Healthy Pregnancy Research Articles

Association of Psychological Wellbeing with Healthy Pregnancy, Maternal and Neonatal Outcomes in Pakistani Females

Association of Psychological Wellbeing with Healthy Pregnancy, Maternal and Neonatal Outcomes in Pakistani Females

The most common teratogens as factors of mutability: A literature review

Introduction: The teratogenic agents during the embryonic period can result in disorders in organ differentiation. Concerns regarding medication use during pregnancy heightened after the thalidomide case in the 1960s, underscoring the need for a balance between caution and effective treatment, given the lack of clear information on risks. The aim of the research was to understand teratogens as factors that increase mutability and highlight the relevance of preventive strategies to ensure fetal and maternal health. Methods: Literature review using the PubMed database, Scopus and Web of Science was conducted. Forty-four articles, documents, clinical trials, and systematic reviews published in English were included. Teratogens and their effects, as well as preventive strategies for teratogenic congenital defects, were explored. Results: Risks associated with specific substances were examined, highlighting their effects on the fetus and providing epidemiological data. Preventive measures such as vaccination, folic acid supplementation, and control of metabolic diseases were addressed. Conclusions: During pregnancy, it is crucial to avoid exposure to chemicals, drugs, and medications that may harm the fetus. Caution should be exercised with the use of medications, and alcohol, tobacco, and illicit drugs should be avoided. Preventive strategies such as vaccination and folic acid supplementation reduce the risk of congenital malformations and promote a healthy pregnancy.

STRUCTURAL ORGANIZATION OF THE MARGINAL AND THORACIC NUCLEI OF THE POSTERIOR HORNS OF THE HUMAN SPINAL CORD IN THE PRENATAL PERIOD

Background. Embryology is the fundamental study that provides insights into the formation stages of the central nervous system and the mechanisms involved in its development. Thus, we can establish clear time intervals for thoracic and marginal nuclei formation during intrauterine development. Aim: To investigate the morphogenesis of the marginal and thoracic nuclei of the posterior horns of the human spinal cord during intrauterine development. Results. In the period of 7-8 weeks of gestation, the first signs of the formation of the thoracic nucleus appear, while for the marginal - 9-10 weeks of gestation. Glial cells are companion cells that always surround neurons. In turn, the cells of each nucleus are characterized by uniformity and similarity in shape and size. At 11-12 weeks of gestation, the thoracic nucleus acquires a typical oval shape. The marginal nucleus begins to separate from the gelatinous substance. Clear boundaries of the thoracic nucleus with its inherent oval shape, in comparison with the marginal one, are formed earlier. We found them in 14-15 weeks of gestation. At the same time, the marginal nucleus is separated from the surrounding structures in 20-21 weeks of gestation. By 29-30 weeks, the thoracic and marginal nuclei finish forming boundaries and occupy positions according to the topography, but the process of neuronal differentiation continues until birth. Conclusion. Understanding the stages of fetal development is critical for ensuring healthy pregnancies. So, considering the data we obtained, it became clear that the thoracic nucleus begins to form earlier than the marginal one. The difference in period is on average 3-4 weeks of gestation. Later, the thoracic nucleus acquires its characteristic shape, while the peripheral nucleus begins to separate from the surrounding tissues. The 29-30th week of gestation is characterized by the completion of the formation of both nuclei and their location by their inherent topography.

The Impacts of Inflammatory and Autoimmune Conditions on the Endometrium and Reproductive Outcomes.

