Later Stages Of Pregnancy Research Articles

The Role of Hyperemesis Gravidarum in the First-Trimester as a Predictor of Intrahepatic Cholestasis of Pregnancy

Background: Intrahepatic cholestasis of pregnancy (ICP) and hyperemesis gravidarum (HEG) are pregnancy-specific liver diseases associated with significant fetal and maternal complications. Typically, HEG is diagnosed in the first trimester of pregnancy, and ICP in the third trimester of pregnancy. The aim of this study is to investigate whether primigravid women diagnosed with ICP between the 26th and 37th weeks of pregnancy were also diagnosed with HEG during the first trimester, and to evaluate whether the diagnosis of ICP can be predicted in pregnant women with a prior diagnosis of HEG. Methods: Our study is a retrospective analysis. A total of 4000 pregnant women, aged 18 to 45 years and between 26th and 37th weeks of gestation, who presented to the Gynecology and Obstetrics Clinic of the Health Sciences University, Istanbul Training and Research Hospital with complaints of pruritus between 01/07/2018 and 01/07/2023, were screened. 227 patients were diagnosed with ICP. Complete medical records and blood test results were available for 141 patients. 39 patients with a history of previous pregnancies and/or comorbidities, as well as 30 patients without available serum total bile acids (TBA) results, were excluded from the study. Of these, 72 pregnant women who met the inclusion criteria were enrolled in the study and grouped into primigravid women with and without a history of HEG in the first-trimester. Demographic characteristics, gestational age, detailed medical history, ultrasound findings, and biochemical parameters—including alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, bilirubin, and fasting bile acid (FBA) levels were statistically compared. Results: In our study, comparisons revealed no significant differences in AST, ALT, alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and direct bilirubin levels (p > 0.05) between the groups with and without a history of HEG diagnosed with cholestasis. In pregnant women diagnosed with cholestasis, the total bilirubin and indirect bilirubin levels were significantly lower (p < 0.05) in the group with a history of HEG compared to the group without a history of HEG. In contrast, TBA levels were significantly higher (p < 0.05) in the group with a history of HEG compared to the group without a history of HEG. Conclusions: This study found that primigravid women with ICP and a history of HEG had elevated TBA levels, while total and indirect bilirubin levels were reduced. This suggests that patients with a history of HEG should be closely monitored in later stages of pregnancy for the development of ICP and potential liver damage. However, larger and more comprehensive studies are needed to confirm these findings.

Association of gestational weight gain rate with infant birth weight and cesarean delivery: A prospective cohort study in Nepal.

Gestational weight gain (GWG) is linked to pregnancy outcomes, such as birth weight and delivery mode, though research in low-income countries like Nepal is limited. We examined the association of GWG rate with infant birth weight and cesarean delivery in a prospective cohort of 191 pregnant women in Nepal, using data collected from August 2018 to August 2019 at a peri-urban hospital in Dhulikhel. Participants included women with singleton, full-term live births, with GWG rate calculated from weight gain between the second and late pregnancy stages, divided by the weeks in between. GWG rate categories-adequate, inadequate, or excessive-were defined by pre-pregnancy Body Mass Index (BMI) specific to GWG recommendations from the 2009 Institute of Medicine report. Ethical approval was obtained from Institutional Review Board of Kathmandu University and Rutgers University. Statistical analyses in SPSS and Stata revealed that 52.4% of mothers exceeded the recommended GWG rate, particularly among overweight and obese women (0.4 ± 0.2 kg/week and 0.5 ± 0.2 kg/week, respectively). The average birth weight was 2964.9 ± 407.0 grams, with 12% of infants classified as low-birth-weight. Cesarean delivery was recorded in 45% of the women. After controlling for factors like age, education, ethnicity, occupation, parity and BMI, each 1 kg/week increase in GWG from the second to third trimester correlated with a 392-gram increase in birth weight (β = 391.9, 95%CI = 67.2-716.7, p = 0.01), while excessive GWG rate led to a 148-gram increase over adequate GWG rate (β = 148.1, 95%CI = 8.7-287.5, p = 0.03). However, GWG rate was not significantly linked to cesarean delivery. These findings suggest that maternal GWG rate positively affects infant birth weight but not cesarean delivery, underscoring the need for larger studies to explore GWG rate's effects on maternal and neonatal outcomes.

