Maternal and neonatal outcomes of pregnancy at 39 weeks and beyond with mild gestational diabetes mellitus

Objectives: The purpose of this study was to retrospectively analyze maternal and neonatal outcomes in pregnant women with mild gestational diabetes mellitus at 39 weeks compared to 40 weeks. Material and methods: Clinical data of 372 cases of mild gestational diabetes mellitus form First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. There were 108 mild GDM patients that delivered at 40–40+6 weeks in our research group, and 264 patients that delivered in 39–39+6 weeks in the control group. Neonatal and maternal outcomes were compared between the two groups. Results: There was no difference between the two groups in the rate of cesarean section (42.6% vs. 45.5%, p = 0.614). The incidence of large for gestational age between the two groups was also not different (11.1% vs. 10.6%, p = 0.887). The rate of postpartum hemorrhage and shoulder dystocia of the two groups was not different either (p > 0.05). There was no significant difference in the incidence of fetal distress, neonatal asphyxia, neonatal pathological jaundice, neonatal hypoglycemia, and neonatal respiratory distress syndrome in the two groups (p > 0.05). Conclusions: There were no significant differences in adverse pregnancy outcomes and neonatal outcomes in women with mild gestational diabetes between deliveries at 39 and 40 weeks

Increased Expression and Altered Methylation of HERVWE1 in the Human Placentas of Smaller Fetuses from Monozygotic, Dichorionic, Discordant Twins

<div><h3>Background</h3><p>The human endogenous retroviral family W, Env(C7), member 1 gene (<em>HERVWE1</em>) is thought to participate in trophoblast cell fusion, and its expression is diminished in the placentas of singleton intrauterine growth-retarded pregnancies. However, there is limited information about the role of <em>HERVWE1</em> in discordant fetal growth in twins. This study was to compare <em>HERVWE1</em> gene expression between the placentas of discordant monozygotic twins and to identify its regulation by methylation.</p> <h3>Methodology/Principal Findings</h3><p>Fetuses from twenty-one pairs of monozygotic, dichorionic, discordant twins were marked as “smaller” or “larger” according to birth weight. Placental <em>HERVWE1</em> mRNA and protein expression profiles were analyzed using quantitative RT-PCR and immunohistochemistry (IHC) staining. Methylation profiles of the <em>HERVWE1</em> promoter region were analyzed using a pyrosequencing assay. DNA methyltransferase (<em>DNMT</em>) transcript levels were analyzed by RT-PCR. 5-methyl cytosine (5-MC) was stained using an immunohistochemical assay. There was a significant negative correlation between <em>HERVWE1</em> mRNA levels and birth weight in twins (<em>P</em><0.01). Whereas the mean methylation level of the <em>HERVWE1</em> promoter region was diminished in the smaller group in discordant twins(<em>P</em><0.01), increased mRNA and protein levels of <em>HERVWE1</em> were found in smaller fetuses compared with larger fetuses in discordant twins(<em>P</em><0.01). There was no significant difference in 5-MC staining intensity between discordant twins (<em>P</em>>0.05). The <em>DNMT3b3</em> mRNA levels in the smaller group were significantly downregulated compared with the larger group in discordant twins(<em>P</em><0.05), whereas the <em>DNMT3b7</em> mRNA levels in the smaller group were significantly upregulated compared with the larger group in discordant twins(<em>P</em><0.05).</p> <h3>Conclusions/Significance</h3><p>In discordant, monozygotic, dichorionic twins, <em>HERVWE1</em> expression was higher in smaller fetuses and lower in larger fetuses. Methylation of the <em>HERVWE1</em> gene promoter region may participate in the regulation of <em>HERVWE1</em> gene expression in discordant twin pregnancies.</p> </div

The association between objectively-measured physical activity during pregnancy and the risk of cesarean delivery: a prospective study

