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Recognizing the importance of ovarian aging research. NATURE AGING 2022; 2:1071-1072. [PMID: 37118542 DOI: 10.1038/s43587-022-00339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Antonella V, De Nola R, Battaglia S, Di Mussi R, Cazzato G, Resta L, Chironna M, Loconsole D, Vinci L, Chiarello G, Marucci M, Cicinelli E. Adverse Maternal Outcomes in Pregnant Women Affected by Severe-Critical COVID-19 Illness: Correlation with Vaccination Status in the Time of Different Viral Strains' Dominancy. Vaccines (Basel) 2022; 10:vaccines10122061. [PMID: 36560471 PMCID: PMC9783263 DOI: 10.3390/vaccines10122061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
This is a monocentric and cross-sectional study conducted at the COVID-19 Division of the Obstetrical and Gynecological Unit and Intensive Care Units (ICUs) of Policlinico di Bari, in Bari, Italy, between September 2020 and April 2022. This study aimed to identify the prevalence of severe-critical COVID-19 illness requiring access to the Intensive Care Unit (ICU) among 287 pregnant patients, and possible correlations between the SARS-CoV-2 variants, the specific pandemic wave (dominated by wild, Alpha, Delta, and Omicron strains), and severe-critical adverse maternal outcomes. The prevalence of severe-critical COVID-19 illness was 2.8% (8/287), reaching 4.9% (8/163) excluding the 4th wave (Omicron dominant). The Delta variant determined the highest risk ratio and odds for access to the ICU due to severe-critical COVID-19-related symptoms compared to the other variants (wild, Alpha, Omicron). During the third wave (Delta), the ICU cases underwent a higher rate of hyperimmune plasma infusion (75%), antibiotic therapy (75%), and remdesivir (33%); all of the patients were intubated. During the Omicron wave, the patients were asymptomatic or with few symptoms: most of them (70%) were vaccinated with a median of two doses. The maternal outcome worsened in the case of Alpha and, especially, Delta variants for severe-critical COVID-19-related symptoms and ICU access.
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Affiliation(s)
- Vimercati Antonella
- Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Rosalba De Nola
- Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
- Correspondence:
| | - Stefano Battaglia
- Interdisciplinary Department of Medicine, University of Bari School of Medicine, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Rossella Di Mussi
- Department of Emergency and Organ Transplantation, Anaesthesia and Resuscitation Division, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Gerardo Cazzato
- Department of Emergency and Organ Transplant, Pathology Division, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Leonardo Resta
- Department of Emergency and Organ Transplant, Pathology Division, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Maria Chironna
- Department of Interdisciplinary Medicine (Laboratory of Molecular Epidemiology and Public Health), University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Daniela Loconsole
- Department of Interdisciplinary Medicine (Laboratory of Molecular Epidemiology and Public Health), University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Lorenzo Vinci
- Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Giulia Chiarello
- Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Massimo Marucci
- Department of Emergency and Organ Transplantation, Anaesthesia and Resuscitation Division, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Ettore Cicinelli
- Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
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Diagnosing Arterial Stiffness in Pregnancy and Its Implications in the Cardio-Renal-Metabolic Chain. Diagnostics (Basel) 2022; 12:diagnostics12092221. [PMID: 36140621 PMCID: PMC9497660 DOI: 10.3390/diagnostics12092221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
Cardio-renal and metabolic modifications during gestation are crucial determinants of foetal and maternal health in the short and long term. The cardio-renal metabolic syndrome is a vicious circle that starts in the presence of risk factors such as obesity, hypertension, diabetes, kidney disease and ageing, all predisposing to a status dominated by increased arterial stiffness and alteration of the vascular wall, which eventually damages the target organs, such as the heart and kidneys. The literature is scarce regarding cardio-renal metabolic syndrome in pregnancy cohorts. The present paper exposes the current state of the art and emphasises the most important findings of this entity, particularly in pregnant women. The early assessment of arterial function can lead to proper and individualised measures for women predisposed to hypertension, pre-eclampsia, eclampsia, and diabetes mellitus. This review focuses on available information regarding the assessment of arterial function during gestation, possible cut-off values, the possible predictive role for future events and modalities to reverse or control its dysfunction, a fact of crucial importance with excellent outcomes at meagre costs.