Gambaran Penatalaksanaan Endorphin Masage Untuk Penurunan Skala Nyeri Punggung Bawah Ibu Hamil Trimester III di TPMB Bd. E Kecamatan Baregbeg

Back pain during pregnancy typically occurs in the third Trimestr. This discomfort is especially common in the later stages of pregnancy, during the third trimester, when the body undergoes significant changes to accommodate the growing baby.in Indonesia reaches 60% -80%. Efforts to reduce pain can use Endorphin Massage to release endorphin compounds, which act as natural pain relievers. The aim of thist research is to determin the description of the management of endorpin masage to reduce the the scale of lowers bak pain in third trimestr pregnan women at TPMB Bd. E Baregbeg District. The method in this research uses descriptive. Sample wer taken fom a population that me the inclusin criteria, a sample of 13 people using an accidental sampling techniqu. The research instrumen used the Numeric Rating Scal (NRS) sheet and SOP. The results obtained before the Endorphin massage were carried out, most of the respondents experienced moderate pain, 7 respondents (53.8%) and after the Endorphin masage, almost all respondents experienced mild pain, with 10 respondents (76.9%). Base on the research results, it is evident that ther is a decreas in the scal of lower back pain in thir trimestr pregnan women after receiving Endorphin massage. It is hoped that midwives will apply and integrate Endorphin massage techniques to help reduce symptoms of back paint in thir trimestr pregnan women.

Combination of body mass index and body fat percentage in middle and late pregnancy to predict pregnancy outcomes in patients with gestational diabetes in Wenzhou, China: a single-centre retrospective cohort study

ObjectivesThe present study aimed to evaluate whether body mass index (BMI) and body fat percentage (BFP) could be used to predict pregnancy outcomes in patients with gestational diabetes mellitus (GDM).DesignRetrospective...

The Impact of Macronutrient and Dietary Patterns on Gestational Diabetes Mellitus

Pregnancy is a physiological condition that increases insulin resistance (IR) due to hormonal changes, including elevated levels of estrogen, progesterone, and human placental lactogen (HPL). Such IR, especially in the later stages of pregnancy, can cause gestational diabetes mellitus (GDM), characterized by glucose intolerance first detected during pregnancy. GDM poses significant health risks for both the mother and the fetus, including the potential for pre-eclampsia, emergency C-sections, and type 2 diabetes (T2D) for the mother, as well as preterm birth, hypoglycemia, and being large for gestational age (LGA) for the baby. Proper dietary modifications can help regulate blood sugar levels, improve insulin sensitivity, and ensure healthy gestational weight gain (GWG), thereby reducing the possibility of undesirable outcomes. This paper discusses the role of energy, carbohydrate, fat, and protein, and compares the effects of the Mediterranean diet (MD) and Western diet (WD) on the risk of GDM. The main objective of this paper is to identify the most effective dietary strategies for preventing and managing GDM. The finding indicates that a MD rich in nutrient-dense foods, complex carbohydrates/lower GI, unsaturated fatty acids (FAs), and balanced protein has beneficial effects on GDM. In contrast, the WD with empty calories, simple carbohydrates/higher glycemic index (GI), saturated FAs (SFA), and animal-based protein increases the risk of GDM. Future studies should continue to explore the long-term effects of dietary interventions, integrate other lifestyle factors, and consider genetic differences to provide comprehensive management strategies for GDM.

