Introduction: Grand multiparity is a known risk factor for maternal and fetal complications. Materials and Methods: We carried out a cross-sectional descriptive study on the delivery of grand multiparas at the materni...Introduction: Grand multiparity is a known risk factor for maternal and fetal complications. Materials and Methods: We carried out a cross-sectional descriptive study on the delivery of grand multiparas at the maternity of the regional hospital annex of Ayos, a semi-rural locality in the Center region of Cameroon. The study covered the period from January 2012 through December 2020, and the objective was to assess the frequency, the determinants and the outcome of delivery in grand multiparas. Results: We recorded 1384 deliveries and enrolled 137 cases of delivery of grand multiparas. This gives a frequency of grand multipara delivery of 9.89%. The mean age of the women was 34.96 ± 4.45 years. Married parturients accounted for 65% of the cases and 16.8% were HIV positive. Delivery occurred at term in 89.9%. In 35.8%, no antenatal consultation was done. The use of the partograph during labor was reported in 11.7%. Per vaginal delivery was noted in 88.3%, emergency cesarean in 10.2% and elective cesarean in 1.5%. The most frequent maternal complications included post-partum hemorrhage (19.9%), genital tract tears (12.4%), endometritis (9.5%) and surgical wound infection (8.7%). No maternal death was recorded. The mean birth weight of the newborns was 3336.8 ± 550 g. Fetal complications were mostly represented by neonatal infection (20.1%), perinatal death (7.9%) and neonatal asphyxia (9.5%). Conclusion: The frequency of grand multiparous delivery in the semi-rural locality of Ayos, Cameroon, was 9.89%. The mean age of parturients was 38.96 years and the proportion of vaginal delivery was 88.3%.展开更多
Impact of PCBs was studied as a major source of physiological effects even very low concentration of PCBs transferred to the infants by mother’s milk. Milk samples were collected from primipara and multipara women. A...Impact of PCBs was studied as a major source of physiological effects even very low concentration of PCBs transferred to the infants by mother’s milk. Milk samples were collected from primipara and multipara women. A significant variation pattern was observed in the level of PCB congeners, as PCBs are lipophilic in nature, another possibility arises that great deals of residues are passed on to infants through mother’s milk. A technique was developed to find out polychlorinated biphenyls (PCB) in breast milk. PCBs were extracted by Matrix Solid-Phase Dispersion (MSPD) and analyzed by Gas Chromatography with Electron Capture Detector. The precision (RSD < 10%, n = 125), recovery (85% to 110%) and limit of quantification (between 0.50 and 3.00 μg·L-1), the chi square analysis at p ≤ 0.05 has shown that the PCB level was higher in multipara as compared to primipara. The analysis of the thirty samples revealed PCB levels above 6.85 μg·L-1 in breast milk samples by analyses of a mixture of PCB congeners. All PCB congeners (28, 52, 101, 123 (+149), 118, 114, 153, 105, 138 (+163), 167, 156 (+171), 157, 180, 170, 189) were found at high level in primiparous and multiparous. Thus, a high correlation between the contamination of breast milk and environmental pollution of PCBs was observed.展开更多
Background:Gestational diabetes mellitus(GDM)brings health issues for both mothers and offspring,and GDM prevention is as important as GDM management.It was shown that a history of GDM was significantly associated wit...Background:Gestational diabetes mellitus(GDM)brings health issues for both mothers and offspring,and GDM prevention is as important as GDM management.It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence.The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China.We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.Methods:A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers.All participants were enrolled from January 2018 to October 2018,where they delivered the second baby during this period.A total of 6204 women were enrolled in this study,and 1002 women with a history of GDM were