Maternal Parameters Research Articles

The Administration of Inactivated and Stabilized Whole-Cells of Saccharomyces cerevisiae to Gestating Sows Improves Lactation Efficiency and Post-Weaning Antimicrobial Use.

Increasingly hyperprolific sows and the need to reduce antibiotics represent challenges in pig farming. The aim of this work was to determine the effects of a postbiotic obtained from inactivated and stabilized whole-cells of Saccharomyces cerevisiae, administered during the sow's gestation, on the performance of the mother and litter. Maternal feed intake, productive parameters, colostrum quality and post-weaning piglets' health were assessed, including antibiotic consumption. The trial involved 183 sows, divided into two groups: (1) sows fed with a daily supplementation of postbiotic during gestation (n = 90); (2) sows without any supplement (n = 93). Piglets were followed up at two different post-weaning sites. The lactation efficiency of the treated sows improved by +5.9% (41.3 ± 11.4 vs. 35.4 ± 11.6%; p = 0.011). Lactating piglets' mortality was lower in the treated group (25.1 ± 16.7 vs. 28.8 ± 14.4%; p = 0.048). The same tendency was shown in both the weaning sites, together with a reduced antibiotic consumption in weaning site 1 (0.72 ± 0.25 vs. 1.22 ± 0.30 DDDvet/PCU; p = 0.047). The results suggest the role of this postbiotic administered to the mother in improving the health status of the piglets. Furthermore, lactation efficiency is suggested as an interesting parameter for assessing the efficiency of farming.

MATERNAL HYPOTHYROIDISM AND ITS EFFECTS ON NEONATAL THYROID FUNCTION: A RETROSPECTIVE STUDY

Objective: The objective of the study is to correlate maternal factors (age, parity, type of delivery, thyroid-stimulating hormone [TSH], and thyroxine [T4] values) and the newborn factors (gestational age, birth weight, and gender) with the TSH and T4 values of the newborn. Methods: A retrospective observational study was conducted on 90 hypothyroid mothers who were delivered at our Institute between January 2022 and March 2023. The 90 neonates born to these hypothyroid mothers underwent newborn screening tests for thyroid functions (tri-iodothyronine, T4, TSH) after 72 h of birth. These values were statistically analyzed with respect to maternal and fetal parameters. Results: 7 of the 90 neonates (7.77%) had elevated TSH values, i.e., >10 mIU/L. T4 values were abnormal in 31 neonates (34.4%), i.e., <11 ug/dL or >21.5 ug/dL but had normal TSH values. There was only one case where T4 levels were low and TSH level elevated. The correlation of TSH values with maternal and fetal parameters such as age of mother, parity, gestational age, baby weight, type of delivery, and the gender of the baby was not significant as p-values were all >0.05. There is a weak negative correlation (r=−0.044) between maternal TSH and neonatal TSH values which was statistically not significant. However, the maternal TSH and baby weight values are having positive correlation (r=0.113). Conclusion: Our study showed no significant correlation between maternal hypothyroidism and newborn TSH and T4 values which may be due to early antennal recognition and supplementation with levothyroxine.

Abstract P208: Cardiovascular Effects Of Antihypertensive Agents In A Rat Model Of Preeclampsia.

