Pregnancy Outcomes In Pregnant Women Research Articles

Pregnancy and primary Sjögren’s syndrome: management and outcomes in a multicentre retrospective study of 54 pregnancies

Objectives: Primary Sjögren’s syndrome (pSS) is one of the most common autoimmune diseases, mainly affecting women during the fourth decade of life. During pregnancy, the presence of anti-Ro/SSa and anti-La/SSb antibodies increases the risk of congenital heart block (CHB). Foetal and pregnancy outcomes in pregnant women with pSS compared with the general population are difficult to evaluate because of confounding factors including age and body mass index (BMI).Method: The aim of this case–control study was to analyse the impact of pSS in pregnant women on foetal and pregnancy outcomes.Results: We enrolled 19 women with pSS (54 pregnancies) matched by age and BMI to 216 controls. Patients with pSS delivered significantly earlier (38 weeks + 3 days vs. 39 weeks + 2 days) and experienced more spontaneous abortions [< 22 weeks of gestation (WG)] than the controls [n = 16/54 (30.0%) vs. n = 1/216 (0.4%); p < 0.00001]. Preterm delivery (≤ 37+6 WG) was significantly higher in the pSS group than in the control group (29% vs. 12%, p = 0.04). pSS activity significantly affected the birthweight percentile, which was lower in pregnancies occurring after the diagnosis of pSS than in those occurring before (32.43 ± 21.57 vs. 60.46 ± 27.37; p = 0.008). No case of CHB was observed.Conclusions: pSS is responsible for an increased risk of spontaneous abortion. The duration of pregnancy is lower in patients with than without pSS, with more premature deliveries. Pregnancies that occur after the onset of the disease result in lower birthweight percentile children than when pSS is not clinically overt.

Chinese herbal medicines for unexplained recurrent miscarriage.

Chinese herbal medicines for unexplained recurrent miscarriage.

Clinical efficacy of therapeutic intervention for subclinical hypothyroidism during pregnancy.

This study explored the effects of levothyroxine (L-T4) replacement therapy on pregnancy outcomes in patients with subclinical hypothyroidism (SCH). We analyzed the effects on pregnancy outcomes with respect to gestational week when the desired thyroid-stimulating hormone (TSH) level was reached as well as the length of time required to reach the target level during L-T4 treatment. This study enrolled 457 patients diagnosed with SCH upon initial thyroid function screening. Subjects were assigned to the treatment group (N = 184), and the control group (N = 273). Two variables were analyzed in the treatment group: the gestational week when the target TSH level was achieved and the length of time required to reach the target level during treatment. Based on these criteria, the treatment group was further divided into subgroups, including three subgroups based on the time required to reach target levels (<4 weeks, 4-8 weeks, and >8 weeks) and gestational week when the target TSH level was achieved (before the 12th, between the 12th-28th, and after the 28th gestational week). The overall risk of complications in the control group was significantly higher than in the treatment group (P < 0.05). After L-T4 treatment, the incidences of premature rupture of fetal membranes (PROM), gestational diabetes mellitus, fetal macrosomia, and postpartum hemorrhage in the group with treatment duration <4 weeks were significantly lower than those in the groups with 4-8 and >8 weeks treatment duration (P < 0.05). L-T4 treatment can significantly reduce the risks of adverse pregnancy outcomes in pregnant women with SCH. The shorter the treatment duration required to reach the target TSH level and the earlier the gestational week when the target TSH level is achieved through treatment, the lower the incidence of complications.

Epidemic Profile of Maternal Syphilis in China in 2013.

Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Methods. Data were from China's Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively. Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.

