Pregnancy Factors Research Articles

Dietary and maternal sociodemographic determinants of perfluoroalkyl and polyfluoroalkyl substance levels in pregnant women

Diet, including drinking water, and demographic characteristics have been associated with PFAS exposure levels in the general population. But data in pregnant women are scarce. We aimed to examine the PFAS levels in relation to these factors in early pregnancy and included 2545 pregnant women in early pregnancy from the Shanghai Birth Cohort. Ten PFAS were measured using high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS-MS) in plasma samples at around 14 weeks of gestation. Geometric mean (GM) ratios were used to estimate the associations between demographic characteristics, food intake and source of drinking water and concentrations of nine PFAS with a detection rate of at least 70%, and the total perfluoroalkyl carboxylic acids (∑PFCA), perfluoroalkyl sulfonic acids (∑PFSA) and all the PFAS concentrations (∑PFAS). Median concentrations of plasma PFAS ranged from 0.03 ng/mL for PFBS to 11.56 ng/mL for PFOA. In the multivariable linear models, maternal age, parity, parental education level, marine fish, freshwater fish, shellfish, shrimps, crabs, animal kidneys, animal liver, eggs, and bone soup in early pregnancy were positively associated with plasma concentrations of certain PFAS. Whereas pre-pregnancy BMI, plant-based foods, and drinking bottled water were negatively associated with some PFAS concentrations. In summary, this study suggested that fish and seafood, animal offal, and high-fat foods (eggs and bone soup) were significant sources of PFAS. PFAS exposure may be reduced by consuming more plant-based foods and potential interventions, such as drinking water treatment.

Association between Progesterone-Only Emergency Contraceptive Pill and Ectopic Pregnancy

Context: Ectopic pregnancy remains a significant cause of morbidity and mortality in the developing countries, where mortality rates are 10 times higher than in the developed countries. In Kenya, there is however no recent data on ectopic pregnancy. Objective: We sought to identify if using an emergency contraceptive pill predisposes to ectopic pregnancy and assess other risk factors for ectopic pregnancy at the Kenyatta National Hospital. Methods: We conducted a case-control study of 120 consecutively sampled women matched for age diagnosed with ectopic pregnancy. Data were analyzed using a statistical package for the social sciences (SPSS software) [version 18.0]. Multivariate logistic regression analysis was performed to calculate the odds ratios (OR) and the corresponding 95% confidence intervals (CI). Results: Of the 120 cases and 120 controls recruited, 27.5% of the cases and 2.5% of the controls had taken Levonogesterol emergency contraceptive (LNG-EC) pill during the menstrual cycle leading to the current pregnancy. Of the cases, 72.7% took the LNG-EC within 24hrs after coitus, while all the controls took the pill within 24-48 hrs. The risk of ectopic pregnancy (EP) increased 12-fold in women who had used LNG-EC (OR=12.44, 95% CI 3.1-49.84) after adjusting for other confounders. EP was associated with an early sexual debut (p= 0.039), and a history of subfertility/infertility (OR=6.87, 95% CI 2.14-22.03). Conclusions: Progesterone only emergency contraceptive pill is as a risk factor for ectopic pregnancy and should be included in the client information leaflet in the drug package insert.

Association between Serum Progesterone Levels and Endometrial Status on hCG Injection in IVF Cycle

Background: Endometrial thickness is a determining factor in successful implantation and pregnancy. So, this study is aimed at assessing the association between the serum levels of progesterone and endometrial status on the day of hCG injection in women treated with in-vitro fertilization (IVF). Methods: Totally, 71 women who underwent IVF cycle were prospectively recruited in this study. On the day of hCG injection, their serum progesterone levels were evaluated with the ELISA kit. The endometrial thickness was examined using transvaginal ultrasound. Patients were divided into two groups, including patients with progesterone ? 1 ng /ml and progesterone> 1 ng/ml. Eventually, patients' demographic and clinical features were statistically compared between two groups. Results: Among all the evaluated demographic and clinical factors, only the rate of nulligravid (P= 0.03) and abortion (P= 0.02) in the progesterone group ? 1 ng/ml was significantly higher than their rate in the progesterone group > 1 ng/ml. Moreover, the mean (SD) endometrial thickness was not significantly different between the two groups (P= 0.83). Conclusion: No significant relationship existed between the serum level of progesterone on the day of hCG injection and the endometrial thickness in women treated with IVF. However, a significant negative correlation existed between its level and the rate of gravidity and abortion.

