Entire Pregnancy Research Articles

Association of ambient air pollutants with maternal thyroid hormones during the entire pregnancy

This study aims to investigate associations between PM10, PM2.5, and NO2 and maternal thyroid hormones. We investigated 443 pregnant women in Zhejiang, China with repeated examinations of serum thyroid hormones at 10, 17, and 32 weeks. Individual exposures to ambient air pollution were retrospectively calculated by inverse distance weighting interpolation. Multivariate linear mixed models were applied to estimate the association between air pollutants and thyroid hormones. PM10 exposure was positively associated with TSH (β: 0.077 [95% CI: 0.003, 0.152]), and negatively associated with FT3 (β: -0.041 [-0.057, -0.025]) and FT4 (β: -0.036 [-0.055, -0.017]) during the 0–90 lag days (per IQR). Similarly, increased exposure to PM2.5 was associated with decreased FT3 (β: -0.016 [-0.032, -0.001]), and increased Tg (β: 0.147 [0.025, 0.269]). Evaluated NO2 levels were associated with decreased FT3 (β: -0.026 [-0.039, -0.014]) and FT4 (β: -0.036 [-0.052, -0.020]), as well as increased Tg (β: 0.129 [0.011, 0.247]). The results indicate that exposure to ambient PM10, PM2.5, and NO2 throughout the entire pregnancy adversely affects thyroid hormones, implying potential health implications of air pollution on maternal thyroid function.

Effects of COVID-19 convalescence on pregnancy outcomes in frozen-thawed embryo transfer: A retrospective cohort study.

In this study, we aimed to examine whether frozen-thawed embryo transfer during the recovery period after coronavirus disease can affect treatment outcomes. This population-based retrospective cohort study included patients who underwent frozen-thawed embryo transfer in the first cycle and did not have a history of coronavirus disease (n = 355, control group) or recovered from coronavirus disease within 6 months (n = 185) or 6-12 months (n = 230). Univariate analysis was performed to determine significant associations between the baseline variables, frozen-thawed embryo transfer cycle characteristics, clinical pregnancy rates, ongoing pregnancy rates, and pregnancy complication rates. Variables with significant associations in the univariate analysis were included in the multivariate logistic regression analysis to identify the effect of baseline characteristics, frozen-thawed embryo transfer cycle characteristics, and history of coronavirus disease on clinical pregnancy, ongoing pregnancy, and pregnancy complication rates. Patients who recovered from coronavirus disease within 6 months were more likely to experience complications during pregnancy than control group patients (33.7% vs. 20.3%, p = 0.001). Multivariate logistic regression analysis confirmed that a history of coronavirus disease within 6 months (odds ratio: 2.34, 95% confidence interval: 1.93-4.58) was a risk factor for pregnancy complications; however, a history of coronavirus disease was not a risk factor for clinical pregnancy rate, ongoing pregnancy rate, human chorionic gonadotrophin positivity rate, abortion rate, or live birth rate. Frozen-thawed embryo transfer can be conventionally performed during the recovery period after coronavirus disease; however, enhanced monitoring and follow-up during pregnancy are necessary to ensure the safety of the entire pregnancy and delivery process.

A steep-increasing blood pressure trajectory from early pregnancy is associated with birth outcomes in the EDEN mother-child cohort.

An enhanced consideration of blood pressure (BP) dynamics during pregnancy could improve its monitoring. Distinct BP trajectories may exist, and some have been linked to adverse fetal development. Using maternal BP measurements spanning almost the entire pregnancy, this study aimed to identify trajectories and assess their association with birth outcomes. Routine BP measurements (median = 8) were extracted from the obstetric records of 1849 mothers from the French EDEN birth cohort. Outcomes included birth weight z-score, prematurity and, for a subsample (n = 1377), placental weight and birth weight-to-placental weight ratio. Maternal SBP trajectories were identified by Latent Class Growth Mixture Modeling. Associations with outcomes were analyzed using adjusted linear or logistic regressions. Two BP trajectories were identified: a first U-shaped and a second steep-increasing, comprising 96 and 4% of mothers, respectively. The steep-increasing trajectory reached the hypertensive threshold around 30 weeks of gestation. Over half of mothers in this trajectory had a hypertensive disorder diagnosis, and 24% had preeclampsia. Mothers in this trajectory had newborns with lower birth weight z-scores [β = -0.31, 95% confidence interval (95% CI) = -0.55 to -0.07] and/or increased likelihood of premature delivery (odds ratio = 4.02, 95% CI = 2.04-7.50). No associations were observed with placental outcomes. Our results suggest the existence of a steep-increasing BP trajectory from the first weeks of pregnancy and associated with poorer birth outcomes. Further investigation into this trajectory's determinants could lead to improved hypertensive disorder risk stratification, ultimately aiding in the prevention of related maternal and fetal consequences.