Introduction: Hypertensive disorders of pregnancy are a leading cause of maternal and neonatal morbidity and mortality. The placental origin of preeclampsia, characterized by hypertension and proteinuria after 20 weeks of gestation, is currently on the test bench. A number of studies reported a cardiovascular origin for preeclampsia, with increased long-term cardiovascular risk for affected women. Despite new insights into pathophysiology, there is a lack of evidence supporting improvement in maternal and neonatal outcomes with current antihypertensive therapy. This study aims to investigate maternal hemodynamics and cardiovascular parameters in a preeclamptic rat model, focusing on changes induced by antihypertensive treatment. Purpose: This study challenges blood pressure as the sole target for antihypertensive therapy in preeclampsia, seeking new insights into the disease's pathophysiology through invasive procedures and assessment of cardiac morphology in a rat model for preeclampsia. Methods: Maternal hemodynamics were invasively measured, and cardiac compliance was assessed via echocardiography. Cardiac phenotyping was performed combining the evaluation of physiology and structural changes. Maternal hearts were investigated at the end of pregnancy and postpartum. Blood pressure was continuously monitored using telemetry. The antihypertensive agents used in the study were methyldopa, nifedipine, and labetalol, which represent standard therapy for women with preeclampsia. Results: In the transgenic rat model for preeclampsia (PE), treatment with methyldopa and nifedipine led to a reduction of blood pressure during gestation whereas labetalol had no effect on the blood pressure (mean arterial pressure: PE 160.80±3.85 mmHg; PE+methyldopa 145.01±3.71 mmHg; PE+nifedipine 122.08±5.62 mmHg; PE+labetalol 163.12±3.12 mmHg). Despite the antihypertensive effects of methyldopa and nifedipine, the maternal hemodynamics as well as the cardiac compliance were unimproved during and after pregnancy. Conclusion: The results showed that standard therapy for women with preeclampsia does not seem to be sufficient to prevent the cardiovascular changes and therefore to reduce the CDV risk.

Changes in the Maternal Serum Inflammatory Parameters of Pregnant Women with Epilepsy

Changes in the Maternal Serum Inflammatory Parameters of Pregnant Women with Epilepsy

Effects of prenatal heat stress on birth weight and birth weight genetic parameters in German Holstein calves

The aim of this study was to infer the effects of heat stress (HS) during late gestation of dams on phenotypes and on direct and maternal genetic parameters for birth weight (BiW). We considered 171,221 Holstein calves kept in 56 large-scale co-operator herds. For a clear separation of maternal effects, only calves from dams with at least 3 offspring were included in the analyses. The genotype data set comprised 41,143 SNPs from 1,883 Holstein bulls. Temperature-humidity indices (THI) during the last 8 wk of gestation were calculated in each herd to reflect prenatal HS. A further prenatal HS descriptor was the first principal component (PC1) from principal component analysis considering the daily THI during the last 56 d of gestation. Regression coefficients of BiW on prenatal THI during the last 12 wk of gestation and PC1 were estimated in 13 consecutive phenotypic analyses. The strongest BiW decline was −0.63 kg per standardized THI, identified during 50 to 56 d before birth. A reaction norm model with weekly prenatal THI or PC1 nested within maternal genetic and maternal permanent environmental effects was defined to infer maternal sensitivity in response to prenatal THI alterations. Direct BiW heritabilities were close to 0.33 in the course of prenatal THI. Maternal BiW heritabilities marginally increased from 0.07 to 0.08 with increasing THI. Genetic correlations between maternal genetic effects at maximum HS levels and remaining THI were larger than 0.95, indicating the absence of genotype by time-lagged HS interactions. In contrast, maternal permanent environmental correlations between BiW at prenatal THI indicating HS with BiW at remaining THI substantially declined with increasing THI distances. Hence, from a herd management perspective, avoiding HS during the dry period of the dams will contribute to a slight increase in fetus growth.

Risks of urgent cesarean delivery preceding the planned schedule: A retrospective cohort study.

The aim of the study was to ascertain risk factors and outcomes of elective cesarean deliveries performed urgently prior to their scheduled date. Women carrying a viable singleton fetus who were scheduled for elective cesarean delivery at a tertiary medical center between 2012-2020 were identified by retrospective database. Differences in maternal and neonatal parameters between those who ultimately required urgent cesarean delivery and those who underwent the procedure as scheduled were analyzed. Of 4403 women who met the inclusion criteria, 559 underwent urgent cesarean delivery before the scheduled date. On multivariate analysis, factors significantly associated with a risk of transformation to an urgent cesarean delivery were chronic hypertension (aOR 1.92, 95% CI 1.30-2.83 P = 0.001), antenatal corticosteroids administration (aOR 3.26, 95% CI 2.38-4.47, P <0.001), and contraindication for vaginal delivery as the reason for elective cesarean delivery (aOR 1.67, 95% CI 1.32-2.12, P <0.001). Neonates born via urgent cesareans had an increased risk of 1-minute Apgar <7 (6% vs. 1.7%, P <0.001), intensive care unit admission (6.6% vs. 2.5%, P <0.001); their mothers were at risk of postpartum hemorrhage (5.9% vs. 3%, P = 0.001). The present study sheds light on the risk factors and maternal and fetal morbidities associated with elective cesarean deliveries that become urgent before the originally scheduled date. Physicians should take this information into account when planning an optimal date for elective cesarean delivery.

