Old Pregnant Woman Research Articles

Estradiol and progesterone from pregnancy to postpartum: a longitudinal latent class analysis.

During the peripartum, women undergo significant hormonal changes that are crucial for fetal development and a healthy pregnancy and postpartum period for mother and infant. Although several studies have determined healthy norm ranges of estradiol and progesterone, there are discrepancies among the reports, rendering it unclear which hormone levels are linked to adverse health outcomes. To account for the impact of sex steroid patterns on health outcomes in mothers and children, a longitudinal assessment of different parameters is needed. We longitudinally assessed a cohort of 130 women over five months during pregnancy and postpartum. The women provided saliva samples and completed psychosocial questionnaires. Hormone analyses were conducted using enzyme-linked immunosorbent assay (ELISA). Different parameters of estradiol and progesterone were analyzed and evaluated in relation to psychometric variables. To examine the presence of heterogenous hormonal trajectories in the peripartum, we applied group-based trajectory modelling as a special case of latent-class group analysis. Estradiol and progesterone levels rose towards the end of pregnancy and dropped sharply after birth, with considerable individual variation, particularly during pregnancy. However, their ratio remained stable. We identified three estradiol trajectory subgroups and two progesterone subgroups. Age influenced progesterone levels, with older pregnant women having higher levels than younger women. Anxiety and depressive symptoms had a predictive value for trajectories of specific subgroups of women. The study also revealed two distinct subgroups regarding the course of estradiol and progesterone fluctuations as well as their ratio. This study provides insights into the course and fluctuation of salivary estradiol and progesterone levels among healthy women during the peripartum period, highlighting significant variations in hormone levels but stability in their ratio during this time. The finding of distinct sex steroid courses in the peripartum is new and suggests the need for further research to explore their impact on health outcomes. Our preliminary results suggest that hormonal fluctuations at the end of pregnancy appear to be a normal occurrence and might even be a protective factor for associated psychological symptoms and sleep disturbances in women.

Effect of basic periodontal treatment on CRP in elderly pregnant women with periodontal disease

Periodontal disease is a chronic infectious disease, which is common and frequent disease in pregnant women. It is an infectious disease caused by a variety of microorganisms, and the physiological changes in pregnant women after pregnancy can promote the occurrence and development of periodontal disease. Women no less than 35 years old are at an increased risk of maternal and fetal complications in pregnancy, older pregnant women with periodontal disease are prone to preterm birth, fetal growth retardation, premature rupture of membranes, and the incidence of neonatal low birth weight is significantly higher than that in older women with healthy oral health, i.e., these risks are increased with age. CRP is an acute-phase protein produced by liver organs, which is produced by hepatocytes under the promotion of inflammatory factors, and serves as the most direct and sensitive marker of inflammatory response. Studies have shown that basic periodontal treatment relieve periodontal tissue inflammation in pregnant women with periodontitis, while significantly reducing their serum CRP concentration, thereby decreasing the occurrence of adverse pregnancy outcomes. The objective of this study is to investigate the effect of basic periodontal treatment on CRP in elderly pregnant women with periodontal disease.

Adolescent Pregnancy: A Comparative Insight into the Prevalence and Risks of Obstetric Complications in a Polish Cohort.

Background: Adolescent pregnancy is associated with increased risk of both maternal and neonatal complications. Common maternal complications include anemia, hypertensive disorders, and a higher incidence of infections, including Group B Streptococcus (GBS). Additionally, adolescents are at increased risk for gestational diabetes and postpartum hemorrhage. Neonatal complications often involve low birth weight, prematurity, and an increased likelihood of neonatal intensive care unit (NICU) admission. Objectives: This study aims to assess and compare the prevalence of obstetric complications between adolescent and older pregnant women. Methods: This retrospective study investigates obstetric outcomes in adolescent pregnancies, analyzing data collected from 1 January 2016 to 30 June 2024. This study included 902 participants, of whom 224 were adolescents. The variables were categorized into maternal, birth, and neonatal characteristics. Results: Adolescent patients demonstrated a significantly higher prevalence of Group B Streptococcus (GBS) infection, affecting 25.89% of this group. Adolescent patients reported 17.86% nicotine use during pregnancy, a rate significantly higher than that of older age groups (p < 0.001). Additionally, adolescent pregnancies were associated with the highest mean blood loss during delivery, averaging 500 mL during vaginal birth and 1050 mL during cesarean section, leading to a higher incidence of blood transfusions (3.13%, p = 0.021). Newborns from adolescent pregnancies had the lowest mean birth weight (3199 g) and length (53.6 cm). Neonatal complications were more frequent in this group, affecting 20.09% of newborns, with a significantly higher rate of admission to intensive care units (2.68%, p = 0.008). These findings underscore the need for targeted interventions and more proactive management strategies to address the specific challenges faced by this population.

