Objective: To characterize the gut microbiota in patients with preeclampsia (PE) compared with healthy controls.Methods: We analyzed and compared the microbiota communities in the feces of 48 PE patients with 48 age-, gestational weeks-, and pre-pregnancy body mass index-matched healthy controls using 16S rRNA gene sequencing, and also we tested fecal and plasma lipopolysaccharide (LPS) and plasma trimethylamine-N-oxide (TMAO) concentration levels in the two groups.Results: Compared with the control group, microbial alpha diversity was lower in the PE group, but there was no statistically significant difference between the two groups. At the phylum level, Firmicutes (51.64% PE vs. 59.62% Control, P < 0.05), Bacteroidetes (40.51% PE vs. 34.81% Control, P< 0.05), Proteobacteria (4.51% PE vs. 2.56% Control, P < 0.05), and Actinobacteria (2.90% PE vs. 1.77% Control, P < 0.05), exhibited significant differences between the PE group and the control group. LEfSe analysis found 17 differentially abundant taxa between the two groups. PICRUSt analysis found that in the KEGG pathways, the microbial gene functions related to LPS biosynthesis were higher in the fecal microbiome of the PE group. The fecal and plasma LPS concentrations and plasma TMAO concentrations of PE patients were higher than those of the healthy controls.Conclusion: PE patients had gut microbiota dysbiosis and increased plasma LPS and TMAO levels, which will lead to a better understanding of the relationship between the gut microbiota and PE.

Background:Antiphospholipid syndrome (APS)-related immune factors are considered as an important cause of recurrent spontaneous abortion (RSA). Anticoagulant and anti-inflammatory treatments are believed to effectively improve adverse pregnancy outcomes by affecting the abnormal autoimmune response of the maternal-fetal interface. The aim of this study was to observe the clinical characteristics and treatment outcomes of anticoagulant regimens and anti-inflammatory plus anticoagulation regimens for APS-related RSA.Methods:APS-related RSA cases from September 2011 to September 2016 at Peking University Third Hospital were retrospectively analyzed. The patients were assigned to study group (anti-inflammation plus anticoagulation) and control group (simple anticoagulation). The incidence of repeat abortion, the incidence of placental dysfunction, the gestational weeks of pregnancy, and the mean weight of the fetus were observed.Results:The pregnancy and neonatal outcome indicators of the repeat pregnancy loss rate (11.11% vs. 22.70%), placental dysfunction-related diseases (6.35% vs. 15.60%), the mean birth weight of infants born after 24 weeks gestation (3152.41 ± 844.67 g vs. 2765.76 ± 816.40 g), full-term delivery weight (3456.28 ± 419.79 g vs. 3076.18 ± 518.79 g), the proportions of low birth weight infants (12.70% vs. 21.98%), and small for gestational age (6.35% vs. 14.18%) differed significantly between the study and control groups (all P < 0.05). The incidence of preterm delivery, term delivery, and stillbirth was not significantly different between the two groups, and there was no significant difference between the study and control groups in gestational age at birth (37.6 ± 3.3 weeks vs. 36.9 ± 3.2 weeks; P > 0.05).Conclusion:The anti-inflammatory and anticoagulation regimen is more effective than the simple anticoagulation regimen in the treatment of APS recurrent abortion.

BackgroundCervical incompetence is an important cause of miscarriage and premature birth and polycystic ovary syndrome is a heterogeneous endocrine disorder that is the most common cause of anovulatory infertility and eugonadotrophic hypogonadism. By now, it is still debated whether women with PCOS have an increased risk of miscarriage and there have been no studies about the pregnancy outcomes of cervical incompetence patients with PCOS.MethodsThe following clinical data of cervical incompetence patients with/without PCOS who were treated between September 2006 and September 2013 were retrospectively analysed: onset gestational age, termination gestational age, pregnancy outcome, co-morbid insulin resistance (IR) in PCOS patients, the influence of IR, co-morbid hyperandrogenism (HA) in PCOS patients, and the influence of HA. The independent samples t-test and chi-square trend test were used to analyse the data.ResultsA total of 178 singleton pregnancy cases with cervical incompetence were identified. The average onset gestational age was 23.9 ± 4.3 weeks, and the average termination gestational age was 32.5 ± 5.5 weeks. Of these 178 singleton pregnancy cases, 40 (22.5 %) ended in miscarriage, 82 (46.1 %) ended in preterm birth, and 56 (31.5 %) ended in term birth. Eighty cases (44.9 %) exhibited PCOS co-morbidity, and those cases had an average onset gestational age of 22.3 ± 3.8 weeks and an average termination gestational age of 31.2 ± 5.7 weeks, which were both significantly different from those of the non-PCOS group (both P < 0.001). Compared with the non-PCOS group (15.3 % miscarriage, 48.0 % preterm birth, and 36.7 % term birth), the PCOS group exhibited worse pregnancy outcomes (31.3 % miscarriage, 43.8 % preterm birth, and 25 % term birth) (P = 0.01). Among the 80 PCOS patients, 45 (56.3 %) exhibited co-morbid IR, and the IR group exhibited significantly worse pregnancy outcomes than the non-IR group (P = 0.03). Among the 80 PCOS patients, 54 cases (67.5 %) exhibited co-morbid HA, and there was no statistical difference on the pregnancy outcomes between the two groups. The multivariate logistic regression model revealed that PCOS was significantly correlated with miscarriage (OR: 3.72, 95 % CI: 1.37–10.13).ConclusionsThe cervical incompetence patients with co-morbid PCOS exhibited earlier onset gestational ages, earlier termination gestational ages and worse pregnancy outcomes. For patients with co-morbid insulin resistance, the pregnancy outcomes were worse than expected.

