妊娠期妇女产次与龋病及牙周病发生关系的探究

目的探究妊娠期妇女龋病及牙周病发生情况和不同产次对妊娠期妇女龋病及牙周病发生的差异。方法以228名妊娠期妇女(其中初产妇140名,经产妇88名)和85名同龄未妊娠妇女(对照)为研究对象,检查其龋病及牙周病发生状况,并记录菌斑指数(PLI)、探诊深度(PD)、临床附着丧失(CAL)、牙石指数(CI)和龈沟出血指数(SBI),进行组间统计分析。结果 (1)初产组(47.86%)、经产组(67.05%)的患龋率均高于对照组(29.41%)(P0.05),且经产组的患龋率高于初产组(P0.05)。初产组、经产组和对照组的龋均分别为1.57、2.18和0.90。(2)PLI、CI、PD、CAL和SBI在初产组(0.60±0.06,1.92±0.54,4.38±1.20,0.21±0.05,2.51±1.14)和经产组(0.71±0.59,2.06±0.97,4.77±1.35,0.22±0.08,3.05±1.40)均高于对照组(0.52±0.28,1.26±0.39,2.80±0.78,0.18±0.11,2.06±1.17)(P0.05),且经产组的PD、SBI高于初产组(P0.05),而初产组和经产组间PLI、CI、CAL的差异无统计学意义(P0.05)。结论妊娠可能导致妇女患龋率、PLI、CI、PD、CAL和SBI的增加,且产次增加可能导致妇女患龋率、PD和SBI的增加。     

Significance of exercise and bed rest in pregnancy--study on the lying postures of gravidas during sleep (2)

For the purpose of determining the most reasonable lying posture for pregnant women, we investigated the lying positions of both 247 non-pregnant women and 302 pregnant women during sleep. As for the rate of each position during the entire period of observation, 33.2% of the non-pregnant women were in the supine position, 41.2% in the lateral position, 18.4% in Sims' position and 7.1% in the prone position. In the pregnant group, the rate of supine position, simple lateral position and Sims' position was 34.2%, 52.2% and 12.7%, respectively, but the rate of the prone position was limited to 0.8%. All of the gravidas assuming the prone position were at less than 16 weeks of gestation. Non-pregnant women could sleep in a variety of positions, but pregnant women could assume the prone position during sleep only in the stage when the abdomen is not yet prominent or distended. Pregnant women were restricted significantly, either consciously or unconsciously, with progress in gestation.     

Factors affecting walking activity at estrus during postpartum period and subsequent fertility in dairy cows

The postpartum period is critical for efficient reproduction, and certain features of the normal estrus cycle during this period have been associated with subsequent reproductive performance. The objectives of the present investigation were to evaluate the effects of environmental, production, and reproductive factors on walking activity at estrus as determined using pedometers during the first 50 days in milk (DIM) (study 1). In a second study, we tried to establish whether pedometer measurements recorded during this period could be used to predict subsequent fertility by considering the number of cows becoming pregnant before 90 DIM. We analyzed data derived from 995 parturitions in a single herd. Detection of estrus was performed using a pedometer system. Variables were screened for associations with walking activity by analysis of variance (ANOVA) through generalized linear model procedures (PROC GLM). Increased milk production and parity, and a mean relative humidity (RH) higher than 95% were associated with lower pedometer measurements. A higher number of animals simultaneously in estrus rendered higher pedometer readings. No significant effects of the year, season, DIM, number of previous estruses, and climatic data other than high mean RH were observed. Relationships between pedometer measurements and other variables recorded during the first 50 days postpartum, and subsequent fertility were assessed by applying logistic regression models. We detected no significant effects of year, milk production, season, and mean activity increase at estrus on high fertility. The likelihood of pregnancy before 90 DIM decreased for each additional lactation and for cows in anestrus between days 0 and 50 postpartum. However, pedometer readings during the first 50 days postpartum were unable to accurately predict subsequent fertility.     

