Pregnancy-related Disorders Research Articles

The Role of Peroxisome Proliferator-Activated Receptors in Preeclampsia.

Preeclampsia is a common pregnancy-related hypertensive disorder. Often presenting as preexisting or new-onset hypertension complicated by proteinuria and/or end-organ dysfunction, preeclampsia significantly correlates with maternal and perinatal morbidity and mortality. Peroxisome proliferator-activated receptors (PPARs) are nuclear receptor proteins that regulate gene expression. In order to investigate the role of PPARs in the pathophysiology of preeclampsia, we conducted a literature review using the MEDLINE and LIVIVO databases. The search terms "peroxisome proliferator-activated receptor", "PPAR", and "preeclampsia" were employed and we were able to identify 35 relevant studies published between 2002 and 2022. Different study groups reached contradictory conclusions in terms of PPAR expression in preeclamptic placentae. Interestingly, PPARγ agonists alone, or in combination with well-established pharmaceutical agents, were determined to represent novel, potent anti-preeclamptic treatment alternatives. In conclusion, PPARs seem to play a significant role in preeclampsia.

Comparison of oxidative stress levels during the third Trimester in normal pregnancy and preeclampsia.

The placenta is a complex transiently formed organ which plays a crucial role in the development of the foetus. As the placenta is responsible for maintaining pregnancy placental defects are mainly responsible for pregnancy-related issues. Preeclampsia is a pregnancy-related disorder due to uteroplacental insufficiency resulting from deficient remodelling of spiral arteries causing ischemic reperfusion injury which is finally responsible for the generation of reactive oxygen species and oxidative stress by the placenta. So, this study was planned to determine and compare serum levels of oxidative stress markers (ischemia-modified albumin and malondialdehyde) in preeclampsia and normal pregnancy in the third trimester. Study design: Cross-sectional comparative study Settings Gynae/Obs Department and Pathology Laboratory, Lahore General Hospital, Lahore. Study population: 42 Pregnant females at 34-36 weeks of gestation were selected. Group 1 compromised 21 normal healthy pregnant females and group 2 included 21 preeclamptic patients. Sampling technique: non-probability purposive sampling. Blood samples were taken at 34-36 weeks of gestation. Serum was stored for ischemiamodified albumin and malondialdehyde. Data was analyzed using SPSS version 20. An Independent t-test was used to compare values between the groups during the third trimester. A pvalue of ≤0.05 was considered significant. Comparison of ischemia-modified albumin and malondialdehyde values between group I and group 2 showed a highly significant difference of pvalue of <0.001. Oxidative stress markers were higher in preeclamptic patients as compared to normal pregnant females during the third trimester suggesting the role of the placenta in oxidative stress.

Association between maternal epicardial adipose tissue, gestational diabetes mellitus, and pregnancy-related hypertensive disorders: a systematic review and meta-analysis.

Several small studies have evaluated the association between epicardial adipose tissue (EAT) and pregnancy-related cardiovascular risk factors such as gestational diabetes mellitus (GDM) or hypertensive disorders. The objective of this study was to quantitatively compare EAT thickening between patients with GDM or pregnancy-related hypertensive disorders and healthy controls. This systematic review and meta-analysis were performed according to PRISMA guidelines. A literature search was performed to detect studies that have quantified EAT in women with GDM and pregnancy-related hypertensive disorders compared to a control group. The primary outcome was EAT thickening estimated by ultrasound expressed in millimeters. Random or fixed effects models were used. Nine observational studies including 3146 patients were identified and considered eligible for this systematic review. The quantitative analysis showed that patients with GDM have a higher EAT thickness (mean difference: 1.1mm [95% confidence interval: 1.0-1.2]; I2 = 24%) compared to the control group. Moreover, patients with pregnancy-related hypertensive disorders showed higher EAT thickness (mean difference: 1.0mm [95% confidence interval: 0.6-1.4]; I2 = 83%) compared to the control group. In conclusion, this study demonstrated that EAT thickening is increased in patients with GDM and pregnancy-related hypertensive disorders compared with healthy controls. Whether or not this association is causal should be evaluated in prospective studies.

Interaction between Long Noncoding RNAs and Syncytin-1/Syncytin-2 Genes and Transcripts: How Noncoding RNAs May Affect Pregnancy in Patients with Systemic Lupus Erythematosus.

