Fetal Birth Weight Research Articles

A Systematic Patent Review (2008-2023) for Treatment in Pregnancy.

During pregnancy, the woman's body undergoes anatomical and physiological changes, making this period susceptible to maternal-fetal diseases and complications. The consequences of not treating pregnant women include premature birth, low birth weight fetuses, and postnatal behavior disorders. Developing new therapies can accelerate the discovery of safe and effective drugs, contributing to designing novel natural and synthetic products to treat complications the pregnancy. This study aimed to carry out a patent review to identify and explore trends in innovation and therapeutic strategies for treating pregnant women. The Espacenet and WIPO databases were used, with the inclusion criteria being the keywords "pregnancy and drug" and code A61k, from 2008 to 2023, and as exclusion were the access to the patent and focus on human pregnant women. After the final screening, 32 patents were selected, with strategies for the treatment of diseases in pregnant women. Of these, 20 patents are on preclinical studies on animals and 12 on pregnant women. It was observed that universities lead the ranking of applications (17/32), and China has the highest number of patents (18/32). Most findings contain herbal medicines and/or the association of natural extracts with synthetic drugs. From this perspective, new drug administration systems were also developed, which can be a promising source for obtaining new medicines for the treatment of pregnant women; however, research is still limited and shows a gap in stimulating the rapid development of safe drugs that improve the health of pregnant women.

Clinical characteristic and zero-fluoroscopy ablation outcomes of tachyarrhythmias in pregnant: a single center study

Abstract Background Although recommended avoid any intervention during gestation in cases of drug refractory of arrhythmias catheter ablation may be necessary in pregnant women. Purpose To present clinical characteristics and outcomes of zero-fluoroscopy catheter ablation during gestation. Methods This prospective, single center study included 84 cases of tachyarrhythmias during gestation. In 44 cases of drug refractory was performed catheter ablation without fluoroscopy (main group). We evaluated the further course of gestation and obstetric outcomes after ablation in comparison with pregnant with antiarrhythmic therapy of tachyarrhythmias (n=40, control group). Results Both groups were comparable by mean age of pregnant (28.2±4.2 vs. 27.3±3.9 years, p=0.093) and mean duration of gestation (24 ±3.4 vs. 23.8 ±3.2 weeks, p=0.123). New onset arrhythmia prevailed in both groups (64% vs. 55%, p=0,280). Supraventricular tachycardia was the most common arrhythmia during gestation (81,8% vs. 52,5%, p=0,005), which was followed by premature contraction (13,6% vs. 40%, p=0,007). Cases of ventricular tachycardia were rare (4,6% vs. 7,5%, p=0,665). Ablation was performed under the guidance of CARTO (45%) and Ensite Precision systems (55%) without using fluoroscopy in all cases. Acute procedural success of zero-fluoroscopy ablation was in 100% with mean procedural time 71±17 minutes without any complication. Outcomes: further course of gestation characterized by increased incidence of uterine contractile activity and placental abruption only in main group (4,54%, p=0.464 and 2.3%, p=642 respectively). There were no differences in the rate of other complication: uterine blood flow violation (15.9% vs 12.9%, p=0.234) and preeclampsia (4.55% vs 5%, p=0.237). Vaginal type of delivery was in the majority of cases in both groups (82% vs 83%, p=0.242). Neonatal outcomes characterized with normal range of fetal birth weight (median 3207,39±485,61 vs. 3312,3±234,1 grams, p=0.709) and 5 minute Apgar score (median 8,4±1,6 vs. 8,7±1,2, p=0.921). There was no incidence of maternal and fetal mortality. In 12 month, follow-up all there was no arrhythmia recurrence. Conclusions Zero-fluoroscopy ablation of tachyarrhythmias in pregnant is feasible and can be safety performed during gestation in cases of drug refractory with benign outcomes.

