Preconception Period Research Articles

Prenatal ozone exposure and risk of intellectual disability.

Knowledge of relationships between tropospheric ozone and mental and developmental health outcomes is currently inconclusive, with the largest knowledge gaps for children. This gap is important to address as evidence suggests that climate change will worsen ozone pollution. We examine the association of average ozone exposure during the preconception period, and first, second and third trimesters of pregnancy on the odds of intellectual disability (ID) in Utah children. For the period of 2002-2020, we assembled daily, tract-level ozone concentration data, data on ID case status, and data on cases' full siblings and population controls. We analyzed the data using generalized estimating equations. Ozone was positively associated with the odds of ID in cases vs. their siblings (in the preconception, first, second and third trimester exposure windows, all p < 0.05, n = 1042) and vs. population controls (only in the second trimester exposure window, p < 0.05, n = 5179). The strength of the association was largest during the second trimester in both analyses. A second trimester average ozone level increase of 10 ppb was associated with a 55.3% increase in the odds of ID relative to full siblings (95% confidence interval [CI]: 1.171-2.058) and a 22.8% increase in the odds of ID relative to population controls (CI: 1.054-1.431). Findings were robust to different subsets of sibling controls as well as several sensitivity analyses. Results document that ozone has a measurable relationship with children's cognitive development in Utah. Evidence suggests that climate change will worsen ozone pollution. The potential amplifying effect of climate change on ozone is more certain than it is for fine particulate matter. This means that ozone and health research will remain relevant into the future. Currently, several systematic reviews and meta-analyses have concluded that knowledge about ozone and cognitive health is insufficient, especially for children. Using two different study designs, we find that prenatal ozone exposure is associated with risk of intellectual disability in children.

The potential utility of cord blood DNA methylation in pediatric clinical practice.

Our understanding of the origins of noncommunicable diseases has evolved over the years with greater consideration given to the lasting influence exposures and experiences during the preconceptional and prenatal periods can have. Research highlights the associations of parental exposures (e.g., diet, obesity, gestational diabetes, lipid profile, toxic exposures and microbiome) with the infant/fetal methylome and suggest associations with infant, child and/or adolescent chronic health outcomes. Thus, epigenetics and specifically cord blood DNA methylation may have utility as biomarkers for disease risk identification and stratification in pediatrics. However, for cord blood DNA methylation analyses to be leveraged as biomarkers of disease risk in pediatric clinical practice, the results must be replicable, validated and clinically meaningful. Challenges and opportunities to this prospect are herein discussed.

Interventions in women with type 2 diabetes mellitus in the pre-pregnancy, pregnancy and postpartum periods to optimise care and health outcomes: A systematic review.

Type 2 diabetes is a chronic condition affecting increasing numbers of women of reproductive age. Recent UK data show more severe adverse offspring outcomes (stillbirth, neonatal death) than in infants of those with Type 1 diabetes. This systematic review aimed to evaluate randomised controlled trials (RCTs) undertaken in the pre-pregnancy, pregnancy and the postpartum periods in women with Type 2 diabetes, to optimise care and health outcomes. Six electronic databases were searched for eligible studies from January 2000 to September 2023; eligibility included RCTs of behavioural components, supplementation, pharmacotherapy and/or medical devices. Studies were screened in duplicate, and data were extracted on outcomes including behavioural, anthropometry, clinical measures and maternal and offspring outcomes. A narrative synthesis was performed. Eleven trials (12 papers) were included (total 1356 women with Type 2 diabetes, n = 25-502). Ten interventions were conducted in pregnancy, and one in the postpartum period. No pre-pregnancy RCTs were identified. Interventions included pharmacotherapies and supplementation, a diabetes-specific antenatal programme, continuous glucose monitoring and postpartum exercise. We found a paucity of interventions limited by inadequate design, statistical power and poor reporting. The largest Type 2 diabetes pregnancy study to date demonstrated evidence of benefit for adding metformin to a standard insulin regimen compared to insulin alone. Other interventions need replication in larger studies among more diverse groups. This review identified few RCTs targeting women of reproductive age with Type 2 diabetes particularly lacking in the preconception and postpartum periods. Tailored pre-pregnancy, pregnancy and postpartum interventions for women with Type 2 diabetes to optimise care and health outcomes are urgently needed.

