Pregnancy Outcomes Research Articles

Restricted Mating Windows and Thrombospondin 2 Gene Deletion Improve the Precision of Parturition Timing in Mice.

Mice are an important model organism for studying reproduction, parturition timing, and embryonic development. Previous reports indicate that limiting mouse breeding periods can reduce variability in fetal weight. To expand on these findings, this study sought to determine whether a restricted breeding window affects mating receptivity, precision of parturition timing, and pregnancy outcomes compared to standard overnight breeding of two common wild-type strains (C57BL/6J and CD-1) of laboratory mice. Since Thrombospondin-2 (Thbs2) knockout (KO) mice exhibit premature cervical remodeling without a shortened gestational length, we examined whether these mutant mice experience more precise parturition timing compared to their wild-type (WT) controls. Our findings revealed that the percentage of CD-1, but not C57BL/6J, female mice that were copulatory plug positive was significantly (p < 0.0001) reduced following a 2-hour restricted mating period in the morning or evening compared to overnight breeding. Conversely, using a 2-hour restricted breeding period in the morning or evening significantly (p < 0.0001) reduced the pregnancy rate of C57BL/6J, but not CD-1, female mice. Additionally, the variance in the gestational length and the timing of parturition was significantly (p < 0.0001) less in C57BL/6J and CD-1 females bred during a 2-hour period in the morning compared to either strain bred overnight. Interestingly, Thbs2 KO mice mated overnight had the shortest variance in parturition times. Pregnancy outcomes were not significantly impacted by breeding schedules or Thbs2 genotype. Collectively, these data reveal that restricted mating windows and deletion of the Thbs2 gene lead to more precise timing of parturition.

Predictors of adverse pregnancy outcomes in patients with systemic lupus erythematosus

To identify predictors of adverse pregnancy outcomes (APOs) in patients with systemic lupus erythematosus (SLE). A retrospective analysis was conducted on 318 SLE patients who delivered at Peking University People' s Hospital from May 2016 to September 2021. These patients were categorized into two groups The APOs group (n=85) and the non-APOs group (n=233). Various factors, including disease duration, clinical manifestations, laboratory parameters, and systemic lupus erythematosus disease activity index 2000 (SLEDAI-2000) scores, were analyzed for their association with APOs. SPSS 26.0 software was used to analyze the data. The mean age of SLE patients in this study was (24.65±5.26) years. Among the 318 pregnancies studied, 302 (302/318, 94.97%) resulted in live births, while 16 (16/318, 5.03%) cases ended in stillbirths, with no neonatal deaths reported. Among the live births, 206 (206/302, 68.21%) were full-term infants, 65 (65/302, 21.52%) cases were small for gestational age (SGA), and 31 (31/302, 10.26%) cases were preterm. The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group (5.82±4.97 vs. 3.74±3.72, t=4.019, P=0.001), suggesting greater disease activity as a risk factor. Similarly, glucocorticoid doses were markedly higher in the APOs group [12.50 (7.50, 50.00) mg vs. 10.00 (5.00, 15.00) mg, P < 0.001], underscoring the link between disease severity and APOs. Univariate analysis revealed that lupus nephritis (31.76% vs. 21.03%, χ2=3.946, P=0.047), thrombocytopenia (24.71% vs. 9.01%, χ2=13.380, P < 0.001), hypocomplementemia (36.47% vs. 26.03%, χ2=4.847, P=0.028), antiphospholipid antibody positivity (20.00% vs. 11.16%, χ2=4.163, P=0.041), and absence of pregnancy treatment (21.18% vs. 11.59%, χ2=4.713, P=0.030) were associated with increased APOs risk. Multivariate Logistic regression identified thrombocytopenia (OR=2.671, 95%CI 1.309-5.449, P=0.007), hypocomplementemia (OR=1.935, 95%CI 1.104-3.393, P=0.021), and antiphospholipid antibody positivity (OR=2.153, 95%CI 1.054-4.399, P=0.035) as independent predictors of APOs. These findings highlight that certain clinical and laboratory features, including thrombocytopenia, hypocomplementemia, and antiphospholipid antibody positivity, are critical independent predictors of APOs in SLE patients. The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.

