Adequate Prenatal Care Reduces the Risk of Adverse Pregnancy Outcomes in Women with History of Infertility: A Nationwide Population-Based Study

<div><p>Objectives</p><p>To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility.</p> <p>Study Design</p><p>A retrospective cohort study.</p> <p>Methods</p><p>Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertility matched to the study sample by maternal age. A conditional logistic regression analysis was performed for the analysis.</p> <p>Results</p><p>Women diagnosed with infertility respectively had 1.39 (95% CI, 1.06~1.83), 1.15 (95% CI, 1.08~1.24), 1.13 (95% CI, 1.08~1.18), and 1.08 (95% CI, 1.05~1.12) higher odds of having very low birth weight (VLBW) babies, preterm births, labor complications, and cesarean sections (CSs) compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of prenatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a VLBW baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile women with adequate care.</p> <p>Conclusions</p><p>Study findings suggest that adequate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility.</p> </div

Additional file 1: of Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety

Multivariate analysis of risk factors for suicidal ideation, depression, and anxiety among perinatal women in Taiwan. (DOCX 20 kb

Adhesion and migration assays were performed with human placental multipotent mesenchymal stromal cells (hPMSCs) and various integrin-blocking antibodies.

<p>(A). hPMSCs were induced to differentiate into endothelial cells, then plated onto surfaces coated with BSA (NC), fibronectin, or vitronectin in the presence or absence of VEGF-A. The differentiated hPMSCs adhered to fibronectin more efficiently than to vitronectin (P<0.001). VEGF-A significantly increased the adhesion of differentiated hPMSCs to fibronectin but not to vitronectin or plates coated with 2.5% BSA solution (NC). (B) Inhibition of differentiated hPMSC adhesion to fibronectin and vitronectin in the presence of blocking antibodies to integrin subunits. A significant inhibition of differentiated hPMSC adhesion to fibronectin was observed in the presence of blocking antibodies to integrin α₅, β₁ or α_vβ₃, but not integrin α_vβ₅. The number of differentiated hPMSCs attached to vitronectin was low. (C) Transwell migration of differentiated hPMSCs induced by VEGF-A (50 ng/ml) with or without fibronectin (0.5 to 50 µg/ml) or vitronectin (0.5 to 50 µg/ml). Fibronectin in the presence of VEGF-A stimulated migration. (D) Inhibition of differentiated hPMSC transwell migration induced by VEGF-A (50 ng/ml) with or without fibronectin (50 µg/ml). Various blocking antibodies to integrin subunits and non-specific IgG were used. Antibodies to integrin subunits α₅ and β₁ were inhibitory. Error bar: SD; Ab: antibody; ECM: extracellular matrix.</p

Integrin expression at the surface of human placental multipotent mesenchymal stromal cells (hPMSCs) before and after inducing differentiation into endothelial cells.

<p>Undifferentiated hPMSCs: A, C, E, G, I; differentiated hPMSCs: B, D, F, H, J. The cells were immunostained using antibody against integrin (A, B) β₁, (C, D) α₄, (E, F) α₅, (G, H) α_vβ₃, or (I, J) α_vβ₅. Scale bar: 10 µm. Immunofluorescence staining revealed significant increases in integrin α₅ and β₁. (K) The change of hPMSC surface integrin expression after differentiation induced by VEGF-A was measured by flow cytometry and expressed in fluorescence intensity units. Change in fluorescence intensity is an index of integrin surface concentration per cell. (L) Quantification of specific mean fluorescence intensity (which corresponds to the increase in fluorescence intensity relative to second antibody alone) is shown (±SD, n = 3). The specific mean fluorescence intensity was higher for both integrins α₅ and β₁ in differentiated hPMSCs. C: controls; E: endothelial cell differentiation induced by VEGF-A.</p

In vitro angiogenesis: formation of capillary-like structures by differentiated human placental multipotent mesenchymal stromal cells (hPMSCs).

<p>hPMSCs were trypsinized, seeded on wells coated with ECMatrix^TM. (A) Human umbilical vein endothelial cells and (B) undifferentiated hPMSCs were used as positive and negative control (shown after 6 hours of culture). (C) hPMSCs induced to differentiate into endothelial cells form characteristic capillary-like structures. Cell elongation and cell interconnecting cell networks were observed. Differentiated hPMSCs were pretreated with antibodies against (D) integrin β₁, (E) α₄, (F) α₅, (G) α_vβ₃, or (H) α_vβ₅. Scale bar: 200 µm. Representative photomicrographs of 3 different experiments are shown. This ability of differentiated hPMSCs to form capillary-like structures was strongly diminished when integrin β₁ or α₅ was inhibited. Blocking antibodies to integrins α₄, α_vβ₃, or α_vβ₅ did not inhibit the formation of capillary-like structures. The capillary-like structures on ECmatrix^TM gel were immunostained using antibody against (I) non-specific IgG or specific endothelial markers (J) von Willebrand factor, (K) CD31, and (L) CD105. Scale bar: 50 µm. Arrows indicate von Willebrand factor, CD31 and CD105 positive cells present in ECmatrix^TM gel. (M) Quantification of the capillary-like structures by measuring the polygonal network (upper panel) and the cumulative tube length (lower panel) formed by differentiated hPMSCs. A significant inhibition of capillary-like structure formation was observed when integrin β₁ or α₅ antibody was applied to the cells. Error bar: SD.</p

Characterization of human placental multipotent mesenchymal stromal cells (hPMSCs) after inducing differentiation into endothelial cells.

<p>Immunofluorescence staining of CD31 in undifferentiated hPMSCs is shown in (A) as a negative control. Immunofluorescence of endothelial markers in differentiated hPMSCs under induced culture conditions: (B) CD31, (C) CD34, (D) VE-cadherin, (E) VEGFR-1, (F) VEGFR-2, (G) von Willebrand factor, (H) von Willebrand factor under high magnification (Scale bar: 1 µm); Weibel-Palade bodies were visible within the differentiated hPMSC cytoplasm (arrow). CD105 was positive in (I) undifferentiated hPMSCs and (J) hPMSCs differentiated into endothelial cells. Cell nuclei were counterstained with DAPI. Scale bar: 10 µm. (K) Flow cytometry analysis of endothelial cell markers on the hPMSC surface before and after differentiation induced by VEGF-A. (L) mRNA for endothelial cell markers was amplified from 2 different strains of undifferentiated hPMSCs (lane 1 and 2) and hPMSCs differentiated into endothelial cells (lane 3 and 4). mRNA from human umbilical vein endothelial cells was used as a positive control (lane 5). The data shown are representative of 3 different experiments.</p

Associations of child’s use of mobile devices and parent–child shared reading with the emotional and behavioral problems among children with mothers with a low depression level—results from multiple linear regression models.

Associations of child’s use of mobile devices and parent–child shared reading with the emotional and behavioral problems among children with mothers with a low depression level—results from multiple linear regression models.</p

Associations of child’s use of mobile devices and parent–child shared reading with the emotional and behavioral problems among children with mothers with a high depression level—results from multiple linear regression models.

Associations of child’s use of mobile devices and parent–child shared reading with the emotional and behavioral problems among children with mothers with a high depression level—results from multiple linear regression models.</p

Associations of general traits and maternal use of mobile devices with child’s exceeding the recommended use of mobile devices—results from multiple logistic regression models (n = 202).

Associations of general traits and maternal use of mobile devices with child’s exceeding the recommended use of mobile devices—results from multiple logistic regression models (n = 202).</p

Child’s daily use of mobile devices according to general characteristics of participants (n = 202).

Child’s daily use of mobile devices according to general characteristics of participants (n = 202).</p