Newborns Of Pregnant Women Research Articles

PREGNANT WOMEN WITH INADEQUATE PRENATAL CARE AND NEUROLOGICAL REPERCUSSIONS ON NEWBORNS

To understand the neurological repercussions on newborns of pregnant women with inadequate prenatal care, it is crucial to explore how the quality of prenatal care can influence children's neurological development. Inadequate prenatal care can result in deficiencies in medical monitoring, such as lack of nutritional supplementation, insufficient monitoring of fetal growth and inadequate treatment of maternal conditions that directly affect the neurological development of the fetus. Objective: Analyze and synthesize the available evidence on the implications neurological disorders in newborns whose mothers received inadequate prenatal care. Methodology: followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist, using databases such as PubMed, Scielo and Web of Science. The descriptors used were "prenatal care", "neurological outcomes", "neonates", "inadequate care" and "neurodevelopment". The inclusion criteria were studies published in the last 10 years, focused on inadequate prenatal interventions and their neurological consequences in newborns, available in English, Spanish or Portuguese. Exclusion criteria included studies unrelated to the topic, non-systematic reviews and studies with small samples. Results: revealed that pregnant women with inadequate prenatal care have a higher incidence of neurological complications in newborns, such as delays in motor and cognitive development, in addition to greater vulnerability neurological diseases such as cerebral palsy. Conclusion: improvements in the quality of prenatal care are essential to mitigate these repercussions and promote better neurological health outcomes in newborns. This review highlights the importance of public health policies that guarantee adequate prenatal care for all pregnant women.

Clinical outcomes in newborns of pregnant women with COVID-19: integrative review.

to analyze clinical outcomes in newborns of pregnant women with COVID-19. integrative review conducted in PubMed, Web of Knowledge, SCOPUS, CINHAL; 2,111 studies were obtained, and 8 articles comprised the final sample. clinical outcomes in neonates of pregnant women positive for COVID-19 were classified according to the following categories: a) contamination by COVID-19, reported in 62.5% of the studies; b) hospital discharge due to improvement, mentioned in 37.5% of the articles; c) death, representing rare cases in 25% of the sample. The most prevalent gestational complication was prematurity, mentioned in 75% of the studies. This complication has been observed due to cases of premature rupture of membranes and placental abruption. despite the knowledge of asymptomatic and mildly symptomatic behavior in neonates, it is important to continue the search for new clinical data, as this public has uncertain reactions to SARS-CoV-2 infection.

Association between different treatment timings and adverse neonatal outcomes in pregnant women with syphilis during pregnancy

Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.

Advantages of sensor-augmented insulin pump therapy for pregnant women with type 1 diabetes mellitus.

To evaluate the efficacy of sensor-augmented pump (SAP) for improving obstetric and neonatal outcomes among pregnant women with type 1 diabetes mellitus by comparing it with continuous subcutaneous insulin infusion plus self-monitoring of blood glucose (continuous subcutaneous insulin infusion [CSII]/SMBG). This retrospective cohort study included 40 cases of pregnancy complicated by type 1 diabetes mellitus treated with SAP (SAP group), and 29 cases of pregnancy complicated by type 1 diabetes mellitus treated with CSII/SMBG (CSII/SMBG group). The obstetric and neonatal outcomes were compared between the two groups. The median of the glycoalbumin levels in the first (18.8% vs 20.9%; P < 0.05) and second (15.4% vs 18.0%; P < 0.05) trimesters, the hemoglobin A1c levels in the peripartum period (6.1% vs 6.5%; P < 0.05) and the standard deviation score of birthweights (0.36 vs 1.52; P < 0.05) were significantly lower in the SAP group than in the CSII/SMBG group. The incidence rate of large for gestational age newborns was significantly lower in the SAP group than in the CSII/SMBG group (27.5% vs 65.5%; P < 0.05). No significant differences in the incidence rates of hypertensive disorders of pregnancy, small for gestational age, respiratory distress syndrome, neonatal hypoglycemia, hypervolemia and hyperbilirubinemia were observed between the groups. The present study showed that SAP therapy is more effective in preventing large for gestational age newborns in pregnant women with type 1 diabetes mellitus than CSII/SMBG.