Associations of ambient air pollution exposure to fine particulate matter and its chemical constituents before and during pregnancy with the risk of full-term small for gestational age: a retrospective cohort study.

In the current study, we explored the associations between exposure to fine particulate matter (PM2.5) constituents and full-term small for gestational age (SGA) in different periods. We included 155,897 participants, and matched the exposure concentrations of PM2.5 and its constituents [sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matter (OM), and black carbon (BC)] according to participants' geographical location. To explore the associations of prenatal exposure to PM2.5 and its constituents with the risk of full-term SGA, we used logistic regression, restricted cubic spline regression (RCS) and quartile g-computation (QGCOMP). We found that individual exposure to PM2.5 and its constituents was positively associated with the risk of full-term SGA (P < 0.05), whether in the year before pregnancy or the entire pregnancy. These associations were more pronounced in the second trimester. We found that the risk of full-term SGA was positively and linearly related to the concentrations of PM2.5 and its constituents (Poverall < 0.05, Pnonlinear > 0.05). The associations of PM2.5 and its constituents with full-term SGA were stronger in multiparous mothers. Moreover, full-term SGA was associated with exposure to mixtures of SO42-, NO3-, NH4+, OM, and BC before pregnancy and in the second and third trimester. Among these, BC was positively associated with full-term SGA at each of the aforementioned stages. The risk of full-term SGA was positively and linearly related to concentrations of PM2.5 and its constituents, and these associations were more pronounced in the second trimester. BC was the most hazardous constituent of PM2.5 that was associated with full-term SGA.

A Requisition to Fortify Unani Supplements with Omega-3 Fats for Mother and Child to Prevent Cardiovascular Diseases

Background: Sustainable and holistic food policy is nowadays an essential requisite to promote health and prevent diseases. Lack of knowledge regarding dietary recommendation in pregnancy contributes to neonatal conditions/illness as well as in developing CVDs in later years of life. Objective: The main aim of this study is to highlight the importance of omega-3-fats in relation to mother and child health and also its link in the primary prevention of CVD and to recognise, enlist and fortify Unani medicines/drugs with omega-3-fats. Conclusion: Considering the scientific importance of role of omega-3 fatty acids in primary prevention of cardiovascular diseases and in maintaining and enhancing mother &amp; infant health development, Omega-3 enriched Unani formulations and food should be advocated to be used extensively during entire pregnancy period.

Effects of Prenatal Exposure to PM 2.5 Chemical Components on Adverse Birth Outcomes and Under-5 Mortality in South Korea.

Exposure to fine particulate matter (PM 2.5 ) during pregnancy has been associated with adverse birth outcomes. However, limited evidence exists on the effects of specific PM 2.5 components. We investigated the association of prenatal exposure to PM 2.5 and its components with birth outcomes and mortality at age <5 years in four metropolitan cities in South Korea. We obtained data from Statistic Korea linking birth records for 2013-2015 to death records under age 5 years. Data for PM 2.5 and 10 of its components were collected from four monitoring stations. We calculated exposures during pregnancy and each trimester for a total of 324,566 births. We used logistic regression to estimate the associations between exposure and risk of preterm birth (PTB) (<37 weeks), low birth weight (<2.5 kg), small for gestational age (birth weight <10 th percentile for the same gestational age), and under-5 mortality. An interquartile range (8.7 µg/m 3 ) increase in exposure to PM 2.5 during the entire pregnancy was associated with increased odds of PTB (odds ratio [OR] = 1.17; 95% confidence interval [CI] = 1.11, 1.23). We observed no association with low birth weight, small for gestational age, or under-5 mortality for the entire pregnancy exposure. Elemental carbon and secondary inorganic aerosols showed higher effect estimates for PTB than did other components. In urban populations of South Korea, exposure to PM 2.5 during pregnancy was associated with an increased risk of PTB. Different components showed varying associations with adverse birth outcomes.

