Objective To systematically review the association between 14 bp insertion/ deletion polymorphism of HLA-G gene and preeclampsia (PE). Methods We electronically searched in the following databases: PubMed, Web of Science, EMbase, CBM, CNKI, WanFang Data, and VIP to collect all the case-control trials on the association between 14 bp insertion/ deletion polymorphism of HLA-G gene and PE. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results Totally 10 studies were recruited. The results of meta-analysis showed that, the preeclampsia group was higher than the control group in the frequencies of HLA-G +14 bp haplotype in the fetus and fathers and the frequencies of HLA-G +14 bp/+14 bp genotype in fathers, but its frequencies of fetal HLA-G −14 bp haplotype was significantly lower. Their pooled OR and 95%CI were 1.42 (1.10 to 1.84), 1.54 (1.25 to 1.90), 2.00 (1.19 to 3.38), and 0.67 (0.54 to 0.82). Compared with the control group, in the preeclampsia group the frequencies of HLA-G +14 bp/+14 bp genotype in fetus were higher, while the frequencies of HLA-G −14 bp/−14 bp genotype were lower (OR=1.75, 95%CI 1.11 to 2.77; OR= 0.57, 95%CI 0.41 to 0.81). In the preeclampsia group, the frequencies of mother (+14 bp/−14 bp)/ fetal (+14 bp/+14 bp) were higher than the control group (OR= 3.77, 95%CI 1.40 to 10.11), while those of mother (−14 bp/−14 bp)/ fetal (−14 bp/−14 bp) and those of father (−14 bp/−14 bp)/fetal (−14 bp/−14 bp) were lower (OR=0.52, 95%IC 0.31 to 0.85; OR=0.33, 95%CI 0.15 to 0.75). Conclusion Paternal and fetal 14 bp insertion/ deletion polymorphism of HLA-G gene might be associated with preeclampsia. And maternal-fetal genotype compatibility analysis might provide new clues for the pathogenesis research and clinical diagnosis of preeclampsia.
Objective To explore the maternal and neonatal outcomes of different types of severe preeclampsia premature birth. Methods The pregnant outcomes of 142 patients with severe preeclampsia premature birth (the study group) were compared with 311 patients with spontaneous premature birth (the control group). Singleton pregnancy was divided into three stages by gestational age: very early premature birth (28-31+6 weeks), moderate premature birth (34-36+6 weeks) and mild premature birth (32-33+6 weeks). Multiple-pregnancy was divided into two stages: lt;34 weeks of gestation group and ≥34 weeks of gestation group. Results he rates of antenatal care and the average birth weight of trial group were much lower than those of control group. he rates of cesarean delivery and complications of trial group were much higher than those of control group. he total neonatal mortality and neonatal intensive care unit (NICU) hospitalization rate of singleton pregnancy in trial group was much higher than that of control group (Plt;0.05). In very early premature birth, neonatal outcomes were particularly bad, but there was no diference between trial group and control group. In moderate premature birth and mild premature birth, the incidences of neonatal pneumonia and the aspiration syndrome of trial group were higher than those of control group, and the duration of NICU hospitalization was longer in trial group than in control group. he incidences of heart failure and postpartum hemorrhage in twin pregnancy combined with severe preeclampsia were particularly high. Conclusion Severe preeclampsia signiicantly afects fetal growth and perinatal outcomes; the average birth weight in each trial group of singleton pregnancy is much lower than that of control group. In moderate premature birth and mild premature birth, the neonatal adverse outcomes of trial group are much higher than those of control group. he total neonatal mortality and NICU hospitalization rate of singleton pregnancy in trial group is much higher than that of control group. In very early premature birth, morbidity and mortality of the newborn is closely related to gestational age. Women of multiple-pregnancy complicated with severe preeclampsia require more concerns about health care in order to prevent heart failure and postpartum hemorrhage.
Objective To investigate the relation of Human Leukocyte Antigen-DRs to Pre-eclampsia/eclampsia （PE/E） by reviewing the observational studies on PE/E. Methods We searched the MEDLINE/PubMed, EMBASE, The Cochrane Library and CBMdisc to July 2005, by combining free text with MeSH words. We assessed the quality of included studies, extracted and analyzed data. Results The odds ratio of fetal-maternal HLA-DR4 antigen frequency in case group versus control group was 2. 60 （95% CI 1.87 to 3.60） with statistical significance. The antigen frequencies of＇other fetal-maternal HLA-DRs in case and control groups were not statistically significant. The antigen frequencies of the couple HLA DRs were not statistically significant between case and control groups. We found that neither the HLA-DR sharing between the couples nor between fetus and mothers in case and control groups were statistically significant. Conclusions The antigen frequencies of HLA-DRs between the couples may have no association with the development of PE/E. The fetal gene types may be related to the development of PE/E. The HLA-DR sharing in mothers and fetus and the couples may have no association with the development of PE/E.