Determinants of Neonatal Mortality in the United States.

Introduction Despite a notable reduction in infant mortality over recent decades, the United States, with a rate of 5.8 deaths per 1,000 live births, still ranks unfavorably compared to other developed countries. This improvement appears inadequate when contrasted with the country's healthcare spending, the highest among developed nations. A significant proportion of this infant mortality rate can be attributed to neonatal fatalities. Objective The present study aimed to determine the risk factors associated with neonatal deaths in the United States. Method Using the United States Vital Statistics records, we conducted a retrospective study on childbirths between 2015 and 2019 to identify risk factors for neonatal mortality. Our final multivariate analysis included maternal parameters like age, insurance type, education level, cesarean section rate, pregnancy inductions and augmentations, weight gain during pregnancy, birth weight, number of prenatal visits, pre-existing conditions like chronic hypertension and prediabetes, and pregnancy complications like gestational diabetes mellitus (GDM). These variables were incorporated to enhance our model's sensitivity and specificity. Result There were 51,174 neonatal mortalities. Mothers with augmentation of labor had a 25% reduction in neonatal mortalities (NM) (OR=0.75; 95% CI 0.72-0.79), while labor induction was associated with a 31% reduction in NM (OR=0.69; 95% CI 0.66-0.72). Women above 40 years had a 29% increase in NM rate (OR=1.29;95% CI 1.15-1.44). Women without prenatal care have a 22% increase in the risk of NM (OR=1.22; 95% CI 1.14-1.30). The present model has a 60.7% sensitivity and a 99.9% specificity. Conclusion In the present study, significant interventions such aslabor induction, augmentation, and prenatal care were associated with improved neonatal outcomes. These findingscould serve as an algorithm for improving neonatal outcomes in the United States.

Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia

BackgroundVarious approaches using epidural analgesia have been employed for relieving labor pain and promoting spontaneous delivery. We aimed to evaluate the effect of nalbuphine and ropivacaine versus fentanyl and ropivacaine on the duration of delivery in parturients.MethodsClinical data of 160 full-term primiparous women who received either nalbuphine or fentanyl in combination with ropivacaine infusion for epidural labor analgesia in our hospital from December 2020 to May 2022 were retrospectively analyzed. The participants were divided into two groups based on anesthesia methods: nalbuphine group (NR group, n = 78) received 0.2 mg/mL nalbuphine combined with 0.1% ropivacaine hydrochloride for patient-controlled epidural analgesia (PCEA) and fentanyl group (FR group, n = 82) received 2 ug/mL fentanyl citrate and 0.1% ropivacaine hydrochloride for PCEA. Both groups received an epidural blockade for labor analgesia at lumbar 2–3 interspace. The duration of the first, second, and third stages of labor, the onset of analgesia, and time before delivery (T0), 15 min of analgesia (T1), 30 min of analgesia (T2), full opening of the uterine opening (T3),exerts force during childbirth(T4), heart rate (HR), blood pressure (BP), blood saturation (SpO2), visual analogue pain scale (VAS) score, Ramsay sedation score, and modified Bromage score, and 5 min were recorded at 2 h postpartum (T5). The neonatal Apgar score, neonatal behavioral neurological assessment (NBNA) score, maternal nausea, vomiting, and itchy skin were recorded.ResultsCompared with the FR group, the first stage of labor duration (p < 0.05) and total duration of labor (p < 0.05) were shortened and the onset of analgesia (p < 0.05) was increased in the NR group. NR group had lower incidence of urinary retention than FR group (p < 0.05). The maternal and neonatal investigational parameters and scores had no significant difference between the two groups.ConclusionsNalbuphine combined with ropivacaine in epidural block labor has a faster onset of analgesia and has a lower incidence of urinary retention than fentanyl combined with ropivacaine, and nalbuphine shortens the duration of the first and total stages of labor. Both nalbuphine and fentanyl can reduce pain during labor, have little effect on maternal hemodynamics, and have no significant effect on neonatal Apgar or NBNA scores.