The maternal 6-to-8 week postnatal check

The maternal postnatal check provides an invaluable opportunity for GPs to check in with new mothers, as well as provide input and support where necessary. In some circumstances, it may be the only time that a new mother sees a GP throughout the entire pregnancy and postnatal period. The appointment usually, but not always, takes place alongside the new baby’s postnatal check between 6 and 8 weeks after birth. Since 2020, the maternal postnatal check has become a requirement within the General Medical Services contract for general practice. Within this article, where the term ‘woman’ or ‘mother’ are used, reference is made to all mothers and birthing people.

Prenatal exposure to temperature variability, gestational duration and preterm birth: A nationwide birth cohort with 3 million singleton births in China.

Prenatal exposure to temperature variability, gestational duration and preterm birth: A nationwide birth cohort with 3 million singleton births in China.

The modifying role of residential greenness on the association between heat waves and adverse birth outcomes: Results from the ELEFANT project.

The modifying role of residential greenness on the association between heat waves and adverse birth outcomes: Results from the ELEFANT project.

Quantifying the association between pregnancy exposure to biomass-attributable PM2.5 and the risk of preterm birth and stillbirth: A case-control study in Sydney, Australia for 2010-2020.

Biomass combustion, including wildfires and residential wood burning, is a significant source of particulate matter (PM2.5) in Australia, with potentially distinct health effects due to its unique chemical composition. This study aimed to quantify the association between exposure to ambient biomass-attributable PM2.5 and the risk of preterm birth and stillbirth across pregnancy windows in Sydney, Australia, from 2010 to 2020. We conducted case-control studies nested within a cohort of 578,391 singleton pregnancies, including 29,954 preterm births and 2,928 stillbirths. Controls were randomly selected using risk-set sampling. Daily all-source PM2.5 estimates at a 5 km resolution were obtained from a previous study. Days exceeding the 95th percentile of all-source PM2.5 at statistical area level 4 without significant dust storm pollution were classified as biomass-affected days. For these days, biomass-attributable PM2.5 was estimated using the remainder component from a seasonal trend decomposition, with the seasonal and trend components representing nonbiomass-attributable PM2.5. Conditional logistic regressions were used to analyze associations between biomass-attributable PM2.5 exposure and outcomes, adjusting for area-level socioeconomic factors, temperature, humidity, and temporal and seasonal trends. The odds ratio for preterm birth per interquartile range increase in biomass-attributable PM2.5 was 1.002 (95% CI = 0.997, 1.007) for the entire pregnancy average exposure, with similar null results across trimesters. For stillbirth, the odds ratio was 1.002 (95% CI = 0.985, 1.019) for the entire pregnancy average exposure, with comparable null findings across trimesters. These results suggest that in Sydney, biomass-attributable PM2.5 exposure during pregnancy may not increase the risk of preterm births or stillbirths.

Association of Ambient Air Pollution and Temperature Exposure with Placental Abruption: A Nested Case-Control Study Based on Live Birth Registrations.