The role of choline in the physiology of reproductivity

Choline is an essential nutrient, but intake among pregnant women is insufficient – only 7% of them consume adequate amounts of choline. The discrepancy between choline requirements and actual intake raises questions about the need for choline supplementation and its potential benefits for pregnant women. The diet of the expectant mother, rich in choline, in the preconception period ensures folliculogenesis and better quality of oocytes, changes the foetal epigenome, counteracting genomic defects during intrauterine development and reducing the susceptibility to metabolic changes in adulthood. Choline is a source of methyl groups and its consumption reduces the risk of NTDs by 7 times, so a promising trend in nutritional support of pregnancy and prevention of NTDs is the intake of folates and choline in combination with other micronutrients. Choline promotes the growth, proliferation and functioning of placental cells, transport of macronutrients, and has an anti-inflammatory effect. The risk of low foetal weight is reduced by 69% when choline is added to the mother’s regular diet. A significant connection has been shown between high levels of choline in the mother and a 2-fold reduction in the risk of preeclampsia, premature birth and a significant effect on the neurodevelopment and mental health of the child – improving neurocognitive functions and reducing the risk of autism and attention deficit hyperactivity disorder. A choline supplement at a dose of 130 mg/day as part of the vitamin-mineral complex Femibion 1 is sufficient to meet the needs for this nutrient during the preconception period and in the first trimester of pregnancy. The need for choline supplementation in the pregravid period and the first trimester of pregnancy is because on folliculogenesis and oocyte protection, epigenetic programming, the effectiveness of preventing congenital malformations of the foetus, participation in metabolic and physiological processes in the placenta, reducing the risk of placenta-associated complications, influence on the development of nervous tissue and brain of the foetus and newborn.

Perinatal Health Insurance And Health Care Use By Immigration Status In 6 US States, 2020-22.

Some noncitizens in the US are not eligible for public health insurance, potentially reducing access to preconception, prenatal, and postpartum care. We compared insurance coverage and health care use from the preconception period to the postpartum period by immigration status, using representative survey data collected from six US states between 2020 and 2022. Respondents were surveyed at two to six months postpartum and at twelve to fourteen months postpartum. Immigration status was classified in three categories: US citizen, permanent resident, and people who were neither citizens nor permanent residents. Compared with US citizens, fewer permanent residents had late postpartum insurance coverage, but coverage rates were otherwise similar. Coverage was lower among noncitizens/non-permanent residents compared with US citizens at every time point except pregnancy, with the largest differences at preconception (50.5percent and 90.5percent, respectively) and late postpartum (53.2percent and 95.1percent, respectively). Fewer permanent residents had health care visits before pregnancy compared with US citizens, but health care use was otherwise similar. Noncitizens/non-permanent residents had substantially lower rates of preconception health care, early and adequate prenatal care, postpartum visits, and having a usual source of care at one year postpartum. Expansion of public insurance to cover immigrants is needed to reduce large inequities in perinatal health insurance and health care use by immigration status.

Associations of maternal and paternal preconception and maternal pregnancy urinary phthalate biomarker and bisphenol A concentrations with offspring autistic behaviors: The PEACE study