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Anele CR, Goldani MZ, Schüler-Faccini L, da Silva CH. Prevalence of Congenital Anomaly and Its Relationship with Maternal Education and Age According to Local Development in the Extreme South of Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138079. [PMID: 35805738 PMCID: PMC9265685 DOI: 10.3390/ijerph19138079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022]
Abstract
Congenital anomalies (CA) contribute to disabilities and health conditions throughout life. Furthermore, they can cause emotional distress to the mothers and children, who may also experience limitations in individual and social development. This study investigated the prevalence of CA and the relationship with maternal education and age according to local development in the extreme south of Brazil. This is a retrospective observational study with birth data from the Live Birth Information System from 2000 to 2017. The association between age and maternal education with the presence of CA was verified using multiple Poisson regression for robust variances in models adjusted for those variables with a preliminary significant association. A total of 5131 (1.5%) had some CA identified at birth between 2000 and 2017. Only advanced age (≥36 years) was associated with CA regardless of macro-region development (p ≤ 0.001). The highest risk was observed in regions with medium development (RR = 1.60; 95% CI 1.30−1.97). Maternal education (<8 years of study) was associated with CA only in mothers from macro-regions with very high development (RR = 1.27; 95% CI 1.03−1.54). These analyses confirmed that women of advanced age are at greater risk of having children with a CA regardless of maternal education and local development, but social characteristics can also have an influence, as regions with higher development had lower prevalence of CA.
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Affiliation(s)
- Carolina Ribeiro Anele
- Postgraduate Program in Child and Adolescent Health, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre 90035-003, RS, Brazil; (C.R.A.); (M.Z.G.); (L.S.-F.)
| | - Marcelo Zubaran Goldani
- Postgraduate Program in Child and Adolescent Health, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre 90035-003, RS, Brazil; (C.R.A.); (M.Z.G.); (L.S.-F.)
- Pediatrics and Primary Health Care Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre 90620-110, RS, Brazil
- Department of Pediatrics, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre 90035-003, RS, Brazil
| | - Lavínia Schüler-Faccini
- Postgraduate Program in Child and Adolescent Health, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre 90035-003, RS, Brazil; (C.R.A.); (M.Z.G.); (L.S.-F.)
- Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil
- Instituto Nacional de Genética Médica Populacional (INAGEMP), Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre 90035-003, RS, Brazil
| | - Clécio Homrich da Silva
- Postgraduate Program in Child and Adolescent Health, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre 90035-003, RS, Brazil; (C.R.A.); (M.Z.G.); (L.S.-F.)
- Pediatrics and Primary Health Care Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre 90620-110, RS, Brazil
- Department of Pediatrics, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre 90035-003, RS, Brazil
- Correspondence: ; Tel.: +55-51-33085601
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Chin AHB, Saifuddeen SM. Is social egg freezing (oocyte cryopreservation) for single women permissible in Islam? A perspective from Singapore. New Bioeth 2022; 28:116-126. [PMID: 35484933 DOI: 10.1080/20502877.2022.2063576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Elective egg freezing (oocyte cryopreservation) for fertility preservation - commonly referred to as social egg freezing or non-medical egg freezing, will be permitted in Singapore from 2023. There is a need for clear religious directives on social egg freezing for the minority Muslim population in Singapore, due to conflicting Fatwas on this medical procedure that were issued in different Islamic countries, in particular Egypt and Malaysia. Although social egg freezing would be beneficial for the fertility preservation of many single Muslim women who are unable to start a family due to various personal circumstances, there are also various potential risks and harms of this medical procedure at the individual and societal level. Hence, based on Maqasid Al-Shariah, by which preventing harm takes precedence over securing benefit in medical treatment (Tadawi), it is posited that social egg freezing should be classified as Makruh, which is permissible but discouraged in Islam.
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Affiliation(s)
| | - Shaikh Mohd Saifuddeen
- Institute of Islamic Understanding Malaysia. No. 2, Langgak Tunku Off Jalan Tuanku Abdul Halim, Kuala Lumpur, Malaysia
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56
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Uptake of COVID-19 Vaccines among Pregnant Women: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10050766. [PMID: 35632521 PMCID: PMC9145279 DOI: 10.3390/vaccines10050766] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 01/27/2023] Open
Abstract
Mass vaccination against COVID-19 is essential to control the pandemic. COVID-19 vaccines are now recommended during pregnancy to prevent adverse outcomes. With this review, we aimed to evaluate the evidence in the literature regarding the uptake of COVID-19 vaccinations among pregnant women. A comprehensive search was performed in PubMed, Medline, Scopus, ProQuest, Web of Science, CINAHL, and medRxiv from inception to 23 March 2022. We performed a meta-analysis to estimate the overall proportion of pregnant women vaccinated against COVID-19. We found 11 studies including 703,004 pregnant women. The overall proportion of pregnant women vaccinated against COVID-19 was 27.5% (95% CI: 18.8–37.0%). Predictors of COVID-19 vaccination uptake were older age, ethnicity, race, trust in COVID-19 vaccines, and fear of COVID-19 during pregnancy. Mistrust in the government, diagnosis of COVID-19 during pregnancy, and fears about the safety and side effects of COVID-19 vaccines were reasons for declining vaccination. The global COVID-19 vaccination prevalence in pregnant women is low. A large gap exists in the literature on the factors influencing the decision of pregnant women to be vaccinated against COVID-19. Targeted information campaigns are essential to increase vaccine literacy among pregnant women.
