Duration Of Pregnancy Research Articles

Rosiglitazone-Mediated Activation of PPARγ Restores HO1 Expression in the Human Preeclamptic Placenta.

Preeclampsia is a hypertensive disorder of pregnancy characterized by chronic placental ischemia and suppression of proangiogenic proteins, causing oxidative stress, hypertension, and maternal systemic organ damage. The transcription factor, PPARγ (peroxisome proliferator-activated receptor-γ) promotes healthy trophoblast differentiation but is dysregulated in the preeclampsia placenta. Our study identifies the beneficial impact of Rosiglitazone-mediated PPARγ-activation in the stressed preeclampsia placenta. We used first trimester placentas, preeclamptic and preterm control placentas, and human trophoblast cell lines to study PPARγ activation. Induction of PPARγ activates cell growth and antioxidative stress pathways, including the gene, heme oxygenase 1 (Hmox1). Protein expression of both PPARγ and HO1 (heme oxygenase 1) are reduced in preeclamptic placentas, but Rosiglitazone restores HO1 signaling in a PPARγ-dependent manner. Restoring disrupted pathways by PPARγ in preeclampsia offers a potential therapeutic pathway to reverse placental damage, extending pregnancy duration, and reduce maternal sequelae. Future research should aim to understand the full scope of impaired PPARγ signaling in the human placenta and focus on compounds for safe use during pregnancy to prevent severe perinatal morbidity and mortality.

Circovirus as a factor controlling the effectiveness of pregnancy in sows

The results of a microscopic examination of the internal organs of virally aborted fetuses are presented in order to determine the causes of reproductive losses in conditions of subclinical circovirus infection in sows. The material of the study was the tissues of the liver, placenta, umbilical cord, spleen and brain of abortion fetuses of sows whose pregnancy was interrupted in the last trimester of pregnancy. They had clinical signs of diseases associated with PCV-2 infection. It has been established that the PCV-2 virus has the ability to penetrate the feto-placental barrier from the mother's body; due to infection of the umbilical cord and placenta, it enters the fetus, in which it exhibits tropism in relation to the cells of the liver, spleen and brain. The development of the virus in the cells of these organs is the cause of the development of inflammatory, dystrophic and necrotic processes in them, affecting the processes of their intrauterine development, therefore in the last trimester of pregnancy, the cells of the liver, spleen and brain do not have functional properties corresponding to the duration of pregnancy, which affects their viability. The study demonstrates the role of circovirus infection in the formation of reproductive losses in sows in industrial conditions.

Mediating processes underlying the associations between maternal obesity and the likelihood of cesarean birth.

Pregnant women with obesity are more likely to experience cesarean birth compared to women without obesity. Yet, little is known about the underlying mechanisms. The objective of this study was therefore to evaluate how mediators contribute to the association between obesity and prelabor/intrapartum cesarean birth. We retrospectively analyzed Swiss cohort data from 394,812 singleton, cephalic deliveries between 2005 and 2020. Obesity (BMI ≥ 30 kg/m2 ) was defined as the exposure and prelabor or intrapartum cesarean birth as the outcomes. Hypothesized mediators included gestational comorbidities, large-for-gestational-age infant, pregnancy duration >410/7 weeks, slower labor progress, labor induction, and history of cesarean birth. We performed path analyses using generalized structural equation modeling and assessed mediation by a counterfactual approach. Women with obesity had a cesarean birth rate of 39.36% vs. 24.12% in women without obesity. The path models mainly showed positive direct and indirect associations between obesity and cesarean birth. In the total sample, the mediation models explained up to 39.47% (95% CI 36.92-42.02) of the association between obesity and cesarean birth, and up to 57.13% (95% CI 54.10-60.16) when including history of cesarean birth as mediator in multiparous women. Slower labor progress and history of cesarean birth were found to be the most clinically significant mediators. This study provides empirical insights into how obesity may increase cesarean birth rates through mediating processes. Particularly allowing for a slower labor progress in women with obesity might reduce cesarean birth rates and prevent subsequent repeat cesarean births in multiparous women.

Zika virus co-opts microRNA networks to persist in placental niches detected by spatial transcriptomics

