Pregnancy Research Articles

Decreased PD-L1 contributes to preeclampsia by suppressing GM-CSF via the JAK2/STAT5 signal pathway

Programmed cell death protein 1 (PD-1) and its ligand PD-L1 have been detected at the materno-embryonic interface in both human and murine pregnancy models. However, research regarding the PD-1/PD-L1 signal in preeclampsia (PE) is limited. In the present investigation, 30 normal pregnant females and 30 PE patients were enrolled. Cellular functional experiments were performed in two trophoblast cell lines by transfection with lentiviral vectors for overexpression and down-regulation of PD-L1. The placental expressions of PD-1, PD-L1, and granulocyte macrophage colony-stimulating factor (GM-CSF) exhibited a notable reduction in PE cases compared with healthy pregnancies. Cellular functional experiments indicated that excessive PD-L1 expression significantly enhanced trophoblast migratory, invasive, and proliferative capabilities while inhibiting cell apoptosis. Additionally, the administration of lentivirus-mediated PD-L1 overexpression could alleviate clinical symptoms (hypertension, proteinuria) of PE-like rats. Therefore, decreased PD-L1 may contribute to PE by inhibiting GM-CSF via activating the JAK2/STAT5 pathway. Our study provides a novel pathway that can be targeted for the therapy of this disease.

Clinical Analysis of Congenital Duodenal Obstruction and the Role of Annular Pancreas

Background and Objectives: Congenital duodenal obstruction (CDO) is a very rare anomaly with an incidence of 1 in 5000–10,000 live births. Annular pancreas is one of the reasons for CDO and is defined as the pancreatic tissue encircling the duodenum. The exact cause of annular pancreas remains unclear. Materials and Methods: A retrospective study was conducted on all prenatally diagnosed cases of CDO, with the diagnoses and ethiology confirmed by surgery after birth from 1 January 2018 to 1 January 2024. The cases suspected of having CDO in their fetuses underwent ultrasound evaluations on a weekly or biweekly basis. The cohort was divided into two groups, “CDO with annular pancreas” and “CDO without annular pancreas”, in order to compare the clinical characteristics and outcomes. Results: A total of 34 cases of CDO were detected prenatally, with 30 of these cases being confirmed through postnatal surgical interventions. The underlying ethiology was duodenal atresia in 15 cases (50%), duodenal web in 2 cases (6.6%) and annular pancreas in 13 cases (43.3%). All cases had a dilated stomach and double bubble sign. Polyhydramnios was identified in all cases except for one. Three cases were terminated and intrauterine demise was observed in one case. Nine of the cases (33%) died in the postnatal period. In 19 cases (55.9%), CDO was associated with chromosomal abnormalities. Chromosomal abnormalities were significantly more common in the cases of CDO with annular pancreas (p = 0.033). Conclusions: The prenatal diagnosis of CDO is mostly based on findings of double bubble and polyhydramnios. An annular pancreas, although rare, is an important cause of neonatal duodenal obstruction. An accurate diagnosis is usually performed during a laparotomy. Given the higher rates of chromosomal abnormalities in cases of annular pancreas, it is clear that more reliable markers or imaging techniques are needed to detect the ethiology of CDO in the prenatal period.

Examining the association between maternal prenatal psychiatric disorders and behavioural problems among offspring in early childhood: population-based study.

