Non-pregnant Group Research Articles

The correlation between ANAs and pregnancy loss and their impact on IVF/ICSI-ET pregnancy outcomes in patients with recurrent pregnancy loss.

To explore the correlation between antinuclear antibodies (ANAs) and pregnancy loss (PL), and to observe its impact on the pregnancy outcomes of invitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in recurrent PL (RPL) patients. In this retrospective study, patients first seen at the hospital between January 2016 and December 2022 and who underwent two ANA tests within 4-6 weeks were included. After exclusion of confounding factors, patients were allocated to the non-pregnancy loss (non-PL), single-PL, or RPL group according to previous number of PLs, and the correlation between PL and ANAs was analyzed. The first embryo transfer (ET) after invitro IVF/ICSI without immunological treatment was placed in the RPL group, and patients were classified into the ANA-negative or ANA-positive subgroup according to ANA titer. The effect of ANAs on pregnancy outcomes in the RPL patients after IVF/ICSI-ET was further analyze. The results of multivariate unordered logistic regression showed that when the non-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P = 0.023) but not for single PL (P = 0.654). When the single-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P = 0.022). Multivariate logistic regression analysis revealed that the early PL rate of the ANA-positive subgroup was significantly higher than that of the ANA-negative subgroup (P = 0.009), and the total PL rate of the ANA-positive subgroup was significantly higher than that of the ANA-negative subgroup (P = 0.049). The results showed that ANA positivity may be related to RPL occurrence, but there was no significant correlation between ANA positivity and single PL. ANA positivity is associated with PL occurrence in RPL patients after transfer, and the correlation is reflected mainly in the first trimester.

Human embryo implantation: The complex interplay between endometrial receptivity and the microbiome.

The endometrial and vaginal microbiota have co-evolved with the reproductive tract and play a key role in both health and disease. However, the difference between endometrial and vaginal microbiota, as well as their association with reproductive outcomes in women undergoing frozen embryo transfer, remains unclear. 120 women who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and whole embryo freezing were enrolled. The vaginal and uterine microbiome were sequenced during the first frozen thawed embryo transfer. Based on whether or not they were pregnant after embryo transfer, women were assigned into two groups, and the microbiome of their reproductive tract was compared. The V3-V4 regions of the 16S rRNA gene were examined in the samples using the Next Generation Sequencing method. In the vagina, the non-pregnant group had higher bacterial species richness and diversity, with significantly lower Lactobacillus levels (91.66 % & 74.50 %) and higher Gardnerella levels (3.92 % & 12.12 %) than pregnant group (P < 0.05). In the uterine cavity, the diversity of uterine microbiome between pregnant group and non-pregnant group showed no significant differences. However, dramatic decrease in Lactobacillus (37.27 % & 33.45 %) and Pseudomonas (9.80 % & 4.08 %) were observed in the non-pregnant group (P < 0.05). There may be a correlation between the composition of female reproductive tract microbiome and the reproductive outcomes of patients with frozen-thawed embryo transfer. Lactobacillus-dominated microbiome in reproductive tract is more likely to be associated with higher clinical and ongoing pregnancy rate.

Sonograms of perineal muscles as a noninvasive diagnosis of pyometra and endometritis in beef cows: a preliminary study

Abstract. Changes in reproductive status affect the perineal muscles. These modifications enable the noninvasive diagnosis of pyometra and mastitis in beef cows. This study aims to assess the thickness and intensity of the coccygeus and levator ani muscles in beef cows affected by the reproductive disorders of pyometra and mastitis. The sample consisted of 59 Bali beef cows, 75 Madura beef cows, and 71 Ongole cross beef cows. The cervical organs, uterine corpus, uterine cornua, and placenta were visualized using transrectal imaging. The resulting images were categorized into two groups: a control group (with nonpregnant nonpartum, pregnant, and nonpregnant postpartum statuses) and a group with reproductive disorders. The coccygeus and levator ani muscles were visualized using transcutaneous imaging. Pregnant Bali beef cows have thicker coccygeus muscles than nonpregnant nonpartum Bali beef cows (P&lt;0.05). Pregnant Madura beef cows have thicker coccygeus muscles than nonpregnant nonpartum and nonpregnant postpartum Madura beef cows (P&lt;0.05). Pregnant Madura beef cows have thicker levator ani muscles than nonpregnant postpartum Madura beef cows (P&lt;0.05). Nonpregnant nonpartum and pregnant Ongole cross beef cows have thicker coccygeus and levator ani muscles than nonpregnant nonpartum and pregnant Bali and Madura beef cows. For pyometra, Bali, Madura, and Ongole cross beef cows have thicker coccygeus and levator ani muscles than endometritis, nonpregnant nonpartum, pregnant and nonpregnant postpartum Bali, Madura, and Ongole cross beef cows. In the control group, only the levator ani muscle of pregnant Bali beef cows had a significant intensity compared to nonpregnant postpartum Bali beef cows (P&lt;0.05). The muscle intensity of the coccygeus and levator ani of nonpregnant nonpartum, pregnant, and nonpregnant postpartum Bali beef cows was higher than nonpregnant nonpartum, pregnant, and nonpregnant postpartum groups for Madura and Ongole cross beef cows. For pyometra, Bali, Madura, and Ongole cross beef cows had higher coccygeus muscle intensity than nonpregnant nonpartum and pregnant Bali, Madura, and Ongole cross beef cows. Reproductive status and disorders affect the diameter of the reproductive tract and plecentome, which affect changes in sonogram thickness and intensity of the coccygeus and levator ani muscles.