Zika virus congenital infection evades double-stranded RNA detection and may persist in the placenta for the duration of pregnancy without accompanying overt histopathologic inflammation. Understanding how viruses can persist and replicate in the placenta without causing overt cellular or tissue damage is fundamental to deciphering mechanisms of maternal-fetal vertical transmission. Placenta-specific microRNAs are believed to be a tenet of viral resistance at the maternal-fetal interface. We aimed to test the hypothesis that the Zika virus functionally disrupts placental microRNAs, enabling viral persistence and fetal pathogenesis. To test this hypothesis, we used orthogonal approaches in human and murine experimental models. In primary human trophoblast cultures (n=5 donor placentae), we performed Argonaute high-throughput sequencing ultraviolet-crosslinking and immunoprecipitation to identify any significant alterations in the functional loading ofmicroRNAs and their targets onto the RNA-induced silencing complex.Trophoblasts from same-donors were split and infected with a contemporary first-passage Zika virus strain HN16 (multiplicity of infection=1 plaque forming unit per cell) or mock infected. To functionally cross-validate microRNA-messenger RNA interactions, we compared our Argonaute high-throughput sequencing ultraviolet-crosslinking and immunoprecipitation results with an independent analysis of published bulk RNA-sequencing data from human placental disk specimens (n=3 subjects; Zika virus positive in first, second, or third trimester, CD45- cells sorted by flow cytometry) and compared it with uninfected controls (n=2 subjects). To investigate the importance of these microRNA and RNA interference networks in Zika virus pathogenesis, we used a gnotobiotic mouse model uniquely susceptible to the Zika virus. We evaluated if small-molecule enhancement of microRNA and RNA interference pathways with enoxacin influenced Zika viruspathogenesis (n=20 dams total yielding 187 fetal specimens). Lastly, placentae (n=14 total) from this mouse model were analyzed with Visium spatial transcriptomics (9743 spatial transcriptomes) to identify potential Zika virus-associated alterations in immune microenvironments. We found that Zika virus infection of primary human trophoblast cells led to an unexpected disruption of placental microRNA regulation networks. When compared with uninfected controls, Zika virus-infected placentae had significantly altered SLC12A8, SDK1, andVLDLR RNA-induced silencing complex loading and transcript levels (-2<log2(fold-change)>2; adjusted P value <.05; Wald-test with false discovery rate correction q<0.05). In silico microRNA target analyses revealed that 26 of 119 transcripts (22%) in the transforming growth factor-β signaling pathway were targeted by microRNAs that were found to be dysregulated following Zika virus infection in trophoblasts. In gnotobiotic mice, relative to mock controls, Zika virus-associated fetal pathogenesis included fetal growth restriction (P=.036) and viral persistence in placental tissue (P=.011). Moreover, spatial transcriptomics of murine placentae revealed that Zika virus-specific placental niches were defined by significant up-regulation of complement cascade components and coordinated changes in transforming growth factor-β gene expression. Finally, treatment of Zika virus-infected mice with enoxacin abolished placental Zika virus persistence, rescued the associated fetal growth restriction, and the Zika virus-associated transcriptional changes in placental immune microenvironments were no longer observed. These results collectively suggest that (1) Zika virus infection and persistence is associated with functionally perturbed microRNA and RNA interference pathways specifically related to immune regulation in placental microenvironments and (2) enhancement of placental microRNA and RNA interference pathways in mice rescued Zika virus-associated pathogenesis, specifically persistence of viral transcripts in placental microenvironments and fetal growth restriction.

Correlation between Administering Misoprostol Vaginal and Intravenous Oxytocin with Successful Delivery

Labor induction is the stimulation of labor before there are signs of spontaneous labor. Induction of labor is performed if the risks of waiting for spontaneous delivery are judged to outweigh the risks of shortening the duration of pregnancy. Several labor induction methods are recommended, namely pharmacological and mechanical or non-pharmacological. Pharmacological induction is induction by administering prostaglandin E¹ analogs, namely misoprostol, and oxytocin, which will affect uterine contraction. This study aims to determine the relationship between vaginal administration of misoprostol and intravenous oxytocin with successful delivery. This research uses observational analytics with a cross-sectional approach. Sampling used the accidental sampling method with a sample of 32 respondents, which was carried out in August 2022. The instrument used for data collection was an observation sheet. The results showed that of the 32 respondents for successful delivery, almost all experienced successful delivery, with 24 respondents (75%). Multivariate data processing using the Spearman Rank test calculated using SPSS obtained a p-value &lt; α = 0.001 (value α = 0.05). It can be concluded that H1 is accepted, which means there is a relationship between the vaginal administration of misoprostol and intravenous oxytocin with successful delivery in pregnant women.

Maternal serum per- and polyfluoroalkyl substances during pregnancy and breastfeeding duration.

