Association of bisphenol A or bisphenol S exposure with oxidative stress and immune disturbance among unexplained recurrent spontaneous abortion women.
- 作者列表："Liang F","Huo X","Wang W","Li Y","Zhang J","Feng Y","Wang Y
:Human exposure to environmental chemicals might play a role in the pathogenesis of unexplained recurrent spontaneous abortion (URSA). Bisphenol A (BPA) and bisphenol S (BPS) have been suggested to affect reproductive health. However, the mechanism remains unclear. To explore the association between BPA and BPS exposure and oxidative stress and immune homeostasis, we conducted a cross-sectional study and revealed BPA and BPS levels in relation to these two factors which were supposed to be implicated in miscarriage. 111 URSA patients were recruited and we analyzed urinary BPA and BPS concentrations, oxidative stress biomarkers (8-hydroxydeoxyguanosine and 8-isoprostane) and serum immune balance biomarkers (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α, TGF-β and IFN-γ). Multivariable linear regression models were used to evaluate the correlation between bisphenols exposure and outcome biomarkers. After adjustment for age, BMI, menstrual cycle, and parity history, creatinine-adjusted BPA was significantly associated with increases in 8-isoprostane (β = 0.74, 95% CI = 0.07, 1.41; p = 0.031) and IFN-γ (β = 0.18, 95% CI = 0.00, 0.36; p = 0.046). No statistical correlation between BPS and biomarkers of oxidative stress or immune balance was observed when all participants were analyzed. Further analysis revealed that in the subgroup of BPS > limit of detection (0.01 ng/ml), creatinine-adjusted BPS was significantly associated with increases in IL-10 (β = 0.22, 95% CI = 0.00, 0.45; p = 0.048). Our findings suggested that BPA and BPS exposure might be related to oxidative stress and immune imbalance in URSA patients. Overall, our work might suggest potential pathogenic and aetiological associations among the bisphenols, biomarkers and URSA, which offers hypotheses for further studies.
: 人类暴露于环境化学物质可能在不明原因复发性流产 (URSA) 的发病机制中起作用。双酚a (BPA) 和双酚S (BPS) 被认为会影响生殖健康。然而，其机制仍不清楚。为了探索BPA和BPS暴露与氧化应激和免疫稳态之间的关联，我们进行了一项横断面研究，并揭示了BPA和BPS水平与这两个因素的关系，这两个因素被认为与流产有关。招募了111名URSA患者，我们分析了尿BPA和BPS浓度、氧化应激生物标志物 (8-羟基脱氧鸟苷和8-异前列腺素) 和血清免疫平衡生物标志物 (IL-1β，IL-2，IL-4，IL-6，IL-8，IL-10，IL-12p70，IL-13，TNF-α，TGF-β 和IFN-γ)。使用多变量线性回归模型评估双酚暴露与结局生物标志物之间的相关性。校正年龄、BMI、月经周期和产次后，肌酐校正的BPA与8-异前列腺素 (β = 0.74，95% CI = 0.07，1.41; p = 0.031) 和IFN-γ (β = 0.18，95% CI = 0.00，0.36) 的增加显著相关; p = 0.046)。当分析所有参与者时，没有观察到BPS与氧化应激或免疫平衡的生物标志物之间的统计学相关性。进一步分析显示，在BPS> 检测限 (0.01 ng/ml) 的亚组中，肌酐校正BPS与IL-10的增加显著相关 (β = 0.22，95% CI = 0.00，0.45; p = 0.048)。我们的研究结果表明，BPA和BPS暴露可能与URSA患者的氧化应激和免疫失衡有关。总的来说，我们的工作可能提示双酚、生物标志物和URSA之间潜在的致病和病因学关联，这为进一步研究提供了假设。
METHODS::Objectives: Serial measurements of sonographic fetal abdominal circumference (AC) are useful for monitoring fetal growth during pregnancy and are essential for predicting macrosomia. The study was aiming to compare the AC profiles of infants born to mothers with or without hyperglycemia in Chinese population.Subjects and methods: The "GDM Prevalence Study (GPS)" was a large study conducted in 22 hospitals in three large cities in China, which included 34,085 NGT (normal glucose tolerant) women, 8272 GDM (gestational diabetes mellitus) women and 729 DM (diabetes mellitus) women. A total of 116,740 scans and 103,377 valid AC measurements were performed for the NGT, GDM and DM groups at different gestational age. AC profiles and fetal growth rates at different stages of pregnancy were compared between different groups.Results: The overall AC growth rate (β) was higher in the macrosomia group than in the no macrosomia group in NGT (β =10.250 versus 9.541, p < .001), GDM (β = 10.572 versus 9.705, p < .001) and DM (β = 11.363 versus 9.924, p < .001) pregnancies. Significant differences were observed between NGT-macrosomia, GDM-macrosomia and DM-macrosomia. Significant differences were also noted between NGT-no macrosomia, GDM-no macrosomia and DM-no macrosomia women. Participants in NGT-macrosomia group exhibited larger AC values than NGT-no macrosomia group beginning at 21 gestational weeks, and GDM-macrosomia group exhibited larger AC values than GDM-no macrosomia group beginning at 22 gestational weeks. AC growth rate was higher in NGT-macrosomia and GDM-macrosomia groups than in the corresponding no macrosomia groups between 22 and 30 gestational weeks.Conclusions: The overall AC growth rates are higher in macrosomia group compared to the no macrosomia group in NGT, GDM as well as DM participants. The significant difference of AC growth rates in NGT-macrosomia and GDM-macrosomia indicate the possible differential underlying mechanisms in developing macrosomia with or without hyperglycemia exposure. Our study demonstrate that larger fetal AC measurements around 21-22 weeks are associated with subsequent diagnosis of macrosomia, suggesting that macrosomia management should be initiated much earlier than we thought.