BackgroundEnvironmental chemical exposures in utero may play a role in autism development. While preconception risk factors for autism are increasingly being investigated, little is known about the influence of chemical exposures during the preconception period, particularly for paternal exposures. MethodsIn 195 children from the Preconception Environmental exposures And Childhood health Effects (PEACE) cohort born to parents recruited from a fertility clinic in Boston, Massachusetts between 2004 and 2017, we quantified concentrations of 11 phthalate metabolites and bisphenol A (BPA) in urine samples collected from mothers and fathers before conception and mothers throughout pregnancy. When children were 6–15 years old, parents completed the Social Responsiveness Scale (SRS) questionnaire assessing autistic behaviors. We used linear mixed effect models to estimate covariate-adjusted associations of phthalate biomarker and BPA concentrations, separately for maternal preconception (n = 179), paternal preconception (n = 121), and maternal pregnancy (n = 177), with SRS T-scores, based on age and gender, in offspring. We used quantile g-computation models for mixture analyses and evaluated modification by selected dietary factors. ResultsThe mean SRS T-score was 47.7 (±7.4), lower than the normative mean of 50. In adjusted models for individual biomarkers or mixtures, few associations were observed and estimates were generally negative (e.g., lower SRS T-scores) and imprecise. We observed associations of higher mono-isobutyl phthalate (MiBP) concentrations measured in maternal preconception and paternal preconception periods with lower SRS T-scores (βmaternal_precon = −1.6, 95% CI -2.7; −0.4; βpaternal_precon = −2.9, 95% CI -4.6; −1.2) for each loge increase. In a subset of participants with maternal preconception nutrition information, we generally observed stronger inverse associations with higher folate and iron intake, particularly for folate intake and MiBP concentrations. ConclusionsUrinary phthalate biomarker and BPA concentrations during preconception (maternal and paternal) and pregnancy (maternal) were not associated with adverse autistic behaviors in these children. Larger studies are needed to elucidate the observed associations, while considering interactions between maternal nutrition and chemical exposures.

Effects of maternal preconception high-fat diet on the fertility of dams and on the somatic parameters and reflex ontogeny of their male offspring

BackgroundFemale consumption of a high-fat diet (HFD) may cause fertility issues and affects offspring development. ObjectiveEvaluate the acute maternal preconception intake of a HFD on the fertility and reproduction parameters of breeding females; and on the somatic parameters and reflex ontogeny of male offspring. MethodsTwenty-four rats were randomized into control (PC; n=12) and high-fat diet group (PHF; n=12) that consumed their respective diets during the 23-day preconception period. After that, 6 rats per group underwent oral glucose tolerance and insulin tolerance tests and were euthanized. The remaining rats were mated, during gestation and lactation, both groups ate a control diet. After birth, the male offspring's somatic parameters and reflexes were assessed. ResultsThe preconception diet caused dyslipidemia in the PHF. The PHF uterus exhibited a higher SFA (50.74 ± 0.32 %), a lower PUFA concentration (35.59 ± 0.33 %), and an increase in arachidonic acid (2.48 ± 0.03 %). PHF rats had hypertrophy in the endometrium, and ovaries with a higher quantity of corpora albicans and immature primordial follicles. The offspring of PHF rats had greater weight (6.70 ± 0.82 g), nasal-anal length (4.93± 0.27 cm), and tail length (1.74 ± 0.12 cm) on the first day of life, and had improved righting reflex, but delayed negative geotaxis reflex. ConclusionsAn acute maternal preconception HFD induced a pro-inflammatory fatty acid profile and changed structure in uterus, altered ovarian follicle profile. Also, potential interference in the size of the pups at birth and in brain development of male offspring.

AN ANALYTICAL STUDY OF NUTRITIONAL STYLE, NUTRITIONAL STATUS, AND MENTAL HEALTH IN THE PRECONCEPTION PERIOD : (TOWARDS OPTIMAL PREGNANCY OUTCOMES)

Background: The preconception period is a crucial period to optimize maternal and fetal health. Preconception nutrition can affect nutritional status and mental health which has an impact on pregnancy readiness. This study aims to analyze the correlation between nutrition and nutritional status and mental health during the preconception period. Method: This study used a prospective cohort study involving women of childbearing age selected by stratified random sampling to obtain 129 respondents. Nutritional Style data were collected through FFQ questionnaires, nutritional status was measured through anthropometry and Hemoglobin examination, and mental health was measured using the DASS questionnaire. Data collection was carried out three times and analyzed using the Pearson correlation test, multiple linear regression and the Wilcoxon test for longitudinal analysis. Result: The results showed that there was no significant correlation between Nutritional Style and BMI (p-value&gt;0.05). However, there was a significant correlation between Nutritional Style and the incidence of anemia, the strongest correlation in the first measurement (p-value 0.001) and the second measurement (p-value 0.049). A significant correlation was found between Nutritional Style and mental health, especially anxiety in the first measurement (p-value 0.022), the second measurement (p-value 0.006) and the third measurement (p-value 0.029), but not with stress and depression. There was a significant increase in nutritional status from the first to the second measurement (p-value 0.020) and the first to the third measurement (p-value 0.003). There was a significant decrease in anxiety from the first to the second measurement (p-value 0.034) and the first to the third measurement (p-value 0.000). Conclusion : Good Nutritional Style during preconception can improve nutritional status and minimize mental health risk. Nutrition intervention programs are needed to improve knowledge and implementation of healthy food nutrition. In addition, regular monitoring of nutritional status and mental health is also needed to optimize pregnancy readiness.