Analysis of risk factors of neonatal hypoglycemia and its correlation with blood glucose control of gestational diabetes mellitus: A retrospective study.

This study aimed to investigate the risk factors associated with neonatal hypoglycemia and its correlation with blood glucose control in patients with gestational diabetes mellitus (GDM). This study was a retrospective study. 880 pregnant women with GDM and their newborns were hospitalized from January 2018 to December 2022 in our hospital. The clinical information of GDM pregnant women and their newborns were reviewed and the hemoglobin A1c (HbA1c) values measured within 1 week before delivery were collected. According to the occurrence of neonatal hypoglycemia, which was divided into the control and observation groups. Logistic regression model was used to estimate the potential factors associated with neonatal hypoglycemia. The association between HbA1c of pregnant women before delivery and abnormal glucose metabolism in newborns was examined using spearman correlation analysis. A total of 104 cases of hypoglycemia occurred in neonates delivered by 880 GDM women and the incidence of neonatal hypoglycemia was 11.82%. There were significant differences in pre-pregnancy overweight or obesity, delivery mode, maternal blood sugar control effect and neonatal feeding standard between the 2 groups of GDM women (P < .05). Pre-pregnancy overweight or obesity, poor blood sugar control in GDM women, and improper neonatal feeding were risk factors for neonatal hypoglycemia. The results of logistic regression analysis showed that abnormal glucose metabolism in newborn (odds ratio [OR]: 2.43, 95% confidence interval [CI]: 1.12-4.73) and neonatal hypoglycemia (OR: 3.04, 95% CI: 1.33-5.79) were a risk factor. We also conducted the logistic analysis to evaluate the correlation between HbA1c before delivery and abnormal glucose metabolism in newborns of pregnant women with GDM through adjusting some potential factors. The results were still significant in the abnormal glucose metabolism in newborn (OR: 2.84, 95% CI: 1.23-6.63) and neonatal hypoglycemia (OR: 3.64, 95% CI: 1.46-8.18). Overweight or obesity of GDM parturient before pregnancy, poor blood glucose control of GDM parturient and improper feeding of newborns are all risk factors for neonatal hypoglycemia. HbA1c before delivery has a certain predictive value for abnormal glucose metabolism in newborns.

Gebelerde Yalnızlık, Sosyal Destek ve Yenidoğanın Hijyenik Bakımına Hazır Oluşluk Arasındaki İlişkinin İncelenmesi

Objective: In the study, we aim to examine the relationship between loneliness, social support, and readiness to hygienic care for newborns in pregnant women. Materials and Methods: The descriptive, cross-sectional and correlational study was conducted on primigravida pregnant women (n=254). The data were collected by using Questionnaire Form, the UCLA Loneliness Scale (UCLA), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Scale for Readiness of Pregnant Women to Hygienic Care of the Newborn (SRPWHCN) were evaluated with Pearson correlation analysis. Results: Median NO2 levels for all countries decreased between 1-The mean age of the pregnant women was 25.75±4.64. A significant relationship was found between various descriptive characteristics of the pregnant women and the scales. It was determined that there was a significant negative relationship between MSPSS and some sub-dimensions and UCLA of the pregnant women (p&amp;lt;0.05). There was a negative relationship between the mean scores of the UCLA and SRPWHCN of the pregnant women and a positive relationship between the mean scores of the MSPSS and SRPWHCN. Conclusions: It was observed that the risk of loneliness increased as social support decreased in pregnant women and their readiness for hygienic care of their newborns decreased as their level of loneliness increased.

Development and Evaluation of a Machine Learning Prediction Model for Small-for-Gestational-Age Births in Women Exposed to Radiation before Pregnancy.

