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Dai J, Mao P, Pu C, Wang X, Liu X. Trimester-specific reference intervals and profile of coagulation parameters for Chinese pregnant women with diverse demographics and obstetric history: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:421. [PMID: 37280539 DOI: 10.1186/s12884-023-05571-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 04/03/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Owing to the changes in childbirth policy in China, this work aimed to update the trimester-specific reference intervals (RIs) for Chinese pregnant women with diverse demographics and obstetric history. This study also investigated how advanced maternal age (AMA) (> 35 years old), gravity, and parity influence gestational coagulation parameters. METHODS In this prospective cross-sectional study, five coagulation parameters were measured using assays provided by Roche diagnostics on Cobas t 711: prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib), and D-dimer, and the trimester-specific 2.5th -97.5th and 95th (D-dimer only) percentiles RIs were established accordingly. Linear regressions were undertaken to analyze the association with demographic characteristics and obstetric history for each parameter. RESULTS 893 eligible pregnant women in different trimesters and at AMA/non-AMA and 275 non-pregnant healthy women were enrolled. For the first, second, and third trimester, respectively, RIs were as follows: APTT (s): 24.8-35.7, 24.6-34.1, and 23.5-34.7; TT (s): 14.4-17.3, 14.1-16.7, and 14.2-17.5; PT (s): 8.30-10.20, 8.00-9.77, and 7.92-9.57; PT-INR: 0.86-1.06, 0.83-1.02, and 0.82-0.98; Fib (g/L): 2.76-4.97, 3.14-5.31, and 3.44-5.93; D-dimer (µg/ml): 0-0.969, 0-2.14, and 0-3.28. No statistically significant differences were observed in TT, D-dimer, and APTT between the AMA and non-AMA women, while PT and PT-INR were shorter and Fib was higher in the AMA group. The association of gravidity and parity with each coagulation parameter is statistically significant (p < 0.05). PT and PT-INR were shortened and D-dimer decreased as gravidity increased. Longer PT and PT-INR, shorter APPT, higher D-Dimer, and lower Fib were associated with increasing parity. CONCLUSIONS This work updated the gestational coagulation profiles of Chinese pregnant women and established trimester-specific RIs accordingly. Establishing specific RIs based on AMA, parity, and gravidity might not be necessary.
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Affiliation(s)
- Jing Dai
- Department of Laboratory Medicine, Shanghai Jiaotong University School of Medicin Ruijin Hospital, Shanghai, China
| | - Peimin Mao
- Department of Blood Transfusion, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Cunying Pu
- Roche Diagnostics (Shanghai) Limited, Medical and Scientific Affairs, Minhang District, Shanghai, China
| | - Xuefeng Wang
- Department of Laboratory Medicine, Shanghai Jiaotong University School of Medicin Ruijin Hospital, Shanghai, China.
| | - Xiaoyan Liu
- Department of Blood Transfusion, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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Qi Z, Wang Y, Lin G, Ma H, Li Y, Zhang W, Jiang S, Gu X, Cao Y, Zhou W, Lee SK, Liang K, Qian L. Impact of maternal age on neonatal outcomes among very preterm infants admitted to Chinese neonatal intensive care units: a multi-center cohort study. Transl Pediatr 2022; 11:1130-1139. [PMID: 35957998 PMCID: PMC9360824 DOI: 10.21037/tp-22-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The percentage of advanced maternal age (aged over 35 years) mothers has been rising across the world, the evidence of maternal age on neonatal outcomes from low- and middle-income countries is scarce. Our objective was to evaluate the effect of maternal age on mortality and major morbidity among very preterm infants admitted to Chinese neonatal intensive care units. METHODS Data from a retrospective multi-center cohort of all complete care very preterm infants admitted to 57 neonatal intensive care units that participated in the Chinese Neonatal Network from January 1st to December 31st, 2019 were analyzed. Neonatal outcomes including mortality or any major morbidity, defined as necrotizing enterocolitis stage 2 or 3, moderate & severe bronchopulmonary dysplasia, severe intraventricular hemorrhage, cystic periventricular leukomalacia, severe retinopathy of prematurity, or sepsis. A multiple logistic regression model was constructed to analyze the independent association between maternal age and neonatal outcome. RESULTS Among 7,698 eligible newborns, 80.5% of very preterm infants were born to mothers between the ages of 21 and 35 years, with 18.0% born to mothers >35 years and 1.5% born to mothers <21 years. Higher rates of maternal hypertension, maternal diabetes, cesarean deliveries, antenatal steroid usage were noted as maternal age increased. The proportion of prenatal care, cesarean section, antenatal steroid usage and inborn for very preterm infants born to mothers <21 years was lower than those of mothers of other ages. Compared to the ages of 21-35 years group, the odds of severe intraventricular hemorrhage (adjusted odd ratio: 2.00, 95% CI: 1.08-3.71) was significantly higher in the ages of 15-20 years group. Increasing maternal age was associated with higher rates of small for gestational age and lower birth weight of very preterm infants, but no correlation between advanced maternal age and very preterm infants mortality or major morbidity. CONCLUSIONS Among very preterm infants, increasing maternal age was associated with higher rates of small for gestational age but not neonatal mortality or major morbidity. Young maternal age may increase the risk of severe intraventricular hemorrhage of very preterm infants.