A Microflow Chip Technique for Monitoring Platelets in Late Pregnancy: A Possible Risk Factor for Thrombosis.

To study the platelet adhesion and aggregation behaviour of late pregnancy women under arterial shear rate using microfluidic chip technology and evaluate the risk of thrombosis in late pregnancy. We included pregnant women who were registered in the obstetrics department of our hospital between January 2021 and October 2022 and underwent regular prenatal examinations. Blood samples were collected at 32-35weeks of gestation for routine blood tests and progesterone, oestradiol, and platelet aggregation function. A microfluidic chip was used to construct an in vitro stenosis vascular model to explore the platelet reactivity at shear rates of 1000s-1, 1500s-1 and 4000s-1. Flow cytometry was used to analyse the effect of shear rate induction on the expression of platelet membrane surface fibrin receptor (PAC-1) and P-selectin (CD62P) in pregnant women. Compared to the non-pregnant healthy control group, the white blood cell count increased and platelet count decreased significantly in late pregnant women (P < 0.05), and platelet reactivity to agonists increased under non-flow conditions (adhesion and aggregation rates, P < 0.05). Microfluidic chip technology showed that platelet aggregation in late pregnant women increased significantly (P < 0.05) in the shear-rate environment and was positively correlated with the shear rate. The degree of aggregation at 4000s-1 was more evident, but the stability of platelet aggregates was low. Shear rate increased PAC-1 and CD62P expression. Microfluidic chip technology was used to analyse the platelet aggregation function under arterial shear rate combined with flow cytometry to detect platelet activation, which was consistent with the traditional non-flow conditions used to evaluate platelet function. However, microfluidic technology can simulate a more realistic in vivo shear rate environment, providing more effective clinical application data and a theoretical basis for the diagnosis and prevention of platelet dysfunction and thrombotic diseases during pregnancy.

Pregnancy and COVID-19: Comparing ICU Outcomes for Pregnant and Nonpregnant Women.

This study compares organ dysfunction, treatment strategies, and unfavorable outcome rates between pregnant and nonpregnant women admitted to the ICU with severe COVID-19, highlighting the increased susceptibility of pregnant women to respiratory infections due to physiological changes. A retrospective, age-matched study was conducted at a referral center specializing in critical care for pregnant women. Data from 14 pregnant/postpartum and 11 nonpregnant women were analyzed at ICU admission and on days 3, 5, and 7. Acute respiratory distress syndrome was diagnosed in 100% of the pregnant/postpartum group and 64% of the nonpregnant group (p = 0.026). Inflammatory parameters were similar between groups, except for lower ferritin levels in the pregnant/postpartum group compared to the nonpregnant (120 vs. 568 µg/L at admission and 90 vs. 616 µg/L on day 3). Creatinine, lactate, and lactate dehydrogenase levels were significantly lower in the pregnant/postpartum group. A reduction in the SOFA score was observed over time in the pregnant/postpartum group (from 7.0 to 4.0 points, p = 0.009), while no change was noticed in the nonpregnant group (from 3.0 to 2.5 points, p = 0.181). Unfavorable outcome rates were similar, with two patients from each group succumbing to the disease (p = 0.604). The findings suggest that pregnancy does not increase the risk of unfavorable outcomes among women with severe COVID-19 receiving ICU treatment. However, additional studies with larger sample sizes are needed to validate these observations.

