Maternal Smoking History Enhances the Expression of Placental Growth Factor in Invasive Trophoblasts at Early Gestation Despite Cessation of Smoking.

Maternal smoking during early pregnancy is associated with a reduced risk for preeclampsia even after smoking cessation during pregnancy. Although the pathophysiology of preeclampsia has not been established, placental growth factor (PlGF) is believed to be a key factor. The aim of this study was to assess the effect of maternal smoking on the PlGF expression in invasive trophoblasts at early gestation. We collected villous tissues from women requesting surgical termination due to non-medical reasons at 7-8 weeks of gestation. The maternal smoking status was evaluated by measuring the serum cotinine level and patients were divided into two groups: active smokers and non-smokers. After separating invasive trophoblasts from villous tissues cultured initially under 2% O2 for 24 hours, the separated invasive trophoblasts were cultured under 2% or 8% O2 for 48 hours. The expression levels of the PlGF gene in villous tissue specimens and in invasive trophoblasts cultured after the conditions were quantified using qRT-PCR. The levels of PlGF protein in the medium were quantified using an ELISA. The gene expression level of PlGF in the villi in the active-smokers was significantly higher than that of the non-smokers. In comparison of the invasive trophoblasts under normoxia and oxygenated conditions, the ratio of PlGF gene expression and protein expression under oxygenation (2% O2+8% O2 / 2% O2+2% O2) in the active-smokers were both significantly higher than in the non-smokers. Maternal smoking history appears to stimulate PlGF expression in invasive trophoblasts under oxygenated conditions. This may be one of several causes leading to the protective effect of maternal smoking on preeclampsia

Current status of community-acquired infection of COVID-19 in delivery facilities in Japan.

A nationwide questionnaire survey about community-acquired infection of coronavirus disease 2019 (COVID-19) was conducted in July 2020 to identify the characteristics of and measures taken by Japanese medical facilities providing maternity services. A case-control study was conducted by including medical facilities with (Cases) and without (Control) community-acquired infection of COVID-19. Responses from 711 hospitals and 707 private clinics were assessed (72% of all hospital and 59% all private clinics provided maternity service in Japan). Seventy-five COVID-19-positive pregnant women were treated in 52 facilities. Community-acquired infection was reported in 4.1% of the facilities. Of these, 95% occurred in the hospital. Nine patients developed a community-acquired infection in the maternity ward or obstetric department. Variables that associated with community-acquired infection of COVID-19 (adjusted odds ratio [95% confidence interval]) were found to be state of emergency prefecture (4.93 [2.17-11.16]), PCR test for SARS-CoV-2 on admission (2.88 [1.59-5.24]), and facility that cannot treat COVID-19 positive patients (0.34 [0.14-0.82]). In conclusion, community-acquired infection is likely to occur in large hospitals that treat a higher number of patients than private clinics do, regardless of the preventive measures used