正常妊娠妇女外周血可溶性白细胞介素－2受体及淋巴细胞亚群的变化

测定了８７例妊娠晚期及２９例正常非孕妇女外周血可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平，同时对其中３６例孕妇及１０９例正常非孕妇女（正常对照）进行外周血淋巴细胞亚群检测。结果：妊娠晚期妇女ｓＩＬ－２Ｒ水平及Ｔｓ细胞（ＣＤ＿８）明显高于正常对照，分别为：２１４６００±７０４００Ｕ／Ｌ比１６２１００±８４１Ｄ０Ｕ／Ｌ，　Ｐ＜０．０１及３７．６％±５．３％比３１．３％±７．０％，Ｐ＜０．０１。妊娠妇女Ｔｈ细胞／Ｔｓ细胞（ＣＤ＿４／ＣＤ＿８）比例明显低于正常对照（１．２±０．２比１．５±０．５，Ｐ＜０．０１）。但总Ｔ淋巴细胞（ＣＤ＿３），ＣＤ＿４，细胞与正常对照相比，差异无显著性，分别为：６４．１％±７．３％比６６．０％±９．９％，Ｐ＞０．０５及４４．１％±５．８％比４３．８％±９．Ｏ％，Ｐ＞０．０５。相关分析表明孕妇ｓＩＬ－２Ｒ水平与ＣＤ＿３、ＣＤ＿４、ＣＤ＿８细胞及ＣＤ＿４／ＣＤ＿８均无显著相关性（ｒ分别为０．２０３２，０．２０７７，０．１０３７及０．１２１４，Ｐ均＞０．０５）。提示：孕妇外周血Ｔ淋巴细胞亚群及血清ｓＩＬ－２Ｒ的变化对维持正常妊娠有重要作用，ｓＩＬ－２Ｒ可能是促进胎儿正常生长的重要介质之一。     

不同孕期及分娩后妇女血清骨钙素浓度的变化

对１４２例不同孕期妇女、３０例分娩后妇女、４７例相应年龄非妊娠健康妇女，分别测量血清骨钙素（ＢＧＰ）、碱性磷酸酶（ＡＫＰ）和钙（Ｃａ）、磷（Ｐ）。结果：血清ＢＧＰ水平，妊娠早期、妊娠中期、妊娠晚期与非妊娠组比较，Ｐ值分别为Ｐ＞０．０５，Ｐ＜０．０１，Ｐ＜０．００１。分娩后即刻测定的血清ＢＧＰ水平，明显高于妊娠各期（Ｐ＜０．００１），呈一个明显的高峰。分娩后第五天降至正常。血清ＡＫＰ水平随妊娠的周数增加而升高，妊娠晚期与非妊娠组比较，差异有极显著性（Ｐ＜０．０１）。本研究结果说明，不同孕期、分娩后妇女骨的代谢有较明显的改变，血清ＢＧＰ、ＡＫＰ是骨代谢瞬间变化的生化指标，为探讨不同孕期及分娩后骨代谢变化提供了依据。     

孕妇血清中抗心磷脂抗体水平对围产儿的影响

目的：探讨孕妇血清抗心磷脂抗体（ａｎｔｉｃａｒｄｉｏｌｉｐｉｎａｎｔｉｂｏｄｙ，ＡＣＡ）水平增高对围产儿的影响。方法：用酶联免疫吸附法（ＥＬＩＳＡ）测定２０８份健康孕妇的血清ＡＣＡ－ΙｇＡ、ＩｇＧ和ＩｇＡ结合指数，观察ＡＣＡ水平与小于胎龄儿、胎儿窘迫及新生儿窒息的关系。结果：小于胎龄儿组和围产儿缺氧组的ＡＣＡ－ＩｇＭ、ＩｇＡ结合指数显著高于对照组（Ｐ＜０．００１～Ｐ＜０．０５），而ＡＣＡ－ＩｇＧ结合指数差异无显著性（Ｐ＞０．２）；小于胎龄儿组的ＡＣＡ－ＩｇＡ结合指数显著高于围产儿缺氧组（Ｐ＜０．０２），但ＡＣＡ－ＩｇＭ和ＩｇＧ结合指数差异无显著性（Ｐ＞０．１，Ｐ＞０．５）；胎儿窘迫、新生儿窒息及胎儿窘迫合并新生儿窒息时，孕妇血清ＡＣＡ－ＩｇＭ、ＩｇＡ和ＩｇＧ结合指数差异无显著性（Ｐ＞０．０５）。结论：孕妇血清中的ＡＣＡ水平增高对围产儿预后具有显著的不良影响     

