Gestational Complications Research Articles

Characterization of Mild Delayed Gestational Hypertension in Rats Following Ozone Exposure.

The contribution of air pollution-induced cardiopulmonary damage on the development of hypertensive disorders of pregnancy and other adverse outcomes of pregnancy has gained increased attention as epidemiological data continue to highlight spatiotemporal pregnancy trends related to air pollution exposure. However clinical mechanistic data surrounding gestational complications remain sparse, necessitating the need for the use of animal models to study these types of complications of pregnancy. The current study seeks to examine the real-time effects of mid-gestational ozone exposure on maternal blood pressure and body temperature through the use of radiotelemetry in a rat model. The exposure resulted in acute depression of heart rate and core body temperature as compared to control animals. Ozone-exposed animals also presented with a slight but significant increase in arterial blood pressure which was perpetuated until term. The data presented here illustrates the feasibility of murine models to assess cardiovascular complications caused by inhaled toxicants during the window of pregnancy.

P-560 Characterization of ploidy level and parental genome inheritance abnormalities in preimplantation human embryos

Abstract Study question Can preimplantation genetic testing (PGT) platforms with integrated genotyping aid the characterization of genome-wide chromosomal abnormalities in human embryos and factors contributing to their occurrence? Summary answer Signatures detected by genotype-criteria-based models in PGT pinpoint origin of haploidy, triploidy and genome-wide uniparental disomy (gwUPD), highlighting recombination deficiencies potentially underpinning these phenomena. What is known already While there is a growing body of knowledge on the frequency and origin of individual chromosome abnormalities, very little is known about genome-wide chromosomal abnormalities in human development. Indeed, genome-wide abnormalities are incompatible with normal human development, making the preimplantation stage the ideal time to characterize them. Novel PGT technologies provide the research and clinical opportunity to characterize both known ploidy-level abnormalities (triploid/haploid) and identify theoretical genome-wide abnormalities undetectable at later stages of development. Study design, size, duration PGT genotyping data from 96660 embryos were used to assess incidence of ploidy-level abnormalities and correlation with potential predisposing clinical factors. Parental origin of putative haploidy and triploidy was assessed on 14 and 41 embryos with parental genotypes available (trios), respectively. For the 41 triploid trios, meiotic origin and recombination rates were also evaluated. A novel genotype-criteria based model to detect theoretical gwUPD and meiotic origin was developed on a semi-contemporaneous 74009 female embryo dataset. Participants/materials, setting, methods PGT was performed with targeted next-generation sequencing, including 5000 genome-wide SNPs. Informative SNPs from trios were used to identify parental origin of haploidy/triploidy. Informative SNPs within 5cM of the centromere were used to evaluate meiotic origin and extended beyond 5cM to identify maternal recombination observing shifts between single (SPH) and biparental (BPH) homologs. gwUPD was predicted when low genome-wide heterozygosity, increased homozygosity in the centromeric region, and decreased similarity to sibling embryos were observed. Main results and the role of chance Genome wide ploidy abnormalities were detected in 1.1% (n = 1.063/96.660; CI 95%: 1-1,2%) of embryos. Haploidy was mainly of paternal origin (n = 12/14), whereas triploidy was exclusively maternal in origin (n = 41/41) and prominently due to meiosis II errors (n = 30/41; 73.2%; 95% CI:57.1-85.8%). Advanced maternal age was positively associated with an increased risk of triploid conceptions (OR = 1.059 per year; p < 0.001). Investigation of maternal recombination rates detected by three consecutive SNPs shifting between SPH and BPH (with a calculated genotyping error of 0.16%) in triploid embryos revealed an outlier group of 7 embryos with statistically lower (P < 0.001) identified crossover events (0-2 events genome-wide) compared to the average 23.7 detectable events genome-wide (SD:4.3). Recombinant gwUPD was predicted in 41 out of 74009 human embryos (0.05%; 95% CI:0.04-0.07%). These embryos showed a high homozygosity in pericentromeric regions, as a proof of each pair of chromosomes being the same parental homolog resulting from a faulty meiosis II, but with detectable heterozygosity regions throughout the rest of the genome, indicating that crossovers occurred between the two parental homologs during prophase I. Multifocal biopsies from the same embryos confirmed the reproducibility of identification of the number of recombination events in triploid embryos and the gwUPD prediction. Limitations, reasons for caution This assay genotypes only a portion of the genome and underestimation of recombination events is possible. Our current detection of gwUPD is limited to recombinant uniparental isodisomy of MII origin only. Therefore, the exact prevalence of these abnormal gwUPD configurations requires further understanding and analysis. Wider implications of the findings Genotyping in routine PGT can identify severe genome-wide abnormalities with associated gestational complications that would otherwise go undiagnosed. Comprehensive characterization of these abnormalities is not possible at later stages of development. Therefore, PGT offers a unique opportunity to delve into their biological origin and identify novel biomarkers for embryo competence. Trial registration number not applicable

