Establishment of trimester-specific reference intervals for hemostatic and hematologic indices and their associations with adverse pregnancy outcomes.

Information on pregnancy and infant outcomes after cladribine tablets exposure is limited, as its use is not recommended during pregnancy. This is a summary of the original published article 'Pregnancy and infant outcomes in multiple sclerosis: findings from the Global MAPLE-MS Pharmacovigilance Program'. The primary outcome is the prevalence of major congenital anomalies (MCAs) in babies. Secondary outcomes include other pregnancy outcomes (live birth, elective termination, spontaneous abortion, ectopic pregnancy, and stillbirth).

The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia.

Pre-weaning mortality and stillbirth rates in dogs are relatively high. Hypoxia during prolonged parturition is the main cause of neonatal death, followed by septic infection, predominantly caused by opportunistic bacteria. Several viruses also contribute to neonate mortality. Good breeding management and vaccination are important in improving newborn survival. The purpose of the study was to establish pregnancy outcome rates in a large cohort of Swedish breeding dogs, information that had not been previously documented. Further, we aimed to identify risk factors associated with abortion, congenital anomalities, and puppy mortality. Last, we wanted to investigate potential risk for transmission of Brucella canis or other zoonoses related to parturition. To achieve this, a web-based questionnaire was distributed to dog breeders in the Swedish Kennel Club. The results comprise data from 1879 breeders on 10,124 puppies from 1791 litters. Abortion rate was 1.5%, stillbirth rate 4.8%, and pre-weaning mortality 3.7%. Disease in the pregnant bitch was associated with spontaneous abortion or resorption. Stillbirth was associated with the bitch having her first litter, dystocia, increased litter size and presence of congential anomalities in the litter. Pre-weaning mortality was associated with dystocia and increased litter size. Having seven or more dogs less than one year old together with the bitch during the last weeks of pregnancy was a risk factor for both stillbirth and pre-weaning mortality, an association not previously shown. Thirty per cent of respondents reported having used mouth-to-nose resuscitation on newborn puppies, a potential transmit route for Brucella canis and other zoonotic agents.

Pregnancy Outcomes in Women With Cardiovascular Disease:A Retrospective Cohort Study from Kaiser Permanente Northern California.

Exposure to mono(2-ethylhexyl) phthalate (MEHP) during pregnancy has been associated with adverse pregnancy and birth outcomes characterized by extravillous trophoblast (EVT) abnormal function. Previous reports have suggested that MEHP can activate the PI3K/AKT pathway in EVT cells, a pathway known to regulate inflammation and angiogenesis in these cells. However, the molecular effects of MEHP on crucial EVT functions such as inflammatory and angiogenic homeostasis remain unexplored. This study aimed to characterize the role of the PI3K/AKT pathway as a mechanism of action of MEHP activity, as well as its effects on inflammatory and angiogenic soluble molecules in HTR-8/Svneo EVT human-derived cells. The results showed that a low (5 μM) MEHP concentration increased AKT phosphorylation, but a high (200 μM) concentration did not. Conversely, a high MEHP concentration, but not a low concentration, promoted nuclear translocation of p65 in a PI3K-dependent manner. Notably, distinct patterns of cytokines were transcriptionally and secretorily activated by high and low concentrations of MEHP. IL1B, CXCL8, and TNF were transcriptionally upregulated by MEHP 5 μM, while gene expression and secretion of IL-6 were induced by MEHP 200 μM, suggesting a biphasic inflammatory dose response. In addition, both MEHP concentrations upregulated the expression of angiogenic molecules (VEGF, PGF, and ANGPTL4) and impaired migration and tube formation in HTR-8/Svneo cells. Both inflammatory and angiogenic responses induced by MEHP were inhibited by the PI3K inhibitor LY294002. Collectively, these data demonstrate that MEHP induces inflammation and impairs angiogenesis partly via PI3K/AKT in HTR-8/SVneo cells. These findings may help to understand previous clinical associations between MEHP exposure and placental pathophysiology.

How safe are the TNF alpha inhibitors with respect to pregnancy outcomes in autoimmune diseases?