Maternal intestinal L. vaginalis facilitates embryo implantation and survival through enhancing uterine receptivity in sows

BackgroundThe embryo implantation quality during early pregnancy is the predominant factor for embryo survival and litter performance in sows. Gut microbiota is demonstrated to show a correlation to pregnancy outcomes by participating in regulating maternal metabolism. However, the specific functional microbiota and its mechanical effects on regulating embryo implantation and survival remain unclear. The objective of this study was to clarify whether embryo implantation and litter performance were affected by maternal intestinal microbiota, and to identify specific microbial communities and its mechanism in regulating embryo implantation.ResultsIn this study, we first conducted 16S rRNA sequencing and metabolomic analysis revealing the intestinal microbiota and metabolism of 42 sows with different litter size to select the potential functional microbiota that may contribute to embryo survival. Then, we explored the effects of that microbiota on embryo implantation and litter performance through microbiota transplantation in mice and sows. We found that maternal intestinal L. vaginalis exhibits enrichment in sows with higher litter size, which could facilitate embryo implantation and survival and ultimately increases litter size in mice. We further employed transcriptomic analysis to determine the characteristics of uterus, which found an enhanced uterine receptivity after L. vaginalis gavage. The plasma untargeted metabolomic analysis after L. vaginalis gavage in mice and targeted metabolomics analysis of in vitro cultured medium of L. vaginalis were used to evaluate the metabolic regulation of L. vaginalis and to reveal the underlying functional metabolites. Next, an increasing adhesion rate of endometrial-embryonic cells and an obvious increasing formation of pinopodes in cell surface of porcine endometrial epithelial cells were observed after treatments of L. vaginalis metabolites, especially galangin and daidzein. Also, the gene expression levels related to uterine receptivity were increased after treatments of L. vaginalis metabolites in porcine endometrial epithelial cells. Finally, we found that L. vaginalis or its metabolites supplementation during early gestation significantly increased the litter performance in sows.ConclusionsOverall, intestinal microbial-host interactions can occur during early pregnancy and may be contribute to maternal metabolic changes and influence pregnancy outcomes in mammals. Our study provides insights of maternal intestinal L. vaginalis to enhance uterine receptivity and to benefit embryo/fetal survival through a gut-uterus axis, contributing to advanced concept and novel strategy to manipulate gut microbiota during early pregnancy, and in turn to improve embryo implantation and reduce embryo loss in sows.C6YXxXexhxcq4SPGBavqB5Video

Antenatal Management and Pregnancy Outcomes in Patient with factor X Deficiency Managed with Prothrombin Complex Concentrates

Antenatal Management and Pregnancy Outcomes in Patient with factor X Deficiency Managed with Prothrombin Complex Concentrates

Overweight and obesity in pregnancy - a retrospective cohort study in Germany.

Overweight and obesity are common among women of reproductive age. 43.8% of women in Germany and 50% of women in the US entering their pregnancy have a body mass index (BMI)≥25. Studies indicate that gestational overweight is associated with maternal and neonatal complications.2034 women from 2015 until 2018 were included. Trends in BMI, gestational weight gain, pregnancy outcome, complications, neonatal weight, and outcome were analyzed. Gestational weight gain was evaluated according to the Institute of Medicine (IOM) guidelines. 34% of the population were overweight with a BMI≥25. The overall weight gain was similar across BMI groups (median 11.0-14.0 kg). 44.1% gained more than recommended. These women were at higher risk of labor induction (33.1% vs. 27.0%, p=0.003), unplanned cesarean section (18.6% vs. 13.6%, p=0.004), lower incidence of spontaneous vaginal birth (54.5% vs. 59.9%, p=0.009), and higher neonatal birth weight (>90th percentile, 14.5% vs. 5.7%, p<0.001). Gestational diabetes was linked to a lower gestational weight gain (odds ratio 0.92, confidence interval 0.90-0.95, p<0.001).One third of the analyzed population was already overweight or obese at the beginning of the pregnancy. In 44.1% of cases, weight gain during pregnancy exceeded the recommended amount. This was associated with complications in pregnancy and labor as well as higher neonatal birth weight. This study highlights the importance of prenatal counseling and intervention on BMI and weight gain.