Patterns of Gestational Hypertension or Preeclampsia Across 2 Pregnancies in Relationship to Chronic Hypertension Development: A Retrospective Cohort Study.

Gestational hypertension (GHTN) and preeclampsia are established risk indicators for chronic hypertension. While recurrence is associated with a greater risk, it is unclear whether there are differences in risk when these gestational complications occur for the first time in an earlier pregnancy versus first occurrence in a subsequent one. We hypothesized that the absence of recurrence reflects a transition toward a lower hypertension risk trajectory, whereas a new occurrence in a later pregnancy indicates a transition toward elevated risk. We analyzed linked data in Quebec, Canada, from public health care insurance administrative databases and birth, stillbirth, and death registries. Our retrospective cohort study included mothers with 2 singleton deliveries between April 1990 and December 2012. The primary exposure was patterns of GHTN or preeclampsia across 2 pregnancies (GHTN/preeclampsia in neither, first only, second only, or both). The outcome was incident chronic hypertension. We performed an adjusted multivariable Cox regression analysis. Among 431 980 women with 2 singleton pregnancies, 27 755 developed hypertension during the follow-up period. Compared with those without GHTN/preeclampsia, those with GHTN/preeclampsia only in the first pregnancy had a 2.7-fold increase in hazards (95% CI, 2.6-2.8), those with GHTN/preeclampsia only in the second had a 4.9-fold increase (95% CI, 4.6-5.1), and those with GHTN/preeclampsia in both pregnancies experienced a 7.3-fold increase (95% CI, 6.9-7.6). Patterns and estimates were similar when we considered GHTN and preeclampsia separately. The magnitude of hypertension risk is associated with the number and sequence of GHTN/preeclampsia-affected pregnancies. Considering both allows more personalized risk estimates.

Vaginal Microbiome and Pregnancy Complications: A Review.

Background/Objectives: There are indications that the microbial composition of the maternal mucosal surfaces is associated with adverse events during pregnancy. The aim of this review is to investigate the link between vaginal microbiome alterations and gestational complication risk. Methods: This comprehensive literature review was performed using Medline and Scopus databases. The following search algorithm was used, "Pregnancy Complications" [Mesh] AND (Vagin*), and after the literature screening, 44 studies were included in the final review. Results: The studies that were included investigated the association between vaginal microbial composition and preterm birth, miscarriage, preeclampsia, ectopic pregnancy, gestational diabetes mellitus, chorioamnionitis, and preterm premature rupture of membranes. In most of the studies, it was well established that increased microbial diversity is associated with these conditions. Also, the depletion of Lactobacillus species is linked to most of the gestational complications, while the increased relative abundance and especially Lactobacillus crispatus may exert a protective effect in favor of the pregnant woman. Several pathogenic taxa including Gardnerella, Prevotella, Sneathia, Bacterial Vaginosis-Associated Bacteria-2, Atopobium, and Megasphera seem to be correlated to higher maternal morbidity. Conclusions: Vaginal microbiome aberrations seem to have an association with pregnancy-related adverse events, but more high-quality homogenous studies are necessary to reliably verify this link.

