Assessment of Cardiovascular Risk Factors During Pregnancy: A Multicenter Study in West Africa, Dakar, Senegal

Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.

Assessment of early factors for identification or prediction severe acute pancreatitis in pregnancy

BACKGROUND Acute pancreatitis in pregnancy(APIP)is a rare and serious condition,and severe APIP(SAPIP)can lead to pancreatic necrosis,abscess,multiple organ dysfunction,and other adverse maternal and infant outcomes.Therefore,early identification or prediction of SAPIP is important.AIM To assess factors for early identification or prediction of SAPIP.METHODS The clinical data of patients with APIP were retrospectively analyzed.Patients were classified with mild acute pancreatitis or severe acute pancreatitis,and the clinical characteristics and laboratory biochemical indexes were compared between the two groups.Logical regression and receiver operating characteristic curve analyses were performed to assess the efficacy of the factors for identification or prediction of SAPIP.RESULTS A total of 45 APIP patients were enrolled.Compared with the mild acute pancreatitis group,the severe acute pancreatitis group had significantly increased(P<0.01)heart rate(HR),hemoglobin,neutrophil ratio(NEUT%),and neutrophil–lymphocyte ratio(NLR),while lymphocytes were significantly decreased(P<0.01).Logical regression analysis showed that HR,NEUT%,NLR,and lymphocyte count differed significantly(P<0.01)between the groups.These may be factors for early identification or prediction of SAPIP.The area under the curve of HR,NEUT%,NLR,and lymphocyte count in the receiver operating characteristic curve analysis was 0.748,0.732,0.821,and 0.774,respectively.The combined analysis showed that the area under the curve,sensitivity,and specificity were 0.869,90.5%,and 70.8%,respectively.CONCLUSION HR,NEUT%,NLR,and lymphocyte count can be used for early identification or prediction of SAPIP,and the combination of the four factors is expected to improve identification or prediction of SAPIP.

Risk Prediction Model for Hypertensive Disorders of Pregnancy Based on Routine Laboratory Indicators and Risk Factors: A Retrospective Analysis

Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.

Factors Associated with Closely Spaced Pregnancies at the Departmental Hospital Centre of Zou-Collines (Benin) in 2022

Introduction: Birth spacing to prevent closely-spaced pregnancies, which are a source of maternal and neonatal morbidity and mortality, is not always respected by our women, as recommended by the World Health Organization (WHO). The objective was to study the factors associated with closely-spaced pregnancies among women followed at the Departmental Hospital Center du Zou et du Colline (DHC/Z-C) in 2022. Study Method: This was a descriptive, analytical cross-sectional study with prospective data collection from 20 May to 30 June 2022. Results: At the end of the study, 83 of the 117 women surveyed had close pregnancies, a frequency of 70.94%. They had an average age of 27.0 ± 6.3 years and were of Fon ethnicity and related in 91.57% of cases. The majority were married (96.60%). The factors significantly associated with these closely spaced pregnancies were age between 25 and 30 years, household occupation, age at first birth, age at marriage, women’s perception of contraceptive method (CM), women’s knowledge of the existence of a center providing family planning services and non-use of MC. Conclusion: Close pregnancies are still very common in the commune of Abomey. It is therefore important to increase the use of contraceptive methods in this part of the country.

Risk Factors and Pregnancy Outcomes： Complete versus Incomplete Placenta Previa in Mid-pregnancy

This prospective study was conducted to compare risk factors and pregnancy outcomes between women with complete placenta previa and those with incomplete placenta previa diagnosed in mid-pregnancy. The study was carried out from April 2014 to December 2015, during which 70 patients with complete previa and 113 with incomplete previa between 20＋0 weeks and 25＋6 weeks of gestation were included. Maternal demographics and pregnancy outcomes were compared between the two groups. Comparisons between categorical variables were tested by chi-squared test and those between continuous variables by Student t test. Resolution ofprevia occurred in 87.43% of the studied women. The mean gestational age at resolution was 32.1＋4.4 weeks. Incidence of maternal age ≥35 years and incidence of prior uterine operation 〉3 were high in women with complete previa （28.6% vs. 8.8%, P=0.003; 28.6% vs. 8.8%, P=0.003）. Resolution ofprevia occurred less often in complete previa group （74.3% vs. 95.6%, P=0.001）. Women with complete previa admitted earlier （37.3±2.0 weeks vs. 38.1±1.4 weeks, P=0.011） and delivered earlier （37.7±1.2 weeks vs. 38.3±1.4 weeks, P=0.025）. Maternal age ≥35 years and prior uterine operation 〉3 increase the risk of complete previa in mid-pregnancy. Placenta previa is more likely to persist in women with complete previa than those with incomplete previa diagnosed in mid- pregnancy. What is more, women with complete previa in mid-pregnancy delivers earlier.

