Pregnancy Outcomes Research Articles

Effect of a Low Glycemic Index/Slow Digesting (LGI/SD) Carbohydrate Product on Maternal Glycemia and Neonatal Body Composition in Obese Pregnant Women: The NIGOHealth Randomized Clinical Trial.

Background/Objectives: Obesity during pregnancy is strongly related to increased insulin resistance, and subsequent development of metabolic syndrome-like disorders, such as glucose intolerance, pre-eclampsia, as well as preterm birth, and cesarean delivery. Nutrition can influence the evolution of glycemic response and may help improve adverse pregnancy outcomes and long-term complications. The main objective of the Nutritional Intervention during Gestation and Offspring Health (NIGOHealth) randomized clinical trial (ClinicalTrials.gov Identifier: NCT02285764) was to investigate the potential effects of a low glycemic index/slow digesting (LGI/SD) carbohydrate product on maternal glycemia (glucose AUC at 27+0-28+6 weeks; maternal fasting blood glucose (MFBG) at 34+0-36+0 weeks), and neonatal body composition. Methods: Obese pregnant women were randomized: 230 in the intervention group (IG), who consumed two servings of an LGI/SD study product daily from 15 weeks of pregnancy until delivery, and 102 participants in the Standard of Care (SOC) group. Results: When analyzing baseline characteristics, significant differences were found in glucose metabolic parameters with higher values for IG than for the SOC group, compromising the group's comparability. Despite this, a statistical analysis was conducted (intention-to-treat analysis/evaluable cohort): no differences were detected regarding maternal blood glucose AUC at 27+0-28+6 weeks, nor for MFBG at 34+0-36+0 weeks. Nonetheless, HbA1c (%) at 34+0-36+0 weeks was significantly lower in the IG vs. the SOC group (5.26 ± 0.03, 5.31 ± 0.04, p = 0.007) after adjusting for baseline conditions. Conclusion: This result might suggest a potential effect of the intervention on Evaluable participants. However, it should be taken with caution, due to the limitations of the study. More RCTs should be carried out to explore the effects of LGI/SD products on glycemic response in obese pregnant women.

The influence and association of blood on transfer catheter and vaginal microbiota on pregnancy outcomes in frozen-embryo transfer cycles.

The influence and association of blood on transfer catheter and vaginal microbiota on pregnancy outcomes in frozen-embryo transfer cycles.

Gluten-free diet during pregnancy and pregnancy outcome: A retrospective cohort study.

A gluten-free diet (GFD) is becoming increasingly popular, especially among young females, and including those without diagnosed celiac disease (CD). Whether a GFD is appropriate during pregnancy remains unclear. Our primary aim was to evaluate the association of a GFD and neonatal birthweight and incidence of large for gestational age (LGA) and small for gestational age (SGA). Secondarily, we sought associations with other obstetric outcomes. The data was collected retrospectively from the Tampere University Hospital database. The study period was from January 2015 to April 2021. The diet information was obtained from self-reported questionnaires. All women following a GFD were included. A total of 79 had CD and 291 followed a GFD without CD diagnosis. The latter are referred to here as people without CD avoiding gluten (PWAG). A total of 456 omnivores were randomly chosen to constitute a control group. Outcomes were analyzed by comparing gluten-free groups to a control group. The median birth weight was higher in the GFD group compared to the controls (3533 vs. 3440 g, P < 0.003), but the incidences of SGA or LGA did not differ between the study groups. The incidence of pregnancy complications was comparable between the groups. Induction of labor was more frequent (aOR 1.52; 95% CI: 1.12-2.08), and the duration of labor was longer (aOR1.56; 95% CI: 1.18-2.06) in the GFD group, especially among PWAG. However, no difference in the cesarean section rate were found between the groups. In the present retrospective cohort study, a GFD did not appear to be associated with adverse pregnancy or neonatal outcomes.

Impacts of Ramadan fasting during pregnancy on pregnancy and birth outcomes: An umbrella review.