Exposure to radiation has been associated with increased risk of delivering small-for-gestational-age (SGA) newborns. There are no tools to predict SGA newborns in pregnant women exposed to radiation before pregnancy. Here, we aimed to develop an array of machine learning (ML) models to predict SGA newborns in women exposed to radiation before pregnancy. Patients’ data was obtained from the National Free Preconception Health Examination Project from 2010 to 2012. The data were randomly divided into a training dataset (n = 364) and a testing dataset (n = 91). Eight various ML models were compared for solving the binary classification of SGA prediction, followed by a post hoc explainability based on the SHAP model to identify and interpret the most important features that contribute to the prediction outcome. A total of 455 newborns were included, with the occurrence of 60 SGA births (13.2%). Overall, the model obtained by extreme gradient boosting (XGBoost) achieved the highest area under the receiver-operating-characteristic curve (AUC) in the testing set (0.844, 95% confidence interval (CI): 0.713–0.974). All models showed satisfied AUCs, except for the logistic regression model (AUC: 0.561, 95% CI: 0.355–0.768). After feature selection by recursive feature elimination (RFE), 15 features were included in the final prediction model using the XGBoost algorithm, with an AUC of 0.821 (95% CI: 0.650–0.993). ML algorithms can generate robust models to predict SGA newborns in pregnant women exposed to radiation before pregnancy, which may thus be used as a prediction tool for SGA newborns in high-risk pregnant women.

EFFECT OF ZINK TABLETS INTERVENTION IN ZINC DEFICIENCY OF TRIMESTER III PREGNANT WOMEN TOWARD WEIGHT AND BODY LENGTH OF NEWBORN

Background: According to 2018 World Health Organization (WHO) data globally, an estimated 17.3% of the population has inadequate zinc intake, with estimates ranging from 5.7% in Oceania to 7.6% in Europe, 9.6% in America and the Caribbean, highest in Africa (23.9%) and Asia (19.6%). Zinc is important for the function of a number of enzymes and growth hormones during pregnancy. In pregnant women, the relative zinc concentration decreases up to 35% due to the influence of hormonal changes and the transport of nutrients from mother to baby.&#x0D; Objectives: The purpose of this study was to identify the effect of giving zinc tablets to pregnant women with zinc deficiency in the third trimester on body weight and length of babies born at the Makassar City Health Center.&#x0D; Methods: This type of research is True Experimental with a pretest-posttest design with a control group. The sample in this study was 62 samples of third trimester pregnant women, and the sampling technique used was purposive sampling. Measurement of zinc levels in third trimester pregnant women using the Elisa reader kit at the Research Laboratory of the Hasanuddin University Teaching Hospital. The research instruments were in the form of a research explanation sheet, respondent's consent sheet, respondent's checklist sheet, and the mother's zinc tablet consumption control sheet for 14 days.&#x0D; Results: Judging from the average value of newborns in pregnant women who did not have zinc deficiency, the average value of birth weight in pregnant women with zinc deficiency was 15.70 g/dL and 18.95 g/dL. zinc deficiency with a value (p &lt; 0.05), while pregnant women with zinc deficiency have an average birth length of 10.00 g/dL and mothers who do not have a deficiency of 19.87 g/dL with a value (p &lt; 0.05). So, it can be concluded that giving zinc tablets to pregnant women in the third trimester has an effect on Birth Weight (BBL) and Birth Length (PBL).&#x0D; Conclusion: Giving zinc tablets has an effect on increasing zinc levels in third trimester zinc deficiency pregnant women and increasing birth weight and length of the baby.&#x0D;

