The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.
РЕЗЮМЕ. Цель. Оценить демографический потенциал Амурской области на основании изучения численности, половозрастного состава, состояния здоровья населения с 2010 года и выделить приоритетные направления сохранения и востановления народонаселения. Материалы и методы. Проведен анализ численности, половозрастного состава и здоровья населения, в том числе заболеваемости беременных и детей в возрасте 0-14 лет, за 8 лет в период с 2010 по 2018 гг. по данным Федеральной службы государственной статистики по Амурской области и формы №32-«Заболеваемость беременных, рожениц, родильниц и новорожденных», формируемой Медицинским информационно-аналитическим центром Министерства здравоохранения Амурской области. Результаты. Численость населения Амурской области с 2010 г. уменьшилась на 4,4% и в 2018 г. составила 798,4 тыс. человек. В Амурской области выявлено увеличение числа женщин в возрастных группах 5-9 и 10-14 лет на 18,7%. Наибольший коэффициент рождаемости отмечен у женщин в возрасте 20-24 года, 25-29 лет и 30-34 года, рост коэффициента рождаемости-в 30-34 года, 35-39 лет и 40-44 года. Суммарный коэффициент рождаемости за исследуемый период увеличился до 1,71. Эти данные свидетельствуют о наличии потенциала для восстановления народонаселения Амурской области в ближайшем будущем. Однако отмечается рост соматической патологии у взрослого населения-болезней органов дыхания, мочеполовой системы и системы кровообращения, у женщин-злокачественных новообразований молочной железы, шейки и тела матки. С высокой частотой диагностируются соматические заболевания при беременности, что осложняет ее течение: анемия, сахарный диабет, гипертензивные расстройства. Отмечается рост заболеваемости детей в возрасте 0-14 лет по основным классам болезней на 17%, чаще-болезнями органов дыхания и пищеварения. Заключение. Ранняя диагностика и своевременное лечение данной патологии, в том числе на этапе планирования беременности, будет иметь влияние на здоровье настоящего и будущих поколений, проживающих в Амурской области. Ключевые слова: численность населения Амурской области, состояние здоровья, демография.
The aim of the study was to assess fertility in women of reproductive age with hypothalamic dysfunction (HD) in the pubertal period and to determine the diagnostic significance of pro-inflammatory (TNF-α and IL-1β), anti-inflammatory cytokine (IL-10) and NF-kB activity in the diagnosis of primary infertility in these women.Materials and Methods: Fertility was assessed in 86 women of reproductive age with HD in the pubertal period. A comparative characteristic of fertile women (Group 1, n=46) and primary infertility women (Group 2, n=21) with HD in the pubertal period was performed. FPG and FPI were determined after 8 to 12 hours of fasting. Serum IRI concentrations were measured using an ELISA kit. The levels of TNF-α, IL-1β and IL-10 were determined in the venous blood serum after a 12-hour fasting, as well as in uterine aspirate (UA) on the 21st day of the menstrual cycle using ELISA kits. The activity of NF-kB was determined in UA on the 21 st day of the menstrual cycle using an enzyme immunoassay kit.Results: BMI in Group 1 was significantly lower than in Group 2: 22.63±2.68 kg/m 2 versus 27.05±4.03 kg/m 2 (P=0.000). WC in women of Group 1 was 66.11±5.66 cm versus 78.52±10.54 cm in Group 2 (P=0.000); WC >80 cm was found in 2(4.4%) and 14(66.7%) women, respectively (P=0.000). The average levels of FPG and FPI were significantly higher in Group 2. Serum levels of TNF-α and IL-1β in Group 2 were significantly higher than in Group 1. The serum level of anti-inflammatory cytokine IL-10 was significantly lower in Group 2; accordingly, the TNF-α/IL-10 ratio in Group 2 was 1.8 times higher than in Group 1. The IL-1β level in UA (P=0.000) and the TNF-α/IL-10 ratio (P=0.02) were significantly higher in women of Group 2 than Group 1, which indicated the pronounced inflammatory effects of TNF-α in the endometrium. In women of Group 2, the NF-kB level in UA was 1.4 times higher than in Group 1 (P=0.000).Conclusion: Every fourth woman of reproductive age with HD in the puberty period has primary infertility. The results obtained indicate the activation of the Th-1 immune response with the formation of the inflammatory reactions at the systemic level and in the endometrium. Diagnostically significant markers of primary infertility are the serum TNF-α level and the UA levels of IL-1β and NF-kB. AbbreviationsBMI, body mass index; FPG, fasting plasma glucose; FPI, fasting plasma insulin; HD, hypothalamic dysfunction; IRI, immunoreactive insulin; IR, insulin resistance; UA, uterine aspirate (an aspirate from the uterine cavity); WC, waist circumference.
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