【摘要】目的探讨骨桥蛋白(OPN)及其受体整合素ανβ3在子痫前期(preeclampsia,PE)患者胎盘组织中的表达及其意义。方法2008年11月2009年9月,采用免疫组织化学方法检测20例PE患者(轻度及重度PE各10例)和14例正常足月孕妇(对照组)胎盘组织中OPN及ανβ3蛋白表达水平。采用RTPCR检测各组孕妇胎盘组织中的OPN、αν和β3的mRNA的表达水平。结果PE组孕妇胎盘组织中OPN及ανβ3蛋白表达低下,与对照组相比,差异有统计学意义(Plt;0.05);重度PE组OPN及ανβ3蛋白表达水平更低,与轻度PE组比较,差异有统计学意义(Plt;0.05)。PE组孕妇胎盘组织中OPN mRNA水平明显低于对照组,两组差异有统计学意义(Plt;0.05);重度PE组OPN mRNA水平显著降低,与轻度PE组比较,两组差异有统计学意义(Plt;0.05);但αν和β3 mRNA的表达水平三组间比较差异无统计学意义。结论OPN及其受体整合素ανβ3在PE胎盘组织中的低表达可能在子痫前期的发病过程中起重要作用。
ObjectiveTo systematically evaluate the association between 936C/T polymorphism in vascular endothelial growth factor (VEGF) gene and the risk of preeclampsia (PE). MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 11, 2014), CBM, CNKI, VIP, and WanFang Data were searched up to November 2014, to collect case-control studies of the association between 936C/T polymorphism in VEGF gene and the risk of PE. Two reveiwers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. And then, meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine case-control studies involving 904 PE patients and 1 113 controls were included. The results of meta-analysis showed that, significant association was found between VEGF gene 936C/T polymorphism and the risk of PE in the total analysis (T vs. C:OR=1.61, 95%CI 1.17 to 2.22, P=0.003; TT vs. CC:OR=2.65, 95%CI 1.37 to 5.11, P=0.004; CT vs. CC:OR=1.55, 95%CI 1.09 to 2.22, P=0.02; TT+CT vs. CC:OR=1.68, 95%CI 1.15 to 2.45, P=0.007; TT vs. CT+CC:OR=2.19, 95%CI 1.31 to 3.68, P=0.003). In the subgroup analysis, significant association of the polymorphism was found in Asians but not in Caucasians. ConclusionVEGF gene 936C/T polymorphism may be associated with PE risk in Asians. Due to limited quantity and quality of the included studies, the conclusion should be assessed in further studies.
Objective To explore the levels and the clinical significance of serum soluble Endoglin (sEng) and soluble Fms-like tyrosine kinase (sFlt-1) in patients with preeclampsia (PE). Methods Ninety-six patients with PE were included from June 2009 to June 2014. The patients were divided into mild PE group (n=54) and severe PE group (n=42), while 40 healthy pregnant women were in the control group. The general situation and laboratory testing were recorded and the serum levels of sEng and sFlt-1 were detected. All patients were routinely followed up with the recording of delivery and neonatal situation. Results The sEng and sFlt-1 levels were highest in the severe PE group [(7345.02±772.73) and (866.08±203.24) ng/L], which was followed by mild PE [(5 547.08±564.06) and (603.99±138.37) ng/L] and control group [(1 840.93±300.71) and (252.68±83.03) ng/L] (P<0.01). Levels of sEng were significantly correlated with sFlt-1 in both mild and severe PE groups. There were significantly correlations between sEng and sFlt-1 in mild or severe PE group respectively. The level of sEng and sFlt-1 was considerably positively correlated with mean arterial pressure, 24-hour urinary protein, serum creatinine, fibrinogen, umbilical artery shrink/diastole and resistance index value, but negatively correlated with prothrombin time, birth weight and the placenta weight (P<0.05). PE patients with sEng of <5 000 ng/L and sFlt-1 levels of <700 ng/L had the risk of severe complications of 6.8% and 14.0%; while patients with sEng of ≥5 000 ng/L and sFlt-1 of ≥700 ng/L had the ratio fo 40.4% and 37.0% respectively (P<0.01). Conclusion Serum levels of sEng and sFlt-1 in PE patients indicate that the severity of disease and outcomes of pregnancy.
Hypertensive disorder of pregnancy (HDP) is a type of disease unique to women during pregnancy. The most common clinical types are gestational hypertension and preeclampsia, which seriously threaten the health of pregnant women and fetuses. At present, there are no established criteria for the prediction and prevention of HDP. In recent years, a large number of studies have been carried out on HDP around the world, and many studies have shown a close correlation between serum uric acid and HDP. This article reviews the results of existing literature, elucidates the relationship between serum uric acid and the pathogenesis of HDP, prediction of HDP occurrence and development, and adverse pregnancy outcomes.