妊高征患者血浆内皮素、过氧化脂质和红细胞超氧化物歧化酶活性的变化

目的：探讨内皮素－１（ＥＴ－１）和过氧化脂质（ＬＰＯ）在妊高征发病中的作用。方法：分别用放射免疫法、硫代巴比妥酸荧光微量法和邻苯二酚自氧化法，测定９５例妇女血浆ＥＴ－１、ＬＰＯ和红细胞超氧化物歧化酶（ＲＢＣ－ＳＯＤ）的活性。其中正常非妊娠妇女１５例（对照组），正常晚期妊娠妇女２０例（正常妊娠组），妊高征患者６０例（妊高征组）。结果：（１）正常妊娠组血浆ＥＴ－１、ＬＰＯ和ＲＢＣ－ＳＯＤ活性均高于对照组（Ｐ＜０．０１），但ＬＰＯ／ＲＢＣ－ＳＯＤ比值差异无显著性；（２）妊高征组的ＥＴ－１和ＬＰＯ／ＲＢＣ－ＳＯＤ比值显著高于正常妊娠组，且随病情的加重而升高，产后３～７天迅速下降；（３）妊高征组的ＥＴ－１和ＬＰＯ／ＲＢＣ－ＳＯＤ比值呈正相关（ｒ＝０．８４６，Ｐ＜０．００１）。结论：提示机体内氧化和抗氧化平衡失调与内皮细胞损伤，在妊高征发病过程中起重要作用。     

甲胎蛋白,游离雌三醇及绒毛膜促性腺激素测定在产前诊断唐…

目的：探讨胎儿胎盘产物甲胎蛋白（ＡＦＰ）、游离雌三醇（ｕＥ３）和β绒毛膜促性腺激素（β－ｈＣＧ）水平与胎儿唐综合征发病的关系。方法：用放射免疫法测定１７例妊娠唐氏综合征胎儿的孕妇（病例组）和１３１例妊娠正常胎儿孕妇（对照组）的外周血、羊水及脐血中ＡＦＰ、ｕＥ３和β－ｈＣＧ水平。结果：病例组孕妇外周血、羊水和脐血中ＡＦＰ水平均低对组（Ｐ〈０．０５）；ｕＥ３水平也均低于对照组（Ｐ〈０．０５）；β－ｈＣ     

正常孕妇及妊高征患者血浆中5-羟色胺和5-羟吲哚乙酸含量的测定

目的　探讨血浆中５羟色胺（５ＨＴ） 和５羟吲哚乙酸（５ＨＩＡＡ） 与妊高征发病的关系。　方法　采用高效液相色谱—电化学检测法测定正常妊娠各期孕妇组及妊高征组血浆中５ＨＴ和５ＨＩＡＡ含量。　结果　正常妊娠各期孕妇组血浆中５ＨＴ含量无显著差异;妊高征组血浆中５ＨＴ含量（７０－４４ ±２８－６９ μｇ／Ｌ）明显高于正常晚孕组（２４－９６±６－５７ μｇ／Ｌ）（ Ｐ＜ ０．０１） ;妊高征组血浆中５ＨＩＡＡ 含量（４－１１±２．３０ μｇ／Ｌ） 较正常晚孕组（７－８７ ±１．７５ μｇ／Ｌ） 明显降低,Ｐ＜ ０．０１。　结论　孕妇血浆中５ＨＴ含量变化可能与妊高征血管收缩的病理过程有关。     