Patients with systemic lupus erythematosus (SLE) often suffer from obstetric complications not necessarily associated with the antiphospholipid syndrome. These events may potentially result from the reduced placental synthesis of the fusogenic proteins syncytin-1 and syncytin-2, observed in women with pregnancy-related disorders. SLE patients have an aberrant noncoding (nc)RNA signature that may in turn dysregulate the expression of syncytin-1 and syncytin-2 during placentation. The aim of this research is to computationally evaluate and characterize the interaction between syncytin-1 and syncytin-2 genes and human ncRNAs and to discuss the potential implications for SLE pregnancy adverse outcomes. The FASTA sequences of the syncytin-1 and syncytin-2 genes were used as inputs to the Ensembl.org library to find any alignments with human ncRNA genes and their transcripts, which were characterized for their tissue expression, regulatory activity on adjacent genes, biological pathways, and potential association with human disease. BLASTN analysis revealed a total of 100 hits with human long ncRNAs (lncRNAs) for the syncytin-1 and syncytin-2 genes, with median alignment scores of 151 and 66.7, respectively. Only lncRNAs TP53TG1, TTTY14, and ENSG00000273328 were reported to be expressed in placental tissue. Dysregulated expression of lncRNAs TP53TG1, LINC01239, and LINC01320 found in this analysis has previously been described in SLE patients as well as in women with a high-risk pregnancy. In addition, some of the genes adjacent to lncRNAs aligned with syncytin-1 or syncytin-2 in a regulatory region might increase the risk of pregnancy complications or SLE. This is the first computational study showing alignments between syncytin-1 and syncytin-2 genes and human lncRNAs. Whether this mechanism affects syncytiotrophoblast morphogenesis in SLE females is unknown and requires further investigation.

Assessing erythroferrone and iron homeostasis in preeclamptic and normotensive pregnancies: A retrospective study

IntroductionPreeclampsia (PE) is a pregnancy-related disorder associated with maternal hypertension and placental dysfunction. A significant micronutrient during pregnancy is iron, which is important in cellular functions. While iron absorption increases in pregnancy, little is known about the exact mechanisms regulating maternal iron levels and transfer through the placenta in normal and complicated pregnancies. MethodsIn this retrospective study, we investigated the regulation of maternal and placental iron availability and storage, in normotensive and pregnancies complicated by early- or late-onset PE. Methods used were analysis of clinical records, ELISA analysis on plasma samples, immunofluorescent and Prussian Blue analysis on placenta biopsies. ResultsFocusing on erythroferrone (ERFE) as a new marker and hormonal regulator of iron, our results demonstrated altered maternal ERFE levels in PE. We are the first to report the expression of ERFE in trophoblasts and indicate its lower levels in early-onset PE placentas. These changes were associated with lower placental transferrin receptor 1 (TfR1) in syncytiotrophoblasts in both early- and late-onset PE. In addition, maternal plasma ERFE levels were elevated in both early- and late-onset PE and hepcidin levels reduced in early-onset PE. Unaltered maternal plasma IL-6 levels suggest mechanism other than inflammation being involved in altered iron regulation in PE pregnancy. DiscussionOur data supports a deregulation in maternal iron bioavailability in early- and late-onset PE vs normotensive pregnancies. The exact role of placental ERFE in regulating maternal-placental-fetal iron transport axis requires further investigation.

CCL21/CCR7 Axis Contributes to Trophoblastic Cell Migration and Invasion in Preeclampsia by Affecting the Epithelial Mesenchymal Transition via the ERK1/2 Signaling Pathway.

Preeclampsia (PE) is a pregnancy-related disorder that is a leading cause of maternal death. The failure of spiral artery remodeling due to insufficient trophoblast migration and invasion is critical in the pathogenesis of PE. Recently, the CC motif chemokine ligand 21 (CCL21) has been widely linked to cancer cell invasion and migration. However, their potential mechanisms are still unknown. In this study, we found that CCL21 expression was significantly lower in the PE group than that in the control group. In vitro experiments revealed that recombinant CCL21 could promote trophoblast cell epithelial-to-mesenchymal transitions (EMTs) and improve migration and invasion. Furthermore, an inhibitor of the ERK1/2 signaling pathway inhibited the CCL21-induced EMT process. Finally, a PE mouse model was established using the NOS inhibitor L-NAME, and we obtained similar results, with downregulated CCL21 and EMT biomarkers and upregulated CCR7. Taken together, these findings suggest that the CCL21/CCR7 axis influences EMT by activating the ERK1/2 signaling pathway, thereby affecting trophoblast cell migration and invasion, which may play a crucial role in the pathogenesis of PE.