Objectives: To evaluate the association between physical activity (PA) and risk of cesarean delivery. Material and methods: 197 singleton pregnant women recruited in this study. Participants were divided into vaginal and cesarean delivery group. PA based objectively monitoring between the two groups was compared. Logistic regression was used to analyze the association between PA and cesarean delivery. Results: Moderate PA (MPA) of cesarean delivery group was less in the first (21.5 vs 27.5 min/day; p = 0.006) and second trimester (19.4 vs 26.8 min/day; p = 0.001). Light PA of cesarean delivery group was less (195.9 vs 217.3 min/day; p = 0.006) with more sedentary time (551.7 vs 529.1 min/day; p = 0.041) in the third trimester. Increased risk of cesarean delivery was noted in cases with MPA &lt; 37.8 min/day compared to MPA ≥ 37.8 min/day (aOR 2.62; 95% CI 1.09 to 6.32; p = 0.031) in the first trimester. MPA &lt; 17.9 min/day in the second trimester increased the risk of cesarean delivery (aOR 3.01; 95% CI 1.57 to 5.75; p = 0.001) compared to MPA ≥ 17.9 min/day. Conclusions: MPA in the first two trimesters were associated with the risk of cesarean section. Women should increase MPA from early pregnancy

Thyroid autoimmunity and adverse pregnancy outcomes: A multiple center retrospective study

BackgroundThe relationship between thyroid autoimmunity (TAI) and adverse pregnancy outcomes is disputable, and their dose-dependent association have not been fully clarified.ObjectiveTo investigate the association and dose-dependent effect of TAI with multiple maternal and fetal-neonatal complications.MethodsThis study is a multi-center retrospective cohort study based on singleton pregnancies of three medical college hospitals from July 2013 to October 2021. The evolution of thyroid function parameters in TAI and not TAI women were described, throughout pregnancy. The prevalences of maternal and fetal-neonatal complications were compared between the TAI and control group. Logistic regression was performed to study the risk effects and dose-dependent effects of thyroid autoantibodies on pregnancy complications, with adjustment of maternal age, BMI, gravidity, TSH concentrations, FT4 concentrations and history of infertility.ResultsA total of 27408 participants were included in final analysis, with 5342 (19.49%) in the TAI group and 22066 (80.51%) in control group. TSH concentrations was higher in TAI women in baseline and remain higher before the third trimester. Positive thyroid autoantibodies were independently associated with higher risk of pregnancy-induced hypertension (OR: 1.215, 95%CI: 1.026-1.439), gestational diabetes mellitus (OR: 1.088, 95%CI: 1.001-1.183), and neonatal admission to NICU (OR: 1.084, 95%CI: 1.004-1.171). Quantitative analysis showed that increasing TPOAb concentration was correlated with higher probability of pregnancy-induced hypertension, and increasing TGAb concentration was positively correlated with pregnancy-induced hypertension, small for gestational age and NICU admission. Both TPOAb and TGAb concentration were negatively associated with neonatal birthweight.ConclusionThyroid autoimmunity is independently associated with pregnancy-induced hypertension, gestational diabetes mellitus, neonatal lower birthweight and admission to NICU. Dose-dependent association were found between TPOAb and pregnancy-induced hypertension, and between TGAb and pregnancy-induced hypertension, small for gestational age and NICU admission

Fusion of genomic, proteomic and phenotypic data: the case of potyviruses

Data fusion has been widely applied to analyse different sources of information, combining all of them in a single multivariate model. This methodology is mandatory when different omic data sets must be integrated to fully understand an organism using a systems biology approach. Here, a data fusion procedure is presented to combine genomic, proteomic and phenotypic data sets gathered for Tobacco etch virus (TEV). The genomic data correspond to random mutations inserted in most viral genes. The proteomic data represent both the effect of these mutations on the encoded proteins and the perturbation induced by the mutated proteins to their neighbours in the protein protein interaction net- work (PPIN). Finally, the phenotypic trait evaluated for each mutant virus is replicative fitness. To analyse these three sources of information a Partial Least Squares (PLS) regression model is fitted in order to extract the latent variables from data that explain (and relate) the significant variables to the fitness of TEV. The final output of this methodology is a set of functional modules of the PPIN relating topology and mutations with fitness. Throughout the re-analysis of these diverse TEV data, we generated valuable information on the mechanism of action of certain mutations and how they translate into organismal fitness. Results show that the effect of some mutations goes beyond the protein they directly affect and spreads on the PPIN to neighbour proteins, thus defining functional modules.This work was supported by the Spanish Ministerio de Economia y Competitividad grants BFU2012-30805 (to SFE), and DPI2011-28112-C04-02, DPI2011-28112-C04-01, DPI2014-55276-C5-1-R (to AF and JP) and by Generalitat Valenciana grant PROMETEOII/2014/021 (to SFE). The first two authors are recipients of fellowships from the Spanish Ministerio de Economia y Competitividad: BES-2012-053772 (to GB) and BES-2012-057812 (to AF-F).Folch-Fortuny, A.; Bosque-Chacon, G.; Picó, J.; Ferrer, A.; Elena, S. (2016). Fusion of genomic, proteomic and phenotypic data: the case of potyviruses. Molecular BioSystems. 12(1):253-261. https://doi.org/10.1039/c5mb00507hS25326112