Introduction: Nutrition during pregnancy plays a crucial role in maternal and foetal health. Iron Deficiency Anaemia (IDA) remains a significant public health problem in India, contributing to adverse pregnancy outcomes. Understanding dietary micronutrient intake in early pregnancy is essential for designing effective interventions. Aim: To evaluate dietary intake of key micronutrients (iron, folic acid, and Vitamin C) and assess their association with Haemoglobin (Hb) concentration during the first trimester of pregnancy in North Karnataka, India. Materials and Methods: A cross-sectional study was conducted among 175 first-trimester pregnant women attending antenatal clinics (ANCs) at KLE Hospital and Research Centre, Belagavi, Karnataka, during June 2023 to May 2024. Dietary intake was assessed using a validated Food Frequency Questionnaire (FFQ). Parameters studied included Hb levels and daily intakes of iron, folic acid, and Vitamin C. Statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) version 20.0 for the Chi-square test, Spearman’s rank correlation, one-sample t-test and Two-way Analysis of Variance (ANOVA using Statista app. A p-value <0.05 was considered statistically significant. Results: The mean age of participants was 25.35±3.98 years, with a mean gestational age of 9.58±2.10 weeks. Mild anaemia was observed in 64 (36.57%) participants, moderate anaemia in 6 (3.43%), and 105 (60%) had normal Hb levels. Mean daily intakes of iron (7.84±3.20 mg), folic acid (58.33±25.67 mcg), and Vitamin C (28.70±18.68 mg) were significantly lower than the Recommended Dietary Allowances (RDA) (p-value <0.001 for all). Spearman’s correlation showed Hb levels in the study participants were not significantly associated with their dietary intake of iron (r-value=0.0023, p-value=0.9755), folic acid (r-value=0.0075, p-value=0.9219), or Vitamin C (r-value=–0.0309, p-value=0.6848). Conclusion: Micronutrient intake among pregnant women in early pregnancy was markedly inadequate, contributing to a significant burden of anaemia. There is an urgent need for targeted interventions such as dietary counselling, supplementation, and food fortification to improve maternal nutritional status and reduce anaemia-related risks.

Bushen Zhuyun Recipe improves endometrial receptivity through kruppel-like factor 4-mediated recruitment of mixed-lineage leukemia 1 to activate homeobox A10 transcription.

Maternal-fetal transfer of emerging bisphenols: Exposure profile and potential link to latrogenic preterm birth.

Protective Effect of Docosahexaenoic Acid Supplementation during Pregnancy against Lipopolysaccharide-Induced Intrauterine Growth Restriction in Fetal Mice.

Endometrial injury is a pathological damage caused by intrauterine infection, repeated miscarriage, or curettage, which can seriously impair fertility. Effective repair of damaged endometrium is crucial. Traditional interventions often only bring moderate improvements; therefore innovative repair strategies are needed. Herein, we propose a novel spatiotemporally responsive piezoelectric microsphere platform, which could be applied for ultrasound-guided endometrial regeneration and fertility recovery. These microspheres are manufactured by microfluidic technology, producing a core-shell structure: a Chinese herb-laden hydrogel embedded in piezoelectric nanoparticles, and wrapped by a viscous polydopamine (PDA) shell. The herbal hydrogel inhibits the release of inflammatory cytokines, and play the role of phytoestrogen to synergistically enhancing sexual function and tissue repair. The PDA shell scavenges reactive oxygen species (ROS), dampening oxidative stress and chronic inflammation. Meanwhile, the encapsulated gold-decorated tetragonal barium titanates (Au@BTO) nanoparticles generate bactericidal ROS upon ultrasonic activation, ensuring sterile local microenvironments. Vessel-on-a-chip and endometrium-injury rats model confirm the microspheres's outstanding compatibility, and their capacity to stimulate cell proliferation, migration and angiogenesis. Intrauterine delivery of the microspheres accelerates endometrial re-epithelialization, amplifies angiogenesis, restores myometrial integrity, and ultimately preserves fertility. With its precise spatiotemporal control and multimodal therapeutic functions, this microsphere system represents a transformative approach for localized treatment of gynecological diseases.

Early-stage cervical cancer tumours ≥2cm present a dilemma for fertility preservation, as guidelines generally discourage fertility-sparing surgery (FSS) due to oncologic risks. Neoadjuvant chemotherapy (NACT) followed by FSS has emerged as an alternative to downstage tumours. This study evaluated recurrence and pregnancy outcomes of NACT+FSS versus upfront FSS. A PROSPERO-registered (CRD42024605906) meta-analysis was conducted using PubMed, EMBASE, and Cochrane (updated Feb 26, 2025). Eligible studies included women with early-stage cervical cancer (FIGO 2018 IB2-IIA1; ≥2cm) undergoing upfront FSS or NACT+FSS. Pooled proportions with 95% confidence intervals (CIs) were calculated using a random effects model. Nineteen observational studies (n=1453) were analysed. Indirect comparison indicated significantly higher pooled pregnancy rate for NACT+FSS (31%; 95% CI: 23-41%) compared to upfront FSS (8%; CI: 1-43%; p=0.002). Pooled recurrence rate was statistically similar: 10% (CI: 5-20%) for upfront FSS and 13% (CI: 9-20%) for NACT+FSS (p=0.415). Studies generally exhibited a moderate-to-high risk of bias. NACT followed by FSS appears to enhance fertility outcomes without increasing oncologic risk compared to upfront FSS in patients with tumours ≥2cm. These findings support the personalized extension of fertility-sparing indications, though prospective validation remains necessary.