TIMPs Expression as A Maternal Cell Free Plasma Biomarker of Severe Preeclampsia: A Case-Control Study.

Preeclampsia (PE) is a pregnancy related disorder with prevalence of 6-7%. Insufficient trophoblastic invasion leads to incomplete remodeling of spiral arteries and consequent decrease in feto-placental perfusion. Altered placental expression of tissue inhibitors of matrix metalloproteinase (TIMPs) is considered to be involved in this process while the balance between matrix metalloproteinases (MMPs) and TIMPs contributes to remodeling of the placenta and uterine arteries by degradation and refurbishing of extracellular matrix (ECM). Therefore, TIMPs, fetal expression pattern was evaluated with the aim of its potential to be used as a determinant for the (early) detection of PE. In this case-control study, cell free fetal RNA (cffRNA) released by placenta into the maternal blood was used to determine expression patterns of TIMP1, 2, 3 and 4 in the severe preeclamptic women in comparison with the normal pregnant women. Whole blood from 20 preeclamptic and 20 normal pregnant women in their 28-32 weeks of gestational age was collected. The second control group consisted of 20 normal pregnant women in either 14 or 28 weeks of gestation (each 10). cffRNA was extracted from plasma and real-time polymerase chain reaction (PCR) was done to determine the expression levels of TIMP1, 2, 3 and 4 genes. Statistical analysis of the results showed significant higher expression of TIMP1-4 in the preeclamptic women in comparison with the control group (P=0.029, 0.037, 0.037 and 0.049, respectively). Also, an increased level of TIMPs expression was observed by comparing 14 to 28 weeks of gestational age in the normal pregnant women in the second control group. An increased cffRNA expression level of TIMPs may be correlated with the intensity of placental vascular defect and may be used as a determinant of complicated pregnancies with severe preeclampsia.

Obstructive Sleep Apnea Is Associated With Late-Onset Preeclampsia in Overweight Pregnant Women in Korea.

Obstructive sleep apnea (OSA) is closely related to maternal obesity in pregnant women, and the association increases with later pregnancy. Obesity and OSA are risk factors of pregnancy-related complications, including gestational hypertension, gestational diabetes mellitus (GDM), and fetal morbidities. We aimed to determine the prevalence of OSA and to assess the impact of OSA on pregnancy-related disorders in overweight pregnant women. Eligible participants who were overweight [body mass index (BMI) ≥ 23 kg/m²] in gestational age 30 weeks or more, assessed OSA using a portable polysomnography at home. Clinical data were collected from pregnant women and their babies. The average age of 51 participants was 34.5 years (27-44 years). The number of primipara was 25 (49%) and that of multipara was 26 (51%). Eight cases of GDM (15.7%) and five cases of preeclampsia (9.8%) were reported, and six patients (11.8%) experienced preterm delivery. In results of polysomnography, 14 patients (27.5%) were diagnosed as OSA. Apnea-hypopnea index moderately correlated with BMI (r = 0.515, P < 0.001). The BMI (P < 0.005) and preeclampsia rate (P < 0.017) were higher in the OSA group compared to the control group. Odds ratios (ORs) adjusting age, BMI, parity, and abortion history were calculated. The presence of OSA increased OR of preeclampsia (OR, 13.1; 95% confidence interval, 1.1-171.3). The majority of preeclampsia patients (4/5, 80%) underwent preterm delivery. OSA is an important risk factor for preeclampsia, resulting in preterm delivery. For overweight pregnant women, an OSA evaluation should be mandatory.

Clinical value of flow-mediated dilatation of brachial artery in hypertensive disorders complicating pregnancy.