The primary objective of this study was to determine the longitudinal profile of serum sST2 (soluble suppression of tumorigenicity 2), IL‐33 (interleukin‐33) and NT‐proBNP (N‐terminal pro‐brain natriuretic peptide) concentrations in twin pregnancies with pre‐eclampsia (PE) and those normotensive twins. The secondary objective was to test whether the change of serum sST2,IL‐33 and NT‐proBNP is related to PE in twin pregnancies. This is a longitudinal nested case–control study and all 156 dichorionic (DC) pregnancies were from a prospective cohort of twin pregnancies who received antenatal care and gave two live births at Peking University Third Hospital between October 2017 and September 2020. Four to five milliliters of peripheral blood of each pregnant woman were collected during the following three intervals: (1) 6–11+6 weeks; (2) 24–27+6 weeks; (3) 28–31+6 weeks. We found that sST2 and NT‐proBNP levels increased as pregnancy progressed in normotensive twin pregnancies and further increased in PE group, while no differences were found in IL‐33 levels throughout pregnancy. Then the correlation of biomarker levels with the occurrence of PE was assessed. Our results indicated that combining maternal serum sST2 and NT‐proBNP levels yielded the highest predictive value on the occurrence of PE significantly higher than the predictive value of any markers alone. Interestingly, the predictive value of second trimester (AUC = 0.876, 95%CI 0.824–0.928, LR−0.338, LR+7.67, p < 0.001)was higher than that of early‐third trimester (AUC = 0.832, 95%CI 0.769–0.896, LR−0.29, LR+3.845, p < 0.001). Serum sST2 and NT‐proBNP concentrations during second and early‐third trimester were associated with the occurrence of PE in twin pregnancies.

IntroductionThis study aimed to determine the correlation between fetal fraction (FF) of cell-free DNA (cf-DNA) and pregnancy complications related to placental dysfunction in Twin Pregnancy.MethodsThis retrospective cohort study analyzed twin pregnant women who underwent non-invasive prenatal testing (NIPT) at 12+0–26+6 weeks of gestation from April 2017 to April 2021. Low fetal fraction (LFF) was defined individually as less than the 25th, 10th, 5th, and 2.5th percentile among all fetal fractions in the cohort. Primary outcomes included gestational hypertension (GH), preeclampsia (PE), gestational diabetes mellitus (GDM), and small for gestational age (SGA). Logistic regression analysis was used to assess the relationship between LFF and pregnancy complications.ResultsA total of 500 twin pregnancies (male-male twins, 245; female-female twins, 255) were included in this study. In LFF group (FF &lt; 25th percentiles), maternal BMI was significantly higher than FF &gt; 75th percentiles (23.6 kg/m2 vs. 21.3 kg/m2; P &lt; 0.001). The risk of SGA increased gradually from FF &lt; 25th percentiles [adjusted odds ratio (OR), 1.71; 95% confidence interval (CI), 1.07–2.99; P = 0.016] to FF &lt; 2.5th percentiles (adjusted OR, 4.44; 95% CI,1.33–14.82; P &lt; 0.015). In addition, the risks of SGA in both fetuses were higher than the risks of at least one fetus SGA in LFF group. LFF had no correlation with GH, PE, and GDM in twin pregnancy.ConclusionLFF has a strong association with increased risk of SGA in twin pregnancy. Moreover, FF of cf-DNA may provide a new idea for the early screening of diseases related to placental dysfunction in twin pregnancy.