Turnover rate of anti-D IgG injected during pregnancy.

Anti-D IgG was injected into 15 Rh-negative women in the 28th week of gestation and into three non-pregnant women. The uptake of anti-D after the intramuscular injections was calculated by measuring the concentration of antibody in the plasma with an autoanalyser. The biological half life and the catabolic rate of anti-D IgG were calculated according to a compartmental model. The recovery in vivo of anti-D was an average 24% in the non-pregnant women and 21% in the pregnant women. The half life of anti-D were 24 and 21 days, respectively. With a dose of 125 micrograms the plasma anti-D concentration was less than 1 ng/ml at about 10 weeks after the injection. With double the dose the concentration at delivery was at least 1 ng/ml. Although 250 micrograms of anti-D IgG seems to be effective when given in the 28th weeks of gestation, the great individual variations in uptake and recovery rates will lead to occasional cases of Rh-immunisation during pregnancy despite all routine regimens.     

Early onset pre-eclampsia: recognition of underlying renal disease.

A follow up study of 84 patients with early onset pre-eclampsia (before 37 weeks'' gestation) showed a high prevalence of underlying renal disease. Renal abnormalities were found in 33 of the 49 primiparas (67%) and in 22 of the 35 multiparas (63%). Two thirds of the multiparas with pre-eclampsia before 37 weeks with a diagnosis of either essential hypertension or renal disease had recurrent pre-eclampsia. Maternal morbidity and fetal mortality were greater in the group with early onset pre-eclampsia than in a group with late onset disease. Idiopathic pre-eclampsia occurred in 10% of primiparas in the early onset group, whereas it was the main condition in over three quarters of primiparas in the late onset group. A presumptive diagnosis of idiopathic pre-eclampsia is likely to be correct only in primiparas who develop the disease after 37 weeks of pregnancy; in all other cases careful search will almost certainly detect an underlying abnormality, predominantly renal.     

9 alpha,11 beta-prostaglandin F2 in pregnancies at high risk for hypertensive disorders of pregnancy,and the effect of acetylsalicylic acid

Our purpose was to determine urinary 9 alpha,11 beta-prostaglandin F2, the primary metabolite of prostaglandin D2, in pregnancies at high risk for hypertensive disorders and the effect of acetylsalicylic acid on 9 alpha,11 beta-prostaglandin F2. Ninety high risk women were randomised to acetylsalicylic acid and placebo groups at 12-14 weeks of gestation, with 43 women in both groups followed up successfully. 9 alpha,11 beta-prostaglandin F2 was determined at baseline, at 24-26, and at 32-34 weeks of gestation. Fifteen normotensive non-pregnant women, 17 normotensive pregnant women at 12-14, and 15 at 30-34 weeks of gestation served as controls. Urinary 9 alpha,11 beta-prostaglandin F2 was significantly higher in pregnant women at 12-14 weeks of gestation as compared to non-pregnant women. High risk pregnancies had higher 9 alpha,11 beta-prostaglandin F2 as compared to normotensive pregnancies at 12-14, and at 30-34 weeks of gestation. Urinary 9 alpha,11 beta-prostaglandin F2 increased throughout pregnancy unrelated to the outcome of the pregnancy or to the treatment.     

Labour is still painful after prepared childbirth training.

Labour pain was measured with the McGill Pain Questionnaire in 87 primiparas and 54 multiparas. The average intensity of labour pain ranked among the most intense pains recorded with the questionnaire. However, the pain scores had a wide range and were influenced by several medical and social variables. They were significantly higher for the primiparas than for the multiparas. Moreover, high pain levels were associated with a history of menstrual difficulties and lower socioeconomic status. The primiparas who had received prepared childbirth training had lower pain scores than those who had received no such training. Nevertheless, the effects of prepared childbirth training were relatively small, and most patients (81%) who received it requested epidural anesthesia. Because many women who received training suffered severe pain during labour, prepared childbirth training and epidural anesthesia should be regarded as compatible, complementary procedures.     