Clinical evidence of pacemaker implantation during gestation: a case series

Abstract Background Although recommended avoid any intervention during gestation in cases of poor tolerance to high degree atrioventricular block, pacemaker implantation may be necessary in pregnant women. Purpose To present outcomes of pacemaker implantation during gestation. Methods This prospective, single center study included 10 cases of pacemaker implantation during gestation (median age of patient - 26 years old at 18 weeks of gestation). We evaluated the further course of gestation and obstetric outcomes after implantation in comparison with pregnant with tachyarrythmias (n=111). Results Among 121 pregnant women with varying arrhythmias high degree atrioventricular block was detected in 10 cases (8,3%). In 6 cases this bradyarrhythmia diagnosed for the first time in gestation (60%). All pregnant with high degree atrioventricular block had clinical signs: dizziness and weakness (100%), syncope (70%), episodes of low blood pressure (100%). Pacemaker implantation performed due to hemodynamic instability and poor tolerance of bradyarrhythmia in all cases. Using electroanatomical mapping (Ensite Precision system)and echocardiographic guidance helped to reduce fluoroscopy time. For one pregnant implanted leadless pacemaker (Micra) with achieved more than 80% atrio-ventricular synchronization. Outcomes: further course of gestation characterized by increased incidence of uterine contractile activity (30%) in cases of high degree atrioventricular block, that was significantly higher than in pregnant with tachyarrhythmias (2%) (p=0.007). There were no differences in the rate of other complication: uterine blood flow violation (20% vs 12%, p=0.520), placental abraption (10% vs 5%, p=0.237) and preeclampsia (10% vs 5%, p=0.237). Vaginal type of delivery was in the majority of cases in both groups (70% vs 86%, p=0.553). Neonatal outcomes characterized with normal range of fetal birth weight (median 3163 vs 3212 grams, p=0.981) and 5 minute Apgar score (median 8.6 vs 8.7, p=0.564). There was no incidence of maternal and fetal mortality. In 12 month follow-up all patient have optimal electrical parameters of devise and remained stable over time. Conclusions High degree atrioventricular block in pregnant characterized by increased rate of uterine contractile activity. Pacemaker implantation during gestation can be effectively performed and associated with benign outcomes.

Evaluation of fetal growth and birth weight in pregnancies with placenta previa with and without placenta accreta spectrum.

We evaluated fetal growth and birthweight in pregnancies with placenta previa with and without placenta accreta spectrum (PAS). We retrospectively studied pregnant patients with placenta previa with or without PAS diagnosed at 20-37weeks' gestation. Estimated fetal weight (EFW) percentile and fetal growth rate were calculated based on ultrasound at two timepoints: 20-24 and 30-34-weeks' gestation. Fetuses were small (SGA) or large for gestational age (LGA) when EFW or abdominal circumference was <10th or >90th percentile for gestational age, respectively. Fetal growth rate was estimated by subtracting EFW percentiles from the two ultrasounds. Birthweight in grams and percentiles were estimated via Anderson and INTERGROWTH-21 standards adjusted for neonatal sex. EFW percentiles, fetal growth rate, birth weight and birthweight percentiles were compared between patients with placenta previa with and without PAS. We studied 171 patients with and 146 patients without PAS. SGA rates did not differ between groups on first (PAS n=3, no-PAS n=3, p=0.8) or second ultrasound (PAS n=10, no-PAS n=8, p=0.8). LGA rates were similar between groups on first (PAS n=11, no-PAS n=9, p=0.8) and second ultrasound (PAS n=20, no-PAS n=12, p=0.6). The growth rate was higher in fetuses with PAS than placenta previa (1.22±22.3 vs.-4.1±18.1, p=0.07), but not significantly. The birthweight percentile was higher in the PAS than the placenta previa group (74 vs. 67, p=0.01). On multi-linear regression, birthweight percentile remained higher in the PAS group, but not significantly. Placenta previa with or without PAS is not associated with SGA, LGA or lower birthweight.

Caesarean section and operative vaginal delivery in Estonia and Finland from 1992 to 2016: registry-based study.

Proportion of normal deliveries is decreasing worldwide. This study analysed operative vaginal deliveries (OVD) and Caesarean sections (CS) with some background factors in Estonia and Finland from 1992 to 2016. Data on all deliveries from 1992 to 2016 were obtained from the Finnish Medical Birth Registry (1 481 160 births) and the Estonian Medical Birth Registry (356 063 births). Time trends were analysed by joinpoint regression, and factors associated with OVD and CS by logistic regression. Odds ratios with 95% CIs were calculated, adjusted for year, maternal age, foetal birthweight, and use of epidural/spinal anaesthesia. One out of four deliveries were operative in Estonia and in Finland by 2016. By 2016, the Estonian CS rate had tripled to 20.9% and the OVD rate had increased by nine times to 5.6%. In Finland, the CS rate increased slightly to 16.4% while the OVD rate nearly doubled to 9.4%. In Estonia, the incidence of OVD was 24% lower (aOR 0.76, 95% Cl 0.74-0.78) and the incidence of CS 9% higher (aOR 1.09, 95% Cl 1.07-1.10) than in Finland. Use of epidural/spinal anaesthesia and foetal birthweight increased the risk of OVD in both countries, maternal age increased the risk of CS in both countries. Even if the CS and OVD rates are different, operative delivery rates may be similar in different countries. Combined analysis of operative deliveries together with background factors gives a better understanding of the trends in birthcare than monitoring CS rates alone.