Incidence of New Asthma in Pregnancy and Associated Risk Factors: A 10-Year Nationwide Population-Based Study.

Pregnancy is a risk factor for asthma exacerbation and may trigger new-onset asthma in nonasthmatics. This study evaluated the epidemiology of newly diagnosed asthma during pregnancy and the associated risk factors among previously nonasthmatic women. Twelve-year medical data from the Korean National Health Insurance claims database (from January 2007 to December 2018) of Korean women who gave birth between January 2012 and December 2015 were collected. Previously nonasthmatic women were defined as those who had not been diagnosed with asthma for at least 4 years before pregnancy. Asthma flare-up was defined as asthma diagnosed three times or more and treated at least once with an oral corticosteroid. A nested case-control study was performed, and then the derived risk factors were applied to whole study population. Among the nonasthmatic women, 7.5% experienced asthma during pregnancy including episodes requiring hospitalization and 18.6% of them visited emergency room. Older age, primiparity, multi-fetal pregnancy, and rhinitis were identified as the risk factors. Among the entire study population, moderate to severe rhinitis was a significant risk factor across all age groups, while primiparity with multi-fetal pregnancy was one for older pregnant women; 22.7% in those ≥ 34 years old experienced asthma flare-ups compared to only 3.5% in the < 34 age group. A substantial portion of pregnant women with no history of asthma experienced an asthma flare-up during pregnancy. Multi-fetal pregnancy as primiparity at a later age and moderate to severe rhinitis are risk factors for the new development of asthma.

Analysis of Risk Factors for Urinary Tract Infections in Pregnant Women: A Retrospective Study.

Urinary tract infections (UTIs) are the most common bacterial infection during pregnancy. This study aimed to investigate the risk factors of UTI during pregnancy. In this study, pregnant women who underwent prenatal examination in our hospital from October 2019 to October 2023 were divided into UTI group and non-UTI group in accordance with whether or not they had a UTI. The general data, clinical data and laboratory indicators of the participants were collected. Multivariate logistic regression was used to analyse the influencing factors of UTI in pregnant women, and the results were shown with odds ratio (OR) and 95% confidence interval (95% CI). A total of 600 pregnant women were included in the study. The results found that 56 women (9.33%) had a combined UTI. The results of midstream urinary bacterial culture in the UTI group showed that Gram-negative bacteria accounted for 60.71% of all detected pathogenic bacteria, and Escherichia coli and Staphylococcus aureus were common strains, accounting for 46.43% and 23.21%, respectively. The proportions of patients in the UTI group who were ≥35 years old, had a high school education or below, had a history of abortion, had gestational diabetes, had ≥three vaginal and anal examinations, had a history of UTI and had urinary tract stones were significantly higher than the non-UTI group (p < 0.05). Multivariate logistic regression analysis showed that age ≥35 years (OR = 9.127; 95% CI: 4.668-17.810; p < 0.001), educational level of high school or lower (OR = 4.184; 95% CI: 2.448-7.160; p < 0.001), gestational diabetes (OR = 3.494; 95% CI: 1.789-6.803; p < 0.001), UTI history (OR = 2.074; 95% CI: 1.114-3.834; p < 0.001) and haemoglobin (Hb) <100 g/L (OR = 8.022; 95% CI: 4.532-14.325; p < 0.001) are risk factors for UTI in pregnant women. The common pathogenic bacteria of pregnant women with UTI are mainly Gram-negative bacteria. Older pregnant women, low educational level, gestational diabetes mellitus, history of UTI and anaemia may be risk factors for UTI in pregnant women.

Global burden of maternal disorders attributable to malnutrition from 1990 to 2019 and predictions to 2035: worsening or improving?