Occurrence of Abortion in Different Breeds of Goats Reared under Semi-intensive Farming System at Organized Farms in Semi-arid Region of India

Background: Abortion is a major health problem of animals including goats, which results in significant financial losses for the farmers. The aim of the current study was to determine the occurrence of abortion in different breeds of goats reared under semi-intensive farming system at the organized farms in the semi-arid region of India, and to determine the relationship between the parity, season, and pregnancy stage of the aborted goats with the incidence of abortions. Methods: The data on the caprine abortions was collected and analyzed. The caprine abortions that occurred at the organized farms under a semi-intensive management system were categorized according to the season at the time of abortion, parity and pregnancy stage of the aborted goats. The Chi-Square test and ANOVA methods were used for the statistical analysis of the abortion data. Result: The occurrence of abortion in goats (combined farm) had a significant association with seasons and stages of pregnancy, whereas it was not associated with parities. Barbari, Jakharana and Jamunapari goats individually showed significant differences in abortion rates across various seasons, but did not exhibit significant variation in abortion rates with respect to different stages of pregnancy or parities. In the study, the majority of abortions were found in the winter season, followed by the rainy and summer seasons; similarly, most of the abortions were noticed in the later stage of pregnancy, followed by the mid- and early stages. There was the highest abortion rate in the goats with parity 3 and above, followed by the first and second parities. Further investigation is required to validate the current findings. In conclusion, the study revealed that abortion rates in goats are significantly influenced by seasonal changes and the stages of pregnancy.

A case of Peripartum Cardiomyopathy with associated Post-Cesarean section and Grand mal seizure

Peripartum cardiomyopathy (PPCM) is a rare but life-threatening disease in later stages of pregnancy. PPCM presents in the last month of pregnancy or within five months of puerperium in the absence of pre- existing heart disease. It remains a poorly understood entity and its management remains a topic of debate. Although majority recovers, long-term morbidity is quitecommon. Peripartum discomforts often mask and delay the diagnosis of PPCM. Unavailability of previous cardiac imaging is rather common and this makes the diagnosis even more complicated. Early and aggressive management towards reducing preload show evidence of better outcome. Here we report a case of PPCM presenting to us diagnosed after Caesarean Section followed by Grand mal seizure. Bangladesh Crit Care J September 2024; 12 (2): 163-166

Ancient Practice of Garbh Sanskar and its Importance in Modern Scenario

Garbh Sanskar is ancient practice of nurturing mental, physical and emotional environment of mother during her pregnancy stage to promote overall well-being of both mother as well as her unborn child. This ancient practice combines holistic habits that include balanced nutrition, Yoga, recitation of Mantra, prayer and meditation, etc. This process inculcates positive values in the subconscious mind of Garbh (fetus) and also nourish mother in all means to manifest optimal strength in all dimensions. The practices of Garbh Sanskar maintain well being of mother and child, these effects subsequently reflects in the later stages of pregnancy and after the child birth. The current scenario witnessed hampered pattern of life style which significantly deteriorate health of women carrying fetus, this may cause problem in normal child birth or disrupt health of new born. Therefore practices of Garbh Sanskar become crucial in modern’s day life style to prevent mother and child from the harmful effects of stressful pattern of current scenario. This article highlights ancient practice of Garbh Sanskar and its importance in modern scenario.

Effects of thiacloprid, a neonicotinoid pesticide, on rat reproductive system: Pregnancy hormone disruption and abortion trends

Thiacloprid (TCL), commonly known as Biscaya, is among the most widely used pesticides in agriculture, designed to eliminate insects by targeting their nicotinic receptors. This study explores the effects of orally administering TCL (at a dose of 50 mg/kg) on the hormone secretion crucial for pregnancy and the factors influencing abortion throughout the early, middle, and late stages of pregnancy in female rats.Following TCL exposure, there were significant increases in levels of 17β-Estradiol, prostaglandins F2α and E2, and serum oxytocin hormone in different stages of pregnancy. In contrast, progesterone and endothelin-1 serum levels notably decreased during the initial and final stages of pregnancy. Additionally, TCL led to a substantial rise in lipid peroxidation levels and a decrease in total thiol molecules and total antioxidant capacity, especially in uterine tissue. Although TCL did not significantly affect the morphological characteristics of the delivered fetuses, it notably increased the number of abortions, especially during the second and third stages of pregnancy.In summary, our findings suggest that TCL elevates the risk of abortion in pregnant rats by disrupting the secretion of hormones crucial for fertility (such as 17β-Estradiol/progesterone) and by increasing the secretion of abortion-inducing hormones like prostaglandins and oxytocin. Furthermore, these effects may be associated with disruptions in the oxidant/antioxidant balance within the ovaries and uterus.

