Fetal Age Research Articles

Abstract MP30: The Role of CD20+ B cells in Mediating Hypertension in Preeclampsia during Pregnancy

Pre-eclampsia (PE), new-onset hypertension after the 20 th week of pregnancy alongside other organ dysfunction, endothelial dysfunction, and immune activation. We have previously shown that CD19+ B cell adoptive transfer causes a PE phenotype in athymic nude rats. CD19 is present on all B cells including plasma cells. CD20 is absent from plasma cells but is present on mature B2 and memory B cells. The objective of this study was to determine if CD20+ B cells, excluding plasma cells, cause maternal hypertension, fetal growth restriction, and endothelial dysfunction. Three hundred thousand placental CD20+ B Cells from normal pregnant (NP) or PE patients were isolated by magnetic separation and injected i.p. into nude athymic rats on gestational day (GD) 12. On GD18, carotid catheters were inserted. On GD19, mean arterial pressure (MAP) was measured and blood and tissues were collected. Preproendothelin (PPET) expression was quantified in kidney and placental tissues using RT-PCR. A student’s t-test was used for statistical analysis. Participants whose placental B cells were used in this study had similar age, pre-pregnancy BMI, and diastolic BP on admission. PE participants had elevated systolic BP at admission (135±4 vs 120±4 mmHg) and delivery (139±6 vs 124±3 mmHg) as well as diastolic BP at delivery (79±4 vs 68±2 mmHg). PE participants also had trending decreases in fetal weight (2621±323 vs 3202±102 g) and gestational age (36±1 vs 39±0 weeks) at delivery. MAP increased from 107±4 mmHg (n=8) in the NP recipient rats to 123±2 mmHg (n=8, p<0.01) in the PE recipient rats. Pup and placental weights were unchanged following adoptive transfer. Renal PPET expression increased by 2.595±0.61 fold (ΔΔct) in PE recipient rats (n=7, p<0.05) compared to NP recipient rats (n=7). Placental PPET expression was unchanged following adoptive transfer. CD20+ B cells from women with PE contribute to hypertension and endothelial dysfunction during pregnancy. This data supports the important role of B cells in the development of PE and improves our understanding of the population of B cells responsible for contribution to the disease.

A postmortem high-resolution MRI study of the development of cochlear nerve-related structures in the second and third trimesters of pregnancy.

Magnetic resonance imaging (MRI) is used to determine whether cochlear nerve development is normal in infants and adults, but it has not yet been used to evaluate cochlear nerve development or measure cochlear nerve-related structures in the fetus. This study sought to provide imaging data for clinical evaluations concerning cochlear nerve development in the fetus using MRI. Postmortem 3.0-Tesla MRI of inner ear was performed in 51 fetuses with normal temporal bones at 25 to 40 weeks of gestation. The continuous scanning protocol incorporated axial three-dimensional (3D) sampling perfection with application-specific contrasts using different flip angle evolution sequences. The images were evaluated to measure the structures of the cochlear aperture (CA), internal auditory canal (IAC), and vestibulocochlear and facial nerves in the cerebellopontine angle (CPA), which have been reported to be associated with cochlear nerve development. We also calculated the ratio between the diameters of the vestibulocochlear and facial nerves. The measurable parameters were compared between the right and left sides. The threshold for statistical significance was set at P<0.05. The inner ear anatomy was discernible on MRI in all the fetal specimens, and growth of the CA, IAC, vestibulocochlear nerve, and facial nerve in the CPA was observed as fetal age increased. There was no significant difference in the measurements of these structures between the right and left sides (all P>0.05). MRI can be used to help evaluate the anatomy and development of the cochlear nerve in the fetus. These normative measurements could be valuable for clinical evaluations of the cochlear nerve.

Does decreased fetal growth estimation in the appropriate for gestational age range affect delivery outcomes?