Preconception Health Education is Provided to Healthy Childbearing Couples in The Preconception Phase

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Several biological, behavioral, and social preventative strategies can improve the chances of having a healthy baby during pregnancy. Preconception health care spans the entire reproductive life cycle. Early preconception counseling should attempt to improve both women's and men's sexual and reproductive health. It should begin with early instruction on healthy lifestyle behaviors, safe sex, and pregnancy planning for childbearing couples. This research aims to develop preconception health education for family-based childbearing age couples planning a healthy pregnancy in Deli Serdang district. The Equivalent Time Series Samples approach was employed in this study as a quasi-experimental approach. The total sample size was 90 couples of reproductive age. &lt;/em&gt;&lt;em&gt;The analysis in this study was carried out descriptively to see the characteristics of each variable studied and to measure the effect of providing health education during the preconception period on the knowledge and perception of Couples of Childbearing Age about preconception health using a paired sample T test. The intervention provided is health education about preconception health provided to couples of childbearing age. The implementation of the research has received approval from the Health Research Ethics Committee of the Medan Health Polytechnic with the number: 01.25.174 /KEPK/POLTEKKES KEMENKES MEDAN 2023. &lt;/em&gt;&lt;em&gt;There is a difference in the average variable knowledge of couples of childbearing age at pretest and posttest with an increase of 5, 2778, and there is also an increase in the perception variable with an increase of 0.8889, and the results of statistical tests using the Paired Samples Test obtained show differences in respondents' knowledge and perceptions before and after the intervention. Family-based preconception health education has been effective in raising the awareness and attitudes of childbearing couples regarding the planning and preparation of a healthy pregnancy as well as in motivating them to seek a check-up at a health care facility.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p class="TableParagraph"&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Health Behavior, Health Services, Preconception Care, Pregnancy&lt;/em&gt;&lt;/strong&gt;

Inflammatory Bowel Disease and Reproductive Health: A Focus on Pregnancy Planning and Outcomes.

Reproductive counseling is crucial for women's health, especially for those with inflammatory bowel disease (IBD), which often affects younger patients during their childbearing years. Patients with IBD need special considerations when planning for pregnancy. Preconception counseling is important as it helps patients make informed decisions about pregnancy and allows for optimal management of IBD before, during, and after pregnancy. In this review, we aim to provide guidance for managing and treating patients with IBD throughout the preconception, pregnancy, and postpartum period.

Implementation of Genetic Carrier Screening at Gynecologic-Related Visits

ObjectiveTo increase patients’ knowledge and access to genetic carrier screening (GCS) in a gynecologic setting by implementing a protocol to universally offer GCS education and screening to reproductive-age women during the preconception period at gynecologic-related visits. DesignThe model for improvement quality improvement process model was used to guide this initiative. Local Problem/SettingScreening for genetic disease has been a part of preconception and genetic care for the past 50 years. Despite its longstanding presence and better accessibility and affordability of testing, there are no established protocols to universally offer screening to reproductive-age women during preconception care in the United States. The project was implemented at an outpatient gynecology clinic in Phoenix, Arizona. ParticipantsFifty-one women ages 18 to 51 years. Intervention/MeasurementsA protocol was implemented to universally offer expanded GCS and health education to reproductive-age women during the preconception period at gynecologic-related visits. Women’s responses to being offered GCS and the rationale for their response was documented on a spreadsheet. ResultsAll 51 participants were offered GCS during their visit. None of those 51 participants had any previous knowledge of GCS. All 51 participants declined GCS; reasons included the following: would consider it once closer to childbearing (53%), did not have any childbearing plans (31.3%), did not have any further childbearing plans (9.8%), or were not worried about the possibility of genetic disease (5.8%). None cited cost as a reason for declining GCS. After project completion, 3 of the 51 participants returned to the clinic to undergo GCS, and the clinic has adopted the intervention described here as its standard of care for patients who meet criteria for GCS. ConclusionIt is imperative to provide health education about GCS to women during preconception care so that they can make informed choices about family planning.