The impact of season, temperature, and direct normal irradiance on IVF pregnancy outcomes: a retrospective cohort study.

This study assessed associations between season, temperature, direct normal irradiance (DNI), and clinical pregnancy outcomes in first fresh in vitro fertilization (IVF) cycle.Methods.We conducted a retrospective cohort study (June 2021-October 2023) of 1179 patients undergoing fresh IVF cycles. Inclusion criteria required age ≤ 45 years, first-time fresh embryo transfer cycles (long/antagonist protocol), excluding preimplantation genetic testing, frozen cycles, or incomplete data. Temperature and DNI were recorded from gonadotropin (Gn) initiation to oocyte retrieval. Binary logistic regression assessed seasonal impacts on clinical pregnancy, while restricted cubic splines (RCS) independently modeled temperature/DNI effects.Results.Compared to winter, clinical pregnancy likelihood was 1.74-fold higher in spring (95% CI:1.11-2.71, P = 0.015) and 1.53-fold in summer (95% CI:1.02-2.30, P = 0.042). Stratified analysis revealed a 2.02-fold increased likelihood in summer cycles using the long protocol (95% CI:1.07-3.82, P = 0.031), whereas no seasonal variation was observed in antagonist protocol. RCS regression analysis indicated a nonlinear relationship between temperature and clinical pregnancy outcomes, which was confirmed in the long protocol group. No significant correlations were observed with DNI or in patients treated with the antagonist protocol.Conclusions.Season and ambient temperature significantly impact IVF clinical pregnancy, especially in the long protocol, with the highest increase in pregnancy rates observed in summer, as well as within the 26.13℃ to 29.68℃ temperature range. No significant effects were observed with DNI or the antagonist protocol. These findings suggest that summer treatment may optimize IVF outcomes, but future studies should prioritize multi-center prospective designs with continuous temperature monitoring to define precise optimal ranges.

Are the morphokinetics of embryos obtained from HPV-positive sperm altered? A Retrospective Cohort Study.

The study aims to compare the embryological morphokinetics of ART embryos derived from HPV-positive versus HPV-negative sperm, assess fertilisation rates, morphology, and pregnancy outcomes, and determine the prevalence of HPV infection in male ART patients. This is a retrospective cohort study. As established by the sample size, the participants were divided into two groups: the first sperm HPV positive group of 57 cases and the second HPV negative group of 57 cases. Participants/Materials, Setting,: We calculated the sample size for evaluating sperm parameters. The estimated number of patients required for the study was 114. The sample size for the morphogenetic evaluation of embryos was equal to 210 embryos in total. The statistical analysis involved the execution of the Student t-test, the Shapiro test the Mann-Whitney. The Chi-square or Fisher tests were then used depending on the sampled data. The enrolled couples were treated with in vitro fertilization with ICSI. Results Morphokinetics showed no statistically significant difference between the two groups examined. Therefore, the speed of the various stages of embryonic growth appears substantially identical. Limitations Morphokinetics showed no statistically significant difference (table V) between the two groups examined. Therefore, the speed of the various stages of embryonic growth appears substantially identical. Conclusions Our results suggest that the disease does not worsen the results of ART and does not modify the morphokinetics of embryos; therefore, screening for sperm HPV in males of couples scheduled for ART does not appear advisable.

Perinatal outcomes of single intrauterine fetal demise in monochorionic diamniotic twins