Placental abruption, a rare disorder of unclear etiology, lacks evidence to illustrate its relationship with exposure to air pollution and temperature. This study aimed to investigate the association between exposure to ambient pollutants and temperatures and placental abruption to identify susceptible time windows and subpopulations. A nested case-control study was based on a live birth registration database in Chongqing, the largest Chinese municipality in China, from 2018 to 2022. The placental abruption cases were each matched with four controls by maternal age at delivery, gestational week, gravidity, parity, and delivery date. Six ambient pollutants [particulate matter (PM) with aerodynamic diameter (), PM with aerodynamic diameter (), , CO, , and ] and temperature were estimated using machine learning algorithms. A conditional logistic regression model analyzed associations of exposure to air pollution and temperature with placental abruption in five time windows (prepregnancy, the entire pregnancy, and each of the 3 trimesters). Stratification analyses were applied to examine potential modifiers including gravidity, parity, mothers' residential area (urban/rural), pandemic experience, and delivery season. After data quality control, 798 cases were identified and matched with 3,192 controls. An exposure relationship was identified between during the pregnancy period and placental abruption (). In comparison with the first quartile level of , the odds ratios (ORs) of abruption associated with exposure to the second, third, and fourth quartile levels of were 1.42 [95% confidence interval (CI): 1.03, 1.96], 1.90 (95% CI: 1.30, 2.76), and 2.27 (95% CI: 1.39, 3.71), respectively. The association for exposure existed in the 3 trimesters but not prepregnancy. Exposure to locally extreme low temperatures ( percentile) in the third trimester was associated with increased risks of abruption (; 95% CI: 1.67, 8.08) in comparison with locally moderate temperatures (25th-75th percentile). Stratified analysis showed no statistical significances within the effect modifiers. Based on a large-scale live birth record, the study suggested that exposure to air pollutants, mainly , during pregnancy may be a substantial risk factor for placental abruption. https://doi.org/10.1289/EHP14714.

Study on embryotropic effects of the supramolecular complex of ivermectin Aniverm-2.0%

The purpose of the research is to evaluate embryotoxic and teratogenic effects of the supramolecular complex of ivermectin aniverm-2.0%.Materials and methods. The experiment was conducted on 100 female rats weighing 180–200 g that were kept in the vivarium of the VNIIP – FSC VIEV. The experimental rats were divided into groups of 8 animals each. The supramolecular complex of ivermectin aniverm-2.0% was administered to inbred pregnant female rats orally in the suspension formulation using an intragastric catheter three times in increased doses. The 1st group pregnant females were administered a total dose of aniverm-2.0% for the first 6 days which was 3 times higher than the therapeutic dose (3.6 mg/kg) by the active substance, and 180 mg/kg by the drug. The 2nd group animals were given the ivermectin substance in a similar dose of 3.6 mg/kg in the suspension formulation on starch paste on the first day of pregnancy. The 1st group rats were given a total dose of aniverm-2.0% increased to 3-fold, equal to 7 days (7–13 days), at a dose of 4.2 mg/kg by the active ingredient, and 210 mg/kg by the drug, and the 2nd group rats received a similar dose of the ivermectin substance of 4.2 mg/kg in the suspension formulation on starch paste on day 7 of pregnancy. On day 14 (days 14–19), the 1st group rats were administered a total dose of aniverm-2.0% for 6 days for the third time at a dose of 3.6 mg/kg by the active ingredient, and 180 mg/kg by the drug, and the second group of animals received the substance of ivermectin at a dose of 3.6 mg/kg by the active ingredient in the suspension formulation on starch paste. The female rats from the 3rd control group were administered starch paste of 5–7 mL three times during the same periods of pregnancy as the experimental animals. On day 20 of embryogenesis, all experimental rats were euthanized. In the females, after slaughter and extirpation of the uterus, the number of embryos, resorptions, and corpus luteum in pregnancy in both ovaries was recorded; the craniocaudal embryo dimensions were measured, their weight was recorded, and their sex was determined. The placenta was measured and weighed to calculate the fetoplacental coefficient. Attention was also paid to deformities and developmental anomalies in the embryos. Some of the fetuses were then placed in Bouin's fluid for further examination of the internal organs using the Wilson method. Another part was fixed in 96.0% alcohol to examine the skeletal system and measure bone length using the Dawson method. To assess embryotoxic effects of the drug, preand post-implantation death and total embryonic mortality were recorded. The obtained results were processed statistically.Results and discussion. In the entire pregnancy period, no signs of intoxication were observed in the animals. The animals were active, ate food readily and gained weight well. Macroscopic examination of the internal organs did not reveal any pathological changes. There were no signs of inflammation, deformities or other abnormalities in the embryos and placentas. Aniverm-2.0% in a three-fold increased dose of 0.6 mg/kg with intragastric administration did not exhibit embryotoxic or teratogenic effects in critical periods of embryogenesis.

