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The Relationship between the Ratio of Neutrophil and Lymphocyte in Preeclampsia Patients Ayuni, Intan Nabilla; Yeni, Cut Meurah; Husnah, Husnah; Sakdiah, Sakdiah
Asian Journal of Healthcare Analytics Vol. 4 No. 1 (2025): May 2025
Publisher : PT FORMOSA CENDEKIA GLOBAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55927/ajha.v4i1.14391

Abstract

Preeclampsia is a hypertensive disorder with elevated blood pressure and proteinuria after 20 weeks of gestation, often involving an exaggerated inflammatory response. This study examined the relationship between the neutrophil-to-lymphocyte ratio (RNL) and preeclampsia. A retrospective analytic study with a cross-sectional approach analyzed medical records of 106 inpatients at Zainoel Abidin Hospital Banda Aceh from January to December 2020. Most patients were aged 20-35 years (64.2%), college-educated (38.8%), housewives (68.9%), and multiparas (62%). RNL analysis showed 8.6% normal and 91.4% abnormal in severe preeclampsia cases. The Spearman correlation test showed p=0.367 (p>0.05), indicating no significant relationship between RNL and preeclampsia. The mean RNL was 6.5267 in preeclampsia and 8.3106 in severe cases, both exceeding the normal cut-off of 4.8. There was no relationship between RNL and preeclampsia, but the mean RNL values were above normal.
Ethnopharmacological insights and clinical prospects of ten Indonesian medicinal plants for pregnancy, postpartum, and lactation: a systematic review Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Rahardjo, Theresia Monica; Suryawan, Aloysius; Rahardjo, Bambang; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.77

Abstract

Background: The perinatal period involves significant physiological and metabolic transitions, particularly concerning hypertensive disorders, preeclampsia, hemorrhage, lactation challenges, and oxidative stress. Although pharmacological therapies are available, their safety and accessibility remain inconsistent, especially in resource-limited settings. Indonesia’s extensive biodiversity and deep-rooted ethnomedicinal traditions offer promising yet underutilized botanical alternatives. This study aimed to review the efficacy of Indonesian medicinal plants used in pregnancy, postpartum, and lactation. Methods: This systematic review investigates ten Indonesian medicinal plants traditionally used during pregnancy, postpartum recovery, and lactation: Sauropus androgynus, Curcuma longa, Moringa oleifera, Nigella sativa, Centella asiatica, Orthosiphon aristatus, Syzygium polyanthum, Andrographis paniculata, Solanum nigrum, and Zingiber officinale. Literature from 2000 to 2025 was reviewed using PRISMA guidelines across global and regional databases. Phytochemical composition, mechanisms of action, therapeutic effects (e.g., antihypertensive, antidiabetic, galactagogue, hemostatic, antioxidant), and clinical relevance were critically evaluated. Results: All ten plants demonstrated pharmacological potential relevant to perinatal health challenges. Notably, Zingiber officinale offers antiemetic and anti-inflammatory benefits during early pregnancy, complementing the lactogenic, antihypertensive, and wound-healing properties of other species. However, gaps persist in human trials, dosage standardization, and regulatory oversight. Conclusion: The review highlights the importance of integrating validated traditional botanicals into perinatal care through interdisciplinary research, targeted clinical trials, and culturally responsive health policies. Bridging ethnopharmacology with maternal health systems offers a scalable, sustainable pathway toward maternal wellness and equity in Indonesia and comparable global settings.
Blood Cadmium and Preterm Birth: A Systems Toxicology Review of Molecular Mechanisms, Placental Disruption, and Translational Obstetric Implications Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Pribadi, Adhi; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.949