Exposure to maternal mental illness during foetal development may lead to altered development, resulting in permanent changes in offspring functioning. To assess whether there is an association between prenatal maternal psychiatric disorders and offspring behavioural problems in early childhood, using linked health administrative data and the Australian Early Development Census from New South Wales, Australia. The sample included all mother-child pairs of children who commenced full-time school in 2009 in New South Wales, and met the inclusion criteria (N = 69 165). Univariable logistic regression analysis assessed unadjusted associations between categories of maternal prenatal psychiatric disorders with indicators of offspring behavioural problems. Multivariable logistic regression adjusted the associations of interest for psychiatric categories and a priori selected covariates. Sensitivity analyses included adjusting the final model for primary psychiatric diagnoses and assessing association of interest for effect modification by child's biological gender. Children exposed in the prenatal period to maternal psychiatric disorders had greater odds of being developmentally vulnerable in their first year of school. Children exposed to maternal anxiety disorders prenatally had the greatest odds for behavioural problems (adjusted odds ratio 1.98; 95% CI 1.43-2.69). A statistically significant interaction was found between child biological gender and prenatal hospital admissions for substance use disorders, for emotional subdomains, aggression and hyperactivity/inattention. Children exposed to prenatal maternal mental illness had greater odds for behavioural problems, independent of postnatal exposure. Those exposed to prenatal maternal anxiety were at greatest risk, highlighting the need for targeted interventions for, and support of, families with mental illness.

Pregnancy entails a U-shaped trajectory in human brain structure linked to hormones and maternal attachment

Growing evidence places the gestational period as a unique moment of heightened neuroplasticity in adult life. In this longitudinal study spanning pre, during, and post pregnancy, we unveil a U-shaped trajectory in gray matter (GM) volume, which dips in late pregnancy and partially recovers during postpartum. These changes are most prominent in brain regions associated with the Default Mode and Frontoparietal Network. The U-shaped trajectory is predominantly linked to gestational factors, as it only presents in gestational mothers and correlates with fluctuations in estrogens over time. Finally, the mother’s mental health status mediates the relationship between postpartum GM volume recovery and maternal attachment at 6 months postpartum. This research sheds light on the complex interplay between hormones, brain development, and behavior during the transition to motherhood. It addresses a significant knowledge gap in the neuroscience of human pregnancy and opens new possibilities for interventions aimed at enhancing maternal health and well-being.

Communicating neurological prognosis in the prenatal period: a narrative review and practice guidelines.

Clinicians may face an array of challenges in conducting fetal neurological consultations including prognostic uncertainty, a lack of training in fetal counseling, and limited opportunity to build rapport with families. In this setting, it is critical to employ high-quality, family-centered care to allow expectant parents to make informed decisions. Despite the challenges and gravity of these consultations, there remains limited data outlining best conduct and communication practices. This narrative review aims to summarize relevant literature around counseling within fetal neurology, focusing on three key themes: (1) discussing neurological prognosis and uncertainty, (2) navigating evolving decision making, (3) recognizing bias and understanding patient context. We provide practical recommendations to clinicians conducting fetal neurological counseling and outline future research priorities. IMPACT: Fetal neurological conditions can have a significant impact on child short- and long-term health outcomes. Prenatal consultations are an important venue to discuss information regarding fetal prognosis and decision making with expectant parents. However, there is limited evidence supporting best communication practices within this setting. This review summarizes current literature around expectant parent prognostic communication preferences and outlines practical recommendations and priorities for future research.

KDM6B-dependent epigenetic programming of uterine fibroblasts in early pregnancy regulates parturition timing in mice.

Current efforts investigating parturition timing mechanisms have focused on the proximal triggers of labor onset generated in late pregnancy. By studying the delayed parturition phenotype of mice with uterine fibroblast deficiencies in the histone H3K27me3 demethylase KDM6B, we provide evidence that parturition timing is regulated by events that take place in early pregnancy. Immediately after copulation, uterine fibroblasts engage in a locus-specific epigenetic program that abruptly adjusts H3K27me3 levels across their genome. In the absence of KDM6B, many of the adjusted loci over-accumulate H3K27me3. This over-accumulation leads to nearby genes being misexpressed in mid-to-late gestation, a delayed effect partly attributable to a second locus-specific but KDM6B-independent process initiated within uterine fibroblasts soon after implantation. This second process employs progressive H3K27me3 loss to temporally structure post-midgestational patterns of gene induction. Further dissection of the ways uterine programming controls parturition timing may have relevance to human pregnancy complications such as preterm labor.