The Association Between Placenta-Mediated Diseases of Pregnancy and Postpartum Maternal Cardiovascular Disease Risk Factors: A Systematic Review

The Association Between Placenta-Mediated Diseases of Pregnancy and Postpartum Maternal Cardiovascular Disease Risk Factors: A Systematic Review

Factors Associated With Readmission for Postpartum Preeclampsia [ID: 1378401

INTRODUCTION: Factors associated with preeclampsia with severe features (PSF) diagnosed on postpartum readmission are understudied, although important. METHODS: Patients were identified using ICD-9/10 codes of PSF diagnosed antenatally or postnatally between 2010 and 2019. We collected background and pregnancy characteristics via electronic medical records and used the Chicago Health Atlas to assign zip code-based socioeconomic hardship and education scores. Descriptive statistics and logistic regressions evaluated whether individual, pregnancy, and neighborhood factors predicted odds of readmission. Model 1 included age, body mass index (BMI), fetal growth restriction, urine protein, preterm delivery, and cesarean section. Model 2 added neighborhood factors, number of hypertensive medications at discharge, and length of delivery inpatient stay. RESULTS: Seven hundred forty-seven participants with PSF were identified, and 108 (14.8%) were diagnosed on postnatal readmission. Our sample was 68.8% Black, aged 29.0±6.8 years, with a mean BMI of 34.7±9.7 kg/m2. In model 1, older age was associated with an increased risk for readmission (adjusted odds ratio [aOR] 1.07, 95% CI 1.03–1.11) while the presence of proteinuria (aOR 0.38, 95% CI 0.24–0.61) and preterm birth (aOR 0.52, 95% CI 0.30–0.91) were associated with decreased risk for readmission. In model 2, older age (aOR 1.09, 95% CI 1.04–1.14) remained significantly associated with increased risk of readmission while the presence of proteinuria (aOR 0.24, 95% CI 0.12–0.45), more hypertensive medications given at discharge (aOR 0.44, 95% CI 0.24–0.82), and longer inpatient stay (aOR 0.60, 95% CI 0.40–0.92) showed decreased odds of readmission. No other studied factors were associated with readmission. CONCLUSION: Older mothers were consistently more at risk for readmission, while more intensive hypertensive treatment (higher number of medications, longer inpatient stay at delivery) protected against readmission.

Hipogonadotropik Hipogonadizmli Kadınlarda İn Vitro Fertilizasyon Sonuçlarının Değerlendirilmesi

Aim: Hypogonadotropic hypogonadism (HH) is a rare clinical condition resulting from gonadal insufficiency due to low pituitary gonadotropin levels. Since ovulation occurs rarely in these patients, the probability of spontaneous pregnancy is very low. The study aimed to evaluate the in vitro fertilization (IVF) treatment outcomes in patients with HH and to compare these results with that of patients with unexplained infertility (UI) who underwent IVF treatment. Material and Methods: In this study, 36 cycles of 28 HH patients who underwent IVF treatment and 72 cycles of 68 patients who underwent IVF treatment for UI were included. Demographic data, ovarian hyperstimulation and cycle outcomes, clinical pregnancy rates, and predictive factors for clinical pregnancy were evaluated retrospectively, and the two groups were compared. Results: In the HH group, clinical pregnancy, and live birth rates per cycle after IVF were significantly higher compared with the UI group (n=16, 44.4% vs. n=17, 23.6%, p=0.027; and n=14, 38.9% vs. n=14, 19.4%; p=0.030, respectively). Although the number of antral follicles (p=0.001) and retrieved oocytes (p=0.042) were significantly higher in the UI group, the number of mature oocytes and grade I-II embryos were similar in the HH and UI groups. The total gonadotropin dose used and duration of stimulation in the HH group were significantly higher than in the UI group (both p=0.001). Conclusion: HH patients responded well to IVF treatment and had better IVF outcomes compared to women who underwent IVF for UI. No prognostic factor that affected pregnancy success in HH patients was detected.