The Adverse Effects of Anxiety and Depression on Pregnant Women with Hypothyroidism in Late Pregnancy.

Maternal depression and anxiety during pregnancy are significant public health concerns commonly reported worldwide among pregnant women. This study aimed to investigate the impact of anxiety and depression on thyroid function, pregnancy outcomes, and sleep quality among pregnant women with hypothyroidism in the later stages of pregnancy. Eighty cases of pregnant women with hypothyroidism in late pregnancy who were treated at Zhangjiakou First Hospital from January 2021 to October 2023 were selected for this retrospective study. The pregnant women in late pregnancy were divided into four groups according to the scores on the Hospital Anxiety and Depression Scale (HADS): control group with 20 cases, anxiety group with 18 cases, depression group with 22 cases, and anxiety-depression group with 20 cases. A comparison was made among the four groups regarding general information of pregnant women in late pregnancy, HADS scale scores, levels of free thyroxine (FT4, FT3), thyroid-stimulating hormone (TSH), occurrence of adverse pregnancy outcomes, and sleep quality at different time periods. There was no statistically significant difference in comparing general information among the four groups of pregnant women in late pregnancy (p > 0.05). There were statistically significant differences in HADS depression and HADS anxiety scores (p < 0.05), levels of FT4, FT3, TSH in pregnant women in late pregnancy postpartum (p < 0.05), occurrence of adverse pregnancy outcomes (p < 0.05), and comparison of sleep quality of pregnant women in late pregnancy at 1, 3, and 5 months of follow-up among the groups (F = 5.735, 23.930, 11.573, p < 0.05). Anxiety and depression significantly impact thyroid function, pregnancy outcomes, and sleep quality in pregnant women with hypothyroidism in late pregnancy, which is detrimental to the health of pregnant women in late pregnancy. Therefore, necessary interventions are needed.

Case study: May human norovirus infection be associated with premature delivery?

Human norovirus (HuNoV) is the leading cause of acute gastroenteritis. The varying severity of chronic infection in patients with underlying immune deficiencies poses additional burdens on public health. However, the potential effects of HuNoV infection during pregnancy, a specific immune perturbed state, have been rarely reported. Recently, four cases of HuNoV-infected patients in the late stages of pregnancy were admitted to the Guangzhou Women and Children's Medical Center, and premature rupture of membranes as primary adverse outcome was observed in these cases. Samples of fetal accessory tissue were collected from two of these cases at delivery to explore the potential pathogenesis. Pathological analysis showed placental malperfusion in both maternal and fetal vascular, while a decrease in vessels was not observed in villi of placenta. There was obvious pathological change in the chorion of fetal membrane, accompanied by a tendency of Th-1 immune bias. Notably, aggregation of M2 macrophages was observed in the chorion of the fetal membrane, potentially recruited for tissue repair. Next-generation sequencing showed minimal changes in immune pathways within placenta tissue. A gene panel associated with immunosuppression was identified in the fetal membrane of HuNoV-infected women compared to those of normal parturient. Taken together, this study provides clues for the association between the HuNoV and premature delivery, which requires the attention of the clinicians.

