Pregnancy Outcomes In Women Research Articles

Epidemiology and Outcomes of Hepatitis E Virus-Associated Hospitalisations in the United States With a Focus on Pregnancy: A Nationwide Population Study, 1998-2020.

Hepatitis E virus (HEV) is typically asymptomatic in developed countries but can be more severe in certain populations. We aim to describe the epidemiology of HEV-associated hospitalisations from 1998 to 2020 in the United States, investigate risk factors for inpatient mortality and describe outcomes in pregnant women. We utilised the National Inpatient Sample and extracted cases of HEV-associated hospitalisations using ICD-9/10 diagnostic codes. Demographic, clinical and pregnancy data were extracted and analysed by chi-square and logistic regression. We identified 3354 cases of HEV-associated hospitalisations; 1689 (50.4%) were female and 1425 (42.5%) were non-Hispanic White. The median age was 50 (IQR: 37-59) years. Hospitalisation rates for HEV ranged from 2.5 per 10,000,000 in 2008 to a peak of 9.6 per 10,000,000 people in the general U.S. population in 2004. The mortality rate was 5.2%. Age ≥ 40 years (OR: 7.73; 95% CI: 1.57-38.09; p = 0.012), HIV infection (OR: 4.63; 95% CI: 1.26-16.97; p = 0.021), and coagulopathy (OR: 7.22; 95% CI: 2.81-18.57; p < 0.001) were associated with increased odds of mortality within the HEV cohort. There were 226 pregnant women with HEV. Rates of maternal death, stillbirth and preterm birth were similar between HEV and non-HEV pregnant cohorts. Hepatitis B and hepatitis C co-infection were significantly more common in the HEV pregnant cohort (p < 0.05). HEV-associated hospitalisations are uncommon in the United States, but likely underdiagnosed. Certain risk factors can be used to predict prognosis of these hospitalised patients. Pregnant women with HEV appear to have favourable maternal and fetal outcomes despite hepatitis B and C co-infection.

Associations of High BMI and Excessive Gestational Weight Gain With Pregnancy Outcomes in Women With Type 1 Diabetes: A Systematic Review and Meta-analysis.

The increased risk of pregnancy complications in type 1 diabetes is mainly attributed to maternal hyperglycemia. However, it is unclear whether other potentially modifiable factors also contribute to risk in this population. We sought to assess whether high BMI and excessive gestational weight gain (GWG) are associated with perinatal complications in type 1 diabetes. We searched Medline, Embase, PubMed, Scopus, Web of Science, and Cochrane databases to January 2024. Studies examining associations between periconception BMI or GWG and perinatal complications in type 1 diabetes were included. We used a predesigned data extraction template to extract study data including year, country, sample size, participants' characteristics, exposure, and outcomes. We included 29 studies (18,965 pregnancies; 1978-2019) in the meta-analysis. A 1 kg/m2/1 kg increase in preconception BMI or GWG was associated with a 3% and 11% increase, respectively, in perinatal complications (BMI odds ratio [OR] 1.03 [95% CI 1.01-1.06]; GWG OR 1.11 [95% CI 1.04-1.18]). Preconception BMI ≥ 25 kg/m2 or excessive GWG was associated with a 22% and 50% increase, respectively, in perinatal complications (BMI OR 1.22 [95% CI 1.11-1.34]; GWG OR 1.50 [95% CI 1.31-1.73]). BMI was associated with congenital malformation, preeclampsia, and neonatal intensive care unit admission. Excessive GWG was associated with preeclampsia, cesarean delivery, large for gestational age, and macrosomia. Limitations included retrospective study design, variable measurement for exposures and outcomes, small number of studies for some outcomes, and no data from Asia and Africa. Addressing maternal BMI prepregnancy and preventing excessive GWG should be key clinical priorities to improve outcomes in pregnant women with type 1 diabetes.