Maternal malnutrition is a major global public health problem that can lead to serious maternal diseases. This study aimed to analyze and predict the spatio-temporal trends in the burden of maternal disorders attributable to malnutrition, and to provide a basis for scientific improvement of maternal malnutrition and targeted prevention of maternal disorders. Data on maternal disorders attributable to malnutrition, including number of deaths, disability-adjusted life years (DALYs), population attributable fractions (PAFs), age-standardized mortality rates (ASMRs), and age-standardized DALY rates (ASDRs) were obtained from the Global Burden of Disease Study 2019 to describe their epidemiological characteristics by age, region, year, and type of disease. A log-linear regression model was used to calculate the annual percentage change (AAPC) of ASMR or ASDR to reflect their temporal trends. Bayesian age-period-cohort model was used to predict the number of deaths and mortality rates to 2035. Global number of deaths and DALYs for maternal disorders attributable to malnutrition declined by 42.35 and 41.61% from 1990 to 2019, with an AAPC of -3.09 (95% CI: -3.31, -2.88) and -2.98 (95% CI: -3.20, -2.77) for ASMR and ASDR, respectively. The burden was higher among younger pregnant women (20-29 years) in low and low-middle socio-demographic index (SDI) regions, whereas it was higher among older pregnant women (30-39 years) in high SDI region. Both ASMR and ASDR showed a significant decreasing trend with increasing SDI. Maternal hemorrhage had the highest burden of all diseases. Global deaths are predicted to decline from 42,350 in 2019 to 38,461 in 2035, with the ASMR declining from 1.08 (95% UI: 0.38, 1.79) to 0.89 (95% UI: 0.47, 1.31). Maternal malnutrition is improving globally, but in the context of the global food crisis, attention needs to be paid to malnutrition in low SDI regions, especially among young pregnant women, and corresponding measures need to be taken to effectively reduce the burden of disease.

Contamination levels of perfluorinated and polyfluoroalkyl compounds in breast milk and assessment of their exposure risk to infants

The purposes of this study are to explore the contamination levels of perfluorinated and polyfluoroalkyl substances (PFASs) in breast milk and assess their exposure risk to infants. Based on data from a birth cohort study conducted in Yingcheng, Hubei Province, from 2018 to 2021, the contents of 23 types of PFASs in the breast milk of 324 pregnant women were determined using isotope dilution-high performance liquid chromatography-tandem mass spectrometry. Multiple linear regression was then performed to analyze the effects of various demographic characteristics and eating habits on the concentration of PFASs in breast milk. The daily PFASs intake of infants through breast milk was estimated, and the exposure risk of infants was also assessed. The results revealed that 23 types of PFASs in breast milk had good linear relationships in the range of 0.2-100 ng/mL, with correlation coefficients greater than 0.992. The limits of detection were 5-42 pg/mL, the limits of quantification were 15-126 pg/mL, the recoveries were 65.6%-108.1%, and the relative standard deviations were 1.6%-12.8%. Perfluorooctane sulfonic acid (PFOS), perfluorooctanoate acid (PFOA), and perfluorohexanesulfonic acid (PFHxS), with median concentrations of 200.7, 63.5, and 25.2 pg/mL, respectively, were the main PFASs found in breast milk. The detection rates of these three contaminants were higher than 80%, whereas the detection rates of other compounds were lower than 45%. The results of multiple linear regression showed that older pregnant women and a higher frequency of pickled food intake may be related to increased PFAS levels in breast milk whereas a higher frequency of legume intake may be related to decreased PFAS levels in breast milk. The median estimated daily intakes (EDIs) of PFOS, PFOA, and PFHxS for infants were 25.1, 7.9, and 3.2 ng/(kg·d), respectively. In summary, this study found notable PFAS levels in breast milk in Yingcheng, Hubei Province. Among these PFASs, PFOS, PFOA, and PFHxS were the main contaminants. Maternal age as well as pickled food and legume intake may affect the PFAS level in breast milk. The health risk of PFAS intake through breast milk to some infants is worthy of attention and further study.

Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil.

Despite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil. Blood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression. Overall, seropositivity was 69/280 (24.6, 95% CI: 19.96-30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73-25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12-12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77-6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity. Co-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations.

Analysis of influencing factors and the construction of predictive models for postpartum depression in older pregnant women.

