Antibodies against beta 2-glycoprotein I (beta 2-GP I) and their relationship to fetoplacental antigens

Binding of beta 2-GP I to anionic phospholipids is thought to be the major antigen required in the reaction of anticardiolipin antibodies to phospholipids. The aim of this study was to investigate the changes of anti-beta 2-GP I IgG during the first and second trimester of pregnancy and the relationship between the levels of anti-beta 2-GP I and fetoplacental antigens and the correlation between anti-beta 2-GP I IgG and antibodies against oxidized low-density lipoprotein IgG (oLAb) in serum of pregnant women. We determined anticardiolipin antibodies (ACA) IgG and maternal serum levels of alpha 1-fetoprotein (AFP), human chorionic gonadotrophin (HCG) and trophoblast-specific beta 1-glycoprotein (SP1) in 204 pregnant women in the first and second trimester. From this group we selected 52 serum samples positive for ACA IgG and 16 samples negative for ACA IgG. In the samples of selected patients, the levels of anti-beta 2-GP I IgG and oLAb IgG were determined. Anti-beta 2-GP I IgG levels significantly decreased in the second trimester (6.2+/-9.3 U/ml, mean +/- S.D.) in comparison with the first trimester (8.3+/-10.4 U/ml) (p=0.05). Multiple of median (MoM) AFP correlated negatively but not significantly in the first trimester with anti-beta 2-GP I (r = -0.261, p = 0.12). In the second trimester this correlation was significantly negative (r = -0.278, p = 0.04). The Spearman correlation coefficients for MoM HCG and anti-beta 2-GP I were 0.158 for the first trimester and 0.174 for the second trimester. MoM SP1 also did not correlate significantly with anti-beta 2-GP I in both trimesters. The correlation between anti-beta 2-GP I IgG and oLAb IgG was not significant (r = -0.06). In the first trimester 40 % serum samples were positive for anti-beta 2-GP I IgG and negative for oLAb IgG or vice versa, while 60 % samples in the second trimester were positive only for one determined autoantibody. We can conclude that the levels of anti-beta 2-GP I IgG decrease during the second trimester probably as the result of the effects of some immunosuppressive agents associated with pregnancy. The finding of negative correlation between AFP and anti-beta 2-GP I suggests that anti-beta 2-GP I has an influence on fetus development.     

Prevalence of various antiphospholipid antibodies in pregnant women

Antiphospholipid antibodies (APAs) are characterized as a heterogeneous population of autoantibodies directed against different target antigens, predominantly anionic phospholipids or phospholipid-containing structures. The presence of APAs has been strongly associated with a variety of clinical disorders including adverse pregnancy complications such as spontaneous abortions, pregnancy-induced hypertension, preeclampsia and intrauterine growth retardation. The purpose of this study was to compare the prevalence of anticardiolipin antibodies (ACAs), which are routinely examined, with APAs directed against phosphatidylserine (APS), phosphatidylinositol (API), phosphatidylethanolamine (APE) and phosphatidylcholine (APC) in the sera of pregnant women. We examined 410 serum samples of pregnant women hospitalized in the department for pathological pregnancies. They underwent prenatal biochemical screening of fetal congenital abnormalities in the first and the second trimester of gravidity. Anticardiolipin IgG and IgM were measured using commercial ELISA kits (ImmuLisa Anti-Cardiolipin Antibody), whereas APS, APE, API and APC were determined by our modified ELISA kit. Among 410 pregnant women we found 21 patients (5.1%) positive for ACA IgG (>20 GPL) and 30 patients (7.3%) positive for ACA IgM (>10 MPL). It was found that 7.8% of pregnant women had at least one high-titer APA IgG and 9.8% high-titer APA IgM. One third of ACA IgG or IgM positive sera contained polyspecific autoantibodies reactive to at least two various phospholipids. In the group of IgG ACA positive women, 28.6% patients were positive for APS, 28.6% were positive or moderately positive for API, 23.8% for APC and 19% for APE. In the group of IgM ACA positive women, 33.3% were also positive for APS, 26.7% for APE, 26.7% for API and 23.3% for APC were present. IgG and IgM ACA negative patients exhibited a significantly lower incidence of other APA than the group of ACA positive pregnant women. It still remains to clarify if the routine examination of APA reacting with other anionic and zwitterionic antigens other than cardiolipin would improve the probability of identifying women liable to adverse pregnancy complications.     