Analysis of Birth Statistics, Examination of Caesarean Rates and Caesarean Indications; Retrospective Study

Purpose This study investigated cesarean delivery rates and indications for cesarean delivery among patients who gave birth in our clinic between 2019 and 2022. Materials and Methods For the study, the data of 16,559 patients who gave birth between 2019 and 2022 in the Obstetrics and Gynecology clinic of a Training and Research Hospital were retrospectively analyzed. The mode of delivery, gender information, fetal birth weight, vaginal delivery, and cesarean section rates and indications for cesarean section were analyzed. Results Among the patients who gave birth in our clinic between January 01, 2019, and December 31, 2022, 58.1% delivered vaginally, and 41.9% delivered by cesarean section. According to the four-year average, 48.5% of the babies born were girls, and 51.5% were boys. The most common indication for cesarean section was previous uterine surgery. The rate of primary cesarean section among cesarean deliveries was 47%. The most common indications for primary cesarean section were fetal distress, breech presentation, and non-progressive labor. Conclusion In our clinic, the four-year average cesarean delivery rate was 41.9%. Although this rate is below the national average of 53%, it is above the Ministry of Health's target rate of 35% in Turkey. When evaluated specifically for our province, we think this is mainly due to the lack of obstetrician-gynecologists in the districts and the high number of referrals to our hospital. Nevertheless, considering these results, it is clear that more comprehensive studies are needed to reduce cesarean section rates.

Correlation of sonographically measured fetal abdominal wall thickness with birth weight in diabetes

ObjectiveTo determine the association between sonographically measured abdominal wall thickness (AWT) and birth weight of fetuses of pregnant women with diabetes. MethodsThis retrospective study included 185 pregnant women who presented to a level I perinatal centre between January 2021 and December 2022. All mothers had diabetes, and were divided into the following subgroups: diet-controlled gestational diabetes mellitus; insulin-dependent gestational diabetes mellitus; type 1 diabetes mellitus; and type 2 diabetes mellitus. At the time of admission, gestational age varied between 29 + 2 and 41 + 2 weeks (+days) of gestation. Weight estimation was performed routinely using the Hadlock I formula. Fetal AWT was determined retrospectively at the same axial level as used for the measurement of abdominal circumference. Only women with a sonographic fetal weight estimation within 5 days before delivery were included. ResultsFor the whole cohort, a moderate positive correlation was found between fetal AWT and estimated fetal weight (r = 0.411, p < 0.001), a moderate correlation was found between fetal AWT and birth weight (r = 0.493, p < 0.001), a weak correlation was found between fetal AWT and body length (r = 0.365, p < 0.001), and a weak correlation was found between fetal AWT and body length percentile (r = 0.276, p < 0.001). No strong differences in parameters were found between the diabetes subgroups. Receiver operating characteristic (ROC) curve analysis was performed to identify newborns with birth weight > 4000 g (macrosomia) and birth weight > 90th percentile according to Voigt in the group with gestational age > 37 weeks. ROC curve analysis was performed to identify newborns with birth weight > 90th percentile in the whole cohort. AWT and sonographically estimated fetal weight were included in the calculation. The combination of AWT and estimated fetal weight only led to a marginal improvement compared with estimated fetal weight alone for predicting newborns with birth weight > 4000 g in the group with gestational age > 37 weeks [area under the curve (AUC) 0.857 vs 0.871], and for predicting newborns with birth weight > 90th percentile in the group with gestational age > 37 weeks (AUC 0.840 vs 0.846) and in the whole cohort (AUC 0.816 vs 0.826). ConclusionA sonographically measured AWT of 7.1 mm in fetuses of diabetic mothers is predictive of birth weight > 90th percentile with sensitivity of 61 %, specificity of 85 %, and AUC of 0.748. ROC curve analysis showed that estimated fetal weight determined by ultrasound (using Hadlock formula I) seems to be slightly superior for the identification of macrosomic fetuses with birth weight > 90th percentile. A threshold value for estimated fetal weight of 3774 g had sensitivity of 70 %, specificity of 86 %, and AUC of 0.816. The combination of AWT and estimated fetal weight in a single formula only yielded a marginal improvement in accuracy compared with the use of estimated fetal weight alone.

Hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus.

