Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy, and has important health implications for mother and child. Changes in the fetoplacental vessels may predict those in the vasculature of the developing fetus, as these have been implicated in the pathogenesis of human GDM. This study aimed to determine the differences in the localization and expression level of VEGFA and VEGFR2 between placentas of women with GDM and placentas of normal pregnancies, which is the first step in elucidating the possible roles of VEGFA and VEGFR2 in the altered uteroplacental function resulting from maternal hyperglycaemia and ultimately in the manifestation of GDM. The expressions of VEGFA and VEGFR2 mRNA and protein in 20 samples from each group were analyzed by real-time PCR, immunohistochemistry and Western blot. The placental blood barrier and angiogenesis were observed by the transmission electron microscopy (TEM) in10 GDM samples and ten controls. The expression levels of VEGFA and VEGFR2 mRNA and protein were significantly decreased in the GDM group (P < 0.05 or 0.01). Immunohistochemical analysis showed the reduced expression of VEGFA and VEGFR2 protein in GDM-affected placental tissues, and the degenerative alterations of the terminal villi vascular. The expressions of VEGFA and VEGFR-2 mRNAs and protein were reduced in GDM-affected placental tissues, suggesting that maternal GDM affects the pathophysiological function of placentas.

Preterm premature rupture of membranes (PPROM) is responsible for one third of all preterm births (PTBs). We have recently demonstrated that long noncoding RNAs (lncRNAs) are differentially expressed in human placentas derived from PPROM, PTB, premature rupture of the membranes (PROM), and full-term birth (FTB), and determined the major biological pathways involved in PPROM. Here, we further investigated the relationship of lncRNAs, which are differentially expressed in spontaneous PTB (sPTB) and PPROM placentas and are found to overlap a coding locus, with the differential expression of transcribed mRNAs at the same locus. Ten lncRNAs (five up-regulated and five down-regulated) and the lncRNA-associated 10 mRNAs (six up- and four down-regulated), which were identified by microarray in comparing PPROM vs. sPTB, were then validated by real-time quantitative PCR. A total of 62 (38 up- and 24 down-regulated) and 1,923 (790 up- and 1,133 down-regulated) lncRNAs were identified from placentas of premature labor (sPTB + PPROM), as compared to those from full-term labor (FTB + PROM) and from premature rupture of membranes (PPROM + PROM), as compared to those from non-rupture of membranes (sPTB + FTB), respectively. We found that a correlation existed between differentially expressed lncRNAs and their associated mRNAs, which could be grouped into four categories based on the gene strand (sense or antisense) of lncRNA and its paired transcript. These findings suggest that lncRNA regulates mRNA transcription through differential mechanisms. Differential expression of the transcripts PPP2R5C, STAM, TACC2, EML4, PAM, PDE4B, STAM, PPP2R5C, PDE4B, and EGFR indicated a co-expression among these mRNAs, which are involved in the ubiquitine-proteasome system (UPS), in addition to signaling transduction and beta adrenergic signaling, suggesting that imbalanced regulation of UPS may present an additional mechanism underlying the premature rupture of membrane in PPROM. Differentially expressed lncRNAs that were identified from the human placentas of sPTB and PPROM may regulate their associated mRNAs through differential mechanisms and connect the ubiquitin-proteasome system with infection-inflammation pathways. Although the detailed mechanisms by which lncRNAs regulate their associated mRNAs in sPTB and PPROM are yet to be clarified, our findings open a new approach to explore the pathogenesis of sPTB and PPROM.

Preconception care is defined as the promotion of the health and well-being of a woman and her partner before pregnancy. Improving preconception health can result in improved reproductive health outcomes. China has issued latest version official guideline for preconception care in 2011. The objective of this cross-sectional study is to determine whether there is a variation in the quality of preconception healthcare services in distinct eastern and northern populations of China, and what factors are associated with such variation.

Introduction: Depression commonly occurs during pregnancy and has become a major public health concern. Depression not only affects the individual but also causes adverse consequences for families and children. However, little is known regarding the depression status and its influencing factors in women during late pregnancy in China. This study aimed to assess the prevalence of maternal depressive symptoms in late pregnancy during the coronavirus disease 2019 (COVID-19) pandemic and further explore the effect of biological, psychological, and social factors on depressive symptoms.Methods: An institution-based cross-sectional survey was conducted among eligible women in the late pregnancy stage and underwent prenatal examination at Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China from December 2022 to February 2023. Data regarding depressive symptoms and biological, psychological, and social factors of the pregnant women were collected via a structured questionnaire. Chi-square test, Fisher's exact tests, and binary logistics regression were used to analyze the data.Results: In total, 535 women in the late pregnancy stage were included in this study, 75 (14.0%) of whom exhibited depressive symptoms. A binary logistic regression analysis revealed that pregnant women who were multiparous (OR: 2.420, 95% CI: 1.188–4.932) and had moderate or severe insomnia symptoms (OR: 4.641, 95% CI: 1.787–12.057), anxiety (OR: 8.879, 95% CI: 4.387–17.971), high fear of COVID-19 (OR: 2.555, 95% CI: 1.255–5.199), moderate or severe family dysfunction (OR: 2.256, 95% CI: 1.141–4.461), and poor social support (OR: 2.580, 95% CI: 1.050–6.337) tended to show depressive symptoms. Conversely, pregnant women who received regular prenatal care (OR: 0.481, 95% CI: 0.243–0.951) and had good drinking water quality at home (OR: 0.493, 95% CI: 0.247–0.984) were more likely to avoid developing depressive symptoms.Conclusion: This study found that the prevalence of maternal depressive symptoms during late pregnancy was high and had multiple influencing factors. Thus, screening for depressive symptoms in women in the late pregnancy stage and providing special intervention programs are necessary, especially for those with risk factors.