Birth outcomes in pregnant women with gestational diabetes mellitus

From the perspective of modern obstetrics, gestational diabetes mellitus (GDM) is considered an epidemic of the 21st century. It can complicate the course of pregnancy at any week of gestation. The purpose of the work was to determine the influence of the gestational age of GDM onset on birth outcomes in pregnant women. Materials and methods: During the study, a retrospective analysis of 362 individual records of pregnant and postpartum women was carried out. Results: Earlier onset of GDM is significantly more often associated with the development of symphysitis in the mother, with fetal growth retardation and the need to use insulin therapy to correct hyperglycemia. Conclusions: Regardless of the period of onset of GDM, pregnant women constitute a risk group for obstetric and perinatal complications.

Adverse Pregnancy Outcomes in Solid Organ Transplant Recipients

Transplant recipients experience high rates of adverse pregnancy outcomes; however, contemporary estimates of the association between solid organ transplantation and adverse pregnancy outcomes are lacking. To evaluate the association between solid organ transplantation and adverse pregnancy outcomes and to quantify the incidence of allograft rejection and allograft loss during pregnancy. PubMed/MEDLINE, EMBASE and Scopus databases were searched from January 1, 2000, to June 20, 2024, and reference lists were manually reviewed. Cohort and case-control studies that reported at least 1 adverse pregnancy outcome in pregnant women with solid organ transplantation vs without solid organ transplant or studies that reported allograft outcomes in pregnant women with solid organ transplantation were included following independent dual review of abstracts and full-text articles. Two investigators abstracted data and independently appraised risk of bias using the Newcastle Ottawa Scale. A random-effects model was used to calculate overall pooled estimates using the DerSimonian-Laird estimator. Reporting followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. Primary pregnancy outcomes were preeclampsia, preterm birth (<37 weeks), and low birth weight (<2500 g). Secondary pregnancy outcomes were live birth rate, gestation, very preterm birth (<32 weeks), very low birth weight (<1500 g), and cesarean delivery. Allograft outcomes were allograft loss and rejection during pregnancy. Data from 22 studies and 93 565 343 pregnancies (4786 pregnancies in solid organ transplant recipients) were included; 14 studies reported adverse pregnancy outcomes, and 13 studies provided data for allograft outcomes. Pregnancies in organ transplant recipients were associated with significantly increased risk of preeclampsia (adjusted odds ratio [aOR], 5.83 [95% CI, 3.45-9.87]; I2 = 77.4%), preterm birth (aOR, 6.65 [95% CI, 4.09-12.83]; I2 = 81.8%), and low birth weight (aOR, 6.51 [95% CI, 2.85-14.88]; I2 = 90.6%). The incidence of acute allograft rejection was 2.39% (95% CI, 1.20%-3.96%; I2 = 68.5%), and the incidence of allograft loss during pregnancy was 1.55% (95% CI, 0.05%-4.44%; I2 = 69.2%). In this systematic review and meta-analysis, pregnancies in recipients of a solid organ transplant were associated with a 4 to 6 times increased risk of preeclampsia, preterm birth, and low birth weight during pregnancy. There was a low overall risk of graft rejection or loss during pregnancy.

Comparative Study of Pregnancy Outcomes in Women With COVID-19 Disease During the Three Waves of the Pandemic in Eastern India.