To study the effect of decreased estimated fetal weight (EFW) percentiles in appropriate for gestational age fetuses. This retrospective cohort study included women who had second and third trimester ultrasound examinations. Delivery and neonatal outcomes of pregnancies with decreased EFW of ≥ 30 percentiles in EFW between ultrasound examinations (decreased growth group) and those without such a decrease (control group) were compared. Deliveries with EFW or birthweight below the 10th percentile were excluded. Among 1610 deliveries, 57 were in the decreased growth group and 1553 in the control group. Maternal characteristics did not differ between the groups except for higher rate of nulliparity in the decreased growth group. We found similar rates of Category II/III monitoring, cesarean deliveries due to non-reassuring fetal heart rate and adverse neonatal outcomes. Neonatal birthweight was lower in the decreased growth group as compared to controls. This study did not find association between the group of appropriate for gestational age fetuses with decreased growth, with adverse outcomes.

Correlation between morphometry of fetal foot and gestational age: a cadaver study

Objectives: This study was conducted on a collection of fetal cadavers to describe the relationship between gestational age and foot parameters specifically in the Turkish population. Methods: The study involved 83 fetal cadavers (45 males, 38 females) ranging from 13 to 40 weeks of gestation, without external anomalies or pathologies. Various foot parameters were measured, including foot width (FW), heel width (HW), foot length (FL), heel-metatarsophalangeal fold (HMF), bimalleolar width (BW), foot dorsum length (FDL), ankle-metatarsophalangeal fold (AMF), malleolus medialis height (MMH), malleolus lateralis height (MLH), and finger length (FiL). These parameters were measured using a digital caliper with a precision of 0.01 mm. The fetuses were grouped by gestational month, and morphometric measurements were taken. Results: A strong and positive correlation was found between all foot parameters and gestational age (months). All parameters increased consistently throughout the fetal period. No significant differences were observed based on gender or side comparisons for any of the parameters. Linear regression equations were developed to estimate gestational age using fetal foot parameters. These parameters explained 72% to 90% of the variation in gestational age. Conclusion: Fetal foot length and related foot parameters can reliably be used to estimate gestational age. Due to the simplicity of these measurements, fetal foot parameters can be utilized to estimate age for babies born outside a hospital setting without the need for specialist equipment. Additionally, for premature babies receiving treatment in neonatal units, foot measurements offer a practical and easily accessible method for age estimation.

Leukocyte-associated immunoglobulin-like receptor 1 (LAIR1) is reduced with preeclampsia and small for gestational aged fetuses

Leukocyte-associated immunoglobulin-like receptor 1 (LAIR1) is an inhibitory receptor expressed on immune cells. We evaluated LAIR1 in placentas from preeclamptic or small for gestational age (SGA) pregnancies, and placental explant model (1 % O2, IL6 and TNFα, or control). LAIR1 mRNA was reduced in placentas from preeclamptic (p < 0.0001, n = 78) and SGA (p < 0.0001, n = 32) pregnancies. LAIR1 protein expression was reduced in placentas from preeclampsia (p < 0.0001, n = 43) and SGA (p = 0.009, n = 10) pregnancies. Hypoxia (1 % O2) reduced LAIR1 mRNA expression in placental explants (p = 0.008). These findings suggest hypoxia modulates LAIR1 expression in the placenta.

Pre-delivery BMI and the Accuracy of Fetal Weight Estimation in Very Preterm Infants

ObjectivesTo examine the relation between maternal pre-delivery BMI and the accuracy of sonographic estimated fetal weight (EFW) in very preterm infants (<32 weeks gestation). MethodsThis retrospective study included singleton infants born between January 2010 and March 2023, at gestational ages 230 to 316 weeks, at a tertiary university-affiliated hospital. Absolute weight, percentage error, absolute percentage error, and overestimation and underestimation of EFW were compared between women with pre-delivery normal weight (BMI 18.5–24.99 kg/m2), overweight (BMI 25.0–29.99 kg/m2), and obesity (BMI >35.0 kg/m2). Multivariate linear regression analyses adjusted for potential confounders were performed to assess relations of maternal pre-conception and of pre-delivery BMI, with EFW accuracy. ResultsIncluded were 286 pregnancies. The absolute difference, percentage error, absolute percentage error, error within the 10% range, and underestimation or overestimation of EFW were similar between the groups. The multivariate linear regression analyses did not show significant associations of pre-conceptional BMI or of pre-delivery BMI with the percentage error. However, for small for gestational age compared to appropriate for gestational age fetuses, the percentage error was greater (8.9% vs. –0.6%, β = 0.35, P < 0.001) and the absolute percentage error was greater (11.0% vs. 6.7%, P < 0.001). Small for gestational age fetuses were at risk of fetal weight overestimation (percentage error exceeding 15%); OR 7.20 (95% CI 2.91–17.80). ConclusionsMaternal pre-delivery BMI was not found to be related to EFW accuracy in very preterm infants. Nevertheless, EFW should be interpreted carefully, as it may underdiagnose poor fetal growth in this population.