Prevalence and Factors Associated with Anemia Pregnancy in a Group of Moroccan Pregnant Women

Background: Pregnancy is typically accompanied by an increase of micronutrient requirements in general and especially iron. This increased need may be an additional risk factor for developing anemia. Purpose of the study: The aim of this study is to provide data on the prevalence of anemia of pregnancy in the maternity ward of the regional hospital in the city of Temara, and examine risk factors that may expose women to anemia during pregnancy. Materiel and Methods: A prospective cross-sectional study of a year was conducted to the hospital Sidi Lahcen in the city of Temara. Sociodemographic and nutritional data were collected through a questionnaire, obstetric and medical histories of women in labor and the results of biological tests were recorded from the patient obstetric file. Results: Among the 849 women surveyed, 690 (82%) had performed a blood count, and among these 117 (16.8%) were found anemic, with the following proportions: 57.6% had mild anemia, 41.5% had moderate anemia and a minority (0.8%) had severe anemia. The pregnant women aged over 35 years were the most exposed to anemia during pregnancy (47%) compared with younger women (p < 0.001). Women who had a history of anemia aside from pregnancy and those who had anemia in earlier pregnancies were more prone to developing anemia in the current pregnancy with a statistically significant difference (p < 0.001). The number of pregnancies, number of previous abortions and place of residence had no influence on the occurrence of anemia of pregnancy. The consumption of fortified flour with iron and vitamins as well as consuming iron rich foods was not a protective factor against the development of anemia of pregnancy. Tea consumption near the meal was not a factor exposing to anemia during pregnancy. Conclusion: Anemia is a public health problem in Morocco. Evidence from our study emphasizes the need to implement educational programs to improve the nutritional knowledge and sensitization of women.

Cervical Pregnancy in a Primigravida Patient without Risk Factors: A Case Report

Cervical pregnancy is defined as the implantation of the egg below of the internal cervical orifice, and remains a rare clinical entity which affects on average 1 out of 20,000 pregnancies worldwide. Its hemorrhagic complications are life-threatening in case of late diagnosis. It occurs mainly on a history of curettage or caesarian which are the most recognized risk factors. The objective pursued here is to discuss the possibility of the occurrence of this rare clinical entity in a primigravida without risk factors and the different therapeutic possibilities according to the technical platforms. Authors report a case of cervical pregnancy at 6 weeks’ gestation occurring in a primigravida without risk factors who consulted at University clinics of Kinshasa (UCK) for a genital hemorrhage chart. The diagnosis was made using ultrasound and treatment provided by curettage followed by the placement of an intra-cervical foley tube for hemostatic purposes. Given its high mortality, the diagnosis must be early even in pregnant women without obvious risk factors. The diversity of therapeutic means gives practitioners a choice depending on the technical platform.

Factors Associated with Early Pregnancy among Adolescent Girls in Schools in Bohicon, Benin in 2022

Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to identify the factors associated with early pregnancies in the municipality of Bohicon in 2022. Materials and Methods: This is a case-control study conducted in Bohicon, involving 47 cases and 94 controls from 16 secondary and technical schools. Cases were selected exhaustively, while controls were randomly drawn from girls aged 10 to 19 in the same class who had never been pregnant. Matching was based on the type of institution and class. Data were collected through a questionnaire and analyzed using Epi info 7.2.1.0 and STATA 15 software, employing multiple conditional logistic regression (5% significance threshold) to identify factors related to early pregnancies. Results: The average age of adolescents was 17.63 years ± 0.09 for cases and 17.12 years ± 0.13 for controls. Associated factors included age over 16 years (p = 0.049), the marital status of the adolescent (single) (p = 0.001), and the monthly pocket money of the adolescent less than 10,000 FCFA (p = 0.031). Conclusion: Three factors related to early pregnancies were identified. To counteract this phenomenon and promote responsible sexuality among adolescents, it is essential to strengthen communication efforts aimed at modifying behaviors.

Factors Associated with Rising Trend in Teenage Pregnancy within the West Gonja Municipality of the Savannah Region of Ghana

Background: Teenage pregnancy is a major public health problem worldwide, also in northern Ghana. The aim of this study was to identify factors contributing to the rising trend in teenage pregnancy and the resultant effects. Materials and Methods: This was a cross-sectional study using a quasi-structured questionnaire on 60 pregnant teenagers. Demographic data and factors associated with teenage pregnancy were collected/analyzed. Results: The mean age of respondents was 17.25 ± 1.93 years. Junior high school students or graduates accounted for 55%. About 35% of participants dropped out of school due to pregnancy. The following factors were identified to be associated with teenage pregnancy: low socio-economic status, no/less sexual- and reproductive-communication with parents, low level of education, no sexual and reproductive health knowledge, and unsafe sexual behaviours. The consequences of teenage pregnancy identified were: truncation of the girls’ education, psychological trauma, and worsening family relationships. The following health consequences were identified;anaemia in pregnancy, severe malaria, hypertension in pregnancy, and prolonged labour. Conclusion: The following factors may account for the rising trend in teenage pregnancy in this area: family-related problem, sociocultural factors, low education level, and the lack of adequate knowledge on reproductive health. Teenage pregnancy caused several problems in themselves and their family members.

