Publications by authors named "Hui-Xia Yang"

113 Publications

Updates on COVID-19 Infection During Pregnancy.

Matern Fetal Med 2020 Apr 13;2(2):65-67. Epub 2020 Mar 13.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/FM9.0000000000000049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428488PMC
April 2020

Four-year-old anti-N-methyl-D-aspartate receptor encephalitis patient with ovarian teratoma: A case report.

World J Clin Cases 2021 Jul;9(19):5319-5324

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

Background: A population-based comparative study in United States shows that the prevalence and incidence of autoimmune encephalitis are comparable to those of infectious encephalitis and its detection is increasing over time. Some patients are complicated with ovarian teratoma. The younger the patient is, the less likely a tumor will be present.

Case Summary: This case report describes the successful treatment of anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis by early laparoscopic ovarian cystectomy and immunotherapy in a 4-year-old female child. And to the best of our knowledge, this detailed case report describes the youngest patient to date with anti-NMDAR encephalitis who underwent laparoscopic ovarian cystectomy.

Conclusion: Although the younger the patient is, the less likely a tumor will be detected, we still emphasize that all patients with suspected or confirmed anti-NMDAR encephalitis should be screened for ovarian tumors if possible. Prompt initiation of immunotherapy and tumor removal are crucial for good outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12998/wjcc.v9.i19.5319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283584PMC
July 2021

A specific bacterial DNA signature in the vagina of Australian women in midpregnancy predicts high risk of spontaneous preterm birth (the Predict1000 study).

Am J Obstet Gynecol 2021 06 7;224(6):634. Epub 2021 Feb 7.

Department of Obstetrics and Gynecology, Peking University First Hospital, No. 8, Xishiku St., Xicheng District, Beijing 100032, China; Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajog.2021.02.003DOI Listing
June 2021

Neuraxial labor analgesia is associated with a reduced risk of postpartum depression: A multicenter prospective cohort study with propensity score matching.

J Affect Disord 2021 02 8;281:342-350. Epub 2020 Dec 8.

Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China. Electronic address:

Background: Depression is a common and serious complication in new mothers. We investigated the hypothesis that neuraxial labor analgesia is associated with a decreased risk of postpartum depression.

Methods: In this multicenter prospective cohort study with propensity score matching, 599 nulliparous women with single term cephalic pregnancy who planned vaginal delivery were enrolled and self-selected neuraxial analgesia or not. The primary outcome was 6-week postpartum depression assessed with the Chinese version Edinburgh Postnatal Depression Scale; a score of ≥10 was set as the threshold of postpartum depression. Logistic regression models were established to assess the association between neuraxial labor analgesia and postpartum depression.

Results: Of the 577 parturients who completed the study, 417 (72.3%) received neuraxial analgesia and 160 (27.7%) did not. After propensity score matching, 433 parturients were included in the analysis; of whom, 279 (64.4%) received neuraxial analgesia and 154 (35.6%) did not. The incidence of postpartum depression was lower in parturients with neuraxial analgesia than in those without (14.9% [62/417] vs. 23.8% [38/160], P=0.012 before matching; 13.3% [37/279] vs. 23.4% [36/154], P=0.007 after matching). After adjustment for confounding factors, neuraxial analgesia was associated with decreased odds of postpartum depression (odds ratio [OR] 0.50, 95% CI 0.28-0.88, P=0.015 before matching; OR 0.40, 95% CI 0.21-0.77, P=0.006 after matching).

Limitations: As an observational study, unidentified confounders might influence the results.

Conclusions: In nulliparae with single term cephalic pregnancy preparing to give vaginal delivery neuraxial analgesia during labor was associated with a decreased risk of 6-week postpartum depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jad.2020.12.027DOI Listing
February 2021

Successful pregnancy after protective hemodialysis for chronic kidney disease: A case report.

World J Clin Cases 2020 Oct;8(19):4521-4526

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

Background: Chronic kidney disease (CKD) affects almost 3% of females of child-bearing age, who have a high risk of adverse maternal and fetal outcomes. Additionally, high renal burden as a result of pregnancy may lead to deterioration of renal function. An increasing number of women with CKD stages 3 to 5 have a strong desire to conceive, and both obstetricians and nephrologists are faced with enormous challenges in terms of their treatment and management.

Case Summary: The case of a 35-year-old pregnant woman with a 10-year history of mild mesangial proliferative glomerulonephritis is described here. CKD progressed from stage 3 to stage 5 rapidly during pregnancy, and protective hemodialysis was started at 28 wk of gestation. Due to preeclampsia at 34 wk of gestation, cesarean section was performed and a healthy baby was delivered. Hemodialysis was discontinued at 4 wk postpartum. After 1 year of follow-up, her renal function was stable, and her baby exhibited good growth and development.

Conclusion: Protective hemodialysis during pregnancy can prolong gestational age and improve maternal and fetal outcomes in women with advanced CKD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12998/wjcc.v8.i19.4521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559658PMC
October 2020

Phosphoproteomics reveals the apoptotic regulation of aspirin in the placenta of preeclampsia-like mice.

Am J Transl Res 2020 15;12(7):3361-3375. Epub 2020 Jul 15.