Abstract

Objectives: Preterm birth (PTB) remains a leading global cause of neonatal morbidity and mortality, with multifactorial origins including inflammation, endocrine disruption, and placental dysfunction. Recent evidence identifies cadmium (Cd), a persistent environmental toxicant, as a modifiable contributor to PTB. This review aims to integrate the mechanistic, molecular, and clinical literature on maternal blood cadmium exposure and its role in the pathogenesis of PTB.Methods: A systematic and integrative review was conducted following PRISMA 2020 guidelines. Literature from 2000 to 2025 was retrieved using PubMed, Scopus, Embase, and Web of Science. Eligible studies included molecular toxicology, animal models, human epidemiological data, and placental mechanistic research addressing cadmium exposure and preterm birth. Inclusion criteria emphasized mechanistic clarity, gestational outcome relevance, and measurable cadmium biomarkers. Figures, tables, and mechanistic diagrams were used to illustrate toxicological convergence pathways.Results: Cadmium disrupts placental homeostasis via oxidative stress, endothelial dysfunction, impaired trophoblast invasion, progesterone suppression, and activation of inflammatory cascades such as the NLRP3 inflammasome. Consistent associations between maternal cadmium burden and PTB risk were found across animal, cellular, and human population studies. However, heterogeneity in exposure assessment, absence of unified risk thresholds, and confounding from co-exposures challenge causal inference. Literature remains fragmented, lacking integration between mechanistic insights and clinical risk models.Conclusions: Cadmium should be reclassified as a central agent in the pathophysiology of PTB. We propose a precision obstetrics framework that includes environmental cadmium screening in high-risk pregnancies, implementation of exposome-informed policies, and prospective multicenter studies with molecular endpoints. Obstetric care must evolve to include toxicological risk profiling as standard practice in the prevention of PTB.Kadmium dalam Darah dan Kelahiran Prematur: Tinjauan Toksikologi Sistemik terhadap Mekanisme Molekuler, Disrupsi Plasenta, dan Implikasi Obstetri TranslasiAbstrakTujuan: Kelahiran Prematur (preterm birth/PTB) tetap menjadi penyebab utama morbiditas dan mortalitas neonatal di seluruh dunia dengan etiologi multifaktorial yang mencakup inflamasi, gangguan endokrin, dan disfungsi plasenta. Bukti terbaru mengidentifikasi kadmium (Cd), suatu toksikan lingkungan persisten, sebagai faktor kontribusi yang dapat dimodifikasi terhadap PTB. Tinjauan ini bertujuan untuk mengintegrasikan literatur mekanistik, molekuler, dan klinis mengenai paparan kadmium dalam darah maternal dan perannya dalam patogenesis PTB.Metode: Tinjauan sistematis dan integratif dilakukan sesuai pedoman PRISMA 2020. Literatur dari tahun 2000 hingga 2025 dikumpulkan melalui database PubMed, Scopus, Embase, dan Web of Science. Studi yang memenuhi syarat mencakup toksikologi molekuler, model hewan, data epidemiologi manusia, dan penelitian mekanistik plasenta yang mengevaluasi hubungan antara paparan kadmium dan kelahiran prematur. Kriteria inklusi menekankan kejelasan mekanistik, relevansi terhadap hasil kehamilan, serta penggunaan biomarker kadmium yang terukur. Gambar, tabel, dan diagram mekanistik digunakan untuk mengilustrasikan jalur konvergensi toksikologis.Hasil: Kadmium mengganggu homeostasis plasenta melalui stres oksidatif, disfungsi endotel, gangguan invasi trofoblas, supresi progesteron, dan aktivasi jalur inflamasi seperti inflammasom NLRP3. Hubungan konsisten antara beban kadmium maternal dan risiko PTB ditemukan dalam studi hewan, seluler, dan populasi manusia. Namun, adanya heterogenitas dalam penilaian paparan, belum adanya ambang risiko yang seragam, serta pengaruh faktor pajanan lainnya menjadi tantangan dalam penarikan kesimpulan kausal. Literatur masih terfragmentasi dan belum mengintegrasikan temuan mekanistik dengan model risiko klinis secara menyeluruh.Kesimpulan: Kadmium seharusnya diklasifikasikan ulang sebagai agen sentral dalam patofisiologi PTB. Kami mengusulkan suatu kerangka kerja obstetri presisi yang mencakup skrining lingkungan terhadap kadmium pada kehamilan berisiko tinggi, menerapkan kebijakan berbasis exposome, serta studi prospektif multisentra dengan titik akhir molekuler. Pelayanan kebidanan harus berkembang dengan mengadopsi profil risiko toksikologis sebagai bagian dari praktik standar dalam pencegahan kelahiran prematur.Kata kunci: Disrupsi Plasenta; Interaksi Endokrin-Inflamasi; Kesehatan Reproduksi Lingkungan; Mekanisme Kelahiran Prematur; Toksisitas Kadmium,
Cadmium Exposure and Preeclampsia: A Systematic Review of Environmental Risk in Pregnancy Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Pribadi, Adhi; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.951