A Review of Interleukin-23/Interleukin-17 Inhibitor Exposure during Pregnancy in Patients with Psoriasis

Psoriasis is an immune cell-mediated chronic relapsing inflammatory skin disease that often develops during the reproductive years of women. The treatment of psoriasis during pregnancy is challenging as remarkable changes occur in the maternal body, and it requires the selection of therapy which is safe for both mother and fetus. The use of interleukin-23 (IL-23)/IL-17 inhibitors has been growing in psoriasis disease management and so the risk of their exposure during pregnancy is increasing too. However, human safety data in pregnancy are limited. This article aims to review pregnancy outcomes associated with IL-23/IL-17 inhibitor exposure in psoriasis patients and to see possible therapeutic options for psoriasis treatment during pregnancy. A search of the PubMed database up to June 2023 for articles was performed. The search strategy included a combination of terms as (pregnancy) AND (psoriasis) AND (Ustekinumab)/(Secukinumab)/(ixekizumab)/(brodalumab)/(guselkumab)/(tildrakizumab)/(risankizumab)/IL-23 inhibitors/IL-17 inhibitors. Resulted articles were reviewed manually for case reports, exposures from registries, and clinical trials. Most of the exposures to IL-23/IL-17 inhibitors were inadvertent, and therapy was suspended upon the detection of pregnancy. No signals on miscarriages, spontaneous abortions, and adverse developmental outcomes have been reported with first-trimester exposures to IL-23/IL-17 inhibitors. However, benefit–risk profile cannot be extrapolated based on first-trimester exposure as the transfer of these biologics across the placenta occurs in the later stage of pregnancy. More safety data from large cohorts of full-term exposure are required for IL-23/IL-17 inhibitors to consider them safe therapeutic options during pregnancy.

Gestational diabetes complicated with preterm birth: a retrospective cohort study

ObjectiveTo delineate the clinical characteristics of preterm birth (PTB) in the context of gestational diabetes mellitus (GDM).MethodsA retrospective cohort study was conducted, including 14,314 pregnant women with GDM who delivered at Fujian Provincial Maternity and Children’s Hospital from January 1, 2018, to December 31, 2021. PTB was stratified into late PTB (34–36 weeks of gestation) and early PTB (< 34 weeks) and pregnancy complications were analyzed.ResultsCompared to the term birth (TB) cohort, a higher prevalence of premature rupture of membranes, hypertensive diseases of pregnancy (HDP), intrahepatic cholestasis of pregnancy (ICP), anemia and cervical insufficiency was observed in the PTB cohort. Notably, early PTB increased the incidence of HDP, ICP, anemia and cervical insufficiency compared to late PTB. In the early stages of pregnancy, early PTB was characterized by elevated triglyceride (TG) levels and decreased high-density lipoprotein cholesterol (HDL-C) levels compared to late PTB. In the late pregnancy stages, early PTB was associated with increased white blood cell (WBC) and neutrophil counts. No disparities were observed in 75 g oral glucose tolerance test (OGTT) between early and late PTB.ConclusionEnhanced surveillance and management of GDM, particularly in the presence of HDP, ICP and anemia, are imperative to mitigate the risk of PTB. The lipid profile may serve as a predictive tool for early PTB in the early stages of pregnancy, warranting further studies.

Neurodevelopmental disorders in children born to mothers involved in maternal motor vehicle crashes.

To evaluate the association between maternal MVCs during pregnancy and neurodevelopmental disorders (NDDs, including intellectual disability, ADHD, ASD, and infantile cerebral palsy) in children. This population-based cohort of live births in Taiwan was analyzed, comparing children born to mothers involved in MVCs during pregnancy with those without such exposure. Children were linked to the insurance database to identify the possible diagnosis of NDDs. The Cox proportional hazards regression model was used to estimate the relative hazards. A total of 19,277 children with maternal MVCs and 76,015 children without exposure were included. Children exposed to maternal MVCs during the first two trimesters or whose mothers sustained mild to severe injuries showed a higher risk of intellectual disability. Severe maternal injuries also increased the risk of infantile cerebral palsy (aHR = 3.86; 1.27-11.78). MVCs in the third trimester, or mild maternal injuries, were associated with a higher risk of ASD (third trimester: aHR = 1.40; 1.04-1.87; mild injuries: aHR = 1.38; 1.09-1.74). Children exposed to maternal MVCs with severe injuries had a higher risk of intellectual disability and cerebral palsy. Third-trimester exposure may increase the risk of ASD. However, these findings should be interpreted cautiously as genetic factors may contribute to the observed association. There is some evidence linking maternal MVCs during pregnancy to the development of neurodevelopmental disorders in children. Children of mothers with severely injured were more likely to suffer from infantile cerebral palsy and intellectual disability. The risk of autism spectrum disorder is higher in children whose mothers are involved in MVCs during the late stage of pregnancy, and there is also an increased risk of intellectual disability during the first two trimesters.