Repeated cesarean section surgery in women with two or more scars on the uterus

Objective: To monitor the outcome of surgical delivery of pregnant women with two or more uterine scars aft er Cesarean section.Materials and Methods: A retrospective study was performed based on the Krasnoyarsk Regional Clinical Center for Maternal and Child Health. The analysis of birth histories and histories of newborns in pregnant women who delivered by Caesarean section with two or more scars on the uterus within 2020 was carried out. Inclusion criteria: single pregnancy of 22 weeks or more, the presence of two or more scars aft er Cesarean section. Exclusion criteria: pregnancy less than 22 weeks, one scar on the uterus, and a scar on the uterus aft er other operations. Pregnant women with multiple pregnancies.Results: The severity of the adhesive process in the abdominal cavity was noted only in patients with three or more uterine scars. An increase in the duration of the Cesarean section operation of more than 60 minutes was observed in the group with three uterine scars and more (40%). Low risk of injuries to neighboring organs, intestines, ureters, and bladder was observed in groups of patients with both two and three uterine scars. More oft en, intraoperative massive blood loss was noted in the group with three scars on the uterus and more (16.67%). Moderate and severe asphyxia in newborns was registered in the group with three or more uterine scars (16.65%).Conclusion: Th e presence of one and/or two scars on the uterus aft er Cesarean section allowed the authors to classify these pregnant women as a low-risk group. The presence of three or more scars on the uterus aft er Cesarean section classifi ed these pregnant women as a high-risk group.

Metabolomics study on the newborns of pregnant women with gestational diabetes

To investigate the metabolic changes of umbilical cord blood in pregnant women with gestational diabetes mellitus(GDM) compared with pregnant women with normal glucose tolerance, and to analyze the effect of GDM on neonatal metabolism. Pregnant women in the first trimester were recruited in the cohort study in Taicang District, Jiangsu Province from 2014 to 2016. Oral glucose tolerance test was used to diagnose GDM, at 24-28 weeks of gestation. Pregnant women with GDM were taken as the case group and normal pregnant women as the control group. Five mL of umbilical cord blood was collected from full-term newborns, and non-target metabolites in serum samples were detected by ultra high performance liquid chromatography-tandem mass spectrometry. The t test, principal component analysis and orthogonal partial least square analysis were used to analyze the difference of metabolites in umbilical cord blood between the two groups. The metabolic pathways involved in the markers were analyzed according to P& lt; 0. 05 and variable importance projection(VIP)& gt; 1. 0. The metabolic pathways involved in the markers were analyzed based on the KEGG database. According to the result of GDM diagnosis, 42 pregnant women with GDM and 39 control pregnant women were included. A total of 868 small molecular metabolites were detected in umbilical cord blood samples. The concentrations of 41 metabolites were different between groups(P& lt; 0. 05 and VIP& gt; 1. 0), including 18 kinds of amino acid metabolites, 9 kinds of lipid metabolites, 5 kinds of exogenous compounds, 4 kinds of nucleotide metabolites, 3 kinds of peptides, 1 kind of vitamin(pantothenic acid) and 1 kind of coenzyme(gulonic acid). γ-glutamylalanine in the GDM group was lower than that in the control group(P& lt; 0. 01), and other compounds in the GDM group were higher than those in the control group(P& lt; 0. 05). Combined with pathway analysis, the above metabolites are mainly involved in lysine degradation pathway and aminoacyl tRNA biosynthesis pathway. Compared with the newborns of pregnant women with normal blood glucose, the metabolites in cord serum from full-term newborns of pregnant women with GDM are mainly characterized by the increase of some amino acids and lipid metabolites.

Maternal consumption of ultra-processed foods and newborn exposure to perfluoroalkyl substances (PFAS).