Background: A healthy pregnancy begins with an adequate endometrial state, even before the arrival of a blastocyst. Proper endometrial priming and the development of a tolerogenic decidua are key steps in creating the perfect environment for implantation and pregnancy. In these processes, the involvement of the maternal immune system seems to be of great relevance, modulating the different decidual immune populations to prepare the endometrium for a potential pregnancy. However, certain local pathologies of an inflammatory and autoimmune nature appear to have a direct impact on these phenomena, thus altering patients' reproductive outcomes. Methods: This literature review analyzes original articles, reviews, systematic reviews, and meta-analyses published between 1990 and 2024, concerning the impact of different inflammatory and autoimmune conditions on endometrial status and fertility. The included papers were obtained from Medline (Pubmed) and the Cochrane library. Results: There is evidence that endometriosis, adenomyosis, and chronic endometritis, through the promotion of a chronic inflammatory environment, are capable of altering endometrial immune populations, and, thus, processes essential for early pregnancy. Among other effects, these conditions have been linked to impaired decidualization, alterations in progesterone responsiveness, and hindered placentation. Similarly, antiphospholipid syndrome (APS), thyroid dysfunction, diabetes, and other pathologies related to glucose and gluten metabolism, due to their autoimmune nature, also appear to have a local impact on the uterine environment, affecting reproductive success through different mechanisms, including altered hormonal response and, again, impaired decidualization. Conclusions: The management of inflammatory and autoimmune diseases in assisted reproduction patients is gaining importance due to their direct impact on the endometrium. It is necessary to follow current expert recommendations and established therapeutic approaches in order to improve patients' prospects, ranging from antibiotic treatment in chronic endometritis to heparin and aspirin in APS, as well as hormonal treatments for endometriosis/adenomyosis or a gluten-free diet in celiac disease. All of them and the rest of the therapeutic perspectives, both current and under investigation, are presented throughout this work, assessing the possible improvements for reproductive outcomes.

Inflammatory markers in relation to maternal lifestyle and adverse pregnancy outcomes in twin pregnancies

It is well known that inflammatory markers play an important role in the development and maintenance of healthy pregnancies. However, the literature regarding inflammation in relation to lifestyle and adverse pregnancy outcomes in twin pregnancies is remarkably uncovered. Therefore, this study aimed at evaluating the concentration of inflammatory markers in dried capillary blood spot samples from 523 women with twin pregnancies, included at a median gestational age of 21+1 weeks. The relationship between inflammatory markers and maternal lifestyle (current smoking status and pre-pregnancy body mass index) in addition to adverse pregnancy outcomes (preeclampsia, gestational diabetes mellitus, and small for gestational age) was analyzed. The study showed that active smoking at inclusion was associated with an elevated concentration of interleukin-8. Furthermore, maternal obesity was associated with an elevated concentration of C-reactive protein and monocyte chemoattractant protein-1. Analysis of the data showed no statistically significant variations in the concentration of the assessed inflammatory markers for neither preeclampsia, gestational diabetes mellitus, nor small for gestational age. The current study promotes future research on the pathophysiology of twin pregnancies in relation to adverse pregnancy outcomes, as the literature within the area remains scarce.

Evaluation of the diagnostic value of the HALP score, uric acid value, and uric acid-creatinine ratio in preeclampsia.

In this study, we aimed to evaluate the diagnostic value of the HALP score, serum uric acid value, and uric acid-creatinine ratio, which are inflammatory markers, in the diagnosis of preeclampsia (PE). One hundred sixty-six pregnant women who met the inclusion and exclusion criteria were included in the study. They were divided into two groups: 81 pregnant women diagnosed with PE (PE group) and 85 pregnant women with healthy pregnancies (control group). Demographic and obstetric stories of the groups; weeks of pregnancy at diagnosis; hematological and biochemical parameters; hemoglobin, albumin, lymphocyte, and platelet (HALP) score and serum uric acid-creatinine ratio (sUA/sCr); and the results of the newborns were recorded and compared between groups. There was no significant difference between the groups in terms of age, gravidity, parity, and body mass index (P values = 0.533, 0.188, 0.085, 0.915, resp.). Mean gestational age, mean birth weight, 1st and 5th minute Apgar scores, and mean umbilical cord pH values were lower in the PE group compared to the control group (P values = 0.0001 for all). Percentage of NICU admissions was higher in the PE group (P = 0.0001). HALP score of the PE group was significantly lower than the control group (2.2 vs. 3.2; P = 0.0001). Uric acid and sUA/sCr ratios were significantly higher in the PE group compared to the control group (for uric acid, 6.2 ± 1.7 vs. 4.5 ± 1.2; P = 0.0001; for sUA/sCr, 12.0 ± 4.0 vs. 9.9 ± 3.1; P = 0.0001). In diagnosing PE, serum uric acid had a sensitivity of 82.7% at values of 4.7 and above, 58% sensitivity at values of sUA/sCr ratio of 10.9 and above, and 3.7% sensitivity at HALP score values of 6.6 and above (P values = 0.0001, 0.001, 0.001, resp.). In our study, we found that the HALP score in PE was significantly lower than in healthy controls, and the uric acid value and sUA/sCr ratios were significantly higher. Diagnostic value of the serum uric acid value and then the sUA/sCr ratio were higher in PE. However, we found that the HALP score was insufficient for diagnosing PE.