Maternal hypoglycemia, a condition characterized by lower than normal blood glucose levels in pregnant women, has been increasingly associated with adverse pregnancy outcomes, including low birth weight (LBW) in neonates. LBW, defined as a birth weight of less than 2500 g, can result from various factors, including maternal nutrition, health status, and metabolic conditions like hypoglycemia. Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus, leading to restricted fetal development and growth. This condition poses significant risks not only during pregnancy but also for the long-term health of the child, increasing the likelihood of developmental delays, health issues, and chronic conditions later in life. Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development, with studies suggesting that alterations in placental blood flow and nutrient transport, as well as direct effects on fetal insulin levels and metabolism, may play a role. Given the potential impact of maternal hypoglycemia on neonatal health outcomes, early detection and management are crucial to minimize risks for LBW and its associated complications. Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth, as well as to develop targeted interventions to support the health of both mother and child. Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.

Evaluation of Maternal Ischemia-Modified Albumin Levels during Pregnancy and Their Effect on Fetal Birth Weight.

Background and Objectives: The purpose of this study is to evaluate the impact of maternal ischemia-modified albumin (IMA) levels on pregnancy-related complications, fetal growth, and development over time. Materials and Methods: The prospective longitudinal and single-center study included 43 pregnant women ages 18 to 43. Routine pregnancy follow-up began at the first antenatal examination for all pregnant women before 14 weeks gestation, with IMA levels measured during the first, second, and third trimesters. The albumin cobalt binding test was used to determine the amount of ischemia-modified albumin (IMA). The patients' medical, sociodemographic, and nutritional data were analyzed. The primary outcome was to investigate how changes in maternal ischemia affected albumin levels during pregnancy and the relationship between these changes and newborn weight. Results: This study included 43 cases with a mean age of 28.5 ± 5.2 years and a mean gestation period of 39.2 ± 1.3 weeks. The mean IMA levels for cases in the first trimester, second trimester, and third trimester were 0.53 ± 0.06, 0.64 ± 0.11, and 0.64 ± 0.06, respectively. The second and third trimesters showed significantly higher levels of ischemia-modified albumin (IMA) than the first trimester (p < 0.01). There was no statistically significant difference in IMA levels between the second and third trimesters (p = 1.000; p > 0.05). There was no statistically significant correlation between fetal birth and percentage changes in IMA measurements between the first and second trimesters, the first and third trimesters, or the second and third trimesters (p > 0.05). Conclusions: Our study determined that maternal ischemia-modified albumin levels during pregnancy did not correlate with fetal birth weight. Our findings revealed that age, sociodemographic changes, BMI, weight gain, and pregnancy complications had no effect on the change in IMA levels during pregnancy. We believe that this result will serve as a benchmark for future studies on IMA levels during pregnancy.

Increased prevalence of negative pregnancy and fetal outcomes in women with primary adrenal insufficiency. A systematic review and meta-analysis.

Maternal primary adrenal insufficiency (PAI) during pregnancy, due to either Addison disease (AD) or congenital adrenal hyperplasia (CAH), is rare. Only few studies have examined the subsequent important outcomes of maternal glucocorticoid and mineralocorticoid deficiencies during pregnancy upon the fetus and the neonate. Therefore, this systematic review and meta-analysis evaluated the impact of these deficiencies, with data from PubMed/Medline, Cochrane/CENTRAL, and Google Scholar. A total of 31 studies were included for qualitative analysis and 11 for quantitative analysis. Studies examining the prevalence of spontaneous abortion, preterm birth, the occurrence of small for gestational age (SGA) neonates, as well as the neonatal birth weight were included. The systematic review revealed a substantial number of spontaneous abortions, preterm births and SGA neonates in pregnant women with PAI. The meta-analysis showed a mean spontaneous abortion prevalence of 18%, 18% and 17% in women with PAI, AD or CAH, respectively. The mean preterm birth prevalence was 11% when women with AD or CAH were analyzed together, and 13% and 9% in women with AD or CAH, respectively, when these women were analyzed separately. The mean prevalence of SGA neonates was 8% when women with AD or CAH were analyzed together, and 5% and 10% in women with AD or CAH, respectively, when these women were analyzed separately. The mean fetal birth weight was within normalcy in all women with PAI, as well as in women with AD or CAH. In conclusion the executed systematic review of 31 studies followed by a meta-analysis of 11 studies in pregnant women with PAI has shown a greater prevalence of pregnancies with negative outcome (spontaneous abortion, preterm birth) and of negative fetal outcome (SGA) in women with either AD or CAH, as compared to control pregnant women.

First-Trimester Cell-Free DNA Fetal Fraction and Birth Weight in Twin Pregnancies.