Among 555 women enrolled in the Healthy Start study (2009-2014), we quantified maternal serum concentrations of 5 PFAS during mid- to late-pregnancy (mean 27 weeks of gestation). Participants self-reported their breastfeeding practices through 18-24 months postnatally. Among all participants and stratified by parity, we estimated associations between maternal PFAS concentrations and breastfeeding discontinuation by 3 and 6 months, using Poisson regression, and breastfeeding duration, using Cox regression. Median PFAS concentrations were similar to those in the general US population. Associations between PFAS and breastfeeding duration differed by parity status. After adjusting for covariates, among primiparous women, associations between PFAS and breastfeeding cessation by 3 and 6 months were generally null, with some inverse associations. Among multiparous women, there were positive associations between perfluorohexane sulfonate, perfluorooctane sulfonate, perfluorooctanoate (PFOA), and perfluorononanoate and breastfeeding cessation by 3 and 6 months. For example, per ln-ng/mL increase in PFOA, the risk ratio for breastfeeding discontinuation by 6 months was 1.45 (95% confidence interval, 1.18, 1.78). Hazard ratios reflected similar patterns between PFAS and breastfeeding duration. Among primiparous women, we did not find evidence for associations between PFAS concentrations and breastfeeding duration. In contrast, among multiparous women, PFAS serum concentrations were generally inversely associated with breastfeeding duration, though estimates may be biased due to confounding by unmeasured previous breastfeeding.

A Comparison of Nifedipine Versus a Combination of Nifedipine and Sildenafil Citrate in the Management of Preterm Labour.

Background Preterm delivery is a significant contributor to neonatal and infant morbidity and mortality. Preventive methods are preferable to treatment protocols for reducing perinatal mortality and morbidity. The calcium channel blocker nifedipine has the potential to be employed as a tocolytic, whereas the phosphodiesterase inhibitor sildenafil citrate promotes smooth muscle relaxation. Objective This study aims to examine the tocolytic effect of nifedipine in combination with sildenafil citrate in managing preterm labour (PTL). Methods After approval from the ethical board, 160 patients fulfilling the selection criteria were enrolled in the study from the outpatient and emergency department of obstetrics and gynaecology, University of Lahore, Pakistan. After taking written informed consent, their demographic profile, i.e., name, age, gestational age at presentation, parity, and expected date of delivery was noted. Patients were randomly assigned in a 1:1 ratio to two study groups (Group A: sildenafil citrate + nifedipine) and (Group B: nifedipine) using a computer-generated random number table to obtain a trial sequence. In group A, each patient was given nifedipine 20 mg orally, followed by 10 mg orally every eight hours for 48 hours and vaginal administration of sildenafil citrate, 25 mg at eight-hour intervals, for 48 hours. In group B, females were given nifedipine 20 mg orally, followed by 10 mg orally every 8 hours for 48 hours. They were kept admitted for 72 hours.SPSS Statistics version 21.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) was used to enter and analyse the collected data. Mean and standard deviation was calculated for quantitative variables like age, gestational age at presentation, gestational age at delivery, and BMI. Frequency and percentage were calculated for parity and preterm delivery. Results The study involved 160 patients, with the average age in Group A being 29.60±4.9 years and in Group B being 30.96±4.98 years. In terms of gestational age at delivery, Group A had an average of 34.16±1.7 weeks, while Group B had an average of 33.5±1.8 weeks (p-value<0.05). Preterm delivery was observed in 68.5% of Group A and 41.3% of Group B, with a significant p-value of 0.001. The study also discovered that the duration of prolonged pregnancy was significantly higher in Group A compared to Group B, with averages of 14.96±10.37 days and 10.24±8.97 days, respectively (p-value=0.002). Conclusion The results of this study suggest that the combination of sildenafil citrate and nifedipine may offer a promising new approach to improving pregnancy outcomes in cases of PTL. In the present study, sildenafil citrate plus nifedipine showed a significant effect in the management of PTL and prolongation in mean gestational age at delivery.

Productive and reproductive traits of cows of Kholmogorskaya breed depending on their origin from sire

Among domestic dairy cattle breeds, Kholmogorskaya breed is very famous. The relevance of the work carried out lies in the evaluation of cows of one of the oldest genealogical lines of Kholmogorskaya breed – the line Khlopchatnic CX 1097, which today is of gene pool interest for this breed. The purpose of the research was to study the productive and reproductive traits of cows of Kholmogorskaya breed depending on their origin from sire. The research was carried out in breeding farms of the Kaluga region breeding cattle of Kholmogorskaya breed. During the research the indicators of milk productivity were studied such as milk yield, fat mass fraction, milk fat yield and reproductive traits such as period of open days, dry period, interval between calving, multiplicity of insemination, coeffi cient of reproductive ability, and duration of pregnancy. The study of the above indicators was carried out on mature cows-daughters of Kholmogorskaya sires: Gonets 85, Zador 313, Douplet 184 and Zemlemer 1901 belonging to the genealogical line Khlopchatnic CX 1097. The daughters of the sire Gonets 85 surpassed the daughters of sires of other producers in milk yield by an average of 838,7 kg. Thus, in cows-daughters of the sire Gonets 85 milk yield for 305 days of mature lactation exceeded the same indicator of the daughters of sire Zador 313 by 1123,3 kg (p &lt; 0,001), and the daughters of sires Douplet 184 and Zemlemer 1901 by 79,6 and 1313,3 kg (p &lt; 0,001), respectively. The duration of the period of open days, the multiplicity of insemination were lower in the daughters of sire Gonets 85, Zador 313 and Douplet 184, compared with the indicators of herdmates from the line Khlopchatnic CX 1097 and Kholmogorskaya breed. At the same time, a slight increase in the duration of pregnancy of the daughters of the sires Gonets 85, Zador 313 and Zemlemer 1901 was established. The results obtained indicate the possibility of line breeding and pure breeding for further improvement of the domestic line Khlopchatnic CX 1097 and the whole Kholmogorskaya breed.

