Association between parity and autoimmune thyroiditis in a general female population

Background: Autoimmune thyroid disease (AIT) is more common in females than in males. Furthermore, it is well documented that the risk of thyroid autoimmunity increases during pregnancy and in the postpartum period. The objective of the present study was to analyse the association between parity and AIT by using ultrasound and serological data.

Methods: The study population included 2156 women, aged 20–79 years. Serum thyroperoxidase antibodies (anti-TPO) and thyrotropin levels were measured and thyroid ultrasonography was performed. AIT was defined according to the combined presence of a hypoechogenic thyroid pattern and positive anti-TPO levels (>200 IU/ml). Odds ratios (OR) and 95% confidence intervals (CI) were calculated.

Results: The analyses revealed an association between parity and AIT. Women with at least one pregnancy had increased odds for AIT (OR 4.6 [95%-CI 1.4–15.1], p < 0.05) compared to women who have never been pregnant. Similar results were observed using hypoechogenic thyroid pattern (OR 1.7 [95%-CI 1.0–2.9], p < 0.05) and positive anti-TPO levels (OR 1.8 [95%-CI 1.0–3.3], p = 0.05) as separate dependent variables or using number of births as alternate independent variable.

Conclusion: In this female population we found an association between parity and AIT and conclude that parity appears to be a potential risk factor for AIT.     

自由体位分娩对母婴分娩结局影响的Meta分析

目的:系统评价初产妇在产程中实施自由体位分娩对母婴结局的影响。方法:计算机检索Pub Med、Embase、CENTRAL、Web of Science、CINAHL、CBM、CNKI、VIP、Wan Fang Data数据库中有关自由体位分娩的随机对照试验,检索时间均为建库至2017年4月4日。由2名研究者独立按纳入、排除标准筛选文献、提取资料、评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果:共纳入18项随机对照试验,3 603例患者。Meta分析结果显示:自由体位分娩与常规卧位分娩在总产程时间(MD=-2.98,95%CI:-3.29~-2.68,P0.000 01)、剖宫产率(RR=0.43,95%CI:0.37~0.51,P0.000 01)、自然分娩率(RR=1.33,95%CI:1.27~1.39,P0.000 01)、产后出血发生率(RR=0.25,95%CI:0.15~0.40,P0.000 01)、会阴Ⅲ度裂伤发生率(RR=0.33,95%CI:0.17~0.67,P=0.002)、宫颈裂伤发生率(RR=0.34,95%CI:0.21~0.55,P0.000 01)、新生儿窒息率(RR=0.31,95%CI:0.21~0.47,P0.000 01)、新生儿颅内出血发生率(RR=0.22,95%CI:0.08~0.57,P=0.002)比较,差异有统计学意义;新生儿吸入综合征发生率(RR=0.73,95%CI:0.30~1.80,P=0.50)比较差异无统计学意义。结论:与常规卧位分娩相比,初产妇产程中采用自由体位分娩可缩短总产程时间,提高自然分娩率,降低剖宫产率,减少产后出血、软产道损伤,降低新生儿窒息和颅内出血的发生率,并且不会增加新生儿吸入综合征的风险。但受纳入研究质量限制,上述结论尚需开展更多高质量研究予以验证。     

Number of parity and the risk of non-Hodgkin lymphomas: a dose–response meta-analysis of observational studies

Background: Epidemiological reports have shown that parity is associated with a risk of developing non-Hodgkin lymphomas (NHL). However, the findings have been inconsistent.

Methods: We searched the EMBASE and PubMed databases for eligible studies up to 10 March 2016. Category and generalized least square regression models were used to perform data analyses.

Results: In total, five cohort and seven case–control studies were identified. Categorical analyses indicated that parity number has little association with NHL and its subtypes. In dose–risk analyses, there were no relationships between parity and NHL risk (p_{for association}?=?0.064; n?=?10). The summarized risk ratio (RR) was 0.97 (95% confidence interval (CI): 0.95–1.00; I²?=?57.8%; p_{heterogeneity}?=?0.014; Power?=?0.79) for each additional live birth increase. Similarly, for B-cell NHL, there was a null association between parity and NHL risk (p_{for association}?=?0.121; n?=?5). The combined RR was 0.96 (95% CI?=?0.90–1.03; I²?=?63.7%; p_{heterogeneity}?=?0.026; Power?=?0.71) for each additional live birth. For follicular NHL, there was still a non-significant association identified (p_{for association}?=?0.071; n?=?4), the pooled RR was 1.00 (95% CI?=?0.95–1.07; I²?=?17.3%; p_{heterogeneity}?=?0.305; Power?=?0.26) per additional live birth.