Department of Obstetrics and Gynecology, Peking University First Hospital Beijing, China.

Preeclampsia (PE) is a severe gestational complication, and dysfunctional placenta plays an essential role in PE pathogenesis. Although low-dose aspirin is currently the most promising prophylactic drug for PE prevention, the exact mechanism of aspirin remains unclear. A previous study reported that treatment with low-dose aspirin could ameliorate PE-like symptoms in lipopolysaccharide (LPS)-induced PE-like mouse model. This study aimed to uncover the potential mechanism of aspirin action in PE through quantitative phosphoproteomics comparison. We established the following four groups: a control (CTRL) group, an LPS-treated (L) group, an LPS + aspirin co-treatment (LA) group, and an aspirin-treated (A) group. A total of 4350 phosphosites and 4170 phosphopeptides from 1866 phosphoproteins were identified in the placenta on embryonic day 13.5. Among the significantly altered phosphoproteins identified, apoptosis-related pathways were significantly regulated in both the L group CTRL group and the LA group L group comparisons. We demonstrated that apoptosis was increased in the placenta of PE-like mice and was inhibited in the LA group by quantify the apoptosis-positive cells and the protein levels of cleaved caspase 3, 8, and 9. Moreover, the phosphorylation of HSP90β (S254) and GSK3β (Y216) may be a crucial factor in the aspirin-mediated regulation of apoptosis according to protein-protein interaction analysis. This study revealed that apoptosis regulation is a mechanism of aspirin action in PE, particularly in women with over-activated inflammation. The phosphorylation of HSP90β (S254) and GSK3β (Y216) could be the key intervention targets.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407703PMC
July 2020

Interpretation of Chinese expert consensus on diagnosis and management of amniotic fluid embolism.

Chin Med J (Engl) 2020 Jul;133(14):1719-1721

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/CM9.0000000000000886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401754PMC
July 2020

The association of the glucokinase rs4607517 polymorphism with gestational diabetes mellitus and its interaction with sweets consumption in Chinese women.

Public Health Nutr 2021 Jun 2;24(9):2563-2569. Epub 2020 Jun 2.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.

Objective: To identify the association of the glucokinase gene (GCK) rs4607517 polymorphism with gestational diabetes mellitus (GDM) and determine whether sweets consumption could interact with the polymorphism on GDM in Chinese women.

Design: We conducted a case-control study at a hospital including 1015 participants (562 GDM cases and 453 controls). We collected the data of pre-pregnancy BMI, sweets consumption and performed genotyping of the GCK rs4607517 polymorphism. Logistic regression was performed to test the association between the rs4607517 polymorphism and GDM, and the stratified analyses by sweets consumption were conducted, using an additive genetic model.

Setting: A case-control study of women at a hospital in Beijing, China.

Participants: One thousand and fifteen Chinese women.

Results: The GCK rs4607517 A allele was significantly associated with GDM (OR 1·35, 95 % CI 1·03, 1·77; P = 0·028). Furthermore, stratified analyses showed that the A allele increased the risk of GDM only in women who had a habitual consumption of sweet foods (sweets consumption ≥ once per week) (OR 1·61, 95 % CI 1·17, 2·21; P = 0·003). Significant interaction on GDM was found between the rs4607517 A allele and sweets consumption (P = 0·004).

Conclusions: This study for the first time reported the interaction between the GCK rs4607517 polymorphism and sweets consumption on GDM. The results provided novel evidence for risk assessment and personalised prevention of GDM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1368980020000609DOI Listing
June 2021

Mean platelet volume in the first trimester as a predictor of gestational diabetes mellitus.

Chin Med J (Engl) 2020 Jun;133(11):1364-1365

Department of Obstetrics and Gynecology, Peking University First hospital, Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing 100026, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/CM9.0000000000000825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289289PMC
June 2020

Evaluation of the gestational diabetes mellitus diagnostic criteria recommended by the international association of diabetes and pregnancy study group for long-term maternal postpartum outcomes in mainland China.

Medicine (Baltimore) 2020 Feb;99(8):e19242

Department of Endocrinology.