Dynamics of blood adipokine levels and their ratios in assisted reproductive technology programs depending on the clinical pregnancy onset

BACKGROUND: The adipokines leptin, adiponectin, and ghrelin are expressed not only in adipose tissue but also in the hypothalamic-pituitary-gonadal axis organs and the uterus. They regulate the gonadotropin-releasing hormone and gonadotropin secretion, steroidogenesis, folliculogenesis, and implantation, and serve as promising markers of assisted reproductive technology program outcomes. AIM: The aim of this study was to evaluate the dynamics of blood adipokine levels and their ratios during the controlled ovarian hyperstimulation in assisted reproductive technology programs depending on the onset of clinical pregnancy. MATERIALS AND METHODS: This study involved 51 patients undergoing infertility treatment using assisted reproductive technology in a short protocol with gonadotropin-releasing hormone antagonists. Depending on the onset of clinical pregnancy, two study groups were formed: non-pregnant (group 1, n = 22) and pregnant (group 2, n = 29). Blood leptin, adiponectin, and ghrelin levels were assessed using enzyme immunoassay at three points: assisted reproductive technology protocol start-up, the day of oocyte pick-up, and the day of embryo transfer. RESULTS: On the day of oocyte pick-up, patients in group 1 had higher leptin levels (5.47 ± 1.92 vs. 3.76 ± 0.75 ng/ml; p = 0.0004), leptin/adiponectin ratios (11.45 ± 4.50 vs. 4.73 ± 1.08; p 0.001), and leptin/ghrelin ratios (0.43 ± 0.17 vs. 0.24 ± 0.07; p 0.001). On the day of embryo transfer, patients in group 1 had higher levels of leptin (6.37 ± 2.13 vs. 3.29 ± 1.21 ng/ml; p 0.001) and adiponectin (0.75 ± 0.22 vs. 0.60 ± 0.09 ng/ml; p = 0.001), as well as ratios of leptin/adiponectin (9.06 ± 3.73 vs. 5.59 ± 2.32; p 0.001), leptin/ghrelin (0.48 ± 0.15 vs. 0.20 ± 0.07; p 0.001), and adiponectin/ghrelin (0.06 ± 0.02 vs. 0.04 ± 0.01; p 0.001). CONCLUSIONS: The data obtained indicate that blood adipokine levels change during the controlled ovarian hyperstimulation in assisted reproductive technology protocols depending on clinical pregnancy and can be used to predict its onset.

Upregulation of Urinary Alpha-2-HS Glycoprotein During Pregnancy of Murrah Buffaloes.

Urine samples were systematically collected from inseminated Murrah buffaloes (Bubalus bubalis) on days 0, 7, 14, 21 and 28 (with day 0 representing the day of artificial insemination). Following confirmation of pregnancy via trans rectal palpation 45 days of insemination, the animals were categorised into pregnant and non-pregnant groups (n = 10 each). The urine samples on 0, 7, 14, 21 and 28 days of pregnant and one sample from non-pregnant preferably collected on 28th day was used for SDS-PAGE after diafiltration. We focused on urine samples obtained on 28th day of insemination as it could contain high fetuin-A levels associated with pregnancy. Each of the two urine samples from both the pregnant and non-pregnant groups underwent purification through wheat germ agglutinin (WGA) affinity separation. The resulting fraction/elute was subsequently employed for the determination and validation of fetuin-A through 1D SDS-PAGE, western blotting and MALDI-TOF analysis. The samples were used for measuring the concentration of fetuin-A by ELISA. Fetuin-A was significantly higher (1020.50 ± 19.75 mg/L) in pregnant Murrah buffalo urine than their non-pregnant counterparts (86.5 ± 6.33 mg/L), with a p < 0.05. On SDS-PAGE analysis, the WGA fractions revealed distinct protein bands, notably between ~54 to 70 kDa and slightly above ~91 kDa, in pregnant Murrah buffaloes compared with their non-pregnant counterparts. Following confirmation of fetuin-A at ~58 kDa through western blotting, the corresponding protein band was excised from the SDS gel and subjected to mass spectrometry for MALDI-TOF analysis. Peptide mass fingerprinting, coupled with protein BLAST, confirmed the upregulated protein as Alpha2-HS glycoprotein, also known as fetuin-A. These findings are crucial for elucidating the presence of fetuin-A in urine samples from pregnant Murrah buffaloes, offering valuable insights into their physiological status.

Skin temperature and anthropometric measurements during pregnancy: A cross-sectional study.