Exposure to a choline-deficient diet during pregnancy and lactation alters the liver transcriptome profile in offspring of dams with fatty liver.

The developmental origin of health and disease hypothesis shows that early adverse exposures can have lifelong health effects. Thus, the aim of this study was to analyze the impact of choline intake during pregnancy and/or lactation on gene expression profiles in the liver of 24-day-old male rat offspring from dams with non-alcoholic fatty liver disease (NAFLD). Phenotypic characteristic, histological examination and global transcriptome pattern of liver tissue specimens obtained from offspring of dams suffering from fatty liver, provided with proper choline intake during pregnancy and lactation (NN), fed a choline-deficient diet during both periods (DD), deprived of choline only during pregnancy (DN), or only during lactation (ND), was performed. The global gene expression profile was analyzed by using microarray approach (Affymetrix® Rat Gene 2.1 ST Array Strip). The relative expression of selected genes was validated by real-time polymerase chain reaction (qPCR). The histological examination of rat liver sections indicated alternations typical for fatty liver in all analyzed groups with increased progression among groups deprived of choline. Choline deficiency in the maternal diet was associated with changes in body mass and composition but not with biochemical marker levels, except for the high density lipoprotein fraction of cholesterol (HDL). Enhanced expression of genes involved in oxidative stress, cell proliferation, activation of catabolic processes related to hepatocyte dysfunction and cell membrane composition were simultaneously observed in all choline-deficient groups. An adequate amount of choline in the diet of a mother with fatty liver during pregnancy and/or lactation can regulate gene expression in the offspring's liver and contribute to a milder stage of the disease in the progeny. Moreover, proper choline supply during the postpartum period is as crucial as during the prenatal period.

Substance Use and Use Disorders During Pregnancy and the Postpartum Period.

Substance use and substance use disorders (SUDs) among pregnant and postpartum individuals have risen dramatically, necessitating enhanced clinician education and intervention strategies. This expert review offers obstetricians and gynecologists (OBGYNs) a comprehensive overview of substance use during the prenatal and postpartum periods. We discuss the epidemiology, maternal and fetal adverse effects, as well as treatment approaches for major substances: nicotine, cannabis, alcohol, benzodiazepines, stimulants, and opioids. Additionally, we address the ethical and legal implications of substance use during pregnancy and emphasize the importance of equitable and non-stigmatizing care. By integrating evidence-based practices, we aim to support OBGYNs in providing optimal care for pregnant and postpartum individuals affected by SUDs.

Infants of diabetic mothers: epidemiology, pathophysiology, fetal heartassessment, structural and functional heart consequences: A narrative review.

Infants of diabetic mothers are neonates born to a woman who had periodic hyperglycaemia during pregnancy. Consequently, infants of diabetic mothers are at higher risks of illness besides morbidity and mortality due to teratogenic effects on the fetal cardiovascular system, causing most frequent CHDs. The primary purpose of this review is to present, on this topic, a better-comprehended review covering pertinent material and data to be informed of severe risks to a newborn's cardiac system and function. These conditions can affect maternal, fetal, neonatal, and future adult health. Further research should be addressed towards the early detection of diabetes, its magnitude, and management. Immediate interventions should be proposed to lessen the diabetes burden and its adversative effects during the prenatal period.

Wisdom tooth extraction: features of the procedure

The third molar (molar) is more often called the wisdom tooth or the "figure of eight" (the third molar is the 8th from the middle of the dentition). It is not preceded by a baby tooth, and the laying does not occur in the prenatal period, but at the age of 3-5 years. The "eight" erupts later than others, when the jaw bones have completely or partially stopped growing between the ages of 14 and 30, sometimes even later. Growth and eruption are completely dependent on the hereditary characteristics of the organism.