Abstract

Objective: To systematically evaluate current scientific evidence on the association between cadmium (Cd) exposure and the risk of preeclampsia in pregnant women, and to explore underlying mechanisms and population-specific patterns.Methods: This systematic review was conducted according to PRISMA guidelines. Comprehensive literature searches were performed across PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar without time restriction, focusing on the past 15 years. Inclusion criteria encompassed original human studies measuring cadmium exposure—biological, dietary, or environmental—and reporting preeclampsia as an outcome. Risk of bias was assessed using the Newcastle-Ottawa Scale.Results: Twenty-five eligible studies were included, spanning case-control, cohort, and cross-sectional designs across diverse geographic regions. Most studies found a positive association between cadmium exposure and increased preeclampsia risk, though methodological heterogeneity exists. Proposed mechanisms include cadmium-induced oxidative stress, endothelial dysfunction, placental insufficiency, and hormonal dysregulation. Evidence also highlights differences in risk based on diet, region, and environmental regulation. However, inconsistencies in exposure metrics and population stratification remain.Conclusion: The cumulative evidence suggests cadmium is a plausible environmental risk factor for preeclampsia. Future research must standardize exposure assessments and address population-specific modifiers. This review provides critical groundwork for hypothesis-driven studies and policy frameworks addressing toxic metal exposure in maternal health.Paparan Kadmium dan Preeklampsia: Tinjauan Sistematis terhadap Risiko Lingkungan pada KehamilanAbstrakTujuan: Penelitian ini bertujuan untuk melakukan tinjauan sistematis terhadap bukti ilmiah terkini mengenai hubungan antara paparan kadmium (Cd) dan risiko preeklampsia pada ibu hamil, serta mengeksplorasi mekanisme biologis yang mendasari dan pola risiko spesifik populasi.Metode: Tinjauan sistematis ini disusun berdasarkan pedoman PRISMA. Pencarian literatur dilakukan secara menyeluruh melalui basis data PubMed, Scopus, Web of Science, ScienceDirect, dan Google Scholar tanpa batasan waktu, dengan fokus pada publikasi 15 tahun terakhir. Kriteria inklusi meliputi penelitian asli pada manusia yang mengukur paparan kadmium—baik secara biologis, dietetik, maupun lingkungan—dan melaporkan preeklampsia sebagai luaran. Risiko bias dinilai menggunakan Newcastle-Ottawa Scale.Hasil: Sebanyak 25 studi memenuhi kriteria dan dianalisis, mencakup desain studi kasus-kontrol, kohort, dan potong lintang dari berbagai wilayah geografis. Mayoritas studi menunjukkan adanya hubungan positif antara paparan kadmium dan peningkatan risiko preeklampsia, meskipun terdapat heterogenitas metodologis. Mekanisme yang diusulkan meliputi stres oksidatif akibat kadmium, disfungsi endotel, insufisiensi plasenta, dan disregulasi hormonal. Bukti juga menunjukkan perbedaan risiko berdasarkan pola diet, lokasi geografis, dan tingkat pengawasan lingkungan. Namun, masih terdapat ketidakkonsistenan dalam metrik paparan dan stratifikasi populasi.Kesimpulan: Bukti kumulatif mendukung bahwa kadmium merupakan faktor risiko lingkungan yang potensial terhadap preeklampsia. Penelitian selanjutnya perlu menstandarkan metode pengukuran paparan dan mempertimbangkan faktor-faktor spesifik populasi. Tinjauan ini memberikan landasan penting bagi studi berbasis hipotesis dan penyusunan kebijakan terkait paparan logam toksik dalam kesehatan maternal.Kata kunci: Komplikasi kehamilan; paparan kadmium; preeklampsia; stres oksidatif; toksikologi lingkungan
Perinatal exposure to ultraprocessed foods and its impact on maternal gut dysbiosis, placental inflammation, and neonatal immune programming: A systematic review Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Pribadi, Adhi; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Majalah Obstetri & Ginekologi Vol. 33 No. 3 (2025): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I32025.236-248

Abstract

HIGHLIGHTS Perinatal ultraprocessed food (UPF) exposure disrupts maternal gut microbiota composition, increasing pro‑inflammatory taxa and systemic endotoxemia. Placental immune activation and oxidative stress represent key mediators linking maternal diet to fetal immune and metabolic programming. Neonatal outcomes include altered regulatory T‑cell development, Th2 immune skewing, allergic sensitization, and early metabolic risk. Integrated dietary counseling, microbiota‑targeted interventions, and public health policies are urgently needed to mitigate transgenerational immune health risks.   ABSTRACT Objective: To synthesize and critically evaluate evidence linking perinatal exposure to ultraprocessed foods (UPFs) with maternal gut dysbiosis, placental inflammation, and neonatal immune programming, and to identify translational implications for perinatal care. Materials and Methods: A systematic narrative review was conducted following PRISMA 2020 guidelines, without PROSPERO registration. Literature searches of major databases (2000–March 2025) identified 1,845 records. After screening and eligibility assessment, 20 studies were included. Study quality was appraised using validated tools, and data were synthesized thematically into evidence domains covering maternal microbiota, inflammatory pathways, placental changes, and neonatal immune outcomes. Results: Maternal UPF consumption was associated with gut dysbiosis characterized by reduced microbial diversity, increased pro-inflammatory taxa, and systemic endotoxemia. Elevated inflammatory biomarkers including lipopolysaccharide, interleukin‑6, tumor necrosis factor‑a, and C‑reactive protein were frequently reported. Limited placental studies revealed increased innate immune activation and oxidative stress. Neonatal immune alterations included regulatory T cell suppression, T helper 2 skewing, increased allergic sensitization, and metabolic programming changes. Evidence strength was highest for maternal gut dysbiosis and immune programming but limited for direct placental mechanisms. Translational opportunities include dietary counseling, microbiota-targeted interventions, and public health strategies aimed at improving maternal diet quality. Conclusion: Perinatal exposure to UPFs adversely impacts the maternal gut–placenta–fetal immune axis. Integrated dietary interventions and population-level nutrition policies are urgently needed to mitigate downstream transgenerational immune risk.