To compare the pregnancy outcomes of surviving fetuses in monochorionic diamniotic (MCDA) twin pregnancies after selective feticide or spontaneous single intrauterine fetal demise (sIUFD), and to explore the influencing factors of prognosis. A total of 219 cases of intra-uterine death of one fetus in MCDA twin pregnancies admitted to Peking University Third Hospital from September 2010 to August 2021 were collected. According to the mode of fetal death, they were divided into the spontaneous sIUFD group (120 cases) and the selective feticide group (99 cases). Data on the maternal conditions during pregnancy, the situation of the intrauterine-dead fetus, and pregnancy outcomes were collected for retrospective case-analysis. The live-birth rates of surviving fetuses in the spontaneous sIUFD group and the selective feticide group were 85.0% and 81.8% respectively, and the total perinatal survival rates of surviving fetuses were 73.3% and 81.8% respectively, and there were no statistically significant differences. Compared with the spontaneous sIUFD group, the selective feticide group had a greater gestational week at delivery, and lower rate of preterm birth before 37 weeks, neonatal asphyxia, and early neonatal mortality. Using the gestational week at delivery as the outcome variable, Cox regression analysis showed that the mode of fetal death was not a risk factor affecting the gestational week at delivery of the surviving fetus, while gestational hypertension and the gestational week of fetal death were independent risk factors affecting the gestational week at delivery of the surviving fetus. Using preterm birth before 37 weeks, intrauterine death of the surviving fetus, and abnormal neonatal cranial ultrasound as outcome variables respectively, unconditional logistic regression analysis showed that the mode of fetal death, the gestational week of fetal death, the position of the dead fetus, and fetal complications were independent risk factors affecting the outcomes of the above-mentioned surviving fetuses. According to the results of the univariate analysis, the above risk factors were included in the multivariate regression analysis, and the results were the same as those of the univariate analysis. For MCDA twin pregnancy patients with severe twin-related complications, the prognosis of surviving fetuses after selective feticide is better. The proactive intrauterine intervention and treatment are of great significance for improving the prognosis of surviving fetuses.

A comparative systematic review and meta-analysis of uterine artery resistance in pregnant women with and without previous history of cesarean section.

Increased uterine artery resistance in pregnant women with a history of cesarean section has been suggested to contribute to adverse pregnancy outcomes. However, the literature presents conflicting reports on this association. In this comparative meta-analysis and systematic review, we aimed to evaluate the studies that reported uterine artery resistance using Color Doppler ultrasonography in pregnant women with and without a history of cesarean section. We searched PubMed, Scopus, Web of Science, and Embase up to April 2024 using relevant keywords. Study selection was performed by two independent researchers, with conflicts resolved by a third. Risk of bias was assessed using the Newcastle-Ottawa Scale. The primary outcomes were the Pulsatility Index (PI) and Resistance Index (RI) Meta-analysis and meta-regression were conducted using STATA version 17. After screening 442 articles, the meta-analysis included six studies, encompassing 1,656 participants. We found a small but statistically significant increase in uterine artery resistance, based on PI, in women with a history of cesarean section (Hedges's g = 0.15, 95% CI [0.03, 0.26], p = 0.01). Heterogeneity among studies was low (I² = 26.60%, p = 0.23), and no significant publication bias was detected (Egger's test, p = 0.81). Analysis of the RI, based on two studies, showed a non-significant increase in the cesarean group (Hedges's g = 0.19, 95% CI [-0.06, 0.43], p = 0.13). A history of cesarean section may be associated with increased uterine artery resistance. These findings suggest a possible benefit in monitoring uterine artery resistance in subsequent pregnancies, mainly using Color Doppler ultrasonography, to better understand potential risks such as preeclampsia and intrauterine growth restriction. However, given the limited evidence, further studies are warranted to confirm these associations and clarify their clinical relevance.

Associations of metabolic dysfunction-associated steatotic liver disease and cardiometabolic risk factor abnormalities with adverse pregnancy outcomes