Identification of Pregnancy Adverse Drug Reactions in Pharmacovigilance Reporting Systems: A Novel Algorithm Developed in EudraVigilance.

There is a need to strengthen the evidence base regarding medication use during pregnancy and to facilitate the early detection of safety signals. EudraVigilance (EV) serves as the primary system for managing and analysing information concerning suspected adverse drug reactions (ADRs) within the European Economic Area. Despite its various functionalities, the current format for electronic submissions of safety reports lacks a specific data element indicating medicine exposure during pregnancy. This paper aims to address the limitations of existing approaches by developing a rule-based algorithm in EV that more reliably identifies cases that are truly representative of an ADR during pregnancy. The study utilised the standardised MedDRA query (SMQ) 'Pregnancy and neonatal topics' (PNT) as a benchmark for comparison. Recognising that the SMQ PNT also retrieves healthy pregnancy outcomes, contraceptive failure, failed abortifacients as well as ADRs not associated with pregnancy, a novel algorithm was tailored to improve the accuracy of identifying suspected ADRs occurring during pregnancy. Upon testing, the algorithm demonstrated superior performance, correctly predicting 90% of cases reporting an ADR during pregnancy, compared to 54% achieved by the SMQ PNT. The implementation of the algorithm in EV led to the retrieval of 202,426 cases. The development and successful testing of the novel algorithm represents a step forward in pregnancy-specific signal detection in EV. Because signals associated with pregnancy may be diluted in a large database such as EV, this study lays the groundwork for future research to evaluate the effectiveness of disproportionality methods on a more refined subset of pregnancy-related ADR reports.

260-OR: Differences in Adipocyte Expandability and Function between Healthy Pregnancies and Pregnancies Complicated by Gestational Diabetes Mellitus and Preeclampsia

260-OR: Differences in Adipocyte Expandability and Function between Healthy Pregnancies and Pregnancies Complicated by Gestational Diabetes Mellitus and Preeclampsia

Rol del hospital de día de diabetes “Ana Goitia” en la reducción de la morbimortalidad materno-infantil

Background: Gestational diabetes is any degree of carbohydrate metabolism disorder that begins or is first diagnosed during pregnancy. It is the most common metabolic disease of pregnancy and a public health problem due to the high prevalence and maternal-fetal complications it can cause. For this reason, it is of vital importance the medical management in the detection of risk factors for the prevention of gestational diabetes, early diagnosis and adequate treatment and follow-up to reduce morbidity and mortality. Material and methods: A systematic literature review and a descriptive study of medical records of patients attended during the period 2022 in the diabetes day hospital of a mother and child hospital in the province of Buenos Aires were carried out. Results: It was observed that, out of 112 births to diabetic mothers, 100% of the women had a normal puerperium, 81% of the babies were born weighing less than 4000g and 9% had fetal macrosomia. Conclusion: In conclusion, the role of the day hospital has proven to be of great importance in reducing complications and promoting a healthy pregnancy. Interdisciplinary collaboration and personalized care are key to address maternal and infant morbidity and mortality

Serum lncRNAs TUG1, H19, and NEAT1 and their target miR-29b/SLC3A1 axis as possible biomarkers of preeclampsia: Potential clinical insights