Pregnancy comprises a period of 41 weeks, in which the female body undergoes several physiological, hormonal and anatomical changes that can generate changes in skin temperature. To describe the thermal profile of pregnant women during the first, second and third trimester of pregnancy. This is a cross-sectional observational study. A total of 104 women participated, divided into three groups: first trimester group (1TG, n=25), second trimester group (2TG, n=27), third trimester group (3TG, n=26), and non-pregnant control group (CG, n=26). All underwent thermographic evaluations using a thermographic camera model E54-EST, and anthropometric measurements of abdominal circumference and diastasis. It was observed that the average skin temperature of pregnant women in the first trimester is higher than the average skin temperature of pregnant women in the third trimester of pregnancy (P<0.05); the abdominal temperature of pregnant women in the first trimester tends to be higher than that of pregnant women in the second and third trimesters (P<0.05); and the breast skin temperature of pregnant women is higher than that of non-pregnant women (P<0.05). Furthermore, there is a tendency for negative correlations between the average skin temperature and the temperature of the abdominal and diastasis regions with fetal development measures. It is generally observed that there are differences in the skin temperatures of regions such as the breast between pregnant women and non-pregnant women, as well as a tendency for higher abdominal temperatures in pregnant women in the first trimester compared to those in the third trimester.

Comparative assessment of adherence in pregnant and non-pregnant women of reproductive age

Objective: to conduct a comparative assessment of adherence to the treatment of pregnant and non-pregnant reproductive age.Material and methods: 115 women (60 pregnant and 55 non-pregnant) of reproductive age from 18 to 49 years old were examined. All patients completed an online electronic questionnaire of quantitative adherence to treatment with further automatic calculation of results and issuance of a conclusion. The prognosis of adherence to lifestyle modification (LSM), adherence to medical support (MS), adherence to drug therapy (DT), total adherence to treatment (TAT) was assessed depending on age, education, labor status, bad habits, the number of births, the presence of hypertension (AH), obesity, extragenital pathology. Adherence was assessed as low in terms of &lt; 50%, mean 50–75%, and high &gt; 75%.Results: adherence to LSM in pregnant women corresponded to a mean level, and non-pregnant to a low level. Low adherence to LSM was found in 33.3% of pregnant and 58.2% of non-pregnant women. TAT values in both groups were in the range of mean adherence, but were higher in pregnant women. In the structure of TAT in pregnant women, unlike non-pregnant women, there was a lower level (21.7% versus 38.2%) and more often a high level (28.3% versus 10.9%). The adherence values of MS and DT and the level distribution did not differ between the groups. In the pregnant group, patients with secondary education and who did not drink alcohol demonstrated a high level of adherence to MS. In the non-pregnant group, only DT adheres to women with secondary education and no smoking were committed compared to smokers and patients with higher education.Conclusion: the current method of determining adherence to treatment is the electronic questionnaire. Adherence to LSM and TAT was significantly higher in pregnant women and corresponded to the mean level, adherence rates to MS and DT did not differ between groups and were also at the mean level. In all examined women, there was no relationship between adherence to LSM, TAT, MS, DT and the studied de facto frames: age, number of births, labor status, presence of AH, obesity. More committed to treatment were pregnant and non-pregnant women with secondary education and no “bad” habits.

Evaluation of Hursitism for Polycystic Ovary Syndrome Women At Al- Ramadi City

The hyper-androgen and huritism in face and body in women is important diseases. It can be used as a possible marker in patients with ovary polycystic syndrome (PCOS). This study was carried out to evaluate DHEA and Testosterone levels associated with huritism and PCOS was studied in serum samples from pregnant, and non-pregnant patients and controls attending clinic Specialized. The study included 38 samples divided into three groups: 21 patients subjects, 6 pregnant women, 15 non-pregnant women with PCOS syndrome, and 17 normal subjects as control of the same age group. The target was selecting pregnant women due to changes in hormonal levels and physiological changes, as well as comparing them with non-pregnant women and control samples. The level of DHEAS was considerably higher in the median among pregnant women than in the control group and between non-pregnant and control groups without statistically significant differences between pregnant and non-pregnant values. Similarly, testosterone shows a statistically significant higher median among pregnant than control and also between non-pregnant and control groups without statistically significant difference between pregnant and non-pregnant values. In conclusion, this study detected a significant increase in testosterone and DHEA in non-pregnant women and then followed by pregnant women compared to the control, and age and the rise of these hormones are factors that cause the appearance of thick hair and thus cause polycystic ovary, which may lead to infertility.

Analysis of influencing factors of clinical pregnancy rate in second cycle intrauterine insemination.

