Influence of Vitamin D Level in the Second Trimester of Pregnancy on the Complications of Chinese Pregnant Women and Fetuses

Background:Vitamin D has been found to have more biological effects beyond the traditional research range,which involve in immunoregulation,occurrence,and development of tumor,reproduction,cell differentiation,and so forth.Herein,the influence of Vitamin D level in the second trimester of pregnancy on the Chinese pregnant women and fetal weight was investigated.Methods:Totally 1,612 pregnant women were followed up during the study,the 25-hydroxyvitamin D(25(OH)D)level was measured with ELISA at the 16th gestational week,and the fasting blood glucose was measured with hexokinase method using an automatic biochemistry analyzer at the same time.At week 24,oral glucose tolerance test(OGTT)was performed to test the blood glucose level(fasting blood glucose,1 h and 2 h after oral administration of glucose).Besides,other indices(e.g.,fetal birth weight)were recorded and analyzed by SPSS version 19.0 software.Results:Pearson’s correlation analysis indicated that the serum 25(OH)D had a negative correlation with blood glucose at 1 h after oral glucose administration at week 24 in OGTT(correlation coefficient:−0.03,P=0.01).However,it did not have correlations with the fasting blood glucose at weeks 16 and 24 as well as the blood glucose at 2 h after oral glucose administration at week 24.The Pearson’s correlation analysis was used to analyze the correlation between Vitamin D level in the pregnant women and fetal birth weight,and there was no correlation between them.Conclusion:The Vitamin D level in the second trimester of pregnancy had a negative correlation with blood glucose glucose at 1 h after oral glucose administration and had no correlation with fetal birth weight.

Maternal Thyroid-Stimulating Hormone Level and Thyroid Peroxidase Antibody Status in the First and Second Trimester of Pregnancy and Their Relationship with the Risk of Gestational Diabetes Mellitus

Objective:To investigate thyroid-stimulating hormone(TSH)levels and thyroid peroxidase antibody(TPOAb)in early pregnancy and to estimate the risk of development of gestational diabetes mellitus(GDM).Methods:The levels of TSH,free thyroxine,free triiodothyronine,and TPOAb were retrospectively evaluated in 2333 pregnant women.All women recruited were divided into groups of TSH high(H),TSH low(L),TSH(H)TPOAb positive(+),TSH(H)TPOAb negative(-),TSH normal(N)TPOAb(+),TSH(L)TPOAb(+),TSH(L)TPOAb(-),and estimated the risk of GDM.Results:TSH level(X^(2)=13.0024,P=0.0015)and TSH combined TPOAb(X^(2)=20.0038,P=0.0012)were correlated to development of GDM.The level of TSH in 95 women was increased,and in 216 women were decreased.Of the 2333 pregnant women,546 patients were diagnosed with GDM,with a prevalence of 23.40%.The prevalence of GDM was 35.78%and 28.70%for the TSH high(H)and TSH low(L)pregnant women,respectively.The increased TSH(P=0.0013,odds ratio:2.09,confidence interval:1.34-3.28)was correlated to increase GDM incidence.TSH(H)TPOAb(+)(n=29),TSH(H)TPOAb(-)(n=58),TSH normal(N)TPOAb(+)(n=265),TSH(L)TPOAb(+)(n=30),TSH(L)TPOAb(-)(n=154)were in this study.The prevalence of GDM was 51.72%,29.31%,23.02%,26.67%,and 29.87%for the TSH(H)TPOAb(+),TSH(H)TPOAb(-),TSH(N)TPOAb(+),TSH(L)TPOAb(+),and TSH(L)TPOAb(-)pregnant women,respectively.Only the TSH(H)TPOAb(+)pregnant women had a significant higher incidence of GDM(P=0.0018,odds ratio:3.63,confidence interval:1.62-8.16).Trimester specific results showed that only second trimester had higher GDM risk either analyze TSH or the combination of TSH and TPOAb.Conclusion:Elevated TSH level and TPOAb positive in the second trimester of pregnancy were correlated to an increased risk of GDM.

Comparison of second-trimester maternal serum free-p-human chorionic gonadotropin and a-fetoprotein between normal singleton and twin pregnancies： a population-based study

Background The second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free β-human chorionic gonadotropin （free β-HCG） and a-fetoprotein （AFP） in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy. Methods On the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free β-HCG of 195 normal twin pregnancy and 26 512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model. Results According to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women （98%）, from the target population accepted prenatal screening for maternal serum AFP, β-HCG detection, and all babies were followed up for at least six months. There were 197 （0.73%） twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect （NTD）, trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free β-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free β-hCG during the 16th gestational week （P=0.012）. Conclusion The weight-correction and gestational age-specific levels of Chinese Han population maternal serum free β-hCG and AFP in normal twins were twice the levels as those in the singleton controls during the 17-19 gestational weeks.

Chronic hypertension superimposed on preeclampsia at 13 gestational weeks： a case report with review

Preeclampsia is represented by hypertension and proteinuria in pregnancy. It usually occurs after 20 gestational weeks. There are few reports on preeclampsia before 20 gestational weeks. In this case, we report a patient with chronic hypertension superimposed with preeclampsia at 13 gestational weeks.

Adhesive ileus in pregnant women

A female patient was of the pregnancy for less than 24 weeks and suffered from adhesive ileus. The conservative treatment with acupuncture was selected to keep the fetus alive. A single-used filiform needle,0.30 mm x 40 mm was used. Zúsānlǐ(足三里ST 36), Shàngjùxū(上巨虚 ST 37), Tàichōng(太冲 LR 3) and Zhigōu(支沟TE 6) were selected bilaterally. At each acupoint, the needle was inserted rapidly and manipulated with the twisting, lifting and thrusting techniques to induce mild stimulation. Additionally, the electric stimulation was added at ST 36 and ST 37, with the continuous wave, 60 times per minute in frequency. The needles were retained for 25 min in each treatment. During the hospital stay, the treatment was given once every day and the condition of the disorder was observed carefully. The patient was discharged from the hospital in her 30 weeks of pregnancy. Afterward, acupuncture treatment was given once every one or two days in clinic till the weeks 34 of pregnancy. After acupuncture treatment,the conditions of abdominal distention, enteric flatus and defecation were relieved sustainably through to the cesarean section in weeks 34 of pregnancy. Both the patient and her infant were healthy when discharged. It was proved that acupuncture therapy was applicable and effective in the pregnant patient with ileus.