The gestational diabetes mellitus (GDM) diagnostic criteria recommended by the International Association of Diabetes and Pregnancy Study Group (IADPSG) were established based on the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study and have been the most commonly used criteria for determining GDM worldwide. Although individuals from mainland China were not included in the HAPO study, the IADPSG criteria have been used in China since 2011. However, the appropriateness of the criteria for evaluating maternal postpartum outcomes in mainland China are unknown. We conducted this study to determine whether the IADPSG criteria are appropriate for Chinese patients for evaluating long-term maternal postpartum outcomes.Eighty-four patients who were diagnosed with hyperglycemia during pregnancy and had delivery in Peking University First Hospital from February 2007 to December 2009 were enrolled in the study. For patients in Group A, GDM was diagnosed using both the National Diabetes Data Group (NDDG) and the IADPSG criteria, while patients in Group B, gestational impaired glucose tolerance (GIGT) was diagnosed using the NDDG criteria while GDM was diagnosed based on the IADPSG criteria. Anthropometric data, glucose metabolism, lipid profiles, β cell function, and insulin resistance index were evaluated and compared to baseline after 5- to 6-year postpartum period.Patients in group A had significantly higher oral glucose tolerance test (OGTT) fasting, 2-hour and 3-hour plasma glucose levels compared to patients in group B at 24 to 28 weeks of gestation (P < .05). No significant differences were observed between the groups for anthropometric data, postpartum abnormal glucose metabolism (50.91% vs 44.83%, P = .596), type 2 diabetes mellitus (T2DM) (16.36% vs 3.45%, P = .167), lipid profiles, β cell function (homeostasis model assessment β-cell function index (HOMA-β) 1.04 vs 0.99, P = .935) and insulin resistance (homeostasis model assessment insulin resistance index (HOMA-IR) 2.01 vs 1.69, P = .583).Patients diagnosed with GDM using either the NDDG or IADPSG criteria had abnormal glucose levels and lipid metabolism after delivery. Patients with mild hyperglycemia had similar postpartum β-cell functional impairment and insulin resistance to those with moderate hyperglycemia during pregnancy. Hence, with respect to maternal long-term postpartum outcomes, the IADPSG diagnostic criteria for GDM could be appropriate for patients in mainland China.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000019242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034689PMC
February 2020

Increasing insulin resistance predicts adverse pregnancy outcomes in women with gestational diabetes mellitus.

J Diabetes 2020 Jun 7;12(6):438-446. Epub 2020 Jan 7.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.

Background: This study aimed to investigate the association between maternal insulin resistance (IR) in the late second trimester and pregnancy outcomes, as well as to identify risk factors of IR among women with gestational diabetes mellitus (GDM).

Methods: A retrospective study was conducted among 2647 women diagnosed with GDM. IR was evaluated using the homeostasis model assessment method for IR (HOMA-IR) in the late second trimester (between 24 and 28 weeks), and the lipid profiles were measured at the same time. Patients were divided into groups based on quartiles of HOMA-IR. The information on pregnancy outcomes and risk factors was extracted from the medical records of all participants and entered electronically. Logistic regression models were used to analyze the associations between HOMA-IR and pregnancy outcomes, as well as the associations between risk factors and HOMA-IR.

Results: Greater IR was associated with cesarean delivery, preterm delivery, macrosomia, and large for gestational age newborns, but only significantly associated with preterm delivery after adjustment for potential confounders (P < .001). Prepregnancy body mass index (BMI), weight gain before diagnosis of GDM, and triglycerides were significantly related with IR in the late second trimester (P < .001). Besides, the total area under the curve of the diagnostic 75-g oral glucose tolerance test and glycosylated hemoglobin A1c increased from the lowest to the highest HOMA-IR groups.

Conclusions: Increasing IR in the late second trimester predicts adverse pregnancy outcomes especially for preterm delivery in women with GDM. Additionally, prepregnancy BMI and weight gain before diagnosis of GDM are independent risk factors for the development of IR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1753-0407.13013DOI Listing
June 2020

Factors associated with human papillomavirus infection - findings from a cervical cancer screening program for female employees in Beijing.

Cancer Manag Res 2019 28;11:8033-8041. Epub 2019 Aug 28.

Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, People's Republic of China.

Background: In 2018, the Beijing Federation of Trade Unions organized a cervical cancer screening program for female employees for the first time. This study aimed to investigate the screening results of this program and determine the factors associated with human papillomavirus (HPV) infection.

Methods: A total of 8297 female employees participating in the screening program between January 1, 2018, and December 31, 2018, were enrolled in this study. The methods for screening cervical cancer included ThinPrep cytology test (TCT) and HPV genotyping test. Single-factor analysis and multiple binary logistic regression analysis were used to identify the factors associated with HPV infection.

Results: Of the 8297 women (median age: 43.00 years), TCT was found to be abnormal in 116 patients (1.40%) and 1169 (14.09%) were positive for HPV genotyping test. Notably, HPV-52 was the most prevalent subtype (3.05%), followed by HPV-16 (2.82%), HPV-58 (2.01%), HPV-51 (1.58%) and HPV-56 (1.49%). Multivariate logistic regression analysis revealed that taxi drivers (OR =1.98; 95% CI =1.31-2.99) and single women with a history of sexual activity (OR =2.32; 95% CI =1.41-3.82) were significantly associated with an increased risk of HPV infection (<0.05), whereas medical workers (OR =0.67; 95% CI =0.51-0.88) and factory workers (OR =0.36; 95% CI =0.17-0.77) were protective factors for HPV infection (<0.05).

Conclusion: HPV-52, HPV-16 and HPV-58 are the most common types of high-risk HPV among female employees in Beijing. Being taxi drivers and single women with a history of sexual activity are significantly associated with the risk of HPV infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/CMAR.S209322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717858PMC
August 2019

Association of adiposity with thyroid nodules: a cross-sectional study of a healthy population in Beijing, China.

BMC Endocr Disord 2019 Oct 16;19(1):102. Epub 2019 Oct 16.

Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144, China.

Background: The relationship between thyroid nodules (TNs) and adiposity is controversial. This paper describes a cross-sectional investigation performed to determine the existence of any such relationship. To assess adiposity, body mass index (BMI) and visceral fat area (VFA) were utilized.