Hypertensive disorders complicating pregnancy (HDCP) are common pregnancy-related disorders. In this study, we aimed to study the clinical value of flow-mediated dilation (FMD) in HDCP and its association with endothelial dysfunction and HDCP-related factors. 160 HDCP patients and 120 healthy pregnancies were enrolled in the study. The expressions of endothelial function markers and FMD were determined. In addition, their correlations in HDCP patients were also analyzed using Pearson's correlation analysis. FMD value decreased gradually from normal pregnancy to severe PE. The levels of plasma nitric oxidase (NO) were significantly lower in the HDCP group than those in the control group, while the levels of plasma endothelin-1 (ET-1) were increased dramatically in the HDCP group. Moreover, the levels of placental growth factor (PLGF) in HDCP women were significantly lower, while the soluble FMS-like tyrosine kinase 1 (sFLt-1) levels were markedly higher than those in control. In addition, the FMD value was correlated with the levels of plasma NO, ET-1, PLGF and sFlt1. It was also found that lower levels of FMD correspond to endothelial dysfunction and abnormal concentrations of PLGF and sFlt-1. The FMD value was associated with endothelial function indicators and could be a strong and non-invasive measure to predict HDCP. The association between the FMD values and endothelial function indicators in HDCP could be helpful for the prediction of pregnant hypertension more accurately.

The Role of Dietary Polyphenols in Pregnancy and Pregnancy-Related Disorders.

Polyphenols are a group of phytochemicals with extensive biological functions and health-promoting potential. These compounds are present in most foods of plant origin and their increased widespread availability through the intake of nutritional supplements, fortified foods, and beverages, has also led to increased exposure throughout gestation. In this narrative review, we focus on the role of polyphenols in both healthy and pathological pregnancy. General information related to their classification and function is followed by an overview of their known effects in early-pregnancy events, including the current insights into molecular mechanisms involved. Further, we provide an overview of their involvement in some of the most common pregnancy-associated pathological conditions, such as preeclampsia and gestational diabetes mellitus. Additionally, we also discuss the estimated possible risk of polyphenol consumption on pregnancy outcomes. The consumption of dietary polyphenols during pregnancy needs particular attention considering the possible effects of polyphenols on the mechanisms involved in maternal adaptation and fetal development. Further studies are strongly needed to unravel the in vivo effects of polyphenol metabolites during pregnancy, as well as their role on advanced maternal age, prenatal nutrition, and metabolic risk of the offspring.

Cyclosporin A Promotes Invasion and Migration of Extravillous Trophoblast Cells Derived from Human-Induced Pluripotent Stem Cells and Human Embryonic Stem Cells.

Extravillous trophoblast (EVT) cells play an essential role in the maternal-fetal interaction. Although abnormal development and function of EVT cells, including impaired migration and invasion capability, are believed to be etiologically linked to severe pregnancy disorders including pre-eclampsia, the associated molecular mechanisms are not clear due to the lack of an appropriate cell model in vitro. Cyclosporin A (CsA) is a macrolide immunosuppressant and also used in clinic to improve pregnancy outcomes. However, whether CsA has any effects on the function of EVT cells has not been well investigated. In this study, we induced differentiation of human-induced pluripotent stem cells (hiPSCs) and human embryonic stem cells (hESCs) into EVT cells (hiPSC-EVT and hESC-EVT cells, respectively) by Y27632, neuregulin-1 (NRG1), A83-01, and matrigel, and collected these derived EVT cells by flow cytometry for sorting cells positive for double human leukocyte antigen-G (HLA-G) and Cytokeratin7 (KRT7), both of which are EVT markers. We then investigated the effects of CsA on the invasion and migration of these derived EVT cells. We found that the hiPSC-EVT and hESC-EVT cells expressed high levels of the EVT markers such as KRT7, integrin alpha 5 (ITGA5), and HLA-G but low levels of OCT4, a stem cell marker, and that CsA significantly promoted the invasion and migration of hiPSC-EVT and hESC-EVT cells compared with HTR-8/SVneo cells. These results represent a possible cell model for studying the function of EVT cells and mechanism of pregnancy-related disorders associated with EVT. In addition, CsA may be used to treat pregnancy complications in clinic associated with deficient EVT function.

Evaluation of Klotho gene expression and NGAL levels following acute kidney injury during pregnancy hypertensive disorders.