The relationship between fetal fraction and birth weight in twin gestations is poorly understood. To investigate the relationship between first trimester cfDNA fetal fraction and birth weight < 10th percentile in twin gestations. This is a planned secondary analysis of the Twin cfDNA Study, a 17-center retrospective cohort of twin pregnancies screened for aneuploidy using cfDNA in the first trimester from 12/2011 - 2/2022, excluding those with positive screen results for chromosomal aneuploidy. CfDNA testing was performed by a single lab using massively parallel sequencing (MPSS). Baseline characteristics and birth weight of pregnancies with normal fetal fraction were compared to those with low (<5%) and high (>95%) fetal fraction using univariable analyses and multivariable regression. A total of 1041 twin pregnancies were included. Chronic hypertension, elevated BMI, and self-identified Black race were associated with fetal fraction <5th percentile. There was no difference in median fetal fraction between those with birth weight <10th percentile in at least one twin (median [IQR] fetal fraction 12.2% [9.8, 14.8] versus those with normal birth weight (10th percentile) in both twins (median [IQR] fetal fraction 12.3% [9.7, 15.2] for normal birth weight, p = 0.49). There was no association between high or low fetal fraction and birth weight <10th percentile for one (p=0.45) or both (p=0.81) twins, and there was no association between high or low fetal fraction and birth weight <5th percentile for one (p=0.44) or both (p=0.74) twins. The results were unchanged after adjustment for potential confounders. In this large cohort, there was no association between the extremes of cfDNA fetal fraction and birthweight < 10th percentile, suggesting that first trimester fetal fraction may not predict impaired fetal growth in twin gestations.

A novel software for method comparison: MCS (method comparison software)—assessing agreement between estimated fetal weights calculated by Hadlock I–V formulas and birth weight

IntroductionThe evaluation of the performance of new methods, expected to provide cheaper and faster results than existing (reference) methods in the health field, is based on comparing the results obtained with this new method to those obtained with the existing method. The primary aim of this study is to examine the correlational and absolute agreement between measurement methods in clinical studies using Bland–Altman analysis and methodological (Ordinary Least Squares, Weighted Ordinary Least Squares, Deming, Weighted Deming, Passing–Bablok, Theil-Sen, and Passing–Bablok for Large Data Sets.) methods, and the secondary aim is to compare the accuracy and precision of Hadlock (I–V) formulas used for fetal weight estimation.Materials and methodsThe study was conducted on singleton pregnancies examined in the Prenatal Diagnosis and Treatment Unit of the Department of Obstetrics and Gynecology at Inonu University Faculty of Medicine and who gave birth in the Obstetrics Unit between 01.01.2020 and 01.09.2023, whose gestational ages were confirmed by first-trimester ultrasonography. Estimated fetal weights were calculated using Hadlock (I–V) formulas, and the agreement of these weights with birth weight was evaluated with Bland–Altman method.ResultsThe comparison of estimated fetal weights calculated using Hadlock formulas with birth weight was analyzed using Bland–Altman analysis, ICC, and CCC values along with regression analyses. According to the mean difference values obtained by Bland–Altman analysis, the estimated fetal birth weights obtained by the Hadlock IV formula were most consistent with the actual birth weights.ConclusionsThe estimated fetal weights obtained using the Hadlock IV formula resulted in the closest measurements to the birth weight. This study showcases the efficacy of a new web-based software, Method Comparison Software (MCS), which can be utilized for evaluating the agreement between different methods in clinical measurements.

Circular RNAs mediate the regulation of maternal placental nutrient transport and fetal development by sugar-sweetened beverages

Epidemiological and experimental studies have demonstrated a strong association between maternal diet and fetal birth weight, obesity, and metabolic syndrome. We investigated the pathways and modes of action of circular RNAs (circRNAs) that mediate the regulation of maternal reproductive performance and fetal development by sugar-sweetened beverages (20 % sucrose water, SSBs) using C57BL/6J mice as a model. Results showed that SSBs significantly increased the reproductive performance (P<0.05), body weight (P<0.01), fetal birth weight (P<0.05), placental weight (P<0.01), and the expression of nutrient transporter genes in the placenta and fetal liver (P<0.05), mainly by accelerating the maternal energy metabolism during pregnancy. However, maternal serum biochemical indices, antioxidant indices, and pathological damage to the liver and placenta predicted that the mother would be at greater health risks during this period. Moreover, transcriptomics results indicated that the differentially expressed (DE) circRNAs in the placenta regulate the maternal multiple metabolic pathways and the placental nutrient transport efficiency by sponging miRNAs and forming growth factors and proteins, ultimately improving the maternal reproductive performance. In addition, we verified the reliability of the sequencing results using reverse transcription polymerase chain reaction and identified the possibility of DE circRNAs binding to nutrient transporter genes using targeting relationship prediction. Finally, we constructed a correlation network that regulates maternal placental nutrient transport based on DE circRNAs, targeted miRNAs and nutrient transport-related genes. This study will provide scientific dietary guidance for pregnant women and new research ideas for preventing and treating pregnancy complications.

