RESUMEN
Genital mycoplasmas (GM), such as Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, and Ureaplasma urealyticum are commonly associated with spontaneous preterm labor (SPTL), spontaneous preterm birth (PTB), and preterm prelabor rupture of membranes (PPROM). This study determined the association between GM and such adverse pregnancy outcomes. We searched for studies published 1980-2019 in MEDLINE, EMBASE, and Web of Science. Studies were eligible when GM was detected during pregnancy. We included 93 and 51 studies in determining the prevalence and the inflammatory biomarkers associated with GM, respectively, using the "metafor" package within R. The protocol was registered with PROSPERO (registration no. CRD42016047297). Women with the studied adverse pregnancy outcomes had significantly higher odds of presence with GM compared to women who delivered at term. For PTB, the odds ratios were: M. hominis (OR: 2.25; CI: 1.35-3.75; I 2: 44%), M. genitalium (OR: 2.04; CIL 1.18-3.53; I 2: 20%), U. parvum (OR: 1.75; CI: 1.47-2.07; I 2: 0%), U. urealyticum (OR: 1.50; CI: 1.08-2.07; I 2: 58%). SPTL had significantly higher odds with M. hominis (OR: 1.96; CI: 1.19-3.23; I 2: 1%) or U. urealyticum (OR: 2.37; CI: 1.20-4.70; I 2: 76%) compared to women without SPTL. Women with PPROM had significantly higher odds with M. hominis (OR: 2.09; CI: 1.42-3.08; I 2: 0%) than women without PPROM. However, our subgroup analysis based on the diagnostic test and the sample used for detecting GM showed a higher prevalence of GM in maternal samples than in fetal samples. GM presence of the cervix and vagina was associated with lower odds of PTB and preterm labor (PTL). In contrast, GM presence in the AF, fetal membrane, and placenta was associated with increased odds of PTB and PTL. However, genital mycoplasmas may not elicit the massive inflammation required to trigger PTB. In conclusion, GM presence in the fetal tissues was associated with significantly increased odds of PTB and PTL.
RESUMEN
OBJECTIVES: To study the impact of diabetes on the long-term cognitive trajectories of older adults in 2 countries with different socioeconomic and health settings, and to determine whether this relationship differs by cognitive domains. This study uses Mexico and the United States to confirm if patterns hold in both populations, as these countries have similar diabetes prevalence but different socioeconomic conditions and diabetes-related mortality. METHODS: Two nationally representative cohorts of adults aged 50 years or older are used: the Mexican Health and Aging Study for Mexico and the Health and Retirement Study for the United States, with sample sizes of 18,810 and 26,244 individuals, respectively, followed up for a period of 14 years. The outcome is cognition measured as a total composite score and by domain (memory and nonmemory). Mixed-effect linear models are used to test the effect of diabetes on cognition at 65 years old and over time in each country. RESULTS: Diabetes is associated with lower cognition and nonmemory scores at baseline and over time in both countries. In Mexico, diabetes only predicts lower memory scores over time, whereas in the United States it only predicts lower memory scores at baseline. Women have higher total cognition and memory scores than men in both studies. The magnitude of the effect of diabetes on cognition is similar in both countries. DISCUSSION: Despite the overall lower cognition in Mexico and different socioeconomic characteristics, the impact of diabetes on cognitive decline and the main risk and protective factors for poor cognition are similar in both countries.
Asunto(s)
Envejecimiento Cognitivo , Disfunción Cognitiva , Diabetes Mellitus , Factores Socioeconómicos , Cognición , Envejecimiento Cognitivo/fisiología , Envejecimiento Cognitivo/psicología , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/fisiopatología , Comparación Transcultural , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidad , Diabetes Mellitus/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Pruebas de Memoria y Aprendizaje , México/epidemiología , Persona de Mediana Edad , Prevalencia , Factores Protectores , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: Cognitive impairment has emerged as an important concern in clinical practice in aging population. Several comorbid factors contribute to etiopathogenesis; one disease of interest is chronic respiratory disease. AIM: The aim of this study is to investigate the association of chronic respiratory disease with risk of cognitive impairment in older Mexicans. MATERIALS AND METHODS: Data were obtained from 2782 Mexicans, aged ≥60 years, enrolled in waves I (2001) and III (2012) of the Mexican Health and Aging Study, a prospective cohort of nationally representative sample of older Mexicans. Participants' self-reported responses were used to categorize them into having respiratory disease or not. Study outcome included participants categorized into "cognitively impaired" or "cognitively normal" groups. Multivariable logistic regression models were used to investigate the relationship. RESULTS: Overall, 16% of cohort participants reported cognitively impaired at Wave III. Compared with older Mexicans without chronic respiratory disease diagnosis, those diagnosed were not significantly associated with risk of cognitive impairment [adjusted odds ratio (OR): 0.94, 95% confidence interval (CI): 0.58-1.58]. CONCLUSION: Chronic respiratory disease is not significantly associated with risk of cognitive impairment in older Mexican adults.
Asunto(s)
Disfunción Cognitiva/etiología , Trastornos Respiratorios/complicaciones , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , México , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
OBJECTIVE: This study investigated the risk of cognitive and functional impairment in older Mexicans diagnosed with arthritis. Participants included 2,681 Mexicans, aged ≥60 years, enrolled in the Mexican Health and Aging Study cohort. METHOD: Participants were categorized into arthritis and no arthritis exposure groups. Primary outcome included participants categorized into "cognitively impaired" or "cognitively normal" groups. Secondary outcomes included participants categorized into Normal, Functionally Impaired only, Cognitively Impaired only, or Dementia (both cognitively and functionally impaired) groups. Multivariable logistic and multinomial regression models were used to assess the relationships. RESULTS: Overall, 16% or 7% were diagnosed with cognitive impairment or dementia. Compared with older Mexicans without arthritis, those who were diagnosed with arthritis had significantly increased risk of functional impairment (adjusted odds ratio [OR] 1.82, 95% confidence interval [CI] = [1.45, 2.29]), but not of dementia. CONCLUSION: Arthritis is associated with increased risk of functional impairment, but not with dementia after 11 years in older Mexicans.