analyzed further.All participants enrolled in the study had an oral glucose tolerance test(OGTT)result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value(when any one of the following values is met or exceeded to the 75-g OGTT:0 h[fasting],≥5.10 mmol/L;1 h,≥10.00 mmol/L;and 2 h,≥8.50 mmol/L).The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated,and its related risk factors were analyzed.Results:In 6204 participants,there are 1002 women(1002/6204,16.15%)with a history of GDM and 5202 women(5202/6204,83.85%)without a history of GDM.There are significant differences in age(32.43±4.03 years vs.33.00±3.34 years vs.32.19±3.37 years,P<0.001),pregnancy interval(4.06±1.44 years vs.3.52±1.43 years vs.3.38±1.35 years,P=0.004),prepregnancy body mass index(BMI)(27.40±4.62 kg/m^(2)vs.23.50±3.52 kg/m^(2)vs.22.55±3.47 kg/m^(2),P<0.001),history of delivered macrosomia(22.7%vs.11.0%vs.6.2%,P<0.001)among the development of diabetes mellitus(DM),recurrence of GDM,and normal women.Moreover,it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM.There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value(18.31±1.90 mmol/L vs.16.27±1.93 mmol/L vs.15.55±1.92 mmol/L,P<0.001),OGTT fasting value(5.43±0.48 mmol/L vs.5.16±0.49 mmol/L vs.5.02±0.47 mmol/L,P<0.001),OGTT 1-hour value(10.93±1.34 mmol/L vs.9.69±1.53 mmol/L vs.9.15±1.58 mmol/L,P<0.001),OGTT 2-hour value(9.30±1.66 mmol/L vs.8.01±1.32 mmol/L vs.7.79±1.38 mmol/L,P<0.001),incidence of impaired fasting glucose(IFG)(fasting plasma glucose≥5.6 mmol/L)(31.3%vs.14.6%vs.8.8%,P<0.001),and incidence of two or more abnormal OGTT values(68.8%vs.39.7%vs.23.9%,P<0.001)among the three groups.Using multivariate analysis,the factors,such as age(1.07[1.02-1.12],P=0.006),prepregnancy BMI(1.07[1.02,1.12],P=0.003),and area under the curve of OGTT in the first pregnancy(1.14[1.02,1.26],P=0.02),have an effect on maternal GDM recurrence;the factors,such as age(1.28[1.01-1.61],P=0.04),pre-pregnancy BMI(1.26[1.04,1.53],P=0.02),and area under the curve of OGTT in the first pregnancy(1.65[1.04,2.62],P=0.03),have an effect on maternal DM developed further.Conclusions:The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy.The associated risk factors for GDM recurrence or development of DM include age,high pre-pregnancy BMI,history of delivered macrosomia,the OGTT level in the first pregnancy,such as the high area under the curve of OGTT,IFG,and two or more abnormal OGTT values.To prevent GDM recurrence,women with a history of GDM should do the preconception counseling before preparing next pregnancy.展开更多
文摘Introduction: Grand multiparity is a known risk factor for maternal and fetal complications. Materials and Methods: We carried out a cross-sectional descriptive study on the delivery of grand multiparas at the maternity of the regional hospital annex of Ayos, a semi-rural locality in the Center region of Cameroon. The study covered the period from January 2012 through December 2020, and the objective was to assess the frequency, the determinants and the outcome of delivery in grand multiparas. Results: We recorded 1384 deliveries and enrolled 137 cases of delivery of grand multiparas. This gives a frequency of grand multipara delivery of 9.89%. The mean age of the women was 34.96 ± 4.45 years. Married parturients accounted for 65% of the cases and 16.8% were HIV positive. Delivery occurred at term in 89.9%. In 35.8%, no antenatal consultation was done. The use of the partograph during labor was reported in 11.7%. Per vaginal delivery was noted in 88.3%, emergency cesarean in 10.2% and elective cesarean in 1.5%. The most frequent maternal complications included post-partum hemorrhage (19.9%), genital tract tears (12.4%), endometritis (9.5%) and surgical wound infection (8.7%). No maternal death was recorded. The mean birth weight of the newborns was 3336.8 ± 550 g. Fetal complications were mostly represented by neonatal infection (20.1%), perinatal death (7.9%) and neonatal asphyxia (9.5%). Conclusion: The frequency of grand multiparous delivery in the semi-rural locality of Ayos, Cameroon, was 9.89%. The mean age of parturients was 38.96 years and the proportion of vaginal delivery was 88.3%.