Analysis of episiotomy incidence and risk factors in vaginal deliveries: a single-center

IntroductionEpisiotomy is a surgical procedure involving the enlargement of the posterior vagina to facilitate the delivery of the baby. This study aims to further investigate the associated risk factors for episiotomy and the specific indications for its use in spontaneous labor. MethodologyThis institutional-based cross-sectional study was conducted among 349 vaginal births with a ratio of 1:4 from January 2020 to December 2020. We recruited study participants using consecutive sampling techniques. The sample size was calculated with a hypothesis test for two population proportions (one-sided test formula). Adjusted odds ratio with the corresponding 95% confidence interval was used to declare the significance of variables. ResultsIn our multivariate analysis, it was found that pregnant women who underwent instrumental delivery (P-value=.00; OR=25.63; 95% CI: 5.76–114.0) and those with fetal birth weight >3,000 grams (P-value=.00; OR=11.31; 95% CI: 3.96–32.32) had the highest risk of undergoing an episiotomy. Subsequently, the duration of the second stage of labor >30 minutes (P-value=.049; OR=16.34; 95% CI: 1.01–264.48) was associated with a slightly increased risk of episiotomy. Fetal head circumference >34 cm was not found to be risk of an increased risk of episiotomy in this study. However, pregnant women aged >30 years (P-value=.049; OR=0.306; 95% CI: 0.94–0.99) showed a reduced risk of episiotomy. ConclusionThe prevalence of episiotomy practice in this study exceeds the recommended threshold set by the World Health Organization (WHO). Instrumental delivery, high birth weight, and prolonged second-stage labor emerged as significant factors influencing episiotomy practice. Hence, further interventions are warranted to mitigate the prevalence of episiotomy practice.

Developmental and heritable genetic defects induced in mice by municipal landfill leachate

Environmental pollution by solid waste leachate is a serious environmental and public health concern. Leachate contamination and pollution of environmental matrices have been reported, but no report of embryotoxic and developmental defects, and heritable transfer of leachate-induced toxicity in mice. We investigated the ability of Aba-Eku landfill leachate to induce embryonic malformations, developmental toxicity, and germline and somatic DNA damage in the F1 of exposed pregnant mice. Pregnant mice (n = 100) were randomly distributed into 5 experimental groups of 20 animals/group and exposed to 0.2 mL of 5–75% concentrations of the leachate (v/v; Aba-Eku landfill leachate: distilled water) by daily gavage from gestational day (GD) zero to postnatal day (PND) 21. A similar treatment was given to pregnant female mice administered with distilled water (negative control). At GD 18, ten dams from the treatment and control groups were sacrificed by cervical dislocation after which the embryos were collected from the uterus for analyses of fetal morphometric and skeletal metamers respectively. We then monitored the developmental conditions of F1 mice from the remaining ten dams until they were weaned at PND 21 and sacrificed at PND 56 and PND 98 for bone marrow micronucleus and spermiogram analyses respectively. We also analyzed the leachate for inorganic and organic pollutants and calculated the Leachate Pollution Index (LPI). The leachate reduced maternal and fetal birth weight and increased fetal mortality and postnatal appearance of physiological markers in the F1 mice. There was a significant increase (p < 0.05) in the frequency of fetal skeletal malformations, micronucleated polychromatic erythrocytes, and apparent decline of epididymal sperm parameters. The concentrations of the inorganic and organic pollutants, and the LPI exceeded standard limits. Exposure of pregnant female mice to Aba-Eku landfill leachate caused embryonic defects and heritable DNA damage in subsequent generations.

Comprehensive Analysis of Placental DNA Methylation Changes and Fetal Birth Weight in Pigs.

Birth weight is a complex multifactorial trait relevant to health states and disease risks in later life. The placenta is essential for proper fetal growth and facilitates gas, nutrient, and waste exchange between the mother and developing fetus. How changes in placental DNA methylation affect fetal birth weight remains to be fully elucidated. In this study, we used whole-genome bisulfite sequencing and RNA sequencing to reveal a global map of DNA methylation and gene expression changes between the placentas of highest birth weight and lowest birth weight piglets in the same litters. The transcriptome analysis identified 1682 differential expressed genes and revealed key transcriptional properties in distinct placentas. We also identified key transcription factors that may drive the differences in DNA methylome patterns between placentas. The decrease in DNA methylation level in the promoter was associated with the transcriptional activation of genes associated with angiogenesis, extracellular matrix remodeling, and transmembrane transport. Our results revealed the regulatory role of DNA methylation in gene transcription activity leading to the differences in placental morphological structures and birth weights of piglets. These results could provide novel clues to clarify the underlying regulatory mechanisms of placental development and fetal growth.