Impact of physical activity on the quality of life of pregnant women

AIM: To study the effect of physical activity on the quality of life of pregnant women at various gestational ages.&#x0D; MATERIALS AND METHODS: An observational cross-sectional study of physical activity and quality of life was performed in 99 pregnant women at various gestational periods. Criteria for inclusion in the study: age 1835 years; absence of acute extragenital pathology; consent to conduct research. Exclusion criteria: age younger than 18 and older than 35 years, the presence of acute extragenital pathology; lack of consent to participate in the study. To assess the physical activity of pregnant women, the international Pregnancy physical activity questionnaire (PPAQ), consisting of 36 questions, was taken as a basis. In order to study the quality of life, an abbreviated methodology of the World Health Organization WHOQOL-26 (World Health Organizations Quality of Life), including 26 questions, was used.&#x0D; RESULTS: To achieve this goal, an adapted Russian-language version of the international questionnaire was developed that determines the level of physical activity in pregnant women PPAQ-RUS, on the basis of which a computer program was created. In the study, data were obtained on the statistically significant effect of a number of parameters of physical activity on the quality of life at various times of the gestational period. The correlation of professional activity with self-perception and the level of physical and psychological well-being, as well as activity associated with physical exercises, indicators of physical and psychological well-being was determined.&#x0D; CONCLUSION: The conducted study can be the basis for further study of the influence of the level of physical activity of pregnant women on the course of the gestational period, as well as the study of the possibility of managing the quality of life of women by changing physical activity depending on the duration of pregnancy.

The relationship between pregnancy count and duration of breast-feeding with metabolic syndrome (Fasa Persian cohort study)

BackgroundChanges that occur during pregnancy and after that during breastfeeding induce some symptoms similar to metabolic syndrome (MetS) risk factors. This study aims to determine the relationship between pregnancy, as well as the duration of breastfeeding and MetS controlling the effect of other risk factors like hypertension, glucose intolerance, triglyceride, central obesity, and reduction of high-density lipoprotein in women of Fasa Persian Cohort Study.Materials and methodsIn this cross-sectional study, 5015 women aged 35–70 years were investigated in the Sheshdeh region from 2016 to 2021, and the information related to the disease symptoms was collected through questionnaires, examinations, and laboratory tests. MetS was calculated based on two guidelines according to adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. For reporting the data, the odds ratio with its 95% confidence interval was used. In order to eliminate the effect of confounders, logistic regression was used.ResultsPrevalence of MetS showed a descending trend in women with up to two pregnancies and it reached 22.6% and 22.4% using ATPIII and IDF methods respectively, while with an increase in the number of pregnancies of more than two, MetS prevalence was ascending. The prevalence of MetS did not have any specific trend across various breastfeeding duration groups. Multivariate analysis approved that the odds ratio of developing MetS in comparison with women who had two pregnancies was significantly increasing trend when the pregnancy counts increased.ConclusionThe chance of developing MetS based on both IDF and ATP III methods after adjustment for confounding effects would grow with an increase in the number of pregnancies to more than two and breast-feeding of more than seven years. It is recommended that women with more than two pregnancies or the long duration of breast-feeding women undergo a specialized examination to investigate and control MetS problems so that future diseases could be prevented.

Maternal serum dioxin-like activity and gestational age at birth and indices of foetal growth: The Aarhus birth cohort