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Affiliation(s)
- Zhiye Qi
- Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, China.,School of Public Health, Kunming Medical University, Kunming, China
| | - Yanchen Wang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Guang Lin
- Division of Neonatology, Zhuhai Women and Children's hospital, Zhuhai, China
| | - Haiyan Ma
- Division of Neonatology, Zhuhai Women and Children's hospital, Zhuhai, China
| | - Yaojin Li
- Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Weiquan Zhang
- Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Siyuan Jiang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China.,Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China.,Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Wenhao Zhou
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China.,Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K Lee
- Maternal-Infants Care Research Centre and Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Kun Liang
- Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liling Qian
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, China
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Long Q, Zhang Y, Zhang J, Tang X, Kingdon C. Changes in caesarean section rates in China during the period of transition from the one-child to two-child policy era: cross-sectional National Household Health Services Surveys. BMJ Open 2022; 12:e059208. [PMID: 35418438 PMCID: PMC9014066 DOI: 10.1136/bmjopen-2021-059208] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Since 2009, China has introduced policies, principally targeting health professionals, to reduce caesarean section (CS) overuse. In 2016, China endorsed a universal two-child policy. Advanced maternal age and previous CS may indicate changes in obstetric risks, which raise concerns on the need for and safety of CS. This study investigated changes in CS rates in 2008-2018, and factors associated with CS use during the period of transition from the one-child to two-child policy era. DESIGN We used births data from the cross-sectional National Household Health Services Surveys in 2013 and 2018. SETTING Population-based national survey. PARTICIPANTS Women who had the last live birth within 5 years before the survey. PRIMARY OUTCOME MEASURE CS rate. RESULTS Overall CS use increased from 40.9% in 2008 to 47.2% in 2014 with significant increase in rural areas and the western region, and slightly decreased to 45.2% in 2018 with the greatest decrease among nulliparous women. Maternal request for CS by urban nulliparous women decreased from 36.8% in 2008-2009 to 22.2% in 2016-2018, but this change was not statistically significant in rural areas. Maternal age over 35 years old (OR 2.40, 95% CI 1.72 to 3.35) and births that occurred at a private hospital (OR 1.52, 95% CI 1.25 to 1.86) were associated with CS use among nulliparous women in 2016-2018. The CS rate among multiparous women increased over time. Individual socioeconomic factors associated with CS use among multiparous women. CONCLUSIONS The CS rate rise in China in 2008-2018 is attributable to increased use in rural areas and the less developed western region. The population policy shift, alongside facility policies for unnecessary CS reduction, are likely factors in CS reduction in urban areas. The challenge remains to reduce unnecessary CS, at the same time as providing safe, universal access to CS for women in need.