ANALYSIS OF OSSIFICATION CENTRES OF THE RADIAL DIAPHYSIS IN FETUSES OF 20-32 WEEKS OF GESTATION

The aim of the study – to investigate the characteristics of ossification of the right andleft radial diaphysis in fetuses of 20-32 weeks’ gestation.Materials and methods. Computed tomography scans of 52 human fetuses at 20-32 weeksof gestation were analyzed to study the characteristics of ossification of the radial bones inhuman fetuses. The results of the study were statistically analyzed in Excel. Student’s t-testfor independent variables and univariate analysis of variance were used to compare means.Results. In human fetuses of 20-32 weeks of gestation, the mean length of ossificationof the right radius increases from 19.63±0.19 mm to 40.87±0.09 mm, and the left radiusincreases from 20.43±0.18 mm to 41.62±0.28 mm, according to the quadratic equation: y= 1.7152 x age – 13.152 (R2 = 0.9825). When analyzing the proximal transverse diameterof the diaphysis of the radius, its increase occurs according to the following quadraticequation: y = 0.2354 x age-1.6858 (R² = 0.9797). In the analysis, the transverse diameterof the middle part of the radius diaphysis increases according to the following quadraticequation: y = 0.1388 x age – 1.0613 (R² = 0.9832). When analyzed, the transversediameter of the distal part of the radial diaphysis increases according to the followingquadratic equation: y = 0.1491 x age – 1.1459 (R² = 0.9847).Conclusion. The obtained morphometric data on ossification of the radial diaphysis can beconsidered normal for the studied 20-32 weeks of gestation and can be used for assessmentof fetal age and for ultrasound diagnosis of congenital pathologies of the upper extremity.

A new insight for investigating the prenatal and postnatal ossification centers of pelvic and femur bones in white New Zealand rabbits (Oryctolagus cuniculus) using 3D CT, double stain technique, and morphometry

BackgroundThe ossification centers in rabbit limbs are related to fetal age and bone maturation. Objective: To address the limited studies on ossification in the hind limbs of New Zealand rabbits, we investigated the prenatal and postnatal development of the pelvic and femur bones. MethodsDouble staining with Alcian Blue and Alizarin Red, computed tomography (CT), and 3D reconstruction were employed to visualize and analyze ossification centers in detail. ResultsUsing double staining, we observed these patterns: At prenatal days 18 and 21, ossification centers appeared in the ilium. By prenatal days 23 and 25, ossification began in the ischium. On postnatal day 1, ilium ossification centers spread across most of the ilium wings, except for the iliac crest, and new centers appeared in the pubis and cotyloid bones. Most bones had ossified by the third week and one month postnatal, except for the iliac crest and ischial tuberosity. At 1.5 months, both were fully ossified. On day 18 post coitum, an ossification center was visible in the middle of the femur shaft. By day 28 post coitum, ossification extended through the shaft, and postnatally, new ossification spots appeared at the extremities by day one and week one. By the third week, complete ossification of the femur head, lesser trochanter, third trochanter, medial condyle, and lateral condyle was observed. At 1.5 months, the entire proximal extremity was ossified. Conclusion3D CT provided clear imaging of ossification progression in the pelvic and femur bones. This study enhances our understanding of vertebrate skeletal development.

The Effects of Maternal Nutrient Restriction during Mid to Late Gestation with Realimentation on Fetal Metabolic Profiles in the Liver, Skeletal Muscle, and Blood in Sheep.