Methods: Between January 1, 2017 and March 3, 2019. Three thousand five hundred thirty four healthy people were examined using thyroid ultrasonography, visceral fat and anthropometric measurements, laboratory tests and questionnaire interview. Binary logistic regression analyses were used.

Results: Of the 3534 healthy subjects, 58.69% (2074/3534) of the subjects had TNs. A total of 55.91% (1976/3534) had BMI ≥ 25 kg/m and 39.67% (1402/3534) had VFA ≥ 100 cm. After adjustment to address confounders, BMI-based overweight and obesity levels only correlated with higher risk TNs when used as a continuous variable (OR = 1.031, 95% CI: 1.008-1.055, P = 0.008), while VFA was both a continuous variable (OR = 1.003, 95% CI: 1.000-1.005, P = 0.034) and a categorical variable (OR = 1.198, 95% CI: 1.014-1.417, P = 0.034) associated with significantly elevated risk of TNs. Analyzing the subgroups, BMI ≥ 25 kg/m (OR = 1.500, 95% CI: 1.110-2.026, P = 0.008) was significantly correlated with TN risk in individuals with TG ≥ 1.7 mmol/L. VFA ≥ 100 cm correlated with the TN risk irrespective of age (< 50 years: OR = 1.374, 95% CI: 1.109-1.703, P = 0.004; ≥ 50 years: OR = 1.367, 95% CI: 1.063-1.759, P = 0.015) and in the following subgroups: women (OR = 4.575, 95% CI: 2.558-8.181, P = 0.000), FBG ≥ 6.1 mmol/L (OR = 1.522, 95% CI: 1.048-2.209, P = 0.027), and TG ≥ 1.7 mmol/L (OR = 1.414, 95% CI: 1.088-1.838, P = 0.010).

Conclusions: Adiposity correlates with TNs. To assess TN risk in Chinese individuals, VFA is better than BMI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12902-019-0430-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794777PMC
October 2019

Thyroid function of twin-pregnant women in early pregnancy.

Chin Med J (Engl) 2019 Sep;132(17):2033-2038

Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.

Background: Serum human chorionic gonadotrophin (hCG) is higher in twin than that in singleton pregnancies. As hCG stimulates the thyroid to produce more free thyroxine (FT4), which may lead to decreased thyroid-stimulating hormone (TSH) levels, the reference ranges of thyroid-related indicators may differ between singleton and twin pregnancies in the first trimester. This study aimed to establish reference ranges for thyroid-related indicators in early twin pregnancies and to compare them with singleton pregnancies.

Methods: Data of 820 twin-pregnant women were extracted from the established database of all pregnant women who delivered at Peking University First Hospital from October 2013 to May 2018; 160 who met National Academy of Clinical Biochemistry criteria were included to establish TSH and FT4 reference ranges. We screened 480 (3:1 paired) women with singleton pregnancies from the same database as controls. The Mann-Whitney test for TSH and FT4 levels was applied for comparisons between singleton and twin pregnancies.

Results: First-trimester reference ranges (4-12 gestational weeks) for twin pregnancies were: TSH 0.69 (0.01-3.35) mIU/L and FT4 16.38 (12.45-23.34) pmol/L. Median TSH was significantly lower at 7 to 12 gestational weeks than that at 4 to 6 gestational weeks (0.62 vs. 0.96 mIU/L, Z = -1.964, P = 0.049); FT4 was not significantly different between the two groups. Compared to singleton pregnancies, median TSH was significantly lower (0.69 vs. 1.27 mIU/L, Z = -6.538, P = 0.000), and FT4 was significantly higher (16.38 vs. 14.85 pmol/L, Z = -7.399, P = 0.000) in twin pregnancies in the first trimester.

Conclusions: Specific reference ranges for thyroid-related indicators for twin pregnancies are needed to avoid a misdiagnosis of thyroid dysfunction. Moreover, establishment of separate reference ranges for 4 to 6 and 7 to 12 gestational weeks in twin pregnancies may be considered.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/CM9.0000000000000381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6793799PMC
September 2019

Value of fasting plasma glucose to screen gestational diabetes mellitus before the 24th gestational week in women with different pre-pregnancy body mass index.

Chin Med J (Engl) 2019 Apr;132(8):883-888

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

Background: Gestational diabetes mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test (OGTT). It is difficult to predict GDM before 24th gestational week because fast plasma glucose (FPG) decreases as the gestational age increases. It is controversial that if FPG ≥5.1 mmol/L before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index (BMI).

Methods: This was a multi-region retrospective cohort study in China. Women who had a singleton live birth between June 20, 2013 and November 30, 2014, resided in Beijing, Guangzhou and Chengdu, and received prenatal care in 21 selected hospitals, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight, BMI < 18.5 kg/m), Group B (normal, BMI 18.5-23.9 kg/m), Group C (overweight, BMI 24.0-27.9 kg/m) and Group D (obesity, BMI ≥28.0 kg/m). The trend of FPG before 24th week of gestation was described, and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported. Differences in the means between groups were evaluated using independent sample t-test and analysis of variance. Pearson Chi-square test was used for categorical variables.