Evolving evidence shows that ultra-processed food consumption may increase exposure to chemicals used in food packaging and production, such as per- and poly-fluoroalkyl substances, phthalates, and bisphenols. Studies suggested that these contaminants may be transferred from mother to child through placenta, increasing concerns for both maternal and child health. This study aimed to investigate the association of maternal consumption of ultra-processed foods with newborn exposure to perfluoroalkyl substances (PFAS) in the PIPA Project (The Rio Birth Cohort Study on Environmental Exposure and Childhood Development). The pilot cohort study conducted with 131 pregnant women-child pairs in a public maternity school in Rio de Janeiro, Brazil, was assessed. Maternal dietary intake in the third trimester of pregnancy was evaluated using a qualitative food frequency questionnaire. Food items were classified as non-ultra-processed food and ultra-processed food using the NOVA system and regular consumption of ultra-processed foods was estimated. Newborns of pregnant women who weekly consumed three or more subgroups of ultra-processed food presented the highest level of PFAS (2.47ng/mL; 95%CI: 1.22; 3.72), compared to non-consumption of ultra-processed food investigated (0 ultra-processed food = 1.86ng/mL; 95%CI: 1.38; 2.50). Additionally, cluster analysis grouped ultra-processed food, fish, and PFAS levels. In conclusion, we found increased levels of PFAS in newborns whose mothers were higher consumers of ultra-processed foods.

Can first trimester pregnancy-associated plasma protein-A predict the surfactant needs of preterm neonates?

Low values of pregnancy associated plasma protein A (PAPP-A), have been shown to be associated with some poor gestational outcomes, especially those related to placental deficiency such as pre-eclampsia and fetal growth restriction as well as preterm labor. The aim of this study was to compare first trimester PAPP-A MoM values with the surfactant needs of newborns of pregnant women who had a preterm delivery. This study included 216 pregnant women who had a preterm delivery, who were found to be in the low-risk group based on their aneuploidy screening. The women were separated into two groups based on the surfactant receipts of their newborns. A record was made of the obstetric history, birth characteristics of the preterm infants, and whether or not there was a need for surfactant. A comparison of the PAPP-A values of the two groups revealed that the group that received surfactant had statistically significantly lower PAPP-A values (t(-3.97) = 0.203, p < 0.001). When the cut-off value of PAPP-A was taken as 1 MoM and the gestational age was analyzed together with the birth weight, PAPP-A alone was found to be a significant independent variable for the prediction of respiratory distress syndrome (RDS) (p = 0.031; OR:8.2 (1.2-55.6)). The result of this study demonstrated that PAPP-A MoM values may be significant in predicting the need for surfactant in RDS, which is a frequently seen condition in the neonatal period.

Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis.

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17–2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61–3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43–2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98–4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country’s per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.

Malaria congénita por Plasmodium falciparum

La malaria congénita (MC) es la infección por Plasmodium spp adquirida in útero o durante el parto y sus manifestaciones clínicas son inespecíficas. Puede causar enfermedad grave en la embarazada y en el recién nacido.Objetivo: describir dos casos de MC causados por Plasmodium falciparum, diagnóstico diferencial de sepsis en recién nacidos de gestantes que hayan visitado o residan en áreas endémicas para malaria.Casos Clínicos: Neonatos de sexo femenino, nacidos en área no endémica para malaria, diagnosticados con sepsis neonatal y tratados con antibióticos sin respuesta clínica. Después de la primera semana de vida la gota gruesa identificó trofozoítos de Plasmodium falciparum y los neonatos recibieron tratamiento con quinina intravenosa con mejoría. Las madres de las recién nacidas tuvieron malaria en el embarazo, una de ellas recibió tratamiento y estaba asintomática y otra tenía malaria complicada al momento del parto.Conclusiones: La MC puede causar enfermedad neonatal grave con manifestaciones clínicas inespecíficas y similares a la sepsis, el tratamiento oportuno disminuye el riesgo de malaria complicada. Es un diagnóstico diferencial en recién nacidos de mujeres con malaria durante el embarazo o gestantes que visiten o residan en áreas endémicas.