Human exposure to lipophilic persistent organic pollutants (lipPOP) is ubiquitous and life-long, beginning during foetal development. Exposure to lipPOP elicits a number of species and tissue specific responses including dioxin-like activity which involve the activation of aryl hydrocarbon receptor (AhR). This study aims i) to describe the combined dioxin-like activity in serum from Danish pregnant women collected during 2011–2013; ii) to assess the association between maternal serum dioxin-like activity, gestational age at birth and foetal growth indices.The serum lipPOP fraction was extracted using Solid Phase Extraction and cleaned-up on Supelco multi-layer silica and florisil columns. The combined dioxin-like activity of the extract was determined using the AhR reporter gene bioassay, expressed as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxic equivalent (TEQ) [AhR-TEQ (pg/g lipid)]. The associations of AhR-TEQ and foetal growth indices (birth weight, birth length and head circumference) and gestational age were assessed by linear regression models.We detected AhR-TEQ in 93.9 % of maternal first trimester serum samples, with a median level of 185 pg/g lipid. Each ln-unit increase in AhR-TEQ was associated with an increase in birth weight of 36 g (95 % CI: 5; 68), birth length of 0.2 cm (95 % CI: 0.01; 0.3) and pregnancy duration of 1 day (95 % CI: 0; 1.5). In women who never smoked, higher AhR-TEQ values were associated with higher birth weight and longer duration of gestation, while in smokers the association was the opposite. Mediation analyses suggested that gestational age may mediate the association of AhR-TEQ with foetal growth indices.We conclude that AhR activating substances are present in the bloodstream of almost all pregnant women in Denmark and the AhR-TEQ level was around four times higher than previously reported. The AhR-TEQ was associated with slightly longer gestational duration and thereby higher birth weight and birth length.

The Effect of Chicory on Bilirubin Level in Newborns Suffering From Jaundice: A Systematic Review

Background: Jaundice is the most prevalent reason for infants’ hospitalization during their first month of birth, and herbal medicine has long been used alongside phototherapy to treat this problem. Objectives: The present systematic review investigates chicory’s influence on bilirubin levels in infants with jaundice. Methods: In this systematic review study, Iranian databases, including Barekat Gostar, Scientific Information Database (SID), Irandoc, and Magiran, along with international databases, including Cochrane Library, Web of Science, Scopus, PubMed, and Google Scholar search engines were explored with relevant keywords to retrieve pertinent studies. Results: Among the 7 selected articles with a sample size of 408 (204 people in the intervention group and 204 in the control group) from 2006 to 2020, 4 studies were in vitro and 3 were randomized clinical trials. Among these studies, mothers’ pregnancy duration ranged between 30.9 and 38.8 weeks, infants’ age ranged between 3 and 7 days, and their weight ranged between 1544 and 3316 g. Although chicory administration varied across the studies, 4 studies reported its effectiveness in reducing infants’ bilirubin, whereas the other 3 articles reported no effect of chicory on bilirubin levels in infants. Conclusions: Iran was the only country that evaluated the effect of chicory on neonatal jaundice in the form of several research studies. However, due to the limited number of studies and the different dosages of chicory, the way of consuming chicory, the type of studies, and the age and weight of babies, we could not reach a general conclusion on the efficacy of chicory.

Labour as a manifestation of systemic inflammatory reaction (Literature review)

Childbirth is the result of a rapid biological reaction, in which the humoral and cellular links of immunity take part. Therefore, all attempts to stop the uterine premature contractile activity at the level of the myometrium have only a temporary effect. This review deals with the modern scientific data about the role of immune mechanisms in the labor activity origin from the point of view of the possibilities of predicting its anomalies and pathogenetically based treatment of premature labor.Cytokine balance plays a role already in the process of implantation, during the interaction between the endometrium and the fertilized egg. The increased content of pro-inflammatory cytokines in the endometrium is more typical for the women with normal implantation than for the patients with recurrent reproductive losses. Endometrial decidualization, vascular remodeling occurs under the influence of pro-inflammatory mediators. The traditional view of the preterm labor pathogenesis assumes its infectious nature, which is confirmed by the prevalence of infection in premature newborns and is explained by the activation of pro-inflammatory mediators.Modern opinions regarding the primacy of the inflammatory response in premature rupture of the fetal membranes are outlined. The heterogeneity of the inflammatory response in different patients found an explanation in the polymorphism of genes encoding the main receptors of the immune response – TOLL receptors. The discovery of numerous proteins of the acute inflammation phase led to the search for their role in the implementation of labor activity. So far, the ability to stimulate labor activity has been shown for FCGR3A protein and haptoglobin.Inadequate consideration of the inflammatory reaction role, in particular its systemic nature, in the pathogenesis of premature labor has led to an overestimation of the possibilities of tocolytic therapy. Meta-analyses indicate that the use of tocolytics, despite the effective increase in the duration of pregnancy, does not improve the condition and prognosis of the newborn. Most tocolytic drugs have a point of application of a part of the myocyte, contact with which blocks its contraction. However, all of them, with the exception of indomethacin, do not affect the immunological causes of the development of premature labor, and therefore do not eliminate their effect on the fetus.The inflammatory reaction does not always have an infectious origin, so the management of routinely prescribing antibacterial drugs to prevent premature births has also not spread. At present, it should be recognized that powerful inflammatory processes underlying labor activity, premature in particular, in most cases determine the inevitability of premature birth.Research on finding the regulation of inflammatory mechanisms for the regulation of labor activity can be considered promising, but they are in the early theoretical stages. For a modern doctor, the systemic nature of the inflammatory reaction is of practical importance for understanding the reasons for the rapid generalization of the process in chorioamnionitis, timely diagnosis and response, as well as the features of the course of the early neonatal period.