A preliminary study on the pregnancy outcomes of pregnant women with positive thyroid peroxidase antibody

Objective To explore the correlation between simple thyroid peroxidase antibody(TPOAb)positive(higher than the normal reference value )and the adverse pregnancy outcomes; and to discuss the necessity of clinical intervention on TPOAb positive and the characteristic of gestational thyroid peroxidase antibody changes. To study wether clinical intervention affects its direction. Methods Subjects were selected from TPOAb positive pregnant women during June 2012 to February 2015. They were registered regularly for thyroid function during pregnancy and 6 weeks postpartum, and timely treated for abnormal thyroid function. They were grouped according to the thyroid function: Group 1(n=122), simple TPOAb positive group; Group 2(n=67), patients with elevated TSH and positive TPOAb who accept the levothyroxine(L-T4)intervention; Group 3(n=120), TPOAb negative healthy pregnant women. They were regularly tested for thyroid function during pregnancy, and with follow-up until 6 weeks postpartum. Results When Group 1 compared with Group 3: the risk of premature rupture of membranes, abnormal amniotic fluid, and fetal distress rate increased, the relative risk(RR)were 3.066, 4.782, 2.605, all P 0.05). When Group 2 compared with Group 3, the risk of premature rupture of membranes, abnormal amniotic fluid, and fetal distress increased(RR were 3.830, 5.537, 3.600 respectively, all P 0.05). Compared with Group 2, Group 1 had no statistical difference between the above observational parameters. The levels of TPOAb from stage T1(the first trimester)to T3(the third trimester)showed a overall downward trend in Group 1 and Group 2, rise again six weeks after child birth. Comparison of the two groups(Group 1 and Group 2), the median value during this period did not reveal any significantly statistical differences(P>0.05). Conclusion In simple TPOAb positive pregnant women, premature rupture of membranes, abnormality in amniotic fluid, and fetal distress were significantly higher than those in healthy pregnant women; even with thyroid function correction the TPOAb positive pregnant women still cannot reduce the adverse pregnancy outcomes. Levels of TPOAb from T1 to T3 presented the overall downward trend and to rise again six weeks after pregnancy. L-T4 intervention for TPOAb positive pregnancy did not show any significant effect.(Chin J Endocrinol Metab, 2015, 31: 1041-1045) Key words: Pregnancy; Thyroid peroxidase antibody; Pregnancy outcomes

Note of Concern: Effects of High-Dose Vitamin D Supplementation on Metabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia

Note of Concern: Effects of High-Dose Vitamin D Supplementation on Metabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia

Safety of topical corticosteroids in pregnancy.

Safety of topical corticosteroids in pregnancy.

The effects of vitamin D plus calcium supplementation on metabolic profiles, biomarkers of inflammation, oxidative stress and pregnancy outcomes in pregnant women at risk for pre-eclampsia.

The present study was designed to examine the effects of vitamin D plus calcium administration on metabolic profiles and pregnancy outcomes among women at risk for pre-eclampsia. In a prospective, double-blind, placebo-controlled trial, 60 women at risk for pre-eclampsia were randomised to take either 50 000 IU vitamin D3 every 2 weeks plus 1000 mg day(-1) calcium supplements (as calcium carbonate) (n = 30) or to receive placebos at the same times (n = 30) from 20 to 32 weeks of gestation. Fasting blood samples were taken at baseline and 12 weeks after intervention to determine related variables. Newborn anthropometric measurements were determined. Taking combined cholecalciferol and calcium supplements, compared to placebo, led to significant reductions in fasting plasma glucose (FPG) [mean (SD)] [-5.7 (5.5) versus -0.6 (12.6) mg dL(-1) , P = 0.04], serum insulin concentrations [-2.8 (6.0) versus +7.7 (9.8) μIU mL(-1) , P < 0.001], homeostasis model of assessment-insulin resistance [-0.8 (1.3) versus +1.6 (2.2), P < 0.001], homeostatic model assessment-beta cell function [-8.2 (25.8) versus +32.6 (41.3, P < 0.001] and a significant rise in quantitative insulin sensitivity check index score [+0.02 (0.02) versus -0.02 (0.02, P < 0.001]. Additionally, pregnant women who received cholecalciferol plus calcium supplements had increased serum high-density lipoprotein (HDL)-cholesterol [+4.6 (8.3) versus -2.9 (7.7) mg dL(-1) , P = 0.001] and plasma total glutathione (GSH) concentrations [+23.4 (124.0) versus -94.8 (130.2) μm, P = 0.001] compared to placebo. However, after adjustment for the baseline levels, maternal age and baseline body mass index, the effects on FPG levels (P = 0.13) and systolic blood pressure (P = 0.13) disappeared. Vitamin D plus calcium administration for 12 weeks had beneficial effects on glycaemic status, HDL-cholesterol, GSH and blood pressure among women at risk for pre-eclampsia.

