HOXA cluster antisense RNA 3 (HOXA‑AS3) is considered to be involved in several malignancies, however, its biological function in the progression of epithelial ovarian cancer (EOC) remains unclear. The present study compared the expression of HOXA‑AS3 in ovarian cancer and normal ovarian tissues and analyzed the association between the expression of HOXA‑AS3 and the survival outcomes of patients with ovarian cancer. RNA interference was used to suppress HOXA‑AS3 expression in ovarian cancer cell lines in order to demonstrate the function of HOXA‑AS3 in ovarian cancer progression. The associations between HOXA‑AS3 and epithelial‑mesenchymal transition (EMT) markers were explored to verify the mechanism of action of HOXA‑AS3 in ovarian cancer. The results of the present study revealed that ovarian cancer tissues exhibited higher HOXA‑AS3 expression than normal ovarian tissues. Clinical data indicated that HOXA‑AS3 was a significant predictor of progression‑free survival and overall survival. Patients with high HOXA‑AS3 expression had a poorer prognosis than patients with low HOXA‑AS3 expression. In vitro experiments using HOXA‑AS3‑knockdown ovarian cancer cell lines demonstrated that HOXA‑AS3 knockdown inhibited cell proliferation and migration. HOXA‑AS3 was a potent inducer and modulator of the expression of EMT pathway‑related markers and interacted with both the mRNA and protein forms of HOXA3. Collectively, the findings of the present study demonstrated that HOXA‑AS3 expression is associated with ovarian cancer progression and thus, may be employed as a prognostic marker and therapeutic target in EOC.

Objective We aimed to compare the maternal and neonatal morbidities associated with elective cesarean delivery (CD) without labor and those associated with induction of labor (IOL) at ≥38 weeks of gestation.Methods This retrospective observational study from 2013 to 2020 included singleton pregnancies in nulliparous women at ≥38 weeks of gestation. Maternal and neonatal morbidities associated with elective CD without labor were compared with those associated with IOL.Results Altogether, 395 women were recruited. Among these, 326 underwent delivery through IOL, while 69 underwent elective CD. The elective CD group exhibited higher maternal age, lower gestational age at birth, and lower neonatal birth weight than the IOL group (P3) after discharge between the groups. Perinatal morbidities were similar between the groups except the incidence of meconium-stained amniotic fluid. Elective CD exhibited similar rates of complications related to composite maternal morbidity when compared with IOL, but had a lower risk of complications related to composite neonatal morbidity (relative risk, 0.45; 95% confidence interval, 0.24-0.85).Conclusion Elective CD and IOL had similar rates of composite maternal morbidity but the former exhibited some benefits against obstetric wound infection. The elective CD group exhibited a decreased risk of composite neonatal morbidity despite lower gestational age at birth and higher maternal age.

Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance with onset or first recognition occurring during pregnancy and GDM could be risk factor for various maternal fetal complications. This study aimed to investigate risks of maternal and neonatal outcomes according to GDM and normal glucose tolerance. This retrospective, observational study included singleton pregnant women who had received a 50-g oral glucose challenge test in 2nd trimester of gestation and gave birth at National Health Insurance Service Ilsan Hospital. Maternal and neonatal complications were compared between GDM and non-GDM groups. Among the 682 women, 56 were diagnosed with GDM and 626 were non-GDM group. Maternal age was older and prepregnant body mass index was higher in GDM. The rate of cesarean delivery, preeclampsia, and transfusion was similar; however, the incidence of preterm birth was higher in GDM. Multivariate analysis, however, showed that GDM was independent risk factor only for preterm birth in <37 weeks (adjusted odds ratio, 2.25; 95% confidence interval, 1.16–4.36). Regarding neonatal morbidities, APGAR score <7 at 5 minutes and the rate of macrosomia were similar; however, the rates of neonatal intensive care unit (NICU) admission, large for gestational age (LGA), and intubation were higher in GDM. Multivariate analysis, however, showed that GDM was not independent risk factor for LGA, NICU admission, and intubation rate. Compared with the non-GDM group, GDM was associated with an increased likelihood of preterm birth <37 weeks, however, did not increase cesarean delivery, postpartum hemorrhage, LGA, and NICU admission rate. This study showed that the majority of women with GDM delivered with similar maternal and neonatal outcomes in non-GDM women.

Moon H, et al. Yonsei Med J. 2023 Dec;64(1):66-70. https://doi.org/10.3349/ymj.2022.0259

RRH: Rural and Remote Health. Published article number: 6404 - Mental health care in rural and remote areas necessitate greater attention during the COVID-19 pandemic