高龄初产妇及胎儿血清过氧化反应的研究

目的分析孕妇年龄与孕妇及胎儿的过氧化反应的关系,研究高龄产妇并发症发病率升高的机理。方法将妊娠晚期妇女１６４例,根据年龄分成３组,第一组：小于３５周岁,７１例;第二组：大于或等于３５周岁但小于４０周岁,６３例;第三组：大于或等于４０周岁,３０例。所有病例均无其它高危因素。分别于分娩时抽取母血和脐血,检测超氧化物歧化酶（ＳＯＤ）和脂质过氧化物（ＬＰＯ）浓度。结果新生儿的Ａｐｇａｒ评分、胎儿体重以及羊水的质和量,３组之间比较,差异无显著性（Ｐ＞０．０５）,剖宫产率随着年龄的增加明显增加;胎儿的ＳＯＤ浓度明显高于孕妇,ＬＰＯ明显地下降（Ｐ＜０．０５）;孕妇的年龄与其血清ＳＯＤ和ＬＰＯ浓度有明显的相关性（ｒ１＝－０．１５４７,Ｐ＜０．０５;ｒ２＝０．２２９９,Ｐ＜０．０１）;第二组和第三组孕妇ＬＰＯ浓度高于第一组（Ｐ＜０．０５）,第三组孕妇ＳＯＤ浓度低于第一组（Ｐ＜０．０５）。结论孕妇的自由基含量和活性相对较高,而自由基的清除能力较弱,胎儿相反;孕妇年龄与血中的ＳＯＤ和ＬＰＯ浓度改变有关     

妊娠妇女及围产儿巨细胞病毒感染的研究

应用酶联免疫法（ＥＬＩＳＡ），对不同孕周孕妇２５６例及其中８４例巨细胞病毒ＩｇＭ抗体（ＨＣＭＶ－ＩｇＭ）阳性的妊娠晚期孕妇所分娩新生儿的脐血，进行ＨＣＭＶ－ＩｇＭ检测。结果：妊娠早期、中期妇女的４２份血清标本中，ＨＣＭＶ－ＩｇＭ阳性１７例，感染率为４０．４８％。妊娠晚期２１４份标本中，ＨＣＭＶ－ＩｇＭ阳性８４例，感染率为３９．２５％。ＨＣＭＶ－ＩｇＭ阳性者围产儿死亡率、新生儿窒息抢救率、胎儿畸形及有异常妊娠病史的妊娠妇女的比例均增加（Ｐ＜０．０１）。提示：ＨＣＭＶ－ＩｇＭ阳性表明妊娠妇女近期有巨细胞病毒（ＨＣＭＶ）感染，或既往有隐性的ＨＣＭＶ感染，在妊娠期复发（活动性感染）。     

长效避孕针醋酸甲孕酮对骨质代谢的影响

本文探讨长效醋酸甲孕酮避孕针（ＤＭＰＡ）对中国妇女骨质代谢的影响。自愿使用１５０ｍｇ ＤＭＰＡ避孕者３０人为实验组;采用阴茎套避孕者３０人组成对照组。１ａ后测定两组血清雌二醇（Ｅ２）、血清碱性磷酸酶（ＡＫＰ）、尿钙／肌酐（Ｃａ／Ｃｒ）、尿羟脯氨酸／肌酐（Ｈｙｐ／Ｃｒ）及非惯用臂桡尺骨超远端骨矿含量（ＢＭＣ）、骨矿密度（ＢＭＤ）。结果显示：两组血清雌二醇、血清碱性磷酸酶、尿钙／肌酐、尿羟脯氨酸／肌酐差异无显著性（Ｐ＞０．０５）,两组臂桡尺骨超远端骨矿含量、骨矿密度无显著性差异（Ｐ＞０．０５）。这说明使用 ＤＭＰＡ　１ａ对中国妇女骨质代谢无影响。     