Factors Associated with Pregnancy Outcomes in Hypertensive Pregnant Women in a District Hospital in Benin

Introduction: Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive pregnant women in Comè district hospital from 2014 to 2016. Methods: This is a retrospective, analytical study carried out in June 2016, involving a total of 345 hypertensive patients. Socio-demographic and medical features, including pregnancy and foetal outcomes parameters, were recorded in the case files. Top-down stepwise logistic regression was performed at the 5% threshold. Results: The frequency of hypertensive disorders during pregnancy was estimated at 7.32% and unfavourable outcomes at 35.65%. The adverse maternal outcomes recorded were postpartum death and haemorrhage whereas adverse foetal issues were prematurity, low birth weight, low Apgar scores, stillbirth and death. Factors statistically associated with pregnancy outcome were paucigravida (OR = 2.01 ([1.05 - 3.88]), p = 0.035), history of stillbirth (OR = 4.75 ([1.01 - 22.1]), p = 0.048) and anticonvulsant therapy (OR = 0.32 ([0.19 - 0.54]), p < 0.001). Conclusion: Adequate monitoring via Antenatal Care (ANC) check-ups, timely recourse to care and an effective communication strategy should reduce hypertensive disorders incidence and adverse outcomes in pregnant women.

The Prevalence Outcome and Associated Factors of Teenage Pregnancy in the Bamenda Health District

Teenage pregnancy is a common public health problem worldwide because teenagers in general are ill-prepared to deal with the burden of pregnancy. Sub-Saharan Africa has the highest burden of teenage pregnancy precisely in the west and central Africa;in Cameroon, about 12% of all births are to teenage mothers. Complications from pregnancy and childbirth are the leading cause of death among girls aged 15 to 19. Though the trend of teenage pregnancy tends to decrease in most parts of the world, this is not the case in our setting. The main aim of this study was to determine the prevalence, outcomes and the associated factors of teenage pregnancy in the Bamenda Health District (BHD). Materials and Method: This was a hospital-based cross-sectional descriptive and analytic study carried out at the maternity and postnatal units of the Bamenda Regional Hospital and the Nkwen Medicalised Health Center. A consecutive non-probabilistic sampling technique was used to recruit participants. A pretested questionnaire was used to collect information from the participant. Data was analysed using the software SPSS version 23. Bivariate logistic regression was used to test for associations. Statistical significance was set at p-value less than 0.05. Result: A total of 325 participants were recruited of which 44 were teenagers. The mean age of the participants was 25.02 ± 0.257 years. The mean age of teenagers was 17.49 ± 0.63 years, and mean adult age was 28.43 ± 5.64 years. The youngest participant was 15 years. Teenagers were significantly more likely to prematurity (OR = 0.14;95% CI = 0.06 - 0.31;PV = 0.001), Low birth weight among teenagers (OR = 0.077;95% CI = 0.03 - 0.21;PV = 0.001), Still birth;OR = 0.07;95% CI = 0.01 - 0.86;PV = 0.03) Neonatal admission also high among teenagers (OR = 0.172, 95% CI = 0.08 - 0.39, PV = 0.001) compared to the babies of their adult counterpart. The rate of caesarean section and episiotomy was high among adult deliveries (21.7%). Conclusion: There is a high prevalence of teenage pregnancy (13.54%) in the Bamenda Health District. prematurity was independently associated with teenage pregnancy. perineal tears were the most common maternal outcome of teenage pregnancy. Adolescents/teenagers in rural areas, having a low level of income, and low level of education were associated with high level of teenage pregnancy.

Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

Influencing factors of the neurodevelopment of high-risk infants

Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.