Development of an inexpensive and rapid two site microenzyme linked immunosorbent assay kit for human alpha fetoprotein

Laboratory scale development of a two site micro enzyme linked immuno assay kit is described. The kit comprises rabbit anti human alphafetoprotein (AFP), anti human AFP IgG peroxidase conjugate and standard AFP. All the above reagents were prepared in the laboratory. The kit is eminently suitable for early screening of blood sample of pregnant women for neural tube defects of their fetuses and for the quantitation of AFP as a tumor marker. The assay kit was used to determine AFP in 76 sera from women at different stages of pregnancy. During 1st trimester AFP level was 18 to 119 ng/ml, during 2nd trimester the concentration varied from 85 to 302 ng/ml and during 3rd from 103 to 580 ng/ml. No evidence for maternal antibody to AFP was found. The above data agree with AFP level in pregnant women reported by earlier workers, using RIA or ELISA. The present ELISA kit would hopefully be much cheaper than internationally available ELISA kits for human AFP.     

Association of obestatin with blood pressure in the third trimesters of pregnancy

Obestatin is a recently discovered 23-amino acid peptide encoded by the same gene that encodes ghrelin. It has been reported that there is a significant negative correlation between the plasma ghrelin concentration and systemic blood pressure in patients with pregnancy-induced hypertension. We investigated the plasma concentration of obestatin in 18 non-pregnant women, 18 normal pregnant women, and 15 patients with pregnancy-induced hypertension. The plasma concentrations of obestatin in these 3 groups of women were 63.4 ± 9.5 pg/ml, 38.1 ± 6.3 pg/ml, and 46.0 ± 9.3 pg/ml, respectively. In non-pregnant women, there was no correlation between the plasma obestatin concentration and the mean arterial pressure. However, there was a positive correlation between the plasma obestatin concentration and the mean arterial pressure in normal pregnant women and pregnant women with pregnancy-induced hypertension. These results suggest that obestatin may have some potential role in the regulation of blood pressure in normal pregnant women and women with pregnancy-induced hypertension.     

1200例孕中期产前筛查结果的回顾性分析

目的：评价孕妇血清标记物（甲胎蛋白AFP、β-绒毛膜促性腺激素β-hCG和雌三醇uE3）的孕中期三联筛查在临床中的应用价值。方法：采用酶联免疫吸附法（ELISA）对1200例孕中期（14～22周）孕妇进行血清标记物AFP、β-hCG和uE3的检测,结合孕龄、孕周、体重等因素,经专门的筛查分析软件,计算唐氏综合征,18三体及神经管缺陷（NTD）的风险率。如孕妇为高风险,则进行胎儿的超声检查和染色体核型分析的产前诊断。结果：在1200例孕妇中,筛查高风险的孕妇有73例,其中唐氏综合征,18三体,NTD高风险孕妇分别为65例,5例和3例,假阳性率为6.08%（73/1200）。其中59例接受了产前诊断,占高风险孕妇的80.8%（59/73）。共检出1例唐氏综合征儿和1例无脑儿,未发现18三体,检出率为100%（2/2）,未有漏诊的情况。妊娠不良结局在筛查高风险组和低风险组的比率分别为17.1%和1.32%,两组有显著性差异（P〈0.01）。结论：利用孕妇血清标记物（AFP、β-hCG和uE3）的孕中期无创伤性产前筛查,结合产前诊断,对减少出生缺陷儿的出生,具有重要意义,并且高风险的筛查结果对胎儿的预后有一定的提示作用。     