Maternal Care Behavior and Care for Children Under Two during the First 1000 Days of Life in Relation to Stunting Incidence in Simoro Village, Sigi Regency

Stunting remains a health problem in Central Sulawesi Province, as its prevalence is still above the national average. Sigi Regency, one of the regencies in Central Sulawesi, has a high stunting prevalence, reaching 26.4%. The risk factors for stunting include various factors, one of which is maternal care behavior during the prenatal, birth and postnatal periods, which are collectively known as care in the first thousand days of life. This study aims to investigate the maternal care behaviors of pregnant women and mothers of children under two years old during the first 1000 days of life in relation to the incidence of stunting in Simoro Village. This quantitative research uses a cross-sectional approach. The sample size in this study consists of 40 participants, including pregnant women and mothers of childrenunder two years old in Simoro Village, Sigi Regency. The sampling technique used is purposive sampling. Data collection through interviews using questionnaires.The analytical method used in this research was the Chi-Square test. The results show that there was a significant relationship between the knowledge variables (p=0.007), attitudes (p=0.031), and maternal care behavior variables during the first 1000 days. There is a significant relationship between maternal care behavior variables during the first 1000 days, namely the variable antenatal visits (p=0.027), compliance with consuming Fe tablets (p=0.006), and exclusive breastfeeding (p=0.032), with the variable incidence of stunting. The conclusion of this study is that there is a relationship between knowledge and attitudes and maternal care behavior during the first 1000 days, and there is a significant relationship between maternal care behavior (antenatal care visits, adherence to consuming Fe tablets, and exclusive breastfeeding) and exclusive breastfeeding. stunting incident in Simoro Village, Sigi Regency.

Association between microplastics in human amniotic fluid and pregnancy outcomes: Detection and characterization using Raman spectroscopy and pyrolysis GC/MS.

Microplastic contamination has emerged as a global environmental concern, while the limitation of single-technique identification methods in complex biological matrices calls for multi-analytical approaches for accurate microplastic detection. This study pioneers a dual-method approach, combining Raman spectroscopy and pyrolysis gas chromatography-mass spectrometry (Py-GC/MS), to investigate microplastics in human amniotic fluid. In total, samples from 48 pregnant women were collected and analyzed under stringent quality control measures, then Raman spectroscopy and Py-GC/MS were employed for comprehensive polymer identification and verification. Our analysis revealed 6 distinct microplastic polymer types in 39 subjects, with an average particle size of 3.05±1.05µm, polytetrafluoroethylene (PTFE, 31.25%), polystyrene (PS, 20.83%), and acrylonitrile-butadiene-styrene (ABS, 14.58%) being the most prevalent. Py-GC/MS analysis corroborated the Raman spectroscopy findings, identifying pyrolytic markers such as fluoroethylene for PTFE and styrene for PS. However, no significant associations were found between microplastic exposure and immediate adverse pregnancy outcomes. This study, for the first time, utilizes a dual-method approach combining Raman spectroscopy and Py-GC/MS to conclusively demonstrate the presence of diverse microplastics in human amniotic fluid, which underscores the need for larger-scale, longitudinal investigations to elucidate the potential long-term health implications of microplastic exposure.

The feasibility of implementing a digital pregnancy and postpartum support program in the Midwestern United States and the association with maternal and infant health.

The benefits of mobile applications in the prenatal period remain understudied. This study assessed associations between the Pregnancy Postpartum Support Program (PPSP), a digital wraparound service, and maternal and infant outcomes in a Medicaid population. A retrospective analysis was conducted on pregnant patients with Medicaid insurance who received care and delivered in a Midwestern United States healthcare system between 8/1/2022-8/15/2023, comparing outcomes among those who did versus did not opt for PPSP enrollment. Enrolled patients were offered a mobile device app providing weekly education, "twenty-four seven" support from a clinical team, and telehealth provider visits. Adjusted multiple covariate analyses were completed using linear and logistic regressions. Patient engagement, vendor-based interaction and perception of care data were also examined. 1912 patients were evaluated: 397 in the PPSP and 1515 in the control group. PPSP cohort inclusion was associated with 4% lower maternal length of stay (LOS) (p=0.05), 14% lower infant LOS (p<0.01), higher mean infant birthweight (p<0.01), lower odds of birthweight <2500g (p=0.05) and lower odds of preterm birth (p=0.04). Nearly 85% of all enrolled reported being "very satisfied" with the program. Overall, the program was positively received by PPSP participants. Favorable outcomes associated with enrollment may be due to the program, unmeasured variables, or both. Our study shows the feasibility of offering digital support to pregnant women who voluntarily enrolled in the PPSP and adds to the evidence evaluating virtual care strategies.

