy according to the percentiles: excessive pregnancy weight gain group of 126 pairs, adequate pregnancy weight gain group of 542 pairs and inadequate pregnancy weight gain group of 117 pairs. Mother's general demographic information was collected. The height and weight were measured when the infant was 42 days, 3, 6, 9, and 12 months of physical examination. Z score was calculated. The differences of Z score in different groups were compared and the RR values of different weight gain during pregnancy on infant obesity were computed.

RESULTSThe weight-for-age Z score (WAZ) of infant at 42 days 3, 6, 9 and 12 months in excessive pregnancy weight gain group were 0.23 ± 0.93, 0.25 ± 1.03, 0.23 ± 0.99, 0.28 ± 1.09, 0.26 ± 1.14, respectively, all higher than that of the corresponding age in adequate pregnancy weight gain group (-0.04 ± 1.02, -0.07 ± 0.99, -0.05 ± 0.98, -0.06 ± 0.97, -0.07 ± 0.95, respectively). The differences were statistically significant (all P values < 0.05). In excessive pregnancy weight gain group, infant body mass index (BMI) at 9 months ((18.01 ± 0.15) kg/m(2)) and 12 months ((17.66 ± 0.15) kg/m(2)) were higher than that of adequate pregnancy weight gain group ((17.63 ± 0.13) and (17.22 ± 0.15) kg/m(2), respectively). The differences were statistically significant (all P values < 0.05). Differences of infant Height-for-age Z score (HAZ) among three groups were not statistically significant (all P values > 0.05). Compared to adequate pregnancy weight gain group, RR (95%CI) value of infant obesity in excessive pregnancy weight gain group was 1.86 (1.14 - 3.03).

CONCLUSIONExcessive maternal weight gain during pregnancy increased the risk of infant obesity within 1 year old.

Female ; Humans ; Infant ; Infant, Newborn ; Obesity ; epidemiology ; Pregnancy ; Pregnancy Trimesters ; Weight Gain

BACKGROUND: Pregnancy has been associated with differences in thyroid function.1 Maternal thyroid dysfunction has been shown to be associated with fetal and obstetric complications and prompt management is of importance. It has thus been recommended by the British and American Thyroid Association11,12 that trimester-specific thyroid function test reference ranges be used in the assessment of thyroid dysfunction. Normative values across the trimesters of pregnancy have been conducted in several countries13,17,19 and in the Philippines. Reference ranges
in the first and second trimesters of pregnancy were conducted by Patal and Hamin et al. which showed values of TSH 0.14-3.84 uIU/mL, FT4 10.44-21.58 pmol/L, FT3 2.4-5.82 pmol/L in the first trimester and TSH 0.10-4.30 uIU/mL, FT4 9.10-19.40 pmol/L, FT3 2.70- 5.190 pmol/L in the second trimester, respectively.
OBJECTIVE: To establish third trimester reference intervals for free thyroid hormones (free triiodothyronine [FT3], free thyroxine [FT4]) and thyrotropin [TSH] from thyroid peroxidase antibody [TPOAb]-negative Filipino
pregnant women.
DESIGN: This is a prospective, cross-sectional study which included consecutive 200 healthy third-trimester pregnant Filipino women attending Philippine General Hospital (PGH) out-patient services. Serum TSH, FT4, FT3, and TPOAb were measured.
MAIN OUTCOME MEASURES: Reference intervals are based on 2.5th and 97.5th percentiles for TSH, FT4, and FT3 among TPOAb-negative third-trimester pregnant Filipino patients.
ANALYSIS: All numerical data were entered in MS Excel and analyzed using STATA 12. FT3, FT4 and TSH were expressed as mean ±SD, range at 2.5th to 97.5th percentiles.
RESULTS: The reference ranges for TSH, FT4 and FT3 in TPOAb-negative third-trimester pregnant population are as follows: TSH= 0.2-3.0 uIU/mL; FT4 = 9.16-18.64 pmol/L and FT3= 2.09-3.7 pmol/L.
CONCLUSION: Reference ranges for thyroid function tests for the third trimester of TPOAb-negative pregnant Filipino women were determined in this study and are as follows: TSH= 0.2-3.0uIU/mL; FT4 = 9.16-18.64pmol/L and FT3= 2.09-3.7pmol/L.