Use of serum leptin and insulin hormones levels as predictors of pregnancy outcome in pregnant women with history of recurrent early pregnancy loss

Abstract Aim To evaluate levels of leptin and insulin in cases of unexplained early RPL in comparison with cases of previous normal pregnancies and suggest these levels as prognostic factors for the continuation of pregnancy beyond the 20th week. Methods A prospective comparative controlled study was conducted at Obstetrics unit of Tanta University Hospital from Jan to Aug 2014 on 50 pregnant women who were divided into two groups: the study group included 25 cases with history of early RPL, and the control group included 25 cases with previous normal pregnancies. Serum levels of leptin and insulin were measured twice in both groups; at 5–8th and 10–12th week. Results Leptin levels in ng/ml in the first sample were 9.414 ± 3.183 and 30.559 ± 10.672 in the control and study groups respectively with significant difference. As for the second sample, it was 11.672 ± 2.611 and 29.733 ± 9.133 in the control and study groups respectively with significant difference. Insulin levels in μlU/ml in the first sample were 18.075 ± 5.845 and 32.502 ± 13.057 in the control and study groups respectively with significant difference. In the second sample, on the other hand, it was 20.237 ± 4.944 and 34.128 ± 12.677 in the control and study groups respectively with significant difference. Leptin showed higher accuracy than insulin in prediction of early pregnancy loss. Conclusion Higher levels of leptin and insulin were found in cases with early RPL especially in the aborted cases. The two hormones could be used as predictors of pregnancy continuation in these cases.

Pregnancy Outcomes in Pregnant Women with Subchorionic Hematoma

Background: The role of subchorionic hematoma (SCH) in the first trimester of pregnancy remains open for discussion. Some authors claim that SCH does not affect the pregnancy; others have found that it is a serious risk factor for adverse pregnancy outcome. The objective of the present study was to explore the outcomes of pregnancy in patients with SCH diagnosed in the first trimester. Methods and Results: The study involved 194 pregnant women who were in terms of 6 to 12 weeks: 115 women with SCH (Group 1) and 79 apparently healthy pregnant women (Group 2). A missed miscarriage was observed in 27/23% women of Group 1 and in 4/5% of Group 2 (P<0.001), recurrent threat of miscarriage in 27/23% and in 4/5% (P<0.001), recurrent bleeding in 14/12% and 2/3% (P<0.02), and the short cervix syndrome in 22/19% and 5/6% (P<0.03) women, respectively. Conclusion: The results of our study show that the presence of SCH adversely affects the first half of pregnancy, leading to recurrent threatened abortion, recurrent threat of miscarriage, missed miscarriage until 12 weeks of gestation, and the short cervix syndrome. (Int I Biomed. 2015;5(3):137-140.)

O128. Placental vascularization indices and uterine artery peak systolic velocity in pregnancy hypertension