Sodium molybdate dihydrate does not exhibit developmental or reproductive toxicity in Sprague-Dawley rats maintained on a marginal copper diet

Groups of 24 weanling female Sprague-Dawley rats were administered molybdenum (Mo) as sodium molybdate dihydrate (SMD) in drinking water at target dose levels of 0, 20, or 40 mg Mo/kg bw/day and fed a semi-purified marginal copper (6.2 ppm Cu) AIN-93 G diet for 8 weeks prior to mating, through cohabitation and pregnancy until Gestation Day 21. The objective was to confirm the reproductive and developmental effects of SMD reported by Fungwe et al. (1990) at estimated doses as low as 1.5 mg Mo/kg bw/day in a similarly designed study with marginal Cu diet (6.3 ppm). There were no test material-related effects at 20 or 40 mg Mo/kg bw/day on mortality, clinical observations, body weight, body weight gain, food consumption, estrous cycling, reproductive performance, maternal macroscopic pathology, ovarian or uterine parameters, litter size, resorptions, fetal sex ratio, fetal weight, or external fetal malformations or variations. Water consumption was increased compared to controls at both dose levels during the pre-mating and gestation periods, with no apparent adverse impact. There was no evidence of copper depletion in serum at any dose level. In conclusion, the no-observed-adverse-effect levels (NOAELs) for systemic, maternal reproductive, and developmental toxicity in this marginal Cu diet study are 40 mg Mo/kg bw/day, consistent with the results of guideline developmental and reproductive toxicity studies of SMD. The results of Fungwe et al. were not replicated, even at higher dose levels of Mo, and their inconsistencies with guideline toxicity studies of Mo are not explained by the marginal dietary Cu level.

Cord vitamin D levels in newborns and its clinical correlation

Vitamin D levels in newborns mainly depend on maternal vitamin D levels and maternal-fetal transfer of Vitamin D and its metabolites during pregnancy. Babies born to mothers with marked Vitamin D deficiency may have neonatal Rickets. There are many factors determining the Vitamin D levels in mother, like skin pigmentation, duration of sunlight exposure, body mass index, degree of altitude, clothing, sunscreen use, weather, air pollution, season and time of the day. Mothers with light - colored skin require a lesser duration of exposure as compared to mothers with dark-colored skin. If left untreated, children can develop hypocalcemic seizures, growth failure, irritability, lethargy, respiratory infections, and allergies, tetany, and laryngospasm and even dilated cardiomyopathy. Hence we performed this study to evaluated the role of cord vitamin D levels. Methods this was a prospective observational study performed on term neonates weighing &gt; 2.5 kg. Cord vitamin D was estimated at birth, and correlated with various maternal parameters such as anaemia, sun exposure, co-morbidities etc. Results: the mean cord vitamin D levels were low in those babies born to mothers with anaemia, lack of pre-natal supplementation of vitamin D and calcium, as well as less sun exposure. Conclusion: Cord vitamin D could be a marker of vitamin D deficiency in neonates born to mothers with risk factors like anaemia, lack of sun exposure and supplementation.