妊娠高血压外周血中促Th2的细胞因子水平及IL-2／IL-10平衡的临床意义

目的：检测妊娠高血压患者外周血中促Th2的分子IL-4、IL-2与IL-10的水平,探讨IL-2／IL-10在妊高症中的临床意义。方法：选择40例未妊娠妇女为对照组,30例正常妊娠妇女为妊娠组,28例妊娠高血压患者为妊娠高血压组,ELISA检测血清中IL-4、IL-2和IL-10的水平。结果：与对照组外周血中IL-4水平（0．53±0．04）pg／ml相比：正常妊娠组IL-4水平升高至（0．91±0．03）pg／ml（P〈0．05）,妊娠高血压组IL-4水平（0．67±0．35）pg／ml升高但明显低于正常妊娠组（P〈0．01）。与对照组外周血中IL-2水平（0．41±0．05）pg／ml相比：正常妊娠组IL-2水平升高至（0．82±0．11）pg／ml（P〈0．01）;妊娠高血压组IL-2水平高达1．57±0．22（pg／m1）明显高于其它两组（P〈0．01）。妊娠高血压组外周血中IL-10水平明显低于正常妊娠组IL-10水平（P〈0．01）;妊娠高血压组外周血中IL-2／IL-10比值明显高于于对照组及正常妊娠组的比值。结论：妊娠高血压患者外周血中细胞因子IL-2和IL-10分泌异常且诱导Th2细胞产生的IL-4降低,打破Th1／Th2平衡,致使Th1型免疫反应增强,使早孕期滋养细胞受到免疫损伤以致侵入能力下降,导致妊娠期高血压疾病的发生。     

Occurrence of Hepatitis C Virus infection in type 2 diabetic patients attending Plateau state specialist hospital Jos Nigeria

Background

Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of antibodies to HEV in Ghana is not known. Therefore we evaluated the prevalence of anti-HEV IgG and anti-HEV IgM among pregnant women seen between the months of January and May, 2008 at the Obstetrics and Gynaecology Department, Korle-Bu Teaching Hospital, Accra, Ghana.

Results

One hundred and fifty-seven women provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV. The median age of participants was 28.89 ± 5.76 years (range 13–42 years). Of the 157 women tested, HEV seroprevelance was 28.66% (45/157). Among the seropositive women, 64.40% (29/45) tested positive for anti-HEV IgM while 35.60% (16/45) tested positive to HEV IgG antibodies. HEV seroprevalence was highest (46.15%) among women 21–25 years of age, followed by 42.82% in = 20 year group, then 36.84% in = 36 year group. Of the 157 women, 75.79% and 22.92% were in their third and second trimesters of pregnancy, respectively. Anti-HEV antibodies detected in women in their third trimester of pregnancy (30.25%) was significantly higher, P < 0.05, than in women in their second trimester of pregnancy (25.0%).

Conclusion

Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection in pregnant women.     

A monoclonal antibody with potential for aiding non-invasive prenatal diagnosis: utility in screening of pregnant women at risk of preeclampsia.

The development of a non-invasive method of prenatal diagnosis in maternal blood has been the goal of our investigations during the last years. We have developed several anti-CD71 monoclonal antibodies and optimized a protocol for the isolation of nucleated red blood cells (NRBC) from peripheral maternal blood. The enhanced traffic of fetal erythroblasts into the maternal circulation in preeclampsia has been investigated by several groups. In this study, we compared one of our antibodies, 2F6.3, with a commercial anti-CD71 antibody in blood samples from pregnant women suffering pregnancy-induced hypertension (PIH) and in a control group of pregnant women without clinical features suggestive of an increased risk of developing preeclampsia. The mAb 2F6.3, developed by our group, has succeeded in isolating a significantly higher number of erythroblasts with less maternal cell contamination than the commercial antibody in both women with PIH and in the control group (p<0.01; Wilcoxon Signed Ranks Test). Fluorescence in situ hybridization analysis also demonstrated that 2F6.3 is a better antibody for the isolation of fetal NRBC in maternal blood than the commercial anti-CD71 antibody.     