Introduction Hypertension during pregnancy affects about 6–9% of pregnant women, it is a leading cause of maternal and fetal morbidity and mortality, and remarkable portion of pregnancy hypertension cases are accompanied by gestational diabetes (GDM). There is a great effort worldwide on reaching greater effectiveness in prediction and prevention in these pathological pregnancies. Objectives The aim of the study was to analyze placental vascularization, uterine artery peak systolic velocity (PSV), placental volume and pre-gestational BMI for the better prediction rate of adverse pregnancy outcomes in pregnant women with essential hypertension (EH), EH associated with gestational diabetes (EH + GDM), pregnancy induced hypertension (PIH), and PIH associated with gestational diabetes (PIH + GDM) compared to a normal blood pressure (NBP) group. Methods We measured placental 3-dimensional power Doppler indices, such as vascularization index (VI), flow index (FI) and vascularization flow index (VFI), and uterine artery PSV in pregnancies complicated with EH ( N = 51), EH + GDM ( N = 13) PIH ( N = 57) and PIH + GDM ( N = 23), and compared these to pregnancies with NBP ( N = 146) with the help of 3-dimensional analysing VOCAL program. We analyzed the correlation between the above mentioned indices, volume of the placenta, pre-gestational BMI, and gestational age. Results VI and VFI were significantly higher in pregnancies with EH (VI:13.27% ±9.77; VFI:5.94 ± 4.99 (mean ± SD)) and significantly lower in pregnancies with PIH (VI:7.75% ±6.50; VFI:3.00 ± 2.3(mean ± SD)) than in pregnancies with NBP (VI:10.18% ±6.16; VFI:5 ± 3.49 (mean ± SD)) ( p p p > 0.01). FI (31.35 ± 12.48) and VFI (1.87 ± 1.20) were significantly ( p p > 0.01). VI(4.13 ± 2.77) and VFI (1.70 ± 1.31) were significantly ( p p > 0.01) PSV was significantly higher in PIH + GDM (66.01 cm/s ±26.03) compared to PIH (56.27 cm/s ±26.56) ( p p The placental volume was smaller ( z -score:-1.5) in EH and PIH than in NBP and higher in EH + GDM and PIH + GDM than in NBP ( z -score:+0.8). Pre-gestational BMI was significantly higher ( p Conclusion The 3-DPD indices combined with PSV in pregnancies complicated with EH + GDM and PIH + GDM showed that GDM aggravates EH and PIH cases significantly. Although our study proved that pre-gestational BMI and placental volume do have effect on placental vascularization, it seems that adverse pregnancy outcomes can be predicted more effectively with the help of 3-DPD indices and PSV measurements during the entire pregnancy compared to conventional uterine artery findings.

Pregnancy Outcomes in Women with Polycystic Ovarian Syndrome

Background: Polycystic ovary syndrome (PCOs) is a common genetic and endocrine disorder affecting 5-10% of women at reproductive age. Aim was to assess pregnancy outcomes of pregnant women with PCOs. Subjects and methods: Comparative descriptive cross-sectional study design was conducted in the labor ward of Obstetrics and Gynecology, Qena University and Qena General Hospital. Convenient sample were 120 pregnant women with PCOs and other 600 pregnant women without PCOs. Data collected by structured interview questionnaire, maternal and neonatal assessment sheet. Results of the study found that pregnancy with PCOs was associated with significantly higher rates of maternal complications as hypertension (14.2%), gestational diabetes mellitus (10.8%), preeclampsia (4.2%), preterm delivery (5%) and cesarean delivery (79.2%) versus (0.7%), (0.7%), (2.3%), (1.7%) and (53.8%) in the non PCOs group. Neonatal complications as APGAR score of less than 7 (19.2%), macrosomia (9.2%), respiratory distress (20.8%) and admission to neonatal intensive care unit (4.3%) versus (2.2%), (3.2%), (6.2%) and (20.8%) in the non PCOs group with highly statistical significant relationship among both groups. Conclusions: This study confirmed higher association of pregnancy complications among PCOs group compared with non PCOs group. Recommendations: women with PCOs should be followed up for complications on pregnancy and neonatal outcomes.

Effects of High-Dose Vitamin D Supplementation on Metabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia

This study was designed to assess the beneficial effects of high-dose (cholecalciferol) vitamin D supplementation on metabolic profiles and pregnancy outcomes among pregnant women at risk for pre-eclampsia. This randomized double-blind placebo-controlled clinical trial was performed among 60 pregnant women at risk for pre-eclampsia according to abnormal uterine artery Doppler waveform. Subjects were randomly divided into 2 groups to receive 50 000 IU vitamin D supplements (n=30) or receive placebo (n=30) every 2 weeks from 20 to 32 weeks of gestation. Fasting blood samples were taken at baseline study and 12 weeks after the intervention to quantify relevant variables. Newborn's anthropometric measurements were determined. Pregnant women who received cholecalciferol supplements had significantly increased serum 25-hydroxyvitamin D concentrations (+17.92±2.28 vs. +0.27±3.19 ng/ml, p<0.001) compared with the placebo. The administration of cholecalciferol supplements, compared with the placebo, resulted in significant differences in serum insulin concentrations (+1.08±6.80 vs. +9.57±10.32 μIU/ml, p<0.001), homeostasis model of assessment-insulin resistance (HOMA-IR) (+0.19±1.47 vs. +2.10±2.67, p<0.001), homeostatic model assessment-beta cell function (HOMA-B) (+5.82±29.58 vs. +39.81±38.00, p<0.001) and quantitative insulin sensitivity check index (QUICKI) score (-0.009±0.03 vs. -0.04±0.03, p=0.004). Furthermore, cholecalciferol-supplemented pregnant women had increased HDL-cholesterol concentrations (+2.67 ± 8.83 vs. -3.23±7.76 mg/dl, p=0.008) compared with the placebo. Finally, cholecalciferol supplementation led to a significant rise in plasma total antioxidant capacity (TAC) concentrations (+79.00±136.69 vs. -66.91±176.02 mmol/l, p=0.001) compared with the placebo. Totally, the administration of cholecalciferol supplements among pregnant women at risk for pre-eclampsia for 12 weeks had favorable effects on insulin metabolism parameters, serum HDL-cholesterol, and plasma TAC concentrations.

Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project.

To determine the effect of rheumatoid arthritis (RA) disease severity on pregnancy outcomes in pregnant women with and without autoimmune diseases. A prospective cohort study was conducted using the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. Pregnant women with RA enrolled between 2005 and 2013 were selected if they (1) delivered a live-born singleton infant; and (2) completed 3 telephone-based measures of RA disease severity prior to 20 weeks' gestation, including the Health Assessment Questionnaire Disability Index (HAQ-DI), pain score, and patient's global scale. Associations between RA disease severity and preterm delivery, small for gestational age (SGA), or cesarean delivery were tested in unadjusted and multivariate analyses using modified Poisson regression models. The sample consisted of 440 women with RA. Several unadjusted comparisons yielded significant associations. After adjustment for covariates, increasing disease severity was associated with risk for preterm delivery and SGA. For each unit increase in HAQ-DI (0-1), the adjusted relative risk (aRR) for preterm delivery increased by 58% (aRR 1.58, 95% CI 1.17-2.15). Among those with HAQ-DI > 0.5, the aRR for SGA was 1.81 (95% CI 1.01-3.33). RA disease severity in early pregnancy, as measured in this study, was predictive of preterm delivery and SGA. These findings suggest that the risk of preterm delivery and SGA in women with RA might be lowered if RA is well controlled early in pregnancy.

Longitudinal Observational Study on Diet Quality during Pregnancy and Its Relation to Several Risk Factors for Pregnancy Complications and Outcomes

Aims: A mother’s diet during pregnancy is considered one of the most important external factors affecting health of her child further in life. Unfavourable diet, together with advanced maternal age, high pre-pregnancy body mass index (BMI), and excessive pregnancy weight gain are considered to be significant risk factors for adverse pregnancy complications and outcomes. The aim of this study was to determine correlations between pre-pregnancy BMI, quality of nutrition during pregnancy, and pregnancy outcomes in pregnant women with an excessive weight gain during pregnancy. Study Design: Randomized, observational, prospective, long-term study. Methodology: The study included pregnant women from the area of the city Osijek, eastern Croatia. The subjects were monitored throughout pregnancy to labour and 6 weeks postpartum. Analysis included anthropometry, blood glucose, incidence of gestosis (i.e. hypertension, gestational diabetes, edemas and proteinuria) and delivery outcomes (e.g. mode of delivery, birth weight) and a24-hour dietary record was used to asses nutrition quality. Based on the risk factors for adverse pregnancy complications and outcomes, two groups of women were selected for the sub-group analysis. The first group of women with a normal pre- pregnancy BMI and an excessive pregnancy weight gain (n=47), and the second group of women with an overweight/obese BMI (BMI≥25 kg/m2) and an excessive pregnancy weight gain (n=43). Results: For women with a normal pre-pregnancy BMI, the balance of specific carbohydrates had the greatest importance on pregnancy complications and outcomes. On the other hand, for women starting pregnancy at-risk ; with an overweight/obese BMI, the total dietary intake of fats and the balance in specific fatty acids had the greatest impact on pregnancy complications and outcomes. Conclusion: The present study provides important data on how specific dietary components influence pregnancy complications and outcomes. This information may be useful in creating specific timed interventions for women of reproductive age, ensuring a healthy pregnancy, and a healthy child.

The Effect of Multi mineral-Vitamin D Supplementation on Pregnancy Outcomes in Pregnant Women at Risk for Pre-eclampsia.

