Publications by authors named "Ka-Wang Cheung"

The role of gut microbiota in live birth attainment upon fertilization (IVF) remains unclear. We recruited 67 women, evaluated bacterial constituents in the serum, and analyzed the gut microbiota composition and functions prior to an IVF-frozen embryo transfer (FET). A higher serum flagellin level, residues from flagellated bacteria, was observed in women without live birth after FET.

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Prenatal and intrapartum invasive tests are possible mechanisms of mother to child transmission (MTCT) of hepatitis B virus (HBV). The viral activity can affect the MTCT risk after invasive tests, but the evidence is scarce. This scoping review discussed the effects of prenatal or intrapartum invasive tests on the risk of HBV MTCT.

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Progress towards achieving global elimination of hepatitis B virus (HBV) by 2030 remains unsatisfactory. Prevention of mother to child transmission is crucial but current Clinical Practice Guidelines (CPGs) gave diverse recommendations, creating confusion and leading to significant challenges in the practical implementation across various regions owing to global inequity. We reviewed 47 CPGs on the management of hepatitis B during pregnancy against twelve important clinical questions.

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  • * A review of over 39,000 deliveries found that higher fasting glucose (FG) and 2-hour glucose (2hG) levels in early pregnancy are linked with increased risks of various complications, starting from specific glucose thresholds.
  • * Every mmol/L increase in FG or 2hG correlates with a greater likelihood of complications such as pre-eclampsia, insulin use, and larger babies, indicating that early pregnancy glycaemia should be monitored more closely in high-risk women.
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  • * This review summarizes what is currently known about B cell functions during pregnancy, highlighting different B cell types and their influences on pregnancy outcomes.
  • * It also discusses the impact of B cell-related autoantibodies, cytokines, and signaling pathways on complications like pregnancy loss, preeclampsia, and preterm birth.
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Objective: To assess the obstetric and neonatal outcomes of Jehovah's Witness (JW) mothers and the willingness to accept blood products after multidisciplinary management.

Study Design: A retrospective case-control study was conducted at Queen Mary Hospital from 2005 to 2020. Delivery records of pregnant women who identified themselves as JW were reviewed.

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Studies demonstrated increased obstetric and neonatal complications in women with schizophrenia-spectrum disorder (SSD), but most inadequately addressed confounders and rarely considered antipsychotic effects. We conducted a meta-analysis and a population-based cohort study evaluating associations of adverse obstetric/neonatal outcomes with SSD and prenatal antipsychotic use. In the meta-analysis, we searched four databases from inception to October-31-2023 and generated pooled risk estimates using random-effect models.

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Aim: To develop evidence-based clinical algorithms for the assessment and management of spontaneous, uncomplicated labour and vaginal birth.

Population: Pregnant women at any stage of labour, with singleton, term pregnancies considered to be at low risk of developing complications.

Setting: Health facilities in low- and middle-income countries.

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Previous research examining bipolar-disorder (BD) and pregnancy/neonatal outcomes yielded mixed results, were mostly derived from Western countries and rarely delineated effect between disorder and mood-stabilizers. This population-based study identified women age 15-50 years who delivered first/singleton child in 2003-2018 in Hong Kong, utilizing territory-wide medical-record database of public healthcare services. Propensity-score weighted logistic-regression analyses adjusted for confounders were employed to examine risk of adverse pregnancy, delivery and neonatal outcomes associated with BD and mood-stabilizers (lithium, anticonvulsants and antipsychotics).

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Background: Unrecognized diabetes mellitus during pregnancy could pose serious maternal and neonatal complications. A hemoglobin A1c level of ≥6.5% was used to diagnose both diabetes mellitus in nonpregnant individuals and diabetes in pregnancy.

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  • This study aimed to compare cervical length measurements in early pregnancy between women who experience spontaneous preterm births and those who deliver at term.
  • Researchers systematically reviewed existing studies by searching databases and included only those measuring cervical length through transvaginal ultrasounds before 16 weeks.
  • Results showed that women with spontaneous preterm births had significantly shorter cervical lengths compared to those who delivered at term, indicating cervical length as a potential indicator for preterm birth risk.
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Fetal hyperthyroidism can occur secondary to maternal autoimmune hyperthyroidism. The thyroid-stimulating hormone receptor antibody (TRAb) transferred from the mother to the fetus stimulates the fetal thyroid and causes fetal thyrotoxicosis. Fetuses with this condition are difficult to detect, especially after maternal Graves disease therapy.