文摘Impact of PCBs was studied as a major source of physiological effects even very low concentration of PCBs transferred to the infants by mother’s milk. Milk samples were collected from primipara and multipara women. A significant variation pattern was observed in the level of PCB congeners, as PCBs are lipophilic in nature, another possibility arises that great deals of residues are passed on to infants through mother’s milk. A technique was developed to find out polychlorinated biphenyls (PCB) in breast milk. PCBs were extracted by Matrix Solid-Phase Dispersion (MSPD) and analyzed by Gas Chromatography with Electron Capture Detector. The precision (RSD < 10%, n = 125), recovery (85% to 110%) and limit of quantification (between 0.50 and 3.00 μg·L-1), the chi square analysis at p ≤ 0.05 has shown that the PCB level was higher in multipara as compared to primipara. The analysis of the thirty samples revealed PCB levels above 6.85 μg·L-1 in breast milk samples by analyses of a mixture of PCB congeners. All PCB congeners (28, 52, 101, 123 (+149), 118, 114, 153, 105, 138 (+163), 167, 156 (+171), 157, 180, 170, 189) were found at high level in primiparous and multiparous. Thus, a high correlation between the contamination of breast milk and environmental pollution of PCBs was observed.
基金supported by grants from the National Key Research and Development Program of China(No.2021YFC2700700)the National Natural Science Foundation of China(No.81801467)the State Key Development Program for Basic Research of China(No.2015CB943304)。
文摘Background:Gestational diabetes mellitus(GDM)brings health issues for both mothers and offspring,and GDM prevention is as important as GDM management.It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence.The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China.We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.Methods:A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers.All participants were enrolled from January 2018 to October 2018,where they delivered the second baby during this period.A total of 6204 women were enrolled in this study,and 1002 women with a history of GDM were analyzed further.All participants enrolled in the study had an oral glucose tolerance test(OGTT)result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value(when any one of the following values is met or exceeded to the 75-g OGTT:0 h[fasting],≥5.10 mmol/L;1 h,≥10.00 mmol/L;and 2 h,≥8.50 mmol/L).The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated,and its related risk factors were analyzed.Results:In 6204 participants,there are 1002 women(1002/6204,16.15%)with a history of GDM and 5202 women(5202/6204,83.85%)without a history of GDM.There are significant differences in age(32.43±4.03 years vs.33.00±3.34 years vs.32.19±3.37 years,P<0.001),pregnancy interval(4.06±1.44 years vs.3.52±1.43 years vs.3.38±1.35 years,P=0.004),prepregnancy body mass index(BMI)(27.40±4.62 kg/m^(2)vs.23.50±3.52 kg/m^(2)vs.22.55±3.47 kg/m^(2),P<0.001),history of delivered macrosomia(22.7%vs.11.0%vs.6.2%,P<0.001)among the development of diabetes mellitus(DM),recurrence of GDM,and normal women.Moreover,it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM.There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value(18.31±1.90 mmol/L vs.16.27±1.93 mmol/L vs.15.55±1.92 mmol/L,P<0.001),OGTT fasting value(5.43±0.48 mmol/L vs.5.16±0.49 mmol/L vs.5.02±0.47 mmol/L,P<0.001),OGTT 1-hour value(10.93±1.34 mmol/L vs.9.69±1.53 mmol/L vs.9.15±1.58 mmol/L,P<0.001),OGTT 2-hour value(9.30±1.66 mmol/L vs.8.01±1.32 mmol/L vs.7.79±1.38 mmol/L,P<0.001),incidence of impaired fasting glucose(IFG)(fasting plasma glucose≥5.6 mmol/L)(31.3%vs.14.6%vs.8.8%,P<0.001),and incidence of two or more abnormal OGTT values(68.8%vs.39.7%vs.23.9%,P<0.001)among the three groups.Using multivariate analysis,the factors,such as age(1.07[1.02-1.12],P=0.006),prepregnancy BMI(1.07[1.02,1.12],P=0.003),and area under the curve of OGTT in the first pregnancy(1.14[1.02,1.26],P=0.02),have an effect on maternal GDM recurrence;the factors,such as age(1.28[1.01-1.61],P=0.04),pre-pregnancy BMI(1.26[1.04,1.53],P=0.02),and area under the curve of OGTT in the first pregnancy(1.65[1.04,2.62],P=0.03),have an effect on maternal DM developed further.Conclusions:The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy.The associated risk factors for GDM recurrence or development of DM include age,high pre-pregnancy BMI,history of delivered macrosomia,the OGTT level in the first pregnancy,such as the high area under the curve of OGTT,IFG,and two or more abnormal OGTT values.To prevent GDM recurrence,women with a history of GDM should do the preconception counseling before preparing next pregnancy.