Estimating the impact of Pregnancy, Systolic and Age on Diabetes for Women by Using Support Vector Regression Model (SVR)

In this paper we have 623 cases of diabetes patients, the data partitioned in to training dataset (500 observations) and testing dataset (123 observations), and the aim is to estimate the impact of pregnancy duration in weeks, systolic and age as factors on diabetes of the women patients for this purpose SVR has been used. According to the results radial kernel function gave highest performance compared to the other kernel functions, the R2 = 83% this implies the factors capable of explaining 83% of diabetes variable with MSE and RMSE of (0.000958 and 0.030956) respectively. And p-values of the three aforementioned variables are less than the significant level of 0.01, implying that the three factors have a statistically significant impact on the response variable. Where Pregnancy duration in weeks has an impact of 0.401 on the patient, that means if duration increase by one week, then diabetes will increase by 0.401 units, also both Systolic and age have a significant positive effect on the response variable, and the amount of impact is (0.621 and 0.557) respectively.

Kisspeptin neuron projections to oxytocin neurons are not necessary for parturition in the mouse

Oxytocin is synthesized by hypothalamic supraoptic nucleus (SON) and paraventricular nucleus (PVN) neurons and is released from the posterior pituitary gland to trigger uterine contractions during parturition. In rats, oxytocin neuron innervation by periventricular nucleus (PeN) kisspeptin neurons increases over pregnancy and intra-SON kisspeptin administration excites oxytocin neurons only in late pregnancy. To test the hypothesis that kisspeptin neurons excite oxytocin neurons to trigger uterine contractions during birth in C57/B6J mice, double-label immunohistochemistry for kisspeptin and oxytocin first confirmed that kisspeptin neurons project to the SON and PVN. Furthermore, kisspeptin fibers expressed synaptophysin and formed close appositions with oxytocin neurons in the mouse SON and PVN before and during pregnancy. Stereotaxic viral delivery of caspase-3 into the AVPV/PeN of Kiss-Cre mice before mating reduced kisspeptin expression in the AVPV, PeN, SON and PVN by > 90% but did not affect the duration of pregnancy or the timing of delivery of each pup during parturition. Therefore, it appears that AVPV/PeN kisspeptin neuron projections to oxytocin neurons are not necessary for parturition in the mouse.

Assessment of caffeine intake in groups of pregnant and breastfeeding women: A cross-sectional analysis

Caffeine is commonly consumed by pregnant and breastfeeding women. The maximum safe dose of caffeine in their diet is 200mg per day, according to the European Food Safety Authority. The purpose of this study was to assess the consumption of caffeinated products by pregnant and breastfeeding women, as well as to estimate their caffeine intake. The number of subjects who qualified for the study was 1112 women, of whom 401 were pregnant and 711 were breastfeeding. The research was conducted with the use of a questionnaire, which included information about food frequency and history of consumption of caffeinated products during the past 3 days. The median (interquartile range) daily caffeine intake among pregnant women was 114.5 (57.6-202.8) mg, and the level of caffeine intake increased with the duration of pregnancy (p<0.001). For breastfeeding women it was 193.7 (100.5-324.8) mg/d. The majority of participants (58.9%) were not able to correctly identify the safe amount of caffeine in their diets. It was observed that the intake of 73.8% of pregnant women and 51.9% of breastfeeding women fit within the safe range (0-200mg/d). The main sources of caffeine were ground coffee, black tea, and instant coffee. For 63,6% of women knowledge about nutrition and supplementation came most often from blogs and social media run by medical professionals. Pleasure was the main reason for drinking coffee and tea. Most pregnant women did not exceed the recommended maximum daily dose of caffeine, while breastfeeding women often did.

Therapeutic Plasma Exchange in Early-Onset Preeclampsia: A 7-Year Monocentric Experience.

Different therapeutic apheresis techniques have been clinically tested to delay preterm delivery in the case of eoPE (early-onset preeclampsia). Our study evaluated the feasibility of TPE (therapeutic plasma exchange) compared to standard-of-care treatment. Twenty patients treated with 95 TPE sessions were included in the final analysis and retrospectively matched with 21 patients with comparable placental dysfunction. Gestational age at admission was 23.75 ± 2.26 versus 27.57 ± 2.68 weeks of gestation (WoG) in the control group (p = < 0.001), mean sFlt-1/PlGF ratio was 1946.26 ± 2301.63 versus 2146.70 ± 3273.63 (p = 0.821) and mean sEng was 87.63 ± 108.2 ng/mL versus 114.48 ± 88.78 ng/mL (p = 0.445). Pregnancy was prolonged for 8.25 ± 5.97 days when TPE was started, compared to 3.14 ± 4.57 days (p = 0.004). The median sFlt-1/PlGF Ratio was 1430 before and 1153 after TPE (-18.02%). Median sEng fell from 55.96 ng/mL to 47.62 mg/mL (-27.73%). The fetal survival rate was higher in TPE-treated cases. NICU (Neonatal Intensive Center Unit) stay was in the median of 63 days in the TPE group versus 48 days in the standard-of-care group (p = 0.248). To date, this monocentric retrospective study, reports the largest experience with extracorporeal treatments in eoPE worldwide. TPE could improve pregnancy duration and reduce sFlt-1 and sEng in maternal serum without impairing neonatal outcomes.

