Stages Of Pregnancy Research Articles

Longitudinal maternal hemodynamic evaluation in uncomplicated twin pregnancies according to chorionicity: physiological cardiovascular dysfunction in monochorionic twin pregnancy.

Maternal cardiac function plays a crucial role in placental function and development. The maternal hemodynamic changes in twin pregnancy are more pronounced than those in singleton pregnancy, presumably due to a greater plasma volume expansion. In view of the correlation between maternal cardiac and placental function, it is plausible that chorionicity could influence maternal cardiac function. The aim of this study was to compare the longitudinal maternal hemodynamic changes between uncomplicated dichorionic (DC) and monochorionic (MC) twin pregnancies and in comparison to singleton pregnancies. Included in the study were 40 MC diamniotic and 35 DC diamniotic uncomplicated twin pregnancies. These were compared with a group of 294 healthy singleton pregnancies from a previous cross-sectional study. All participants underwent a hemodynamic evaluation using an Ultrasound Cardiac Output Monitor (USCOM®), at three different stages in pregnancy (11-15 weeks, 20-24 weeks and 29-33 weeks). The following parameters were recorded: mean arterial pressure (MAP), stroke volume (SV), stroke volume index (SVI), heart rate, cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), stroke volume variation, Smith-Madigan inotropy index (INO) and potential-to-kinetic-energy ratio (PKR). In the first trimester, DC and MC twin pregnancies showed lower MAP, SVR and PKR and higher CO and SV in comparison to singleton pregnancy. In the second trimester, maternal CO (8.33 vs 7.30 L/min, P = 0.03) and CI (4.52 vs 4.00 L/min/m2 , P = 0.02) were significantly higher in MC compared with DC twin pregnancy. In the third trimester, compared with in singleton pregnancy, women with MC twin pregnancy showed significantly higher PKR (24.06 vs 20.13, P = 0.03) and SVRI (1837.20 vs 1698.48 dynes × s/cm5 /m2 , P = 0.03), and significantly lower SV (78.80 vs 88.80 mL, P = 0.01), SVI (42.79 vs50.31 mL/m2 , P < 0.01) and INO (1.70 vs 1.87 W/m2 , P = 0.03); these differences were not observed between DC twin and singleton pregnancies. Maternal cardiovascular function undergoes significant change during uncomplicated twin pregnancy and chorionicity influences maternal hemodynamics. In both MC and DC twin pregnancy, hemodynamic changes are detectable as early as the first trimester, showing higher maternal CO and lower SVR compared with singleton pregnancy. In DC twin pregnancy, the maternal hemodynamics remain stable during the rest of pregnancy. In contrast, in MC twin pregnancy, the rise in maternal CO continues in the second trimester in order to sustain the greater placental growth. There is a subsequent crossover, with a reduction in cardiovascular performance during the third trimester. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Pregnancy stressors and postpartum symptoms of depression and anxiety: the moderating role of a cognitive–behavioural therapy (CBT) intervention

BackgroundLittle is known about the association between stressors (especially positive stressors) during pregnancy and postpartum depression and anxiety.AimsWe investigated the association between positive and negative stress events during different stages...

Modern aspects of identifying and managing pregnant women with preeclampsia

This article explores the importance of early detection and systematic monitoring of pregnant women with preeclampsia at the stage of consultation in the antenatal clinic, management of labor and the postpartum period. The authors, based on their experience working at City Clinical Hospital No. 52 in Moscow, consider the features of diagnosing this complication, methods for monitoring the condition of patients and effective pregnancy management strategies to prevent possible complications (such as eclampsia and HELLP syndrome). The main emphasis of the article is on the importance of prenatal screening, regular assessment of blood pressure, protein levels in the urine and other clinical indicators during observations at the prehospital stage and in the departments of the maternity hospital. The results and recommendations obtained provide valuable information for healthcare institutions and medical personnel monitoring and managing pregnant women at risk of developing preeclampsia. Preeclampsia is one of the most dangerous complications of pregnancy, which can lead to irreversible consequences for the mother and fetus. One of the key factors for success in the treatment of preeclampsia is early detection and dynamic monitoring of patients at all stages of pregnancy. This article presents aspects of identifying preeclampsia at the stage of antenatal clinic, maternity hospital and the role of midwives in this process.