Efficacy of Chinese Herbal Medicines on Pregnancy Outcomes in Patients with Endometriosis in Long-Term Management: A Multicenter Retrospective Cohort Study.

To analyze the factors related to pregnancy of endometriosis and whether Chinese herbal medicines (CHMs) can improve pregnancy outcomes in patients with endometriosis in long-term management. This multicenter cohort study retrospectively analyzed the clinical data of endometriosis patients with fertility needs from January 2019 to November 2019. A total of 252 patients with endometriosis from 5 level-III Grade A hospitals in Beijing were included in this study. Univariate and multivariate logistic regression analysis were performed for the relevant factors. The propensity score matching (PSM) function of SPSS software was used to match the CHMs group with the non-CHMs group. The pregnancy rate and live birth rate were analyzed. The results of univariate analysis showed that age, disease course, presence of infertility, presence of adenomyosis, time after surgery or use of gonadotropin-releasing hormone agonist (GnRH-a), use of CHMs and follow-up time were influencing factors of pregnancy in endometriosis patients (P<0.05). The results of multivariate analysis showed that age, presence of adenomyosis, time after surgery or use of GnRH-a, use of CHMs and follow-up time were independent factors affecting pregnancy in endometriosis patients, among which, age ⩾35 years old, presence of adenomyosis and follow-up time >6 months were independent risk factors (OR=0.445, 0.348, 0.140, respectively, P<0.05), time after surgery or use of GnRH-a ⩽6 months and use of CHMs were independent protective factors (OR=3.839, 3.842, respectively, P<0.05). After PSM, 99 pairs of two groups were matched successfully. The pregnancy rate of the CHMs group was higher than that of the non-CHMs group [55.56% (55/99) vs. 36.36% (36/99), P<0.05]. The live birth rate of the CHMs group was higher than that of the non-CHMs group [49.49% (49/99) vs. 35.35% (35/99), P<0.05]. CHMs can effectively improve clinical pregnancy rate and live birth rate of patients with endometriosis in the chronic disease management.

SYSTEMATIC REVIEW: THE EFFECT OF ADOLESCENT BEHAVIOR ON UNWANTED PREGNANCY

One indicator of the country's progress can be seen from the maternal mortality rate in which adolescents are the group of contributors to this figure. Pregnancy is unwanted to be the cause of maternal death because of the many complications during pregnancy and childbirth. Not to mention the other postpartum impacts that must be borne by adolescents. Many factors influence unwanted pregnancy, one of which is the factor of adolescent behavior itself, of course, there are many factors that influence adolescent behavior, which causes unwanted pregnancy. The aim of this study is to see what aspects of adolescent behavior affect unwanted pregnancies This study is a literature study of several journals, theses, and other scientific articles on behaviors that affect unwanted pregnancy in adolescents. Adolescent behavior factors for unwanted pregnancy include beliefs &amp; perceptions about premarital sexual behavior and contraception. From a cognitive point of view where the level of knowledge related to pregnancy is undesirable. A negative attitude will encourage adolescents to engage in risky behavior. Adolescent motivation which becomes the reason for engaging in risky behavior is the need to fulfill adolescent lifestyles. The risky actions that affect unwanted pregnancies are the behavior of consuming alcohol, illegal drugs, and not using contraceptives.