Performance of ‘Janani Suraksha Yojana (JSY)’ in Udaipur District of Rajasthan

Maternal health is crucial for a healthy family, a healthy society and a healthy nation. Poor maternal health has been a major issue of concern both at the global and national levels and many initiatives have been taken to improve it. It was one of the targets of the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). ‘Janani Suraksha Yojana (JSY) was launched in India in 2005 to reduce the maternal mortality ratio (MMR) by increasing institutional deliveries so that women can have better ante-natal and post-natal care with cash incentives. It is necessary to assess how this scheme has contributed to improvising maternal health parameters, especially in the low-performing areas at the time of its implementation. Thus, this paper tries to analyse the performance of JSY in the Udaipur district of Rajasthan which is majorly a tribal area and poor performing district of the poorly performing state in this regard and compare it with the state performance. For this purpose, the achievements of the five parameters related to maternal health and JSY, i.e., antenatal registration within 12 weeks, at least three antenatal check-ups, institutional deliveries, JSY beneficiaries and immunization were analysed for Udaipur and Rajasthan with the help of secondary data collected from Directorate of Medical, Health &amp; Family Welfare Services, Jaipur from the year 2008-09 to 2018-19. The composite performance index of JSY was also computed and compared to summarise its performance at both levels. It is concluded that the performance of JSY has improved in Udaipur and Rajasthan during the study period. Still, both are far from achieving the targets of JSY, especially of 100 per cent institutional delivery, and have to put in extra efforts to achieve them.

Frequency of Pregnancy Induced Hypertension (PIH) in Patients Presenting with Hypothyroidism

Objective: Preeclampsia is a potentially fatal condition during pregnancy and following delivery. Numerous organs' functions can be influenced by preeclampsia. It is crucial, as this illness may be linked to abnormalities in thyroid function. Therefore, the aim of this study was to assess the frequency of thyroid dysfunction and its association with hypertension in pregnant women. Methodology: This descriptive cross sectional study was conducted at Obstetrics and Gynecology Unit-I, Civil Hospital, Karachi, using a non-probability consecutive sampling technique. The duration of the study was about six months from October 2022 till March 2023. A total of 80 pregnant women who were between the ages of 18 and 40, had gestational ages between 20 and 40 weeks, and had laboratory results that suggested hypothyroidism were included in this study. A chi-square test was applied to evaluate the association between maternal age, parity, gestational age, serum levels of TSH and T4 and pregnancy induced hypertension. Results: The study findings showed that most of the women 33(41.25%) were between 26 to 35 years of age. The mean age of the pregnant women was 29.43±4.64 years. The mean parity was 1.74±0.83 and the mean gestational age was 30.33±5.22 weeks, and the mean duration of hypothyroidism was 4.27±2.06 years. Concerning thyroid parameters, the mean T4 was 5.79±1.21 pmol/L, and the mean TSH was 6.28±2.03 mIU/L. Additionally, there was an insignificant association observed between pregnancy induced hypertension and maternal age, gestational age, parity, and thyroid hormone parameters. Conclusion: This study concluded that alterations in the thyroid function of pregnant women led to pregnancy induced hypertension. Only 25% of hypothyroid pregnant women had gestational hypertension. Furthermore, age, parity, gestational age, and thyroid parameters of pregnant women were insignificantly associated with pregnancy induced hypertension. Keywords: Pregnancy induced hypertension, hypothyroidism, gestational age.

The herbicides glyphosate and glufosinate and the cyanotoxin β-N-methylamino-l-alanine induce long-term motor disorders following postnatal exposure: the importance of prior asymptomatic maternal inflammatory sensitization