Effect of Passive Leg Raising on Systemic Hemodynamics of Pregnant Women: A Dynamic Assessment of Maternal Cardiovascular Function at 22–24 Weeks of Gestation

Objective

To investigate functional hemodynamic response to passive leg raising in healthy pregnant women and compare it with non-pregnant controls.

Materials and Methods

This was a prospective cross-sectional study with a case-control design. A total of 108 healthy pregnant women at 22–24 weeks of gestation and 54 non-pregnant women were included. Cardiac function and systemic hemodynamics were studied at baseline and 90 seconds after passive leg raising using non-invasive impedance cardiography.

Main outcome measures

Trends and magnitudes of changes in impedance cardiography derived parameters of cardiac function and systemic hemodynamics caused by passive leg raising, and preload responsiveness defined as >10% increase in stroke volume or cardiac output after passive leg raising compared to baseline.

Results

The hemodynamic parameters in both pregnant and non-pregnant women changed significantly during passive leg raising compared to baseline, but the magnitude and trend of change was similar in both groups. The stroke volume increased both in pregnant (p = 0.042) and non-pregnant (p = 0.018) women, whereas the blood pressure and systemic vascular resistance decreased (p<0.001) following passive leg raising in both groups. Only 14.8% of pregnant women and 18.5% of non-pregnant women were preload responsive and the difference between groups was not significant (p = 0.705).

Conclusion

Static measures of cardiovascular status are different between healthy pregnant and non-pregnant women, but the physiological response to passive leg raising is similar and not modified by pregnancy at 22–24 weeks of gestation. Whether physiological response to passive leg raising is different in earlier and later stages of pregnancy merit further investigation.     

Specific antigen of granular cells of the human endometrium

Rabbits were immunized by homogenates of endometrium obtained from women during 10-12 weeks of gestation. A specific antiserum was obtained by absorption of the crude antiserum by blood cells and plasma proteins of men with different kinds of ABO and Rh antigens, till disappearance of positive reaction with men's serum protein in the Ouchterlony test. Such an adsorbed specific antiserum continued to react with the sera of pregnant women. Two antigens, numbers 1 and 2, respectively, were determined by the Ouchterlony test. Another group of rabbits was immunized by antigens detected in the precipitation test. A monospecific antidecidual antiserum (ADS 1092) was obtained against number 2 antigens. This antiserum revealed only one antigen in sera of women with gestation and did not react with sera of non-pregnant women. In the slides of endometrium of pregnant women of 10-12 weeks of gestation ADS 1092 had a strong positive reactive with the cytoplasm of one type of endometrium cells. The immunomorphological analysis by the non-direct Coons test and the PAP-test permits to identify cells with the positive reaction as granular cells. It is concluded that the granular cells may be a source of one of the serum antigens detected in women with gestation.     

Plasma levels of the immunomodulatory cytokine interleukin-10 during normal human pregnancy: a longitudinal study

Pregnancy is proposed to be a Th2 phenomenon, where Th2 cytokines inhibit Th1 responses to improve foetal survival. The importance of interleukin-10 (IL-10), an immunomodulatory cytokine produced by Th2 cells, in the maintenance of normal pregnancy is becoming increasingly apparent. In a longitudinal case-control study, the physiological effect of pregnancy on plasma IL-10 was investigated. The plasma concentration of IL-10 was determined using an ELISA technique in 99 pregnant women sampled at 12, 20 and 35 weeks of gestation, 38 non-pregnant control subjects sampled in parallel and in a subgroup of women sampled at 3 days post-partum (n, pregnant 21, non-pregnant 21). Plasma IL-10 was significantly higher in pregnant women at 12, 20 and 35 weeks of gestation (p<0.05, p<0.01 and p<0.0001, respectively), and in mothers post-delivery (p<0.01) when compared to non-pregnant control subjects. Furthermore, there was no significant effect of gestational time on IL-10 concentration. Results from the current study suggest that elevated IL-10 is a physiological consequence of normal healthy pregnancy. These findings help clarify previous conflicting results and establish a range for plasma levels of IL-10 in normal healthy pregnancy.     