1,25-Dihydroxyvitamin D3 protects against placental inflammation by suppressing NLRP3-mediated IL-1β production via Nrf2 signaling pathway in preeclampsia

BackgroundMaternal vitamin D deficiency is associated with an increased risk of preeclampsia, a potentially life-threatening multi-system disorder specific to human pregnancy. Placental trophoblast dysfunction is a key factor in the development of preeclampsia, and the activation of NOD-like receptor protein 3 (NLRP3) inflammasome may play a crucial role in this process. Previous studies have suggested that vitamin D can exert beneficial effects by suppressing inflammasome activation, but the underlying mechanism has not been fully elucidated. This study aims to explore the protective effects of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on the placenta and to investigate the mechanisms by which 1,25(OH)2D3 attenuates NLRP3 inflammasome activation in a rat model of preeclampsia and hypoxia-cultured placental trophoblast cells. ResultsOur findings demonstrated that supplementation of rats with 1,25(OH)2D3 mitigated placental inflammation and prevented multi-organ dysfunction associated with preeclampsia. Treatment with 1,25(OH)2D3 inhibited inflammasome-mediated inflammation in trophoblast cells via its receptor VDR by reducing the expression of NLRP3, caspase-1, and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), decreasing IL-1β production, reducing mitochondrial reactive oxygen species generation, and enhancing the expression and enzymatic activity of Cu/Zn-superoxide dismutase (SOD). Mechanistically, 1,25(OH)2D3 upregulated nuclear factor erythroid 2-related factor 2 (Nrf2) signaling, subsequently suppressing NLRP3-mediated IL-1β overproduction in trophoblast cells. ConclusionsOur study indicates that 1,25(OH)2D3 inhibits NLRP3-mediated inflammation in trophoblast cells during preeclampsia by stimulating the Nrf2 signaling pathway and inhibiting oxidative stress.

Antagonisation of Prokineticin Receptor-2 Attenuates Preeclampsia Symptoms.

Preeclampsia (PE) is the most threatening pathology of human pregnancy. Placenta from PE patients releases harmful factors that contribute to the exacerbation of the disease. Among these factors is the prokineticin1 (PROK1) and its receptor, PROKR2 that we identified as a mediators of PE. Here we tested the effects of PKRA, an antagonist of PROKR2, on the attenuation of PE symptoms. We used the genetic PE mouse model, STOX1 that overexpresses Stox1 gene in a heterozygosis manner in the placenta. This model allowed exploiting two genotypes of the offspring, those that overexpress the Stox1 gene, and the WT that grow in a PE environment (STE). We characterised the effect PKRA (1 μM) on the attenuation of PE symptoms and compared its effects on STOX1 and STE placentas. We also used STOX1 overexpressing trophoblast cells to decipher the PROK1-underlying mechanism. We demonstrated that (i) antagonisation of PROKR2 attenuated PE-mediated hypertension and proteinuria, (ii) STE placentas and foetuses exhibited better outcomes in response to PKRA, (iii) the secretome of STOX1-trophoblasts impacted the integrity of the fetal vasculature that was attenuated by PKRA treatment. This study demonstrates the direct involvement of the PROK1 in PE and identifies PKRA as a promising therapy for PE.