Clinical and epidemiological features of congenital syphilis with antenatal fetal asphyxia

Syphilis is a systemic venereal disease that causes skin, mucous membranes, internal organs and musculoskeletal system lesions, and damages the fetus in the womb. The fetus is infected in the 16th–20th weeks of pregnancy, mostly transplacentally. The outcomes of congenital syphilis are miscarriages, stillbirths, premature births, the birth of a child with active and latent course of syphilis, and the birth of a healthy child. A clinical case of untreated congenital syphilis with antenatal fetal asphyxia is presented. First of all, the attention is drawn to the aggravated obstetric anamnesis: the first and second pregnancies ended in intrauterine fetal asphyxia and therefore a non-developing pregnancy. In the 8th–9th weeks of the current pregnancy antibodies to Treponema pallidium were detected – IgG, M, titer 1:1280, and a consultation with a dermatovenereologist was recommended. However, during the entire pregnancy period, no dermatovenereological examination, tests or treatment measures were carried out. Concomitant trichomoniasis and acute respiratory viral infections in a mild form were revealed and sanitized twice. At 27 weeks of pregnancy, antenatal fetal asphyxia was determined by ultrasound examination. The autopsy of the fetus revealed intrauterine pneumonia, and the postmortem examination of the placenta – pronounced dystrophic changes specific to congenital syphilis. This case demonstrates that ignoring the dermatovenereological therapeutic and diagnostic measures which were required, contributed to the disease progression and resulted in the development of antenatal fetal asphyxia. Timely detection and correction of all existing changes are necessary for a favorable course of pregnancy.

The Dynamic Changes in Maternal Thyroid Parameters Across the Three Trimesters and Their Differential Effects on the Occurrence of Adverse Obstetric Outcomes.

Thyroid parameters undergo significant dynamic changes during pregnancy. This study aimed to comprehensively analyze the impact of abnormal thyroid parameters in each trimester on the incidence of common adverse obstetric outcomes. Blood samples drawn for thyroid parameters in each trimester during the antenatal period were determined after the participants gave birth. Serum thyrotropin, free thyroxine, free triiodothyronine, anti-thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TgAb) levels were tested using electrochemiluminescence immunoassays. Among all the participants, TAI and hypothyroxinemia in the first trimester (T1) were significantly related to an increased risk of gestational hypertension [OR=5.136, 95% CI 1.537-17.158 and OR=7.683, 95% CI: 1.890-31.229, respectively]. Additionally, subclinical hypothyroidism in T1 was independently associated with a higher risk of postpartum hemorrhage [OR = 38.063, 95% CI 2.091-692.834].Besides, subclinical thyrotoxicosis in T1 showed a significant correlation with a raised risk of small for gestational age [OR=14.650, 95% CI 1.221-175.760]. Among euthyroid women during the whole pregnancy, either TPOAb+ or TgAb+ in the third trimester was an independent risk factor of premature birth [OR=5.092, 95% CI 1.059-24.481] and low birth weight [OR=8.165, 95% CI 1.717-38.824], respectively. Our findings indicate the importance of screening thyroid parameters in early pregnancy and the need to dynamically monitor these parameters throughout the entire pregnancy.

Prenatal exposure to ozone and bone mineral density in early childhood: Susceptible window identification.

Prenatal exposure to ozone and bone mineral density in early childhood: Susceptible window identification.

Pregnant nurses' occupational stress and associated factors: A comparative cross-sectional study with other healthcare workers, physical workers, and desk workers.

To examine occupational stress levels and associated factors among pregnant nurses through a comparison with pregnant non-nurses. This cross-sectional study included 1060 working pregnant women. Participants completed questionnaires including the Brief Job Stress Questionnaire, work conditions, obstetric conditions, Sense of Coherence Scale, and self-management behaviors questionnaire. The participants were categorized into four groups: nurses, other healthcare workers, physical workers, and desk workers. Comparisons were made between the four groups and by gestational ages using Dunnett's test and chi-squared test, and associated factors were examined using ordinal logistic regression analysis. Analysis of 847 valid responses showed that the nurse group had a higher occupational stress, higher job demand, and lower job control at any gestational age than the other profession groups. Nurses' occupational stress was associated with factors such as frequent overtime work, fewer break times, lower manager support, and lower prioritizing the fetus. Particularly, fewer break times and lower prioritizing the fetus were nurse-specific associated factors. The study showed that pregnant nurses are exposed to higher occupational stress throughout the entire pregnancy than other occupations. The stress was related to modifiable factors such as fewer break times and lower prioritizing the fetus. To manage occupational stress, pregnant nurses should avoid overtime, take breaks, and prioritize the fetus in the workplace. Hospital administrators would need to provide work coordination support and consider certain regulations regarding hazardous work restrictions for pregnant nurses. Future cohort studies are required to better understand occupational stress among pregnant nurses.