Prevalence of Multi Drug Resistant Coagulase Negative Staphylococci among some Pregnant Women Attending Antenatal Clinic in Yola, Nigeria

Study’s Novelty/Excerpt This study presents findings on the prevalence and characterization of coagulase-negative staphylococci (CoNS) among pregnant women in public health facilities in Yola, revealing a significant prevalence rate of 26.97%. The research highlights the high susceptibility of CoNS to certain antibiotics and the alarming presence of multi-drug resistant and extended spectrum beta-lactamase (ESBL) producing strains. This underscores the necessity for routine screening of pregnant women for CoNS to prevent potential gestational complications, providing crucial data for public health interventions and antibiotic stewardship programs. Full Abstract Coagulase negative staphylococci have been reported to be a frequent agent of uncomplicated UTI in young sexually active women which can also lead to symptomatic infection, low birth weight (LBW) babies and preterm delivery. This study was undertaken to determine the prevalence and characterize coagulase negative staphylococci among pregnant women in public health facilities in Yola. A total of 250 urine samples were collected from pregnant women attending antenatal clinic at Specialist Hospital and Boshang Clinic and Maternity both in Yola. The samples were cultured on cysteine lactose electrolyte deficient medium and isolates characterized using phenotypic methods. The prevalence of coagulase negative staphylococci from this study was 26.97%, Staphylococcus aureus 16.29% and Escherichia coli 36.51%. The frequency of CoNS was highest among age group of 36-40 years and least among 16-20 years (12.5%). CONS isolated from this study demonstrated high susceptibility to pefloxacin, ciprofloxacin, erythromycin, ceftriaxone and streptomycin. Some isolates showed high resistance to ampiclox, cefuroxime and amoxicillin. About 83% of the isolates had multiple antibiotic resistant indexes greater than 0.2 with about 25% of the antibiotic resistance being plasmid mediated. Furthermore, phenotypic screening using the double disk synergy test showed that 20 (40%) of the isolates were extended spectrum beta lactamase (ESBL) producing. This study revealed the presence of multi-drug resistant and ESBL producing coagulase negative staphylococci among pregnant women in the study area. There is therefore the need for pregnant women to be screened for coagulase negative staphylococci to avoid complications during gestation period.

UK neonatal stoma practice: a population study

ObjectiveThe optimal time for neonatal stoma closure is unclear and there have been calls for a trial to compare early and late surgery. The feasibility of such a trial will...

Comparison of pregnancy outcomes between indigenous and non-indigenous lupus patients.

To compare pregnancy outcomes between IA and non IA lupus patients. Pregnancy in lupus patients confers an increased risk of maternal and fetal morbidity. There are no data on pregnancy outcomes for indigenous Australian (IA) patients with lupus. Using state-wide longitudinal hospital morbidity data, we studied 702 pregnancies in IA (n = 31) and non-indigenous (NI) patients with lupus (n = 357) in Western Australia and compared rates for live birth (LB), preterm birth (PB) and gestational complications in the period 1985-2015. Results are presented as medians or frequency. IA patients had proportionally more pre-existing renal disease (35 vs 13%, P < 0.01) and lower socio-economic status (P = 0.02). Age at first pregnancy was lower in IA patients (27 vs 30 years, P < 0.001), recorded gravidity was similar (2 vs 2, P > 0.6) and elective termination (n = 138) was more frequent in NI than IA pregnancies (21.1 vs 4.8%, P < 0.01). For continued pregnancies (59 in IA and 505 in NI), respective outcomes were as follows: LB 84.7% versus 91.5% (P = 0.15), spontaneous abortion 13.5% versus 6.9% (P = 0.13), (pre-)eclampsia 8% versus 9.9% (P = 0.89), PB 12% versus 13.4% (P = 0.98) and caesarean delivery 30% versus 47.2% (P = 0.02). Gestational diabetes (26% vs 6.1%), renal flares (20% vs 5.6%) and infections (22% vs 6.3%) were all more frequent in IA lupus pregnancies (all P < 0.001). The burden of comorbidities was higher in IA patients with lupus due to renal flares, gestational DM and infections. Although PB rates were overall high, they were, however, similar for IA and NI lupus pregnancies, as were LB rates.

Cardiovascular complications during delivery hospitalizations in patients with nonalcoholic fatty liver disease in pregnancy.

