Neonatal Infection among Women with Prior Premature Labor

Objectives: Since studies demonstrate that neonates born to mothers having been cared for premature labor will suffer from congenital neonatal sepsis, we aimed to evaluate the prevalence and main risk factors of neonatal infection among mothers having experienced a prior premature labor. Methods: This was a cross sectional study carried out from January 1st throughout 31st December, 2013 at the university clinics of Kinshasa. It concerned all delivered women at term having been cared for premature labor prior to giving birth a live newborn. Maternal variables of interest were: parity, gestation, age, intrapartum fever, malaria, urogenital infection during the last 2 weeks before delivery (UGI), premature rupture of membranes (PROM), cervical cerclage, meconium-stained amniotic fluid (MSAF) and the way of delivery. For neonates attention was paid on gestational age, birth weight, admission at neonatal intensive care unit (ANICU) and infection as stated within three days after birth. T-test and Chi-square were used where appropriate. Logistic analysis was used to determine the risk for maternal variables to induce neonatal infection (OR and CI), the significance stated at p < 0.05. Results: Fifty two mother-infant couples were recruited. Of these 19 neonates were infected (prevalence of 36.5%). Mean age, gestational age and birth weight were 30.19 ± 5.32 years, 37.2 ± 2 weeks and 2638 ± 588 g, respectively. Infected neonates had their gestational age and birth weight significantly lower whilst proportion of ANICU higher than that on non infected. Prematurity, PROM, UGI, prior cerclage and MSAF were significantly more frequent in couples with neonatal infection. Prematurity, birth weight <2500 g and UGI were found to enhance the risk by 3 to 4 times. Conclusion: The prevalence of neonatal infection was very high. Prematurity, birth weight <2500 g and maternal UGI were found to enhance the risk by 3 to 4 times.

Terminal Pregnancy Complicated by Measles and Premature Labor:a Case Report

Measles infection in pregnant women is a very dangerous clinical condition.Patients usually had complicated pneumonia,and virus could pass through the placenta to the fetus and lead to premature delivery,stillbirth,miscarriage and neonatal measles.In this report,one such case,which was diagnosed by clinical signs and symptoms,clinical and laboratory examination was described.After proper therapeutic treatment,the infection was well-controlled and a baby was born by nature labor.

Rural labor migration and farmers’arrangements of rice production systems in Central China:Insight from the intergenerational division of labor

Rice production is crucial for food security in China,and its relationship with rural labor migration has been studied extensively.Labor migration in rural China has taken new forms in recent years.There has been a discernible trend wherein adult children have started migrating to cities while their elderly parents return to villages to re-engage in on-farm work.The phenomenon has notably shaped the intergenerational division of labor(IDL)within households.However,it remains to be seen how farmers adjust their rice production systems in response to the IDL.The age of 60 years for employment injury insurance is the eligibility threshold for off-farm employment and is used to obtain a source of exogenous variation in the IDL.Based on a representative household survey of 1,752 rice farmers in the Hubei Province of Central China,our fuzzy regression discontinuity analysis reveals that farmers in IDL households are more likely to adopt ratoon rice(RR)than single cropping rice(SR)or double cropping rice(DR).The effect of the IDL varies under different levels of operational scales and specialized agricultural service availability.Further analysis suggests that farmers’arrangements are associated with two potential mechanisms of downward intergenerational transfer.Monetary transfer for urban housing purchases increases RR in IDL households,and time transfer for intergenerational childcare significantly promotes SR in IDL households.This study enhances the understanding of the relationship between rural labor migration and rice production in China,providing a reference for adjusting rice production systems to ensure food security.

Safety and effectiveness of butorphanol in epidural labor analgesia:A protocol for a systematic review and meta-analysis

BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.

Association of Squatting Activities of Pregnant Women during the Antenatal Period and Labor Outcomes