Heat stress disrupts the ovarian microenvironment in cattle: An in vivo analysis of hormonal alterations, oxidative stress-induced apoptosis, and reduced pregnancy outcomes.

Pregnancy induces a variety of hormonal, vascular, and immunological changes that can significantly affect the oral cavity, particularly the periodontium. Periodontitis, a chronic inflammatory disease of the supporting structures of the teeth, has been increasingly linked to adverse pregnancy outcomes such as preterm birth, low birth weight, and preeclampsia. This review explores the complex relationship between pregnancy and periodontal health, emphasizing the bidirectional nature of their interaction. The findings highlight the importance of early diagnosis and management of periodontal disease in pregnant women.

Fetal death is a major pregnancy complication, with rates of 5.5 per 1,000 births in the UnitedStates and substantially higher in India (24.7/1,000) and Pakistan (44.5/1,000). Maternal vascular malperfusion (MVM) is the most frequent placental lesion associated with fetal death, occurring in 58 % of fetal deaths and 31 % of preterm neonatal deaths in South Asia. Angiogenic imbalance, characterized by a low placental growth factor (PlGF) to soluble fms-like tyrosine kinase-1 (sFlt-1) ratio, has been associated with MVM and fetal death in high-income countries. We examined whether maternal serum concentrations of PlGF, sFlt-1, and their ratio differ between mothers with and without MVM among stillbirths and preterm neonatal deaths in India and Pakistan. This retrospective cohort analysis used data from the PURPOSe study (Project to Understand and Research Preterm Pregnancy Outcomes and Stillbirths in South Asia). Maternal blood was collected at delivery, and placental histopathology was classified according to the Amsterdam criteria. Serum PlGF and sFlt-1 were measured using Elecsys® immunoassays, with analyses stratified by gestationalage. Placental MVM was present in 44-57 % of stillbirths and 31-38 % of preterm neonatal deaths. Between 28 and 36weeks, women with MVM had significantly lower PlGF and higher sFlt-1 and sFlt-1/PlGF ratios(p<0.001). A tenfold decrease in PlGF or increase in the ratio was associated with MVM (OR 0.5 and 1.7, respectively). The maternal sFlt-1/PlGF ratio identifies pregnancies with fetal or neonatal death associated with placental MVM, particularly between 28 and 36weeks' gestation.

The purpose of the study is to explore the potential of novel genetic markers in predicting and diagnosing hypertensive conditions during pregnancy, focusing on their role in key pathological processes. The relevance of this study is determined by the necessity to improve methods for the early detection and effective management of pregnancy complications, particularly those associated with elevated blood pressure, which pose a threat to the health of both mother and foetus. The research methodology involves a systematic analysis of scientific literature from the past five years, specifically from 2019 to 2024, emphasising the integration of data from various populations and research approaches within the field of molecular medicine. The main findings demonstrate that certain molecular markers reflecting gene activity exhibit high accuracy in predicting the risks of complications associated with hypertension of pregnancy. It is established that these markers can detect disturbances in the regulation of vascular tone, angiogenesis processes, and inflammatory responses long before the onset of clinical symptoms. This opens up opportunities for timely medical intervention and a personalised approach to pregnancy management. The results of the study confirm the potential of utilising genetic markers in clinical practice to improve pregnancy outcomes and reduce risks for both mother and child. The practical value lies in the possibility of developing new screening programmes and therapeutic strategies based on the individual characteristics of patients, contributing to more effective management of hypertensive disorders during pregnancy.

Can middle cerebral artery Doppler predict adverse outcomes in growth-restricted fetuses? A systematic review and meta-analysis.

Given the persistently high rates of adverse pregnancy outcomes (APOs) in women with antiphospholipid syndrome (APS) despite standard therapy, updated guidance is needed to support individualized care. This review summarizes current understanding of the obstetric management of APS, including pathogenic mechanisms, preconception evaluation, pregnancy management, and emerging therapeutic approaches. Recent studies reinforce the central role of inflammation, rather than thrombosis alone, in APS-related pregnancy morbidity. This evolving paradigm has prompted interest in immune-modulating strategies alongside conventional treatment. Early prospective data suggest that TNF-α inhibition may significantly reduce APOs in pregnant women with APS. Animal studies demonstrate immunomodulatory effects of statins at the maternal-fetal interface, although human evidence regarding statins remains limited. Updated clinical recommendations also clarify management surrounding assisted reproductive technology, emphasizing the importance of preconception antiphospholipid antibody screening and risk-based thromboprophylaxis to mitigate complications during ovarian stimulation and early pregnancy. Obstetric APS remains a major cause of maternal-fetal morbidity. Advances in understanding placental inflammation have expanded potential therapeutic targets, but standardized treatment remains limited. Optimal care requires risk-stratified, multidisciplinary management and further research to improve pregnancy outcomes.

Pregnancy and neonatal outcomes following statin exposure in early pregnancy: a nationwide consultation-based cohort study in Japan.