O-196 Evidence-based management of mosaic embryos - a single Centre experience from prospective transfer and birth outcomes of 565 mosaic embryos

Abstract Study question What are the pregnancy and neonatal outcomes of prospective transfer of 565 mosaic embryos and what are the key determinants influencing the outcome? Summary answer Mosaic (diploid/aneuploid) embryos have a significant developmental potential with good neonatal outcomes allowing personalized management and evidence based prioritization of embryos for transfer. What is known already Since the first report of healthy babies born after mosaic transfer, the gradual accumulation of knowledge on mosaic embryo transfers in the International Registry of Mosaic Embryo Transfers provided the necessary reassurance for clinical management of mosaic embryos. Large and comprehensive data from single centres with consistent clinical genetic counselling and laboratory practices for preimplantation and prenatal testing offer valuable contribution to the current practices. The aim of this study was to evaluate the pregnancy and neonatal outcomes after mosaic embryo transfers and to evaluate for associations between embryo genetic aberrations, static morphology and specific outcomes. Study design, size, duration This is a retrospective cohort study that took place in a single academic IVF centre (The CReATe Fertility Centre, Toronto, Canada), where we analysed the results from high resolution PGT-A, embryo morphologic features and pregnancy outcomes of 3529 frozen embryo transfers from 2016-2022. Associated patient demographic data, transfer outcome and neonatal outcome of 2964 euploid and 565 mosaic embryo transfers were analyzed. Participants/materials, setting, methods All patients received genetic counselling prior to frozen embryo transfer. High resolution NGS PGT-A was performed using the Illumina platform and BluGnome and NxClinical for data analysis. Clinically relevant findings were aberrations &amp;gt;10Mb and mosaicism from 25%-75%. Comparison of clinical and morphological characteristics of euploid, low-level mosaic (25%-&amp;lt;50% aneuploid cells in trophectoderm biopsy), and high-level mosaics (50% -75%) was performed with R-statistical package, Mathlab and SSPS software. p &amp;lt; 0.05 with CI 95% was considered significant. Main results and the role of chance Of the total 565 mosaic embryos transferred 77.1% had mosaicism levels ≥25%-&amp;lt;50% (Group1-n=436): 54.8% had segmental chromosome mosaic (SCM)gain/loss, 45.2% had whole chromosome mosaicism(WCM)(trisomy/monosomy); and 22.9% had mosaic levels of ≥ 50-&amp;lt;70% (Group2-n=129)(50.4% with SCM and 49.6% with WCM). The overall ongoing pregnancy rate(OPR) for mosaic embryos was 33% and the miscarriage rate was 6%. Compared with euploid embryos, mosaic embryos have significantly lower implantation (p = 0,OD0.62-CI[0.5-0.7]) and OPR(p = 0,OD0.5-CI[0.4-0.6]). Pregnancy outcomes are determined by level of mosaicism: Group1 have better implantation(p = 0.005,OD1.8-CI[1.18-2.78]) and OPR compared to Group2. High level of mosaicism independently affected the OPR of SCM(p = 0.003) and WCM(p = 0.02) embryos. WCM had lower implantation rates compared to SCM (p = 0.005,OD1.6-CI[1.15-2.27]). Mosaic monosomies had the lowest impanation and OPR of all mosaic embryos (14% and 8%,respectively). Within Group1 and Group2 good static morphology was associated with higher OPR for SCM and WCM embryos. Birth outcomes were available for 118 babies from mosaic-FET and from 802 euploid-FET. There is no difference in duration of pregnancy and birth weight between mosaic and euploid-FET. No gross-fetal anomalies were reported in the mosaic group at birth. There was one termination&amp;lt;20GW due to fetal anomalies and one stillbirth. For euploid transfers, 11 had fetal anomalies, there were 7-terminations and 2-stillbirths. Limitations, reasons for caution Although this is the largest single centre study to date that evaluated genomic, morphology and outcome data of mosaic transfers, the numbers are still low to analyze the impact of specific chromosomal aberrations on pregnancy outcome. Wider implications of the findings Mosaic embryos should be considered for transfer and prioritized based on the level of mosaicism, type of chromosomal aberration and static morphology. The implantation potential is lower than euploid embryos however established pregnancies result in healthy babies born at term and normal birth weight. Trial registration number CReATe Fertility Centre, Toronto, Canada