Association of lipid levels at different stages of pregnancy with gestational diabetes mellitus and the incidence of neonatal macrosomia: A retrospective study.

To investigate the correlation between lipid levels during gestation and the incidence rate of gestational diabetes mellitus (GDM) and macrosomia. Clinical records of 607 pregnant women with GDM (GDM group) who delivered in the Obstetrics Department of Fujian Maternal and Child Health Hospital from May to December 2018 and of 833 women with uncomplicated pregnancies (control group) were retrospectively analyzed. After delivery, the entire cohort was further grouped based on the weight of the neonates: women who delivered newborns with body mass <4 kg comprised the normal group (n = 1367), and pregnancies that resulted in delivery of neonates with body mass >4 kg were classified as the macrosomia group (n = 73). Fasting serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and TG/HDL-C ratio were compared between the groups at the early (10-12 weeks), middle (24-28 weeks), and late (28 weeks-delivery) stages of pregnancy, and the correlation between the lipid indices and the rates of GDM and macrosomia were analyzed. There was a gradual increase in TC, TG, LDL-C, and TG/HDL-C levels with increasing gestational weeks in pregnant women. TG and TG/HDL-C levels were markedly higher, while HDL-C was lower in women with GDM compared with women of the same gestational age with uncomplicated pregnancies (p < 0.05). Lipid metabolism disorders exist in pregnant women with GDM at different gestational stages and are closely related to the higher incidence of macrosomia. TG, TG/HDL-C, and HDL-C in early and late pregnancy are independent risk factors for macrosomia in all trimesters, and TG/HDL-C ratio at different gestational stages has a good predictive value for macrosomia.

3D printing of realistic body phantoms: Comparison of measured and simulated organ doses on the example of a CT scan on a pregnant woman.

Medical examinations or treatment of pregnant women using ionizing radiation are sometimes unavoidable. In such cases, the risk of harm to the embryo and fetus after exposure to ionizing radiation must be carefully estimated. However, no commercially available anthropomorphic body phantoms of pregnant women are available for dose measurements. A promising possibility for the production of body phantoms for patient groups that are not adequately represented by the phantoms of reference persons is 3D printing. However, this approach is still in the evaluation phase. To print the abdomen of a woman in the late stage of pregnancy and compare the dose distribution measured using thermoluminescence dosimeters (TLDs) in the printed phantom for two different computed tomography (CT) protocols with the corresponding results of Monte Carlo simulations on voxel models of the pregnant woman. The physical phantom was produced through multi-material extrusion printing using different print materials identified in previous studies to simulate homogeneous soft tissues and the mean compositions of maternal and fetal bones. The 3D printed abdomen was combined with a conventionally produced anthropomorphic female phantom to obtain a whole-body phantom of a pregnant woman. Dose values resulting from two different CT scans acquired at tube voltages of 80 and 120kV were measured using TLDs positioned in the physical phantom and cross-validated with the results of Monte Carlo simulations performed for two different voxel models. The first was a voxelized model of the produced phantom itself and the second a realistic digital model of a pregnant woman. Representative CT values of the materials used in the printed phantom were determined from the acquired CT images. The CT values of maternal and fetal tissue structures in the phantom are comparable to CT values of real human tissues. The difference between most organ doses measured in the 3D printed phantom and simulated in the voxel models was below 20% and equivalent within the measurement uncertainties. Only the dose to the fetal head was up to 50% higher and not equivalent for the realistic model and the 80kV-protocol. As expected, the agreement was better for the voxelized than for the realistic model. For both models a slight energy dependence was observed, with larger deviations for the 80-kV protocol especially for organs located in the pelvic region. Individualized physical body phantoms, such as that of a pregnant woman, can be produced using 3D printing. The good agreement between measured and simulated doses to the fetus cross-validates both dosimetric methods. Therefore, this study demonstrates the suitability of 3D printing phantoms for patients not adequately represented by commercially available body phantoms of reference persons.