Aim: To investigate impact of antenatal squatting activities on labour outcomes. Methods: All eligible primigravida women, with singleton cephalic fetuses, who presented to ward 18 of Colombo South Teaching Hospital, Sri Lanka, during the period 1st of February to 28th of May 2017 were invited into the study. Those who were already in active stage of labor (at least more than two moderate contractions per 10 minutes) on admission were excluded. Demographic data such as age, ethnicity, religion, educational level, occupation, latrine type in use, and booking Body mass index (BMI) were collected via an interviewer administered questionnaire. Data related to labor (modified Bishop score at onset of active labor, labor augmentation, pain relief, labor duration, mode of delivery, episiotomy or tears) and neonatal outcome (birth weight, APGAR score at 1, 5, 10 minutes) were collected from delivery notes. A pre tested interviewer administered questionnaire was used to obtain data regarding routine squatting activities during the previous 6 months. Pain visual analogue scale was used on day after delivery to assess the degree of labour pain. Duration of each squatting activity per day and number of days engaged with the activity per week;were used to calculate total squatting hours per week. In the absence of an accepted threshold for adequate squatting, we employed the sample mean as an operational data-driven threshold to define “more” against “less” squatting activities. Women who did not have squatting activities were considered as the controls. We used chi-square and Fisher’s exact tests to compare characteristics and outcomes between those engaging in more and less levels of squatting activity. We fitted a series of logistic regression models with each dichotomized outcome as the dependent variable, more/less squatting activity as the main independent variable of interest, and age, gestation period, BMI and patient’s occupation as covariates. The resulting adjusted odds ratios (AOR) and their 95% confidence intervals (CI) and statistical significance (p < 0.05) were used to draw conclusions of adjusted associations. Results: We recruited 430 women into this study. Overall, 68% of the women were of 20 - 30 years old, 47% had normal body mass index and 65% were housewives. The most frequent squatting activities were for urination/defecation and clothes washing (146 and 62 minutes/week, respectively). Mean total time was 246 minutes per week, of which more than 147 women (34%) achieved above this level of squatting activities. Those with more squatting activities had a greater modified Bishop Score ≥ 6/10 (92% vs 82%;p < 0.01);labor duration of <6 hours (82% vs 56%;p < 0.01), less likely for labour augmentation (39% vs 51%;p < 0.01) and pain relief (53% vs 65%;p = 0.013). Similar results were obtained after adjustments for maternal age, BMI, gestational age and occupation. However, there were no significant differences in the mode of delivery (normal vaginal vs instrumental vs caesarean), episiotomy rate, birth weight and neonatal Apgar scores. Conclusion: Squatting activities of more than 246 minutes per week may improve labor outcome. Women should be encouraged to increase squatting exercises or incorporate more habitual squatting activities antenatally.

Is Induction of Labor with Early Rupture of Membranes Associated with an Increased Rate of Clinical Chorioamnionitis?

Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study Design: A retrospective cohort study was performed on women undergoing IOL. Early ROM was defined as ROM at a modified Bishop score less than 5, cervical dilation less than 4 cm, or cervical effacement less than 80%. The rate of clinical chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017. The rate of cesarean delivery was higher for patients with early ROM by any definition: 32% compared to 17.5% by modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p = 0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In patients undergoing IOL, early ROM may be associated with an increased rate of clinical chorioamnionitis when performed at a cervical effacement of less than 80% and an increased rate of cesarean delivery.

Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective:To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor.Methods:According to the order of admission,74 elderly women were divided into the control group and the observation group.In addition to the routine perinatal nursing interventions,the observation group strengthened the implementation of midwives’psychological nursing interventions.The duration of labor,mode of delivery,psychological state,and stress response indexes of the two groups were analyzed and compared.Results:The observation group had a shorter duration of all labor stages and total duration of labor than the control group,a lower cesarean section rate than the control group,and a higher degree of improvement in anxiety,depression,and stress response indexes in the 3-day postpartum period as compared to the control group(P<0.05).Conclusion:The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor,reduce the cesarean section rate,and improve the psychological state and stress indicators,which is worth promoting.

A Study on the Correlation of Body Mass Management During Pregnancy with Adverse Pregnancy Outcomes and Labor Progression

Objective:To investigate the effects of body mass management during pregnancy on adverse pregnancy outcomes,duration of labor,and neonatal birth weight.Methods:472 pregnant women who visited Beijing Anzhen Hospital from January to December 2023 were selected,and the pregnant women were divided into 236 each in the observation group and the control group.Body mass of pregnant women was measured and BMI was calculated in early and late pregnancy respectively,and the pregnant women in the control group were guided by routine management,while the observation group was guided by body mass management during pregnancy.The growth of maternal body mass,mode of delivery,postpartum hemorrhage,neonatal score,neonatal blood glucose at birth,and umbilical artery blood,as well as the comparison of the duration of labor,were observed.Results:The observation group was significantly better than the control group in terms of mode of delivery,postpartum hemorrhage,and body mass growth,with statistically significant differences(P<0.05),and there was no statistical significance in terms of neonatal scores,neonatal blood glucose at birth,and umbilical artery blood(P>0.05);the time of the first stage of labor and the time of the second stage of labor of the mothers in the observation group was significantly better than that of the control group,with statistical differences(P<0.05),and the time of the third stage of labor of the mothers in the observation group was statistically better than that of the control group.There was no statistically significant difference between the time of the third stage of labor in the observation group and the control group(P>0.05),and the time of the total stage of labor in the observation group was statistically better than that in the control group(P<0.05).Conclusion:Body mass management during pregnancy can effectively improve maternal control of weight gain,reduce labor time,and decrease the occurrence of adverse pregnancy outcomes.