The burden of unintended pregnancies among Indian adolescent girls in Bihar and Uttar Pradesh: findings from the UDAYA survey (2015–16 & 2018–19)

BackgroundUnintended pregnancy severely affects the health and welfare of women and children, specifically if women are young and vulnerable. This study aims to determine the prevalence of unintended pregnancy and its determinants among adolescent girls and young adult females in Bihar and Uttar Pradesh. We believe the present study is unique as it examines the association between unintended pregnancy and sociodemographic factors among young female population in two states of India from 2015–19.MethodsThe data for the present study is derived from the two-wave longitudinal survey “Understanding the lives of adolescents and young adults” (UDAYA) conducted in 2015–16 (Wave 1) and 2018–19 (Wave 2). Univariate, bivariate analysis along with logistic regression models were employed.ResultsThe results revealed that 40.1 per cent of all currently pregnant adolescents and young adult females reported their pregnancy as unintended (mistimed and unwanted) in Uttar Pradesh at Wave 1 of the survey, which decreased to 34.2 per cent at Wave 2. On the contrary, almost 99 per cent of all currently pregnant adolescents in Bihar reported their pregnancy as unintended at Wave 1, which decreased to 44.8 per cent at Wave 2. The sociodemographic factors like age, caste, religion, education, wealth, media and internet use, knowledge and effective contraception highly impacted unintended pregnancy in Bihar and Uttar Pradesh. The longitudinal results of the study revealed that place of residence, internet use, number of wanted children, heard about contraception and SATHIYA, use of contraception, side effects of contraception, and the confidence in getting contraceptives from ASHA/ANM did not appear significant predictors at Wave 1. However, they emerge significant over time (Wave 2).ConclusionsDespite many recently launched policies for adolescents and the youth population, this study comprehended that the level of unintended pregnancies in Bihar and Uttar Pradesh stands worrisome. Therefore, adolescents and young females need more comprehensive family planning services to improve their awareness and knowledge about contraceptive methods and use.

Maternal migraine and risk of pediatric cancers.

Maternal migraine has been linked to adverse birth outcomes including low birth weight and preterm birth, as well as congenital anomalies in offspring. It has been speculated that this may be due to the use of medications in pregnancy, but lifestyle, genetic, hormonal, and neurochemical factors could also play a role. There is evidence for varying cancer incidences among adults with migraine. Here, we utilized data from national registries in Denmark to examine associations between maternal diagnoses of migraine and risk for cancer in offspring. We linked several national registries in Denmark to identify cases from the Cancer Registry among children less than 20years (diagnoses 1996-2016) and controls from the Central Population Register, matched to cases by birth year and sex (25:1 matching rate). Migraine diagnoses were identified from the National Patient Register using International Classification of Diseases, versions 8 and 10 codes and migraine-specific acute or prophylactic treatment recorded in the National Pharmaceutical Register. We used logistic regression to estimate the risk of childhood cancers associated with maternal migraine. Maternal migraine was positively associated with risk for non-Hodgkin lymphoma (odds ratio [OR]=1.70, 95% confidence interval [CI]: 1.01-2.86), central nervous system tumors ([OR=1.31, 95% CI: 1.02-1.68], particularly glioma [OR=1.64, 95% CI: 1.12-2.40]), neuroblastoma (OR=1.75, 95% CI: 1.00-3.08), and osteosarcoma (OR=2.60, 95% CI: 1.18-5.76). Associations with maternal migraine were observed for several childhood cancers, including neuronal tumors. Our findings raise questions about the role of lifestyle factors, sex hormones, genetic, and neurochemical factors in the relationship between migraine and childhood cancers.

Overview of Risk Factors for Ectopic Pregnancy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Introduction: Ectopic pregnancy is an emergency condition that is the cause of maternal death during the first trimester of pregnancy. Most extrauterine implantations occur in the fallopian tubes. This study aimed to find an overview factor risk of ectopic pregnancy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.&#x0D; Methods: This study was a descriptive observational study and used secondary data from medical record data at the medical record installation of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. A total of 100 research subjects participated in this study, and the research subjects met the inclusion criteria. The inclusion criteria in this study were patients with ectopic pregnancy disorders who were treated at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, over 18 years of age and had complete medical record data. Data analysis was carried out using SPSS software version 25. Univariate analysis was performed to present the distribution frequency data for each variable test.&#x0D; Results: The majority of research subjects had an age range of 26-35 years (55%). The most common risk factors in this study were a history of abortion in a previous pregnancy (47%), parity 0 (46%), and abortion occurring in the first pregnancy (35%).&#x0D; Conclusion: Maternal age, history of abortion, parity, and gravidity are risk factors that play a role in the incidence of ectopic pregnancy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.