Clinical characteristics and treatment during preconception and perinatal period of infertile women with non-classical 21-hydroxylase deficiency

ObjectiveA single-center observational study to determine the clinical characteristics and therapeutic dose adjustments in women of reproductive age with infertility and non-classical 21-hydroxylase deficiency (NC-21OHD).DesignA retrospective analysis of 20 women of reproductive age who were diagnosed with NC-21OHD during an infertility evaluation at Shengjing Hospital of China Medical University from January 2013 to May 2024 was performed. The clinical manifestations, auxiliary examinations, adjustment of glucocorticoid (GC) treatment during preconception and perinatal period, and pregnancy outcomes were analyzed.Results14 of 16 patients (87.5%) had inappropriately elevated progesterone levels during the follicular phase. The average levels of 17α-hydroxyprogesterone, testosterone, androstenedione, and dehydroepiandrosterone sulfate in the follicular phase were also significantly increased. All 20 infertile patients received GC treatment before preparing for pregnancy. During the follow-up, six of 20 patients had seven conceptions. three patients had spontaneous abortions in the first trimester and four patients delivered babies (4/20). Three patients had a GC dose that was maintained throughout pregnancy and one had an increase in the GC dose starting in the second trimester. Of the remaining 16 patients, seven are still trying to conceive and nine had discontinued treatment.ConclusionsAn abnormal increase in the follicular phase progesterone level is the most common serologic marker for NC-21OHD among infertile women. Ovulation can be restored after GC treatment, but the proportion of successful conceptions remains low. The dose of GCs in most pregnant women remained unchanged throughout pregnancy.

Safety of Medications Used to Treat Autoimmune Rheumatic Diseases During Pregnancy and Lactation.

Autoimmune rheumatic diseases (ARDs) often affect women during their reproductive years, and early studies of pregnancy in these patients reported high rates of adverse outcomes. Continuation or initiation of safe and effective medications in the preconception period is beneficial for maintaining or achieving disease quiescence throughout pregnancy thereby improving both maternal and pregnancy outcomes. The European Alliance of Associations for Rheumatology, the American College of Rheumatology, and the British Society for Rheumatology have published recommendations and guidelines regarding management of ARDs during pregnancy. The American College of Obstetricians and Gynecologists and the American Gastroenterological Association have also provided guidance statements with relevant recommendations. This review provides an overview of available recommendations for medication use in ARD pregnancy, with discussion of safety considerations for maternal and fetal well-being. Medications considered compatible with pregnancy include hydroxychloroquine, sulfasalazine, azathioprine, cyclosporine, tacrolimus, and TNF inhibitors. Methotrexate, mycophenolate, leflunomide, and cyclophosphamide should be avoided before and during pregnancy. Other medications, most of them newer, are largely discouraged for use in pregnancy due to inadequate data or concerns for neonatal immunosuppression, including non-TNF biologics and small molecule therapies. Further investigation is needed regarding effects of non-TNF biologics, biosimilars, and small molecules in pregnancy. Important efforts for the future will include improved methodologies to gather critical safety data, with consideration of inclusion of pregnant women in clinical trials, a complex and controversial issue. Long-term information on outcomes in offspring of treated women is lacking for many of these medications.

Biologic Use During Pregnancy and Breastfeeding in Dermatology: An Evidence-Based Review.

Biologic medications have revolutionized the treatment of many dermatologic conditions. However, their use during pregnancy and breastfeeding is a subject of ongoing concern due to limited data on their safety in these populations. As the course of many inflammatory skin conditions is unpredictable during pregnancy and may worsen, biologics are important therapeutic tools for disease stabilization in this patient population. In this review, we provide a comprehensive summary of the gestational safety profile of biologics commonly used in dermatology and provide recommendations during pre-conception, pregnancy, and post-partum periods. We also examine fertility data, placental transfer of biologics, and postpartum immunosuppression/immunomodulation data. J Drugs Dermatol. 2024;23(11):1010-1015. doi:10.36849/JDD.7816R1.