While the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and long-term cardiovascular risks has been studied, the impact of MASLD on cardiovascular events during delivery hospitalizations remains relatively unexplored. This study aims to examine the prevalence of cardiovascular diseases (CVDs) and cardiac arrhythmias in pregnant patients with MASLD and identify potential risk factors. A retrospective analysis of hospital discharge records from the National Inpatient Sample database between 2009 and 2019 was conducted to assess maternal cardiovascular outcomes. Multivariable logistic regression models were employed, and adjusted odds ratios (AOR) were calculated to evaluate the association between MASLD and cardiovascular outcomes during pregnancy. The study sample included 17 593 pregnancies with MASLD and 41 171 211 pregnancies without this condition. Women with MASLD exhibited an increased risk of congestive heart failure [AOR 3.45, 95% confidence interval (CI) 1.04-11.43], cardiac arrhythmia (AOR 2.60, 95% CI 1.94-3.49), and gestational hypertensive complications (AOR 3.30, 95% CI 2.93-3.72). Pregnancies with MASLD were also associated with a higher rate of pulmonary edema (AOR 3.30, 95% CI 1.60-6.81). MASLD is an independent risk factor for cardiovascular complications during delivery hospitalizations, emphasizing the necessity for prepregnancy screening and targeted prevention strategies to manage CVD risks in expectant patients with MASLD.

As manifestações dermatológicas da síndrome do ovário policístico: Uma revisão bibliográfica

Objective: To identify and understand the pathophysiology of dermatological clinical manifestations in patients with Polycystic Ovary Syndrome. Literature review: Polycystic ovary syndrome (PCOS) is highly common among women of reproductive age. Although its etiology is poorly understood, the diagnosis is made by associating the various clinical manifestations of the disease and using the Rotterdam criteria - at least two of which are hyperandrogenism, multiple ovarian cysts and irregularity of the menstrual cycle. The symptoms are divided into dermatological, systemic, gynecological and reproductive. Dermatological symptoms include hirsutism, acne vulgaris, acanthosis nigricans, seborrheic dermatitis, androgenetic alopecia and, in more severe cases, virilization. Patients with PCOS often have a reduced quality of life due to its complications, including difficulty getting pregnant, gestational complications and even infertility. For the best management of this syndrome, a multidisciplinary approach is needed, involving various areas of medicine in line with the patient's complaints, and a clinical control approach for circulating androgen levels.

A mixed-methods study to investigate feasibility and acceptability of an early warning score for preterm infants in neonatal units in Kenya: results of the NEWS-K study

Preterm birth (< 37 weeks gestation) complications are the leading cause of neonatal mortality. Early-warning scores (EWS) are charts where vital signs (e.g., temperature, heart rate, respiratory rate) are recorded, triggering action. To evaluate whether a neonatal EWS improves clinical outcomes in low-middle income countries, a randomised trial is needed. Determining whether the use of a neonatal EWS is feasible and acceptable in newborn units, is a prerequisite to conducting a trial. We implemented a neonatal EWS in three newborn units in Kenya. Staff were asked to record infants’ vital signs on the EWS during the study, triggering additional interventions as per existing local guidelines. No other aspects of care were altered. Feasibility criteria were pre-specified. We also interviewed health professionals (n = 28) and parents/family members (n = 42) to hear their opinions of the EWS. Data were collected on 465 preterm and/or low birthweight (< 2.5 kg) infants. In addition to qualitative study participants, 45 health professionals in participating hospitals also completed an online survey to share their views on the EWS. 94% of infants had the EWS completed at least once during their newborn unit admission. EWS completion was highest on the day of admission (93%). Completion rates were similar across shifts. 15% of vital signs triggered escalation to a more senior member of staff. Health professionals reported liking the EWS, though recognised the biggest barrier to implementation was poor staffing. Newborn unit infant to staff ratios varied between 10 and 53 staff per 1 infant, depending upon time of shift and staff type. A randomised trial of neonatal EWS in Kenya is possible and acceptable, though adaptations are required to the form before implementation.

Reduction of cardiovascular complications during delivery hospitalization in patients undergoing bariatric procedures.