Maternal sleep disturbance during pregnancy and child intelligence quotient: A metabolome-wide association study in the Shanghai Birth Cohort.

The impact of maternal sleep disturbances during pregnancy on long-term neurodevelopment and the role of metabolites in this process are not well understood. In a prospective cohort study, we aimed to investigate the associations between maternal sleep disturbances during each trimester and child intelligence quotient (IQ) at the age of 4 years and to identify metabolites that might mediate these relationships. This study included 1,870 mother-child pairs from the Shanghai Birth Cohort (SBC). Maternal sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) questionnaire in the first and second trimesters, and a simplified version of the PSQI was used in the third trimester. Child IQ was evaluated at age 4 using the Wechsler Primary and Preschool Scale of Intelligence-Fourth Edition (WPPSI-IV). We conducted untargeted analyses of maternal serum metabolomics in the first trimester in 1,461 subjects. We employed multiple linear regression models to examine the associations between maternal sleep disturbances during each trimester and child IQ. Additionally, we utilized longitudinal latent class analysis (LLCA) to identify patterns of sleep quality changes throughout the three trimesters and employed multiple linear regression models to investigate how these sleep patterns across the entire pregnancy were associated with child IQ. We applied a 'meet-in-the-middle' approach to identify potential metabolites linking maternal sleep disturbances during early pregnancy with child IQ. Longer sleep latency was associated with lower child Full-Scale IQ (FSIQ) and verbal comprehension index (VCI) for the first trimester, while lower child fluid reasoning index (FRI) for the second trimester. Longer sleep latency throughout the pregnancy was associated with decreased FSIQ (β = -4.68; 95% CI: -8.32, -1.03), VCI (β = -6.38; 95% CI: -10.39, -2.37), and FRI (β = -4.29; 95% CI: -7.96, -0.63). We found that inositol, indoleacrylic acid, and 4-hydroxyquinoline emerged as potential biomarkers that play an intermediary role in the association between maternal sleep disturbances and child IQ. Sleep disturbance during pregnancy may be a risk factor for compromised IQ in preschool-aged offspring. Alterations in inositol and tryptophan metabolism might be the mediator for the link between maternal sleep disturbances and child IQ.

A196 MATERNAL AND NEONATAL OUTCOMES IN PREGNANT WOMEN WITH IBD TREATED WITH USTEKINUMAB OR RISANKIZUMAB: A CASE SERIES

Abstract Background Biologics are an important therapy for patients with moderate to severe IBD. These include Ustekinumab (UST) – anti-IL-12/23, and the newer biologic Risankizumab (RIS) – anti-IL23. For UST, the PIANO registry and some cohort studies found no significant difference in maternal/neonatal outcomes compared to controls. However, the EPI-MERES registry found an increase in likelihood of small for gestational age births, and one study reported a slower initial postnatal growth rate for in-utero exposed infants. RIS currently has limited evidence in pregnancy. Aims We present a case series of maternal and neonatal outcomes of UST and RIS treated pregnant patients with IBD. Methods We conducted a single-centre case series including patients treated with UST and RIS at any point during pregnancy enrolled between Jan 1, 2017 and Jul 31, 2024. Data was collected on maternal outcomes including live birth, miscarriage, delivery method, and pregnancy-related complications. Neonatal outcomes included preterm birth, small for gestational age (SGA), large for gestational age (LGA), congenital anomalies, NICU admission, APGAR scores, and neonatal infection. Results There were 23 UST patients – 21 (91.3%) had live births and 2 (8.7%) had miscarriages. Of the 21 that delivered, there were 12 (57.1%) vaginal deliveries, 8 (38.1%) elective c-sections, and 1 (4.8%) emergency c-section due to placental insufficiency. One patient had gestational diabetes, 1 had pre-eclampsia, but there were no preterm premature rupture of membranes or intrauterine growth restrictions (IUGR). Of the 21 neonates, 3 (14.3%) were preterm, 1 (4.8%) was SGA, 3 (14.3%) were LGA, and 1 unknown. There were no congenital anomalies. Five (23.8%) infants were admitted to the NICU after birth and 1 (4.8%) was reported to have a postnatal infection within 3 months. Of the 12 infants with known APGAR scores, 10 had scores ≥7 at 1 minute, and 2 were &amp;lt;7. At 5 minutes, all scores were ≥7. Of the 2 RIS patients, 1 was exposed to RIS throughout the entire pregnancy and the other was given a dose during the 1st and 3rd trimester only. Both pregnancies resulted in live births with 1 vaginal delivery and 1 elective c-section. One neonate was LGA. One had an APGAR score of 8 at 1 minute and 9 at 5 minutes. The other infant scored 9 at 1 minute and the score at 5 minutes was not documented. There were no preterm births, congenital anomalies, or pregnancy-related complications. Conclusions In our case series of UST and RIS exposed pregnancies, there were no significant adverse maternal or neonatal outcomes. Further data is necessary to better characterize the safety of both medications. Funding Agencies None