To date, the epigenetic signature of preeclampsia (PE) is not completely deciphered. Oxidative stress-responsive long non-coding RNAs (lncRNAs) are deregulated in preeclamptic placenta; however, their circulating profiles and diagnostic abilities are still unexplored. We investigated serum redox-sensitive lncRNAs TUG1, H19, and NEAT1, and their target miR-29b/cystine/neutral/dibasic amino acids transporter solute carrier family 3, member 1 (SLC3A1) as potential non-invasive biomarkers of PE risk, onset, and severity. We recruited 82 patients with PE and 78 healthy pregnant women. We classified PE patients into early-onset (EOPE) and late-onset (LOPE) subgroups at a cut-off 34 gestational weeks and into severe and mild PE subgroups by blood pressure and proteinuria criteria. Bioinformatics analysis was employed to select lncRNAs/microRNA/target gene interactions. Serum H19, NEAT1, and SLC3A1 mRNA expression were reduced, meanwhile miR-29b levels were elevated, whereas there was no significant difference in TUG1 levels between PE patients and healthy pregnancies. Serum H19 levels were lower, whereas miR-29b levels were higher in EOPE versus LOPE. Serum miR-29b and H19 levels were higher in severe versus mild PE. ROC analysis identified serum H19, NEAT1, miR-29b, and SLC3A1 as potential diagnostic markers, with H19 (AUC = 0.818, 95%CI = 0.744–0.894) and miR-29b (AUC = 0.82, 95%CI = 0.755–0.885) were superior discriminators. Only H19 and miR-29b discriminated EOPE and severe PE cases. In multivariate logistic analysis, miR-29b and H19 were associated with EOPE, using maternal age and gestational age as covariates, while miR-29b was associated with severe PE, using maternal age as covariate. Studied markers were correlated with clinical and ultrasound data in the overall PE group. Serum H19 and TUG1 were negatively correlated with albuminuria in EOPE and LOPE, respectively. NEAT1 and SLC3A1 were correlated with ultrasound data in EOPE. Likewise, TUG1, miR-29b, and SLC3A1 showed significant correlations with ultrasound data in LOPE. Conclusively, this study configures SLC3A1 expression as a novel potential serum biomarker of PE and advocates serum H19 and miR-29b as biomarkers of EOPE and miR-29b as a biomarker of PE severity.

Individual-Level and Community-Level Predictors of Healthy Pregnancy Outcomes in Multigravid Black Women.

To identify individual- and community-level factors that predict the odds of multigravid Black women having consecutive pregnancies without adverse pregnancy outcomes. We conducted a secondary analysis of 515 multigravid Black women from a longitudinal observational study (2017-2019). We assessed the presence of adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, placental abruption, and pregnancy loss) for the index and prior pregnancies. We examined U.S. Census data, medical records, and surveys across multiple socioecologic domains: personal, behavioral, socioeconomic, and policy. We estimated adjusted odds ratios (aORs) and 95% CIs for the association between individual- and community-level factors and consecutive healthy pregnancies using hierarchical logistic regression models adjusted for maternal age, body mass index (BMI), gravidity, interpregnancy interval, and median household income. Among 515 multigravid Black women (age 27±5 years, BMI 31.4±8.9, gravidity 4±2), 38.4% had consecutive healthy pregnancies without adverse pregnancy outcomes. Individual-level factors associated with consecutive healthy pregnancies included normal glucose tolerance (aOR 3.9, 95% CI, 1.2-12.1); employment (aOR 1.9, 95% CI, 1.2-2.9); living in communities with favorable health indicators for diabetes, hypertension, and physical activity; and household income of $50,000 per year or more (aOR 3.5, 95% CI, 1.4-8.7). When individual and community factors were modeled together, only income and employment at the individual and community levels remained significant. Individual and community income and employment are associated with consecutive healthy pregnancies in a cohort of Black patients, emphasizing the need for comprehensive, multilevel systems interventions to reduce adverse pregnancy outcomes for Black women.

Choline-An Underappreciated Component of a Mother-to-Be's Diet.

The nutritional status of the mother-to-be has a key impact on the proper development of the fetus. Although all nutrients are important for the developing baby, recent research indicates the importance of adequate choline intake during the periconceptional period, pregnancy, and lactation. Choline plays a key role in the biosynthesis of cell membranes, supporting liver function, neurotransmission, brain development, and DNA and histone methylation. Choline participates in the formation of a child's nervous system, supports its cognitive development, and reduces the risk of neural tube defects. The human body is incapable of producing sufficient choline to meet its needs; therefore, it must be obtained from the diet. Current data indicate that most women in their reproductive years do not achieve the recommended daily intake of choline. The presented narrative review indicates the importance of educating mothers-to-be and thereby increasing their awareness of the effects of choline on maternal and child health, which can lead to a more aware and healthy pregnancy and proper child development.

