BACKGROUND Postpartum hypertension poses a considerable health risk.Despite research on gestational hypertension,comprehensive studies focusing on postpartum hypertension in communities are limited.Understanding its p...BACKGROUND Postpartum hypertension poses a considerable health risk.Despite research on gestational hypertension,comprehensive studies focusing on postpartum hypertension in communities are limited.Understanding its prevalence and associated risk factors is crucial for effective prevention and management.AIM To provide insights for postpartum hypertension’s prevention and management.METHODS In total,3297 women who gave birth between June 2021 and December 2022 in Xuhui District,Shanghai were selected.Blood pressure was measured thrice within one month post-delivery during home visits.Eighty-six women with hypertension were followed up for four months to analyze hypertension persistence and its related risk factors.A predictive model for persistent postpartum hypertension was established and verified using the Nomo diagram model.RESULTS Hypertension prevalence 1 month post-delivery was 2.61%(86/3297).Among the 86 pregnant women,32(37.21%)had persistent hypertension at four months post-delivery.Multivariate logistic regression analysis revealed that older age[odds ratio(OR)=1.212;95%confidence interval(CI):1.065–1.380]and higher pre-pregnancy body mass index(BMI)(OR=1.188;95%CI:1.006–1.404)were associated with hypertension(OR=10.781;95%CI:1.006–1.404)during pregnancy.A 95%CI of 1.243–93.480 is a risk factor for persistent postpartum hypertension.The Nomograph model accurately predicted the risk of persistent postpartum hypertension,demonstrating high precision.CONCLUSION In Xuhui,older age,higher pre-pregnancy BMI,and gestational hypertension are risk factors for persistent postpartum hypertension.Our prediction model can identify high-risk individuals,thereby improving patient quality of life.展开更多
Autism spectrum disorder(ASD)is a group of heterogeneous,multi-factorial,neurodevelopmental disorders resulting from genetic and environmental factors interplay.Infection is a significant trigger of autism,especially ...Autism spectrum disorder(ASD)is a group of heterogeneous,multi-factorial,neurodevelopmental disorders resulting from genetic and environmental factors interplay.Infection is a significant trigger of autism,especially during the critical developmental period.There is a strong interplay between the viral infection as a trigger and a result of ASD.We aim to highlight the mutual relationship between autism and viruses.We performed a thorough literature review and included 158 research in this review.Most of the literature agreed on the possible effects of the viral infection during the critical period of development on the risk of developing autism,especially for specific viral infections such as Rubella,Cytomegalovirus,Herpes Simplex virus,Varicella Zoster Virus,Influenza virus,Zika virus,and severe acute respiratory syndrome coronavirus 2.Viral infection directly infects the brain,triggers immune activation,induces epigenetic changes,and raises the risks of having a child with autism.At the same time,there is some evidence of increased risk of infection,including viral infections in children with autism,due to lots of factors.There is an increased risk of developing autism with a specific viral infection during the early developmental period and an increased risk of viral infections in children with autism.In addition,children with autism are at increased risk of infection,including viruses.Every effort should be made to prevent maternal and early-life infections and reduce the risk of autism.Immune modulation of children with autism should be considered to reduce the risk of infection.展开更多
Pregnancy represents a dynamic period with physical and physiological changes in both the mother and her developing fetus. The dramatic 2-3 fold increase in the active hormone 1,25（OH）2D concentrations during the ea...Pregnancy represents a dynamic period with physical and physiological changes in both the mother and her developing fetus. The dramatic 2-3 fold increase in the active hormone 1,25（OH）2D concentrations during the early weeks of pregnancy despite minimal increased calcium demands during that time of gestation and which are sustained throughout pregnancy in both the mother and fetus suggests an immunomodulatory role in preventing fetal rejection by the mother. While there have been numerous observational studies that support the premise of vitamin D＇s role in maintaining maternal and fetal well-being, until recently, there have been few randomized clinical trials with vitamin D supplementation. One has to exhibit caution, however, even with RCTs, whose results can be problematic when analyzed on an intent-to-treat basis and when there is high non-adherence to protocol （as if often the case）, thereby diluting the potential good or harm of a given treatment at higher doses. As such, a biomarker of a drug or in this case ＂vitamin＂ or pre-prohormone is better served. For these reasons, the effect of vitamin D therapies using the biomarker circulating 25（OH）D is a far better indicator of true ＂effect.＂ When pregnancy outcomes are analyzed using the biomarker 25（OH）D instead of treatment dose, there are notable differences in maternal and fetal outcomes across diverse racial/ethnic groups, with improved health in those women who attain a circulating 25（OH）D concentration of at least 100 nmol. L-1 （40 ng. mL-1）. Because ,an important issue is the timing or initiation of vitamin D treatment/supplementation, and given the potential effect of vitamin D on placental gene expression and its effects on inflammation within the placenta, it appears crucial to start vitamin D treatment before placentation （and trophoblast invasion）; however, this question remains unanswered. Additional work is needed to decipher the vitamin D requirements of pregnant women and the optimal timing of supplementa展开更多