To investigate the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and the risk of adverse pregnancy outcomes, and to analyze the impact of the type and severity of cardiometabolic risk factor (CMRF) abnormalities on this association. A retrospective cohort study was conducted among primiparous women with singleton pregnancies who had registered at Beijing Friendship Hospital from March 10, 2020, to December 31, 2022. A total of 2 623 women were included. Basic characteristics and delivery outcomes were documented, liver ultrasound and relevant prenatal examinations were performed, and adverse pregnancy outcomes were diagnosed. Modified Poisson regression models were used to analyze the association between MASLD and adverse pregnancy outcomes. The relationship between the type or severity of CMRF abnormalities in MASLD and the risk of adverse pregnancy outcomes was also explored. After adjusting for confounding factors including age, gestational weight gain, and education level, MASLD was associated with an increased risk of cesarean section (RR=1.531, 95%CI: 1.304-1.799, P < 0.001), gestational diabetes mellitus (GDM; RR=2.409, 95%CI: 1.948-2.979, P < 0.001), pregnancy-associated hypertension (PAH; RR=3.062, 95%CI: 2.069-4.533, P < 0.001), preterm birth (RR=2.145, 95%CI: 1.342-3.429, P=0.001), and large for gestational age (LGA; 2.224, 95%CI: 1.599-3.095, P < 0.001). However, no significant associations were found for small for gestational age or postpartum hemorrhage. After adjusting for other CMRF abnormalities, the risk of adverse pregnancy outcomes varied among MASLD pregnant women with different CMRF abnormalities: the body mass index abnormal group had higher risks of cesarean section, GDM, PAH, preterm birth, and LGA; the glucose abnormal group had an increased risk of GDM; the blood pressure abnormal group had a higher risk of PAH; the high density lipoprotein cholesterol abnormal group had higher risks of cesarean section, GDM, and PAH; and the triglyceride abnormal group was associated with higher risks of GDM and preterm birth. Additional, as the severity of CMRF abnormalities increased, the risks of cesarean section (RR=1.199, 95%CI: 1.112-1.292, P < 0.001), GDM (RR=1.478, 95%CI: 1.345-1.624, P < 0.001), PAH (RR=1.626, 95%CI: 1.367-1.934, P < 0.001), preterm birth (RR=1.384, 95%CI: 1.120-1.710, P=0.003), and LGA (RR=1.422, 95%CI: 1.224-1.650, P < 0.001) continued to rise. MASLD during pregnancy is associated with an increased risk of multiple adverse pregnancy outcomes, and the type and severity of CMRF abnormalities significantly influence this association. These results suggest that attention should be paid to the specific CMRF abnormalities when diagnosed MASLD, as this may help to facilitate targeted interventions and reduce the risk of adverse pregnancy outcomes.

A comparative systematic review and meta-analysis of uterine artery resistance in pregnant women with and without previous history of cesarean section

BackgroundIncreased uterine artery resistance in pregnant women with a history of cesarean section has been suggested to contribute to adverse pregnancy outcomes. However, the literature presents conflicting reports on this association. In this comparative meta-analysis and systematic review, we aimed to evaluate the studies that reported uterine artery resistance using Color Doppler ultrasonography in pregnant women with and without a history of cesarean section.MethodsWe searched PubMed, Scopus, Web of Science, and Embase up to April 2024 using relevant keywords. Study selection was performed by two independent researchers, with conflicts resolved by a third. Risk of bias was assessed using the Newcastle-Ottawa Scale. The primary outcomes were the Pulsatility Index (PI) and Resistance Index (RI) Meta-analysis and meta-regression were conducted using STATA version 17.ResultsAfter screening 442 articles, the meta-analysis included six studies, encompassing 1,656 participants. We found a small but statistically significant increase in uterine artery resistance, based on PI, in women with a history of cesarean section (Hedges’s g = 0.15, 95% CI [0.03, 0.26], p = 0.01). Heterogeneity among studies was low (I² = 26.60%, p = 0.23), and no significant publication bias was detected (Egger’s test, p = 0.81). Analysis of the RI, based on two studies, showed a non-significant increase in the cesarean group (Hedges’s g = 0.19, 95% CI [−0.06, 0.43], p = 0.13).ConclusionA history of cesarean section may be associated with increased uterine artery resistance. These findings suggest a possible benefit in monitoring uterine artery resistance in subsequent pregnancies, mainly using Color Doppler ultrasonography, to better understand potential risks such as preeclampsia and intrauterine growth restriction. However, given the limited evidence, further studies are warranted to confirm these associations and clarify their clinical relevance.