Human ; Female ; Adult ; Thyrotropin ; Thyroxine ; Triiodothyronine ; Iodide Peroxidase ; Thyroid Function Tests ; Pregnancy Trimesters ; Thyroid Diseases ; Thyroid Hormones

BACKGROUND/AIMS: Elevated transaminase levels are often detected during pregnancy. Causes are variable and difficult to differentiate. Furthermore, there is no practical guideline for abnormal transaminase levels in pregnancy. The aim of this study was to suggest a strategy for managing elevated transaminase level during pregnancy. METHODS: One hundred and fiftyfive women with elevated transaminase level were included from an antenatal care center between January 1, 2003 and December 31, 2004. Another 221 women with normal transaminase levels were enrolled as control group. We analyzed documented causes, changes in laboratory tests, and pregnancy outcomes. RESULTS: Two groups showed no difference in baseline characteristics except the duration of pregnancy, parity, and albumin level. Of abnormal results, 39.4% occurred between 30 and 40 gestational weeks while 29% occurred between 10 and 20 gestational weeks. Common causes were hyperemesis gravidarum followed by pre-eclampsia, viral hepatitis, and HELLP syndrome. Excluding viral hepatitis, 69 patients showed abnormal results in the first two trimesters and the results were normalized during the follow-up period. AST and ALT levels were 52.9 (+/-49.6) IU/L and 83.3 (+/-77.0) IU/L during the first two trimesters in the patient group. Abnormal results during the third trimester were associated with shorter duration of pregnancy. CONCLUSIONS: Elevated transaminase levels up to 3 to 4 times of the upper normal limit during the first two trimesters could be safely observed with careful history taking and hepatitis viral antigen tests. However, abnormal results in the third trimester were associated with a shorter duration of pregnancy and should be managed carefully.
Adult ; Alanine Transaminase/*blood ; Aspartate Aminotransferases/*blood ; Data Interpretation, Statistical ; Female ; Humans ; Liver Function Tests ; Pregnancy ; Pregnancy Complications/diagnosis/*epidemiology ; Pregnancy Trimesters ; Retrospective Studies

OBJECTIVETo understand the level of hemoglobin (Hb) and determine the risk factors of Hb concentration among the Tibetan pregnant women in rural Lhasa.

METHODSBetween August 2008 and May 2011, a hospital-based study was conducted among 1 530 Tibetan pregnant women after getting their informed consent in agricultural and pastoral areas in maternity clinic or hospital in city, county and township level of Lhasa. Their blood samples were tested and related socio-demographic information was collected. Blood was collected on tip of finger and the Hb concentration was measured using B-Hemoglobin photometer. American Centers for Disease Control and Prevention(CDC) method was used to adjust the Hb measurements based on altitude for estimating the prevalence of anemia. Anemia was assessed according to WHO criteria. A hemoglobin concentration of less than 110 g/L in a pregnant woman was considered an indication of anemia.

RESULTSFrom August 2008 to May 2011, 1 530 Tibetan pregnant women living at (3 716.4 ± 69.1) m above sea level in rural Lhasa were examined. The findings indicated that average Hb concentration was (122.0 ± 17.5) g/L; the Hb concentration of 1(st), 2(nd) and 3(rd) trimester were (125.5 ± 18.0), (122.5 ± 16.9) and (120.6 ± 17.4) g/L, respectively. The Hb concentration of pregnant women decreased with the increase of gestational age(P < 0.05). Based onCDC method and the adjusted Hb level, the prevalence of anemia in pregnant women were 85.6% (1 310/1 530), the prevalence of anemia of 1(st), 2(nd), and 3(rd)rd trimester were 79.5% (206/259) , 86.1% (395/459)and 87.3% (698/800), respectively (P < 0.05) . The rate of moderate and severe anemia were 46.7% (612/1 310) among pregnant women. Multiple linear regression analysis showed that high Hb level was associated significantly with low family income status (β = 2.74, 95%CI:1.73-3.74), no bad habits (drinking or smoking) (β = 7.34, 95%CI:4.87-9.81) and fewer times of pregnancies(β = -1.62, 95%CI:-2.93--0.31) after adjusting for potential confounding factors.