General Movements Assessment in Infants with High Birth Weight

BackgroundHigh birth weight (HBW) describes fetal birth weight of more than 4000 g. Infants with HBW have a high risk of developing neurological and developmental problems. Until recently, there were no studies in the literature that investigated the quality of spontaneous movements and the integrity of the developing nervous system in infants with HBW. The aims of this study were (1) to describe age-specific detailed early spontaneous movements in infants with HBW and (2) to compare the detailed early spontaneous movements of infants with HBW and normal birth weight (NBW). MethodsTwenty-two infants with HBW (median birth weight = 4190 g) and 22 infants with NBW (median birth weight = 3255 g) were included at 10 to 19 weeks post-term age (median = 13 weeks). All infants were assessed according to General Movement Assessment using three- to five-minute video recordings. Video recordings of each infant were evaluated using Motor Optimality Score for three- to five-month-old infants-Revised score sheet. ResultsMotor Optimality Score-Revised (MOS-R) (P < 0.001), observed postural patterns (P < 0.001), and age-adequate movement repertoire (P = 0.005) were significantly lower in the infants with HBW. Infants with HBW had more aberrant (abnormal or absent) fidgety movements (18%) than those with NBW (0%). ConclusionsThe results of this study demonstrated that the motor repertoire of infants with HBW tended to decrease more than that of those with NBW. To enable the follow-up of progression as a result of these assessments infants in need should be referred to age-adequate early intervention programs.

Risk factors for postpartum stress urinary incontinence: An updated systematic review and meta-analysis

&lt;b&gt;Background:&lt;/b&gt; The objective of this meta-analysis was to identify and quantify postpartum stress urinary incontinence (SUI) risk factors.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; We systemically searched three electronic databases (PubMed, Scopus, and Web of Science). The evaluated variables as risk factors were pooled as odds ratio (OR) with the corresponding 95% confidence intervals (CI).&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; 63 studies were included. The analysis found a significant positive association between SUI and vaginal delivery (OR=2.15), age (OR=1.44), BMI (OR=1.19), parity (OR=1.43), and fetal-birth weight (OR=1.08).&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; Age, parity, delivery with forceps, birth weight, maternal body mass index, induction of labor, length of the second stage of labor, history of prenatal SUI, and vaginal delivery were all risk factors for postpartum SUI.&lt;br /&gt; &lt;b&gt;Scientific novelty:&lt;/b&gt; This systematic review and meta-analysis provides the most comprehensive and updated evidence to date.&lt;br /&gt; &lt;b&gt;Practical significance of the results:&lt;/b&gt; Healthcare personnel should be taught to recognize and treat postpartum SUI risk factors.

Vitrification preservation of good-quality blastocysts for more than 5years reduces implantation and live birth rates.