Preconception and Early-Pregnancy Body Mass Index in Women and Men, Time to Pregnancy, and Risk of Miscarriage

Obesity in women is associated with reduced fertility and an increased risk of miscarriage. These associations might also be present across the full range of body mass index (BMI) categories as well as among men. To investigate the associations of preconception BMI in both partners with time to pregnancy and miscarriage. This population-based prospective cohort study was conducted in Rotterdam, the Netherlands, between August 9, 2017, and July 1, 2021. A total of 3604 women and their partners were included from the preconception period onward with follow-up until birth. The date of analysis was July 12, 2024. Body mass index (calculated as weight in kilograms divided by height in meters squared) measured in preconception or early pregnancy. Fecundability, defined as the probability of conceiving within 1 month; subfertility, defined as time to pregnancy or duration of actively pursuing pregnancy of more than 12 months or use of assisted reproductive technology; and miscarriage, defined as pregnancy loss before 22 weeks of gestation. These measures were assessed using questionnaires and via the obstetric caregiver. The study population for time-to-pregnancy analyses consisted of 3033 episodes among women (median age, 31.6 years [IQR, 29.2-34.5 years]; median BMI, 23.5 [IQR, 21.2-26.5]) and 2288 episodes among men (median age, 33.4 years [IQR, 30.5-36.8 years]; median BMI, 24.9 [IQR, 23.0-27.4]). The study population for miscarriage analyses consisted of 2770 pregnancy episodes among women (median age, 31.5 years [IQR, 28.9-34.3 years]; median BMI, 23.5 [IQR, 21.3-26.7]) and 2189 pregnancy episodes among men (median age, 33.5 years [IQR, 30.4-36.8 years]; median BMI, 25.0 [IQR, 23.0-27.5]). Higher BMI in women and men was associated with lower fecundability: for every unit increase in BMI, fecundability decreased (fecundability ratio [FR]: women, 0.98 [95% CI, 0.97-0.99]; men, 0.99 [95% CI, 0.98-1.00]). Women with overweight (FR, 0.88 [95% CI, 0.80-0.98]) and obesity (FR, 0.72 [95% CI, 0.63-0.82]) had lower fecundability compared with women with normal weight. Compared with normal weight in women, underweight (odds ratio [OR], 1.88 [95% CI, 1.22-2.88]), overweight (OR, 1.35 [95% CI, 1.11-1.63]), and obesity (OR, 1.67 [95% CI, 1.30-2.13]) were associated with increased odds of subfertility. In men, obesity was associated with increased odds of subfertility (OR, 1.69 [95% CI, 1.24-2.31]). Compared with normal weight in women, overweight (OR, 1.49 [95% CI, 1.12-1.98]) and obesity (OR, 1.44 [95% CI, 1.00-2.08]) were associated with increased odds of miscarriage. In this cohort study, BMI outside of the normal category in women and men during the preconception or early-pregnancy periods was associated with time to pregnancy and miscarriage. Optimizing BMI in women and men from the preconception period onward might be an important strategy to improve fertility outcomes.