Association Between Particulate Matter Exposure and Preterm Birth in Women With Abnormal Preconception Thyrotropin Levels: Large Cohort Study.

Prior research has linked exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) with preterm birth (PTB). However, the modulating effect of preconception thyroid stimulating hormone (TSH) levels on the relationship between PM2.5 exposure and PTB has not been investigated. This study aimed to assess whether preconception TSH levels modulate the impact of PM2.5 exposure on PTB. This cohort study was conducted in Guangdong, China, as a part of the National Free Pre-Pregnancy Checkups Project. PM2.5 exposure was estimated by using the inverse distance weighting method. To investigate the moderating effects of TSH levels on trimester-specific PM2.5 exposure and PTB, we used the Cox proportional hazards model. Additionally, to identify the susceptible exposure windows for weekly specific PM2.5 exposure and PTB, we built distributed lag models incorporating Cox proportional hazards models. A total of 633,516 women who delivered between January 1, 2014, to December 31, 2019, were included. In total, 34,081 (5.4%) of them had abnormal preconception TSH levels. During the entire pregnancy, each 10-μg/m3 increase in PM2.5 was linked to elevated risks of PTB (hazard ratio [HR] 1.559, 95% CI 1.390-1.748), early PTB (HR 1.559, 95% CI 1.227-1.980), and late PTB (HR 1.571, 95% CI 1.379-1.791) among women with abnormal TSH levels. For women with normal preconception TSH levels, PM2.5 exposure during the entire pregnancy was positively associated with the risk of PTB (HR 1.345, 95% CI 1.307-1.385), early PTB (HR 1.203, 95% CI 1.126-1.285), and late PTB (HR 1.386, 95% CI 1.342-1432). The critical susceptible exposure windows were the 3rd-13th and 28th-35th gestational weeks for women with abnormal preconception TSH levels, compared to the 1st-13th and 21st-35th gestational weeks for those with normal preconception TSH levels. PM2.5 exposure was linked with a higher PTB risk, particularly in women with abnormal preconception TSH levels. PM2.5 exposure appears to have a greater effect on pregnant women who are in the early or late stages of pregnancy.

Single-cell transcriptomic analysis of immune cell dynamics in the healthy human endometrium

The microenvironment of the endometrial immune system is crucial to the success of placental implantation and healthy pregnancy. However, the functionalities of immune cells across various stages of the reproductive cycle have yet to be fully comprehended. To address this, we conducted advanced bioinformatic analysis on 230,049 high-quality single-cell transcriptomes from healthy endometrial samples obtained during the proliferative, secretory, early pregnancy, and late pregnancy stages. Our investigation has unveiled that proliferative natural killer (NK) cells, a potential source of endometrial NK cells, exhibit the most robust proliferative and differentiation potential during non-pregnant stages. We have also identified similar differentiation trajectories of NK cells originating from proliferative NK cells across four stages. Notably, during early pregnancy, NK cells demonstrate the highest oxidative phosphorylation metabolism activity, and, in conjunction with macrophages and T cells, exhibit the strongest type II interferon response. With spatial transcriptome data, we have discerned that the most robust immune-non-immune interactions are associated with the promotion and inhibition of cell proliferation, differentiation and migration during four stages. Furthermore, we have compiled lists of stage-specific risk genes implicated in reproductive diseases, which hold promise as potential disease biomarkers. Our study provides insights into the dynamics of the endometrial immune microenvironment during different reproductive cycle stages, thus serving as a reference for detecting pathological changes during pregnancy.