Clinico-Demographic Profile and Maternal and Neonatal Outcomes of Rape Related Pregnancy in Western Visayas Philippines

Context: Pregnancy as a consequence of rape is a continuing and significant public health issue1. In this study, we explore the association between the clinico-demographic profiles and maternal and neonatal outcomes of rape-related pregnancy in Western Visayas Philippines. Method: We conducted an analytic cross-sectional study in two Department of Social Welfare and Development (DSWD) maintained women’s shelters in Western Visayas Philippines from February 2017 to June 2017. The validated questionnaire was divided into five parts: socio demographic profile of the pregnant residents; maternal and neonatal outcome of the pregnancy identified; perpetrator of the mother; custody of the newborn; and psychiatric consult. Only chart review was done by the DSWD Social Worker in charge of the Record Section to complete the research tool. Upon completion, the social worker turned over the data to the researcher. The researcher encoded and analyzed the data using SPSS trial version 21. Results: Records of 41 women who were admitted to the shelter were included. Most of them (90.2%) were teenagers’ ages 10 to 19 years old. They did not graduate high school (80.6%), no occupation (87.9%) and no income (82.9%). None of the 41 women were subjected to psychiatry check up during the prenatal period. Maternal outcome includes: undergone Cesarean section (14.6%); maternal complications (9.7%) and psychiatric diagnosis post-delivery (14.6%). Neonatal outcome includes: mortality rate of 2.4% and neonatal sepsis (43.9%). The rape incidents were incestuous (51.2%) and most of the newborns were transferred to other centers for placement (41.5%). Conclusions: The result of this study indicates that there is a need for a multi- disciplinary clinical and social management and planning for survivors of violence against women and children.

MORPHOGENESIS OF BRANCHIOGENIC GLANDS OF THE NECK IN THE FETAL PERIOD OF ONTOGENESIS

Branchiogenic glands play an important role in the control of calcium and iodine levels and thus have a direct impact on muscle contraction and neurotransmission. Variations in the structure and ectopic location of parathyroid and thyroid glands increase the complexity of thyroid and parathyroid surgery. Aim. To study the variants of structure and anatomical features of the parathyroid and thyroid glands at different stages of fetal development. Materials and methods. To study the anatomical variability of the branchiogenic glands of the neck in the fetal period of ontogenesis, we chose a set of classical methods of morphological research: morphometry, thin dissection under the control of a microscope, and photographic documentation. The material for the study were 48 preparations of human fetal cadavers from the 4th to the 10th month of intrauterine development. Digital parameters of organs and their correlation with neighboring organs and structures were grouped into appropriate age groups and processed by non-parametric methods of variation statistics with calculation of their arithmetic mean, its error and determination of probability of differences by Student's t-test using MS Excel and Biostatistics programs. The study was conducted in accordance with the main provisions of the Law of Ukraine ¹ 1801-XII "Fundamentals of the Legislation of Ukraine on Health Care", GCP (1996-2016), the Declaration of Helsinki of the World Medical Association for the Ethical Principles of Scientific Medical Research Involving Human Subjects (1964-2013), the Convention of the Council of Europe on Human Rights and Biomedicine (04.04.1997), Order of the Ministry of Health of Ukraine No. 690 dated 23.09.2009, and therefore concluded that the proposed study should be recommended for publication. The article is a fragment of the research work of the Department of Surgery № 1 of Bukovinian State Medical University: ‘Development, substantiation and implementation of new approaches to the diagnosis and treatment of some acute surgical diseases, prediction of their course and prevention of complications’, state registration number - 0121U110501: 01.2021-12.2025. Results. At the beginning of the fetal period of human ontogenesis there is an intensive development of the parathyroid glands. Variability of morphology of upper and lower parathyroid glands was found in 15 fetuses of 4-5 months of age. During this period, the following forms were observed: elongated, oval, bean-shaped, crescent-shaped. In the study of 15 fetuses at the age of 6-7 months, the following variations in the shape of the upper and lower parathyroid glands were found: oval, elongated, round, crescent, lenticular, bean-shaped. Topographically, we found the following variations in the location of the upper parathyroid glands: 1) between the upper and middle thirds of the thyroid lobes; 2) at the level of the upper third of the thyroid gland; 3) at the level of the middle third of the thyroid gland; 4) in the parenchyma of the thyroid gland; 5) above the thyroid lobes - 40% (20 cases), 36% (18 cases), 10% (5 cases), 8% (4 cases), 6% (3 cases), respectively. Conclusions. 1. The variants of the structure and topography of the thyroid gland, the upper parathyroid gland and the lower parathyroid gland, which we have identified, can be anatomical conditions for the development of both congenital pathology and variants of normal structure, which can nevertheless cause iatrogenic disorders during surgery. 2. In fetuses of 4-10 months of age, numerous variants of the structure and topography of the upper parathyroid gland and lower parathyroid gland are observed, which differ significantly from their typical structure. 3. The aplasia of the upper pineal gland detected in two human fetuses of 7 months of age is due to the peculiarities of their organogenesis and the formation of syntopia in the embryonic and prenatal periods of prenatal morphogenesis. 4. The obtained data on individual anatomical variability of the pineal glands should be taken into account by endocrinologists and ultrasonographers when performing diagnostic and surgical procedures.