The global surge in obesity presents a significant health challenge, leading to increased adoption of bariatric surgery as an intervention. However, the correlation between bariatric surgery and cardiovascular outcomes during subsequent pregnancies remains unclear. The aim of our study was to determine the prevalence of cardiovascular complications during delivery hospitalizations in patients with bariatric procedure. We performed a retrospective analysis utilizing the National Inpatient Sample database to examine data from delivery admissions of pregnant women with obesity and a history of bariatric surgery. These admissions were identified using International Classification of Diseases (ICD) codes from 2009 to 2019. In comparing pregnant individuals who had undergone bariatric surgery with those with obesity but had no such surgical history, we assessed the prevalence of cardiovascular complications. Our study included 3,027,987 pregnancies in individuals with obesity and an additional 117,350 pregnancies following bariatric surgery. Compared to patients without bariatric surgery, post-surgery patients were older (32.84 years vs 29.02 years), primarily White (59.0%), and mostly treated in large urban hospitals. Cardiovascular outcomes showcased reduced odds of congestive heart failure [Adjusted odds ratios (AOR) 0.11, 95% confidence intervals (CI) 0.01-0.74], gestational hypertensive complications (AOR 0.55, 95% CI 0.53-0.59), and cardiac arrhythmia (AOR 0.76, 95% CI 0.64-0.89) in the post-surgery group, with no significant difference in peripartum cardiomyopathy rates (AOR 0.72, 95% CI 0.29-1.76) and no instances of stroke or acute MI. Perinatally, the surgery cohort had higher odds of preterm birth (AOR 1.30, 95% CI 1.24-1.38) and fetal growth restriction (AOR 2.47, 95% CI 2.32-2.63) but fewer incidents of being large for gestational-age (AOR 0.35, 95% CI 0.32-0.38). As bariatric surgery became increasingly recognized as a significant factor in certain complications, its prevalence among the study population increased from 2009 to 2019. In summary, our research indicates that bariatric surgery is associated with a decreased risk of cardiovascular complications during delivery. This study highlights how insights from bariatric surgery outcomes could shape clinical guidelines for managing obesity in pregnant women.

Pregnancy outcomes and complications after renal transplantation

Introduction. Chronic kidney disease (CKD) in pregnancy poses certain risks of both gestational complications and adverse perinatal outcomes, which increase with the decline of renal function.Aim to access pregnancy outcomes in patients who underwent nephrotransplantation.Materials and methods. Retrospective study of pregnant women who gave birth at Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in the period from 2005 to 2021: 102 pregnancies in 97 patients were analyzed: five recipients had two successful pregnancies.Results. The average age of pregnant women was 31 ± 4.03 years. In equal proportions, patients underwent related or cadaveric kidney transplantation – 52% (n = 53) and 48% (n = 49) of cases, respectively. The average delivery time was 35.5 ± 2.7 weeks. The average weight of newborns was 2545 ± 655 grams. Premature birth (PB) occurred in 47.1%, the average period of birth was 33.4 ± 2.87 weeks, of which early birth (&lt;32 weeks) was 22.5%. The average period of pregnancy after transplantation was 5 ± 3.31 (1–18) years, this period was not associated with obstetric complications or deterioration of graft function. A significant increase in the following parameters was noted during pregnancy: serum creatinine level (p = 0.006), proteinuria (p = 0.003). The glomerular filtration rate also decreased significantly by the end of pregnancy (p = 0.011). Preeclampsia was the leading cause of decreased graft function during pregnancy (32.4%).Conclusions. In general, pregnancy outcomes after nephrotransplantation are favorable, but there is an increased risk of preeclampsia, preterm birth, including operative delivery, urinary tract infection and anemia.

A Retrospective Analysis of Postpartum Adherence to Follow-up in High-risk Obstetric Patients in Primary Care