To explore the factors influencing the clinical pregnancy rate in the Reproductive Center of the Affiliated Hospital of North Sichuan Medical College in the second cycle, a retrospective analysis of the clinical data of 175 patients who underwent the second cycle of intrauterine insemination (175 cycles) from July 2019 to July 2022 was performed. According to whether the patients reached clinical pregnancy, they were divided into the pregnant group (32 cycles) and non-pregnant group (143 cycles). The age, infertility years, infertility factors, infertility type, number of sinus follicles, intimal thickness, intimal type, basal follicle-stimulating hormone, basal luteinizing hormone, basal estradiol, stimulation regimen, season, body mass index, and male semen quality were statistically analyzed between the 2 groups. The number of intrauterine insemination (IUI) in the second cycle was 175, and the clinical pregnancy rate was 18.3% (32/175). The age of the pregnant group was lower than that of the non-pregnant group [(26.7 ± 1.07) vs (30.56 ± 0.51), P = .05]. The clinical pregnancy rate in patients aged ≤30 years was significantly higher than that in patients aged > 30 years [28.6% vs 7.1%, P < .05]. Among infertility factors, the pregnancy rate of patients who underwent IUI due to female factors was significantly higher than that of male factors, combined factors (both male and female), and unexplained infertility, and the differences were statistically significant [37.1% vs 22.4%, 18.2%, 3.2%, P < .05]. In multivariate logistic regression analysis, age and infertility factors were independent influencing factors of clinical pregnancy rate in the second cycle of IUI. In, while in artificial insemination, female age and infertility factors were important factors affecting the clinical pregnancy rate of the second cycle of IUI. If the outcome of the first cycle is not pregnant, the female age is <30 years, infertility is the female factor, and the second cycle of IUI can be considered.

Comparison of subfoveal choroidal thickness in pre-eclamptic, healthy pregnant, and non-pregnant women.

The purpose of the study was to compare the choroidal thickness (CT) in pre-eclamptic (PE), healthy pregnant, and age-matched healthy non-pregnant females by spectral-domain optical coherence tomography (SD-OCT) and to investigate any possible correlation between subfoveal CT (SFCT) and mean arterial pressure (MAP) in PE. This was a hospital-based, comparative study. A total of 90 females (30 in each group) aged 20-40 years were recruited prospectively over 1 year. Females with refractive error beyond ±3 D, intraocular pressure >21 mmHg, prior ocular trauma or surgeries, systemic diseases, pregnancy-related complications (except PE), and poor OCT scans were excluded. Following comprehensive ophthalmic evaluation, CT was measured bilaterally using SD-OCT (EDI) at the subfoveal region and at 1500 μm nasal and temporal to fovea. Systolic and diastolic blood pressures were recorded in all. The PE group had significantly thinner choroid (SFCT: 337.5 ± 49.8 OD, 333.0 ± 50.8 OS) as compared to the healthy non-pregnant group (SFCT: 351.6 ± 34.4 OD, 365.3 ± 33.6 OS) and healthy pregnant group (SFCT: 374.2 ± 44.1 OD, 377.2 ± 49.5 OS) (P < 0.05) in all locations (nasal, temporal, and subfoveal) in both eyes (except for OD nasal CT). However, there was no significant correlation between SFCT and MAP in the PE group. Significantly lower CT in PE without any direct correlation between SFCT and MAP may implicate that choroidal thinning in PE is governed by multifactorial choroidal vasospasm and endothelial dysfunction, instead of MAP solely.

The Effects of Pregnancy Status on Lacrimal Caruncle Temperature, Intraocular Pressure and Rectal Temperature in Cats: A Preliminary Study.

The objectives of this study were to compare the body temperatures between pregnant and nonpregnant cats from two sites, lacrimal caruncle temperature (LCT) and rectal temperature (RT), and to compare intraocular pressure (IOP) between pregnant and nonpregnant cats. This study was performed on 13 pregnant and 16 anoestrous cats. The gestation period of the pregnant cats ranged from 20 to 45 days. A vaginal smear was also performed to determine the sexual cycles of nonpregnant cats. The IOP was measured using a rebound tonometer. The pregnant cats (38 ± 0.7°C) exhibited a lower RT than the nonpregnant cats (38.5 ± 0.5°C) (p < 0.05). No significant differences existed between the pregnant and nonpregnant groups in the right (R)-LCT or left (L)-LCT (p > 0.05). The average LCT temperature measured 32.30 ± 2.23°C in cats. The right (R)-IOP in pregnant cats (17.69 ± 5.6mm Hg) was significantly lower than in nonpregnant cats (22.37 ± 5.27mm Hg) (p < 0.029). Pregnant cats exhibited a significantly lower left (L)-IOP value (17.69 ± 5.76mm Hg) compared to nonpregnant cats (23.18 ± 5.55mm Hg) (p < 0.015). This study presents a preliminary report that documents a noteworthy reduction in RT in pregnant cats (38 ± 0.7°C) as compared to cats in anoestrus. Pregnancy also has an effect on the IOP. It was hypothesised that the hormonal changes induced by pregnancy in cats would have a substantial impact on IOP and RT. Although body temperature can be measured using LCT, RT should still be utilised as the reference measurement site.