文摘BACKGROUND Postpartum hypertension poses a considerable health risk.Despite research on gestational hypertension,comprehensive studies focusing on postpartum hypertension in communities are limited.Understanding its prevalence and associated risk factors is crucial for effective prevention and management.AIM To provide insights for postpartum hypertension’s prevention and management.METHODS In total,3297 women who gave birth between June 2021 and December 2022 in Xuhui District,Shanghai were selected.Blood pressure was measured thrice within one month post-delivery during home visits.Eighty-six women with hypertension were followed up for four months to analyze hypertension persistence and its related risk factors.A predictive model for persistent postpartum hypertension was established and verified using the Nomo diagram model.RESULTS Hypertension prevalence 1 month post-delivery was 2.61%(86/3297).Among the 86 pregnant women,32(37.21%)had persistent hypertension at four months post-delivery.Multivariate logistic regression analysis revealed that older age[odds ratio(OR)=1.212;95%confidence interval(CI):1.065–1.380]and higher pre-pregnancy body mass index(BMI)(OR=1.188;95%CI:1.006–1.404)were associated with hypertension(OR=10.781;95%CI:1.006–1.404)during pregnancy.A 95%CI of 1.243–93.480 is a risk factor for persistent postpartum hypertension.The Nomograph model accurately predicted the risk of persistent postpartum hypertension,demonstrating high precision.CONCLUSION In Xuhui,older age,higher pre-pregnancy BMI,and gestational hypertension are risk factors for persistent postpartum hypertension.Our prediction model can identify high-risk individuals,thereby improving patient quality of life.
文摘Autism spectrum disorder(ASD)is a group of heterogeneous,multi-factorial,neurodevelopmental disorders resulting from genetic and environmental factors interplay.Infection is a significant trigger of autism,especially during the critical developmental period.There is a strong interplay between the viral infection as a trigger and a result of ASD.We aim to highlight the mutual relationship between autism and viruses.We performed a thorough literature review and included 158 research in this review.Most of the literature agreed on the possible effects of the viral infection during the critical period of development on the risk of developing autism,especially for specific viral infections such as Rubella,Cytomegalovirus,Herpes Simplex virus,Varicella Zoster Virus,Influenza virus,Zika virus,and severe acute respiratory syndrome coronavirus 2.Viral infection directly infects the brain,triggers immune activation,induces epigenetic changes,and raises the risks of having a child with autism.At the same time,there is some evidence of increased risk of infection,including viral infections in children with autism,due to lots of factors.There is an increased risk of developing autism with a specific viral infection during the early developmental period and an increased risk of viral infections in children with autism.In addition,children with autism are at increased risk of infection,including viruses.Every effort should be made to prevent maternal and early-life infections and reduce the risk of autism.Immune modulation of children with autism should be considered to reduce the risk of infection.
基金Funded in part by NIH/NICHD R01 HD043921the Thrasher Research Fund+1 种基金NIH/NCATS UL1 RR029882UL1 TR000062
文摘Pregnancy represents a dynamic period with physical and physiological changes in both the mother and her developing fetus. The dramatic 2-3 fold increase in the active hormone 1,25（OH）2D concentrations during the early weeks of pregnancy despite minimal increased calcium demands during that time of gestation and which are sustained throughout pregnancy in both the mother and fetus suggests an immunomodulatory role in preventing fetal rejection by the mother. While there have been numerous observational studies that support the premise of vitamin D＇s role in maintaining maternal and fetal well-being, until recently, there have been few randomized clinical trials with vitamin D supplementation. One has to exhibit caution, however, even with RCTs, whose results can be problematic when analyzed on an intent-to-treat basis and when there is high non-adherence to protocol （as if often the case）, thereby diluting the potential good or harm of a given treatment at higher doses. As such, a biomarker of a drug or in this case ＂vitamin＂ or pre-prohormone is better served. For these reasons, the effect of vitamin D therapies using the biomarker circulating 25（OH）D is a far better indicator of true ＂effect.＂ When pregnancy outcomes are analyzed using the biomarker 25（OH）D instead of treatment dose, there are notable differences in maternal and fetal outcomes across diverse racial/ethnic groups, with improved health in those women who attain a circulating 25（OH）D concentration of at least 100 nmol. L-1 （40 ng. mL-1）. Because ,an important issue is the timing or initiation of vitamin D treatment/supplementation, and given the potential effect of vitamin D on placental gene expression and its effects on inflammation within the placenta, it appears crucial to start vitamin D treatment before placentation （and trophoblast invasion）; however, this question remains unanswered. Additional work is needed to decipher the vitamin D requirements of pregnant women and the optimal timing of supplementa