Introduction Healthcare systems around the world were disrupted by the COVID-19pandemic. Multiple waves were experienced by most countries, and clinical symptoms and severity varied between these waves. A COVID-19 infection in pregnant women may result in complications for both the mother and the fetus and thus pose an additional challenge for clinicians. The study of the different presentations, complications, and pregnancy outcomes during the three waves is important to study the effect of the disease on pregnant women. Objective This study aimed to analyze and compare the clinical presentations, comorbid conditions, complications, and pregnancy outcomes in women with SARS-CoV-2infection during the three waves of the pandemic. Methodology The present study is a comparative study undertaken at Tata Main Hospital, a referral hospital in Jamshedpur in eastern India. The study period was from May 2020 to February 2022 and was divided according to the three waves of the pandemic. The duration of the first wave was between 1st May 2020 and 28thFebruary 2021; the second wave was between 1stMarch 2021 and 31stOctober 2021; and the third wave was between 1stNovember 2021 and 28thFebruary 2022. A total of 306 pregnant women tested positive for COVID-19 disease during the study period. A retrospective collection of data was done, and clinical findings, laboratory results, comorbid conditions, and outcomes were compared across the three waves. Results During the first wave of the pandemic, 139 COVID-19-positive pregnant women were admitted to our hospital. During the second wave, 110 admitted pregnant women tested positive for SARS-CoV-2 infection, and during the third wave, 57 pregnant women tested positive for SARS-CoV-2 infection. Asymptomatic or mild disease was the most commonly seen presentation during all the waves, but a significantly higher number of moderate and severe cases were seen during the second wave. The second wave also witnessed a higher rate of cesarean sections when compared to the other two waves. The preterm delivery rate was 27.8%, 24.7%, and 25% during the first, second, and third waves of the pandemic, respectively. The third wave of the pandemic had the highest percentage of stillbirths, which was significantly higher than both the first and second waves. The COVID-19 test was positive in four babies during the study period. Conclusion The severity of COVID-19 disease varied among the three waves, and the second wave recorded the maximum number of moderate and severe cases.Maternal mortality was also significantly higher during the second wave. The rate of preterm deliveries was high during all the waves, and theincidence of stillbirths was highest during the third wave.

Impact of elevated serum estradiol levels before progesterone administration on pregnancy outcomes in frozen-thawed embryo transfer for hormone replacement therapy

ObjectiveThe objective of this retrospective cohort study is to investigate the impact of monitoring serum estradiol (E2) levels before progesterone administration within hormone replacement therapy (HRT) on pregnancy outcomes in women undergoing frozen-thawed embryo transfer (FET).MethodsAnalyzed HRT-FET cycles conducted at a reproductive center from 2017 to 2022. Serum E2 levels were measured prior to progesterone administration. Multivariate stratified and logistic regression analyses were performed on 26,194 patients grouped according to terciles of serum E2 levels before progesterone administration.ResultsThe clinical pregnancy rate (CPR) and live birth rate (LBR) exhibited a gradual decline with increasing serum E2 levels across the three E2 groups. Even after controlling for potential confounders, including female age, body mass index, infertility diagnosis, cycle category, number of embryos transferred, fertilization method, indication for infertility, and endometrial thickness, both CPR and LBR persistently showed a gradual decrease as serum E2 levels increased within the three E2 groups. The same results were obtained by multivariate logistic regression analysis.ConclusionsThis large retrospective study indicates that elevated serum E2 levels before progesterone administration during HRT-FET cycles are associated with reduced CPR and LBR post-embryo transfer. Therefore, it is advisable to monitor serum E2 levels and adjust treatment strategies accordingly to maximize patient outcomes.

Pregnancy outcomes in women with Celiac disease in Northeast Iran: a regional retrospective cohort study

PurposeTo investigate the odds and associations of pregnancy outcomes with exposure to biopsy-confirmed celiac disease (CD) in Northeast Iran.MethodsIn this regional retrospective cohort study, pregnancy records of all women with celiac disease who visited Celiac Disease Clinic of Imam-Reza Hospital from 2017 to 2023 (exposed group) and a sample of women without CD (unexposed group) were extracted using the Electronic Health Record of Mashhad University of Medical Sciences called “Sina”. The unexposed group was randomly selected of the database and matched to exposed group on age, location of residence, socioeconomic factors. Our exclusion criteria included age ≥ 45, presence of concomitant disorders, history of non-obstetric uterine surgery, induction of pregnancy through assisted reproductive technology, and any concurrently ongoing pregnancy at the time of study. Pregnancy outcomes evaluated in this study included normal delivery, miscarriage, preterm labor, preeclampsia, and stillbirth. Adjusted odds ratios were calculated using logistic regression adjusted for confounders.ResultsNinety pregnancy records of women with CD and 270 pregnancies of women without CD were included in this study. Low neonatal birthweight (i.e. under 2500 g) had no significant association with CD (aOR = 0.99, 95% CI = 0.92–1.06), as well as postpartum hemorrhage (aOR = 1.12, 95%CI = 0.91–1.38), fetal anomaly (aOR = 0.89, 95%CI = 0.69–1.15), miscarriage (aOR = 1.00, 95%CI = 0.91–1.10), ectopic pregnancy (aOR = 0.94, 95%CI = 0.73–1.20), preterm labor (aOR = 1.00, 95%CI = 0.92–1.10), gestational diabetes mellitus (aOR = 1.07, 95%CI = 0.98–1.16), gestational hypertension (aOR = 0.99, 95%CI = 0.89–1.11), and gestation hypothyroidism (aOR = 0.95, 95%CI = 0.82–1.11). However, we found significantly lower odds of preeclampsia in pregnancies affected by CD (aOR = 0.83, 95%CI = 0.69–0.99).ConclusionCeliac disease was not associated with increased odds of low neonatal birthweight, postpartum hemorrhage, fetal anomaly, miscarriage, ectopic pregnancy, preterm labor, gestational diabetes mellitus, gestational hypertension and gestational hypothyroidism. Preeclampsia had significantly lower odds in pregnancies affected with CD.