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  • The study focused on healthy infants with vitamin D deficiency (VDD), highlighting that those without proper supplementation are at higher risk for persistent deficiency.* -
  • A total of 131 infants participated, with the majority being boys; most were exclusively breastfed and given a standard vitamin D dose of 400 IU, rather than higher doses needed for treating VDD.* -
  • Results showed that many infants remained vitamin D deficient as they grew, indicating exclusive breastfeeding and lack of supplementation significantly contribute to ongoing vitamin D insufficiency.*
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  • Early-onset preeclampsia (EOPE) is a serious pregnancy problem that starts early but shows symptoms later on, and it's hard to predict or treat.
  • A protein called adrenomedullin (ADM) is found in high amounts in the placenta during early pregnancy, and it helps with important processes in the placenta.
  • Research shows that when ADM is low in pregnant women who go on to develop EOPE, it can lead to complications, but increasing ADM levels can help reduce these issues in studies with mice.
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To date, there is a lack of randomized trial data examining the use of the antiviral nirmatrelvir/ritonavir in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant persons. This target trial emulation study aimed to address this gap by evaluating the use of nirmatrelvir/ritonavir in nonhospitalized pregnant women with symptomatic SARS-CoV-2 Omicron variant infection. Among patients diagnosed between 16 March 2022 and 5 February 2023, exposure was defined as outpatient nirmatrelvir/ritonavir treatment within 5 days of symptom onset or coronavirus disease 2019 (COVID-19) diagnosis.

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Background: Integrating telehealth in an obstetric care model is important to prepare for possible infection outbreaks that require social distancing and limit in-person consultations. To ensure the successful implementation of obstetric telehealth in Hong Kong, it is essential to understand and address pregnant women's concerns.

Objective: This study aimed to assess pregnant women's attitudes, concerns, and perceptions regarding telehealth obstetric clinic services in Hong Kong.

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  • This text highlights the importance of maternal-fetal interactions, particularly focusing on glycosylation, which involves attaching sugar chains (glycans) to molecules essential for a healthy pregnancy.
  • It aims to review recent research on glycosylation's roles at the maternal-fetal interface and its effects on pregnancy outcomes, including complications like implantation failure and preeclampsia.
  • The review utilized a thorough search of relevant literature from 1980 to 2023 to gather insights on glycosylation, glycosyltransferases, and glycan-binding proteins affecting endometrial receptivity and placentation.
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Medulla Tetrapanacis (MT) is a commonly used herb to promote lactation and manage mastitis in lactating mothers. However, its anti-inflammatory and anti-bacterial effects are currently unknown. We hypothesized that MT water extract possesses anti-inflammatory and anti-bacterial effects by modulating macrophage polarization to reduce the release of inflammatory mediators and phagocytosis via inactivation of MAPKs pathways.

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Background: Spontaneous preterm birth (PTB) affects 6.5% of deliveries in Hong Kong. Quantitative fetal fibronectin (fFN) is under-utilised as a test for PTB prediction in Hong Kong.

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Pregnancy involves a wide range of adaptations in the maternal body. Maternal immune tolerance toward the foreign fetus is critical for a successful pregnancy. Decidual macrophages are the primary antigen-presenting and phagocytic cells responsible for antigen presentation and apoptotic cell removal.

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  • Reducing maternal mortality is crucial globally, but Hong Kong has low reporting on maternal deaths, raising concerns about underreporting of these incidents.
  • A study conducted across all public maternity hospitals from 2000 to 2019 identified 173 maternal deaths, revealing that conditions like suicide, stroke, and cancer were significant causes, with a notable number occurring in the postpartum period.
  • The findings indicate a maternal mortality ratio range of 1.63 to 16.78 deaths per 100,000 live births, highlighting the need for improved data collection and understanding of maternal health issues in Hong Kong.
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The placenta is important for fetal development in mammals, and spatial transcriptomic profiling of placenta helps to resolve its structure and function. In this study, we described the landscape of spatial transcriptome of human placental villi obtained from two pregnant women at the first trimester using the modified Stereo-seq method applied for paraformaldehyde (PFA) fixation samples. The PFA fixation of human placenta villi was better than fresh villi embedded in optimum cutting temperature (OCT) compound, since it greatly improved tissue morphology and the specificity of RNA signals.

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Fetal structural congenital abnormalities (SCAs) complicate 2-3% of all pregnancies. Whole-exome sequencing (WES) has been increasingly adopted prenatally when karyotyping and chromosomal microarray do not yield a diagnosis. This is a retrospective cohort study of 104 fetuses with SCAs identified on antenatal ultrasound in Hong Kong, where whole exome sequencing is performed.

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Aim: To evaluate the causes of miscarriage and subsequent pregnancy outcomes among different phenotypes of second trimester miscarriage.

Methods: Retrospective analysis of 170 consecutive second trimester miscarriages between 14 + 0 and 23 + 6 weeks recorded in the Clinical Data Analysis and Reporting System from 2012 to 2021. Cases were excluded if miscarriages occurred before 14 + 0 weeks of gestation, data were incomplete, or passage of the fetus happened before the clinical assessment.

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Objectives: Infant vaccination against the hepatitis B virus began in the World Health Organization South East Asia Region and the Western Pacific Region between 1983 and 2016. This systematic review examined the seroprevalence of hepatitis B surface antigen (HBsAg) in children and the rate of mother-to-child transmission (MTCT) in these regions between 1990 and 2020.

Methods: MEDLINE and EMBASE were searched for articles published between January 1990 and September 2020, which reported seroprevalence of HBsAg in children aged 0-15 years and/or the rate of MTCT in the South East Asia Region and Western Pacific Region.

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