Perivascular Adipose Tissue and Uterine Artery Adaptations to Pregnancy.

Pregnancy is characterized by longitudinal maternal, physiological adaptations to support the development of a fetus. One of the cardinal maternal adaptations during a healthy pregnancy is a progressive increase in uterine artery blood flow. This facilitates sufficient blood supply for the development of the placenta and the growing fetus. Regional hemodynamic changes in the uterine circulation, such as a vast reduction in uterine artery resistance, are mainly facilitated by changes in uterine artery reactivity and myogenic tone along with remodeling of the uterine arteries. These regional changes in vascular reactivity have been attributed to pregnancy-induced adaptations of cell-to-cell communication mechanisms, with an emphasis on the interaction between endothelial and vascular smooth muscle cells. Perivascular adipose tissue (PVAT) is considered the fourth layer of the vascular wall and contributes to the regulation of vascular reactivity in most vascular beds and most species. This review focuses on mechanisms of uterine artery reactivity and the role of PVAT in pregnancy-induced maternal vascular adaptations, with an emphasis on the uterine circulation.

THE EFFECT OF PRE-CONCEPTIONAL NUTRITION EDUCATION ON INCREASING KNOWLEDGE IN PRE-MARRIAGE WOMEN IN GARUT DISTRICT

Introduction: Many nutritional problems are associated with high maternal and child morbidity rates. Maternal health status is a determinant of the quality of future generations, so it is important to improve the nutritional quality of women early on. Pre-marital women are a priority for health improvement because they are in the pre-conception period. This is a crucial period because it will determine the quality of the pregnancy and the welfare of the baby being born. Knowledge as a factor that determines concern for the fulfillment of balanced nutrition. Special efforts through preconception nutrition education for brides and grooms need to be made in order to achieve a healthy family and quality offspring. The purpose of this study was to determine whether there was an increase in knowledge through pre-conceptional nutrition education for women of premarital childbearing age in Garut district. Objectives: The number of respondents in this study were 30 people selected by purposive sampling method. The data analysis used is the T-dependent statistical test because the data is normally distributed. Method: This study used a pre-experimental design with one group pre-posttest design. The population in this study were women of childbearing age who had planned a wedding in Garut district. Result: The results showed that preconception nutrition education had a significant effect (p value = 0.000) on knowledge with an average increase of 1.77. Conclusion: It is recommended that the health office and the ministry of religion organize nutrition education activities for premarital women in preparing for a healthy pregnancy.

Sick leaves among healthy pregnant Croatian healthcare workers during the COVID-19 pandemic due to loopholes in the occupational safety system.

The aim of this study was to explore occupational safety in pregnant Croatian healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. To this end we composed an anonymous questionnaire that included pregnancy data, risk assessment and mitigation, and workplace intervention and distributed it to HCWs through social media of their groups and associations. The study includes a total of 173 respondents (71.1 % physicians, 19.7 % nurses, 9.2 % other HCWs) diagnosed with pregnancy in 2020 and 2021. Employers were notified about HCWs' pregnancy at the eighth (IQR 7.0-11.0) week of pregnancy, which delayed workplace risk assessment and mitigation beyond the first trimester. Only 19.6 % of the participants had the risk assessed and mitigated, mostly on their own initiative (76.5 %). After notifying employers about pregnancy, 37.0 % of participants opted for temporary work incapacity (TWI) due to "pregnancy complications" despite healthy pregnancy, 16.8 % were granted a pregnant worker's paid leave at the expense of the employer, while 5.8 % continued to work at the same workplace. Nurses used the TWI benefit more frequently than physicians (58.8 % vs 30.1 %, P=0.004). Our findings suggest that occupational safety of pregnant HCWs in Croatia lacks clear-cut and transparent strategies to protect pregnant HCWs, forcing them to misuse the healthcare system.

Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Prediction of Pregnancy Loss: a Case-control Study.