Results: The prevalence of GDM was 20.0% (6806/34,087) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. FPG was higher in women with higher pre-pregnancy BMI. FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM. The incidence of GDM in women with FPG ≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥5.10 mmol/L and pre-pregnancy BMI <24.0 kg/m (78.5% [62/79] vs. 52.9% [64/121], χ = 13.425, P < 0.001).

Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/CM9.0000000000000158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595770PMC
April 2019

Association of pre-pregnancy body mass index and gestational weight gain with labor stage.

Chin Med J (Engl) 2019 02;132(4):483-487

Department of Perinatal Medicine, Beijing Obstetric and Gynecology Hospital, Capital Medical University. Beijing 100026, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/CM9.0000000000000093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595710PMC
February 2019

[Testicular histology does not affect the clinical outcomes of ICSI in men with non-obstructive azoospermia].

Zhonghua Nan Ke Xue 2017 Oct;23(10):889-893

Department of Gynecology and Obstetrics, Peking University First Hospital, Beijing 100034, China.

Objective: To investigate whether testicular histology influences the clinical outcomes of intracytoplasmic sperm injection (ICSI) in men with non-obstructive azoospermia (NOA).

Methods: We retrospectively analyzed the clinical data about 73 cases of NOA undergoing ICSI, including 105 ICSI cycles and 79 embryo transfer cycles. The infertility of the patients was attributed to male factors only or both male and female tube factors and the females' age was ≤38 years. Based on testicular histology, we divided the ICSI cycles into three groups: hypospermatogenesis (HS, n = 72), maturation arrest (MA, n = 21) and Sertoli cells only (SCO, n = 12). We recorded and analyzed the age of both the males and females, infertility duration, base follicle-stimulating hormone (FSH) level, dose and days of gonadotropin (Gn) administration, estradiol (E2) and progesterone (P) levels on the day of human chorionic gonadotropin (hCG) administration, endometrial thickness, number of metaphase II (MII) oocytes, and rates of fertilization, transferrable embryos, high-quality embryos, clinical pregnancy, and abortion.

Results: The rates of fertilization, failed fertilization, transferrable embryos, and high-quality embryos, and the average number of transferred embryos were 67.03% (553/825), 9.52% (10/105), 85.66% (472/551), 35.03% (193/551), and 2.10, respectively, resulting in 44 pregnancies (55.70%) and 42 live births (53.16%), with no birth defects. No statistically significant differences were observed among the HS, MA and SCO groups in the mean age of the men and women, infertility duration, base FSH level, Gn dose, Gn days, E2 and P levels on the hCG day, endometrial thickness, or number of MII oocytes, nor in the rates of fertilization (68.51% vs 64.39% vs 61.45%), transferrable embryos (85.05% vs 90.48% vs 83.05%), or high-quality embryos (33.09% vs 41.67% vs 38.98%). The rates of clinical pregnancy and embryo implantation were higher in the HS (60.00% and 37.61%) and SCO (62.50% and 50.00%) than in the MA group (37.50% and 21.21%), but with no statistically significant differences (P >0.05).

Conclusions: Once testicular sperm is retrieved, desirable clinical outcomes can be achieved in ICSI for NOA patients, which is not affected by testicular histopathology.
View Article and Find Full Text PDF

Download full-text PDF

Source
October 2017

Exercise and its role in gestational diabetes mellitus.

Chronic Dis Transl Med 2016 Dec 20;2(4):208-214. Epub 2016 Dec 20.

Department of Obstetrics and Gynecology of Peking University First Hospital, Beijing 100034, China.

Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second or third trimester of pregnancy that is not clearly either type 1 or type 2 diabetes. GDM is a common medical complication in pregnancy that has been rapidly increasing worldwide. GDM is associated with both short- and long-term health issues for both mothers and offspring. Consistent with type 2 diabetes, peripheral insulin resistance contributes to the hyperglycemia associated with GDM. Accordingly, it is important to identify strategies to reduce the insulin resistance associated with GDM. To date, observational studies have shown that exercise can be a non-invasive therapeutic option for preventing and managing GDM that can be readily applied to the antenatal population. However, the relevant mechanisms for these outcomes are yet to be fully elucidated. The present review aimed to explain the potential mechanisms of exercise from the perspective of reducing the insulin resistance, which is the root cause of GDM. Exercise recommendations and opinions of exercise during pregnancy are briefly summarized.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cdtm.2016.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643755PMC
December 2016

Diagnosis, prevention and management of gestational diabetes mellitus.

Chronic Dis Transl Med 2016 Dec 4;2(4):199-203. Epub 2016 Dec 4.

Department of Obstetrics and Gynecology of Peking University First Hospital, Beijing 100034, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cdtm.2016.11.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643832PMC
December 2016

Cesarean Section Rate in Singleton Primiparae and Related Factors in Beijing, China.

Chin Med J (Engl) 2017 Oct;130(20):2395-2401

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 10034, China.

Background: The cesarean section rate (CSR) has been a main concern worldwide. The present study aimed to investigate the CSR in Beijing, China, and to analyze the related factors of CS delivery.