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57
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Lin PF, Chen FC, Chen JY, Hu LH, Xie WJ, Liu TY, Guo SB, Lin XM, Liu XW, Ye XH, Li M, Jiang CH. Incidence and familial clustering of infantile hemangiomas: A multicenter study. J Eur Acad Dermatol Venereol 2022; 36:1641-1647. [PMID: 35470460 DOI: 10.1111/jdv.18179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The exact incidence of infantile hemangiomas (IH) in the Chinese population is still unknown. A positive family history of IH was considered as a risk factor for the development of IH. OBJECTIVES This study aims to investigate the incidence of IH in the Chinese population and the mechanism of family history increases the risk for IH development. METHODS 2489 women and their newborns were enrolled in the prospective study. All newborns were followed up for 12 months to determine whether they developed IH. In addition, 213 IH probands and their 174 siblings were enrolled in the study. The incidence of IH in siblings of the IH probands was investigated. Information regarding risk factors for IH and demographic data were collected on all children. RESULTS Of the 2572 newborns, 58 IH were identified in 56 (2.2%) newborns. The majority of IH were located on the trunk (46.6%). Siblings of the IH probands were at increased risk for the development of IH (P = 0.024, relative risk 2.451), and the occurrence of prenatal risk factors for IH(P = 0.003) compared with the general population. CONCLUSIONS Our study showed that the incidence of IH is 2.2% in the Chinese population. Siblings of the individuals with IH were at increased risk for the development of IH may be related to the family clustering of prenatal risk factors for IH. Further exploration of the mechanisms and common features of these prenatal risk factors may help to disclosure the origin and pathogenesis of IH.
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Affiliation(s)
- Peng-Fei Lin
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China.,Department of Plastic Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China
| | - Fa-Chun Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Jia-Yao Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China.,Department of Plastic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 51000, China
| | - Li-Han Hu
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Wen-Jun Xie
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Ting-Yuan Liu
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Sheng-Bin Guo
- Department of Obstetrics, Fujian, Maternal and Child Health Hospital, Fuzhou, 350001, China
| | - Xue-Mei Lin
- Department of Obstetrics, Fuzhou Fuxing Maternity Hospital, Fuzhou, 350001, China
| | - Xiu-Wu Liu
- Department of Obstetrics, Fujian, Maternal and Child Health Hospital, Fuzhou, 350001, China
| | - Xian-Hua Ye
- Department of Clinical Laboratory, Fuzhou Fuxing Maternity Hospital, Fuzhou, 350001, China
| | - Ming Li
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China.,Department of Plastic Surgery and Regenerative Medicine Institute, Fujian Medical University, Fuzhou, 350001, China.,Tissue and Organ Regeneration Engineering Center of Fujian Higher Education, Fuzhou, 350001, China
| | - Cheng-Hong Jiang
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China.,Department of Plastic Surgery and Regenerative Medicine Institute, Fujian Medical University, Fuzhou, 350001, China.,Tissue and Organ Regeneration Engineering Center of Fujian Higher Education, Fuzhou, 350001, China
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Inequalities in Birth Weight in Relation to Maternal Factors: A Population-Based Study of 3,813,757 Live Births. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031384. [PMID: 35162402 PMCID: PMC8835086 DOI: 10.3390/ijerph19031384] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 02/06/2023]
Abstract
Background: Despite numerous studies of women having children later in life, evidence of the relationship between maternal factors and newborn outcomes in Central and Eastern European countries is limited. This study aimed to examine the association between maternal age, biological determinants, including parity and sex of the newborn, demographic and social background, and birth weight in 3.8 million singleton live births in Poland. Methods: The effect of maternal age on birth weight (in grams and Z-scores) adjusted for confounders was assessed using Generalized Linear Models. Results: The mean (±SD) birth weights of neonates born to primiparous women and multiparous women were 3356.3 ± 524.9 g and 3422.7 ± 538.6 g, respectively, which corresponded to a Z-score of −0.07 ± 0.96 and 0.14 ± 1.00, respectively (p ≤ 0.001). After controlling for biological, demographic, and social factors, a significant decrease in birth weight was found for primiparous women of the age group ≥30 years and multiparous women aged ≥35 years compared to the age group of 25–29 years. The lowest neonatal birth weight was observed in the case of women aged ≥45 years. Confounders did not affect birth weight Z-scores among primiparous women, whereas among multiparous women, together with educational factors, they reversed Z-scores from positive to negative values. The lower birth weight of neonates was overall associated with lower maternal education. Conclusions: Regardless of parity, advanced maternal age is strongly associated with a decreased neonatal birth weight, implying complications in early pregnancy and the antenatal period as well as obstetric complications. Counseling to support women’s family planning decisions and improving women’s education during their reproductive age may help to alleviate unfavorable newborn outcomes.