甲胎蛋白、游离雌三醇及绒毛膜促性腺激素测定在产前诊断唐氏综合征中的应用

目的：探讨胎儿胎盘产物甲胎蛋白（ＡＦＰ）、游离雌三醇（ｕＥ３）和β绒毛膜促性腺激素（β－ｈＣＧ）水平与胎儿唐氏综合征发病的关系。方法：用放射免疫法测定１７例妊娠唐氏综合征胎儿的孕妇（病例组）和１３１例妊娠正常胎儿孕妇（对照组）的外周血、羊水及脐血中ＡＦＰ、ｕＥ３和β－ｈＣＧ水平。结果：病例组孕妇外周血、羊水和脐血中ＡＦＰ水平均低于对照组（Ｐ＜０．０５）；ｕＥ３水平也均低于对照组（Ｐ＜０．０５）；β－ｈＣＧ水平均高于对照组（Ｐ＜０．０５）。结论：检测孕妇外周血中ＡＦＰ、ｕＥ３、β－ｈＣＧ可用于胎儿唐氏综合征的产前诊断     

A study on alkaline phosphatase in cervical mucus using disc electrophoresis

A simple filter-disc-absorption technique for sampling human cervical mucus had been developed by colleagues of author. Using this technique, electrophoretic patterns of proteins and phosphorylase in cervical mucus had been reported. In this presentation, I report isoenzyme patterns of alkaline phosphatase (ALP) in the cervical mucus of normal pregnant women and patients with various gynecological diseases using this developed technique. Electrophoresis was carried out with 11.25% polyacrylamide separating gel. The separating gel was prepared using the stacking buffer system at pH 6.7. By this system, the stacking effect was maintained in the gel and the molecular sieve effect was sharpened. ALP activity was demonstrated using 5-bromo-3-indolyl phosphate as the substrate. Placental ALP was identified by its electrophoretic mobility and thermostability. Placental ALP was demonstrated in cervical mucus from 85 pregnant women as early as 6 weeks' gestation. In sera, however, the enzyme activity was demonstrated after 21 weeks' gestation. In cervical mucus and sera of non-pregnant women, and of patients with myoma of the uterus, ovarian tumor and cervical cancer, placental ALP was not demonstrated.     

¿Ingieren suficiente calcio nuestras gestantes?

Objective

To quantify calcium intake in a group of pregnant Spanish women.

Material and methods

A total of 115 pregnant women were evaluated in a prospective observational study. Dietary information was prospectively collected from pregnant women at 15 and 28 weeks’ gestation using 7-day food records. Daily calcium intake throughout pregnancy, as well as differences between rural and urban populations, were analyzed.

Results

The mean calcium intake was 930.60 ± 300.71 mg/day (range, 345-1,462) at 15 weeks’ gestation and 1,083.03 ± 330.59 mg/day (range, 274-2,150) at 28 weeks’ gestation. In 76.8% of the respondents, dietary calcium intake was below the recommended daily intake for pregnant women in Spain. No significant differences were found between early and late pregnancy or between rural and urban populations.

Conclusions

Dietary calcium intake is deficient in a high percentage of pregnant women in Spain.     

Calcium levels during the initiation of labor

OBJECTIVE: To investigate the physiological role of calcium in the labor process. STUDY DESIGN: Eighty-eight term healthy pregnant women who gave birth to normal healthy neonates participated in our study. We compared calcium levels between pregnant women who had normal delivery and those who underwent scheduled cesarean section. The control group consisted of pregnant women with gestation > or =37 weeks without contractions. The groups were compared with respect to calcium levels: (a) in maternal blood serum; (b) in blood serum of the neonates and mothers; and (c) in blood serum between neonates. RESULTS: Significantly higher calcium levels were found in the group of pregnant women who delivered vaginally compared to those who delivered by scheduled cesarean section and those of the control group. CONCLUSION: We assume that the increased calcium levels during the first stage of labor are involved with a possible role of calcium in the mechanism of initiation of labor.     