Term pregnancy-induced labor refers to the use of artificial methods to induce uterine contractions and terminate pregnancy after 37 wk. It is a common method to prevent overdue pregnancy and to deal with high-risk pregnancies. In addition, it can alleviate maternal complications and cause the fetus to leave the adverse intrauterine environment early, which is beneficial to the outcome of pregnancy. To explore the effect of a birthing ball on labor by inducing cervical ripening and its influence on labor and the neonatal blood gas index. Twenty-two women who were scheduled to undergo labor induction and delivery in the obstetrics department of our hospital were randomly divided into two groups: the delivery ball group (childbirth ball combined with COOK balloon induction) and the conventional group (COOK balloon induction alone). The cervical Bishop score before and after intervention, duration of labor at each stage, mode of delivery, neonatal umbilical venous blood pH, oxygen partial pressure (PO₂), carbon dioxide partial pressure (PCO₂), and the 1-min Apgar score were recorded. After the intervention, the cervical Bishop score of the delivery ball group (7.84 ± 1.52) was significantly higher than that of the conventional group (7.32 ± 1.29) (P < 0.05), and the cervical Bishop scores of the two groups after intervention were significantly higher than those before intervention (P < 0.05). After the intervention, the first stage of labor (510.9 ± 98.7 min), the second stage of labor (43.0 ± 8.5 min), and the total duration of labor (560.0 ± 120.9 min) in the delivery ball group were lower than those in the routine group, with a first stage of labor of 602.1 ± 133.2 min, a second stage of labor of 48.4 ± 9.1 min, and a total duration of labor of 656.8 ± 148.5 min (P < 0.05). There was no significant difference in the time of the third stage of labor between the two groups (P > 0.05). There was no significant difference in the pH, PO₂, and PCO₂ values of newborns between the delivery ball group and the conventional group (P > 0.05). The 1-min Apgar score of the delivery ball group was higher than that of the conventional group (9.10 ± 0.38 points vs 8.94 ± 0.31 points, P < 0.05). The natural delivery rate of the delivery ball group was higher than that of the conventional group (91.00% vs 78.00%, P < 0.05). The use of a birthing ball combined with a COOK balloon for inducing labor has a better effect on promoting cervical ripening, shortening the time of labor, and improving the Apgar score of newborns.

Background: Insomnia is the most common sleep disorder in the general population, especially among pregnant women, and it is considered a major public health issue. Not only can it cause mental and physical problems in pregnant women, but it may also affect the growth of the fetus. However, there are few reports on the prevalence and influencing factors of insomnia symptoms in third-trimester women in China. The objective of this study was to assess the prevalence of insomnia symptoms among pregnant women in the third trimester in a moderately developing region of China and to further explore the associated factors of insomnia symptoms from various aspects.Methods: A cross-sectional survey was conducted among eligible pregnant women in the third trimester from December 2022 to February 2023. Data on socio-demographic characteristics, clinical characteristics, and behavioral and psychological characteristics of pregnant women were collected through a structured questionnaire. The Chi-square test and multivariate logistics regression were applied to explore the associated factors of insomnia symptoms.Results: A total of 535 pregnant women in the third trimester were included in this study, and the prevalence of insomnia symptoms was 59.8%. Multivariate logistic regression analysis revealed that pregnant women who lived together with elders (OR: 0.58, 95%CI: 0.40–0.86), had low perceived stress (OR: 0.58, 95%CI: 0.35–0.97), had no threatened abortion (OR: 0.55, 95%CI: 0.32–0.93) and had good doctor-patient communication (OR: 0.66, 95%CI: 0.45–0.98) were more likely to stay away from insomnia symptoms. However, pregnant women with anxiety symptoms (OR: 2.27, 95%CI: 1.28–4.03), fear of childbirth (OR: 1.63, 95%CI: 1.11–2.40) and a high experience of COVID-19 fear (OR: 1.61, 95%CI: 1.03–2.54) tended to have insomnia symptoms.Conclusions: The prevalence of insomnia symptoms in pregnant women is high in Lianyungang city in eastern China in the third trimester. Insomnia symptoms is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of insomnia symptoms in the third trimester and to focus on pregnant women with risk factors for insomnia symptoms.