This study examined the relationship between hypertensive disorders and acute kidney injury (AKI) during pregnancy by evaluating Klotho (KL) gene expression and Neutrophil gelatinase-associated lipocalin (NGAL) levels in pregnant women. Pregnant women were divided into 3 groups: (1) Pregnancy related hypertensive disorders with AKI (PR-AKI) (9 cases), (2) hypertensive disorders pregnancy (HDP) (40 cases), and (3) normal pregnancy (30 cases). For each group, Klotho gene transcription levels in the blood, Klotho and NGAL proteins levels, Malondialdehyde (MDA) and superoxide dismutase (SOD) activity levels were measured in serum. Statistical comparisons were made among the three groups. Klotho/β-actin transcript levels and serum KL protein concentrations were significantly decreased in hypertensive disorder pregnancies with AKI complications. Serum NGAL protein levels were significantly increased in the hypertensive disorder pregnancies with AKI complications. Total serum Klotho protein was negatively correlated with creatinine, while serum NGAL was positively correlated with serum creatinine, urea nitrogen, uric acid, systolic blood pressure, diastolic blood pressure and 24h urine protein levels. Serum levels of MDA and SOD were significantly increased in the hypertensive disorder pregnancy with AKI and the overall MDA concentration was negatively correlated with Klotho protein concentration. Klotho protein was found to have a direct effect on creatinine, and a mediating effect of MDA was found. Decreased expression of Klotho protein in correlation with increased levels of oxidative stress are found during of AKI complications in pregnancy hypertensive disorders.

Therapeutic value of dietary nitrate supplementation in pregnancy-related hypertensive disorders

Therapeutic value of dietary nitrate supplementation in pregnancy-related hypertensive disorders

Potential role of uric acid to activate NLRP3 inflammasome triggering endothelial dysfunction in preeclampsia

Preeclampsia (PE) is a pregnancy-related disorder associated with increasing maternal death rates and affecting 2–8% of pregnant women worldwide. Arterial hypertension and proteinuria, followed by other maternal dysfunctions are classic clinical parameters to identify this disease. Furthermore, hyperuricemia is strictly related to PE, and high plasmatic levels of uric acid have been associated with disease severity. The inflammation in the endothelium caused by danger signals, such as uric acid crystals, is persistent and stimulates the release of inflammatory cytokines, and activates the NLRP3 inflammasome. The mechanisms underlying endothelial dysfunction induced by the metabolism of uric acid, and consequently increased levels of inflammation and oxidative stress in women with PE could be ameliorated with interventions related to inhibition of the NLRP3 activation MSU-mediated and may improve the prognostics of this disease.

Fundoscopic Findings in Pregnancy Related Hypertensive Disorders and Its Association with Maternal and Fetal Outcomes

Objectives: To determine the prevalence of retinal changes in pregnancy-related hypertensive disorders and their association with maternal and fetal outcomes. Introduction: There is a grave risk to both mother and child when hypertensive problems complicate pregnancy. However, hypertensive sort of disorders during pregnancy have been allied to poor maternal and also neonatal outcomes. This research aimed to evaluate effects of hypertensive sort of disorders of pregnancy on both mothers and their unborn children by analyzing the prevalence, causes, and treatment of these conditions. Subjects and methods: BBH Rawalpindi, Inpatient Department of Gynecology and Obstetrics conducted the case-control research during the period from January 2021 to June 2021. In all, 149 patients participated in the research. Because seven patients could not be located, 142 cases were analyzed. Mild class preeclampsia (65.0 instances), severe class preeclampsia (32.0 hot cases), and also eclampsia (one case) were the subcategories used to categorize patients further, according to research. Thirty-one women who were not hypertensive throughout pregnancy were enlisted as controls. Results: Ninety percent of cases manifested with some edema. About a quarter basically patients had proteinuria above 300.0 mg/24 hours (26.76%), nearly half had proteinuria over two g/24 hours (47.18%), and about a quarter had urine protein based excretion of 3.0-5.0 g/24 hours (25.35%). Usually, incidence of specially HELLP (normally hemolysis, increased liver based special enzymes, and also squat platelet tot up) set of symptoms was 2.80%, raised bilirubin levels were seen in 47%, illustration symptoms occurred in 6.4%, vaginal based hemorrhage occurred in 11.30%, in addition to 42.2% of cases involved the central nervous system. It was shown that eclampsia was the cause of mortality in 2.8% of all maternal deaths. 16.9 percent of births were stillbirths, while 4.23 percent of newborns died. Conclusion: Compared to pregnant women with normal blood pressure, those who suffer from hypertensive disorders of pregnancy have a higher risk of having a baby born with complications. Our research did find a declining trend, although it was less than those seen in other studies; this may be because more of our study's births occurred in hospitals. Keywords: Neonatal outcome, maternal outcome, acute renal failure, and the HELLP syndrome

Increased Ca2+-dependent intrinsic tone and arterial stiffness in mesenteric microvessels of hypertensive pregnant rats