METHODS::Background: Pregnancy outcomes are affected by many different factors. One of the influential factors on pregnancy outcomes is the male partner as an important person to mother's wellbeing.Objective: The aim of the present study was to investigate the effects of male partner's role including socioeconomic support, emotional support, accompanying pregnant women during prenatal care visits (PNC) and labor, and the level of pregnant women's satisfaction from their partners' support and involvement during pregnancy on pregnancy outcomes.Method: Two hundred first gravid pregnant women with mean age of 23.2 ± 4.3 were studied. Primary outcomes were total maternal and neonatal adverse outcome (TMNAO), total maternal adverse end result (TMAE), and total neonatal adverse outcome (TNAO), regardless of the type of outcomes. Preterm labor and delivery; premature rupture of membrane (PROM) and preterm premature rupture of membrane (PPROM); preeclampsia and eclampsia; placental abruption; chorioamnionitis; stillbirth; meconium passage; maternal death; postpartum hemorrhage; poor progression labor; abnormal vaginal bleeding in third trimester of pregnancy; low birth weight and neonatal need for CPR or intubation, neonatal anomaly, NICU admission, and neonatal mortality were also analyzed as subgroup outcomes.Results: One hundred twenty-seven (63.5%) participants showed a kind of total maternal and neonatal adverse outcome (TMNAO), 72 (36%) deliveries resulted in a kind of neonatal adverse outcome (TNAO), and 104 (52%) of participants had a kind of maternal adverse end result (TMAE). Iranian fathers showed a significantly higher rate of TMNAO than Afghan fathers did (82 versus 69%, odds ratio: 2.9, 95% CI 1.0-7.8, p: .01). Mother's nationality showed the same result (82 versus 64%, odds ratio: 2.6, 95% CI 0.9-6.8, p: .03). Iranian fathers showed a significantly higher rate of TMAE than Afghan fathers did (79 versus 58%, odds ratio: 2.7, 95% CI 1.1-6.3, p: .01). Mother's nationality showed the same result (78 versus 60%, odds ratio: 2.4, 95% CI 1.0-5.6, p: 0.02). Neonates with Iranian fathers showed significantly more TNAO than those with Afghan fathers (50 versus 31%, odds ratio: 2.21, 95% CI 0.9-5.5, p: .04). The same trend was observed among Iranian mothers in comparison to Afghan mothers (50 versus 32%, odds ratio: 2.11, 95% CI 0.9-4.6, p: .06). Of mother's age, mother's BMI, father's age, father's BMI, and mother's nationality, only father's BMI contributed significantly to the binary logistic regression model (n = 116, R2: 9%, p: .028). It was found that for each decreased unit in BMI, the risk of TNAO was increased by 16%, p: .03. Moreover, Father's family history of preeclampsia resulted in a higher prevalence of total neonatal adverse outcome (TNAO) in comparison with lack of such family history (87 versus 43%, odds ratio: 8.9, 95% CI 1.1-74.5, p: .02). Besides, mothers' participation in prenatal care (PNC) visits, assessed by caregivers, was significantly more satisfactory in neonates without any adverse outcome than those with neonatal adverse outcomes (median (IQR) = 2 (1-2) versus 2 (2-3), p: .04). PROM, pre-eclampsia, NICU admission, neonatal intubation, low Apgar score minute 0, and low Apgar score minute 5 were significantly more prevalent in participants revealing positive father's family history of pre-eclampsia. Regarding psychosocial exposures, placental abruption was more prevalent in mothers with exposure to verbal aggression versus non-exposed ones (9 versus 2%, odds ratio: 4.0, 95% CI 0.9-24.6, p: .04). Moreover, a weak positive association between neonatal gestational age at birth and quality of mother's participation in PNC visits (r: +0.3, p: .01) as well as mother's satisfaction from father's commitment to PNC visits was found (r: +0.1, p: .03).Conclusion: Male partners may play a key role in pregnant women and fetus's heath.
METHODS::Objective: To compare maternal and neonatal outcomes by forceps vaginal delivery versus cesarean delivery during the second stage of labor.Methods: We conducted a retrospective cohort study in a large tertiary maternity center in Shanghai, China through 2007-2016. A total of 7046 women carrying a singleton term nonanomalous fetus with vertex presentation who underwent forceps vaginal delivery, or cesarean delivery from a low station in the second stage of labor were included.Results: Of the 7046 women, 6265 underwent forceps and 781 underwent second stage cesarean delivery. Forceps were associated with lower frequency of maternal infection (2.2 versus 4.7%), but higher incidence of mild postpartum hemorrhage (PPH) (4.3 versus 0.6%). When the procedures were performed for fetal indication, forceps were associated with lower frequency of the composite of perinatal mortality and/or hypoxic ischemic encephalopathy (HIE) (0.5 versus 1.9%; adjusted odds ratio (aOR), 0.24; 95% CI: 0.08-0.75), and also shorter decision to delivery interval (12.3 ± 3.5 versus 19.1 ± 5.0 min). The neonatal infection rate was higher in the forceps group (3.9 versus 2.0%). There were no differences in other neonatal outcomes including birth trauma.Conclusions: In women who had a need for intervention during the second stage with a station of +2 or below, forceps were associated with a lower frequency of maternal infection but a higher rate of PPH. Deliveries performed for nonreassuring status were accomplished faster by forceps and were associated with a lower frequency of the composite of perinatal mortality and HIE.