Background:The objective of this study was to determine the favorable effects of multi mineral-Vitamin D supplementation on pregnancy outcomes among women at risk for pre-eclampsia.Methods:This randomized double-blind controlled clinical trial was conducted among 46 women at risk for pre-eclampsia at 27 weeks’ gestation with positive roll-over test. Pregnant women were randomly assigned to receive either the multi mineral-Vitamin D supplements (n = 23) or the placebo (n = 23) for 9-week. Multi mineral-Vitamin D supplements were containing 800 mg calcium, 200 mg magnesium, 8 mg zinc, and 400 IU Vitamin D3. Fasting blood samples were taken at baseline and after 9-week intervention to measure related factors. Newborn's outcomes were determined.Results:Although no significant difference was seen in newborn's weight and head circumference between the two groups, mean newborns’ length (51.3 ± 1.7 vs. 50.3 ± 1.2 cm, P = 0.03) was significantly higher in multi mineral-Vitamin D group than that in the placebo group. Compared to the placebo, consumption of multi mineral-Vitamin D supplements resulted in increased levels of serum calcium (+0.19 vs. −0.08 mg/dL, P = 0.03), magnesium (+0.15 vs. −0.08 mg/dL, P = 0.03), zinc (+8.25 vs. −21.38 mg/dL, P = 0.001) and Vitamin D (+3.79 vs. −1.37 ng/ml, P = 0.01). In addition, taking multi mineral-Vitamin D supplements favorably influenced systolic blood pressure (SBP) (−1.08 vs. 6.08 mmHg, P = 0.001) and diastolic blood pressure (DBP) (−0.44 vs. 3.05 mmHg, P = 0.02).Conclusions:Multi mineral-Vitamin D supplementation for 9-week in pregnant women at risk for pre-eclampsia resulted in increased newborn's length, increased circulating levels of maternal serum calcium, magnesium, zinc and Vitamin D, and led to decreased maternal SBP and DBP.

Impacts of dietary fat changes on pregnant women with gestational diabetes mellitus: a randomized controlled study.

This study aims to determine the impact of increasing polyunsaturated fatty acid intake on blood glucose, lipid metabolism, and pregnancy outcomes of pregnant women with gestational diabetes mellitus. Under constant total energy and protein intake, 84 pregnant women with gestational diabetes mellitus were randomly divided into the experimental and control groups, which were given oil-rich and conventional low-oil meals, respectively. After the dietary intervention, the intake and energy supply of fat and the three fatty acids were significantly higher in the experimental group than the control group (p<0.001). The intake and energy supply of polyunsaturated fatty acids increased significantly post-intervention in the experimental group but did not change in the control group. In both the intervention and the control group, fasting blood glucose, 2 h postprandial plasma glucose, and the insulin resistance index decreased significantly post-intervention (p<0.05); the lipid changes were consistent between groups. Pregnancy outcomes did not differ significantly between the two groups (p>0.05). An appropriate increase in polyunsaturated fatty acid intake benefits pregnant women with gestational diabetes mellitus as well as fetuses, as long as the diet therapy follows basic recommendations and total energy intake is strictly controlled.

RETRACTED ARTICLE: The favorable effects of garlic intake on metabolic profiles, hs-CRP, biomarkers of oxidative stress and pregnancy outcomes in pregnant women at risk for pre-eclampsia: randomized, double-blind, placebo-controlled trial

Statement of Retraction We, the Editor and Publisher of The Journal of Maternal-Fetal & Neonatal Medicine, have retracted the following article: Rezvan Aalami-Harandi, Maryam Karamali & Zatollah Asemi (2015), The favorable effects of garlic intake on metabolic profiles, hs-CRP, biomarkers of oxidative stress and pregnancy outcomes in pregnant women at risk for pre-eclampsia: randomized, double-blind, placebo-controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine, 28:17, 2020-2027, DOI: https://doi.org/10.3109/14767058.2014.977248 Following publication, significant concerns were raised by a third party1 about the integrity of the data and the reported findings in the article. When approached for an explanation, the authors and their institution have been cooperative in providing some original data and documents. In order to verify the reported findings, the article and the original data provided by the authors were sent for review by an external statistical reviewer. Both the journal editorial team and the external statistical reviewer were unable to confirm the integrity of the trial design and the main outcome of the external review was that the article's conclusions are unreliable. Therefore, as the editorial team no longer have confidence in the reported conclusions the decision has been made to retract the article. The authors listed in the publication have been informed. The authors do not agree with the retraction. We have been informed in our decision-making by our editorial policies and the COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as 'Retracted'.