Changes in China's fertility policy have led to a significant increase in older pregnant women. At present, there is a lack of analysis of influencing factors and research on predictive models for postpartum depression (PPD) in older pregnant women. To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women. By adopting a cross-sectional survey research design, 239 older pregnant women (≥ 35 years old) who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects. When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth, the Edinburgh PPD Scale (EPDS) was used to assess the presence of PPD symptoms. The women were divided into a PPD group and a no-PPD group. Two sets of data were collected for analysis, and a prediction model was constructed. The performance of the predictive model was evaluated using receiver operating characteristic (ROC) analysis and the Hosmer-Lemeshow goodness-of-fit test. On the 42nd day after delivery, 51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms. The incidence rate was 21.34% (51/239). There were statistically significant differences between the PPD group and the no-PPD group in terms of education level (P = 0.004), family relationships (P = 0.001), pregnancy complications (P = 0.019), and mother-infant separation after birth (P = 0.002). Multivariate logistic regression analysis showed that a high school education and below, poor family relationships, pregnancy complications, and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women (P < 0.05). Based on the influencing factors, the following model equation was developed: Logit (P) = 0.729 × education level + 0.942 × family relationship + 1.137 × pregnancy complications + 1.285 × separation of the mother and infant after birth -6.671. The area under the ROC curve of this prediction model was 0.873 (95%CI: 0.821-0.924), the sensitivity was 0.871, and the specificity was 0.815. The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant (χ2 = 2.749, P = 0.638), indicating that the model did not show an overfitting phenomenon. The risk of PPD among older pregnant women is influenced by educational level, family relationships, pregnancy complications, and the separation of the mother and baby after birth. A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.

Longitudinal changes of oxidative stress and PON1 lactonase activity and status in older pregnant women undergoing assisted reproductive technology: a prospective nested case-control study

BackgroundChildbearing in women with advanced maternal age (AMA) has increased the need for artificial reproductive technology (ART). ART and oxidative stress are associated with many pregnancy complications. Paraoxonase (PON) 1 is one of the key components responsible for antioxidative activity in high-density lipoprotein (HDL). This study aimed to investigate the longitudinal changes of oxidative stress and PON1 lactonase activity and status in older women undergoing ART.MethodsThis prospective nested case-control study included 129 control and 64 ART women. Blood samples were obtained respectively at different stages of pregnancy. PON1 level and lactonase activity were assessed using 7-O-diethylphosphoryl-3-cyano-4-methyl-7-hydroxycoumarin (DEPCyMC) and 5-thiobutyl butyrolactone (TBBL) as a substrate, respectively. A normalized lactonase activity (NLA) was estimated based on the ratio of TBBLase to DEPCyMCase activity. Serum total oxidant status (TOS), total antioxidant capacity (TAC), malondialdehyde (MDA), homocysteine (HCY), PON1 C-108T and Q192R genetic polymorphisms, and metabolic parameters were analyzed.ResultsLactonase activity and level of PON1 gradually decreased with pregnancy progression, while glycolipid metabolism parameters and TAC levels increased with pregnancy progression or significantly raised during the 2nd and 3rd trimesters, and NLA of PON1, TOS, OSI, MDA, and HCY significantly increased before delivery in the ART and control groups. Compared with the control women, the ART women had substantially higher or relatively high lactonase activity and NLA of PON1 and TAC during pregnancy; higher triglyceride (TG), total cholesterol, low-density lipoprotein cholesterol, atherogenic index, apolipoprotein (apo) B, and apoB/apoA1 ratio in the 1st trimester; and higher fasting glucose, fasting insulin, homeostatic model assessment of insulin resistance, and TG levels before delivery. No significant differences were found in the frequencies of PON1 C-108T and Q192R genotypes and alleles between the ART and control groups.ConclusionsWomen with AMA undergoing ART had higher TAC, PON1 lactonase activity, and PON1 NLA than control women, suggesting increased compensatory antioxidant capacity in ART women, thus showing higher sensitivity to oxidative stress-related injury and diseases.

EP16.11: Abnormal placental cord insertion increases in the lateral placenta of older pregnant women

EP16.11: Abnormal placental cord insertion increases in the lateral placenta of older pregnant women

Factors associated with oral health care behaviors of pregnant women in a northeastern province in Thailand: A hospital-based cross-sectional study.