Preeclampsia is a pregnancy-related hypertensive disorder (HTN-Preg) with unclear mechanisms. We have shown increased vascular reactivity to extrinsic vasoconstrictors in HTN-Preg rats. Here, we test whether microvascular intrinsic tone and arterial stiffness could contribute to HTN-Preg, and examined the underlying cellular mechanisms. On gestational day 19, BP was recorded in normal pregnant (Preg) rats and Preg rats with reduced uterine perfusion pressure (RUPP), and mesenteric microvessels were mounted on a pressure myograph for measurement of intrinsic tone, simultaneous changes in [Ca2+]i (fura-2 340/380 ratio), and arterial stiffness. Arteries were incubated in Ca2+-containing and 0 Ca2+ (2 mM EGTA) Krebs, pressurized at 10 to 110 mmHg in 10 mmHg increments, and the % change in vessel diameter from initial diameter at 10 mmHg was analyzed for measurement of total (active + passive) intrinsic tone and passive intrinsic response, respectively. The passive response was then subtracted from the total intrinsic tone to determine the active myogenic tone. The strain–stress relationship was also constructed as a measure of arterial stiffness. BP was higher in RUPP vs Preg rats. In Ca2+-containing Krebs, increases in intraluminal pressure caused smaller increases in diameter and greater increases in [Ca2+]i in microvessels of RUPP vs Preg rats, suggesting increased Ca2+-dependent myogenic tone. In 0 Ca2+ Krebs, increases in pressure also caused less increases in diameter in microvessels of RUPP vs Preg rats, but with no changes in [Ca2+]i, suggesting changes in the structure and mechanics of the arterial wall. The total and passive strain–stress relationship was shifted to the left in microvessels of RUPP vs Preg rats, suggesting increased arterial wall stiffness. Histology and immunohistochemistry showed greater vascular wall thickness and collagen-I staining in RUPP vs Preg rats, supporting changes in the wall architecture and structural proteins. The increased active myogenic tone and underlying increases in Ca2+ signaling as well as the increased passive intrinsic response, arterial stiffness and collagen-I in the mesenteric microvessels could play a role in the regulation of blood flow to the splanchnic region and the increased vascular resistance and BP in HTN-Preg.

Why We should Recommend Exercise in Pregnancy?

Objective: This narrative review is presenting the impact of exercise on pregnant women and fetus and provides current recommendations for exercise in pregnancy. Mechanism: Exercise during pregnancy has a numerous effects on both pregnant woman and her fetus. When recommending exercise during pregnancy, it is necessary to keep in mind the physiological responses of the body’s systems during exercise, changes occuring in pregnancy and the influence of this changes on pregnant woman’s body as well as on the fetus and fetal responses to exercise during pregnancy. The type, intensity, duration, and frequency of exercise should be adjusted to the level of physical activity of pregnant women and period of pregnancy in order to achieve clinically significant health benefits. Findings in Brief: Exercise in pregnancy is beneficial for both the mother and her fetus and contributes to the prevention of pregnancy-related disorders. It is recommend to exercise 30 minutes daily five days a week with a tendency to increase the exercise each day in order to accumulate 150 to 300 minutes of exercise per week with moderate intensity. Conclusions: Regular exercise leads to specific adaptation processes of the body systems improving the physical and mental health of pregnant women with positive effect on her fetus.

