scholarly journals Analysis of the Relationship between the Level of Second Trimester Amniotic Fluid Alpha-Fetoprotein and Adverse Pregnancy Outcomes

2015 ◽  
Vol 05 (04) ◽  
pp. 72-75
Author(s):  
东明 李
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Lin ◽  
Hua Jin ◽  
Lei Chen

Abstract Background This study aimed to explore the relationship between insulin resistance (IR) and adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM), and to determine the risk factors for IR in women with GDM. Methods This study employed a retrospective survey of 710 women diagnosed with GDM. Serum lipids, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and serum protein were measured in the first trimester (6–12 weeks), and OGTT and fasting insulin tests were performed in the second trimester (24–28 weeks). These results were then used to evaluate IR by homeostasis model assessment (HOMA). When HOMA-IR ≥ 2.0, IR was diagnosed. The relationship between HOMA-IR and adverse pregnancy outcomes was analyzed by a logistic regression model, and multiple stepwise regression was used to analyze the risk factors of IR. Results IR significantly increasd the risk of the hypertensive disorders of pregnancy and large for gestational age (LGA) (OR = 5.31,95%CI:1.87,15.10; OR = 1.65,95%CI:1.10, 2.48, respectively) in women with GDM, but not for cesarean section, premature delivery, premature rupture of membranes, postpartum hemorrhage, macrosomia and SGA. Compared to normal groups, greater body mass index (BMI) before pregnancy category (overweight or obesity group) were associated with higher risk of IR in the second trimester, the OR (95% CI) were 4.09 (2.65, 6.30) and 6.52 (2.99, 14.20). And higher level of FPG (OR = 1.63, 95%CI: 1.11, 2.40), TG (OR = 1.32, 95%CI: 1.08, 1.63) and weight gain before diagnosis of GDM (OR = 1.08, 95%CI: 1.02, 1.15) were also associated with higher risk of IR in the second trimester in women with GDM, while age (OR = 0.94, 95%CI: 0.90, 0.98)was the weak protective factor for IR. Conclusion GDM with IR in the second trimester increased adverse pregnancy outcomes, especially the risk of hypertensive disorders of pregnancy and LGA. In addition, FPG, HbA1c, and TG in early pregnancy, pre-pregnant BMI and weight gain before diagnosis of GDM were all independent risk factors for IR.


2021 ◽  
Author(s):  
Jing Lin ◽  
Hua Jin ◽  
Lei Chen

Abstract Background: This study aimed to explore the relationship between insulin resistance (IR) and adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM), and to determine the risk factors for IR in women with GDM.Methods: This study employed a retrospective survey of 710 women diagnosed with GDM. Serum lipids, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and serum protein were measured in the first trimester (6-12 weeks), and OGTT and fasting insulin tests were performed in the second trimester (24-28 weeks). These results were then used to evaluate IR by homeostasis model assessment (HOMA). When HOMA-IR≥2.0, IR was diagnosed. The relationship between HOMA-IR and adverse pregnancy outcomes was analyzed by a logistic regression model, and multiple stepwise regression was used to analyze the risk factors of HOMA-IR. Results: GDM with IR was significantly associated with the hypertensive disorders of pregnancy and large for gestational age (LGA) (P=0.002, 0.012, respectively). Body mass index (BMI) before pregnancy, FPG, HbA1c, and total triglyceride (TG) in early pregnancy were all significantly positively correlated with IR in the second trimester (P<0.05), while age was significantly negatively correlated with IR (P<0.001). Conclusion: GDM combined with IR in the second trimester increases adverse pregnancy outcomes, especially the risk of hypertensive disorders of pregnancy and LGA. In addition, BMI before pregnancy, FPG, HbA1c, and TG in early pregnancy are all independent risk factors for IR.


2019 ◽  
Author(s):  
Sijian Li ◽  
Jinsong Gao ◽  
Jing Hu ◽  
Xiaoxu Chen ◽  
Juntao Liu ◽  
...  

Abstract Background: Although China has a large population and increasing incidence of ulcerative colitis (UC), data on pregnancy outcomes in women with UC are insufficient and the relationship between simple clinical colitis activity index (SCCAI) and pregnancy outcomes has rarely been studied. This retrospective study aimed to assess the relationship between SCCAI and pregnancy outcomes of Chinese women with UC and explore factors affecting pregnancy outcomes. Methods: Overall, 23 pregnancies of 18 patients with UC were included. The following factors were analyzed: SCCAI before and during pregnancy; basic conditions, comorbidities, and treatment before and during pregnancy; frequency and details of pregnancy-related complications; and mode of delivery. Clinical characteristics, disease condition, and treatment details were compared between patients with and without adverse pregnancy outcomes. Results: The SCCAI was significantly lower in the remission group than in the active group (P < 0.001), except in the second trimester, but no significant difference in recurrence/exacerbation rate was found. There were 18 live births (remission group, 15; active group 3; P > 0.05). No significant difference in the frequency and characteristics of pregnancy-related complications was noted between the two groups. Outcomes of 15 pregnancies were satisfactory, but the other eight cases had adverse pregnancy outcomes. Patients with adverse pregnancy outcomes had higher SCCAI in the second trimester than the patients without adverse outcomes (P = 0.034). Multivariate analysis showed no statistically significant risk factor for adverse pregnancy outcomes. Conclusion: Chinese women with UC can usually achieve favorable pregnancy outcomes under multidisciplinary management, and a higher SCCAI in the second trimester has a positive correlation with adverse pregnancy outcomes.