Methods: An observational study was conducted in 15 medical centers in Beijing using a systemic cluster sampling method. In total, 15,194 pregnancies were enrolled in the study between June 20, 2013 and November 30, 2013. Independent t-tests and Pearson's Chi-square test were used to examine differences between two groups, and related factors of the CSR were examined by multivariable logistic regression.

Results: The CSR was 41.9% (4471/10,671) in singleton primiparae. Women who were more than 35 years old had a 7.4-fold increased risk of CS delivery compared with women <25 years old (odd ratio [OR] = 7.388, 95% confidence interval [CI] = 5.561-9.816, P < 0.001). Prepregnancy obese women had a 2-fold increased risk of CS delivery compared with prepregnancy normal weight women (OR = 2.058, 95% CI = 1.640-2.584, P < 0.001). The excessive weight gain group had a 1.4-fold increased risk of CS delivery compared with the adequate weight gain group (OR = 1.422, 95% CI = 1.289-1.568, P < 0.001). Gestational diabetes mellitus (GDM) women and DM women had an increased risk of CS delivery (1.2- and 1.7-fold, respectively) compared with normal blood glucose women. Women who were born in rural areas had a lower risk of CS delivery than did those who were born in urban areas (OR = 0.696, 95% CI = 0.625-0.775, P < 0.001). The risk of CS delivery gradually increased with a decreasing education level. Neonates weighing 3000-3499 g had the lowest CSR (36.2%). Neonates weighing <2500 g had a 2-fold increased risk of CS delivery compared with neonates weighing 3000-3499 g (OR = 2.020, 95% CI = 1.537-2.656, P < 0.001). Neonates weighing ≥4500 g had an 8.3-fold increased risk of CS delivery compared with neonates weighing 3000-3499 g (OR = 8.313, 95% CI = 4.436-15.579, P < 0.001).

Conclusions: Maternal age, prepregnancy body mass index, gestational weight gain, blood glucose levels, residence, education level, and singleton fetal birth weight are all factors that might significantly affect the CSR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.216415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684626PMC
October 2017

Endometriosis Fertility Index for Predicting Pregnancy after Endometriosis Surgery.

Chin Med J (Engl) 2017 Aug;130(16):1932-1937

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

Background: The endometriosis fertility index (EFI) has a predictive value for pregnancy after surgery. In vitro fertilization and embryo transfer (IVF-ET) is a good treatment to infertility. This study aimed to provide external validation of EFI, assess the factors affecting the ability of EFI to predict cumulative spontaneous pregnancy rates (PRs), and propose reasonable advice for treatment by evaluating the effect of infertility management combining surgery and IVF-ET.

Methods: This retrospective study enrolled 345 endometriosis-related infertile women after laparoscopic surgery from January 2012 to January 2016. Among them, 234 patients tried to conceive naturally and were divided into six groups according to their different EFI scores. Of the 345 patients, 307 with an EFI score ≥5 were divided into non-IVF-ET group (n = 209) and IVE-ET group (n = 98) to compare the cumulative PRs. Cumulative PRs' curves were calculated using the Kaplan-Meier product limit estimate and the differences were evaluated by log-rank test. Independent predictive factors for pregnancy were assessed using the Cox regression model.

Results: Significant differences in spontaneous PRs among different EFI scores were identified (χ2=29.945, P< 0.05). The least function score was proved to be the most important factor for EFI (χ2 = 6.931, P< 0.05) staging system. In patients with an EFI score ≥5 after 12 months from surgery, the cumulative PRs of those who received both surgery and IVF-ET were much higher than the spontaneous PRs of those who received surgery alone (χ2=4.160, P= 0.041).

Conclusions: The EFI is a reliable staging system to predict the spontaneous PR of patients. The least function score was the most influential factor to predict the spontaneous PR. Patients with an EFI score ≥5 after 12 months from surgery are recommended to receive IVF-ET to achieve a higher PR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.211892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555127PMC
August 2017

High Prevalence of Gestational Diabetes Mellitus in Beijing: Effect of Maternal Birth Weight and Other Risk Factors.

Chin Med J (Engl) 2017 May;130(9):1019-1025

World Diabetes Foundation, Gentofte 2820, Denmark.

Background: Gestational diabetes mellitus (GDM) is associated with both short- and long-term adverse health consequences for both the mother and her offspring. The aim was to study the prevalence and risk factors for GDM in Beijing.

Methods: The study population consisted of 15,194 pregnant women attending prenatal care in 15 hospitals in Beijing, who delivered between June 20, 2013, and November 30, 2013, after 28 weeks of gestation. The participants were selected by cluster sampling from the 15 hospitals identified through random systematic sampling based on the number of deliveries in 2012. A questionnaire was designed to collect information.

Results: A total of 2987 (19.7%) women were diagnosed with GDM and 208 (1.4%) had diabetes in pregnancy (DIP). Age (OR: 1.053, 95% CI: 1.033-1.074, P < 0.01), family history of diabetes mellitus (OR: 1.481, 95% CI: 1.254-1.748, P < 0.01), prepregnancy body mass index (BMI) (OR: 1.481, 95% CI: 1.254-1.748, P < 0.01), BMI gain before 24 weeks (OR: 1.126, 95% CI: 1.075-1.800, P < 0.01), maternal birth weight (P < 0.01), and fasting plasma glucose at the first prenatal visit (P < 0.01) were identified as risk factors for GDM. In women with birth weight <3000 g, GDM rate was significantly higher.