Metabolic syndrome in type 1 diabetes mellitus. Does it have any impact on the course of pregnancy?

To determine whether the symptoms of metabolic syndrome (MS), if accompanied by oxidative stress (OS), in type 1 diabetes mellitus (DM) patients could affect the course of pregnancy and the perinatal outcome. Oxidized low density lipoproteins (ox-LDL) and total lipid peroxides (TLP) were studied in 98 pregnant women with type 1 DM in the I(st) and III(rd) trimesters. 24% of the participants met the criteria of MS. Vascular complications were significantly more frequent in the MS-group (41.9% vs. 17.4% in the non-MS group, p<0.05). No differences in the markers of OS between the MS and the non-MS groups were noted in either the I(st) or the III(rd) trimester. A significant gestational rise in Per-Ox was found in both groups. Chronic hypertension was associated with significant differences in ox-LDL levels in both the I(st) and III(rd) trimester. No differences in perinatal outcome, as measured by abnormal birth weight or poor neonatal status (Apgar score<6, umbilical venous and/or arterial pH<7.20), were found. Conclusions: 1) MS in type 1 DM is associated with some changes in markers of oxidative stress, but it poses no additional risk to the course of pregnancy and perinatal outcome in properly controlled and treated pregnant women with type 1 DM. 2) Maternal hypertension is the only component of MS in diabetic pregnancy that is associated with significant changes in markers of oxidative stress. 3) MS is significantly more frequent in diabetic pregnant women with co-existing vascular complications and obesity.     

Zinc and copper concentrations in serum from Spanish women during pregnancy

A cross-sectional study of serum zinc (Zn) and copper (Cu) levels in 31 healthy pregnant women and 51 healthy, nonpregnant controls living in the Mediterranean area of Granada, Spain, was performed. The subjects were divided into two groups: Group A, consisted of pregnant women in three categories according to the trimester of pregnancy, and Group B consisted of nonpregnant women acting as controls. In pregnant women, serum Zn levels were found from 0.300-1.340 mg/L and serum Cu from 0.936-2.304 mg/L, whereas in the nonpregnant women group, the mean serum levels were 0.947 ±0.265 mg/L for Zn and 1.092 ±0.365 mg/L for Cu. Serum Zn progressively decreased with gestation. Mean Zn levels were 0.829 ±0.253, 0.846 ±0.329, and 0.620 ±0.142 mg/L, corresponding to the first, second, and third trimesters of pregnancy, respectively. Serum Zn concentrations were significantly lower in pregnant women as compared to controls: 0.712 ±0.236 mg/L vs 0.947 ±0.265 mg/L, respectively (p < 0.05). In contrast, Cu levels increased with period of gestation from 1.053 ±0.498 mg/L in the first trimester to 1.616 ±0.304 mg/L in the second and 1.689 ±0.344 mg/L in the third. Serum Cu levels in the second and third trimesters of pregnancy were significantly higher (p < 0.05) than those determined during the first trimester and for nonpregnant controls. Both Zn and Cu during pregnancy did not appear to be dependent on the subject’s age (p > 0.05).     

The concentrations of urinary prostaglandins E and plasma prostaglandins F2α and E during induction of ovulation with human gonadotropins

Plasma prostaglandins F₂α and E (PGF₂α, PGE) and urinary PGE were measured in 10 women treated with human gonadotropins (HMG) and subsequently with human chorionic gonadotropins (HCG). Five women became pregnant (6 pregnancies). There was no correlation between concentrations of plasma PGF₂α or PGE and plasma estradiol or progesterone. Urinary PGE concentrations showed a positive correlation with estradiol before HCG and a negative correlation with progesterone after HCG, only in women who subsequently became pregnant.Higher urinary PGE concentrations before HCG suggest that either HMG or rising estradiol levels stimulate PGE renal production. The significant negative correlation.between urinary PGE and progesterone concentrations, after HCG, in those patients who became pregnant suggests that ovarian production of progesterone may decrease renal production of PGE.     