The systemic inflammation response index (SIRI) and systemic immune inflammation index (SII) have recently been investigated as new prognostic markers for obstetric morbidities. However, there are few studies on their predictive role in patients with pregnancy loss. Predicting miscarriages may be useful to support and prevent selected cases.The aim of this study was to investigate the role of SIRI and SII in the prediction of pregnancy loss. A total of 800 patients were included in the retrospective case-control study at a tertiary hospital.Group 1 consisted of 200 patients who had a pregnancy loss for the first time; group 2 consisted of 200 patients with recurrent pregnancy loss; the control group consisted of 400 patients who had a healthy pregnancy. The groups were compared in terms of maternal characteristics, SIRI and SII. Receiver operating characteristic analysis was performed to determine optimal cut-off values for SIRI and SII in predicting pregnancy loss. SIRI and SII were higher in the group with recurrent pregnancy loss than in the control group (p < 0.001).SIRI was higher in the first pregnancy loss group than in the control group (p < 0.001).To predict recurrent pregnancy loss, optimal cut-off values were 1.57 (80% sensitivity, 70% specificity) and 924.12 (74% sensitivity, 57% specificity) for SIRI and SII, respectively. For first pregnancy loss prediction, the optimal cut-off value was 1.38 for SIRI, with 75% sensitivity and 60% specificity. SIRI and SII may be used as inflammatory markers to predict recurrent pregnancy loss. High SIRI values can also help to predict first pregnancy loss.

A causal model of eating behaviors among Thai pregnant women working in industrial factories

Abstract Objective This study aimed to examine the causal model of eating behaviors among pregnant women working in industrial factories. Methods This cross-sectional study was conducted on 210 participants, attending 4 healthcare centers, at a tertiary care hospital in Chonburi province, Thailand. Data were collected using 7 questionnaires: demographic form, eating behavior questionnaire, perceived benefits of the healthy eating questionnaire, perceived barriers to the healthy eating questionnaire, perceived self-efficacy questionnaire, social support questionnaire, and accessibility to healthy foods questionnaire. Descriptive statistics and path analysis were used for data analysis. Results The participants had relatively high mean scores for eating behaviors. The final model fitted well with the data χ2 = 12.86, df = 10, P = 0.23; χ2/df = 1.29; comparative fit index (CFI) = 0.98; goodness-of-fit index (GFI) = 0.98; adjusted goodness-of-fit index (AGFI) = 0.95; root mean square error of approximation (RMSEA) = 0.04. Four factors—perceived benefits (β = 0.13, P &lt; 0.05), perceived self-efficacy in healthy eating (β = 0.22, P &lt; 0.001), pregnancy planning (β = 0.28, P &lt; 0.001), and accessibility to healthy foods in the factory (β = 0.12, P &lt; 0.05)—positively affected eating behavior, while only perceived barriers to healthy eating had a negative effect on eating behavior (β = −0.24, P &lt; 0.001). All the above factors explained 27.2% of the variance in eating behaviors. Conclusions Nurses or healthcare providers can apply these findings to create an eating behavior modification program, focusing on pregnancy planning, behavior-specific variables, and interpersonal and situational influence, to promote the nutritional status of pregnant women working in industrial factories.

The placenta in fetal death: molecular evidence of dysregulation of inflammatory, proliferative, and fetal protective pathways