Comparison of HBV-specific T cell reactivity across the pregnant, postpartum and non-pregnant women with chronic HBV infection.

To investigate the features of HBV-specific T cell reactivity across the pregnant, postpartum or non-pregnant women with chronic HBV infection. A total of 283 patients with chronic HBV infection were enrolled in this study, including 129 patients during pregnancy, 58 patients during postpartum less than 6 months and 96 non-pregnant patients at childbearing age. A universal ELISpot assay was set up using a broad-spectrum T-cell epitope peptide library which containing 103 functionally validated CD8+ T-cell epitopes derived from overall HBsAg, HBc/eAg, HBx and HBpol proteins and fitting to the human leukocyte antigen polymorphisms of Chinese population. Then, The functional HBV-specific T cells in peripheral blood were detected. The spot-forming units (SFUs) of HBV-specific T cells in the pregnant group showed no statistical difference from the postpartum group, but significantly less than that in the non-pregnant group (p = 0.046). In the untreated patients, the pregnant group displayed HBe/cAg-specific T cells (SFUs) less than the non-pregnant group (P = 0.025) and the postpartum group (P = 0.045). Meanwhile, in the NUCs-treated patients, the three groups presented similar HBV-specific T cell reactivity. Furthermore, the SFUs in the NUCs-treated pregnant group were similar to that in the NUCs-untreated pregnant group. Importantly, ROC analysis demonstrated that the HBV-specific T cells (SFUs) (AUC = 0.742) and combined with HBsAg levels (AUC = 0.775) or with HBeAg level (AUC = 0.78) had a good predictive performance for hepatitis progression during pregnancy group. Pregnancy can reduce HBV-specific T cell reactivity in the women with chronic HBV infection, and NUCs treatment cannot improve their HBV-specific T cells reactivity. Routine monitoring of HBV-specific T cells during pregnant and postpartum period can provide precise evaluation for immune function and valuable guidance for treatments.

Pregnancy intentions and outcomes among young married women in Nepal

BackgroundApproximately 44% of Nepalese women ages 15–49, desiring to avoid pregnancy, do not use modern contraceptives, resulting in an estimated 539,000 unintended pregnancies annually. ObjectivesThis study aims to investigate the association between young, newly married women's pregnancy intentions and subsequent pregnancies. Study designData were collected longitudinally from 200 recently married women ages 18–25 in Nepal. Surveys conducted every six months over 18 months covered various health domains. The study used mixed-effects logistic regression models to account for repeated measurement of correlated data over time. The primary outcome was pregnancy. Pregnancy intention was determined based on responses to, “When would you like to have a child in case you were to have one?” Participants were recategorized into a dichotomous variable for analytical purposes: “Right away” or “Not right away.” ResultsA total of 133 participants became pregnant during the study, with sociodemographic characteristics showing minimal differences between pregnant and nonpregnant groups. Women intending to become pregnant right away had significantly higher odds of becoming pregnant (OR, 4.03; 95% CI, 2.51–6.48) after adjusting for covariates. Among those not intending immediate pregnancy, over 70% became pregnant, suggesting potential barriers to achieving reproductive goals. ConclusionsYoung, newly married women in Nepal intending immediate pregnancy have higher odds of becoming pregnant. However, a substantial proportion of those hoping to delay pregnancy still experience unintended pregnancies, indicating challenges in meeting reproductive goals. The findings underscore the need for addressing barriers to contraceptive access and societal norms impacting women's reproductive autonomy in Nepal.

Reduction of misdiagnosis in urinary tract infections during pregnancy: The role of adjusted urine flow cytometry parameters.

Urinary tract infections (UTIs) pose a significant health concern, particularly among pregnant women, for whom accurate diagnosis is essential. However, the use of Urine flow cytometry (UF) for detecting UTIs in this demographic often results in misdiagnosis. The objective of this study was to explore the reasons behind these diagnostic errors and to develop a strategy to minimize the rate of UTI misdiagnosis in pregnant women. The study enrolled 1,200 women aged 18 to 40 years, categorized into pregnant and non-pregnant groups. UTIs were diagnosed using urine bacterial culture, microscopic examination, and UF, followed by statistical analysis to identify any discrepancies in diagnosis between the groups. Following the calibration of UF analyzer's parameters, the most effective CR(WBC)-CW-FSC-P Gain setting for diagnosing UTIs in pregnant women through UF was ascertained by applying the Youden index. The clinical diagnosis rate of UTIs was significantly higher in pregnant women (40.91%) compared to non-pregnant women (20.26%). However, urine microscopy and bacterial culture showed no significant difference in the rates of UTIs between the two groups, suggesting a potential for misdiagnosis. The false-positive rate for WBCs detected by UF was 30.43%, and adjusting the CR(WBC)-CW-FSC-P Gain value of UF reduced the false-positive rate to 9.45%. The incidence of UTIs in pregnant women may be overestimated because of the limitations inherent to UF. Adjusting the parameters of the UF analyzer, particularly the CR(WBC)-CW-FSC-P Gain value, can significantly reduce the rate of UTI misdiagnosis in pregnant women.