Perinatal outcomes in pregnant women with ITP: a single tertiary center experience.

In this study, we aimed to compare the maternal and neonatal outcomes in pregnant women diagnosed with idiopathic thrombocytopenic purpura (ITP) in our clinic between different platelet groups. This study was designed retrospectively. A total of 62 pregnant women with ITP were included in the study. Demographic and clinical data for all cases were evaluated. Perinatal outcomes were evaluated according to platelet counts. The median age of the patients participating in the study was 27, and their ages ranged from 21 to 44. ITP was diagnosed before pregnancy in 32.3 % (n=20) of the patients and during pregnancy in 67.7 % (n=42). The average platelet counts of the patients during the first trimester and birth were 104.8/μL (15-168) and 84/μL (16-235), respectively. The average platelet count of newborns is 242/μL. The most common (74.2 %) ITP treatment method is the combination of steroids and IVIG. The platelet count of 80.6 % of newborns is above 151/μL. There was no statistical difference between the results of both mothers and fetuses when the groups were categorized according to maternal platelet levels. In this study, no difference was observed in maternal and neonatal morbidity and mortality rates, despite the different platelet counts of patients with ITP. The cooperation of the hematology, gynecology, obstetrics, and neonatology departments is responsible for this.

Innovative hemostasis technique for cesarean section in placenta previa: A retrospective study.

To evaluate hemostatic efficacy, complications, and subsequent pregnancy outcomes in women with placenta previa who underwent combined vertical compression sutures in the lower uterine segment and intrauterine balloon tamponade (Hot-Dog method) to achieve hemostasis after cesarean section. We retrospectively reviewed data for 117 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between 29 and 38 weeks' gestation. Treatments were as follows: (1) conventional-intravenous oxytocin administration after placental detachment and suturing of bleeding points at the detachment site as needed (conventional group) (n = 47). (2) Intrauterine balloon tamponade alone (balloon group) (n = 41). (3) Vertical compression sutures + intrauterine balloon tamponade (Hot-Dog group) (n = 29). The placenta accreta spectrum prevalence was significantly higher in the balloon and Hot-Dog groups versus the conventional group. The prevalence of anteriorly located placenta was significantly higher in the Hot-Dog versus balloon groups. Intraoperative and total blood loss were significantly higher in the Hot-Dog versus conventional groups. Postoperative blood loss was significantly lower in the Hot-Dog versus balloon groups. Fewer additional procedures for managing postoperative hemorrhage were required in the Hot-Dog versus conventional and balloon groups. The number of subsequent pregnancies in the conventional, balloon, and Hot-Dog groups was 11 (23.4%), 8 (19.5%), and 4 (13.8%), respectively; all resulted in live births at term without serious obstetric complications. The Hot-Dog method is a straightforward and safe hemostasis technique for placenta previa that preserves fertility and controls severe bleeding.

Lupus pregnancy outcomes in women with previous adverse outcomes: a prospective cohort study.