Fetal gender affects maternal serum total and placental alkaline phosphatase levels during pregnancy

OBJECTIVE: To analyze whether fetal gender affects total alkaline phosphatase (ALP) and placental ALP levels in normal pregnancy, and to determine the gestational age at which the difference occurs. METHODS: In this longitudinal study, serum total and placental ALP measurements were carried out in 30 normal pregnant women during different ranges of gestational weeks. Infant sex was recorded at the delivery for all women included in the study. Total and placental ALP levels were compared between pregnant women bearing female and male fetuses. RESULTS: At all gestational weeks studied, both total and placental ALP levels were higher in pregnant women carrying female fetuses than in male bearing pregnant women. Particularly, both total (260.9+/-110.2 versus 239.9+/-102.3; p=0.03) and placental (73.1+/-22.4 versus 61+/-18.2; p=0.04) ALP levels were significantly higher in the female group than in the male between 24 and 28 weeks, and the significant difference persisted between 32 and 36 weeks (p=0.02). CONCLUSIONS: Fetal gender seems to affect total and placental ALP levels in healthy pregnant women, particularly during the second and third trimester of pregnancy. Higher ALP levels in pregnant women with female fetuses than in those with male fetuses may suggest that knowledge of the fetal gender may be in particular importance for the studies using ALP as a marker for the prediction of variety of diseases and complications seen during pregnancy.     

Biochemical modifications of human whole saliva induced by pregnancy

Objective To assess human unstimulated whole saliva components during pregnancy, to determine the relation, if any, between pregnancy and oral health, particularly total protein concentration, α-amylase activity, sialic acid content and calcium and phosphate concentrations were evaluated.
Design Cross-sectional study.
Participants Forty-five healthy primigravid women; 15 nonpregnant women acted as controls.
Results 1. A higher total protein content at 10 and 21 weeks of gestation with respect to the controls and to pregnant women at 40 weeks; 2. a higher α-amylase activity at 10 and 21 weeks of gestation compared with the controls and to pregnant women at 40 weeks; 3. an increased sialic acid content at 21 and 40 weeks; 4. decreased calcium and phosphorus concentrations at 21 and 40 weeks of gestation.
Conclusions Pregnancy modifies saliva composition. This could play a pivotal role in the incidence of pregnancy-induced dental caries.     

Urinary calcium as an early marker for preeclampsia

Women who develop preeclampsia during pregnancy excrete less calcium than healthy pregnant women. Whether this reduction in calcium excretion precedes or follows hypertension is unknown. We prospectively measured urinary calcium excretion in 103 consecutive nulliparous women at risk for preeclampsia and presenting for prenatal care before 24 weeks' gestation. Serial 24-hour urine specimens were obtained at 10-24 weeks, 25-32 weeks, and 33 weeks to term. After delivery, the charts were reviewed for the presence of preeclampsia and gestational hypertension. At the first collection, patients who later developed preeclampsia excreted less urinary calcium (169 +/- 30 mg/24 hours; mean +/- standard error of the mean) than those who remained normotensive (298 +/- 15 mg/24 hours) (P less than .05); this reduction persisted throughout gestation. Using a receiver operator curve, we calculated a predictive threshold calcium value for hypertension of 195 mg/24 hours. The difference in the incidence of preeclampsia between pregnant women with calcium excretion values at or below 195 mg/24 hours (87%, 95% confidence interval 52-98%) and those with values above that level (2%, confidence interval 0.3-8%) was highly significant (Fisher exact test, P less than .0001). The 95% lower limit of relative risk for preeclampsia in patients with a calcium excretion equal to or below 195 mg/24 hours in the first collection was 9.4. These observations suggest a pathophysiologic role for altered urinary calcium excretion in women with preeclampsia that may contribute to the early identification of patients at risk for this disease.     