The relationship of serum vitamin D, calcium, and phosphorus levels of mothers with growth indices of their newborns in pregnant women admitted to Hajar hospital of Shahrekord in 2016

Background and aims: Vitamin D deficiency is a known pandemic problem which has thousands of bad health outcomes. The aim of the current study was to investigate the effect of maternal vitamin D, Ca, and PO4 levels on growth indexes of newborns at birth and 1 month and 3 months after delivery in pregnant women admitted to Hajar hospital of Shahrekord, Iran in 2016. Materials and Methods: This descriptive-analytical study was conducted on 196 pregnant women admitted to the hospital. During pregnancy, 5 mL of mother’s blood and 5 mL of umbilical cord blood were taken. Serum calcium and phosphorus levels were determined immediately after sampling and then centrifuged. After collecting the samples, 25-OHD levels were measured by ELISA method. Neonatal growth indexes such as weight, height, and head circumference atbirth,1 month, and 3 months were measured. Data were analyzed using independent samples t test, ANOVA, and correlation coefficient by SPSS version 16.0. Results: Deficiency of vitamin D, phosphorus, and calcium was observed in 76%, 1%, and 25% of women, respectively. Moreover, deficiency of vitamin D, phosphorus, and calcium was reportedin56.1%, 15.8%, and 9.2% of newborns, respectively. There was a significant relationship between calcium level in newborns and their weight and height at birth, one month, and three months of age ( P&lt;0.05). Levels of vitamin D, calcium and phosphorus of mother and newborns were significantly correlated ( P&lt;0.05). Conclusion: More than two-thirds of mothers and more than half of the newborns were deficient in vitamin D. There was also a lack of calcium in one third of mothers and 9.2% of newborns, and phosphorus deficiency was observed only in 1% of mothers and 15.8% of newborns. Due to the low intake of these materials through nutrition, the supplementation of these substances, especially vitamin D and calcium, is required during pregnancy.

Biochemical markers and effectivity of the preventive therapy of the fetal distress and preterm delivery in pregnant women with polyhydramnios

Polyhydramnios in pregnant women are one of the most frequent pathologies in obstetrics, which is caused by an increase in the use of ultrasound screening of pregnant women and ranges from 1–3 to 8%. The aim of the study was to evaluate changes in blood biochemical parameters, biophysical profile of the fetus and the health status of newborns in pregnant women with polyhydramnios during the prophylactic therapy of this pathology and to estimate the frequency of polyhydramnios occurrence under the influence of preventive therapy in pregnant women at risk of polyhydramnios. We examined 120 pregnant women at gestational age from 20 to 38 weeks between the ages of 20 and 39 years: 1 group consisted of 30 healthy pregnant women, 2 group — 90 pregnant women with chronic polyhydramnios, which was divided into two subgroups: 40 pregnant women without fetal distress in 1 subgroup and 50 pregnant women with fetal distress in 2 subgroups. 1 subgroup of pregnant women received prophylactic Magnerot, Tivortin, Larnamine, Lymphomyosot and vitamin D3. The 2nd subgroup of pregnant women received traditional treatment according to the clinical protocol of the Ministry of Health of Ukraine №900 dated December 27, 2006, №782 dated December 29, 2005. Prenatal diagnosis was carried out by the method of enzyme-linked immunosorbent assay: the metabolite level of vitamin D-25 OH(D) was determined, anti-inflammatory cytokines IL–10, IL–6, vascular endothelial growth factor VEGF, malonic aldehyde, carbonyl groups of proteins, superoxide dismutase, serum protein content. Conducted ultrasound examination of the fetus and dopplerometry of uterine-placental vessels, cardiotocography of the fetus, evaluated the biophysical profile of the fetus. The significance of the difference between the compared groups was determined using Student's t test. In pregnant women with chronic polyhydramnios, a decrease in endogenous glutathione antioxidant reserves, a decrease in the activity of the superoxide dismutase antioxidant enzyme, an increase in the activity of the pro-oxidant enzyme xanthine oxidase and the presence of cytokine imbalance have been found. It is shown that among all biochemical changes in the body of pregnant women with chronic polyhydramnios, vitamin D deficiency, inflammation and disturbance of angiogenesis play the most important role in the development of fetal distress. Pregnant women at high risk of polyhydramnios who received the proposed preventive therapy for fetal distress, improved fetoplacental blood flow, decreased the percentage of placental dysfunction by 1.8 times, fetal distress — by 1.5 times, premature birth — by 2 times, decreased asphyxia in newborns 1.7 times, the rate of perinatal morbidity in newborns decreased 1.9 times, compared with the group of pregnant women receiving traditional therapy. Thus, the positive effect of preventive therapy of pathology of pregnant women with polyhydramnios was confirmed clinically and biochemically.