Oral healthcare behavior leads to oral health status. Factors associated with oral healthcare behavior might affect oral hygiene in pregnant women, who are at high risk for gingivitis and dental caries. This study aimed to explore factors associated with oral healthcare behaviors during pregnancy among pregnant women in a northeastern province of Thailand. A total of 405 pregnant women who attended antenatal care clinics at one of the government hospitals in the province were invited to participate in this cross-sectional study. Dentists in the hospitals measured pregnant women's gingivitis and dental calculus status using mouth mirrors and explorers. A structured questionnaire was used to obtain variables of interest. Linear regression analysis, Beta and 95% confidence interval (CI) were applied. The majority were 20-24 years old (33.6%). Most of the participants had received upper secondary education (37.6%). Majority had gingivitis (88.1%) and dental calculus (88.6%). The findings revealed that age (Beta = -0.129, 95%CI = -0.269, -0.016), educational level (Beta = 0.118, 95% CI = 0.110, 0.183), and oral health literacy (Beta = 0.283, 95% CI = 0.156, 0.319) were statistically significant factors associated with oral healthcare behaviors. Younger pregnant women had better oral healthcare behaviors than older pregnant women and pregnant women had better oral healthcare behaviors due to higher educational levels and oral health literacy. Oral health promotion should be improved through oral health literacy, and interventions should be added to improve oral care skills particularly in older pregnant women as they are at a greater risk for poor oral healthcare behaviors.

The Importance of Early Diagnosis for Gestational Diabetes Mellitus

Recently, there has been an increase in the number of young individuals with obesity, as well as an increase in the number of older pregnant women, resulting in a higher incidence not only of gestational diabetes, but also of diabetes during the first trimester. In addition, there has been an increase in the number of pregnant women with higher-than-normal glucose tolerance that do not meet the diagnostic criteria for diabetes at their first prenatal examination. In such cases, it is important to consider whether it is appropriate to wait until gestational age of 24 weeks to diagnose gestational diabetes via the oral glucose tolerance test or whether early diagnosis and management should be pursued. There is a lack of high-quality research on the appropriate timing and methods for early diagnosis of gestational diabetes. The upcoming results of the ongoing the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) study will provide an opportunity to evaluate the appropriate timing for gestational diabetes diagnosis.

RISK FACTORS THE OCCURRENCE OF PREMATURE BIRTH

The article presents the data of a retrospective analysis of the frequency and structure of obstetric and perinatal complications based on the data of 100 cases of premature births in the Chernivtsi Regional Perinatal Center of Chernivtsi in 2021. This complication occurs much more often in older pregnant women, which is confi rmed by the data of other authors. A signifi cant number of pregnant women with premature birth suff ered infectious diseases in childhood. The given data indicate a certain infl uence of gynecological diseases in the development of premature birth. Pregnant women with premature birth often have various complications of the current pregnancy, a high frequency of complications of pregnancy and childbirth is observed. This causes a high frequency of operative interventions in childbirth. The retrospective analysis shows that the manifestations of miscarriage in the early gestational periods have a very adverse eff ect on the course of pregnancy and the intrauterine condition of the fetus and newborn.

Increasing maternal age associates with lower placental CPT1B mRNA expression and acylcarnitines, particularly in overweight women.

Older pregnant women have increased risks of complications including gestational diabetes and stillbirth. Carnitine palmitoyl transferase (CPT) expression declines with age in several tissues and is linked with poorer metabolic health. Mitochondrial CPTs catalyze acylcarnitine synthesis, which facilitates fatty acid oxidization as fuel. We hypothesized that the placenta, containing maternally-inherited mitochondria, shows an age-related CPT decline that lowers placental acylcarnitine synthesis, increasing vulnerability to pregnancy complications. We assessed CPT1A, CPT1B, CPT1C and CPT2 mRNA expression by qPCR in 77 placentas and quantified 10 medium and long-chain acylcarnitines by LC-MS/MS in a subset of 50 placentas. Older maternal age associated with lower expression of placental CPT1B, but not CPT1A, CPT1C or CPT2. CPT1B expression positively associated with eight acylcarnitines and CPT1C with three acylcarnitines, CPT1A negatively associated with nine acylcarnitines, while CPT2 did not associate with any acylcarnitine. Older maternal age associated with reductions in five acylcarnitines, only in those with BMI≥ 25kg/m2, and not after adjusting for CPT1B expression. Our findings suggest that CPT1B is the main transferase for placental long-chain acylcarnitine synthesis, and age-related CPT1B decline may underlie decreased placental metabolic flexibility, potentially contributing to pregnancy complications in older women, particularly if they are overweight.