Energy-Adjusted Dietary Inflammatory Index in pregnancy and maternal cardiometabolic health: findings from the ROLO study

Excessive inflammation during pregnancy has been linked to adverse long-term health outcomes for both mothers and their children. One such outcome is maternal cardiometabolic dysfunction. The Energy-Adjusted Dietary Inflammatory Index is a method of scoring the overall inflammatory potential of the diet. Research on how the inflammatory potential of the maternal diet during pregnancy affects maternal cardiometabolic factors is limited. We investigated if the maternal Energy-Adjusted Dietary Inflammatory Index was associated with maternal cardiometabolic factors during pregnancy. This is a secondary analysis of 518 individuals who participated in the ROLO (Randomized cOntrol trial of a LOw glycemic index diet in pregnancy) study. Maternal Energy-Adjusted Dietary Inflammatory Index scores were calculated in early (12-14 weeks' gestation) and late pregnancy (34 weeks' gestation) using data collected from 3-day food diaries. Body mass index, blood pressure, fasting lipid profiles, glucose levels, and HOMA1-IR were obtained in early and late pregnancy. Multiple linear regression examined associations between early-pregnancy Energy-Adjusted Dietary Inflammatory Index and early and late maternal cardiometabolic markers. In addition, the relationship between late-pregnancy Energy-Adjusted Dietary Inflammatory Index and late cardiometabolic factors was explored. Regression models were adjusted for maternal ethnicity, maternal age at delivery, education level, smoking status, and original randomized control trial group allocation. In regression models examining late-pregnancy Energy-Adjusted Dietary Inflammatory Index with late lipids, change in lipid level from early to late pregnancy was also adjusted for. Women's mean (standard deviation) age at delivery was 32.8 (±4.01) years, with median (interquartile range) body mass index of 24.45 (23.34-28.20) kg/m2. Mean (standard deviation) Energy-Adjusted Dietary Inflammatory Index was 0.59 (±1.60) in early pregnancy and 0.67 (±1.59) in late pregnancy. In adjusted linear regression analysis, first-trimester maternal Energy-Adjusted Dietary Inflammatory Index was positively associated with maternal body mass index (B=0.007; 95% confidence interval, 0.003-0.011; P=.001), early-pregnancy cardiometabolic markers including total cholesterol (B=0.155; 95% confidence interval, 0.061-0.249; P=.001), triglycerides (B=0.043; 95% confidence interval, 0.005-0.080; P=.03), low-density lipoproteins (B=0.129; 95% confidence interval, 0.049-0.209; P=.002), and diastolic blood pressure (B=0.538; 95% confidence interval, 0.070-1.006; P=.02), and late-pregnancy cardiometabolic markers including total cholesterol (B=0.127; 95% confidence interval, 0.012-0.243; P=.01) and low-density lipoproteins (B=0.110; 95% confidence interval, 0.010-0.209; P=.03). In the third trimester, Energy-Adjusted Dietary Inflammatory Index was associated with late-pregnancy diastolic blood pressure (B=0.624; 95% confidence interval, 0.103-1.145; P=.02), HOMA1-IR (B=0.030; 95% confidence interval, 0.005-0.054; P=.02), and glucose (B=0.003; 95% confidence interval, 0.003-0.034; P=.03). No associations were observed between third-trimester Energy-Adjusted Dietary Inflammatory Index and late-pregnancy lipid profiles. Maternal diets with a higher Energy-Adjusted Dietary Inflammatory Index, which were low in anti-inflammatory foods and rich in proinflammatory foods, were associated with increased levels of cardiometabolic health risk factors in pregnancy. Promoting dietary intakes that have a lower inflammatory potential may support more favorable maternal cardiometabolic profiles during pregnancy.