Poor maternal nutrition during gestation negatively affects offspring growth and metabolism. To evaluate the impact of maternal nutrient restriction and realimentation on metabolism in the fetal liver, skeletal muscle, and circulation, on day 50 of gestation, ewes (n = 48) pregnant with singletons were fed 100% (CON) or 60% (RES) of requirements until day 90 of gestation, when a subset of ewes (n = 7/treatment) were euthanized, and fetal samples were collected. The remaining ewes were maintained on a current diet (CON-CON, n = 6; RES-RES, n = 7) or switched to an alternative diet (CON-RES, RES-CON; n = 7/treatment). On day 130 of gestation, the remaining ewes were euthanized, and fetal samples were collected. Fetal liver, longissimus dorsi (LD), and blood metabolites were analyzed using LC-MS/MS, and pathway enrichment analysis was conducted using MetaboAnalyst. Then, 600, 518, and 524 metabolites were identified in the liver, LD, and blood, respectively, including 345 metabolites that were present in all three. Nutrient restriction was associated with changes in amino acid, carbohydrate, lipid, and transulfuration/methionine metabolic pathways, some of which were alleviated by realimentation. Fetal age also affected metabolite abundance. The differential abundance of metabolites involved in amino acid, methionine, betaine, and bile acid metabolism could impact fetal epigenetic regulation, protein synthesis, lipid metabolism, and signaling associated with glucose and lipid metabolism.

Development of the basic architecture of neocortical circuitry in the human fetus as revealed by the coupling spatiotemporal pattern of synaptogenesis along with microstructure and macroscale in vivo MR imaging.

In humans, a quantifiable number of cortical synapses appears early in fetal life. In this paper, we present a bridge across different scales of resolution and the distribution of synapses across the transient cytoarchitectonic compartments: marginal zone (MZ), cortical plate (CP), subplate (SP), and in vivo MR images. The tissue of somatosensory cortex (7-26 postconceptional weeks (PCW)) was prepared for electron microscopy, and classified synapses with a determined subpial depth were used for creating histograms matched to the histological sections immunoreacted for synaptic markers and aligned to in vivo MR images (1.5T) of corresponding fetal ages (maternal indication). Two time periods and laminar patterns of synaptogenesis were identified: an early and midfetal two-compartmental distribution (MZ and SP) and a late fetal three-compartmental distribution (CP synaptogenesis). During both periods, a voluminous, synapse-rich SP was visualized on the in vivo MR. Another novel finding concerns the phase of secondary expansion of the SP (13 PCW), where a quantifiable number of synapses appears in the upper SP. This lamina shows a T2 intermediate signal intensity below the low signal CP. In conclusion, the early fetal appearance of synapses shows early differentiation of putative genetic mechanisms underlying the synthesis, transport and assembly of synaptic proteins. "Pioneering" synapses are likely to play a morphogenetic role in constructing of fundamental circuitry architecture due to interaction between neurons. They underlie spontaneous, evoked, and resting state activity prior to ex utero experience. Synapses can also mediate genetic and environmental triggers, adversely altering the development of cortical circuitry and leading to neurodevelopmental disorders.

Correlation of global cardiac sphericity index and neonatal outcomes of appropriate for gestational age foetuses, small for gestational age foetuses and growth restricted foetuses delivered at term in Dr. Jose Fabella memorial hospital: a prospective cohort study

Correlation of global cardiac sphericity index and neonatal outcomes of appropriate for gestational age foetuses, small for gestational age foetuses and growth restricted foetuses delivered at term in Dr. Jose Fabella memorial hospital: a prospective cohort study

Evaluation of Chondral Defect Repair Using Human Fibronectin Adhesion Assay-Derived Chondroprogenitors Suspended in Lyophilized Fetal Collagen Scaffold: An Ex Vivo Osteochondral Unit Model Study.