Background and Objectives: Texas is a state with a well-documented statistical rate of the nation’s highest maternal mortality rates. Maternal mortality has a multiplicity of risk factors including gestational complications, not limited to diabetes mellitus, hypertension, and preeclampsia. The high-risk obstetrics (HROB) initiative was created at CommuniCare Health Centers in San Antonio, TX, to provide resources to obstetric (OB) patients identified as high risk for perinatal and postpartum complications. The goal of this analysis is to assess the consistency with which HROB patients enrolled present to the first and second OB postpartum follow-up visits and subsequently family medicine follow-up visits. Methods: The patients were enrolled in this initiative based on a criterion for being considered high risk for obstetrical complications including hypertensive disease, preeclampsia, eclampsia, and diabetes mellitus. One hundred ninety-two patient charts were reviewed and 180 were included in this retrospective analysis. Results: A multivariate analysis revealed that an adjusted odds ratio for postpartum follow-up among HROB patients was 1.65 (95% confidence interval = 0.71–3.83). A positive trend was observed for HROB patients’ OB postpartum follow-up visits, whereas a negative trend was observed for family medicine postpartum follow-up visits. Conclusion: Prevention strategies aimed at reducing postpartum loss to follow-up identified in this study could promote better health outcomes among HROB patients in San Antonio, TX.

ЭКСПЕРТНАЯ ОЦЕНКА КАЧЕСТВА МЕДИЦИНСКОЙ ПОМОЩИ ДЛЯ СНИЖЕНИИ РЕПРОДУКТИВНЫХ ПОТЕРЬ

The paper considers and highlights the modern principles and methods for assessing the quality of the process of providing medical care, as the most complex and least regulated component of the entire multicomponent system for assessing the quality of medical care. To date, two directions have been formed - theoretical and practical - to solve the problem of quality control of the medical care process. One, standardization, is based on previous medical experience - "method of choice", protocols of management. The second is the quality of the medical care process technology. Quality control of the result is carried out "post factum". Purpose: introduction of effective methods for assessing the quality of medical care by trimesters of pregnancy to reduce reproductive losses. Material and methods: statistical, analytical, prognostic, epidemiological analysis. Results and discussion. The results of the analysis of the assessment of the quality of medical care received by a woman during pregnancy, based on a study of medical records, as well as a study of the opinions of pregnant women, are presented. Comparison of the data obtained makes it possible to reveal the correlation dependence of the results of an expert assessment of the quality of medical care on the timing of a woman's registration for pregnancy. Integral registration defects were determined in the collection of anamnesis data from the examined women in the process of dynamic observation of pregnancy at the outpatient stage. The study of the state of the quality of medical care provided to pregnant women, women in childbirth and puerperas, took place in a complex manner, including laboratory diagnostic studies, registration of medical documentation and possible errors in making a clinical diagnosis. It has been proven that errors in diagnosis and treatment, as a rule, negatively affect the patient's condition. The sub-optimal use of resources is reflected in the lack of respect and use of existing standards. In the study groups with the highest risk of providing medical care of inadequate quality, there were violations that are associated with the risk of worsening the condition of a pregnant woman and the development of gestational complications in the future.

Comparison of pregnancy outcomes after bariatric surgery by sleeve gastrectomy versus gastric bypass

ObjectiveBariatric surgery has an impact on subsequent pregnancies, in particular an association between gastric bypass and small for gestational age. Knowledge is lacking on whether sleeve gastrectomy is associated with more favorable pregnancy outcomes. This study aimed to compare the impact of sleeve gastrectomy and Roux-en-Y gastric bypass on the incidence of small for gestational age (SGA), and of adverse pregnancy outcomes. Study designWe conducted a retrospective study in a single reference center, including all patients with a history of sleeve or bypass who delivered between 2004 and 2021 after their first pregnancy following bariatric surgery. We compared the incidence of SGA, intrauterine growth retardation, preterm delivery and adverse maternal outcomes between patients who had sleeve versus bypass. ResultsOf 244 patients, 145 had a sleeve and 99 had a bypass. The proportion of SGA < 10th percentile did not differ between the two groups (38/145 (26.2 %) vs 22/99 (22.22 %), respectively, p = 0.48). Preterm birth < 37 WG was lower in the sleeve group (5/145 (3.45%) vs 12/99 (12.12 %) in the bypass group (p = 0.01), as well as NICU hospitalizations (3 (2.07%) vs 12/99 (12.12%), p < 0.01). There was no difference regarding adverse maternal outcomes such as gestational diabetes and hypertensive complications. The proportion of SGA was not lower in patients with bypass when adjusting for other risk factors (BMI, smoking, geographic origin, diabetes and hypertension) (aOR 0.70; 95%CI 0.01 – 2.85). Conclusionsleeve was associated with an incidence of SGA which was as high as after bypass, however the incidence of preterm birth was lower.

