| Objective:To explore the correlation between high mobility group protein B1(high mobility group box1,HMGB1),paraoxonase-1(paraoxonasel-1,PON-1)and monocyte chemoattractant protein-1(monocyte chemotactic protein-1,MCP-1)and(meconium stained amniotic fluid,MSAF).Methods:Collect the clinical cases of neonates and pregnant mothers who were admitted to two hospitals from January 2018 to December 2019 in somewhere,signed informed consent for specimen collection,amniotic fluid third degree fecal infection and amniotic fluid clearing.It is divided into two groups,MSAF group and control group.Newborns with full-term single fetal amniotic fluid of degree Ⅲ feces are set as MSAF group,and newborns with full term single fetal amniotic fluid are set as control group.By comparing gender,gestational age,By comparing relevant clinical data,analyze the high-risk factors of MS AF.Collect specimens from patients who collected clinical data.The fetal placenta and umbilical cord blood of the full-term amniotic fluid with Ⅲ degree fecal staining and full-term amniotic fluid were collected.Divided into two groups,the MSAF group with full-term amniotic fluid Ⅲ degree fecal staining,n=38;the control group of full-term amniotic fluid clear,amniotic fluid n=35.Both groups of placenta were HE stained to observe the pathological changes of placenta.Immunohistochemical staining was used to observe the expression of HMGB1 in placenta tissues of MSAF group and control group.Detect the content of MCP-1 in cord blood.Result:1.Correlation between clinical data of pregnant mothers and neonates and MSAF:average gestational age(41.38 ± 1.40)weeks in the MSAF group;average gestational age(39.20 ± 1.24)weeks in the control group,comparing birth weight,age and gender of the mother in the MSAF group with the control group,There is no statistically significant difference between the factors of first-trimester/partum maternal,hyperthyroidism,hypothyroidism and anemia,and the history of fetal care(P>0.05).There were statistically significant differences in gestational age,gestational diabetes,hypertension during pregnancy,abnormal umbilical cord,abnormal placenta,and neonatal asphyxia(P<0.05).Among them,gestational age and placental abnormalities are high-risk factors for amniotic fluid fecal infection.The OR are 2.639(95%CI:1.646-4.231)and 4.506(95%CI:1.034-19.631),respectively,and are positively correlated.2.A total of 73 cases of placenta HE staining in MS AF group and control group,6 cases of acute chorioamnionitis(5 cases in MSAF group,1 case in control group),32 cases of chronic chorioamnionitis(23 cases in MSAF group,control group 2 cases).In the MSAF group,3 cases had chorionic amniotic columnar epithelial metaplasia and 35 cases had no abnormal placenta.HMGB1 immunohistochemistry experiments in the placenta revealed that HMGB1 was mostly expressed in placental trophoblasts,vascular endothelial cells,amniotic epithelial cells and interstitial cells.The expression intensity of HMGB1 in placenta tissue in MSAF group was higher than that in control group,the difference was statistically significant(P<0.05).3.The content of PON1 in umbilical cord blood of MSAF group was 80.40 ±24.67nmol/mL,and that of control group was 95.65±24.33noml/mL.Cord blood PON-1 was compared between the two groups.The MSAF group was lower than the control group,the difference was statistically significant(P<0.05).The content of cord blood MCP-1 in the MSAF group was 271.10(174.35-326.62)pg/mL,the control group was 104.89(50.15-184.19)pg/mL,the cord blood MCP-1 was compared between the two groups,and the MSAF group was more obvious than the control group.Elevated,the difference is statistically significant(P<0.05).Conclusion:1.Abnormal gestational age and placenta are the clinical high-risk factors that cause MSAF.2.Placental chorioamnionitis may be one of the causes of MSAF.3.HMGB1,PON-1,and MCP-1 may be involved in the occurrence of MSAF,suggesting that oxidation/antioxidation imbalance and inflammation may be one of the mechanisms of MSAF. |
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