Chondral defect repair is challenging due to a scarcity of reparative cells and the need to fill a large surface area, compounded by the absence of self-healing mechanisms. Fibronectin adhesion assay-derived chondroprogenitors (FAA-CPs) have emerged as a promising alternative with enhanced chondrogenic ability and reduced hypertrophy. De-cellularized bio-scaffolds are reported to act as extracellular matrix, mimicking the structural and functional characteristics of native tissue, thereby facilitating cell attachment and differentiation. This study primarily assessed the synergistic effect of FAA-CPs suspended in fetal cartilage-derived collagen-containing scaffolds in repairing chondral defects. The de-cellularized and lyophilized fetal collagen was prepared from the tibio-femoral joint of a 36 + 4-week gestational age fetus. FAA-CPs were isolated from osteoarthritic cartilage samples (n = 3) and characterized. In ex vivo analysis, FAA-CPs at a density of 1 × 106 cells were suspended in the lyophilized scaffold and placed into the chondral defects created in the Osteochondral Units and harvested on the 35th day for histological examination. The lyophilized scaffold of de-cellularized fetal cartilage with FAA-CPs demonstrated effective healing of the critical size chondral defect. This was evidenced by a uniform distribution of cells, a well-organized collagen-fibrillar network, complete filling of the defect with alignment to the surface, and favorable integration with the adjacent cartilage. However, these effects were less pronounced in the plain scaffold control group and no demonstrable repair observed in the empty defect group. This study suggests the synergistic potential of FAA-CPs and collagen scaffold for chondral repair which needs to be further explored for clinical therapy. The online version contains supplementary material available at 10.1007/s43465-024-01192-6.

Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction during Pregnancy on Fetal Brain Development Detected by Neurosonography: A Secondary Analysis of a Randomized Clinical Trial (IMPACT BCN).

We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12 months old. This was a secondary analysis of a randomized clinical trial (2017-2020), including 1,221 singleton pregnancies at high risk for small-for-gestational age. Participants were randomized into three groups at 19-23 weeks' gestation: Mediterranean diet intervention, stress reduction program, or usual care. A detailed neurosonography was performed on 881 participants at mean (SD) 33.4 (1.1) weeks' gestation. Neurosonographic measurements were done offline. ASQ was performed on 276 infants at 1 year of corrected age. Biparietal diameter was similar among study groups. Mediterranean diet group fetuses had deeper insula (26.80 [1.68] versus 26.63 [1.75], mm, p = 0.02) and longer corpus callosum (42.98 [2.44] versus 42.62 [2.27], mm, p = 0.04), with a lower rate of suboptimal score infants in ASQ problem-solving domain (6.2 vs. 16.3%, p = 0.03). Stress reduction group fetuses had deeper insula (26.90 [1.75] versus 26.63 [1.75], mm, p = 0.04) and lower rates of suboptimal score infants in ASQ fine motor domain (4.3 vs. 12.8%, p = 0.04), compared to usual care group fetuses. Maternal structured intervention during pregnancy of the trial has the potential to modify offspring's neurodevelopment.

Correlation of Gestational Age with Anterior-Posterior Thigh Diameter Measured by Two-Dimensional Sonography

Background: Anterior-posterior thigh diameter measurement via two-dimensional sonography (2D-US) correlates with fetal gestational age and reflects the growth and development of fetal thigh muscles and bones. This measurement, alongside estimated gestational age, offers valuable insights into fetal well-being and growth during pregnancy. This study aimed to evaluate the correlation of gestational age with anterior-posterior thigh diameter measured by two-dimensional sonography and estimated gestational age. Methods: This cross-sectional study was conducted at the Department of Radiology and Imaging, Mymensingh Medical College &amp; Hospital, Mymensingh, Bangladesh from January 2010 to January 2012. As the study subjects, a total of 250 healthy women between the 24th and 38th weeks of normal pregnancy were enrolled by using a purposive sampling technique. For data analysis, SPSS version 23.0 was used. Results: The mean age of the participants was 24.79 ± 4.71 years with a range from 18 to 35 years. More than one-third (34.0%) of the women were in the age range of 21-25 years. The mean gestational age of all participants was 30.93 ± 4.32 weeks. Primigravida accounted for more than half (56.4%) of them. A statistically significant positive correlation was observed between fetal anterior-posterior thigh diameter and gestational age (p&lt;0.001. Conclusion: There is a statistically significant positive correlation between fetal anterior-posterior thigh diameter and gestational age.

Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses.

To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses. Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1-5.1 and 5.2-10). Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476). Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.

Correlation of Estimated Gestational Age with the Anterior-Posterior Thigh Diameter and Other Parameters of Fetal Biometry

Background: Accurate gestational age estimation is vital for tracking pregnancy, identifying growth issues, and guiding clinical decisions. Including anterior-posterior thigh diameter (APTD) in fetal biometry enhances fetal health assessment. Correlating EGA with APTD and other biometry parameters is crucial for evaluating fetal growth and development. This study aimed to evaluate the correlation of estimated gestational age with the anterior-posterior thigh diameter and other parameters of fetal biometry. Methods: This cross-sectional study was conducted at the Department of Radiology and Imaging, Mymensingh Medical College &amp; Hospital, Mymensingh, Bangladesh, from January 2010 to January 2012. A total of 250 healthy women between the 24th and 38th weeks of normal pregnancy were enrolled using a purposive sampling technique. Data analysis was performed using SPSS version 23.0. Results: More than one-third (34.0%) of participants were aged 21-25 years. The mean gestational age was 30.93 ± 4.32 weeks, and over half (56.4%) were primigravida. Significant positive correlations were found between fetal anterior-posterior thigh diameter and gestational age (r=1.0; p&lt;0.001), bi-parietal diameter (r=0.856; p&lt;0.001), head circumference (r=0.962; p&lt;0.001), abdominal circumference (r=0.972; p&lt;0.001), and femur length (r=0.948; p&lt;0.001). Conclusion: The fetal anterior-posterior thigh diameter shows significant positive correlations with several parameters, including gestational age, biparietal diameter, head circumference, abdominal circumference, and femur length in this study.

&lt;i&gt;IGF1R&lt;/i&gt; rs907806 and &lt;i&gt;GHSR&lt;/i&gt; rs572169 genetic variants in fetal macrosomia

BACKGROUND: Being strongly affected by maternal and fetal genetic factors, intrauterine environment plays a critical role in fetal growth. Intrauterine conditions, in turn, are largely determined by the genetic factors. AIM: The aim of this study was to evaluate the effect of the IGF1R rs907806 and GHSR rs572169 genetic variants on the weight of newborns. MATERIALS AND METHODS: This prospective study included 221 mother-newborn pairs. The inclusion criteria were singleton pregnancy and informed consent to participate in the study. The exclusion criteria were severe somatic, oncological and acute illnesses three months prior or during pregnancy, gestational diabetes mellitus, refusal to participate in the study at any stage, and insufficient data. The study groups included patients with type 1 diabetes mellitus (group I), type 2 diabetes mellitus (group II), and no carbohydrate metabolism disorders (group III). Cord blood samples were obtained after delivery. The IGF1R rs907806 and GHSR rs572169 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism analysis. The main outcomes were delivery of a large for gestational age fetus (weight of more than the 90th percentile INTERGROWTH-21st). The secondary outcomes were diabetic fetopathy, diabetic cardiomyopathy, and neonatal hypoglycemia. RESULTS: In group III, the minor G allele of the IGF1R rs907806 variant was more frequent in large-for-gestational-age newborns (p = 0.017; odds ratio 3.039; 95% confidence interval 1.244–7.424) than in those with a weight of less than 90th percentile. For the GHSR rs572169 variant, no similar trend was observed. This pattern was pronounced in the male newborns only (rs907806 AA vs. AG+GG; p = 0.046; odds ratio 4.229, 95% confidence interval 1.181–15.139). In newborns with hypoglycemia, a higher frequency of the GG genotype of the GHSR rs572169 (GA) variant was observed in the total sample (p = 0.004) and the type 1 diabetes mellitus group (p = 0.0496). CONCLUSIONS: The IGF1R rs907806 variant may affect birthweight in the male newborns of mothers without carbohydrate metabolism disorders. The observed association of neonatal hypoglycemia with the GG genotype of the GHSR rs572169 variant requires further investigation. Genetic factors can contribute to prognostic models of perinatal complications, while improving their early diagnosis opportunities.