The primary objective of this prospective cohort study was to assess the usefulness of a predefined multidisciplinarycare pathway-based management on pregnancy outcome(s) in women with SLE who already had at least one adverse obstetric outcome(s). Between March 2010 and March 2023, all consecutive, consenting women with SLE who already had at least one previous adverse obstetric outcome (preterm labour, pre-eclampsia, termination of pregnancy, miscarriage, intrauterine growth retardation (IUGR), preterm birth, low birth weight (LBW), intrauterine death (IUD) or stillbirth] were prospectively screened and counselled. The protocol comprised preconception and post-natal drug and disease status review, periodic ante-natal visits for the monitoring of pregnancy and drug and disease status review and post-natal drug and disease status review and contraception advice. Therapeutic changes were made as necessary at each visit. A total of 213 women were screened and 197 women (age, 28 ± 6.34years) were enrolled who had 226 pregnancies. Previous poor obstetric outcomes were miscarriage(s), 186; termination of pregnancy, 4; preterm labour, 51; IUGR, 36; IUD or stillbirth, 16; low birth weight (LBW), 44 and pre-eclampsia, 4. Seventy-seven (39%) women had secondary APS and 37 (19%) had a history of lupus nephritis. There were 194/226 (86%) live births [40 LBW (18%); caesarean section in 101 (45%)]. Thirty pregnancies culminated in miscarriages and 2 in IUDs (14%). Sixty-eight patients (30%) experienced lupus flare during pregnancy (36 mild, 20 moderate and 8 severe). Our experience underscores the usefulness of a predefined multidisciplinarycare pathway-based managementfor improving pregnancy outcomes in women with SLE who had previous adverse outcomes. Key Points • In women with SLE who had previous adverse obstetric outcome(s) a risk of poor outcome in subsequent pregnancy remains. • Good pregnancy outcomes in these women could be achieved bypredefined multidisciplinary care pathways focussed on addressing all relevant issues. • Improved access to rheumatology services and collaboration between rheumatologists and obstetricians is key to improving outcomes in SLE pregnancies.

Pregnancy Outcome in Women with Decreased Fetal Movement Beyond 34 Weeks of Gestation

Introduction: The fetal movement though subjective still is considered an important sign of fetal well-being. It is used as the first method for fetal well being assessment. Decreased fetal movement (DFM) always alerts the obstetricians and needs appropriate intervention as it is generally found to be associated with poor fetomaternal outcome. This study was conducted to determine the pregnancy outcome in women with decreased fetal movements at gestational age ≥34 weeks to 42 weeks of gestation. Methods: This was a hospital- based retrospective observational study done in Obstetrics and Gynecology Department of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from April 2020 to April 2021. Descriptive analysis and data processing was done by using IBM SPSS Statistics 22. Results: There were a total of 82 women with decreased fetal movement. Among these, induction of labor was done in 35.5%, while 23.1% had preterm delivery, 47.6% had cesarean delivery and 51.1% had vaginal delivery with 1.2% vaccum delivery. Though there were higher rates of low APGAR score (15.8%), meconium stained liquor (MSL) (21.9%) and Neonatal Unit admission (NNU) (21.9%), all the babies admitted were discharged except for one perinatal death (1.2%). There was no still birth. Conclusion: Although perinatal mortality was low in women with decreased fetal movement with negligible still birth, however there were increased MSL and neonatal admission. Hence raising awareness of DFM among women, its early identification, further assessment with ultrasound, cardiotocogram and structured management protocol is beneficial .

Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-Women's Endocrinology.

To provide the latest scientific knowledge on the efficacy of inositols for improving reproductive disorders in women with and without polycystic ovary syndrome (PCOS) and to reach a consensus on their potential use through a Delphi-like process. A panel of 17 endocrinologists and 1 gynecologist discussed 4 key domains: menses irregularity and anovulation, fertility, pregnancy outcomes, and neonatal outcomes. A total of eight consensus statements were drafted. Myo-inositol (Myo) supplementation can be used to improve menses irregularities and anovulation in PCOS. Myo supplementation can be used in subfertile women with or without PCOS to reduce the dose of r-FSH for ovarian stimulation during IVF, but it should not be used to increase the clinical pregnancy rate or live birth rate. Myo supplementation can be used in the primary prevention of gestational diabetes mellitus (GDM), but should not be used to improve pregnancy outcomes in women with GDM. Myo can be preconceptionally added to folic acid in women with a previous neural tube defects (NTD)-complicated pregnancy to reduce the risk of NTDs in newborns. Myo can be used during pregnancy to reduce the risk of macrosomia and neonatal hypoglycemia in mothers at risk of GDM. This consensus statement provides recommendations aimed at guiding healthcare practitioners in the use of inositols for the treatment or prevention of female reproductive disorders. More evidence-based data are needed to definitively establish the usefulness of Myo, the appropriate dosage, and to support the use of D-chiro-inositol (DCI) or a definitive Myo/DCI ratio.