Safety of anti-tumor necrosis factor therapy during pregnancy in patients with inflammatory bowel disease

Treatment of inflammatory bowel disease has significantly improved since the introduction of biological agents, such as infliximab, adalimumab, certolizumab pegol, and golimumab. The Food and Drug Administration has classified these factors in category B, which means that they do not demonstrate a fetal risk. However, during pregnancy fetuses are exposed to high anti-tumor necrosis factor(TNF) levels that are measurable in their plasma after birth. Since antibodies can transfer through the placenta at the end of the second and during the third trimesters, it is important to know the safety profile of these drugs, particularly for the fetus, and whether maintaining relapse of the disease compensates for the potential risks of fetal exposure. The limited data available for the anti-TNF drugs to date have not demonstrated any significant adverse outcomes in the pregnant women who continued their therapy from conception to the first trimester of gestation. However, data suggest that antiTNFs should be discontinued during the third trimester, as they may affect the immunological system of the newborn baby. Each decision should be individualized, based on the distinct characteristics of the patient and her disease. Considering all the above, there is a need for more clinical studies regarding the effect of antiTNF therapeutic agents on pregnancy outcomes.

Predictors of Adverse Pregnancy Outcomes Following Traumatic Injuries

Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.

Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

Osteoprotegerin,interleukin and hepatocyte growth factor for prediction of diabetes and hypertension in the third trimester of pregnancy

BACKGROUND Gestational diabetes mellitus(GDM)raises the risk of high blood pressure and may cause a series of life-threatening complications in pregnant women.Screening and management of GDM and gestational hypertension(GH)in pregnancy helps to control and reduce these risks and prevent adverse effects on mothers and their fetuses.Currently,the majority criteria used for screening of diabetes mellitus is oral glucose tolerance tests,and blood pressure test is usually used for the screening and diagnosis of hypertension.However,these criteria might not anticipate or detect all GDM or GH cases.Therefore,new specific predictive and diagnostic tools should be evaluated for this population.This study selected three biomarkers of osteoprotegerin(OPG),interleukin(IL)and hepatocyte growth factor(HGF)for GDM and GH predication and diagnosis.AIM To explore the feasibility of changes in placental and serum OPG,IL and HGF as tools for prediction and diagnosis of diabetes and hypertension in pregnant women.METHODS From January 2018 to January 2019,44 pregnant women with GDM and GH were selected as an observation group,and 44 healthy pregnant women were selected as a control group in the same period.Serum OPG,IL and HGF were compared between the two groups.RESULTS The levels of OPG and HGF in the observation group were lower than in the control group,and the level of IL-1βwas higher in the observation group than in the control group(all P<0.05).Furthermore,OPG and HGF were negatively associated with gestational diabetes and gestational hypertension,while IL-1βwas positively associated with GDM complicated with GH(all P<0.05).CONCLUSION The evaluation of serum OPG,HGF and IL-1βlevels in patients with coexistent gestational diabetes complicated with hypertension can predict the degree of disease and play an important role in the follow-up treatment and prognosis prediction.

Seroprevalence of <i>Brucella</i>Antibodies and Risk Factors Associated with Human Brucellosis in High-Risk Occupational Groups of the Noun Division in the West Region of Cameroon

Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of Brucella from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect Brucella antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and Brucella antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of Brucella antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (P = 0.04;X2 = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;P = 0.001), no formal education (OR: 6.4;P = 0.03) and assistance of animal during parturition (OR: 7.2;P < 0.0001) appeared as factors that may increase the risk of Brucella infections. The detection of Brucella antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.

Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

AIM： To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS： A total of 2 147 persons （1 111 females, age 42.8 ＋ 12.7 years; 1 036 males, age 42.3 ＋ 13.1 years） participating in an investigation on the prevalence of Echinococcus rnultilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index （BMI）. A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS： Gallbladder stones were detected in 171 study participants （8.0%, n = 2 147）. Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy （yes/no） and number of pregnancies did not exert any influence. CONCLUSION： Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations.

Management of monogenic diabetes in pregnancy:A narrative review

Pregnancy in women with monogenic diabetes is potentially complex,with significant implications for both maternal and fetal health.Among these,maturity-onset diabetes of the young(MODY)stands out as a prevalent monogenic diabetes subtype frequently encountered in clinical practice.Each subtype of MODY requires a distinct approach tailored to the pregnancy,diverging from management strategies in non-pregnant individuals.Glucokinase MODY(GCK-MODY)typically does not require treatment outside of pregnancy,but special considerations arise when a woman with GCK-MODY becomes pregnant.The glycemic targets in GCK-MODY pregnancies are not exclusively dictated by the maternal/paternal MODY genotype but are also influenced by the genotype of the developing fetus.During pregnancy,the choice between sulfonylurea or insulin for treating hepatocyte nuclear factor 1-alpha(HNF1A)-MODY and HNF4A-MODY depends on the mother’s specific circumstances and the available expertise.Management of other rarer MODY subtypes is individu-alized,with decisions made on a case-by-case basis.Therefore,a collaborative approach involving expert diabetes and obstetric teams is crucial for the compre-hensive management of MODY pregnancies.