The Use of Antidepressant Medications During Pregnancy and the Risk of Neonatal Seizures: A Systematic Review.

This review examined the current literature about the potential relationship between the use of antidepressants during pregnancy and neonatal seizures. PubMed was searched for English language reports published between January 1, 1996, and October 31, 2018, by using combinations of the following key words: pregnancy, neonatal outcome, neonatal convulsion, neonatal seizure, SSRI, selective serotonin norepinephrine reuptake inhibitor (SNRI), tricyclic antidepressant (TCA), antidepressants, sertraline, fluoxetine, paroxetine, citalopram, escitalopram, fluvoxamine, venlafaxine, mirtazapine, duloxetine, bupropion, amitriptyline, imipramine, and clomipramine. A total of 9 relevant studies that met the review criteria were examined. The prevalence rates of neonatal seizures in the antidepressant groups and control groups were 0.30% to 0.91% and 0.10% to 0.30%, respectively. The use of selective serotonin reuptake inhibitors was associated with up to 5-fold increase in the risk of neonatal seizures. Compared with the controls, higher risks were reported in newborns of pregnant women using any antidepressant or tricyclic antidepressants albeit in a limited number of studies. Exposure to antidepressants in the third trimester of pregnancy appeared to be associated more with neonatal seizures compared with earlier exposure. Although an increased risk of neonatal seizures in newborns antenatally exposed to antidepressants especially selective serotonin reuptake inhibitors may be suggested, the available studies have severe methodological limitations to enable any firm conclusion.

Association between glycated albumin, fructosamine, and HbA1c with neonatal outcomes in a prospective cohort of women with gestational diabetes mellitus

To investigate whether glycated albumin, fructosamine, and hemoglobin A1c (HbA1c) are associated with neonatal complications in newborns of pregnant women with gestational diabetes mellitus (GDM). Between November 2016 and September 2017, women with a singleton pregnancy and GDM were enrolled in a prospective study in an obstetric Portuguese referral center. Glycemic markers were compared between mothers of newborns with and without complications. Multivariable logistic regression models and corresponding areas under the receiver operating characteristic curve (AUC) were used. A total of 85 women participated in the study. Raised levels of glycated albumin and fructosamine were associated with at least one neonatal complication (OR- [odds ratio] estimate: 1.33, P=0.015; OR: 1.24, P=0.027, respectively) and with respiratory disorders at birth (OR 1.41, P=0.004; OR 1.26, P=0.014, respectively). HbA1c was not associated with these outcomes. All biomarkers were associated with large-for-gestational age (LGA) status (OR 1.61, P<0.001; OR 1.45, P<0.001; OR 3.62, P=0.032 for glycated albumin, fructosamine, and HbA1c, respectively). All had similar AUC for at least one neonatal complication (0.82; 0.81; 0.79, respectively). For newborn respiratory disorders, AUCs were 0.83, 0.81, and 0.76, respectively, and for LGA status were 0.81, 0.79, and 0.71, respectively. Raised values of glycated albumin and fructosamine were associated with particular perinatal complications in newborns of mothers with GDM, better discriminating mothers of newborns with and without complications than HbA1c.

Profile of Pregnant Women with Gestational Diabetes Mellitus at Increased Risk for Large for Gestational Age Newborns.