Serum reference levels of selenium,zinc and copper in healthy pregnant women at a prenatal screening program in southeastern mediterranean region of Turkey

ProjectThe aim of the study was to investigate the serum reference range for Selenium (Se), Zinc (Zn) and Copper (Cu) levels in women of 10–14 (group I) and 16–20 (group II) weeks of gestation and compare them with those in non-pregnant healthy women and healthy men.ProcedureThis cross-sectional study was performed in 351 pregnant women [group I (n: 177) and group II (n: 174)], 30 non-pregnant women and 30 men as controls. The levels of Se, Zn and Cu levels were determined on flame and furnace atomic absorption spectrophotometer using Zeeman background correction.ResultsIn the 10–14 weeks of gestation Se, Zn and Cu serum levels were 44.85±9.23, 81.30±31.94 and 132.33±38.24 ug/dl, in 16–20 weeks of gestation were 47.18±10.92, 74.25±22.47 and 164.86±39.69 ug/dl, in non-pregnant women were 55.38±8.81, 121.41±29.22 and 104.75±39.14 ug/dl also in men 72.24±9.28, 134.85±15.95 and 78.29±20.90 ug/dl, respectively.ConclusionA significant low level of serum Se, Zn and a high level of Cu in the pregnant women in the 10–14 and 16–20 weeks of gestation were detected when compared with that of non-pregnant women and men.     

Plasma lipids and apolipoproteins A and B in human pregnancy

A cross sectional study was carried out in 200 normal pregnant women between 8-40th weeks of gestation, 25 women during delivery and 25 women 6 weeks after delivery. Plasma and lipoprotein lipids were measured using standard procedures. Apolipoprotein A (Apo A) and Apolipoprotein B (Apo B), were measured by electroimmunoassay. Plasma levels of Apo A were elevated in pregnant women but the elevations were not significant until 17-20 weeks of gestation. Apo A during pregnancy was significantly correlated (p less than 0.001) with high density lipoprotein cholesterol (HDL-C). The level of Apo B increased progressively during pregnancy and it was significantly correlated (p less than 0.001) with total cholesterol (TC), plasma triglycerides (TG) and phospholipids (PL). Apo A and Apo B levels returned to non pregnant values within the puerperium, whereas TC, TG and PL remained significantly elevated above controls (p less than 0.01) 6 weeks post partum.     

Correlations of pedometer readings with energy expenditure in workers during free-living daily activities

In a total of 23 subjects consisting of 10 clerical and 13 assembly workers in a factory, the pedometer readings during a day of free-living activity were analyzed for the relation with energy expenditure as determined by the simultaneously recorded 24-hour heart rate. The 24-hour energy expenditures in the clerical and assembly workers were 9515 kJ (2274 kcal) and 9698 kJ (2318 kcal) respectively. The whole day readings of the pedometer for all the subjects moderately correlated (r = 0.438, p less than 0.05) with the net energy cost (NEC) as determined by subtracting the sleeping metabolic cost from the energy expenditure (clerical workers: r = 0.781, p less than 0.01; assembly workers: r = 0.188, p less than 0.05). The correlation analysis of the pedometer readings with the NEC in three activity phases in a day (work, commuting and staying at home), showed that the extent of the relationship differed by job types and activity phases. The best correlation was obtained during commuting in both of the job types (clerical workers: r = 0.843, p less than 0.01; assembly workers: r = 0.743, p less than 0.01). During work, a quite strong correlation (r = 0.889, p less than 0.01) was obtained with the clerical workers but not with the assembly workers. No significant correlations were found in the data while the subjects were at home. The capacity of the pedometer to detect the impacts of body movements, and the characteristics of activity, are responsible for the differences in correlation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Assessing pedometer accuracy while walking, skipping, galloping, sliding, and hopping