Contribution of the MERISE-Type Conceptual Data Model to the Construction of Monitoring and Evaluation Indicators of the Effectiveness of Training in Relation to the Needs of the Labor Market in the Republic of Congo

This study proposes the use of the MERISE conceptual data model to create indicators for monitoring and evaluating the effectiveness of vocational training in the Republic of Congo. The importance of MERISE for structuring and analyzing data is underlined, as it enables the measurement of the adequacy between training and the needs of the labor market. The innovation of the study lies in the adaptation of the MERISE model to the local context, the development of innovative indicators, and the integration of a participatory approach including all relevant stakeholders. Contextual adaptation and local innovation: The study suggests adapting MERISE to the specific context of the Republic of Congo, considering the local particularities of the labor market. Development of innovative indicators and new measurement tools: It proposes creating indicators to assess skills matching and employer satisfaction, which are crucial for evaluating the effectiveness of vocational training. Participatory approach and inclusion of stakeholders: The study emphasizes actively involving training centers, employers, and recruitment agencies in the evaluation process. This participatory approach ensures that the perspectives of all stakeholders are considered, leading to more relevant and practical outcomes. Using the MERISE model allows for: • Rigorous data structuring, organization, and standardization: Clearly defining entities and relationships facilitates data organization and standardization, crucial for effective data analysis. • Facilitation of monitoring, analysis, and relevant indicators: Developing both quantitative and qualitative indicators helps measure the effectiveness of training in relation to the labor market, allowing for a comprehensive evaluation. • Improved communication and common language: By providing a common language for different stakeholders, MERISE enhances communication and collaboration, ensuring that all parties have a shared understanding. The study’s approach and contribution to existing research lie in: • Structured theoretical and practical framework and holistic approach: The study offers a structured framework for data collection and analysis, covering both quantitative and qualitative aspects, thus providing a comprehensive view of the training system. • Reproducible methodology and international comparison: The proposed methodology can be replicated in other contexts, facilitating international comparison and the adoption of best practices. • Extension of knowledge and new perspective: By integrating a participatory approach and developing indicators adapted to local needs, the study extends existing research and offers new perspectives on vocational training evaluation.

Research on the Implementation Path of Labor Education in Colleges and Universities from an International Perspective

Universities shoulder the important mission of talent cultivation,scientific research,social service,cultural heritage and innovation,and international exchange and cooperation.International exchange and cooperation have become the fifth major function of universities.Based on the background of the globalization era,undergraduate colleges and universities should pay more attention to the cultivation of students’intercultural communication and understanding ability while cultivating their professional skills,and take expanding students’international vision and enhancing the international competitiveness of China’s education as important tasks.Labor education is an important content of the national education system,which has the comprehensive nurturing value of cultivating morality,increasing intelligence,strengthening physical fitness,and cultivating beauty.Higher education institutions should further optimize the system of labor education,expand students’space and field of thinking in the process of labor education,and broaden students’international perspectives.

The Practical Path of Labor Curriculum in Compulsory Education in China from the Perspective of Overlapping Influence Domain Theory

Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive practical activity courses.Exploring the practical path of labor curriculum in compulsory education in China has become the primary task of labor education in China.Based on the practical situation of labor curriculum in compulsory education in China,drawing on the theory of overlapping influence domains,and from the perspective of collaborative education among family,school,and community,this paper proposes a curriculum practical path of“school-led”family-school-community collaboration and a curriculum practical path guided by“student-centered”sentiment,in order to provide references for the practice of labor curriculum in compulsory education in China.