Biochemical changes associated with blood pressure reduction induced by calcium supplementation during pregnancy

In a study population that comprised 34 normal black pregnant women, biochemical changes are compared between a group of women who received 1.5 gm of calcium supplementation a day and a group of women who received placebos. The blood pressure-lowering effect of calcium supplementation appears to involve a mechanism that relates parathyroid hormone and plasma renin activity. Other alterations in calcium and magnesium metabolism, as reflected by increased urinary calcium excretion and serum magnesium levels, may also contribute to this effect. Subgroups of study participants with initial (less than 26 weeks' gestation) low levels of serum calcium and plasma renin activity are the ones with the largest reductions in blood pressure. Whether these alterations can produce a reduction in the incidence of pregnancy-induced hypertension is the next question to be answered in this area.     

Screening for periodontitis in pregnant women with salivary enzymes

AIM: To develop a test for the screening of pregnant women for periodontitis using saliva prior to a dental examination. METHODS: A cross-sectional research design was employed. Whole unstimulated saliva was collected from 221 pregnant women prior to a dental examination at the Amagasaki Public Health Office and levels of activity of lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), and of occult blood in the saliva were measured. The data were compared with Community Periodontal Index of Treatment Needs (CPITN) scores. The diagnostic performance of LDH, ALP, and occult blood was determined in terms of sensitivity, specificity, and the area under receiver operating characteristics (ROC) curves. The optimal combination of parameters for screening periodontitis was determined at maximum sensitivity and specificity. RESULTS: Periodontitis (CPITN 3, 4) in 19 women (8.6%) and gingivitis (CPITN 1, 2) in 129 women (58.4%) were observed. The activity levels of LDH and ALP were significantly higher in the pregnant women with periodontitis than those with gingivitis or a healthy periodontium. To distinguish between the pregnant women with periodontitis and the others, a cut-off value of 684 IU/L for LDH and of 75 IU/L for ALP were determined by a ROC analysis. The test combining LDH, ALP, and occult blood showed the highest diagnostic performance; with a sensitivity value of 0.90, specificity value of 0.62, positive predictive value of 0.18, and negative predictive value of 0.98. CONCLUSIONS: A test combining the parameters salivary LDH, ALP and occult blood is useful for screening pregnant women for periodontitis.     

Observational study of vitamin D levels and pain in pregnant immigrant women living in Sweden

The aim was to determine the prevalence of vitamin D insufficiency in pregnant immigrant women assessed by the levels of 25-hydroxyvitamin D, parathyroid hormone (PTH) and alkaline phosphatase (ALP) as well as the correlation to musculoskeletal pain. Sixty-eight pregnant immigrant women were included. Fifty-one native Swedish pregnant women served as controls. 25-hydroxyvitamin D, PTH, ALP and musculoskeletal pain, rated on a visual analogue scale, were analyzed in all women in gestational week 12 and in the immigrant women at 6–12 months postpartum. A significantly higher proportion of immigrant women (77.9%) had levels of 25-hydroxyvitamin D <25?nmol/l compared with 3.9% in controls. Of the immigrant women, 29.4% had 25-hydroxyvitamin D levels <12?nmol/l, but none of the controls. Musculoskeletal pain evaluated with a visual analogue scale (VAS) was significantly higher for the immigrant women than for the controls at gestational week 12. However, no within group correlation was seen between 25-hydroxyvitamin D levels, PTH or ALP and pain. A significant negative correlation between changes in 25-hydroxyvitamin D and pain from gestational week 12 to postpartum was observed. Hypovitaminosis D is prevalent in immigrant women living in Sweden. There is an indication that pain might be associated with hypovitaminosis D.     

19-Hydroxyandrostenedione - A Factor in Pregnancy Hypertension

39 normotensive pregnant women (52 samples) and 47 patients with hypertensive disease of pregnancy (69 samples) between gestation 26 and 41 weeks were examined. The average plasma concentration of 19-hydroxyandrostenedione (19-OH-A) in the hypertensive pregnant women was significantly higher (p<t).001, mean ± standard deviation 482 ± 96.3 pg/ml) than that of the normotensive pregnant women (345 ± 60.2 pg/ml). 19-OH-A concentration was Independent of length of gestation in both normotensive or hypertensive pregnant women.