Biomechanics is a physical phenomenon which mainly related with deformation and movement of life forms. As a mechanical signal, it participates in the growth and development of many tissues and organs, including ovary. Mechanical signals not only participate in multiple processes in the ovary but also play a critical role in ovarian growth and normal physiological functions. Additionally, the involvement of mechanical signals has been found in ovarian cancer and other ovarian diseases, prompting us to focus on the roles of mechanical signals in the process of ovarian health to disease. This review mainly discusses the effects and signal transduction of biomechanics (including elastic force, shear force, compressive stress and tensile stress) in ovarian development as a regulatory signal, as well as in the pathological process of normal ovarian diseases and cancer. This review also aims to provide new research ideas for the further research and treatment of ovarian-related diseases.
INTRODUCTION:
Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. The aim of our study was to assess NICU admission rates and composite neonatal morbidity (CNM) in pregnancies with persistent FGR, and to evaluate fetal outcomes based on FGR associated with negative growth velocity.
METHODS:
We conducted a retrospective cohort study of women with non-anomalous singleton pregnancies complicated by FGR who delivered at our institution. Growth velocity was calculated by subtracting the EFW percentile at the final growth scan from the percentile at the first growth scan and dividing by the number of weeks between the scans.
RESULTS:
124 women with pregnancies complicated by FGR were identified. 82 women met inclusion criteria for growth velocity evaluation, 91 women met criteria for assessment of perinatal outcomes of interest. Patients with persistent FGR had an earlier gestational age at time of delivery (36.2 vs. 37.7 wks, p= 0.01), and lower birth weight (2150 gm vs 2601 gm, p=0.005). NICU admission and CNM were higher in pregnancies with persistent FGR (40.3% vs. 13.6%, p=0.036, 37.7% vs. 13.6, p=0.039). Neonates with negative growth velocity more likely delivered at an earlier gestational age (36.2 vs 37.6 weeks, p=0.027), delivered by cesarean section (59.1% vs 36.8%, p=0.044) and had lower birthweight (2154 vs 2475 grams, p=0.020).
CONCLUSION:
Pregnancies with persistent FGR are associated with increased NICU admissions, and composite neonatal morbidity. Similarly, pregnancies with FGR and negative growth velocity are more likely to deliver early, have lower birthweight, and deliver by cesarean section compared to those with growth.
OBJECTIVE: Investigate whether there are racial differences in efficacy of prenatal DHA supplementation to prolong gestation and prevent early preterm birth STUDY DESIGN: Secondary analysis from a randomized-controlled adaptive-design superiority trial investigating the efficacy of DHA to reduce preterm birth < 34 weeks. 1100 women randomized to receive standard prenatal dosing of DHA, 200 mg (n¼492) or higher dose, 1000 mg (n¼540), daily from < 20 weeks to delivery. We compared DHA levels and pregnancy outcomes of participants selfreported as Non-Hispanic Black (NHB) to those of other races and ethnicities (R/E). A path analytic model was performed using three simultaneous regressions: (1) Baseline serum DHA regressed on race, (2) Delivery cord DHA regressed on baseline DHA, race, DHA dose (200 vs 1000 mg/day), and assigned DHA dose*maternal race interaction; and (3) Gestational age(GA; transformed) on baseline DHA level, delivery cord DHA level, and maternal race. Bayesian statistical analysis identified predictor effect via posterior probabilities (PP) and 95% credible intervals (CI) RESULTS: GA at birth was lower for Black women than other R/E, -0.62 wks (CI, -0.42, -0.82), PP¼1.00, as was maternal DHA at enrollment, -0.72% of RBC total fatty acids (CI -0.96, -0.47). DHA at delivery (cord blood) was lower for Black women than other R/E, increased with higher enrollment DHA and higher dose supplementation, but the dose effect was slightly smaller for Black women. The impact of dose on GA at birth was mediated through DHA level at delivery. The dose effect for 1000 mg vs 200 mg/day for Black women was 0.16 wks (CI 0.06, 0.27), similar to the effect for other R/ E of 0.16 wks (CI 0.11, 0.22). CONCLUSION: Higher dose DHA supplementation during pregnancy has a positive effect on later gestational age at birth. The beneficial effect of supplementation is similar for Black mothers; however, they are at risk of shorter gestational length and lower DHA levels at baseline. These data suggest that Black women may require higher DHA supplement dosing to overcome these baseline differences and achieve comparable benefit.
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