Prediction of Pregnancy Outcomes in Women with Threatened Abortion Using Ultrasound Parameters, Uterine Artery Doppler, and Serum Progesterone Levels: A Prospective Cohort Study

Prediction of Pregnancy Outcomes in Women with Threatened Abortion Using Ultrasound Parameters, Uterine Artery Doppler, and Serum Progesterone Levels: A Prospective Cohort Study

Course and outcome of pregnancy in women with Alport syndrome

Course and outcome of pregnancy in women with Alport syndrome

Possibilities of Predicting the Manifestation of HELLP Syndrome

Introduction. Despite the use of modern principles of treatment of severe preeclampsia, mortality rates for mother and newborn in the development of life-threatening complication of preeclampsia, such as HELLP syndrome, remains high. The introduction of accurate models of early diagnosis and prediction of the probability of manifestation and severity of the HELLP syndrome into everyday medical practice will improve the safety of delivery of pregnant women with severe preeclampsia.The aim of the study is to determine the current state of the issue and systematize current data on methods of predicting the probability of HELLP syndrome manifestation.Materials and methods. An analytical review of the literature. A qualitative analysis of clinical trials and reviews on prediction of HELLP syndrome was conducted using the following data sources: PubMed and Google Scholar. The search was carried out in Russian and English, using the keywords “predictors”, or “prediction”, and “HELLP syndrome”. The date of the last search query is 22 March 2024.Results. Anamnestic data and initial characteristics of patients with HELLP syndrome were analyzed.Discussion. The analytical review included publications devoted to the study of the influence of predictive capabilities of potential biochemical markers, clinical and anamnestic signs and instrumental examination data on the probability of HELLP syndrome development.Conclusion. Adequate prediction of the manifestation of HELLP syndrome is possible on the basis of a comprehensive analysis of all identified factors, allowing the identification of effective prognostic models to improve maternal and fetal outcomes in pregnant women with severe preeclampsia.

Comparison of ICSI and Spontaneous Pregnancy Outcomes in Women with Unexplained Infertility

Aim: This study aimed to investigate whether there is a difference between the results of intracytoplasmic sperm injection (ICSI) pregnancies and subsequent spontaneous pregnancies with a diagnosis of unexplained infertility. Material and Methods: In this retrospective study, a total of 48 women who first conceived with ICSI and then achieved spontaneous pregnancy were included. Duration and causes of infertility, time to spontaneous conception, pregnancy outcomes, and maternal and neonatal complications were evaluated. Results: Maternal age was older in the spontaneous pregnancy group compared to the ICSI group (p=0.029). The gestational age at delivery was found similar in both groups. Although birth weight was higher in the spontaneous pregnancy group, the difference between the groups was not statistically significant (p=0.382). The time to achieve pregnancy was shorter in the spontaneous pregnancy group (p=0.001). Gestational diabetes was significantly higher in the spontaneous pregnancy group (p=0.001), while amniotic fluid abnormality, gestational hypertension (p=0.001), and preterm delivery (p=0.001) were significantly higher in the ICSI group. While the number of babies with the 1st-minute low Apgar score was higher in the ICSI group (%4.16 vs 2.08%, p=0.001), the 5th-minute Apgar score was similar. Conclusion: Even if couples are evaluated as infertile, it should be taken into consideration that they can achieve spontaneous pregnancy. It may be rational to wait for spontaneous pregnancy in eligible couples with unexplained infertility and not to refer the patient for early assisted reproductive techniques.