Performance of the immunoglobulin G avidity and enzyme immunoassay IgG/IgM screening tests for differentiation of the clinical spectrum of toxoplasmosis

Toxoplasmosis has been well known as an important human infection to consider especially in pregnant women. Although many serologic methods are available, the diagnosis of toxoplasmosis can be extremely difficult. The presence of increased levels of Toxoplasma-specific IgG antibodies indicates an infection, but it does not differentiate between a recent and past infection. The purpose of our study was to compare the performance of the ELISA T. gondii IgG/IgM test, a widely used enzyme-linked immunosorbent assay, to the ELISA IgG avidity method. One hundred and four serum samples (from 38 males and 66 females) were tested and evaluated from symptomatic patients (chorioretinitis, lymphadenopathy), and from women in their first trimester of pregnancy who were suspected of having toxoplasmosis. The high IgG avidity and ELISA IgG antibody levels were in agreement for 51 of the specimens (49.0%). Thirty-eight discrepant (borderline) results from the IgG avidity method were positive for IgM (3 specimens) and IgG (37 specimens). Interestingly, out of the eight serum samples that were positive for both IgG and IgM antibodies, two samples were low IgG avidity, and three samples were borderline. There was no statistically significant relation observed between the results of the IgG avidity method and the ELISA IgG test, and the IgG avidity method and ELISA IgM test (chi2 = 1.987; p = 0.370 and chi2 = 2.152; p = 0.341, respectively). The IgG avidity method was considered easy to perform and an acceptable approach for the differentiation of discrepant results (recent/chronic) and for the current detection of T. gondii antibodies. We concluded that the determination of IgG avidity is a helpful tool for the diagnosis of the ocular form of toxoplasmosis and it is a safe method for screening this disease in the first trimester of pregnancy.     

Determination of specific immunoglobin G avidity in serodiagnosis of toxoplasmosis

A total of 37 serum samples from pregnant women were examined for the avidity of toxoplasma IgG antibodies using commercially available enzyme immunoassay (Vidas Toxo IgG Avidity, bio Merieux). Low values of the avidity index were found for 4 samples and borderline ones were found in further 3 cases. Out of 19 serum samples showing the presence of IgG and IgM toxoplasma antibodies, 13 had high avidity index, including 9 samples from women in the first trimester of pregnancy. The results of examinations in these 9 cases allowed to exclude the possibility that toxoplasma infection was acquired during gestation. It is to be concluded that determinations of antitoxoplasma IgG avidity should become routine in every pregnant woman positive in the test for specific IgM antibody.     

Sodium outflow rate through lymphocyte cellular membranes in women with arterial hypertension caused by pregnancy and in health pregnant women]

Ouabain- and furosemide-dependent rate of sodium outflow through lymphocytes cellular membranes was measured in both healthy pregnant women and those with arterial blood hypertension caused by pregnancy. It was shown, that ouabain-dependent sodium outflow rate is decreased in healthy women in the I, II, and III trimester of pregnancy, while in women with arterial hypertension in the III trimester. No difference in sodium outflow rate both total and furosemide-dependent in healthy pregnant women during the I, II and III trimester, and in pregnant women with arterial hypertension due to pregnancy in the III trimester was noted. No difference in sodium outflow rate was noted in pregnant women with the arterial hypertension due to pregnancy with familial history of the hypertension.     