Compact groups with a dense free abelian subgroup

The compact groups having a dense infinite cyclic subgroup (known as monothetic compact groups) have been studied by many authors for their relevance and nice applications. In this paper we describe in full details the compact groups $K$ with a dense free abelian subgroup $F$ and we describe the minimum rank $r_t(K)$ of such a subgroup $F$ of $K$. Surprisingly, it is either finite or coincides with the density character $d(K)$ of $K$.

Obstetric outcomes of twin pregnancies at advanced maternal age: A retrospective study

Objective: To evaluate obstetric outcomes in twin pregnancies of advanced maternal age (≥35 years). Materials and methods: A retrospective study involved 470 twin pregnancies in a single center from Sep. 1, 2012 to Mar. 31, 2015. Clinical characteristics and obstetric outcomes were recorded and compared among twin pregnancies who were classified as follows: age 20–29, 30–34, 35–39 and ≥40 years. Results: The incidence of gestational diabetes (age 20–29 years 15.8%; 30–34 years 24.3%; 35–39 years 30.4%; ≥40 years 57.1%; p = 0.004) and premature delivery (20–29 years 58.6%; 30–34 years 69.1%; 35–39 years 72.2%; ≥40 years 85.7%; p = 0.001) significantly increased with increasing age whereas spontaneous abortion (20–29 years 27.6%; 30–34 years 11.6%; 35–39 years 11.4%; ≥40 years 0.0%; p = 0.021) decreased in twin pregnancies of advanced maternal age. In addition, the rate of postpartum hemorrhage increased almost continuously by age and advanced maternal age was described as a risk factor for postpartum hemorrhage (age 35–39, adjusted OR 3.377; 95% confidence interval 1729–6.598; p < 0.001; age ≥ 40, adjusted OR 10.520; 95% CI 1.147–96.492; p = 0.037). However, there was no significant difference between advanced maternal age and adverse neonatal outcomes. Conclusion: In twin pregnancies, advanced maternal age experienced significant higher risk of postpartum hemorrhage, gestational diabetes and premature delivery. Neither adverse neonatal outcomes nor stillbirth was significantly associated with maternal age

Serum concentrations of fibroblast growth factors 19 and 21 in women with gestational diabetes mellitus: association with insulin resistance, adiponectin, and polycystic ovary syndrome history.

BACKGROUND: Fibroblast growth factor 19 (FGF19) and FGF21 are considered to be novel adipokines that improve glucose tolerance and insulin sensitivity. In the current study, we investigated serum FGF19 and FGF21 levels in patients with gestational diabetes mellitus (GDM) and explored their relationships with anthropometric and endocrine parameters. METHOD: Serum FGF19 and FGF21 levels were determined by enzyme-linked immunosorbent assay (ELISA) in patients with GDM (n = 30) and healthy pregnant controls (n = 60) matched for maternal and gestational age. Serum FGF19 and FGF21 levels were correlated with anthropometric, metabolic, and endocrine parameters. RESULTS: Circulating levels of FGF19 were significantly reduced in patients with GDM relative to healthy pregnant subjects, whereas FGF21 levels were increased in GDM patients. Serum FGF19 levels independently and inversely correlated with insulin resistance (increased homeostasis model assessment of insulin resistance, HOMA-IR) and were positively related to serum adiponectin in both groups. In contrast, serum FGF21 levels independently and positively correlated with insulin resistance and serum triglycerides and were inversely related to serum adiponectin. In addition, in the combined population of both groups, those women with preconception polycystic ovary syndrome (PCOS) history had the lowest levels of FGF19, which were significantly lower than those in GDM patients without PCOS history and those in controls without PCOS history. CONCLUSIONS: Circulating FGF19 levels are reduced in GDM patients, in contrast with FGF21 levels. Both serum FGF19 and FGF21 levels are strongly related to insulin resistance and serum levels of adiponectin. Considering the different situation between FGF19 and FGF21, we suggest that reduced serum FGF19 levels could be involved in the pathophysiology of GDM, while increased serum FGF21 levels could be in a compensatory response to this disease