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Affiliation(s)
- Qian Long
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, National Health Commission of the People's Republic of China, Beijing, China
| | - Jing Zhang
- Nursing School, Hangzhou Normal University, Hangzhou, China
| | - Xiaojun Tang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Carol Kingdon
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
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4
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He XL, Hu XJ, Luo BY, Xia YY, Zhang T, Saffery R, De Seymour J, Zou Z, Xu G, Zhao X, Qi HB, Han TL, Zhang H, Baker PN. The effects of gestational diabetes mellitus with maternal age between 35 and 40 years on the metabolite profiles of plasma and urine. BMC Pregnancy Childbirth 2022; 22:174. [PMID: 35236326 PMCID: PMC8892719 DOI: 10.1186/s12884-022-04416-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance in pregnancy and without a history of diabetes mellitus. While there are limited metabolomic studies involving advanced maternal age in China, we aim to investigate the metabolomic profiling of plasma and urine in pregnancies complicated with GDM aged at 35–40 years at early and late gestation. Methods Twenty normal and 20 GDM pregnant participants (≥ 35 years old) were enlisted from the Complex Lipids in Mothers and Babies (CLIMB) study. Maternal plasma and urine collected at the first and third trimester were detected using gas chromatography-mass spectrometry (GC-MS). Results One hundred sixty-five metabolites and 192 metabolites were found in plasma and urine respectively. Urine metabolomic profiles were incapable to distinguish GDM from controls, in comparison, there were 14 and 39 significantly different plasma metabolites between the two groups in first and third trimester respectively. Especially, by integrating seven metabolites including cysteine, malonic acid, alanine, 11,14-eicosadienoic acid, stearic acid, arachidic acid, and 2-methyloctadecanoic acid using multivariant receiver operating characteristic models, we were capable of discriminating GDM from normal pregnancies with an area under curve of 0.928 at first trimester. Conclusion This study explores metabolomic profiles between GDM and normal pregnancies at the age of 35–40 years longitudinally. Several compounds have the potential to be biomarkers to predict GDM with advanced maternal age. Moreover, the discordant metabolome profiles between the two groups could be useful to understand the etiology of GDM with advanced maternal age. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04416-5.
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Affiliation(s)
- Xiao-Ling He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China
| | - Xiao-Jing Hu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Bai-Yu Luo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Yin-Yin Xia
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Ting Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China
| | - Richard Saffery
- Cancer & Disease Epigenetics, Murdoch Children's Research Institute and Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
| | | | - Zhen Zou
- Institute of Life Sciences, Chongqing Medical University, Chongqing, 400016, China
| | - Ge Xu
- Institute of Life Sciences, Chongqing Medical University, Chongqing, 400016, China
| | - Xue Zhao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Hong-Bo Qi
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China
| | - Ting-Li Han
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,Institute of Life Sciences, Chongqing Medical University, Chongqing, 400016, China. .,Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Hua Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
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Shi P, Zhao L, Yu S, Zhou J, Li J, Zhang N, Xing B, Cui X, Yang S. Differences in epidemiology of patients with preeclampsia between China and the US (Review). Exp Ther Med 2021; 22:1012. [PMID: 34345294 PMCID: PMC8311229 DOI: 10.3892/etm.2021.10435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/11/2021] [Indexed: 12/14/2022] Open
Abstract
Preeclampsia (PE) is a complex complication that occurs during pregnancy. Studies indicated that morbidity from PE exhibits marked variations among geographical areas. Disparities in the incidence of PE between China and the US may be due to differences in ethnicity and genetic susceptibility, maternal age, sexual culture, body mass index, diet, exercise, multiple pregnancies and educational background. These epidemiological differences may give rise to differences between the two countries in terms of diagnostic and therapeutic criteria for PE. PE may be largely attributed to susceptibility genes and lifestyles, such as diet, body mass index and cultural norms regarding sexual relationships. The epidemiologic differences of patients with PE between the two countries indicated that appropriate prevention plans for PE require to be developed according to local conditions.
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Affiliation(s)
- Ping Shi
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Lei Zhao
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Sha Yu
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Jun Zhou
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Jing Li
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Ning Zhang
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Baoxiang Xing
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Xuena Cui
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Shengmei Yang
- Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
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Martinelli KG, Gama SGND, Santos Neto ETD. The role of parity in the mode of delivery in advanced maternal age women. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-93042021000100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to describe the profile of Brazilian Advanced Maternal Age (AMA) women (> 35 years) according to parity, as well as to analyze the role of parity in the relationship between AMA and mode of delivery. Methods: this is a cross-sectional study, based on the “Nascer no Brasil” (Born in Brazil) survey. The data were collected in 2011/2012. The chi-square test was performed to verify the association between parity and maternal, prenatal and delivery characteristics, maternal habits, pre-pregnancy diseases, maternal complications and obstetric history. Results: of the 2,510 puerperal AMA women, 20.2% were nulliparous, 54.4% had one or two previous births and 25.4% had three or more previous births. The nulliparous women had higher schooling, higher economic class and adequate BMI, were white; and had better maternal habits when compared to multiparous. However, they were also more submitted to cesarean section, although without reported complications. Conclusions: one cannot speak of AMA pregnant women as a homogeneous group in Brazil. There are inequalities that can be revealed via parity, since nulliparous women have maternal characteristics, habits and access to prenatal care and childbirth that are more advantageous than multiparous women.