Maternal and Fetal Outcomes in Obesity Complicated Pregnancies

Background and Aim: Obesity in reproductive age women is growing to epidemic proportions causing adverse perinatal outcomes and various pregnancy complications. Pregnant women with obesity pose risks for child and maternal health in terms of intrapartum, antenatal, postpartum and neonatal complications. The current study aim was to find the maternal and fetal outcomes in complicated pregnancies of obese women. Methodology: This cross-sectional study was conducted on 164 pregnant women in the Department of Obstetrics and Gynecology, Lahore General Hospital, from April 2021 to March 2022. Prior to study conduction, ethical approval was granted from the institution research and ethical committee. Informed consent was taken from each individual. Based on BMI index for pre-pregnancy, participants were categorized as normal weight (19-25 kg/m2), overweight (25-30 kg/m2), and obese (≥30 kg/m2). All the pregnant women with gestational age of 20 weeks who were willing to participate were enrolled. Underweight women with previous anomaly babies and miscarriage were excluded. Maternal and fetal outcomes were recorded. SPSS version 25 was used for data analysis. Results: The overall mean age of the participants was 26.4±3.61 years. Based on BMI (kg/m2), the participants were distributed as follows; 26.8% (n=44) of normal weight (19-25 kg/m2), 28.1% (n=46) of overweight (25.0 - 30 Kg/m2), and 45.1% (n=74) of obese ((≥30 kg/m2). Majority of overweight and obese women were ≥ 30 years old. Diabetes before pregnancy was strongly related to obesity (16.3%, p&lt;0.0001). Lower weight gain (10.3 ± 6.9 Kg) were seen in obese pregnant women. Comparing to the normal weight women, overweight and obese women physical exercise more often (p=0.01). Obese women were more susceptible to the risk of developing hyperglycemic disturbance (OR= 6.2; 3-10.5), hypertension (OR=6.8, 3.0-15.5), and HbA1c ≥ 6. 5 % (OR=3.5; 1.1-10.8). Longer hospitalization (4.1 ± 2.9 days) was seen in infants born to obese mother (p=0.005). The gestational age babies born from obese mother had a proportion of (14.6%) (p=0.022) with higher abdominal and thoracic circumference (30.7 ± 2.1 cm) and (32.8 ± 1.9 cm) respectively. Conclusion: Our study concluded that adverse perinatal outcomes and pregnancy complications could be caused by obesity in pregnant women. Obese women were more susceptible to increase risk of developing gestational diabetes mellitus, postpartum complications, pregnancy related hypertensive disorders, pre-eclampsia, preterm birth, cesarean section, and longer hospital stay. The importance of weight status before and during pregnancy should be identified to have adequate treatment. Keywords: Pregnancy, Maternal outcomes, Fetal outcomes, Obesity

MiR-372-3p promotes preeclampsia progression by regulating twist1.

Preeclampsia (PE) is a common pregnancy-related disorder worldwide. PE is mainly characterized by the defective migration and invasion of trophoblast cells. MicroRNAs (miRs) have been reported to serve an important role in PE. The purpose of the study was to explore the pathogenesis and therapeutic targets of preeclampsia. In the present study, reverse transcription-quantitative PCR analysis revealed that the expression levels of miR-372-3p were upregulated in placental tissues from patients with PE. Notably, the expression levels of miR-372-3p were significantly upregulated in patients with early-onset PE compared with patients with late-onset PE. Moreover, in vitro analysis using wound healing, Transwell and western blotting assays demonstrated that miR-372-3p overexpression inhibited the migration, invasion and epithelial-mesenchymal transition (EMT) of HTR-8/SVneo trophoblast cells, respectively. Bioinformatics analysis and a dual luciferase reporter assay revealed that miR-372-3p is sponged by twist family bHLH transcription factor 1 (twist1). Rescue experiments found that miR-372-3p overexpression suppressed trophoblast cell migration, invasion and EMT by downregulating the expression of twist1. In conclusion, the present study revealed that high level of miR-372-3p may act as a factor to cause PE and may also be a potential novel therapeutic target for PE.

Evaluation of Liver Function Tests in Normal Pregnancy-An Observational Epidemiological Study-Kumbakonam Urban Rural Epidemiological Study-KURES 10

Early interpretation of liver function tests (LFTs) can result in timely management and it may decrease the incidence of complications in both the mother and the foetus. Normal LFTs don't always imply a normal liver. A number of drawbacks can occur when interpreting basic blood LFTs. Abnormal Liver Function Tests (LFTs) in pregnancy must be properly interpreted to avoid diagnostic pitfalls. we did a routine testing in 498 asymptomatic antenatal mothers in the third trimester. Ninety-seven percentage of mothers had normal bilirubin while 93 % had normal enzyme levels. The other abnormal values were also within 1 to 1.5 % above the normal. No mother had any symptoms. Only two patients had gallstones whose LFTs were normal. Two mothers had tattoo marks while the other two were HbSAg positive. All the 498 mothers had an uneventful progress towards delivery. Cross consultation done on a few cases with abnormal values were non-contributory. Pregnancy-related disorders are the most common reason for unusual liver function tests during pregnancy, especially in the third trimester. We omitted such cases to support our hypotheses of avoiding undue testing. The most prevalent is pre-eclampsia-related disorder. This is the first such study on a huge sample size. We suggest a routine testing of LFTs is not needed in otherwise healthy antenatal mothers.