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations. To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes. We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching PubMed, CINAHL, and Cochrane Registry of Systematic Reviews databases between November 2023 and February 2024. We included all systematic and narrative reviews examining the impacts of Ramadan fasting on pregnancy and birth outcomes. The primary outcome was the change in birth weight, gestational age at birth, fetal growth indices, and Apgar score as well as the risk of delivery by cesarean section and the risks of gestational diabetes and pre-eclampsia. We summarized the data using narrative synthesis and descriptive statistics as appropriate. This study was registered with PROSPERO, ID: CRD42023478819. Out of 943 published reports identified across all database searches, 13 systematic and narrative reviews were included, of which three were systematic reviews with meta-analysis, six were systematic reviews without meta-analysis, and the remaining four were narrative reviews. There is no sufficient evidence that Ramadan fasting during pregnancy may reduce gestational age at birth or increase the risk of preterm birth (PTB). There is little evidence to support the hypothesis that maternal Ramadan fasting may reduce birth weight or increase the risk of low birth weight (LBW). Systematic reviews showed pooled estimates of odds ratios ranging between 0.93 (95% confidence interval [CI] 0.60-1.44) and 0.99 (95% CI 0.72-1.37) for PTB, and between 1.05 (95% CI 0.87-1.26) and 1.37 (95% CI 0.74-2.53) for LBW. There is no sufficient evidence that Ramadan fasting during pregnancy may increase the risk of delivery by cesarean section, gestational diabetes, or the risk of pre-eclampsia. None of the reviews reported evidence regarding the impacts of fasting during pregnancy on rare but clinically significant pregnancy and birth outcomes such as stillbirth, miscarriage, congenital anomalies, or neonatal deaths. There is little evidence that Ramadan fasting during pregnancy can negatively impact pregnancy and birth outcomes. Primary research studies on this issue suffered from significant methodologic limitations and systematic reviews showed significant heterogeneity for several pregnancy and birth outcomes. High-quality primary research studies that collect data on multiple confounders and effect modifiers are needed to investigate this issue and help reaching evidence-based recommendations.

GDF15 promotes trophoblast invasion and pregnancy success via the BMPR1A/BMPR2/p-SMAD1 pathway: Implications for recurrent miscarriage.

GDF15 promotes trophoblast invasion and pregnancy success via the BMPR1A/BMPR2/p-SMAD1 pathway: Implications for recurrent miscarriage.

Tuberculosis in pregnancy: a growing concern

Tuberculosis (TB) remains one of the most prevalent diseases globally, with an estimated 10.6 million new cases reported in 2022.1 The causative agent is the bacterium Mycobacterium tuberculosis, and its classic symptoms include cough, fever, dyspnoea, chills, stabbing chest pain, and weight loss.2 Although TB is generally considered a curable disease, it can be fatal if left untreated, particularly if contracted during pregnancy. Tuberculosis can affect all stages of female reproduction.3 Therefore, screening and diagnosis are crucial in reducing morbidity and mortality. While pregnancy does not affect disease progression or susceptibility, the outcomes of pregnancy can be severely impacted by TB.4 A meta-analysis conducted by S Sobhy in 2017 demonstrated that active TB in pregnant women significantly increases the risk of maternal morbidity, antenatal admission, miscarriage, anaemia, perinatal death, birth asphyxia, and caesarean delivery.5 Another US-based study led by Erika M. Dennis et al. investigated the effects of active TB on pregnant and non-pregnant women. The study, which comprised 4058 cases, found that active TB in pregnancy resulted in an 80% higher risk of pregnancy complications in pregnant women compared to non-pregnant women. Moreover, the rate of in-hospital deaths among TB-infected pregnant individuals was 37 times higher than that of non-infected pregnant women. These complications included severe eclampsia, severe pre-eclampsia, and postpartum haemorrhage.6 These studies highlight a pressing concern and emphasize the need for measures to mitigate the effects of TB on pregnancy. As TB predominantly affects disadvantaged populations, it is prevalent in underdeveloped and developing countries, such as Pakistan. Consequently, physicians must be aware of how TB can impact diagnosis, prognosis, treatment, and pregnancy outcomes. Furthermore, physicians should educate the general population about TB during pregnancy and prioritize their efforts towards pregnant women who are highly susceptible, such as those residing in impoverished areas or with infected individuals. A more effective approach would involve collaboration between obstetricians, gynaecologists, healthcare providers, and infectious disease specialists. Pregnant women should undergo TB screening if they exhibit symptoms or live in close proximity to TB-infected individuals. These measures will contribute to eradicating the spread of TB and its adverse effects, as well as preventing the transmission of multidrug-resistant TB.

Association between regular physical activity during pregnancy and perinatal outcomes: A population-based cohort study.