Association Between Maternal Copper/Zinc Intake and the Risk of Preterm Birth

Background: The relationship between maternal copper and zinc intake and the risk of preterm birth is unclear Objectives: This study was designed to investigate the effects of daily copper and zinc intake before and during pregnancy on the risk of preterm birth and to assess whether there is an interaction between copper and zinc intake and the risk of preterm birth Methods: A nested case - control study was conducted in Lanzhou, involving 880 cases and 8017 controls. Eligible participants were interviewed about their diet and characteristics during pregnancy. Unconditional logistic regression was used to determine the association between dietary copper and zinc intake and the risk of preterm birth, including its clinical subtypes. A multivariate adjusted restricted cubic spline (RCS) model was used to investigate the nonlinear relationship between dietary copper and zinc intake and the risk of preterm birth. Results: The study revealed that compared to pregnant women with the highest dietary copper intake before and during pregnancy, those with copper intake in the lower three quartiles (quartiles 1, 2, and 3) had increased risks of preterm birth, with adjusted odds ratios (ORs) of 1.05 (0.96 - 1.14), 1.05 (0.93 - 1.18), and 1.04 (0.82 - 1.32), respectively. The trend test yielded significant results (P = 0.013), particularly in late pregnancy, indicating an association between lower copper intake and increased risks of preterm and spontaneous preterm birth. Maternal dietary zinc intake during pregnancy was positively associated with the risk of preterm birth. The adjusted ORs for quartile 2 compared to quartile 4 were 1.29 (1.09 - 1.52), 1.55 (1.13 - 2.12), and 1.20 (1.00 - 1.46) throughout pregnancy, indicating significantly increased risks in the mid to late stages of pregnancy. No significant association was found between zinc intake and medically induced preterm birth. Zinc intake below the nutritional reference value in late pregnancy was significantly associated with an increased risk of preterm birth (P &lt; 0.05). A nonlinear relationship was observed between copper/zinc intake and the risk of preterm birth (P Nonlinear &lt; 0.05). A synergistic effect of low copper and zinc intake on the risk of preterm birth was found (OR: 2.23, 95% CI: 1.64 - 3.04, P &lt; 0.001). Conclusions: Efforts to promote adequate copper and zinc intake before and during pregnancy need to be intensified to reduce the incidence of preterm birth.

Application of the electrocardiography method for the diagnosis of foaling in horses

Diagnosis of pregnancy is a responsible and integral procedure in the list of measures aimed at obtaining a healthy horse population. Pregnancy confirmation can be performed using different methods, with ultrasound examination (US) being the most widespread and universal. However, this method has some limitations and disadvantages. An alternative to the ultrasound method for diagnosing pregnancy and monitoring the fetus in the middle and late stages of pregnancy can be the electrocardiography (ECG) method. A description of this method for recording the biopotentials of the fetal heart is found in Soviet and modern foreign literature. However, this method of research is not reflected in modern Russian literature and in practice has been undeservedly forgotten. The purpose of this study is to update data on the described diagnostic method, as well as to assess the possibility and reliability of using the ECG method for diagnosing and monitoring pregnancy in horses.The experiment involved a Hanoverian mare whose pregnancy was confirmed by ultrasound. ECG registration was performed on days 121, 150, 184, 214, 245, 276, 304, 335 of pregnancy.As a result of the research, the following was established. The earliest period of pregnancy at which it was possible to detect a fetal ECG was 150 days. By the 11th month of pregnancy, there was a clear trend towards a decrease in the fetal heart rate and a significant increase in the voltage of the fetal teeth.This type of research is easily reproducible in the field, does not require expensive equipment, is characterized by a high level of objectivity of the data obtained and can be recommended for use in the daily practice of an equine veterinarian. As a research prospect, to identify general patterns and distinguish between states of conditional norm and pathology, it can be recommended to conduct further studies with a larger sample of animals.