Anthropometric and body composition characteristics during pregnancy: A study from West Bengal,India

The present cross-sectional study was aimed at investigating changes in anthropometric, body composition and blood pressure characteristics during pregnancy. A total of 406 healthy, pregnant women aged between 16 and 33 years participated in the study. Pregnant women were recruited from the outpatient department of the two-referral hospital in Bolpur subdivision of Birbhum district, West Bengal, India. Anthropometric measures such as height, weight, three circumferences and skinfold thickness at four sites (biceps, triceps, subscapular and suprailaic) were obtained using standard techniques. Percentages of body fat (%BF), intra abdominal visceral fat (IVF), basal metabolic rate (BMR) and body mass index (BMI) were measured using an Omron body fat analyser. Two forenoon blood pressure measurements were also taken and averaged for analysis. Subjects were categorized into three trimester groups: Group I, n = 30; Group II, n = 163; and Group III, n = 213. ANOVA with Scheffe's post-hoc test revealed that Group I had significantly lower mean than both Group II and Group III for systolic blood pressure and IVF, whereas Group I had significantly lower mean than Group III for BMI, BMR, %BF, diastolic blood pressure and skinfolds. The mean change in maternal weight from the first to the third trimester was merely 3 kg. Mean waist circumference varied from the first to the third trimester but not from the first to the second trimester. Furthermore, significantly increased systolic and diastolic blood pressure was observed across the trimesters. However, longitudinal studies involving interaction of body fat topography and pregnancy-induced hormones are required to further our understanding of gestation mechanism.     

Selenium and malondialdehyde content and glutathione peroxidase activity in maternal and umbilical cord blood and amniotic fluid

Placenta tissue may be a major source of lipid peroxidation products in pregnancy. It was proven that placental peroxidation activity increases with gestation. Selenium (Se), as an essential constituent of glutathione peroxidase (GSH-Px), takes part in the reduction of hydrogen peroxides and lipid peroxides. Malondialdehyde (MDA) is a major breakdown product split off from lipid peroxides. In this study, Se and MDA content and GSH-Px activity were measured in blood and plasma taken from 20 apparently healthy nonpregnant women between 19 and 38 yr of age and from 115 unselected pregnant women between 17 and 45 yr of age (35 in the first trimester, 22 in the second trimester, 38 in the third trimester, and 20 within 2 d of delivery). Samples of umbilical cord blood and amniotic fluid were taken from women in the second and third trimesters and at delivery. The Se content was measured by atomic absorption spectrometry (AAS), plasma MDA concentration by thiobarbituric acid reaction, and Se-dependent GSH-Px spectrometrically. Blood and plasma Se contents of nonpregnant women were below those considered adequate, indicating low selenium intake. In comparison to nonpregnant women, pregnant women had significantly decreased whole-blood and plasma Se levels in the second and third trimesters and at delivery. The significant drop of whole-blood SeGSH-Px activity was observed in the first trimester of pregnancy and its lower activity was maintained until delivery. A significant drop in plasma SeGSH-Px activity occurred in the second trimester and attained the minimal level at delivery. The Se level and SeGSH-Px activity in maternal and umbilical cord blood were at similar levels. Amniotic-fluid SeGSH-Px activity was nondetectable or exceptionally low and its Se content remained unchanged during pregnancy. Plasma levels of MDA were significantly decreased in the second and third trimesters and at delivery. The fetal blood plasma at birth had a lower MDA level compared to the levels of MDA of their mothers at delivery. A low, but significant inverse correlation existed between blood SeGSH-Px activity and plasma MDA content and between plasma Se and plasma MDA contents during pregnancy. A significant decrease of Se and SeGSH-Px activities (antioxidant enzyme) in both blood and plasma suggests a possible drop in total antioxidant status during pregnancy. Elevated MDA plasma levels might be the result of increased lipid peroxidation in placental tissue during pregnancy.     

Alpha-fetoprotein in Abortion

The clinical value of maternal serum alpha-fetoprotein (AFP) as a guide to the outcome of threatened abortion was assessed. After the thirteenth week of gestation, abortion occurred more frequently (10/12) in women with abnormal serum AFP levels than in those (2/12) whose AFP concentrations were within the normal range. Low levels were present in women with blighted ovum and high concentrations were associated with intrauterine fetal death. In legal first and second trimester abortions, the circulating maternal AFP levels in postabortion samples were often higher than before abortion, irrespective of whether abortion was performed instrumentally or induced with prostaglandins. Maternal serum AFP levels provide a new means for prediction of the outcome of threatened abortion.     