Pre-Pregnancy Obesity and Infants' Motor Development within the First Twelve Months of Life: Who Is Expected to Be the Ultimate Carrier of the Obesity Burden?

Pre-pregnancy obesity is a significant public health concern with profound implications for maternal and child health. The burgeoning evidence suggests that maternal obesity prior to conception is intricately linked with an increased risk of gestational complications, as well as with adverse neonatal outcomes. Furthermore, the long and short-term health of offspring, including the risk of early motor development impairment, obesity, and metabolic syndrome in childhood and adulthood, may be adversely affected as well. Addressing pre-pregnancy obesity is critical for improving overall maternal and child health outcomes, and therefore, the aim of this study was to evaluate the connections linking pre-pregnancy obesity with infants' motor development within the first twelve months of infants' lives. This study included 200 mother-infant pairs divided into two groups based on their pre-pregnancy body mass index values. To assess infants' early motor development, we used the Alberta Infant Motor Scale (AIMS) and evaluated the parameters of infants' early motor development at the ages of three, six, nine, and twelve months. Pre-pregnancy overweight/obesity was significantly associated with excessive gestational weight gain (p < 0.001), fetal macrosomia (p = 0.022), and a family history of diabetes and cardiovascular diseases (p = 0.048 and p = 0.041, respectively), as well as with all observed parameters of early motor development at the ages of three, six, nine, and twelve months: AIMS 3 months total (p < 0.001), AIMS 6 months total (p < 0.001), AIMS 9 months total (p < 0.001), and AIMS 12 months total (p < 0.001). Furthermore, pre-pregnancy overweight/obesity was a significant predictor for AIMS 6 months total (p = 0.043) and AIMS 6 months supination (p = 0.017). Pre-pregnancy obesity is a critical determinant of pregnancy outcomes and offspring early motor development, with possible far-reaching implications for children's long-term well-being. Addressing this issue requires a comprehensive approach that includes preconception weight management, targeted interventions during the pregnancy and postpartum periods, and ongoing research to better understand the underlying mechanisms and develop effective strategies for prevention and management.

Proteomic studies of VEGFR2 in human placentas reveal protein associations with preeclampsia, diabetes, gravidity, and labor

VEGFR2 (Vascular endothelial growth factor receptor 2) is a central regulator of placental angiogenesis. The study of the VEGFR2 proteome of chorionic villi at term revealed its partners MDMX (Double minute 4 protein) and PICALM (Phosphatidylinositol-binding clathrin assembly protein). Subsequently, the oxytocin receptor (OT-R) and vasopressin V1aR receptor were detected in MDMX and PICALM immunoprecipitations. Immunogold electron microscopy showed VEGFR2 on endothelial cell (EC) nuclei, mitochondria, and Hofbauer cells (HC), tissue-resident macrophages of the placenta. MDMX, PICALM, and V1aR were located on EC plasma membranes, nuclei, and HC nuclei. Unexpectedly, PICALM and OT-R were detected on EC projections into the fetal lumen and OT-R on 20–150 nm clusters therein, prompting the hypothesis that placental exosomes transport OT-R to the fetus and across the blood–brain barrier. Insights on gestational complications were gained by univariable and multivariable regression analyses associating preeclampsia with lower MDMX protein levels in membrane extracts of chorionic villi, and lower MDMX, PICALM, OT-R, and V1aR with spontaneous vaginal deliveries compared to cesarean deliveries before the onset of labor. We found select associations between higher MDMX, PICALM, OT-R protein levels and either gravidity, diabetes, BMI, maternal age, or neonatal weight, and correlations only between PICALM-OT-R (p < 2.7 × 10–8), PICALM-V1aR (p < 0.006), and OT-R-V1aR (p < 0.001). These results offer for exploration new partnerships in metabolic networks, tissue-resident immunity, and labor, notably for HC that predominantly express MDMX.