The purpose of this study was to determine the accuracy of the pedometer when walking, skipping, galloping, sliding, and hopping. One hundred-two college students were fitted with a pedometer (Walk4Life LS-7010) at mid-thigh on the right and left of the hip. Participants then performed the randomly assigned movements for the length (26 m) of a hardwood court playing surface, during which time the investigator tallied the steps with a hand counter. Each step with the lead foot elicited a tally on the counter. Participants were instructed to perform the movement at a brisk pace, to jump-stop at the end of the court, and to remain still until after the pedometer reading was recorded. Repeated measure ANOVAs using the Bonferroni technique were used to compare differences between pedometer counts and hand counts. Significant differences were evident between the hand tally counts and readings from the right and left pedometers during all five locomotor movements (P < .01). Mean error was lowest between the hand tally and the average of the right and left pedometers while walking (-1.35 +/- 1.60) and hopping (-2.94 +/- 2.33), and increased while sliding (-6.42 +/- 4.78), galloping (-8.22 +/- 4.63), and skipping (-8.30 +/- 4.45). Results indicate the pedometer may not consistently register the vertical force produced by the trail foot contact, the lead foot contact, or a combination of the two while skipping, galloping, and sliding. Though the pedometer is a valid instrument when estimating physical activity levels, caution is urged when interpreting movements other than walking.     

Pregnant women exaggerate cautious gait patterns during the transition between level and hill surfaces

Falls are the leading cause of nonfatal injury across all age groups and a common incident for pregnant women. Thus, there is a critical demand for research to evaluate if walking strategies in pregnant women change throughout pregnancy in order to effectively intervene and minimize the incidence rate. The aim of the present study was to analyze modifications in temporal–spatial parameters as well as muscle activity during hill walking transitions in pregnant women between gestational week 20 and 32. Based upon previous literature, we hypothesized that in comparison to level walking, the transition strides of pregnant women would be distinct between trimesters in order to accommodate the physical changes within twelve weeks. Thirteen pregnant women completed a series of randomly assigned walking conditions on level and hill surfaces during gestational week 20 and 32. Our results demonstrated that pregnant women modulated their gait patterns throughout pregnancy with additional joint flexion as well as muscle activity at the ankle, knee and hip. In summary, pregnant women exaggerate cautious gait patterns by walking slower and wider with greater joint flexion and muscle activity in order to safely transition between level and hill surfaces.     

Digestibility of macronutrients and nitrogen balance in pregnant rabbits

Primiparous New Zealand White does have been used to establish the weekly differences of several apparent digestibility coefficients (CDA) and the nitrogen balance, between pregnant and non-pregnant does, as well as the evolution of the same parameters along the state of gestation. The intake was 180 g/animal and day at the most. The results show that protein followed by dry matter CDAs were the most negatively affected in pregnant does with regard to the non-pregnant ones and throughout the gestation. For the other CDAs, the differences were only significant in the fourth week between pregnant and non-pregnant does, and also with regard to the remaining weeks of gestation. In this way, the organic matter and carbohydrate CDAs were lower whereas the fat one became higher. In relation to nitrogen balance, it was meaningfully greater in the third week of pregnancy with respect to the control animals. Also, a gradual increase may be observed throughout the gestation state, being especially important in the third and fourth week.     