Conclusions: One out of every five pregnant women in Beijing either had GDM or DIP and this constitutes a huge health burden for health services. Prepregnancy BMI and weight gain before 24th week are important modifiable risk factors for GDM. Ensuring birth weight above 3000 g may help reduce risk for future GDM among female offsprings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.204930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421170PMC
May 2017

Relationship between Oral Glucose Tolerance Test Characteristics and Adverse Pregnancy Outcomes among Women with Gestational Diabetes Mellitus.

Chin Med J (Engl) 2017 May;130(9):1012-1018

Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Petah-Tiqva, Tel-Aviv 6997801, Israel.

Background: Hyperglycemia is associated with adverse pregnancy outcomes. However, the relationships between them remain ambiguous. This study aimed to analyze the effect of different oral glucose tolerance test (OGTT) results on adverse perinatal outcomes.

Methods: This retrospective cohort study included data from 15 hospitals in Beijing from June 20, 2013 to November 30, 2013. Women with gestational diabetes mellitus (GDM) were categorized according to the number and distribution of abnormal OGTT values, and the characteristics of adverse pregnancy outcomes were evaluated. Chi-square test and logistic regression analysis were used to determine the associations.

Results: In total, 14,741 pregnant women were included in the study population, 2927 (19.86%) of whom had GDM. As the number of hyperglycemic values in the OGTT increased, the risk of cesarean delivery, preterm births, large-for-gestational age (LGA), macrosomia, and neonatal complications significantly increased. Fasting hyperglycemia had clear associations with macrosomia (odds ratios [OR s]:1.84, 95% confidence intervals [CI s]: 1.39-2.42,P < 0.001), LGA (OR: 1.70, 95% CI: 1.29-2.25,P < 0.001), and cesarean delivery (OR: 1.33, 95% CI: 1.15-1.55,P < 0.001). The associations were stronger as fasting glucose increased. GDM diagnosed by hyperglycemia at OGTT-2 h was more likely to lead to preterm birth (OR: 1.50, 95% CI: 1.11-2.03,P < 0.01).

Conclusions: Various characteristics of OGTTs are associated with different adverse outcomes. A careful reconsideration of GDM with hierarchical and individualized management according to OGTT characteristics is needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.204928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421169PMC
May 2017

Diabetes Management beyond Pregnancy.

Chin Med J (Engl) 2017 05;130(9):1009-1011

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.204938DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421168PMC
May 2017

Clinical Analysis of Postpartum Hemorrhage Requiring Massive Transfusions at a Tertiary Center.

Chin Med J (Engl) 2017 03;130(5):581-585

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

Background: The reports on massive transfusions (MTs) in obstetrics have recently been an increasing trend. We aimed to define the clinical features, risk factors, main causes, and outcomes of MTs due to severe postpartum hemorrhage (PPH) and the frequency trends over the past 10 years.

Methods: We retrospectively analyzed the data of 3552 PPH patients who were at ≥28 weeks of gestation in the Obstetric Department of Peking University First Hospital from January 2006 to February 2015. The clinical records of patients receiving MT with ≥5 units (approximately 1000 ml) of red blood cells within 24 h of giving birth were included. The Pearson's Chi-square and Fisher's exact tests were used to compare the frequency distributions among the categorical variables of the clinical features.

Results: One-hundred six women were identified with MT over the 10-year period. The MT percentage was stable between the first 5-year group (2006-2010) and the second 5-year group (2011-2015) (2.5‰ vs. 2.7‰, χ2 = 154.85, P = 0.25). Although uterine atony remained the main cause of MT, there was a rising trend for placental abnormalities (especially placenta accreta) in the second 5-year group compared with the first 5-year group (34% vs. 23%, χ2 = 188.26, P = 0.03). Twenty-four (23%) women underwent hysterectomy, and among all the causes of PPH, placenta accreta had the highest hysterectomy rate of 70% (17/24). No maternal death was observed.

Conclusions: There was a rising trend for placental abnormalities underlying the stable incidence of MT in the PPH cases. Placenta accreta accounted for the highest risk of hysterectomy. It is reasonable to have appropriate blood transfusion backup for high-risk patients, especially those with placenta accreta.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.200545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339932PMC
March 2017

Analysis of correlation factors and pregnancy outcomes of hypertensive disorders of pregnancy - a secondary analysis of a random sampling in Beijing, China.

J Matern Fetal Neonatal Med 2017 Mar 3;30(6):751-754. Epub 2016 Jun 3.

o General Hospital of Jingmei Group , Beijing , PR China.

Objective: We aimed to assess the prevalence and risk factors for hypertensive disorders and to study the main pregnancy outcomes in the Beijing area of China.

Study Design: This study randomly sampled 15 hospitals in Beijing from Jun 2013 to Nov 2013 and evaluated 15 194 deliveries. Logistic regression analysis was used to study the association between risk factors and hypertensive disorders. Pregnancy outcomes included preterm birth, cesarean delivery and small for gestational age (SGA).