Pregnancy Outcome in Women with Pulmonary Artery Hypertension: A Retrospective Time-bound Study in a Tertiary Care Institute in North Eastern India

Pregnancy Outcome in Women with Pulmonary Artery Hypertension: A Retrospective Time-bound Study in a Tertiary Care Institute in North Eastern India

Exposure to golimumab during pregnancy: Results from the Company's global safety database.

Data on the use of golimumab (GLM) during pregnancy are limited. This study evaluated pregnancy outcomes in women treated with GLM during pregnancy. Cumulative data on GLM-exposed pregnancies from the Company's global safety database (GSD) are summarized. Cases were medically confirmed maternal exposures to GLM during pregnancy or within 3 months prior to conception with a reported pregnancy outcome. Pregnancy outcomes (e.g., live births) and congenital anomalies in prospectively reported cases (i.e., pregnancy outcome not known when first reported to the company) are presented in a descriptive manner. As of May 31, 2022, 261 prospectively reported pregnancies exposed to GLM were reported in the GSD: 214 (82.0%) live births (including six sets of twins), 31 (11.9%) spontaneous abortions (including one set of twins), 13 (5.0%) induced/elective abortions, 2 (0.8%) reported intrauterine death/still birth, and 1 (0.4%) fetal adverse event in an ongoing pregnancy. The majority of pregnancies had exposure to GLM at least in the first trimester of pregnancy. In total, seven congenital anomalies (7/261; 2.7%) were reported. Of these seven congenital anomalies, five were considered major according to EUROCAT classification version 1.4. Among the five prospectively reported congenital anomalies noted in live births (5/214; 2.3%), four were classified as major (4/214; 1.8%). The rates of adverse pregnancy outcomes and major congenital anomalies in prospectively reported pregnancy cases with exposure to GLM in the Company's GSD were consistent with published background rates for the general population.

Risk prediction for preeclampsia in CKD patients: development of a model in a retrospective cohort.

Chronic kidney disease (CKD) mayaffect women of childbearing age and maylead to substantial maternal and foetal morbidity and mortalityin pregnancy. There is a lack of prediction models for preeclampsia and adverse pregnancy outcomes in pregnant women with CKD. This study aimed to create a prediction nomogram for these issues. This retrospective cohort study included clinical data from 627 women with CKD and their 627 pregnancies at Peking University First Hospital between January 1, 2009, and December 31, 2022. Multivariate logistic regression analysis was conducted to identify independent prognostic factors and develop a nomogram for predicting the occurrence of preeclampsia. The identified risk factors were utilised to construct the nomogram, which was subsequentlyinternally validated using receiver operating characteristic (ROC) analysis and calibration curve assessment. According to our multivariate analysis, age, blood urea nitrogen (BUN), serum creatinine (Scr), mean arterial pressure (MAP), 24-h proteinuria, and CKD stage were identified as predictors of preeclampsia. Additionally, Scr, MAP, BUN, and 24-h proteinuria were found to be predictors of adverse pregnancy outcomes. The nomogram for predicting preeclampsia had an area under the ROC curve of 0.910, while the nomogram for predicting adverse pregnancy outcomes had an area under the ROC curve of 0.906. Both models demonstrated excellent discriminatory ability. A nomogram based on 24-h proteinuria, serum creatinine, serum urea and age, and MAP allows predicting the occurrence of preeclampsia and other adversepregnancy-related outcomes in CKD patients.

Systematic review and meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome

Screening for polycystic ovary syndrome (PCOS) in antenatal care is inadequate, largely owing to the lack of clarity around whether PCOS is an independent risk factor for pregnancy complications. This systematic review and meta-analysis include 104 studies and 106,690 pregnancies in women with and without PCOS from inception until 13th July 2022. We report that women with PCOS are younger and have higher body mass index (BMI) around conception and have greater gestational weight gain. The odds of miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia and cesarean section are higher in women with PCOS. The increased odds of adverse outcomes in PCOS remain significant when age and BMI are matched and when analyses are restricted to high-quality studies. This work informed the recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome, emphasizing that PCOS status should be captured in all women who are planning to, or have recently become pregnant to facilitate prevention of adverse outcomes and improve pregnancy outcomes.