BackgroundPrenatal maternal immune activation (MIA) and/or perinatal exposure to various xenobiotics have been identified as risk factors for neurological disorders, including neurodegenerative diseases. Epidemiological data suggest an association between early multi-exposures to various insults and neuropathologies. The “multiple-hit hypothesis” assumes that prenatal inflammation makes the brain more susceptible to subsequent exposure to several kinds of neurotoxins. To explore this hypothesis and its pathological consequences, a behavioral longitudinal procedure was performed after prenatal sensitization and postnatal exposure to low doses of pollutants.MethodsMaternal exposure to an acute immune challenge (first hit) was induced by an asymptomatic lipopolysaccharide (LPS) dose (0.008 mg/kg) in mice. This sensitization was followed by exposing the offspring to environmental chemicals (second hit) postnatally, by the oral route. The chemicals used were low doses of the cyanotoxin β-N-methylamino-l-alanine (BMAA; 50 mg/kg), the herbicide glufosinate ammonium (GLA; 0.2 mg/kg) or the pesticide glyphosate (GLY; 5 mg/kg). After assessing maternal parameters, a longitudinal behavioral assessment was carried out on the offspring in order to evaluate motor and emotional abilities in adolescence and adulthood.ResultsWe showed that the low LPS immune challenge was an asymptomatic MIA. Even though a significant increase in systemic pro-inflammatory cytokines was detected in the dams, no maternal behavioral defects were observed. In addition, as shown by rotarod assays and open field tests, this prenatal LPS administration alone did not show any behavioral disruption in offspring. Interestingly, our data showed that offspring subjected to both MIA and post-natal BMAA or GLA exposure displayed motor and anxiety behavioral impairments during adolescence and adulthood. However, this synergistic effect was not observed in the GLY-exposed offspring.ConclusionThese data demonstrated that prenatal and asymptomatic immune sensitization represents a priming effect to subsequent exposure to low doses of pollutants. These double hits act in synergy to induce motor neuron disease-related phenotypes in offspring. Thus, our data strongly emphasize that multiple exposures for developmental neurotoxicity regulatory assessment must be considered. This work paves the way for future studies aiming at deciphering cellular pathways involved in these sensitization processes.

Cost-effectiveness of the dual prevention pill for contraception and HIV pre-exposure prophylaxis.

Women in sub-Saharan Africa (SSA) experience the world's highest rates of both HIV infection and unintended pregnancy. The Dual Prevention Pill (DPP) is a novel multipurpose prevention technology (MPT) that co-formulates HIV pre-exposure prophylaxis (PrEP) and combined hormonal oral contraception into a single daily pill. As a dual indication product, the DPP may be preferred by women facing these overlapping health risks. However, most SSA countries face severe healthcare resource constraints. Research is needed to assess whether, in what populations, and in what use cases the DPP would be cost-effective. We augmented an agent-based SSA HIV model with maternal health parameters including unintended pregnancy, abortion, and maternal mortality. Based on a previous market analysis, we assumed a primary DPP user population of current oral contraceptive users ages 25-49, and alternative user populations in different risk groups (age 15-24, sex workers, HIV-serodiscordant couples) and baseline product use profiles (unmet need for contraception, oral PrEP use, condom use). In three geographies (western Kenya, Zimbabwe, South Africa), we estimated HIV infections averted, pregnancies averted, disability-adjusted life-years (DALYs) averted, and the incremental cost-effectiveness ratio (ICER) over a 30-year time horizon, assuming equivalent adherence to the DPP as to oral contraceptives, higher adherence, or lower adherence. The DPP is likely to be a cost-effective alternative to oral PrEP among users in need of contraception. Among women not already using PrEP, the DPP is likely to be cost-saving in sex workers and serodiscordant couples. The DPP is unlikely to be cost-effective in oral contraceptive users in the general population. Switching from oral contraception to the DPP could be net harmful in some settings and populations if it were to substantially reduces adherence to oral contraception. Results were robust to a range of time horizons or discount rates. The DPP has the potential to be cost-effective and cost-saving in populations at substantial HIV risk. Outcomes are sensitive to adherence, implying that effective counseling and decision-making tools for users considering the DPP will be essential. More research is needed to understand real-life adherence patterns and ensure health benefits achieved from contraception alone are not lost.

Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain.

Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55-5.75)] and low [OR = 4.39 (2.15-8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5-82.6) and 77.2% (53.5-88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD adherence could be related to gestational weight gain adequacy and that optimal adherence could reduce iron deficiency and/or anemia during pregnancy in the studied population.

Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratio in Preterm Premature Rupture of Membranes.