Association between antenatal diagnosis of late fetal growth restriction and educational outcomes in mid-childhood: A UK prospective cohort study with long-term data linkage study

Fetal growth restriction (FGR) is associated with a suboptimal intrauterine environment, which may adversely impact fetal neurodevelopment. However, analysing neurodevelopmental outcomes by observed birthweight fails to differentiate between true FGR and constitutionally small infants and cannot account for iatrogenic intervention. This study aimed to determine the relationship between antenatal FGR and mid-childhood (age 5 to 7 years) educational outcomes. The Pregnancy Outcome Prediction Study (2008-2012) was a prospective birth cohort conducted in a single maternity hospital in Cambridge, United Kingdom. Clinicians were blinded to the antenatal diagnosis of FGR. FGR was defined as estimated fetal weight (EFW) <10th percentile at approximately 36 weeks of gestation, plus one or more indicators of placental dysfunction, including ultrasonic markers and maternal serum levels of placental biomarkers. A total of 2,754 children delivered at term were divided into 4 groups: FGR, appropriate-for-gestational age (AGA) with markers of placental dysfunction, healthy small-for-gestational age (SGA), and healthy AGA (referent). Educational outcomes (assessed at 5 to 7 years using UK national standards) were assessed with respect to FGR status using regression models adjusted for relevant covariates, including maternal, pregnancy, and socioeconomic factors. Compared to healthy AGA (N = 1,429), children with FGR (N = 250) were at higher risk of "below national standard" educational performance at 6 years (18% versus 11%; aOR 1.68; 95% CI 1.12 to 2.48, p = 0.01). By age 7, children with FGR were more likely to perform below standard in reading (21% versus 15%; aOR 1.46; 95% CI 0.99 to 2.13, p = 0.05), writing (28% versus 23%; aOR 1.46; 95% CI 1.02 to 2.07, p = 0.04), and mathematics (24% versus 16%; aOR 1.49; 95% CI 1.02 to 2.15, p = 0.03). This was consistent whether FGR was defined by ultrasound or biochemical markers. The educational attainment of healthy SGA children (N = 126) was comparable to healthy AGA, although this comparison may be underpowered. Our study design relied on linkage of routinely collected educational data according to nationally standardised metrics; this design allowed a high percentage of eligible participants to be included in the analysis (75%) but excludes those children educated outside of government-funded schools in the UK. Our focus on pragmatic and validated measures of educational attainment does not exclude more subtle effects of the intrauterine environment on specific aspects of neurodevelopment. Compared to children with normal fetal growth and no markers of placental dysfunction, FGR is associated with poorer educational attainment in mid-childhood.

The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score-matched analysis.

This study examined obstetric outcomes in patients diagnosed with uterine adenomyosis. This historical cohort study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. The study population was all hospital deliveries in women aged 15-54 years between January 2016 and December 2019. The exposure was a diagnosis of uterine adenomyosis. The main outcome measures were obstetric characteristics, including placenta previa, placenta accreta spectrum, and placental abruption. Secondary outcomes were delivery complications including severe maternal morbidity. Analytic steps to assess these outcomes included (i) a 1-to-N propensity score matching to mitigate and balance prepregnancy confounders to assess obstetric characteristics, followed by (ii) an adjusting model with preselected pregnancy and delivery factors to assess maternal morbidity. Sensitivity analyses were also performed with restricted cohorts to account for prior uterine scar, uterine myoma, and extra-uterine endometriosis. After propensity score matching, 5430 patients with adenomyosis were compared to 21 720 patients without adenomyosis. Adenomyosis was associated with an increased odds of placenta accreta spectrum (adjusted-odds ratio [aOR] 3.07, 95% confidence interval [CI] 2.01-4.70), placenta abruption (aOR 3.21, 95% CI: 2.60-3.98), and placenta previa (aOR 5.08, 95% CI: 4.25-6.06). Delivery at <32 weeks of gestation (aOR 1.48, 95% CI: 1.24-1.77) and cesarean delivery (aOR 7.72, 95% CI: 7.04-8.47) were both increased in women with adenomyosis. Patients in the adenomyosis group were more likely to experience severe maternal morbidity at delivery compared to those in the nonadenomyosis group (aOR 1.86, 95% CI: 1.59-2.16). Results remained robust in the aforementioned several sensitivity analyses. This national-level analysis suggests that a diagnosis of uterine adenomyosis is associated with an increased risk of placental pathology (placenta accreta spectrum, placenta abruption, and placental previa) and adverse maternal outcomes at delivery.