Association of sleep traits with risk of adverse pregnancy outcomes: a Mendelian randomisation analysis

Background The aims of this study are to investigate the causal relationships between sleep traits and the risk of gestational diabetes mellitus (GDM), preterm birth, and foetal growth restriction (FGR). Methods This two-sample Mendelian Randomisation (MR) study was conducted from May to June 2024 to investigate the associations between seven sleep traits and GDM, preterm birth, and FGR. The study utilised data from large-scale genome-wide association study datasets, and specifically focused on individuals of European descent. The main analysis employed inverse-variance-weighted MR, with sensitivity analyses conducted to mitigate potential pleiotropy-induced biases. Additionally, multivariable MR analysis was conducted to adjust for potential confounding factors. Results Genetically predicted excessive daytime sleepiness (OR 13.67; 95% CI, 1.03–180.59; p = 0.047) and sleep apnoea (OR 1.29; 95% CI, 1.00–1.65; p = 0.049) were found to be associated with a higher risk of GDM. No sleep trait was associated with either preterm birth or FGR. These results were robust across various sensitivity analyses. In the multivariable MR analysis, adjusting for body mass index (BMI) and smoking, the genetically instrumented excessive daytime sleepiness (OR 14.58; 95% CI 1.67–127.36; p = 0.015) and sleep apnoea (OR 1.30; 95% CI 1.02–1.64; p = 0.030) were consistently associated with an increased GDM risk. Conclusions This study suggests a causal relationship between both excessive daytime sleepiness and sleep apnoea to the development of GDM. Excessive daytime sleepiness and sleep apnoea demonstrate promise as potentially preventable risk factors for GDM.

Omega-3 fatty acids improves tamoxifen-induced sexual dysfunction in male Wistar rats by modulating NO/cGMP signaling and monoamine neurotransmitters activities.

Tamoxifen (TAM) is an off-label treatment option for men with breast cancer, infertility, and gynecomastia. Unfortunately, one of the undesirable effects of TAM is sexual dysfunction. Therefore, this study was designed to investigate the possible associated mechanisms with TAM-induced sexual dysfunction and the possible ameliorative effect of omega-3 fatty acids (O3FA). Animals were randomly divided into control, O3FA, TAM, and TAM + O3FA. All treatment lasted for 28 days. TAM exposure impaired sperm qualities (count, motility, viability, and normal morphology) and led to a decline in serum testosterone and an increase in luteinizing hormone, follicle-stimulating hormone, prolactin, and estradiol. Furthermore, TAM led to an increase in mount, intromission, and ejaculation latencies and a decrease in their corresponding frequencies. It also led to a decrease in motivation to mate and an increase in post-ejaculatory interval. These events were associated with impaired pregnancy outcomes, hormonal imbalance, a decrease in nitric oxide/cyclic cyclic guanosine monophosphate and dopamine and an increase in acetylcholine esterase and serotonin activities. These observed TAM-induced sexual dysfunction markers were ameliorated in animals that received O3FA and TAM co-treatment. O3FA ameliorates TAM-induced sexual dysfunction.

Innate immune responses to pathogens at the maternal-fetal interface.

During pregnancy, the maternal immune system must navigate a balance between fetal tolerance and a response to acquired microbial infections. Cells at the maternal-fetal interface coordinate this response throughout gestational stages in a dynamic manner, integrating endocrine, developmental, inflammatory and metabolic cues. Although many maternal and fetal cell types activate innate immune signalling pathways in response to infections, excessive inflammation can disrupt tolerance, affect placental function and impair fetal development, leading to congenital disease and other pregnancy complications. In this Review, we discuss the mechanisms of pathogen recognition in the maternal and fetal compartments of the placenta and the consequences of these responses to pregnancy outcomes.

Role of vitamin D in the pathogenesis of early-onset preeclampsia: a narrative review.

Early-onset Preeclampsia (EOPE) is a severe pregnancy complication that poses significant risks to both maternal and fetal health, often leading to fetal growth restriction and maternal morbidity. Despite extensive research, the etiology of EOPE remains unclear, though emerging evidence suggests that vitamin D (VD) may play an important role in placental development and function. Recent studies associate VD deficiency with adverse pregnancy outcomes, including EOPE, through mechanisms such as impaired trophoblast invasion and immune dysregulation at the maternal-fetal interface. This review aimed to synthesize current literature on the role of VD in the pathogenesis of EOPE. We reviewed in vitro, in vivo, and clinical studies to evaluate the impact of VD on immune modulation, angiogenesis, oxidative stress, and trophoblast migration and invasion in the placenta. This comprehensive review aims to provide insights into how VD deficiency exacerbates placental dysfunction, contributing to the development of EOPE. These insights support the rationale for VD supplementation as a potential preventive strategy and highlight the need for further clinical investigation.