This study aimed to investigate maternal hematological laboratory parameters of pregnancies complicated with preterm premature rupture of membranes (PPROM) compared to mothers of healthy-term infants (control group). This case-controlstudy included 158 mothers who were divided into PPROM (n=67) and control (n=91) groups, respectively. Laboratory parameters of platelet, lymphocyte, and neutrophil counts, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) were recorded at the time of diagnosis for the PPROM group and at the time of hospital admission for birth for the control group. NLR was significantly higher in the PPROM group than in the control group (p=0.001). The cutoff value of NLR to predict PPROM was 6.73 (AUC=0.671, 95% confidence interval=0.58-0.75,p=0.000). A cheap and routine NLR blood test can be used to predict PPROM before labor.

The Trace Element Concentrations and Oxidative Stress Parameters in Afterbirths from Women with Multiple Pregnancies.

The aim of this study was to evaluate the intensity of oxidative stress by measuring the concentrations of lipid peroxidation products (LPO) in fetal membrane, umbilical cord, and placenta samples obtained from women with multiple pregnancies. Additionally, the effectiveness of protection against oxidative stress was assessed by measuring the activity of antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and glutathione reductase (GR). Due to the role of iron (Fe), copper (Cu), and zinc (Zn) as cofactors for antioxidant enzymes, the concentrations of these elements were also analyzed in the studied afterbirths. The obtained data were compared with newborn parameters, selected environmental factors, and the health status of women during pregnancy to determine the relationship between oxidative stress and the health of women and their offspring during pregnancy. The study involved women (n = 22) with multiple pregnancies and their newborns (n = 45). The Fe, Zn, and Cu levels in the placenta, umbilical cord, and fetal membrane were determined using inductively coupled plasma atomic emission spectroscopy (ICP-OES) using an ICAP 7400 Duo system. Commercial assays were used to determine SOD, GPx, GR, CAT, and LPO activity levels. The determinations were made spectrophotometrically. The present study also investigated the relationships between trace element concentrations in fetal membrane, placenta, and umbilical cord samples and various maternal and infant parameters in women. Notably, a strong positive correlation was observed between Cu and Zn concentrations in the fetal membrane (p = 0.66) and between Zn and Fe concentrations in the placenta (p = 0.61). The fetal membrane Zn concentration exhibited a negative correlation with shoulder width (p = -0.35), while the placenta Cu concentration was positively correlated with placenta weight (p = 0.46) and shoulder width (p = 0.36). The umbilical cord Cu level was positively correlated with head circumference (p = 0.36) and birth weight (p = 0.35), while the placenta Fe concentration was positively correlated with placenta weight (p = 0.33). Furthermore, correlations were determined between the parameters of antioxidative stress (GPx, GR, CAT, SOD) and oxidative stress (LPO) and the parameters of infants and maternal characteristics. A negative correlation was observed between Fe and LPO product concentrations in the fetal membrane (p = -0.50) and placenta (p = -0.58), while the Cu concentration positively correlated with SOD activity in the umbilical cord (p = 0.55). Given that multiple pregnancies are associated with various complications, such as preterm birth, gestational hypertension, gestational diabetes, and placental and umbilical cord abnormalities, research in this area is crucial for preventing obstetric failures. Our results could serve as comparative data for future studies. However, we advise caution when interpreting our results, despite achieving statistical significance.