Modeling the spatial patterns of antenatal care utilization in Nigeria with inference based on Pólya-Gamma mixtures

Despite the vast advantages of making antenatal care visits, the service utilization among pregnant women in Nigeria is suboptimal. A five-year monitoring estimate indicated that about 24% of the women who had live births made no visit. The non-utilization induced excessive zeroes in the outcome of interest. Thus, this study adopted a zero-inflated negative binomial model within a Bayesian framework to identify the spatial pattern and the key factors hindering antenatal care utilization in Nigeria. We overcome the intractability associated with posterior inference by adopting a Pólya-Gamma data-augmentation technique to facilitate inference. The Gibbs sampling algorithm was used to draw samples from the joint posterior distribution. Results revealed that type of place of residence, maternal level of education, access to mass media, household work index, and woman's working status have significant effects on the use of antenatal care services. Findings identified substantial state-level spatial disparity in antenatal care utilization across the country. Cost-effective techniques to achieve an acceptable frequency of utilization include the creation of a community-specific awareness to emphasize the importance and benefits of the appropriate utilization. Special consideration should be given to older pregnant women, women in poor antenatal utilization states, and women residing in poor road network regions.

Discussion on Application Strategies of Genetic Counseling

In recent years, with the rapid development of the field of genetics, genetic counseling services have developed rapidly in obstetrics, reproductive genetics, pediatrics and other disciplines, and are also gradually developed in the medical process of other disciplines such as oncology and multidisciplinary consultation. Genetic counseling physicians can reduce the risk of recurrence of genetic diseases by judging the pathogenesis of genetic diseases, selecting appropriate genetic testing techniques, analyzing test results, diagnosing diseases, carrying out genetic counseling to assist the treatment of genetic diseases, and giving fertility guidance. Genetic counseling service is the genetic counseling physicians through appropriate genetic counseling strategies to genetic basic research and genetic laboratory testing technology into clinical transformation, reduces the risk of birth defects and genetic diseases recurrence,reduces the mental and economic burden of hereditary diseases on the patients themselves, their families and society. At the same time, with the opening-up of Chinese fertility policy, the increase of the proportion of older pregnant women and the increase of the risk of birth defects, as well as the implementation of the "Healthy China 2030" program, the demand for genetic counseling services has increased in many disciplines. This paper will discuss the practical application of the current genetic counseling service strategy in clinical medicine.

Comparison of Perinatal and Neonatal Outcomes of Very Advanced Maternal Aged Pregnants and Early Adolescent Pregnant Women

Aims: In recent years, very early pregnancies and very advanced pregnancies have increased. In our study, we aimed to compare these groups in terms of maternal and fetal risks. Materials and Methods: This study retrospectively were compared the perinatal outcomes of women of reproductive age in 80 early adolescent pregnant (16 years and younger) and 67 older pregnant women (45 years and older) followed in Siirt Training and Research Hospital between 2017 and 2021 in Siirt Training and Research Hospital (Siirt, Turkey). In cases gravida, parity, hemogram, biochemistry, urine, week of birth, fetal weight, gender, APGAR 1-5. min, mode of delivery (vaginal delivery/ cesarean section), miscarriage, neonatal death, premature rupture of membranes (PROM), premature birth, placental ablation, fetal distress, intrauterine death, gestational diabetes mellitus (GDM), preeclampsia, surmaturation, polyhydramnios , oligohydramnios, presentation anomaly, multiple pregnancy, intrauterine growth retardation (IUGR), postpartum hemorrhage, placenta previa, maternal and fetal outcomes in three pregnant groups were evaluated. Results: Normal spontaneous vaginal delivery (NSVD)/Cesarean section (C/S)" parameter was found to be significantly higher in pregnant women aged 45 and above, while it was found to be significantly lower in the group aged 16 and below(p&lt;0.0001). Spontaneous abortion, on the other hand, was not found significantly in the 16-year-old and younger group compared to the other groups, while it was significantly higher in pregnant women aged 45 and above(p&lt;0.0001).The incidence of GDM was significantly higher in pregnant women aged 45 and over, but it was not determined in pregnant women aged 16 and younger (p=0.003). The incidence of preeclampsia was also found to be significantly higher in pregnant women aged 45 and over (p&lt;0.0001). The incidence of polyhydramnios was significantly higher in the risky pregnant group than in the control group (p=0.015). The incidence of presentation anomaly was found to be significantly higher in pregnant women aged 45 and over (p=0.012). No statistically significant difference was found in other parameters. Conclusion : Both early adolescent pregnancies and very advanced age pregnancies have their own problems. The obstetrician should be aware of these in his approach to both groups.