Parity modifies the effect of genetic variants associated with gestational duration and birth weight.

Gestational duration and birth weight are linked to both short- and long-term adverse health outcomes in mothers and their offspring. Previous genome-wide association studies on these pregnancy outcomes have been successful but have overlooked the number of a mother's previous pregnancies. In this study, we explored if parity (the number of children a mother has previously delivered) modifies the maternal or foetal genetic effect of gestational duration and birth weight (gene × parity interactions) using data from the Norwegian Mother, Father, and Child Cohort Study in up to 58,528 mothers and their offspring. Potential genetic effect differences were investigated by: (1) performing parity-stratified genome-wide association studies, (2) testing SNP × parity interactions, (3) testing the interaction between a polygenic prediction of the traits and parity, and (4) assessing the genetic correlation within each outcome across parity. For both phenotypes, we identified shared and distinct loci for each outcome in terms both of genetic region and number in the parity-stratified genome-wide association studies, and the genetic correlation by parity deviated from one for all outcomes. The strongest evidence of genetic modification effect by parity was found for gestational duration in the maternal genome where genetic effects were stronger in the first pregnancy compared to later pregnancies. For instance, the polygenic prediction of the maternal genome on gestational duration had a significant interaction with parity (p-value interaction = 5 × 10 -5 ). The results for birth weight were more uncertain, suggesting that the identified gene × parity interactions is largely limited to gestational duration. In conclusion, our study reveals that parity modifies the genetic effects on gestational duration and highlights the relevance of considering parity in genetic studies on pregnancy outcomes.

Teenage Pregnancy Trends, Outcomes, And Prevention Strategies

Background The public health problem of teenage pregnancy continues to affect the health status of mothers and children worldwide. Young pregnant persons are more likely to experience negative pregnancy outcomes that lead to premature delivery and babies born with low weight. The prevalence of teenage pregnancy shows little reduction since international organizations started working on it because the problem primarily affects countries that are still developing. Objectives To evaluates teenage pregnancy patterns by studying clinical effects together with intervention methods that minimize unwanted side effects. Study Design: A Retrospective Observational Study. Place and duration of study. Department of Gynae Gomal Medical College Dera Ismail Khan Pakistan from January 2023 through December 2023. Methods The study collected data from teenage pregnancies at Department of Gynae Gomal Medical College Dera Ismail Khan Pakistan from January 2023 through December 2023.during the period spanning from January 2023 through December 2024. Hospital records provided information regarding maternal age and various demographic characteristics besides pregnancy results. Statistical examinations utilized SPSS version 25.0 to perform the analyses where p&lt;0.05 established the statistical significance. Results 200 teenage pregnancy cases where subjects averaged 17.2 years old standard deviation ± 1.5. Among the examined pregnancies preterm birth occurred in 20% of cases and low birth weight affected 15% of births. The Study showed that teenage pregnancies yielded better results with contraception use since the p-value reached 0.01. The study showed that 40 percent of participants already had access to contraception during the time when they grew pregnant. Conclusion Teenage pregnancies present several major health risks to mothers and their newborn infants. The implementation of sex education programs along with increased access to contraception methods leads to encouraging outcomes in reducing negative pregnancy results. The Study needs to expand its efforts toward better healthcare availability combined with expanded sexual education opportunities for young adults.