Dynamics of antibody nuclease activity in blood of women during pregnancy and lactation

In human milk we previously found catalytic antibodies (abzymes) catalyzing hydrolysis of DNA, RNA, NMP, NDP, and NTP and also phosphorylation of proteins and lipids. In the present study we have analyzed nuclease activities of antibodies in blood of women during pregnancy and lactation. Blood of healthy male and female volunteers lacked catalytically active antibodies, whereas antibodies from blood of pregnant women hydrolyzed DNA and RNA and their relative activity varied over a wide range. Relative blood abzyme activities significantly increased after delivery and at the beginning of lactation. The highest abzyme activity was observed in blood of parturient women. Although the dynamics of changes in antibody DNase activity during pregnancy was rather individual for each woman, there was a common trend in the increase in antibody activity in the first and/or third trimester of the pregnancy. The DNase activity of IgG and IgM from blood of healthy pregnant women was 4-5 times less than that from pregnant women with pronounced autoimmune thyroiditis.     

Profil des hormones thyroïdiennes chez les femmes enceintes : analyse de 125 cas à l’hôpital général de Yaoundé

This study was aimed at determining the evolution and the kinetics of thyroid hormones in a sub-population of pregnant women in Cameroon. We carried out a prospective study (from January 2005 to January 2006) on 125 consenting pregnant women at the Yaoundé General Hospital. Clinical and gyneco obstetric data with the gestational age were noted on a pre-designed questionnaire. Blood samples were drawn for serum assay of thyroxin (T4), triiodothyronine (T3) and thyroid stimulating hormone. The results were read with the “Oakfield health care” Gamma – 12 counter using the RIASTAT software. These patients, divided into four groups consisted of: 32 non pregnant women in the control group; 33 pregnant women in the first trimester; 30 pregnant women in the second trimester and 30 at the third trimester. The mean serum levels of T3 and T4 were relatively high in all pregnant women (irrespective of the gestational age) than in the control group. Serum levels of T3 and T4 were raised the first trimester with and progressively reduced in 2nd and 3rd trimester. On otherhand, TSH levels progressively increased as from the 2nd trimester to attain a maximum in the 3rd trimester. We can therefore conclude that blood levels of thyroid hormone as well as TSH vary during pregnancy and differ in titres with respect to the gestation age.     

妊娠中期孕妇血糖水平变化与新生儿体质及大脑发育的关系

摘要 目的：探讨妊娠中期孕妇血糖水平变化与新生儿体质及大脑发育的关系。方法：2018年2月到2021年1月选择在本院建档分娩的妊娠中期妊娠期糖尿病(Gestational diabetes,GDM)孕妇105例作为研究对象,根据孕妇血糖控制情况进行分组,孕妇血糖控制较好纳入良好组,其他纳入对照组。调查分娩的新生儿体质、大脑发育情况并进行相关性分析。结果：在105例孕妇中,血糖控制良好85例,控制不良20例。良好组的孕周、年龄、孕前体重指数、孕次、产次等与对照组对比差异无统计学意义(P>0.05)。良好组新生儿分娩第3个月的体重与身长都高于对照组(P<0.05)。良好组新生儿分娩第3个月的MDI与PDI评分都高于对照组(P<0.05)。在105例孕妇中,Spearsman相关分析显示血糖控制水平与新生儿的体重、身长、智力发育指数(Intelligence Development Index,MDI)评分、精神运动发育指数(Intelligence Development Index,PDI)评分等都存在相关性(P<0.05)。多因素Logistic回归分析显示血糖控制水平都为影响新生儿体重、身长、MDI评分、PDI评分的危险因素(P<0.05)。结论：妊娠中期妊娠期糖尿病孕妇血糖控制水平与新生儿体质、大脑发育存在相关性,血糖控制不佳可导致新生儿体质发育缓慢与智力水平下降。