Conclusions: Our data identified little evidence suggesting that high parity is a protective factor against the development of NHL, including its B-cell and follicular subtypes.     

间苯三酚联合缩宫素对需引产分娩的初产妇产程进展和分娩结局的影响

目的 探讨间苯三酚联合缩宫素应用对于需引产分娩的初产妇产程进展、产妇及新生儿分娩结局的影响.方法 选取2019年1月至2020年12月在合肥市第三人民医院需引产分娩的足月单胎初产妇60例,采用随机数字表法分为观察组与对照组,每组30例,对照组单用缩宫素治疗,观察组应用缩宫素联合间苯三酚治疗,收集产妇的产程进展、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率、阴道分娩率和新生儿Apgar评分等,并对两组数据进行比较.结果 观察组第一产程、总产程时间分别为(407.9±125.4)min、(450.5±131.0)min,均显著短于对照组的(663.3±218.2)min、(722.1±223.4)min(P<0.05).两组阴道分娩率、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率的差异无统计学意义(P>0.05).结论 间苯三酚联合缩宫素静滴,可缩短产程,且不影响母婴安全.     

妊娠早期孕妇发生亚临床甲减的影响因素分析

目的调查本地区妊娠早期孕妇发生亚临床甲减(SCH)的患病情况及分析其影响因素。方法采用横断面流行病学调查方法,纳入妊娠早期孕妇2036例,按照TSH、FT4水平分为亚甲减组、正常对照组,描述两组孕妇一般情况,比较两组间实验室检测指标等因素的差异。结果2036例孕妇中亚甲减组116例(5.7%)。亚甲减组年龄、孕次、BMI的均值高于正常组,差异具有统计学意义(P<0.05)。实验室检测指标分析,亚甲减组血清TSH、TG-Ab、CHO水平高于正常组,FT4水平低于正常组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示BMI[OR=2.187(1.593~3.003)]、孕次[OR=2.584(1.184~5.638)]是妊娠早期发生亚临床甲减的危险因素(P<0.05);而FT4[OR=0.630(0.496~0.800)]则是其保护因素(P<0.05)。结论BMI、孕次是妊娠早期亚临床甲状腺功能减退发生的独立危险因素,低水平FT4也是以后发生SCH的危险因素,应积极检测并预防,以降低不良妊娠结局的发生。     

Number of children and change in markers of metabolic health over 9-years in men and women. Data from the DESIR study

Aim

Parity is associated with an increased risk of coronary heart disease and type 2 diabetes, possibly mediated by long-term modification of metabolic health. Studying associations between the number of children with health and disease in men in addition to women allows for differentiation between the social and lifestyle influences of child-rearing, and the biological influences of childbearing. We sought to determine whether the number of children is associated with the incidence of raised fasting glucose (fasting plasma glucose ≥ 6.1 mmol/L) and changes in glucose, insulin, insulin resistance and β-cell function over 9-years.

Methods

Analysis of 1798 women and 1737 men from the DESIR study.

Results

The number of children was associated with change in fasting glucose for women (P_trend = 0.02) and men (P_trend = 0.03), and increased incidence of raised fasting glucose by 30% (95% CI: 15, 47%) per child for men, but not women (3% [95% CI: −8, 15%]). There was a J-shaped association between number of children and change in insulin (P = 0.01) and insulin resistance (P = 0.005) for women, and a reduction in β-cell function in parous women (P = 0.07). Men with children had increases in insulin (P = 0.02), insulin resistance (P = 0.02), and β-cell function (P = 0.07).

Conclusions

The number of children a person has is associated with changes in metabolic health indices long after childbirth for both men and women. The distinct gender differences in deterioration of metabolic health indices emphasize that childbearing and child-rearing are likely to have differential influences on metabolic health.     