Influence of Adipose Tissue on Early Metabolic Programming: Conditioning Factors and Early Screening.

Obesity and being overweight have become one of the world's most severe health issues, not only because of the pathology but also because of the development of related comorbidities. Even when children reach adulthood, the mother's environment during pregnancy has been found to have a significant impact on obesity prevention in children. Thus, both maternal dietary habits and other factors such as gestational diabetes mellitus, excessive weight gain during pregnancy, smoking, or endocrine factors, among others, could influence newborn growth, adiposity, and body composition at birth, in childhood and adolescence, hence programming health in adulthood. The aim of this review is to analyze the most recent human studies on the programming of fetal adipose tissue to determine which modifiable factors may influence adiposity and thus prevent specific disorders later in life by means of a bibliographic review of articles related to the subject over the last ten years. The importance of a healthy diet and lifestyle not only during pregnancy and the first months of life but also throughout childhood, especially during the first two years of life as this is a period of great plasticity, where the foundations for optimal health in later life will be laid, preventing the emergence of noncommunicable diseases including obesity, diabetes mellitus type 2, hypertension, being overweight, and any other pathology linked to metabolic syndrome, which is so prevalent today, through health programs beginning at a young age.

The inter- and multi- generational epigenetic alterations induced by maternal cadmium exposure.

Exposure to cadmium during pregnancy, from environmental or lifestyle factors, has been shown to have detrimental fetal and placental developmental effects, along with negatively impacting maternal health during gestation. Additionally, prenatal cadmium exposure places the offspring at risk for developing diseases in infancy, adolescence, and adulthood. Although given much attention, the underlying mechanisms of cadmium-induced teratogenicity and disease development remain largely unknown. Epigenetic changes in DNA, RNA and protein modifications have been observed during cadmium exposure, which implies a scientific premise as a conceivable mode of cadmium toxicity for developmental origins of health and disease (DOHaD). This review aims to examine the literature and provide a comprehensive overview of epigenetic alterations induced by prenatal cadmium exposure, within the developing fetus and placenta, and the continued effects observed in childhood and across generations.

Laparoscopic treatment of advanced interstitial pregnancy: key steps for a successful management

To describe a conservative laparoscopic treatment of an advanced case of interstitial pregnancy diagnosed in a woman at 14 weeks of gestational age. Video case report with demonstration of diagnostic work-up and laparoscopic management of rare subtypes of ectopic pregnancy SETTING: University tertiary care hospital. A 32-year-old nulliparous woman at 14 weeks of gestational age, presented with moderate abdominal pain. She reported an history of irregular periods however, no risk factor for ectopic pregnancy were identified. HCG levels was 7345 mIU/mL. Transvaginal ultrasound revealed an empty uterine cavity and a complex heterogeneous mass of 6 cm on the left cornual region. Myometrial thickness surrounding the gestational sac was 4 mm. There were several critical strategies for this laparoscopic approach. To reduce intraoperative bleeding, the peritoneum was opened, the ureters were identified, and bulldog clamps were used to temporarily reduce uterine vascularization. An intramyometrial injection of vasopressin was performed. After a first cornuostomy attempt, we had to get on a cornual resection to achieve a complete removal of the ectopic mass. Multilayer uterine suture and anatomical restoration to prevent adhesion was then accomplished. Institutional review board approval was not required for this case report as per our institution's policy; patient consent was obtained for publication of the case. Description of a laparoscopic management of huge interstitial pregnancy RESULTS: The overall operation time was 55 minutes, and the estimated blood loss was 55cl. A successfully conservative treatment was achieved with no short-term complications. Postoperative ultrasound showed a normal uterus and complete regression of hCG was obtained two weeks after surgery. Interstitial ectopic pregnancy presents a high risk of maternal mortality considering that the interstitial part of the tube, because of its thickness, has a great capacity to expand before rupture.