Prenatal exposure to PM2.5 led to impaired respiratory function in adult mice

BackgroundPM2.5 is a complex mixture, with water-soluble inorganic ions (WSII), mainly NH4+, SO42−, and NO3−, constituting major components. Early-life PM2.5 exposure has been shown to induce adverse health consequence but it is difficult to determine whether such an effect occurs prenatally (preconception, gestational) or postnatally in human studies. MethodsFour groups of C57BL/6 J mice were assigned to four exposure conditions: PM2.5 NO3−, PM2.5 SO42−, PM2.5 NH4+ and clean air, and exposure started at 4 weeks old. At 8 weeks old, mice bred within group. The exposure continued during gestation. After delivery, both the maternal and F1 mice (offspring) were kept in clean air without exposure to PM2.5. Respiratory function and pulmonary pathology were assessed in offspring mice at 8 weeks of age. In parallel, placenta tissue was collected for transcriptome profiling and mechanistic investigation. ResultsF1 mice in PM2.5 NH4+, SO42- and NO3− groups had 32.2 % (p=6.0e-10), 30.3 % (p=3.8e-10) and 16.9 % (p=5.7e-8) lower peak expiratory flow (PEF) than the clean air group. Importantly, the exposure-induced lung function decline was greater in male than female offspring. Moreover, exposure to PM2.5 WSII before conception and during gestation was linked to increased airway wall thickness and elevated pulmonary neutrophil and macrophage counts in the offspring mice. At the molecular level, the exposure significantly disrupted gene expression in the placenta, affecting crucial functional pathways related to sex hormone response and inflammation. ConclusionsPM2.5 WSII exposure during preconception and gestational period alone without post-natal exposure substantially impacted offspring’s respiratory function as measured at adolescent age. Our results support the paradigm of fetal origin of environmentally associated chronic lung disease and highlight sex differences in susceptibility to air pollution exposure.

Prenatal Vitamin D Deficiency and Maternal and Fetal Health Outcomes.

Vitamin D deficiency (VDD) is a significant health issue that could have serious implications for the well-being of women and their offspring. Prenatal vitamins are widely used, but deficiency still occurs frequently in the preconception period, during pregnancy, and in breastfed infants. We analyzed the association between prenatal VDD and maternal and fetal health outcomes by reviewing studies conducted in Europe. The literature was searched for articles published in the last 10 years focusing on preeclampsia, gestational diabetes mellitus, preterm birth, low birth weight, asthma, and autism spectrum disorder. We identified a total of 43 review articles, 31 original articles, and two guidelines. During pregnancy, VDD is associated with a higher likelihood of developing gestational diabetes mellitus and preeclampsia. It may also lead to an increase in the risk of preterm birth, low birth weight, as well as asthma, and autism spectrum disorder in the offspring. While the official guidelines for vitamin D dosage differ in various countries, health authorities usually recommend a total daily supplement intake of 400-2,000 IU. In conclusion, this review emphasizes the importance of establishing guidelines for vitamin D supplementation as well as the requirement of official standards for the consumption of vitamin D in the prenatal period. Future research should concentrate on developing more unified approaches to vitamin D assessment and establishing preventative measures that can be incorporated into prenatal care programs.

Treatment of spondyloarthritis with disease-modifying anti-rheumatic drugs during pregnancy and breastfeeding: comparing the recommendations and guidelines of the principal societies of rheumatology.

This paper aims to provide an overview of the use of treatments available for axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) during pregnancy and breastfeeding, according to current national recommendations and international guidelines, as well as data on the impact on pregnancy outcomes of paternal exposure to treatment. We performed a narrative review of national and international recommendations and guidelines on the reproductive health of patients suffering from rheumatic diseases. The last updated recommendations and guidelines were considered source data. We reported updated information regarding the treatment of axSpA and PsA with nonsteroidal anti-inflammatory drugs, intra-articular glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs, and targeted synthetic DMARDs during the preconception period, pregnancy, and breastfeeding, as well as data related to paternal exposure. We highlighted any medications that should be discontinued and/or not used in the reproductive age group and also treatments that may be continued, avoiding the withdrawal of drugs that can be used in the different phases, thus preventing the risk of increasing disease activity and flares before, during, and after pregnancy in SpA patients. The best management of pregnancy in patients with SpA is based on knowledge of updated drug recommendations, a careful and wise evaluation of the risks/benefits of starting or continuing treatment from the SpA diagnosis in a woman of childbearing age through pregnancy and lactation, and sharing therapeutic choices with other healthcare providers (in particular, gynecologists/obstetricians) and the patient.

100 - Disordered eating in the preconception period: findings from the Begin Better Study

100 - Disordered eating in the preconception period: findings from the Begin Better Study

246 - A mapping review of Australian and international obesity-related policies for women during preconception, pregnancy, and postpartum periods using a weight stigma lens.

246 - A mapping review of Australian and international obesity-related policies for women during preconception, pregnancy, and postpartum periods using a weight stigma lens.