Maternal testosterone and fetal sex

To investigate the influence of fetal sex on maternal testosterone levels throughout pregnancy, blood was sampled from 37 healthy pregnant women from week 14 until term and at 6 weeks postpartum. Testosterone concentrations were measured with a highly specific RIA after chromatographic purification. Mean (+/- SD) testosterone at the end of gestation was significantly higher compared to non-pregnant values (3.10 +/- 2.38 mM/l, n = 32 vs 1.14 +/- 1.06 nM/l, n = 35). It appeared that in women carrying a male fetus testosterone levels gradually increased during pregnancy up to 3.99 +/- 2.72 nM/l. In women carrying a female fetus the levels decreased after the first trimester from 2.44 nM/l to 1.80 nM/l. A statistically significant difference (P less than 0.01) existed in maternal testosterone concentrations between both groups during the second half of pregnancy.     

Seasonal variations in prolactin, growth hormone and thyroid hormones and the prolactin surge at ovulation do not affect litter size of ewes during pregnancy in the oestrous or the anoestrous season

Injection of bromocriptine from 5 days before until 5 days after mating clearly suppressed the periovulatory prolactin surge in ewes in the anoestrous and oestrous season but did not change the litter size significantly. Progesterone, GH, TSH or thyroid hormone concentrations were not influenced by the bromocriptine treatment. The progesterone concentrations were lower during the first weeks after mating in the anoestrous season compared to the oestrous season, while there was no difference between pregnant and non-pregnant ewes. During later gestation this seasonal difference was only observed in the non-pregnant ewes. At the same time there was a clear difference between pregnancy and non-pregnancy in both seasons. The prolactin, GH and thyroid hormone values also varied significantly during gestation. Since these patterns are identical in pregnant and non-pregnant ewes, the fluctuations are due to environmental factors and not to pregnancy or altered progesterone concentrations. In the anoestrous season prolactin, GH, T4 and T3 levels were higher than in the breeding season, while rT3 showed the opposite pattern. The TSH concentration did not differ between the two seasons. These results suggest that seasonal variations in prolactin, GH and thyroid hormones or the periovulatory prolactin surge do not affect litter size of ewes during pregnancy in the oestrous or the anoestrous season.     

Effects of early pregnancy on regional adipose tissue metabolism

Adipose tissue metabolism was studied in needle biopsies from femoral and abdominal subcutaneous depots, in 12 healthy young women, during early (9-11 weeks) pregnancy, and 6 weeks after a legal abortion. Both during pregnant and non-pregnant conditions, a higher lipoprotein lipase (LPL) activity was seen in the femoral compared to the abdominal region, but the LPL activity was not influenced by early pregnancy. Rates of fatty acid esterification and acylglyceride synthesis were not different between regions, nor affected by pregnancy. The stimulatory effect of norepinephrine (10(-7) M) on lipolysis was significantly greater in the abdominal than in the femoral region in both the pregnant and non-pregnant condition. This difference was apparently due to higher alpha-adrenergic activity in the femoral region. Pregnancy per se had no effect on lipolytic response to norepinephrine. These findings indicate that lipid accumulation is favoured in the femoral region in young women both during pregnant and non-pregnant conditions.     

Differences in the pattern visual evoked potential between pregnant and non-pregnant women

It has been proposed that latencies of some components of the pattern-reversal visual evoked potential (PRVEP) are shorter in women than in men because of differences in levels of circulating sex steroids. Pregnancy is a time when serum levels of oestrogen and progestogen are considerably greater than in the non-pregnant state. Whole and half field PRVEP latencies and amplitudes have been compared in 16 pregnant and 38 healthy non-pregnant women. The mean P100 latencies for all responses were shorter in the pregnant women, with statistically significant differences for the left eye whole field latency (P < 0.05) and the left eye right and left half field latencies (P < 0.005 and P < 0.05, respectively) and the right eye right half field latency (P < 0.05). The latencies in women in the pregnant group showed a negative correlation with gestation, which reached statistical significance for the REWF (r = −0.55, P < 0.05). These observed differences in PRVEP latencies in pregnant and non-pregnant women and the association between latency and gestation are likely to be due to differences in circulating sex steroids, and this effect may be the principal reason for latency differences between the sexes.