The Science of Amniotic Fluid Embolism

With many countries around the world facing aging populations and declining birth rates, governments are encouraging women to have children. However, few countries are really concerned about the effects of pregnancy on women, and society is hiding the risks and symptoms of pregnancy and postpartum complications as if to get more women to have children by hiding these facts. What I believe is that only when women truly understand the process and risk factors of pregnancy can they be prepared to give birth with confidence. People are always afraid of the unknown. This article systematically analyzes the disease with the highest mortality rate during pregnancy, amniotic fluid embolism (AFE). Hopefully, this article will make more people aware of this rare but highly fatal disease. This article introduces various aspects of AFE, the most central part of which should be the analysis of the causes of AFE and the current treatment methods. The author hopes that after reading this article, the reader will be able to eliminate as many questions as possible about AFE.

ART outcomes of patients in women with Isolated Hypogonadotropic Hypogonadism: a retrospective study in China

BackgroundIsolated Hypogonadotropic Hypogonadism (IHH) is a rare reproductive disorder caused by the dysfunction of the gonadotropin-releasing hormone axis. Patients with IHH typically fail to enter or develop through puberty and retain infertile without an exogenous hormone supplement. This study aimed to investigate the population characteristics and reproductive outcomes in IHH patients undergoing assisted reproductive technology (ART) treatment, and evaluate the best-performed predictor for ovarian response and clinical pregnancy in patients with IHH.MethodsThis retrospective cohort study included 83 women with IHH who underwent fresh ART cycles and non-diagnosed controls (n = 676). The receiver operating characteristic curves were generated to assess the predictor for the ovarian response. Logistic regression analyses were performed to investigate the independent factors for clinical pregnancy in IHH.ResultsThe basal hormone levels were significantly lower in the IHH group compared to the control group. The fertilization rate and 2PN rate were significantly higher in IHH groups, as was the number of transferable embryos. The study identified that AMH was the best predictor of high ovarian response in IHH, with an AUC of 0.767 (0.573, 0.961). Conversely, the follicle-to-oocyte index (FOI) exhibited the highest AUC of 0.814 (0.642, 0.985) for predicting low ovarian response. Based on FOI values, the IHH patients were divided into two groups, and the study found a significant increase in clinical pregnancy rate (43.8%, 58%; P < 0.001) and live birth rate (37.5%, 58%; P < 0.001) from the low FOI to the normal FOI groups. Moreover, the number of oocytes retrieved, fertilized embryos/rate, 2PN embryos/rate, and number of excellent quality embryos were significantly higher in the normal FOI group (P < 0.001 or P = 0.005) than in the low FOI group. Logistic regression analyses revealed FOI to be the independent factor affecting clinical pregnancy in IHH patients.ConclusionsThe study findings suggest that patients with IHH were good responders to IVF treatment. Although AMH was the best-performed predictor for the high ovarian response, FOI had the best capability in predicting the low ovarian response. FOI was an independent factor affecting clinical pregnancy in IHH undergoing IVF/ICSI.

EFFORTS TO INCREASE PREGNANT WOMEN'S KNOWLEDGE ABOUT HIGH-RISK PREGNANCY WITH HEALTH EDUCATION

Pregnancy is a physiological condition that can become pathological if there are complications that affect the health of both the mother and the baby. Pregnant women need to be aware of potential high-risk pregnancy factors and understand the importance of early detection. Health education is an essential tool for improving pregnant women's knowledge in this area. The aim of this study is to explore the impact of health education on pregnant women's knowledge about high-risk pregnancy. To achieve this, we conducted a review of existing research sources obtained from Google and Google Scholar. The sources were taken within the last five years, from 2018 to 2022. A total of 13 articles were identified, consisting of national and international journals that focused on pregnant women who received interventions in the form of health education about high-risk pregnancy. The findings suggest that health education has a positive impact on pregnant women's knowledge and can help reduce the risks associated with high-risk pregnancies.