Placenta gross examination and cord insertion in women with malaria in pregnancy

Background: Malaria in pregnancy is a common condition endemic to the coastal and lake regions in sub-Saharan Africa. The condition may contribute to abnormal placental development. This study aimed to determine how malaria in pregnancy alters the placental morphology and cord insertion.Materials and methods: This study followed an analytical cross-sectional design. The placenta from 58 mothers who have had malaria in pregnancy and 58 without a history of malaria in pregnancy were collected. The birth weights and placental weights were measured. The tissues were macroscopically examined for morphological features and the type of placental cord insertion. These were recorded and entered into SPSS for data analysis. Descriptive statistics, graphs and charts were obtained, and inferential statistics were carried out using the independent sample t-test and chi-square tests. A Pvalue of ≤ 0.05 was considered statistically significant.Results: The mean placental weights observed were 478.27g ± 40.95 among the cases and 511.55g ± 35.58 among the controls, with the odds of having low placental weight significantly greater for those with malaria than those without P=0.001, OR=4.424. There was a significant difference in the proportion of abnormal cord insertions between women with malaria in pregnancy and those without(p&lt;0.05). Areas of white infarct and meconium staining were noted in some of the placenta of the women with malaria in pregnancy.Conclusion: Malaria in pregnancy alters placental morphology and cord insertion. This study gives more insight into understanding adverse pregnancy outcomes in women who have had malaria in pregnancy.

Association of maternal overweight and gestational diabetes mellitus with offspring adiposity trajectory: from birth to early adolescence.

We aimed to examine offspring adiposity trajectories from birth to age 9-14 years and to assess the joint associations of maternal overweight and gestational diabetes mellitus (GDM) with these trajectories. This is a prospective cohort study with 564 mother-child dyads from the Hyperglycemia and Adverse Pregnancy Outcome study Hong Kong field centre. Assessments and anthropometric measurements were taken during pregnancy, at delivery and at median ages of 7 and 10 years postpartum. Offspring adiposity was primarily assessed using sum of skinfold thickness. We used linear mixed-effect models to evaluate the independent and joint associations of maternal overweight and GDM with the offspring adiposity trajectories, and applied group-based trajectory modelling to identify distinct patterns of adiposity development based on both statistical indices and clinical interpretability. Offspring skinfold thickness trajectories varied significantly based on maternal overweight and GDM (p<0.05). Group-based trajectory modelling identified two trajectory groups for skinfold thickness: 52.1% with slow increase and 47.9% with rapid increase. Combined maternal overweight and GDM was associated with 6.90-fold increased risk (95% CI 1.89, 33.32; p=0.006) of the rapidly increasing trajectory. Linear mixed-effect model analysis showed greater increases in skinfold thickness among offspring of mothers with either condition, with the highest trajectory observed in offspring of mothers with both conditions (β 1.62; 95% CI 0.69, 2.54; p=0.001). Maternal overweight and GDM are independently and jointly associated with rapidly increasing adiposity trajectories from birth to early adolescence. The findings underscore the importance of considering both maternal metabolic conditions when evaluating offspring adiposity risk.

Associations of Nausea and Vomiting of Pregnancy with Maternal and Fetal Outcomes

Background: Nausea and Vomiting in Pregnancy (NVP) and Hyperemesis Gravidarum (HG) are common pregnancy-related conditions that can significantly impair maternal quality of life and, in severe cases, impact pregnancy outcomes. This study aimed to assess the prevalence of NVP and HG, evaluate their association with pregnancy progression and neonatal outcomes, and investigate the role of pharmacological therapy. Methods: A prospective observational study was conducted at the University Hospital of Siena between September 2023 and September 2024. Seventy-nine pregnant women aged 28–34 years were enrolled and followed throughout pregnancy. Symptom severity was assessed using the PUQE questionnaire during scheduled outpatient visits. Patients with NVP received pharmacological treatment with doxylamine succinate/pyridoxine hydrochloride. Results: Nausea and Vomiting in Pregnancy was reported by 59% of patients, with all cases categorized as mild or moderate; no severe HG cases were observed. Symptoms resolved by the third trimester. A significant association was observed between NVP and a positive family history of the condition (OR: 3.66, 95% CI: 1.20–11.21; p = 0.025). Logistic regression analysis also revealed that NVP was associated with an increased risk of gestational hypertension (15% vs. 0%, p = 0.04), and a decreased likelihood of gestational diabetes (OR: 0.24, 95% CI: 0.07–0.86) and cesarean section (OR: 0.34, 95% CI: 0.13–0.87). No significant differences were found in neonatal outcomes, including birth weight, Apgar scores, or fetal complications. Conclusions: While NVP may influence maternal outcomes, the condition does not significantly affect neonatal health. Early pharmacological treatment improves maternal well-being and may reduce hospitalization rates. Larger multicenter studies are needed to confirm these findings.