Background The objective of this survey was to explore the association between pregnancy complications and perinatal outcome from regionally total birth population. Methods In this prospectively collected data of complete birth registries from all level I-III hospitals in Huai’an in 2015, perinatal morbidity and mortality in relation to pregnancy complications and perinatal outcome were analyzed using international definitions. The results were compared with that of 2010 survey in the same region. Results Of 59,424 total births in the hospitals of level I ( n = 85), II (16) and III (6), delivery rate was 30.4, 40.1 and 29.5%, and rates of pregnancy complications were 12.9, 9.8 and 21.1% (average 14.1%), with antenatal corticosteroids rate in < 37 gestational weeks being 17.3, 31.0 and 39.9% (mean 36.6%), respectively. The preterm birth rate was 0.6, 2.7 and 9.5% (mean 4.06%), and the composite rate of fetal death, stillbirth, and death immediately after delivery was 0.1, 0.4 and 0.6%, respectively. By multivariable logistic regression analysis, congenital anomalies, low Apgar scores, multi-pregnancy and amniotic fluid contamination were risk factors of adverse perinatal outcomes. Despite a higher rate of pregnancy complications than in 2010 survey, perinatal and neonatal mortality continued to fall, in particular in very preterm births. The high cesarean delivery rate in non-medically indicated cases remained a challenge. Conclusions Our regional birth-population data in 2015 revealed a robust and persistent improvement in the perinatal care and management of high risk pregnancies and deliveries, which should enable more studies using similar concept and protocol for vital statistics to verify the reliability and feasibility. Electronic supplementary material The online version of this article (10.1186/s12884-019-2323-6) contains supplementary material, which is available to authorized users.
Summary Preeclampsia (PE), a pregnancy-specific disease, has become one of the leading causes of maternal and neonatal morbidity and mortality. Pathogenesis of PE has still not been fully addressed and there is a great need to develop early diagnosis markers and effective therapy. This study aimed to determine if lncRNA SNHG14 has a protective effect on placental trophoblast and prevents PE. SNHG14 levels in the peripheral blood from patients with PE or from women with healthy pregnancies were detected using RT-qPCR. The relationship between SNHG14 and miR-330-5p was determined using a dual-luciferase reporter assay. In addition, cell proliferation and cell cycle were evaluated by performing CCK8 assays and flow-cytometric analysis, respectively. Wound-healing and transwell assays were performed to assess cell migration and invasion ability. lncRNA SNHG14 was downregulated in PE patients; it was involved in trophoblast proliferation and regulated cell proliferation during G1/S transition. In addition, lncRNA SNHG14 promoted migration, invasion and epithelial–mesenchymal transition (EMT) in HTR-8/SVneo cells. Luciferase reporter assay indicated that lncRNA SNHG14 served as a molecular sponge for miR-330-5p and negatively regulated miR-330-5p expression in PE. Furthermore, the effects of silenced SNHG14 on trophoblast proliferation, migration, invasion and EMT were reversed by addition of miR-330-5p inhibitor, suggesting that in PE lncRNA SNHG14 functions by competitively binding to miR-330-5p. Taken together, the current study demonstrated that in PE lncRNA SNHG14 is a vital regulator by binding to miR-330-5p. SNHG14 might serve as a therapeutic application in PE progression.
Background To explore the prevalence, outcome and perinatal risks of neonatal hypoxemic respiratory failure (NRF) in a survey of all livebirths from a regional network of perinatal-neonatal care during the transition period after 5-year universal health insurance implemented in China. Methods Clinical data of all neonatal respiratory morbidities in Huai’an were retrospectively collected in the regional perinatal network database of all livebirths as vital statistics in 2015. NRF was defined as hypoxemia requiring continuous positive airway pressure (CPAP) and/or mechanical ventilation (MV) for at least 24 h. Mortality risks of antenatal and perinatal morbidities, major respiratory therapies and complications were analyzed by multivariable logistic regression model. Results There were 788 NRF cases identified in 9.9% (7960) hospitalized, or 13.3‰ (59056) livebirths, in which 6.7% received intensive care and 93.0% critical care. The major underlying morbidities were respiratory distress syndrome (RDS, 36.4%) and pneumonia/sepsis (35.3%), treated mainly by CPAP, MV and surfactant. Significantly improved outcomes by surfactant in RDS were in patients with birthweight (BW) < 1500 g or gestational age (GA) < 32 weeks. The overall mortality rate in NRF was 18.4% whereas for those of BW < 1000 g and GA < 28 weeks, 70% and 54%, respectively. The multivariable regression analysis showed the highest odds for NRF death among meconium aspiration syndrome, congenital anomalies, BW < 1500 g and necrotizing enterocolitis, whereas born in level III hospitals, cesarean delivery, CPAP and MV were associated with markedly reduced death odds. Conclusions The salient findings with associated risk estimates reflected efficiency of respiratory support as critical care in a prefectural regional network infrastructure for annual livebirths in 5.6 million inhabitants. It implicated the representativeness of contemporaneous perinatal-neonatal care standard at medium to medium-high level, in one/fourth of the population of China, aiming at saving more life of very critical and preterm infants for better survival. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03603-9.
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