Does vitrification cryopreservation of embryos for more than 5 years affect the pregnancy outcomes after frozen embryo transfer (FET)? Vitrification cryopreservation of good-quality blastocysts for more than 5 years is associated with a decrease in the implantation rate (IR) and live birth rate (LBR). Previous studies have predominantly focused on embryos cryopreserved for relatively short durations (less than 5 years), yet the impact of extended cryopreservation duration on pregnancy outcomes remains a controversial issue. There is a relative scarcity of data regarding the efficacy and safety of storing embryos for 5 years or longer. This retrospective study involved 36665 eligible vitrified-thawed embryo transfer cycles from 1 January 2016 to 31 December 2022, at a single fertility center in China. Patients were divided into three groups according to embryo storage time: Group 1 consisted of 31565 cycles, with storage time of 0-2 years; Group 2 consisted of 4458 cycles, with a storage time of 2-5 years; and Group 3 included 642 cycles, with storage time exceeding 5 years. The main outcome measures were IR and LBR. Secondary outcome variables included rates of biochemical pregnancy, multiple pregnancy, ectopic pregnancy, and miscarriage, as well as neonatal outcomes. Reproductive outcomes were analyzed as binary variables. Multivariate logistic regression analysis was used to explore the effect of preservation time on pregnancy outcomes after correcting for confounding factors. In addition, we also assessed neonatal outcomes, such as large for gestational age (LGA) and small for gestational age (SGA). IRs in the three groups (0-2, 2-5, and >5 years) were 37.37%, 39.03%, and 35.78%, respectively (P = 0.017), and LBRs in the three groups were 37.29%, 39.09%, and 34.91%, respectively (P = 0.028). After adjustment for potential confounding factors, compared with the 0-2 years storage group, prolonged embryo vitrification preservation time (2-5 years or >5 years) did not affect secondary outcomes such as rates of biochemical pregnancy, multiple pregnancy, ectopic pregnancy, and miscarriage (P > 0.05). But cryopreservation of embryos for more than 5 years reduced the IR (adjusted odds ratio (aOR) 0.82, 95% CI 0.69-0.97, P = 0.020) and LBR (aOR 0.76, 95% CI 0.64-0.91, P = 0.002). Multivariate stratified analysis also showed that prolonging the cryopreservation time of blastocysts (>5 years) reduced the IR (aOR 0.78, 95% CI 0.62-0.98, P = 0.033) and LBR (aOR 0.68, 95% CI 0.53-0.87, P = 0.002). However, no effect on cleavage embryos was observed (P > 0.05). We further conducted stratified analyses based on the number and quality of frozen blastocysts transferred, and the results showed that the FET results after transfers of good-quality blastocysts in the >5 years storage group were negatively affected. However, the storage time of non-good-quality blastocysts was not significantly associated with pregnancy outcomes. Regarding the neonatal outcomes (of singletons), embryo vitrification preservation time had no effect on preterm birth rates, fetal birth weight, or neonatal sex ratios. However, as the storage time increased, rates of SGA (5.60%, 4.10%, and 1.18%) decreased, while rates of LGA (5.22%, 6.75%, and 9.47%) increased (P < 0.05). After adjusting for confounding factors, the increase in LGA and the decrease in SGA were significantly correlated with the duration of storage time. This was a retrospective study using data from a single fertility center, even though the data had been adjusted, our findings still need to be validated in further studies. With the full implementation of the two-child policy in China, there may be more patients whose embryos have been frozen for a longer time in the future. Patients should be aware that the IR and LBR of blastocysts are negatively affected when the cryopreservation time is longer than 5 years. Couples may therefore consider shortening the time until FET treatment. This study was supported by the National Nature Science Foundation of China (No. 82101672), Science and Technology Projects in Guangzhou (No. 2024A03J0180), General Guidance Program for Western Medicine of Guangzhou Municipal Health Commission (No. 20231A011096), and the Medical Key Discipline of Guangzhou (2021-2023). None of the authors have any conflicts of interest to declare. N/A.

O-191 Delayed fetal growth in pregnant women with polycystic ovary syndrome using serial ultrasonographic biometry

Abstract Study question To investigate the effect of maternal polycystic ovary syndrome (PCOS) on intrauterine growth and perinatal outcome of offspring. Summary answer Maternal PCOS might have an adverse impact on fetal growth, represented by serial biometric measurements, and consequently lower the birth weight. What is known already Women with PCOS often have low fertility and high risk of certain pregnancy complications, including miscarriage, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP) and preterm birth (PTB). In addition, the offspring of PCOS mothers are susceptible to short- and long-term health consequences, such as metabolic diseases and neuropsychiatric disorders. And the suboptimal intrauterine environment caused by maternal PCOS condition might be the origin of impaired long-term health of the offspring. Study design, size, duration A total of 1153 pregnant women with pregestational diagnosis of PCOS and 1383 non-PCOS controls were included in the retrospective case-control study for clinical record and ultrasonographic database at women’s hospital, school of medicine, Zhejiang university over a 6-year period. Participants/materials, setting, methods Maternal demographic data, fetal biometric measurements with ultrasound, obstetrical and neonatal outcomes were analyzed. A meta-analysis of birth weight in PCOS offspring in the literature was performed to assess the relationship between the maternal PCOS and neonatal growth. Main results and the role of chance After adjustment for potential confounding variables, we found that biparietal diameter (BPD) and femur length (FL) were notably smaller in fetuses of women with PCOS than controls across the entire gestation. This effect still existed after excluding three major pregnancy complications of PCOS, including GDM, HDP and PTB. Although other fetal biometry including estimated fetal weight and birth weight in PCOS offspring were comparable with controls in our study, the meta-analysis of 22 studies showed that the birth weight in offspring of women with PCOS was lower than controls (WMD -37.813, 95%CL [-69.713, -5.913]), especially for offspring in South America (WMD -84.69, 95%CL [-166.69, -2.68]). Limitations, reasons for caution First, data of other fetal parameters like abdominal and head circumference was scanty. Second, neonatal anthropometric parameters apart from the birth weight were not included. Lastly, we did not have the long-term follow-up results of the offspring to explore the potential effect of delayed fetal biometry in their later life. Wider implications of the findings More attention needs to be paid to the smaller-than-average fetuses in PCOS mothers, and proper management may be needed during and after pregnancy. Further studies are needed to confirm the intrauterine growth pattern of the PCOS offspring and its clinical significance in the neonatal period and beyond. Trial registration number N/A