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Sun G, Lin Y, Lu H, He W, Li R, Yang L, Liu X, Wang H, Yang X, Cheng Y. Trends in cesarean delivery rates in primipara and the associated factors. BMC Pregnancy Childbirth 2020; 20:715. [PMID: 33228631 PMCID: PMC7684937 DOI: 10.1186/s12884-020-03398-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022] Open
Abstract
Background Few studies have focused on cesarean delivery (CD) trends among primipara under the one-child and the two-child policies. This study aimed to explore the trends in CD rates among primipara during 1995–2019 and the associated factors with CD risk. Methods This study obtained clinical data on primiparous mothers and newborns from 1995 to 2019 at a large tertiary hospital in Wuhan, China. Trends in CD rates were calculated using the joinpoint regression analysis. The Chi-square tests and log-binomial regression analyses were used to evaluate the associations between primary variables and CD risk. Results CD rates showed a significant upward trend with an average annual percentage change (APC) of 2.2% (95% CI: 0.6, 3.8%) during the study period. In 1995–2006, the CD rates continued to increase with an APC of 7.8% (95% CI: 4.8, 10.9%). After 2006, the CD rates started to decline by an APC of − 4.1% (95% CI: − 5.5, − 2.6%). The CD rates non-significantly increased from 36.2% in 2016 to 43.2% in 2019. Moreover, the highest CD rate during 2015–2019 was observed on August 30 (59.2%) and the lowest on September 1 (29.7%). Primipara of older age and those with >3pregnancies had higher risks of CD. Furthermore, primipara who gave birth to newborns with low birth weight and macrosomia had higher risks of CD. Conclusions Maternal and fetal as well as social and cultural factors may contribute to the rising trend of CD rates. Effective measures should be taken to control CD under the two-child policy, especially for primipara. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03398-6.
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Affiliation(s)
- Guoqiang Sun
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Ying Lin
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Honglian Lu
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Wenjing He
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Ruyan Li
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Lijun Yang
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Xian Liu
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Hongyan Wang
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Xuewen Yang
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China
| | - Yao Cheng
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuluo Road 745#, Hongshan District, Wuhan, 430070, Hubei, China.
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Shi Y, Ma J, Xue Y, Wang J, Yu B, Wang T. The assessment of combined karyotype analysis and chromosomal microarray in pregnant women of advanced maternal age: a multicenter study. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:318. [PMID: 31475188 DOI: 10.21037/atm.2019.06.63] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Retrospectively analyzed the results of prenatal diagnosis and hoped to provide scientific clinical guidance of prenatal screening and diagnosis for the women in advanced maternal age (AMA). Methods In total, 4,224 women of AMA who accepted prenatal diagnosis by amniocentesis (AC) from two prenatal diagnosis centers were recruited for this study. After genetic counseling and informed consent, 3,475 women received karyotype analysis only, 703 were examined by both karyotype analysis and chromosomal microarray (CMA), while 46 cases selected CMA only. Both centers used the same detection platform, experimental scheme, and quality control standards. Results A total of 164 women with chromosomal abnormal results were found, the abnormality rate was 3.88% (164/4,224). Among them, 145 (3.4%, 145/4,224) cases were detected as abnormal chromosome number, 19 cases (0.4%, 19/4,224) as abnormal chromosome structure. Compared with simple AMA women, the abnormality rate was significantly increased in the AMA women who combined with other indications, particularly in number abnormalities (22.5% vs. 1.0%, P<0.001). Forty-eight copy number variations (CNVs) were detected, moreover 10 cases (0.24%, 10/4,224) were proved as pathogenic or likely pathogenic CNVs. With the CMA technology, the rate of additional abnormalities with clinical significance was 1.42% (10/703). Chromosome number abnormalities significantly increased with age (P<0.001), while there were no such trends in chromosomal structural abnormalities (P=0.624). Conclusions About 3.88% fetuses of AMA women had chromosomal abnormalities, the abnormality rate increased with their age. The application of CMA could increase the diagnostic rate by about 1.4% for AMA women, and greatly reduce their tension.
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Affiliation(s)
- Ye Shi
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China
| | - Jun Ma
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215000, China
| | - Ying Xue
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215000, China
| | - Jing Wang
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China
| | - Bin Yu
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China
| | - Ting Wang
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215000, China
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