Novel insights into the complex interplay of immune dysregulation and inflammatory biomarkers in preeclampsia and fetal growth restriction: A two-step Mendelian randomization analysis

Background: The relationship between genetic immune dysregulation and the occurrence of preeclampsia (PE) or PE with fetal growth restriction (PE with FGR) has yielded inconsistent findings, and the underlying mediators of this association remain elusive. We aimed to explore the causal impact of genetic immune dysregulation on the risk of PE or PE with FGR and to elucidate the role of specific transcriptomes in mediating this relationship. Methods: A two-step Mendelian randomization (MR) analysis was performed to explore the link between immune dysregulation and PE or PE with FGR, as well as to identify potential inflammatory biomarkers that act as mediators. GWAS summary data for outcomes were obtained from the FinnGen dataset. The analyses encompassed five systemic immune-associated diseases, four chronic genital inflammatory diseases, and thirty-one inflammatory biomarkers. Summary-data-based MR (SMR) and HEIDI analysis were conducted to test whether the effect size of single nucleotide polymorphisms (SNPs) on outcomes was mediated by the expression of immune-associated genes. Results: The primary univariable analysis revealed a significant positive correlation between systemic lupus erythematosus (SLE), type 1 diabetes (T1D), type 2 diabetes (T2D), and rheumatoid arthritis (RA) with the risk of PE or PE with FGR. Surprisingly, a counterintuitive finding showed a significant negative association between endometriosis of pelvic peritoneum (EMoP) and the risk of PE with FGR. None of the inflammatory factors had a causal relationship with PE or PE with FGR. However, there was a significant association between lymphocyte count and the risk of PE with FGR. Within the lymphocyte subset, both the proportion of Natural Killer (NK) cells and absolute counts of naïve CD4+ T cells demonstrated significant effects on the risk of PE with FGR. Two-step MR analysis underscored the genetically predicted lymphocyte count as a significant mediator between T1D and PE with FGR. Additionally, SMR analysis indicated the potential involvement of SH2B3 in the occurrence of PE with FGR. Conclusions: Our findings provided substantial evidence of the underlying causal relationship between immune dysregulation and PE or PE with FGR and some of these diseases proved to accelerate immune cells disorders and then contribute to the risk of incident PE or PE with FGR

An Investment Decision Model for Underground Urban Utility Tunnel Based on MIVES and Real Option Theory from a Sustainable Perspective

Although the importance of urbanization, urban renewal and sustainable development have been increasingly recognized, with the accelerating process of urbanization, the urban above-ground space is no longer sufficient for the process of urbanization, and downward development of the city has become inevitable. Underground Urban Utility Tunnel (UUUT) is an effective measure to promote the sustainable development of urban underground space (UUS). However, decision makers still cannot fully consider the economic, social, environmental and technological factors, as well as the future risks of the project and the value of flexibility in management. In this paper, an investment decision model for UUUT is proposed that combines the Integrated Value Model for Sustainable Assessment (MIVES) and the real option theory, which comprehensively considers the social, economic, environmental and technological impacts, and assists the government in carrying out the investment decision analysis of UUUT from a sustainability perspective by applying the real option theory to the economic evaluation process. The primary process of this study can be divided into four steps. (1) establishment of the investment decision index system for UUUT; (2) determination of the quantitative criteria for each indicator; (3) calculation of the feasibility of UUUT; and (4) a case study to demonstrate the feasibility of the proposed model, as well as the achieved results. The proposed investment decision model can be used as an auxiliary tool in the early planning stage of UUUT, and also for the comparison and selection of different options for UUUT