Association between regular physical activity during pregnancy and perinatal outcomes: A population-based cohort study.

Inflammatory features in placentas of women with endometriosis and their relation to maternal and neonatal outcomes.

Inflammatory features in placentas of women with endometriosis and their relation to maternal and neonatal outcomes.

Interpregnancy and pregnancy lifestyle intervention (INTER-ACT): a randomized controlled trial.

Interpregnancy and pregnancy lifestyle intervention (INTER-ACT): a randomized controlled trial.

Safety and efficacy of extended expectant management in preterm premature rupture of membrane between 32 and 34 weeks of pregnancy-A randomization control trial.

Safety and efficacy of extended expectant management in preterm premature rupture of membrane between 32 and 34 weeks of pregnancy-A randomization control trial.

Oocyte Cryopreservation Outcomes in Women With Hematological Malignancies Undergoing Chemotherapy-A Systematic Review and Meta-Analysis.

Oocyte Cryopreservation Outcomes in Women With Hematological Malignancies Undergoing Chemotherapy-A Systematic Review and Meta-Analysis.

Impact of IVF-ET on obstetrics and perinatal outcomes in advanced maternal age women.

Impact of IVF-ET on obstetrics and perinatal outcomes in advanced maternal age women.

Hydroxychloroquine improves pregnancy outcomes by inhibiting excessive autophagy in extravillous trophoblast caused by an anti-phospholipid syndrome.

Hydroxychloroquine improves pregnancy outcomes by inhibiting excessive autophagy in extravillous trophoblast caused by an anti-phospholipid syndrome.

Hydroxychloroquine can reduce fetal growth restriction in a dexamethasone-induced rat model.

Hydroxychloroquine can reduce fetal growth restriction in a dexamethasone-induced rat model.

Pre-gestational restraint stress affects reproductive outcomes in adult rats by modulating ovarian and uterine function.

Pre-gestational restraint stress affects reproductive outcomes in adult rats by modulating ovarian and uterine function.

Multidisciplinary assessment of the impact of assisted reproductive techniques on pregnancy and long-term outcomes of mother and child: Foundation of the LE-REP (Leipzig Reproductive Health) Center.

About 8-10 % of all people of reproductive age are unable to conceive children. In recent years, an increased number of consultations for fertility treatments has been observed with a continuing positive trend. It is known that infertility itself and assisted reproductive technologies (ARTs) are frequently associated with recurrent miscarriages, pregnancy complications or psychosocial problems. In parallel, metabolic and vascular diseases and obesity are becoming a growing issue, even among the younger population, and are affecting fertility and pregnancy outcomes of mother and child. Possible interactions between these conditions and the underlying mechanisms are not well understood hitherto. Furthermore, reproductive outcomes are increasingly challenged by the potential effects of environmental pollution on key reproductive processes, including oocyte maturation and atresia, sperm quality, implantation as well as their role in recurrent miscarriages. The Leipzig reproductive health (LE-REP) project is aimed at investigating the interplay between ARTs and the aforementioned reproductive challenges, including different aspects of fertility problems, early and late pregnancy as well as long-term effects on mothers and their children born via fertility treatment. This multidisciplinary initiative is expected to provide a deep understanding of underlying mechanisms, providing a framework for future preventive strategies improving reproductive health. Finally, LE-REP aims to establish a high-level university fertility center of excellence, combining advanced clinical care, cutting-edge research and education to train future reproductive medicine specialists.

The impact of thyroid function, autoimmunity, and subsets of Th cells in follicular fluid on ovarian reserve and embryo quality in assisted reproductive technology (ART).

The impact of thyroid function, autoimmunity, and subsets of Th cells in follicular fluid on ovarian reserve and embryo quality in assisted reproductive technology (ART).

Risk factors for failed enhanced recovery after planned caesarean delivery.

Risk factors for failed enhanced recovery after planned caesarean delivery.

The role of necroptosis in pathological pregnancies: Mechanisms and therapeutic opportunities.

The role of necroptosis in pathological pregnancies: Mechanisms and therapeutic opportunities.

Buprenorphine-naloxone versus buprenorphine for opioid use disorder during pregnancy: A systematic review and meta-analysis.

Buprenorphine-naloxone versus buprenorphine for opioid use disorder during pregnancy: A systematic review and meta-analysis.