Author(s):  
Urmila Karya ◽  
Sweta Kumari ◽  
Anupam Rani ◽  
Shakun Singh

Background: Alpha-fetoprotein (AFP) is the major serum protein in the embryonic stage and in the early fetal stage. The aim of this study was to measure maternal serum AFP levels in second trimester between 15-20 weeks of gestation and to determine whether unexplained elevated MSAFP levels is an effective predictor of adverse pregnancy outcome among Indian population.Methods: This study was a prospective observational study, carried out on 400 pregnant women. Maternal serum alpha-fetoprotein (MSAFP) was measured between 15 and 20 weeks of gestation after excluding congenital malformation or birth defects. MSAFP level was determined by using a radio-immunoassay technique. Women with MSAFP level >2.0 MoM was considered as abnormal while MSAFP level≤ 2.0 MoM was considered as normal. All women were followed up till delivery and pregnancy outcomes were noted and compared between two groups.Results: Women with elevated MSAFP had significantly higher adverse pregnancy outcomes (75.4%) compared to women with MSAFP ≤2.0 MoM (26.1%) (p<0.0001 with relative risk of 2.89, 95% confidence interval 2.276 -3.667).Conclusions: Unexplained elevated MSAFP has high sensitivity, specificity, positive predictive value and negative predictive value in predicting adverse pregnancy outcomes. It would, therefore be worthwhile screening pregnant women in second trimester for maternal serum alpha-fetoprotein levels as it would help to identify high risk pregnancies and allow close antenatal survillence for better pregnancy outcome.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.


2011 ◽  
Vol 31 (10) ◽  
pp. 995-998 ◽  
Author(s):  
Vajiheh Marsoosi ◽  
Reihaneh Pirjani ◽  
Ashraf Jamal ◽  
Laleh Eslamian ◽  
Abbas Rahimi-Foroushani

2015 ◽  
Vol 29 (13) ◽  
pp. 2093-2097 ◽  
Author(s):  
Thaniyaporn Settiyanan ◽  
Chanane Wanapirak ◽  
Supatra Sirichotiyakul ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
...  

2022 ◽  
Vol 226 (1) ◽  
pp. S314-S315
Author(s):  
Alexandria Kraus ◽  
Lauren Kucirka ◽  
Hina Shah ◽  
Juan Prieto ◽  
Nancy Chescheir ◽  
...  

2021 ◽  
Author(s):  
Zhi-Hao Huang ◽  
Ting-Ting Peng ◽  
Sheng-Guang Yan ◽  
Dong-Dong Yu ◽  
Jun-Chao Qiu ◽  
...  

Abstract Objective: Aim to the relationship between adverse pregnant outcomes with chronic hepatitis B virus (HBV) infection in pregnant women. Simultaneously, assess the incidence of adverse pregnancy outcomes (APO) among different serum HBV status in pregnant women. Method: From 2017 to 2019, we studied HBsAg (+) pregnant women and HBsAg (-) who gave birth at our hospital in Guangzhou City, China. We compared of the incidence of pregnant women with HBsAg(+) or HBsAg(-). Further, among HBsAg(+) pregnant women, We compared of the incidence of pregnant women with HBeAg(+) group or HBeAg(-) group, high HBV DNA loads (HBV DNA≥2×10^5IU/mL) group or low HBV DNA loads (HBV DNA<2×10^5IU/mL) group, respectively. Finally, multivariate logistic regression analysis was used to evaluate the independent association between HBV infection and the risk of developing APO.Result: First, Our research Indicates that the rates of gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), premature rupture of membrane (PROM), Fetal distress (FD), Oligohydramnios, Premature delivery (PD), Low birth weight (LBW), Meconium contamination (MC), Neonatal hyperbilirubinemia(NH) in HBsAg(+) group were higher than those in HBsAg(-) group (P<0.05). Second, among 711 HBsAg(+) pregnant women, the rates of GDM and ICP in high loads of HBV DNA were higher than those in low loads of HBV DNA group (P<0.05). Similarly, The rates of ICP in HBeAg(+) group were higher than those in HBeAg(-) group. Further, through multivariable logistical regression model analysis, we observed maternal HBsAg carrier (OR, 6.758; 95% CI, 2.358-19.369) had an independent risk for ICP. Similarly, HBsAg carrier(OR, 1.101; 95% CI, 1.066-1.137) ,advanced age (OR, 1.407; 95% CI,1.016-1.137) and abortion(OR,1.446; 95% CI, 1.062-1.969) had independent risk for GDM. Conclusions: Chronic HBV infection can increase the rate of host adverse pregnancy outcomes (APO). The maternal viral load and HBeAg status were significantly associated with the incidence of GDM and ICP. Maternal HBsAg carrier had an independent risk for GDM and ICP.


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