Favorable effects of vitamin D supplementation on pregnancy outcomes in gestational diabetes: a double blind randomized controlled clinical trial.

Gestational diabetes mellitus (GDM) has been recognized as a significant risk factor for unfavorable pregnancy outcomes. Prevalence of vitamin D deficiency is highly prevalent among women with GDM. This study was designed to assess the effect of vitamin D supplementation on pregnancy outcomes of pregnant women with GDM who were not on oral hypoglycemic agents. This randomized controlled clinical trial was performed among 45 pregnant women diagnosed with GDM at 24-28 weeks' gestation. Subjects were randomly assigned to consume either vitamin D supplements (cholecalciferol) or placebo. Individuals in the vitamin D group (n=22) received 50 000 IU vitamin D3 pearl 2 times during the study: at study baseline and day 21 of intervention and those in placebo group (n=23) received 2 placebos at the mentioned times. Fasting blood samples were taken at baseline to measure fasting plasma glucose. Participants underwent a 3-h oral glucose tolerance tests (OGTT) and the blood samples were collected at time 60, 120, and 180 min to measure plasma glucose levels. Newborn's weight, height, head circumference, Apgar score, and hyperbilirubinemia were determined. Taking vitamin D supplements, compared with placebo, resulted in improved pregnancy outcomes; such that those in the vitamin D group had no case of polyhydramnios, while 17.4% of subjects in placebo group had this condition (p=0.04). In addition, newborn's hyperbilirubinemia was significantly lower in vitamin D group than that in placebo group (27.3% vs. 60.9%, p=0.02). In conclusion, vitamin D supplementation for 6 weeks among pregnant women with GDM resulted in decreased maternal polyhydramnios and infant hyperbilirubinemia compared with placebo. Clinical trial registration number www.irct.ir:IRCT201305115623N7.

A meta analysis on risks of adverse pregnancy outcomes in Toxoplasma gondii infection.

ObjectiveQuantified risks of congenital Toxoplasma gondii infection and abnormal pregnancy outcomes following primary maternal infection were evaluated with meta- analysis based on published studies.MethodsThe related literatures were searched in multiple literature databases regardless of languages. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the risks of vertical transmission of Toxoplasma gondii and abnormal pregnancy outcomes following primary maternal infection with meta-analysis.Results53 of the 2632 searched literatures were included in our analysis. The incidence of abnormal pregnancy outcomes in T. gondii infected pregnant women (infected group) was significantly higher than that in the uninfected pregnant women (control group) (OR = 5.10; 95% CI, 3.85–6.75). Toxoplasma gondii infection rate in the abnormal-pregnancy-outcome group was significantly higher than in the normal-pregnancy group (OR = 3.71; 95% CI, 3.31–4.15). The pooled rate of vertical transmission was 20% (95% CI, 15%–26%) in maternal infection of T. gondii. The incidences of vertical transmission in women who were infected in the first, second or third trimester of pregnancy were 5% (95%CI, 2%–16%), 13% (95%CI, 7%–23%), and 32% (95%CI, 24%–41%), respectively. The rates of vertical transmission in women who were treated with spiramycin-only, PSF (pyrimethamine + sulfadiazine + folinic acid) or PS (pyrimethamine + sulfadiazine) combined with spiramycin, or other untypical treatments were 13% (95%CI, 7%–22%), 13%(95%CI, 7%–25%), and 24%(95%CI, 18%–32%), respectively.Conclusions Toxoplasma gondii infection can result in adverse pregnancy outcomes in pregnant women. The pooled rate of vertical transmission was 20% in maternal infection and the incidences of vertical transmission increased in the first, second or third trimester of pregnancy. The pooled rates of transmission in groups treated with spiramycin-only, PSF or PS combined with spiramycin, or other untypical treatments were not significantly different.