CONCLUSIONHb concentration level in pregnancy was rather low in rural Lhasa. The increase of family income, reduction the intervals of pregnancies and no bad habits might benefit for the improvement of Hb level of pregnant women in this region.

Altitude ; Anemia ; Demography ; Female ; Hemoglobins ; Humans ; Income ; Pregnancy ; Pregnancy Complications, Hematologic ; epidemiology ; Pregnancy Trimesters ; Prevalence ; Risk Factors ; Rural Population ; Socioeconomic Factors ; Tibet

OBJECTIVETo isolate fetal DNA from maternal plasma and examine its fetal origin.

METHODSFetal DNA in maternal plasma was isolated from 150 samples in the first trimester and mid-trimester of pregnancy, respectively. Real-time fluorescence quantitative polymerase chain reaction PCR (FQ-PCR) was used to determine sex-determining region Y (SRY) gene on Y chromosome.

RESULTSEighty-two women in the first trimester and 90 women in the mid-trimester carried male fetuses,70 and 90 samples of them were positive, respectively. The mean concentrations were (58.82+/-20.90) copies/ml and (152.08+/-62.61) copies/ml. The results of FQ-PCR were negative in the women who carried female fetuses.

CONCLUSIONThe results show that fetal SRY gene can be found at a time as early as 42 days of gestation in maternal plasma by the use of FQ-PCR. The number of fetal DNA increases with gestational age. The real-time FQ-PCR is of great value in the non-invasive prenatal diagnosis.

Adult ; DNA ; blood ; genetics ; isolation & purification ; Female ; Fetus ; metabolism ; Fluorescence ; Gestational Age ; Humans ; Polymerase Chain Reaction ; methods ; Pregnancy ; Pregnancy Trimesters ; Sex-Determining Region Y Protein ; genetics

BACKGROUNDThe rate of cesarean delivery has significantly increased in China in the last decade. Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in mid-trimester than those without such a history. The aim of our study was to evaluate the influences of the potential risk factors on uterine rupture in women with prior cesarean.

METHODSWe conducted this retrospective study of women with prior cesarean section, who underwent mid-trimester pregnancy termination between January 2006 and December 2013 in Peking Union Medical College Hospital. The protocol was oral administration of mifepristone and misoprostol for the patients with the gestational ages below 16 weeks or intra-amniotic injection of ethacridine lactate (EL) for those with at least 16 weeks of gestational ages. The thickness of the lower uterine segment (LUS) was measured before the termination of pregnancy. Logistic regression was used to study the risk factors of uterine rupture.

RESULTSThe total rate of successful abortion was 93.9% (62/66). Four patients failed in induction, and one of them received curettage, whereas the other three experienced uterine rupture (4.5%). The successful rates of abortion were 85.7% (30/35) for women treated with mifepristone-misoprostol and 86.1% (31/36) for those treated with EL. There was a significant difference in the mean LUS thickness between the uterine rupture group (3.0 ± 2.0 mm) and the nonrupture group (7.0 ± 3.0 mm) (P < 0.05). The LUS thickness of <3 mm was associated with uterine rupture during mid-trimester pregnancy termination in women with prior cesarean (odds ratio, 94.0; 95% confidence interval 4.2-2106.1) after adjusted maternal age, gestational age, interdelivery interval and prior cesarean section. Severe bleeding that required transfusion occurred in one case (1.5%).

CONCLUSIONSBoth the mifepristone-misoprostol and the EL regimens were effective and safe for the termination of mid-trimester pregnancy in women with prior cesarean. A thinner LUS is associated with a relatively high risk of uterine rupture.