Navigating the Digital Realm: An In-depth Analysis of Pregnancy Apps for Maternal Health and Nutrition

Due to the rise in nuclear families, many pregnant women utilize mobile applications to get information about pregnancy, labour, and postpartum care. The development of a baby takes nine months from egg to zygote to embryo to fetus to newborn (nine months to be precise). Whatever happens during this period before birth, determines what he is going to be like at the time of birth as well as in later life. Pregnancy is therefore of the utmost significance. Aim of the study was to analyze the already existing pregnancy apps for their content and quality provided on health care during pregnancy and proper nutrition care during prenatal period. To analyze these pregnancy apps, 40 apps available on Google Play Store were downloaded and installed on an Android phone. Each and every app is critically assessed by the investigator for its content and quality based on different criteria using self-structured schedule. Majority of the apps available on play store lacked crucial information related to health care and nutrition during pregnancy. However, it was determined that the material which was available was found accurate and relevant but insufficient. Women are increasingly using mobile apps to access information about pregnancy. There are several pregnancy apps available, however they do not meet the needs of Indian mothers who are expecting. These apps offer information, but it is sparse and difficult to understand. Therefore, it is necessary to create a pregnancy app specifically for Indian mothers that offers adequate information in Hindi and regional dialects.

Association between prenatal factors and incidence of stunting in toddlers aged 0 – 23 months: A case-control study

Background: Stunting is impaired growth caused by chronic malnutrition in the first thousand days of life divided into prenatal and postnatal period. The prenatal period starts from conception until before time of birth. It is caused by multifactor including dietary consumption, infectious diseases, maternal nutrition, socioeconomic factors, and environmental factors. Objective: This study aims to identify the correlation between prenatal factors and incidence of stunting in toddlers aged 0 – 23 months in the area of Puskesmas Guntur II (Guntur II Primary Health Care), Demak Regency.Methods: This was an analytic observational study with a case control design. Independent variables in this study were haemoglobin levels, iron tablet consumption behaviour, chronic energy deficiency (CED) status, maternal height, and antenatal care (ANC) frequency. Its sampling technique was a purposive and consecutive sampling. Its data were analysed by chi-square for bivariate analysis and logistic regression test for multivariate analysis.Results: The results of correlation between haemoglobin levels (p = 0,012; OR = 4,375; CI = 1,320 – 14,504), iron tablet consumption behaviour (p= 0,297; OR = 1,727; CI = 0,616 – 4,845), chronic energy deficiency status (p = 0,045; OR = 3,333; CI = 0,998 – 11,139), maternal height (p = 0,045; OR = 3,333; CI = 0,998 – 11,139), and ANC frequency (p = 0,067; OR = 2,667; CI = 0,924 – 7,699) with incidence of stunting . Risk factors for stunting based on multivariate analysis are chronic energy deficiency status (β = 1,703; p = 0,014; OR = 5,489; CI = 1,417 – 21,263) and frequency of ANC (β = 1,460; p = 0,018; OR = 4,307; CI = 1,287 – 14,417).Conclusion: The haemoglobin levels, maternal height, and CED status have significant correlation with incidence of stunting in toddlers aged 0 – 23 months. The CED status is the dominant risk factor of incidence of stunting in toddlers aged 0 – 23 months.