Low-density granulocytes are related to shorter pregnancy duration but not to interferon alpha protein blood levels in systemic lupus erythematosus

BackgroundAn increased risk of pregnancy complications is seen in women with systemic lupus erythematosus (SLE), but the specific immunopathological drivers are still unclear. Hallmarks of SLE are granulocyte activation, type I interferon (IFN) overproduction, and autoantibodies. Here we examined whether low-density granulocytes (LDG) and granulocyte activation increase during pregnancy, and related the results to IFNα protein levels, autoantibody profile, and gestational age at birth.MethodsRepeated blood samples were collected during pregnancy in trimesters one, two, and three from 69 women with SLE and 27 healthy pregnant women (HC). Nineteen of the SLE women were also sampled late postpartum. LDG proportions and granulocyte activation (CD62L shedding) were measured by flow cytometry. Plasma IFNα protein concentrations were quantified by single molecule array (Simoa) immune assay. Clinical data were obtained from medical records.ResultsWomen with SLE had higher LDG proportions and increased IFNα protein levels compared to HC throughout pregnancy, but neither LDG fractions nor IFNα levels differed during pregnancy compared to postpartum in SLE. Granulocyte activation status was higher in SLE relative to HC pregnancies, and it was increased during pregnancy compared to after pregnancy in SLE. Higher LDG proportions in SLE were associated with antiphospholipid positivity but not to IFNα protein levels. Finally, higher LDG proportions in trimester three correlated independently with lower gestational age at birth in SLE.ConclusionOur results suggest that SLE pregnancy results in increased peripheral granulocyte priming, and that higher LDG proportions late in pregnancy are related to shorter pregnancy duration but not to IFNα blood levels in SLE.

O-055 Efficacy of Laparoscopic Abdominal Cerclage in Women With Prior 2nd Trimester Losses/Preterm Birth: Perinatal Outcomes of Case Series

Abstract Study question What is the efficacy of laparoscopic abdominal cerclage (LAC) that placed during periconceptional period in singletons with prior 2nd trimester pregnancy losses/preterm deliveries (PTDs)? Summary answer LAC seems to prolong pregnancy duration and enhance perinatal outcomes in singletons prior 2nd trimester losses/PTDs. What is known already Cervical insufficiency (CI) is defined as the inability of the uterine cervix to retain a pregnancy till term without the signs and symptoms of clinical contractions ,with an incidence up to 1% (Berghella, 2011). Cervical cerclage (CC) has been proposed as an effective treatment for CI in terms of successfully prolonging the pregnancy period and improving the perinatal prognosis. The common clinical approach is transvaginal cervical cerclage (TVC), which is a feasible and relatively easy technique. However, some group of women may experience late abortions and/or PTD and LAC has been proposed to enhance pregnancy outcomes. Study design, size, duration Case series consisting of singletons with at least 2 prior PTDs and managed with LAC was reviewed between January 2019-November 2022. After placement of LAC, reproductive and perinatal outcomes of women were reviewed for 2 years. Participants/materials, setting, methods All women with at least 2 prior 2nd trimester losses and/or PTDs were offered to LAC procedure during the period. After having informed consents, total of 28 LAC procedures were performed. All surgeries were performed by a single experienced laparoscopist in the same center. Non-absorbable mersilene tape was placed during preconceptional period. Reproductive outcomes including spontaneous and assisted conception cycles and perinatal outcomes were reported. Main results and the role of chance A total of 28 LAC proceudres were performed during the period. Mean age of women was 34±2 and mean numbers of previous 2nd trimester losses/PTDs was 2.8±0.8, of which all of them were &amp;lt;24 weeks. Total of 8 women have had gynecologic surgery in their history. Less than 12 months interval, 19 out of 28 women got pregnent; 13/28 conceived spontaneously and 6/28 conceived with after IVF treatment. For the perinatal outcomes; there were no single case of 2nd trimester losses/PTDs &amp;lt;24 weeks in the entire cohort. 15 women delivered &amp;gt;34 weeks and remaining 4 delivered at term (&amp;gt;37 weeks). During the gestation, no additional medication was provided to pregnants such as progesterone treatment. The mean gestational age was 35 4/7 weeks. There were no remarkable adverse events during the pregnancy. All newborns were healthy without remarkable issues, only 2 infants required intensive care for less than 2 weeks. Limitations, reasons for caution Small sample size, lack of a control group and randomization and heterogenious patient population. Wider implications of the findings LAC appears to have favorable pregnancy outcomes in singletons with prior pregnacy losses and/or PTDs. To precisely conclude, randomized controlled trials are needed with different intervention arms in the same population. Trial registration number non applicable