The protective role of social support on prenatal depression among pregnant women of advanced maternal age: a Three-Trimester follow-up study in China

The aim of this study was to compare the depressive symptoms during pregnancy between pregnant women aged over 35 years and those aged less than 35 years and to evaluate the protective effect of social support in early pregnancy against prenatal depressive symptoms. One hundred and seventy one women aged over 35 years and 342 trimester-matched women aged less than 35 years were included from a level III hospital in Shenzhen, China. The self-report Edinburgh Postnatal Depression Scale (EPDS) and Social Support Rating Scale (SSRS) were used to evaluate prenatal depression and social support in early pregnancy. The proportions of women aged over 35 years who screened positive for prenatal depression were 22.8%, 23.4%, and 24.0% in the first, second and third trimesters, respectively. Advanced maternal age (≥35 years) was a positive predictor of prenatal depressive symptoms (β = 0.747, P = 0,008). Social support, especially objective support (β = -0.030, P = 0.002) and subjective support (β = -0.028, P = 0.006) in early pregnancy, had stronger protective effects against prenatal depressive symptoms for women aged over 35 years than younger women. Our findings support that older pregnant women experience more depressive symptoms than younger pregnant women, and social support could serve as a targeted intervention to decrease prenatal depressive symptoms. Impact statement What is already known on this subject? Depressive symptoms, which are strongly associated with adverse psychosocial and birth outcomes, appear to be prevalent and change in nature. Social support is an important protective factor against prenatal depression. What the results of this study add? Pregnant women of advanced maternal age experienced more depressive symptoms than younger women during the prenatal period. Social support, especially objective support and subjective support, had stronger protective effects against prenatal depression for women aged over 35 years than women aged less than 35 years. What the implications of these findings are for clinical practice? Screening of prenatal depression should be strengthened, especially for women aged over 35 years, and improving subjective support could improve their emotional experience.

Cross-Cultural Adaptation and Validation of the Pregnancy Mobility Index for the Italian Population: A Cross-Sectional Study.

Introduction: Pregnancy is a specific condition that modifies the mobility of women. In this population, it seems important to use specific tools to properly assess them. The Pregnancy Mobility Index (PMI) was created in 2006 with the aim of assessing mobility in pregnant women. The goal of this study was to translate, adapt, and evaluate the statistical properties of the questionnaire in the Italian pregnant population. Methods: The PMI underwent translation and transcultural adaptation. Reliability and concurrent validity, compared to the Oswestry Disability Index (ODI), was investigated on a sample of pregnant women. An ANOVA was performed to detect differences in the PMI score considering the Body Mass Index (BMI) and age of the sample. Results: The PMI was forward translated, back translated, and transculturally adapted. A consensus meeting accepted the final version of the questionnaire. The PMI was given to 93 pregnant women. PMI showed excellent reliability for every item and the total score (Cronbach’s alpha of 0.945). Concurrent validity compared with ODI items 2–9 was strong considering the total score, with r = 0.726, but moderate comparing the first item of the ODI and the total score of the PMI, r = 470, and considering the total score of both questionnaires (r = 0.683). The ANOVA showed statistical difference in pregnant women with lower BMI for every subscale and total score of PMI (p = 0.009) and for outdoor mobility considering age (p = 0.019). Conclusions: The PMI seems to be a valid and reliable tool to assess mobility in the pregnant population. Pregnant women with a lower BMI showed a greater mobility score in the PMI. In turn, younger pregnant women presented a lower mobility score compared to older pregnant women.