Abortion, Induced ; adverse effects ; methods ; Cesarean Section ; Ethacridine ; therapeutic use ; Female ; Humans ; Mifepristone ; therapeutic use ; Misoprostol ; therapeutic use ; Pregnancy ; Pregnancy Trimesters ; Retrospective Studies ; Uterine Rupture ; etiology

BACKGROUNDPrenatal diagnoses are extremely advantageous for pregnant women with high-risk indicators and can help prevent the birth of malformed infants. However, no large-scale statistical study analyzing the correlation between fetal chromosome disorders and abnormal indicators during pregnancy has been done in China. The objectives of this study were to diagnose and analyze fetal chromosome abnormalities, determine the feasibility of the various prenatal test methods and establish diagnostic guidelines for the early, middle, and late trimesters.

METHODSFrom January 2004 to May 2009, 2782 pregnant women at high-risk underwent prenatal diagnoses. Categorized data expressed as either actual counts or percentages were analyzed by the chi-square or Fisher's exact test. Chorionic villus sampling was performed in the early-trimester (10 - 12 weeks of gestation), amniocentesis in mid-trimester (16 - 28 weeks of gestation), and umbilical cord blood collection in mid- or late-trimester (16 - 37 weeks of gestation). In 51 cases either autopsy samples from intrauterine fetal deaths or placental tissues from aborted fetuses were tested.

RESULTSChromosomal abnormalities were observed in 3.99% (111/2782) of the samples. Overall, the success rate of cytogenetic analysis for high-risk pregnancy groups was 98.17% (2731/2782). It was significantly less successful when used to analyze data from the chorionic villus sampling compared with that from amniocentesis and umbilical cord blood (P = 0.000). Abnormal chromosome carriers had the highest percentage of abnormal chromosomes (67.86%) when compared with chromosomal abnormalities in patients with ultra-sonographic "soft markers" (11.81%), advanced maternal age (4.51%) and those who had positive serum screening results (P = 0.000).

CONCLUSIONSInvasive prenatal diagnostic techniques are feasible tools for confirming fetal chromosomal abnormalities. Abnormal chromosomes detected in one of the parents carrying abnormal chromosome, ultrasound soft markers, advanced maternal age or positive serum screening results were associated with a higher frequency of fetal genetic diseases.

Adult ; Amniocentesis ; Chorionic Villi Sampling ; Chromosome Aberrations ; Chromosome Disorders ; diagnosis ; Cytogenetics ; Female ; Humans ; Karyotyping ; Pregnancy ; Pregnancy Trimesters ; Prenatal Diagnosis ; Young Adult

OBJECTIVETo study the prevalence of cerebral palsy (here in after referred to CP) in children aged 1 - 6 in Guangxi, China, and its epidemiologic characteristics and relevant risk factors.

METHODSInvestigations on the prevalence and etiology of CP in children at ages of 1 - 6 were conducted in Nanning, Hengxian and Qinzhou of Guangxi from June to December in 1998, with a cluster sampling.

RESULTSTotally, 150 806 children aged 1 - 6 were investigated in Nanning, Hengxian and Qinzhou of Guangxi, with 89 418 boys and 61 388 girls. Among them, 193 children were diagnosed as CP, with a prevalence rate of 1.28 per thousand, higher in boys (136 cases, 1.52 per thousand ) than in girls (57 cases, 0.93 per thousand ), with statistical significance (chi(2) = 9.536 7, P = 0.02). Logistic regression analysis showed that risk factors for CP were children who could not cry after birth (neonatal asphyxia), Apgar score less than eight, delivery at lower level of maternity hospital, number of mother's gravidity, no prenatal checks for mothers, and taking antipyretics and preserved food with salt during pregnancy.

CONCLUSIONSPrevalence of CP in children of Guangxi was at a lower level in comparison with that in other areas at home and abroad, which, maybe, was related with the lower neonatal survival and higher infant mortality.

Cerebral Palsy ; classification ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Logistic Models ; Male ; Pregnancy ; Pregnancy Trimesters ; Prevalence ; Risk Factors