Gestational diabetes mellitus (GDM) is associated with a higher risk of perinatal morbidity and mortality, and its main complication is the occurrence of large for gestational age (LGA) newborns. The present study aims to characterize pregnant women with GDM and to identify factors associated with the occurrence of LGA newborns in this population. A cross-sectional study was performed based on medical records of women whose prenatal care and delivery were performed at the Maternal and Child Unit of the Hospital Universitário of the Universidade Federal do Maranhão, state of Maranhão, Brazil. A total of 116 pregnant women diagnosed with GDM were included according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). The variables associated with LGA newborns after multivariate analysis were: obesity prior to pregnancy (OR = 11.6; 95% CI: 1.40-95.9), previous macrosomia (OR = 34.7; 95% CI: 4.08-295.3), high blood glucose levels in the 3rd trimester (OR = 2,67; 95% CI: 1.01-7.12) and combined change in the oral glucose tolerance test (OGTT) (fasting + postdextrose) (OR = 3.53; 95% CI: 1.25-14.2) = 1.17-10.6). Otherwise, insufficient weight gain during pregnancy reduced the risk for LGA newborns (OR = 0.04; 95% CI: 0.01-0.32). Obesity prior to pregnancy, previous macrosomia, high blood glucose levels in the 3rd trimester, and combined change in the OGTT were independent predictive factors for LGA newborns in pregnant women with GDM.

METABOLIC THERAPY IN WOMEN WITH PLACENTARY DYSFUNCTION

The need for micronutrients during pregnancy increases by 25% due to increased consumption of the fetal organism. Omega-3 PUFAs are not synthesized in the human body and are indispensable, and are also part of the structural components of not only the brain lipids, but also the cells of the immune, cardiovascular systems and the visual analyzer. The use of Omega-3 PUFA promotes blood circulation in the mother-placenta-fetus system, improves the rheological properties of blood, prevents the development of preeclampsia and affects the reduction of perinatal complications. High efficiency, good tolerability, absence of teratogenic and embryotoxic actions allow wide use of Omega-3 PUFA in obstetric-gynecological practice.The aim of the study was a comparative analysis of the course of pregnancy, childbirth and the state of newborns in pregnant women with placental dysfunction who received metabolic therapy and those who did not receive it.Material and methods of the study. A prospective analysis of the course of pregnancy, childbirth and the state of newborns was conducted in 130 pregnant women with placental dysfunction (PD) at the gestation period of 28-34 weeks, which gave birth in Odessa Regional Perinatal Center of the Regional Clinical Hospital. Patients were divided into 2 groups: I – the main group (MG) (n = 67) – pregnant women with PD who received metabolic therapy in the form of 300 mg of Omega-3 PUFA per day for 4 weeks, II – control group (CG) ( n = 63) – pregnant women with PD who did not receive metabolic therapy. In the examined patients of MG, it was found that, according to the Doppler study of FPC, pregnancy was complicated by violations of the fetus-placental blood flow of the II st. in 36 (53,7%) and III st. – 8 (12,0%). And in pregnant women of CG is significantly more likely – 45 (71,4%) and 14 (22,2%), respectively. Such complications of newborns as RDS – 31 (49,2%), IVH – 33 (52,4%), HIE – 49 (77,8%), NEC – 34 (54,0%) were more often expressed in women of CG.Conclusions. The use of Omega-3 PUFA improves perinatal outcomes, reduces the incidence of IVH 17 (25,4%), reduces the frequency of HIE 27 (40,3%), reduces the incidence of NEC 16 (23,9%), and reduces the the risk of developing RDS in premature infants 22 ( 32,8%). Newborns of MG pregnant had higher scores on the Apgar scale (1st. min. – 6,66 ± 1,0, and 5 th. -7,26 ± 0,81 point) compared to the newborns of women of the CG (1st. min. – 5,65 ± 1,54 p., the 5 th. – 6,38 ± 1,68 p.). The average weight of children at birth was greater in the MG (1608 ± 292 g, in the CG-1470 ± 304 g.).