PSIII-2 Exploring differential gene expression and pathways associated with pregnancy outcomes in beef heifers

Abstract Heifer fertility is a key factor in the success of beef production systems, as the reproductive performance of a heifer correlates with her stayability in the breeding herd. However, despite being reproductively mature and physically healthy, 5 to 15% of these heifers fail to conceive within a designated breeding season. The underlying physiological mechanisms preventing these heifers from achieving pregnancy remain elusive. Therefore, this study aimed to determine differentially expressed genes (DEGs) and biological pathways associated with pregnancy outcomes in beef heifers. Angus-Simmental crossbred heifers were subjected to an estrus synchronization and fixed-time artificial insemination (AI) program (7-d CO-Synch + CIDR) and blood samples were collected at the time of AI for isolation of peripheral white blood cells (PWBC). After pregnancy check, heifers were classified as pregnant (P) and non-pregnant (NP). Based on that, 6 animals per group were randomly selected for total RNA isolation from the PWBC samples, and genome-wide expression was measured through RNA sequencing. The RNA-Seq data were analyzed using an in-house bioinformatics pipeline, with filtered reads aligned to the Bos taurus reference genome using STAR. DEGs were identified using DESeq2, followed by functional analysis using ShinyGO. Our approach unveiled 230 DEGs, comprising 102 up and 128 downregulated genes in the NP group (P-value ≤ 0.05 and |log2FC| &amp;gt; 0.5). Upregulated genes included those from the cytochrome P450 superfamily (CYP27B1 and CYP2U1). The genes SCML2, USIG2, and FBP1 were upregulated and have been associated with immune response and increased PWBC counts. This may be related to the over-representation of biological processes involved in cell division based on the upregulated genes. KEGG pathway over-representation analysis of DEGs retrieved allograft rejection, graft-versus-host disease, type I Diabetes Mellitus, insulin signaling pathway, and transcriptional misregulation of cancer. These pathways included genes such as BOLA-DQB, PRKAR1B, CALML4 and JUP, which were reported as downregulated during times of inflammatory response. Another downregulated gene was GZMB, which is needed for proper cell targeting during immune response. This finding may provide a link between immune function and early pregnancy failure. However, the relationship between the immune system and pregnancy warrants further investigation. Our results shed light on the molecular mechanisms underlying reproductive performance in beef heifers and support previous studies associating immune function with pregnancy outcomes. These differentially expressed genes may be further explored as potential avenues for enhancing fertility in beef production systems.

Clinical characteristics and pregnancy outcomes in pregnant women with TB: a retrospective cohort study

Purpose The influence of pregnancy on tuberculosis (TB) has not been well studied. This study aimed to investigate the demographics, clinical characteristics and outcomes of pregnant-related TB compared with the general population with TB. Methods We retrospectively analysed medical records of women during pregnancy or within six months postpartum with active TB who were admitted to the West China Hospital between 2011 and 2022. According to age, gender and admission time, the general population with active TB was matched at a ratio of 1:2, and the demographics, clinical characteristics and outcomes were compared. Results All the participants in both the pregnant and non-pregnant groups were females, averaging 26 years old, with a majority of Han nationality (72.4% vs. 69.5%, respectively). The two groups were comparable (p < .05). Pregnant TB cases showed higher rates of fever (61% vs. 35%), dyspnoea (39.9% vs. 18.7%), neurological symptoms (34.4% vs. 11.0%) and miliary TB (24.5% vs. 10.9%) compared to non-pregnant cases (p < .05). Additionally, the pregnant group exhibited lower red blood cell counts (3.62 × 109/L vs. 4.37 × 109/L), lower albumin levels (31.20 g/L vs. 40.40 g/L) and elevated inflammatory markers (p < .05). Pregnant women with TB had severe outcomes, with 16.3% requiring intensive care unit (ICU) care and a 3.3% TB-related mortality rate – higher than local averages. In contrast, the non-pregnant group had lower rates (0.8% for ICU admission, and no TB-related deaths). Moreover, active TB during pregnancies led to a high rate of spontaneous abortion (34.1%), with military pulmonary TB identified as the sole risk factor for severe TB in pregnancies (OR: 3.6; 95% CI: 1.15, 11.34). Conclusions Manifestations of TB in pregnant women differ from those in the general population with TB. Pregnancy complicated with active TB greatly harms the mother and foetus and requires special attention in the future.

