Enantioselective syntheses Enantioselective syntheses O 0031Catalytic Asymmetric Epoxidation of Alkenes with Arabinose-Derived Uloses.-Four L-erythro-2-uloses such as (I) are prepared and applied as catalysts in the epoxidation of trans-stilbene using Oxone as oxidant. Compounds (I) exhibit good enantioselectivities (up to 90% e.e.) but give only poor yields due to decomposition of the uloses during the reaction. Three L-threo-3-uloses such as (II) are not decomposed under epoxidation conditions and higher yields but lower enantioselectivities are obtained. (II) give moderate enantioselectivities and good yields in epoxidations of di-and trisubstituted alkenes.
Objectives: To determine the prevalence of psychiatric disorders in Chinese pregnant women in Hong Kong, the effect of psychiatric disorders on pregnancy and perinatal outcomes, and the effect of antidepressants on pregnancy and perinatal outcomes. Methods: We retrospectively reviewed medical records of women who delivered in Tuen Mun Hospital after 24 weeks of gestation between 1 January 2016 and 31 December 2017. Chinese pregnant women with psychiatric disorders were identified. Women with multiple pregnancy were excluded. Results: Of 9049 Chinese pregnant women included, 216 (2.4%) reported psychiatric disorders, with depressive disorders being the most prevalent (1%). Compared to pregnant women with no psychiatric disorders, pregnant women with psychiatric disorders were more likely to have gestational diabetes (10.2% vs 5.7%, p=0.005) and/ or pre-existing diabetes (4.2% vs 1.9%, p=0.018) and preterm births before 37 weeks (13.9% vs 7.5%, p=0.001). Similarly, women with depressive disorders were more likely to have gestational diabetes (11.4% vs 5.7%, p=0.022) and preterm birth before 37 weeks (13.6% vs 7.5%, p=0.031). In multiple logistic regression, pregnant women with psychiatric disorders or depressive disorders were associated with nearly twofold increase in the risks of gestational diabetes mellitus and preterm birth before 37 weeks, after adjusting for cofounding factors. Conclusion: Depression and psychiatric disorders were associated with preterm birth and gestational diabetes. Use of antidepressants had no adverse effect on maternal or fetal outcomes.
To review medical records of pregnant women with positive non-invasive prenatal testing (NIPT) results for sex chromosome abnormalities who attended Tuen Mun hospital between 2015 and 2021. Patient decision after prenatal diagnosis, confirmatory diagnostic testing results, and pregnancy/neonatal outcomes were summarised. Methods: Medical records of women with abnormal NIPT results for sex chromosome abnormalities who attended Tuen Mun Hospital between January 2015 and December 2021 were retrospectively reviewed. Results: 56 Chinese women attended our prenatal diagnostic clinic with abnormal NIPT results for sex chromosome abnormalities involving 45,X (n=17), 47,XXY (n=10), 47,XXX (n=6), 47,XYY (n=8), disproportionate level of sex chromosomes (n=9), copy number variants of sex chromosomes (n=3), and suspected maternal sex chromosome imbalance (n=3). 53 had singleton pregnancies and three had dichorionic-diamniotic twin pregnancies. 58.9% had conventional combined Down syndrome screening; 15.2% of them were at high risk for trisomy 21. 33 (58.9%) of the patients opted for invasive diagnostic test: amniocentesis (n=29), chorionic villus sampling (n=3), and chorionic villus sampling followed by amniocentesis (n=1). Confirmatory cytogenetic test results (including postnatal results) were available in 35 cases. The overall positive predictive value of NIPT to detect fetal sex chromosome aneuploidies was 71.4%; the value was 42.9% for detecting 45,X, 100% for detecting 47,XXY, 80% for detecting 47,XXX, and 83.3% for detecting 47,XYY. False positive results were observed in three cases of confined placental mosaicism and three cases of vanishing twin pregnancies. Two women with 47,XXX and one woman with mosaic 45,X/46,XX were also incidentally discovered. Conclusion:Positive NIPT results for sex chromosome abnormalities can be caused by true fetal sex chromosome abnormalities, confined placental mosaicism/placental mosaicism, vanishing twins, and maternal X chromosome abnormalities. Multidisciplinary management can help prenatal counselling and genetic diagnosis. Follow-up confirmatory cytogenetic analysis prenatally and/or postnatally is useful to characterise the numeric or structural fetal sex chromosome abnormalities and their mosaic patterns, and can maximise the benefits of prenatal genetic screening in obtaining more genetic information to support pregnancy management and clinical care of affected unborn child.
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