BackgroundIt is estimated that over 2 million cases of fetal death occur worldwide every year, but, despite the high incidence, several basic and clinical characteristics of this disorder are still unclear. Placenta is suggested to play a central role in fetal death. Placenta produces hormones, cytokines and growth factors that modulate functions of the placental-maternal unit. Fetal death has been correlated with impaired secretion of some of these regulatory factors. Objective(s)The aim of the present study was to evaluate, in placentas collected from fetal death, the gene expression of inflammatory, proliferative and protective factors. Study designCases of fetal death in singleton pregnancy were retrospectively selected, excluding pregnancies complicated by fetal anomalies, gestational diabetes, intrauterine growth restriction and moderate to severe maternal diseases. A group of placentas collected from healthy singleton term pregnancies were used as controls. Groups were compared regarding maternal and gestational age, fetal sex and birth weight. Placental mRNA expression of inflammatory (IL-6), proliferative (Activin A, TGF-β1) and regulatory (VEGF, VEGFR2, ATP-binding cassette (ABC) transporters ABCB1 and ABCG2, sphingosine 1-phosphate (S1P) signaling pathway) markers was conducted using real-time PCR. Statistical analysis and graphical representation of the data were performed using the GraphPad Prism 5 software. For the statistical analysis, Student’s t-test was used, and P values < 0.05 were considered significant. ResultsPlacental mRNA expression of IL-6 and VEGFR2 resulted significantly higher in the fetal death group compared to controls (P<0.01), while activin A, ABCB1 and ABCG2 expression resulted significantly lower (P<0.01). A significant alteration in the S1P signaling pathway was found in the fetal death group, with an increased expression of the specific receptor isoforms sphingosine 1-phosphate receptor 1, 3 and 4 (S1P1, S1P3, S1P4) and of sphingosine kinase 2 (SK2), one of the enzyme isoforms responsible for S1P synthesis (P<0.01). Conclusion(s): The present study confirmed a significantly increased expression of placental IL-6 and VEGFR2 mRNA, and for the first time showed an increased expression of S1P receptors and SK2 as well as a decreased expression of activin A and of selected ATP-binding cassette transporters, suggesting that multiple inflammatory and protective factors are deranged in placenta of fetal death.

Free ultrasound examination (ultrasound) with the theme "optimize pregnancy examination to guard a healthy pregnancy."

The health of pregnant women is one of the key factors in creating a healthy and quality next generation. To increase awareness and access of pregnant women to health services, especially pregnancy examinations. This activity aims to provide ultrasound services to pregnant women, so that they can monitor fetal development more optimally and detect early the possibility of abnormalities or complications during pregnancy. The implementation of this activity involves medical professionals who are experienced in the field of obstetrics and gynecology. Pregnant women who take part in this activity receive a thorough ultrasound examination, accompanied by consultation related to the results of the examination and education about the importance of health monitoring during pregnancy. The results of this activity show the high enthusiasm and need of the community for pregnancy health services, especially in areas that have limited access to health facilities. This activity is expected to be the first step in efforts to improve the quality of maternal and child health in the future. Community Service activities have been successfully carried out with a significant impact on the participants. The program not only provides pregnant women with wider access to quality pregnancy screenings, but also improves their understanding of the importance of health monitoring during pregnancy.

Non-Targeted Metabolomics Analysis of Mother and Infant in Gestational Diabetes Mellitus and Neonatal Clinical Characterization.

The goal was to analyze serums of GDM patients and healthy pregnant women using HPLC-MS and preliminarily screen differential metabolites by metabolomics. Sixty pregnant women who underwent elective cesarean section at term in Dongguan Dalang Hospital from January 2023 to April 2023 were selected and divided into the GDM group and healthy pregnancy group. Pre-pregnancy and pregnancy examination information, such as age, BMI, OGTT results, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and other clinical data were col-lected for statistical analysis. Non-targeted metabolomics of serum from 30 GDM patients and 30 healthy pregnant women were studied by HPLC-MS, and different ions were searched. The structures of differential metabolites were identified by HMDB database. The metabolic pathways of differential metabolites were analyzed by KEGG database. The OGTT result, pCO2, pO2, HCO3, BE, Apgar score, and bilirubin levels in the GDM group were higher than those in the healthy pregnancy group (p < 0.05). However, there were no significant differences in age, triglyceride, total cholesterol, newborn birth weight, newborn birth blood glucose, and blood gas pH between the two groups (all p > 0.05). Using p < 0.05 as the screening standard, 55 differential metabolites were identified in serum, mainly including fatty acyl, carboxylic acids and their derivatives, steroids and their derivatives, ketoacids and their derivatives, and pyrimidine nucleosides, etc., all of which were up-regulated or down-regulated to varying degrees. The 55 metabolites were mainly involved in the metabolism of pyrimidine, pyruvate, alanine, aspartic acid, glutamic acid, and arachidonic acid, glycolysis, and biosynthesis of unsaturated fatty acids. The discovery of these metabolites provides a theoretical basis for an indepth understanding of GDM pathogenesis. Non-targeted metabonomics analysis of blood metabonomics research technology has shown great potential value in the early diagnosis of obstetric diseases and the study of disease mechanisms.