Evaluation of the Effect of Early-Onset Steroid Treatment in the COVID-19-Positive Pregnant Women on Pregnancy Outcomes.

Coronavirus disease 2019 (COVID-19) is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress and preterm delivery are the two major complications induced by SARS-CoV-2 infection during pregnancy. In the presence of dyspnea, the use of systemic corticosteroids was recommended in pregnant and non-pregnant groups. Our primary aim was to investigate the effect of early-onset steroid treatment on mortality and adverse effects in pregnant women with COVID-19. Our secondary aim was to investigate the effect of steroid treatment on the length of hospital stay and intensive care unit (ICU) stay, and duration of treatment. The study also investigated infection, preterm birth, and ideal body weight (lbw) in newborns. In this retrospective study, 253 patients were divided into three groups according to steroid administration. In Group 1 patients (n:112), treatment was started at the time of hospitalization. In Group 2 patients (n:90), treatment was started at least 24 h after hospitalization. Group 3 consisted of patients (n:51) who did not receive steroid treatment. Methylprednisolone (32 mg/day) was given to pregnant patients with a gestational age below 24 weeks or above 34 weeks, and dexametazone (6 mg/day) was given in four doses followed by 32 mg/day methylprednisolone for the others (whose baby was at a gestational age of 24 weeks and above but less than 34 weeks). The hospital stay, ICU stay, and steroid administration time were significantly lower in the Group 1 when compared to the others (p < 0.05). The steroid treatment requirement was 4.4 days in Group 1 and 5.7 days in Group 2 (p < 0.05). While no death was observed in Group 1, one patient died in Group 2 and three patients died in Group 3. There was no difference between the groups in terms of complications, including preterm labor. No death was also observed with early-onset treatment. Early-onset treatment may be beneficial for fewer hospitalizations, fewer ICU stays, and less mechanical ventilation requirement in pregnant women with COVID-19. In addition, with early treatment, the total number of steroid administration days was reduced, which is important in terms of reducing the risk of side effects.

Angiogenic factor-driven improvement of refractory thin endometrium with autologous platelet-rich plasma intrauterine infusion in frozen embryo transfer cycles.

A beneficial effect on endometrial thickness (EMT) and improvement of pregnancy outcome after intrauterine infusion of platelet-rich plasma (PRP) has been suggested. This study assessed the effect of intrauterine PRP infusion on live birth rate and obstetrical outcomes and analyzed cytokines that can potentially improve pregnancy outcomes through PRP. This study was a prospective cohort study conducted in a university hospital fertility center. The study included ninety-one patients who had a history of two or more failed in vitro fertilization (IVF) attempts and refractory thin endometrium that remained unresponsive after at least two conventional treatments for thin endometrium. Patients were treated with an intrauterine infusion of autologous PRP between days 7 and 14 of their hormone replacement therapy-frozen embryo transfer (HRT-FET) cycle. PRP was administered at 3-day intervals until their EMT reached 7mm. After a maximum of three PRP administrations, embryo transfer (ET) was performed. The primary outcome was the live birth rate. Secondary outcomes included the implantation rate and increase in EMT compared to the previous cycle. We compared the cytokines related to angiogenesis in a patient's whole blood (WB) and PRP by utilizing a commercial screening kit. The live birth rate in the PRP treatment cycle was 20.9% (19 of 91 patients), significantly superior to the previous cycle without PRP infusion (p < 0.001). The implantation rate was also significantly higher during the PRP treatment cycle (16.4%) compared to the previous cycle (3.1%) (p < 0.001). The mean EMT post-PRP treatment was 6.1 mm, showing a significant increase of 0.8 mm (p < 0.001). Nonetheless, an increase in EMT was also observed in the non-pregnancy group. No adverse effects were reported by patients treated with autologous PRP. Cytokine array analysis confirmed marked increases in well-known pro-angiogenic factors such as Ang-1, EGF, LAP (TGF-b1), MMP-8, PDGF-AA, and PDGF-AB/PDGF-BB. Intrauterine PRP infusion offers a safe and effective treatment for patients with refractory thin endometrium and implantation failures. The angiogenic cytokines present in PRP are the primary drivers of this improvement.