DYNAMIC S OF ERYTHROPOIESIS INDICATORS IN OFFSPRING UNDER PRENATAL EXPOSURE TO EXPERIMENTAL MATERNAL GENITOURINARY SYSTEM CHRONIC INFLAMMATORY PROCESS CAUSED BY P. MIRABILIS AND S. PYOGENES UROISOLATES

Introduction. Understanding the pathogenetic mechanisms underlying anemia in offspring caused by pathogenic factors associated with chronic inflammatory processes in the maternal genitourinary system can facilitate the development of new methods for prevention and treatment. The aim of this study was to investigate the impact of an experimental chronic inflammatory process in the maternal genitourinary system, induced by Proteus mirabilis and Streptococcus pyogenes, on the dynamics of erythropoiesis indicators in offspring. Materials and methods. Modeling of genitourinary system chronic inflammatory process caused by Proteus mirabilis and Streptococcus pyogenes was carried out on Wistar Albino Glaxo population female rats of reproductive age with the subsequent taking of one-week, one- and two-month-old offspring. Blood and blood serum of little rats was used for analysis. Hematological tests were conducted at the “MED-ECO” laboratory, including the assessment of serum iron levels, total iron-binding capacity, hemoglobin concentration, red blood cell count, hematocrit, erythropoietin concentration, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, reticulocyte count, and red cell distribution width (in both absolute values and percentages). Statistical analysis of the obtained data was performed using the Statistica 7 software. Results. A comparative analysis of erythropoiesis indicators revealed significant differences both between the experimental groups and between the experimental groups and the control group. The most pronounced changes were observed in erythropoietin levels, red blood cell counts, and hemoglobin content in the blood of 7-day-old animals, particularly in offspring exposed to a maternal genitourinary system chronic inflammatory process induced by P. mirabilis uroisolates. In this group, the indicators were significantly reduced compared to the control group (p≤0.001). A decrease in hemoglobin content relative to the number of erythrocytes suggests that the anemia observed has a compensatory nature. The noted trend of increased mean cell volume and mean cell hemoglobin values indicates activation of compensatory mechanisms in 2-month-old offspring. Hematocrit levels were reduced in all experimental groups compared to the control (p&lt;0.001), with the most substantial reductions observed in 7-day-old and 1-month-old rats exposed to the maternal genitourinary system chronic inflammatory process caused by P. mirabilis uroisolates. Conclusion. In the experiment, the dynamics in changes of erythropoiesis indicators has been revealed depending on type of causative agent of genitourinary system chronic inflammation and the age of offspring exposed to maternal genitourinary system chronic inflammatory process caused by uroisolates P. mirabilis and S. pyogenes in prenatal period. Deficiency of erythropoietin has been established in all experimental groups, especially in 2-month-old rats under the influence of P. mirabilis-induced genitourinary system chronic inflammatory process. The results of this experimental study confirm the involvement of impaired iron metabolism in the pathogenesis of anemia in offspring born from mothers whose pregnancy occurred against the background of genitourinary system chronic inflammatory process. The pathophysiological significance of changes in erythropoiesis indicators in the development of anemia in offspring prenatally exposed to a maternal genitourinary system chronic inflammatory process was established experimentally.