The Bidirectional Interaction Between Insulin and the Hypothalamus–Pituitary–Adrenal Axis in Normal Pregnant Mares

The aim of this study was to determine if the changes in plasma insulin, glucose (GLU), fructosamine (FRUCT), adrenocortical hormone (ACTH), and cortisol (CORT) concentrations in mares of different ages were substantial enough to indicate the need to also establish specific reference intervals for pregnant Spanish Purebred mares with a heterogeneous body conditional score (BCS). A total of 45 mares were used in the study, which were classified according to age into 24 &lt;10 years (from 4 to 9 years) and 21 &gt;10 years (from 10 to 18 years). According to the BCS, mares &lt;10 and &gt;10 years were distinguished into three groups as follows: underweight (BCS &lt; 4–5; n = 8), moderate (BCS = 6–7; n = 8), and overweight (BCS = 8; n = 8) (BCS &lt; 4–5 (n = 7), BCS = 6–7 (n = 7), and BCS = 8 (n = 7)), respectively. The main results of this study were that (I) circulating insulin, GLU, FRUCT, ACTH, and CORT concentrations were altered throughout the whole duration of pregnancy in mares; that (II) aging and BCS significantly affected insulin, ACTH, and CORT changes; and that (III) ACTH-CORT significantly correlated with insulin, FRUCT, and GLU. The results may have implications for health and disease and warrant future prospective investigations on the bidirectional interaction between insulin and the hypothalamus–pituitary–adrenal (HPA) axis in equine species, affecting the GLU and FRUCT profile through the entire physiological pregnancy.

Odnos monociti/HDL-holesterol kao rani prognostički marker razvoja komplikacija u trudnoći

Pregnancy complications increase the long-term cardiovascular risk for both the mother and the child. Inflammation is a common mechanism underlying the development of pregnancy complications and atherosclerosis. This study aims to investigate whether the monocyte/HDL cholesterol ratio can serve as a predictive marker for the risk of pregnancy complications. A total of 84 pregnant women participated in this study, 41 of whom had a normal pregnancy course, while 43 experienced complications. Lipid status parameters were measured using enzymatic methods and total blood count was measured using a hematology analyzer. In the first trimester of pregnancies with complications we observed significantly higher levels of total cholesterol (P &lt; 0.01), low-density lipoprotein cholesterol (LDL-C) (P &lt; 0.01) and triglycerides (P &lt; 0.001) compared to pregnancies without complications, whereas no differences were observed in high-density lipoprotein cholesterol (HDL-C). Pregnant women with complications had a significantly higher proportion of monocytes throughout the entire pregnancy, and lower concentrations of HDL-C in the second trimester (P &lt; 0.05). The risk of developing complications in pregnancy was 11 times higher if the monocyte/HDL-C ratio was elevated in the first trimester (OR: 11.42; 95% CI: 4.05-32.19; P &lt; 0.001). Our results indicate that monocyte/HDL-C ratio could be used as a simple and cost-effective early prognostic biomarker of pregnancy complications.