Rice melatonin deficiency causes premature leaf senescence via DNA methylation regulation

In a study of DNA methylation changes in melatonin-deficient rice mutants,mutant plants showed premature leaf senescence during grain-filling and reduced grain yield.Melatonin deficiency led to transcriptional reprogramming,especially of genes involved in chlorophyll and carbon metabolism,redox regulation,and transcriptional regulation,during dark-induced leaf senescence.Hypomethylation of mCG and mCHG in the melatonin-deficient rice mutants was associated with the expression change of both protein-coding genes and transposable element-related genes.Changes in gene expression and DNA methylation in the melatonin-deficient mutants were compensated by exogenous application of melatonin.A decreased S-adenosyl-L-methionine level may have contributed to the DNA methylation variations in rice mutants of melatonin deficiency under dark conditions.

Being a Father of a Premature Newborn: The Parental Experience and the Father/Premature Newborn Relationship: A Study Carried out in the Department of Neonatology Intensive Care Unit of Mohammed VI University Hospital

Introduction: Despite advances in obstetrics and pediatrics over the past 20 years, premature birth remains an unpredictable event that can have a devastating impact on parenthood. This study aimed to analyze the psycho-affective experiences of fathers of premature newborns. Methods: This was a descriptive cross-sectional study, carried out in the department of neonatology and neonatal intensive care unit of the CHU Mohamed VI in OUJDA, over 6 months from March 2022 to August 2022. It focused on 30 fathers of premature newborns hospitalized in our department. Results: The majority of fathers described a state of fear and stress, and attributed their negative experience to the unexpected nature of the premature birth. At the first meeting, half the fathers had a positive image of their newborn’s physical appearance, while 22% of fathers reported feeling uncomfortable about their newborn’s low weight. Most fathers reported that they appreciated the welcome they received, the skill with which they cared for their newborn, and the availability of the pediatrician to provide information on their child’s state of health. Two fathers enjoyed skin-to-skin contact with their newborns. None of the fathers met a psychologist. When they returned home, half the fathers had a positive outlook, marked by happiness at being able to fully invest in their role as fathers, the other half reported being torn between the desire to see their child integrated into the family cocoon and the fear of not being able to manage delicate situations properly without a medical team. Conclusion: Bringing a premature baby into the world can be a difficult experience, leading to the development of even minor psychological distress in some fathers, and hence the need for specific psychological care.

Current Status of Stem Cells in the Treatment of Premature Ovarian Failure

Premature ovarian failure (POF) is a prevalent cause of female infertility. POF features include estrogen hypofunction, amenorrhea, infertility, and high gonadotropin levels. The etiology of POF is genetic diseases, autoimmune diseases, enzyme defects and environmental factors. The development of Regenerative medicine has made stem cell and exosome (EXOs) therapy effective for POF. This review discusses POF stem cell research and development.

Application of mesenchymal stem cell therapy for premature ovarian insufficiency: Recent advances from mechanisms to therapeutics

The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complications that profoundly affect female reproductive function and overall health.Unfortunately,current clinical treatment strategies for this condition are limited and often yield unsatisfactory outcomes.These approaches typically involve hormone repla-cement therapy combined with psychological support.Recently,mesenchymal stem cell(MSC)therapies for POI have garnered considerable attention in global research.MSCs can restore ovarian reproductive and endocrine functions through diverse mechanisms,including controlling differentiation,promoting angiogenesis,regulating ovarian fibrosis,inhibiting apoptosis,enhancing autocrine and paracrine effects,suppressing inflammation,modulating the immune system,and genetic regulation.This editorial offers a succinct summary of the application of MSC therapy in the context of POI,providing evidence for groundbreaking medical approaches that have potential to enhance reproductive health and overall well-being for women.

Significance of oxidative stress and antioxidant capacity tests as biomarkers of premature ovarian insufficiency: A case control study

BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby considerably reducing the quality of life of females.Given the continuum in weakened ovarian function,progressing from incipient ovarian failure(IOF)to transitional ovarian failure and further to POI,it is necessary to develop biomarkers for predicting POI.The oxidative stress states in IOF and POI were comprehensively evaluated via oxidative stress[diacron-reactive oxygen metabolites(d-ROMs)]test and anti-oxidant capacity[biological antioxidant potential(BAP)].METHODS Females presenting with secondary amenorrhea over 4 mo and a follicle stimulating hormone level of>40 mIU/mL were categorized into the POI group.Females presenting with a normal menstrual cycle and a follicle stimulating hormone level of>10.2 mIU/mL were categorized into the IOF group.Healthy females without ovarian hypofunction were categorized into the control group.Among females aged<40 years who visited our hospital from January 2021 to June 2022,we recruited 11 patients into both POI and IOF groups.For the potential antioxidant capacity,the relative oxidative stress index(BAP/d-ROMs×100)was calculated,and the oxidative stress defense system was comprehensively evaluated.RESULTS d-ROMs were significantly higher in the POI and IOF groups than in the control group,(478.2±58.7 U.CARR,434.5±60.6 U.CARR,and 341.1±35.1 U.CARR,respectively)(U.CARR is equivalent to 0.08 mg/dL of hydrogen peroxide).However,no significant difference was found between the POI and IOF groups.Regarding BAP,no significant difference was found between the control,IOF,and POI groups(2078.5±157.4μmol/L,2116.2±240.2μmol/L,and 2029.0±186.4μmol/L,respectively).The oxidative stress index was significantly higher in the POI and IOF groups than in the control group(23.7±3.3,20.7±3.6,and 16.5±2.1,respectively).However,no significant difference was found between the POI and IOF groups.CONCLUSION High levels of oxidative stress suggest that evaluating the oxidative stress state may be a useful indicator for the early detection of POI.

Exploration of standard dosage for GnRH antagonist protocol and dosage adjustments after premature luteinizing hormone surge

The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.

Acquired methemoglobinemia in a third trimester puerpera and her premature infant with sodium nitrite poisoning:A case report

BACKGROUND The common cause of sodium nitrite poisoning has shifted from previous accidental intoxication by exposure or ingestion of contaminated water and food to recent alarming intentional intoxication as an employed method of suicide/exit.The subsequent formation of methemoglobin(MetHb)restricts oxygen transport and utilization in the body,resulting in functional hypoxia at the tissue level.In clinical practice,a mismatch of cyanotic appearance and oxygen partial pressure usually contributes to the identification of methemoglobinemia.Prompt recognition of characteristic mismatch and accurate diagnosis of sodium nitrite poisoning are prerequisites for the implementation of standardized systemic interventions.CASE SUMMARY A pregnant woman was admitted to the Department of Critical Care Medicine at the First Affiliated Hospital of Harbin Medical University due to consciousness disorders and drowsiness 2 h before admission.Subsequently,she developed vomiting and cyanotic skin.The woman underwent orotracheal intubation,invasive mechanical ventilation(IMV),and correction of internal environment disturbance in the ICU.Her premature infant was born with a higher-than-normal MetHb level of 3.3%,and received detoxification with methylene blue and vitamin C,supplemental vitamin K1,an infusion of fresh frozen plasma,as well as respiratory support via orotracheal intubation and IMV.On day 3 after admission,the puerpera regained consciousness,evacuated the IMV,and resumed enteral nutrition.She was then transferred to the maternity ward 24 h later.On day 7 after admission,the woman recovered and was discharged without any sequelae.CONCLUSION MetHb can cross through the placental barrier.Level of MetHb both reflects severity of the sodium nitrite poisoning and serves as feedback on therapeutic effectiveness.

Recent Research Progress in Premature Ovarian Failure

Premature ovarian failure refers to ovarian function failure in women before the age of 40 years due to follicular depletion or follicular dysfunction resulting in abnormal hormone levels.The etiology and pathogenesis of premature ovarian failure may be related to genetic,immunological,medical,environmental,infectious,psychological and enzyme deficiencies.The treatment involves Western medicine,Chinese medicine,and a combination of Chinese and Western medicine,and the treatment level includes hormone level,cellular level,surgery and psychological aspect.This paper would like to review the progress of the etiology,pathogenesis and treatment of premature ovarian failure in recent years.

Research Progress on the Prevention of Premature Infant Lung Injury and Neonatal Respiratory Support

In the past 40 years,advances in neonatal intensive care unit(NICU)technology have enabled premature infants with lower birth weight and younger gestational age to survive.But with it comes an increase in the incidence of long-term respiratory dysfunction,mainly in the form of bronchopulmonary dysplasia(BPD).Preventing lung injury is crucial for preventing BPD and improving the long-term prognosis of premature infants.Therefore,how to avoid ventilator-associated lung injury has become a focus of clinical and scientific research in premature infants in recent years.This article will elaborate on the susceptibility and pathophysiology of premature infant lung injury,ventilation strategies for preventing lung injury,and new advances in neonatal respiratory support.