Toward smartphone-based blood pressure monitoring

A single-centre, prospective longitudinal study to assess changes in maternal arterial stiffness and cardiac output parameters among low-risk healthy pregnant women.Thirty low-risk, healthy, pregnant women attending their routine antenatal dating ultrasound scan were recruited. Non-invasive assessment of arterial stiffness and cardiac output was undertaken at five gestational windows from 11 to 40 weeks of pregnancy. Data were analysed using a linear mixed model incorporating time and other relevant predictors as fixed effects, and patient as a random effect.Gestational age had a significant effect on all arterial stiffness parameters, including brachial augmentation index (AIx) (p = .001), aortic AIx (p = .002) and aortic pulse wave velocity (p = .002). The aortic AIx (%) reduced during pregnancy: the lowest mean (standard error, SE) was 4.07 (1.01) at 28 weeks before it increased to 7.04 (SE 1.64) at 40 weeks.Similarly, non-invasive assessments of cardiac output (p < .001), stroke volume (p = .014), heart rate (p < .001) and total peripheral resistance (p < .001) demonstrated significant changes with gestational age. Mean cardiac output (l/m) increased during pregnancy reaching a peak at 28 weeks gestation 6.66 (SE 0.28), but dropped thereafter to reach 5.71 (SE 0.25) around term.The current study provides pregnancy normograms for gestational changes in arterial stiffness and cardiac output parameters among low-risk, healthy pregnant women. Further work will be required to assess the risk of placental mediated diseases and pregnancy outcome among pregnant women with parameters outside the normal range.

The Value of Serum Fibrinogen/Uric Acid Ratio as a Novel Marker of Fetal Growth Restriction in Preeclampsia at 34 Weeks

Background: Fetal growth restriction (FGR) is a common alignment that complicates pregnancy, especially for preeclampsia cases; therefore earlier detection is crucial to improve the outcome. Objective: We examine whether the ratio of maternal serum fibrinogen to serum uric acid (ms F/U) can serve as a marker FGR in patients with preeclampsia at 34 weeks. Material and Methods: A cross-sectional study recruited 98 preeclamptic primigravidae at the University Teaching Hospital from June 2018 to June 2019. Patients were sent for laboratory and ultrasound examinations. Maternal parameters include systolic and diastolic blood pressure, serum fibrinogen, and serum uric acid. Ultrasonic fetal parameters include amniotic fluid index AFI, estimated fetal weight EFW, pulsatility index PI, and resistance index RI. Results: Pearson’s correlation between ms F/U ratio and all other feto-maternal variables was significant as P value was &lt;0.0001. The ms F/U ratio showed strong positive correlations with EFW and AFI. The ms F/U ratio showed strong inverse correlations with PI, RI, systolic, diastolic blood pressure, and albumin/creatinine ratio. The strength of association tested by a coefficient of Mallow showed the strongest association between ms F/U versus fetal weight. The highest Odd ratio for FGR was 45, associated with the ms F/U ratio. The cutoff value for ms F/U ratio was 26.08 mg/dL with an estimated sensitivity and specificity of 85% and 96.25%, respectively, with an AUC of 0.82. Conclusion: Strong and significant correlation of ms F/U ratio with feto-maternal parameters at high sensitivity and specificity added to its simplicity, and cost-effectiveness makes ms F/U ratio a reliable marker for earlier FGR to improve the outcome.

Prenatal Developmental Oral Toxicity Evaluation of Defatted Fenugreek Seed Flakes (FenuflakesTM) in Laboratory Rats

Fenugreek seed-based ingredients showed potential health benefits towards female-specific conditions. The present work is aimed to assess the prenatal oral toxicity of fibers and protein rich defatted fenugreek seed flakes (Fenuflakes™). The acute oral toxicity and dose range-finding studies in non-pregnant and pregnant rats were conducted before the main study. The selected doses of Fenuflakes (500, 1000, and 2000 mg/kg) were orally gavaged to rats daily from day 0 to day 19 (one day before the expected day of parturition) post-conception with the concurrent vehicle control (VC) group. On the 20th day of gestation, the maternal and embryo-fetal toxicity parameters were recorded after the cesarean sections of dams. Results: Fenuflakes in tested doses exposure did not show significant toxicological changes in maternal (body weights, food intake, anogenital distance, or clinical observations) and embryo-fetal evaluations (number of corpora lutea, resorptions, and implantations, or fetus weights, sex ratio or incidence of anomalies) compared with VC. Conclusion: Oral prenatal exposure to Fenuflakes was found safe with no significant maternal and embryo-fetal toxicities. The "No Observed Adverse Effect Level” (NOAEL) of Fenuflakes (&gt; 2000 mg/kg/day) can be used for risk assessment before human consumption in pregnant female population.