Awareness of the Importance of Lifestyle Modification on the Prevention of Gestational Complications in Preconception Care of Women

Background: Preconception care mainly depends on minimising the risks faced before conception, collecting all possible information before conception, and using all sources to improve the reproductive health of pregnant women. Preconception is a great opportunity for early determination of any health risk and to optimise the health of implicit moms and protect the unborn foetus from any type of health risk as well as birth defect. This study presents the best scientific approach method for developing preconception intervention packages under different conditions. Objective: To determine the awareness of the importance of lifestyle modification in the prevention of gestational complications during the preconception period. Methods: This study was approved by the Ethical Committee and Protocol Committee (protocol no. 600/2022-2023). The subjects of this observational study were women who are primigravidae and reside in Karad, India. Using random sampling, 93 participants who were primigravidae were included. A questionnaire was distributed to individuals within the age range of 21 to 30 years, based on preconception care, lifestyle modification, family support and precautionary measures. Results: It was found that out of 91 participants, only 4.3% had excellent knowledge, 8.6% had very good knowledge, 27.96% had good knowledge, 53.76% had fair knowledge and 5.38% had poor education regarding preconception care. Conclusion: The awareness among women regarding the importance of lifestyle modification in the prevention of gestational complications during the preconception period was significantly lower.

Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study.

Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ ИСХОДОВ БЕРЕМЕННОСТИ ПОСЛЕ ИНФЕКЦИИ COVID-19, ПЕРЕНЕСЕННОЙ ВО ВТОРОМ И ТРЕТЬЕМ ГЕСТАЦИОННЫХ ПЕРИОДАХ

Introduction. Issues of providing medical care to pregnant women in the setting of COVID-19 infection remain a priority for physicians of many health professions, since it is this disease an increased incidence of adverse outcomes for both mothers and fetuses is associated with in recent years. Aim. To study the peculiarities of pregnancy course and outcomes after COVID-19 infection that has developed in the second and/or third gestation periods. Materials and Methods. Birth histories for 2021 were analyzed. Group 1 (n=30) consisted of patients with COVID-19 infection developed in the second trimester, group 2 (n=69) of those with the infection developed in the third trimester. We studied the anamnesis details, pregnancy and labor complications, and perinatal outcomes. Statistical analysis has been performed using Excel MS and Statistica 7.0 programs. The data obtained are presented as mean values (M) and standard deviation (SD), as well as the absolute (n) and relative (%) frequencies of observations. To establish the significance of differences between two mean values of parameters, Student’s t-test was used, and Pearson’s χ2 criterion was used for qualitative parameters (differences at p&lt;0.05 were considered significant). Results and Discussion. It was found that the course of pregnancy after COVID-19 infection, regardless of the disease manifestation times (p&gt;0.05), is associated with developing placental insufficiency (30.0 % in group 1 and 50.7 % in group 2), the symptoms of threatened abortion (46.7 and 53.6%, respectively), hypertensive disorders (18.7 and 24.6%, respectively), anemia (43.3 and 46.4%, respectively), colpitis (10.0 and 27.5%, respectively), bacterial vaginosis (20.0 and 17.4%, respectively), and the premature rupture of fetal membranes (16.6 and 15.9%, respectively), with the prevalence of at term deliveries (86.7 and 97.1%, respectively; p=0.05), but with an increase in the incidence of the infantile asphyxia in 53.3 and 52.2%, respectively. Cerebral ischemia (40.0 and 36.2%, respectively), congenital developmental anomalies (30.0 and 10.1%, respectively; p=0.01), perinatal hypoxic damage of the central nervous system (23.3 and 5.8%, respectively; p=0.01), neonatal jaundice (23.3 and 4.7%, respectively; p=0.004), and intrauterine pneumonia (10.0 and 5.8%, respectively) prevailed in the structure of neonatal morbidity. Conclusions. Pregnant women are 2.3 times more likely to be infected with COVID-19 in the third trimester compared to the incidence in the second trimester. The course of pregnancy after COVID-19 infection is accompanied by forming placental insufficiency with the development of gestational complications, without affecting the timing of delivery, but increasing the frequency of the need for surgical aids in labor in the manifestation of infection in the third trimester. The incidence of neonatal morbidity increases statistically significantly with the clinical manifestations of COVID-19 infection in mothers in the second trimester.