第二产程手膝俯卧位分娩对高龄初产妇分娩控制感及分娩结局的影响

【目的】探讨第二产程手膝俯卧位分娩对高龄初产妇分娩控制感及分娩结局的影响。【方法】选择2016年7月至2017年12月本院诊治的高龄初产妇148例,按照随机数表法分为观察组和对照组,每组74例。对照组产妇第二产程采用常规仰卧体位,观察组采用手膝俯卧位,比较两组产妇分娩控制感量表(LAS)、视觉模拟疼痛量表(VAS)、视觉模拟焦虑量表(VAS^A)及分娩结局。【结果】观察组LAS、VAS、VAS^A评分均明显低于对照组(r=12.686,11.322,15.078,P<0.01);第二产程时间明显短于对照组,产后2h出血量明显少于对照组(t=9.496,8.174,P<0.05);自然分娩率、会阴完整率明显高于对照组(90.54%vs75.68%,20.27%vs8.11%)(χ^2=5.824,4.495,P<0.05)。【结论】第二产程手膝俯卧位能缓解高龄初产妇焦虑和疼痛程度,提高分娩控制感,改善分娩结局,值得临床推广应用。     

Stress urinary incontinence 3 years after pregnancy: correlation to mode of delivery and parity

The aim was to estimate the incidence of stress urinary incontinence 3 years after delivery and its correlation to mode of delivery and parity. A longitudinal cohort study was conducted with 120 women at the Antenatal Clinic at the State University of Campinas. There was a significant difference in the incidence of postpartum stress urinary incontinence (SUI) among patients with SUI during pregnancy (p > 0.0001). Women that were asymptomatic during pregnancy and had vaginal delivery developed SUI 2.4 times more frequently than after c-section (19.2% and 8.0%, respectively). The incidence of SUI after delivery dropped significantly in the primiparous (p = 0.0073) and multiparous 2–3 (p < 0.0001), but not in the multiparous with four or more deliveries (66.7% to 60.0%) (p = 0.5637). A significant correlation has been observed between parity and SUI (p = 0.0299). Pregnancy possibly predisposes to SUI 3 years after delivery as well as parity. No significant correlation has been demonstrated between mode of delivery and SUI.     

Interhemispheric transfer of spatial and semantic information: Electrophysiological evidence

The goal of this study was to cast light on the existence of functional callosal channels for the interhemispheric transfer (IHT) of spatial and semantic information. To do so, we recorded event‐related potentials in healthy humans while performing a primed odd‐even discrimination task. Targets were visually presented numbers preceded by single‐letter primes signaling the probable presentation of an odd or an even number. Primes and targets could appear either in the same or in different visual fields, thus requiring an IHT in the latter case. The P1 and N2 components were influenced by IHT of spatial information only, whereas the later N400 was influenced by IHT of both spatial and semantic information. This was not the case for the P3b, which was modulated by semantic validity only. These results provide novel evidence of the existence of a temporally separated interhemispheric exchange of spatial and semantic information.     

Clinicopathologic characteristics of breast cancer in BRCA-carriers and non-carriers in women 35 years of age or less

PurposeBreast cancer diagnosed in women 35 years of age or less accounts for <2% of all breast cancer cases. Clinical and pathologic characteristics of early onset breast cancer are not well defined in BRCA mutation carriers and non-carriers.Methods194 women diagnosed with breast cancer at 35 years of age or less who had BRCA1/2 mutation testing were included in the study. Logistic regression models were fit to determine the associations between clinical variables and BRCA status.ResultsThirty-two (17%) and 12 (6%) patients had BRCA1 and BRCA2 mutations, respectively. BRCA1-carriers had a higher likelihood of a positive family history (FH) of breast and/or ovarian cancer (P = 0.001), or first-degree relatives diagnosed with breast cancer at <50 years old (P = 0.001) compared to non-carriers. BRCA2-carriers were more likely to have a FH of male breast cancer compared to noncarriers (P = 0.02). Among BRCA2-carriers, the age at first full-term pregnancy was younger in ER-negative cases compared with ERpositive cases (19.5 vs. 28.5 years old; P = 0.01). BRCA1-carriers with a later age at menarche were more likely to have a later stage at diagnosis (P = 0.04). Non-carriers with a lower BMI were more likely to have lymph node involvement (P = 0.03).ConclusionsSeveral associations were identified between reproductive risk factors or BMI and disease characteristics. Further characterization may result in a better understanding of the trends in young onset breast cancer in BRCA-carriers and non-carriers.