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Condrat CE, Filip L, Gherghe M, Cretoiu D, Suciu N. Maternal HPV Infection: Effects on Pregnancy Outcome. Viruses 2021; 13:2455. [PMID: 34960724 PMCID: PMC8707668 DOI: 10.3390/v13122455] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022] Open
Abstract
The human papilloma virus (HPV) infection, caused by a ubiquitous virus typically transmitted through the direct contact of infected organs, either through the skin or mucosa, is the most common sexually transmitted infection, placing young women at a high risk of contracting it. Although the vast majority of cases spontaneously clear within 1-2 years, persistent HPV infection remains a serious concern, as it has repeatedly been linked to the development of multiple malignancies, including cervical, anogenital, and oropharyngeal cancers. Additionally, more recent data suggest a harmful effect of HPV infection on pregnancy. As the maternal hormonal environment and immune system undergo significant changes during pregnancy, the persistence of HPV is arguably favored. Various studies have reported an increased risk of adverse pregnancy outcomes among HPV-positive women, with the clinical impact encompassing a range of conditions, including preterm birth, miscarriage, pregnancy-induced hypertensive disorders (PIHD), intrauterine growth restriction (IUGR), low birth weight, the premature rupture of membranes (PROM), and fetal death. Therefore, understanding the mechanisms employed by HPV that negatively impact pregnancy and assessing potential approaches to counteract them would be of interest in the quest to optimize pregnancy outcomes and improve child survival and health.
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Affiliation(s)
- Carmen Elena Condrat
- Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania;
| | - Lidia Filip
- Dermatology Department, Victor Babes Clinical Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Mirela Gherghe
- Department of Nuclear Medicine, Alexandru Trestioreanu Oncology Institute, 022328 Bucharest, Romania
| | - Dragos Cretoiu
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania;
- Department of Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
| | - Nicolae Suciu
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania;
- Division of Obstetrics, Gynecology and Neonatology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
- Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
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60
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Yang L, Wang H, Li Y, Zeng C, Lin X, Gao J, Luo S. Development of a Novel Nomogram for Predicting Premature Rupture of Membrane in Pregnant Women With Vulvovaginal Candidiasis. Front Med (Lausanne) 2021; 8:717978. [PMID: 34869416 PMCID: PMC8636144 DOI: 10.3389/fmed.2021.717978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to develop a nomogram to predict the risk of premature rupture of membrane (PROM) in pregnant women with vulvovaginal candidiasis (VVC). Patients and methods: We developed a prediction model based on a training dataset of 417 gravidas with VVC, the data were collected from January 2013 to December 2020. The least absolute shrinkage and selection operator regression model was used to optimize feature selection for the model. Multivariable logistic regression analysis was applied to build a prediction model incorporating the feature selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the prediction model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was assessed using bootstrapping validation. Results: Predictors contained in the prediction nomogram included age, regular perinatal visits, history of VVC before pregnancy, symptoms with VVC, cured of VVC during pregnancy, and bacterial vaginitis. The model displayed discrimination with a C-index of 0.684 (95% confidence interval: 0.631-0.737). Decision curve analysis showed that the PROM nomogram was clinically useful when intervention was decided at a PROM possibility threshold of 13%. Conclusion: This novel PROM nomogram incorporating age, regular perinatal visits, history of VVC before pregnancy, symptoms with VVC, cured of VVC during pregnancy, and bacterial vaginitis could be conveniently used to facilitate PROM risk prediction in gravidas.
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Affiliation(s)
- Lilin Yang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haikuan Wang
- Acupuncture, Moxibustion and Rehabilitation School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanfang Li
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cheng Zeng
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xi Lin
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie Gao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Songping Luo
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
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