Fetal Gestational Age Prediction in Brain Magnetic Resonance Imaging Using Artificial Intelligence: A Comparative Study of Three Biometric Techniques

Accurately predicting a fetus’s gestational age (GA) is crucial in prenatal care. This study aimed to develop an artificial intelligence (AI) model to predict GA using biometric measurements from fetal brain magnetic resonance imaging (MRI). We assessed the significance of using different reference standards for interpreting GA predictions. Measurements of biparietal diameter (BPD), fronto-occipital diameter (FOD), and head circumference (HC) were obtained from 52 normal fetal MRI cases from Rush University. Both manual and AI-based methods were utilized, and comparisons were made using three reference standards (Garel, Freq, and Bio). The AI model showed a strong correlation with manual measurements, particularly for HC, which exhibited the highest correlation with actual values. Differences between GA predictions and picture archiving and communication system (PACS) records varied by reference, ranging from 0.47 to 2.17 weeks for BPD, 0.46 to 2.26 weeks for FOD, and 0.75 to 1.74 weeks for HC. Pearson correlation coefficients between PACS records and GA predictions exceeded 0.97 across all references. In conclusion, the AI model demonstrated high accuracy in predicting GA from fetal brain MRI measurements. This approach offers improved accuracy and convenience over manual methods, highlighting the potential of AI in enhancing prenatal care through precise GA estimation.

Expression Profiles of ITGA8 and VANGL2 Are Altered in Congenital Anomalies of the Kidney and Urinary Tract (CAKUT).

Kidney failures in infants are mostly caused by congenital anomalies of the kidney and urinary tract (CAKUT), which are among the most common congenital birth disorders worldwide when paired with cardiac abnormalities. People with CAKUT often have severe kidney failure as a result of a wide range of abnormalities that can occur alone or in conjunction with other syndromic disorders. In this study, we aimed to investigate the expression pattern of CAKUT candidate genes alpha-8 integrin (ITGA8) and Van Gogh-like 2 (VANGL2) in fetal tissues of healthy and CAKUT-affected kidneys using immunohistochemistry and immunofluorescence. We found that under CAKUT circumstances, the expressions of ITGA8 and VANGL2 are changed. Additionally, we showed that VANGL2 expression is constant during fetal aging, but ITGA8 expression varies. Moreover, compared to normal healthy kidneys (CTRL), ITGA8 is poorly expressed in duplex kidneys (DKs) and dysplastic kidneys (DYS), whereas VANGL2 is substantially expressed in dysplastic kidneys (DYS) and poorly expressed in hypoplastic kidneys (HYP). These results point to VANGL2 and ITGA8 as potential prognostic indicators for CAKUT malformations. Further research is necessary to explore the molecular mechanisms underlying this differential expression of ITGA8 and VANGL2.

Placental biophysical model for prediction of early onset fetal growth restriction in first and second trimester of pregnancy: A prospective cohort study

IntroductionTo assess the placental biometry, placental biomarkers and uterine artery Doppler in each trimester of pregnancy for prediction of early-onset fetal growth restriction (EO FGR). MethodsIn this prospective cohort study placental biometry; biomarkers PAPP-A, sFLT-1, and PlGF along with the uterine artery blood flow evaluation was done serially at 11–14, 20–24 and 28–32 weeks of gestation. The above parameters were compared between women with early onset FGR and controls. ResultsOut of 1008 fully followed cases, the small for gestational age fetuses were 227/1008 (22.5 %), and EO FGR were 84/1008(8.3 %).The placental length, volume, and PlGF levels were significantly lower, whereas the uterine artery PI(Ut PI) was significantly higher at all time points among cases. The sFLT-1 level showed a significant increase among cases, whereas it decreased among controls from the first to the second trimester. The detection rate using PV/UtA PI was 60 % in the first trimester and 66.7 % in the second trimester at 30 % FPR. ConclusionThe PV/Ut PI in first and the second trimester was a good marker for the prediction of pregnancies at increased risk of developing EO FGR.