Results: The prevalence of hypertensive disorders, preeclampsia (PE) and severe PE was 4.4, 2.7 and 1.8%, respectively. The risk factors for hypertensive disorders and severe PE were maternal body mass index before pregnancy, gestational weight gain (GWG), gestational diabetes and pre-gestational diabetes, and third trimester cholesterol (CHOL) levels. First trimester high-density lipoprotein was a protective factor for severe PE. The incidence of hypertensive disorders increased with maternal age. Preterm delivery, cesarean delivery and small infant size for gestational age were more prevalent in the severe PE group compared with the non-hypertensive group.

Conclusions: In the Beijing area of China, maternal body mass index before pregnancy, GWG, maternal complications of gestational diabetes and pre-gestational diabetes, and third trimester CHOL levels are risk factors for both hypertensive disorders of pregnancy and severe PE. First trimester high-density lipoprotein is a protective factor for severe PE. Severe preeclampsia leads to a higher incidence of preterm delivery, cesarean delivery and SGA infants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14767058.2016.1186161DOI Listing
March 2017

Folding Sutures Following Tourniquet Binding as a Conservative Surgical Approach for Placenta Previa Combined with Morbidly Adherent Placenta.

Chin Med J (Engl) 2015 Oct;128(20):2818-20

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0366-6999.167365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736896PMC
October 2015

Lifestyle intervention for gestational diabetes mellitus prevention: A cluster-randomized controlled study.

Chronic Dis Transl Med 2015 Sep 21;1(3):169-174. Epub 2015 Oct 21.

Department of Obstetrics and Gynaecology, Peking University First Hospital, Beijing 100034, China.

Objective: The study was to examine whether gestational diabetes mellitus (GDM) can be prevented by early trimester lifestyle counseling in a high-risk population.

Methods: From September 2012 to January 2013, 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks visit and asked to fill out a questionnaire on GDM risk evaluation. According to the questionnaire and medical records, those with at least one risk factor of GDM were included in the intervention study and randomly allocated to two groups, intervention group and control group. Routine prenatal care was offered, while standardized two-step lifestyle intervention was provided to the intervention group during 6-8 gestational weeks, and at 12-13 gestational weeks, enforcement intervention based on maternal anthropometrics were offered. Both groups were followed until 75 g oral glucose tolerance test (OGTT) testing at 24-28 gestational weeks. The weight gain after intervention and the prevalence of GDM were used to evaluate the effect.

Results: (1) According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the positive rate of GDM for the intervention group was 17.16% (23/134), lower than the control group which was 23.91% (33/138),  = 0.168. (2) The weight gain during the first and second trimester for the intervention group was (1.38 ± 2.34) kg and (5.51 ± 2.18) kg, lower than in the control group which was (1.41 ± 2.58) kg and (5.66 ± 2.25) kg, ( = 0.905,  = 0.567). (3) Positive rate of GDM for those fasting plasma glucose (FPG) ≥5.1 mmol/L during early pregnancy was 11/36 (30.55%) for the intervention group that was lower than 17/37 (45.95%) for the control group, but the statistical difference was not significant ( = 0.076).

Conclusion: The positive rate of GDM could be reduced by a certain amount lifestyle intervention from the beginning of pregnancy. More validated effective intervention should be explored in the high-risk pregnant women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cdtm.2015.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643589PMC
September 2015

Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index.

J Matern Fetal Neonatal Med 2016 1;29(13):2205-9. Epub 2015 Oct 1.

p General Hospital of Jingmei Group , Beijing , China.

Objective: To estimate the risk of adverse maternal and perinatal outcomes in women with different pre-pregnancy body mass index (BMI).

Methods: We conducted a cohort study with 14 451 singleton pregnancies in 15 medical centers in Beijing between 20 June 2013 and 30 November 2013 using cluster random sampling. We divided participants into four groups based on pre-pregnancy BMI: Group A (underweight): BMI < 18.5 kg/m(2), Group B (normal): 18.5-23.9 kg/m(2), Group C (overweight): 24-27.9 kg/m(2), Group D (obesity): ≥28 kg/m(2). We used multivariate analysis to evaluate the association of the risk of adverse pregnancy outcomes and pre-pregnancy BMI.

Results: The prevalence of maternal overweight and obesity was 14.82% (2142/14 451) and 4.71% (680/14 451) in the study population, respectively. Higher pre-pregnancy BMI is associated with higher prevalence of gestational diabetes (GDM), macrosomia, Cesarean section (C-section), preeclampsia and postpartum hemorrhage. Pre-pregnancy overweight or obesity increases the risk of adverse pregnancy outcomes, regardless of GDM status.

Conclusions: Pre-pregnancy overweight or obesity is associated with increased risk of adverse pregnancy outcomes. Nutrition counseling is recommended before pregnancy in women who have overweight or obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/14767058.2015.1081167DOI Listing
January 2017

Comprehensive understanding of developmental origins of health and disease concepts: Early intervention to non-communicable diseases in China.

Chronic Dis Transl Med 2015 Sep 29;1(3):141-144. Epub 2015 Sep 29.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cdtm.2015.08.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643576PMC
September 2015
-->