Caesarean section under spinal anesthesia for a mother with dilated cardiomyopathy in a resource-limited setting: a case report

Introduction and importance: Peripartum cardiomyopathy is an uncommon form of cardiomyopathy that develops in the latter stages of pregnancy or in the first few weeks following delivery. Anaesthetic management of caesarean section of a parturient with dilated cardiomyopathy is challenging due to its nature of impaired ventricular contractility coupled with cardiovascular changes during pregnancy. This is significantly worse in a resource-constrained environment with restricted access to medications and equipment. Case presentation: We report a case of a 31-year-old multigravida parturient presented with a diagnosis of dilated cardiomyopathy and a low ejection fraction undergoing emergency caesarean section. Successful management of a parturient with dilated cardiomyopathy undergoing a caesarean section under spinal anaesthesia is reported in this case report. Clinical discussion: Spinal anaesthesia is another alternative for the successful management of patients with dilated cardiomyopathy (DCM) using a low dose of bupivacaine with intrathecal adjuvants. Our report indicates that caesarean section also may be managed safely with spinal anaesthesia alone in patients with DCM, by using low-dose bupivacaine and intrathecal morphine. The slight haemodynamic changes were adjusted with fluid infusion. The use of vasopressors was not required to manage the hypotension. Conclusion: General anaesthesia, epidural alone, and epidural combined with spinal anaesthesia are the widely used anaesthetics techniques for caesarean section in patients with heart disease. Spinal anaesthesia with low-dose bupivacaine with opioids is another suitable choice. The case report is written according to the CARE guideline (https://www.care-statement.org).

Italian Guidelines for the diagnosis and treatment of Fetal Alcohol Spectrum Disorders: detecting alcohol drinking during pregnancy.

Fetal Alcohol Spectrum Disorders (FASD) is an encompassing term used to describe a range of afflictions brought about by the consumption of alcohol during gestation. The detrimental effects primarily manifest in the central nervous system, growth, and distinctive facial features. Given that there are no known treatments for FASD, the meticulous screening for this condition in the earliest stages of pregnancy bears immense significance, ensuring the avoidance of the grievous consequences stemming from exposure to alcohol in utero. Screening measures for FASD encompass the assessment of alcohol biomarkers such as Phosphatidylethanol (PEth) in the maternal bloodstream, Fatty Acid Ethyl Esters (FAEEs) in the meconium, and Ethyl Glucuronide (EtG) in the meconium, maternal urine and hair. In particular, urinary EtG is highly sensitive and could be routinely used in pregnant women for detecting also occasional drinking. Questionnaire evaluations including AUDIT-C, T-ACE, and TWEAK, alongside a detailed Food Diary method to identify alcohol misuse and high-risk pregnancies, are also available. However, these questionnaires might provide an inadequate reflection of alcohol consumption in women due to their inclination to dissemble to comply with prevailing sociocultural expectations. Hence, this comprehensive review advocates for the indispensable integration of alcohol biomarkers detection in the course of pregnancy monitoring, as it constitutes a valuable tool for facilitating FASD screening.

Nausea and Vomiting of Pregnancy and its Management with the Dual-Release Formulation of Doxylamine and Pyridoxine.

Nausea and vomiting of pregnancy (NVP) is among the most common conditions that pregnant women encounter in the early stages of pregnancy. It can affect up to 85% of pregnant women, thus representing a significant public health concern. NVP results in substantial negative physical, emotional, and financial consequences. Despite its prevalence, the pathogenesis remains elusive. Few guidelines have been published; however, several interventions exist for the symptomatic treatment of NVP. The aim of this review is to provide an overview of modern treatment strategies of NVP with a special focus on the recently approved dual-release formulation of the doxylamine and pyridoxine combination. This combination was approved by the Food and Drug Administration (FDA) in November 2016 for the treatment of NVP when conservative management fails, and it has been introduced to the American market in April 2018. The maximum plasma concentration (T max ) of doxylamine and pyridoxal-5-phosphate is reached 3.5h and 15 h, respectively, after administration of one tablet twice daily, or 4.5h and 0.5h, respectively, when one tablet is administered just once daily. In addition, the delayed-release combination allows sufficient levels of doxylamine and the active metabolite pyridoxal-5-phosphate in the systemic circulation, providing symptoms relief in the subsequent morning. Hence, the dual-release formulation can improve the quality of life of pregnant women suffering from NVP. Additionally, large epidemiological trials have shown no increased risk of adverse effects to newborns, demonstrating that its use is not teratogenic.

Prevalence of Subclinical Hypothyroidism among Pregnant Women

Background: Some studies have associated subclinical hypothyroidism with obstetric complications such as preeclampsia, preterm birth, and placental abruption. Objective: To investigate the prevalence of subclinical hypothyroidism in patients with preeclampsia and normotensive pregnant women ending their pregnancy at Enrique Garces Hospital. Methods: This is a descriptive cross-sectional study conducted between February 2020 and 2022. The study included pregnant women between 20 and 35 years of age, with singleton pregnancies in the third trimester. The women were in labor and diagnosed with subclinical hypothyroidism and preeclampsia in the current pregnancy. The women underwent blood sampling. Also, the thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels were measured by chemiluminescence. Results: A total of 639 women were evaluated; Among these women 509 (79.66%) were normotensive, 137 (26.92%) had subclinical hypothyroidism, and 372 (73.08%) did not have subclinical hypothyroidism, 130 (20.34%) had preeclampsia, 34 (26.15%) of them with subclinical hypothyroidism and 96 (73.85%) not having subclinical hypothyroidism. The overall prevalence of subclinical hypothyroidism was 26.76%. In the normotensive group the prevalence of subclinical hypothyroidism was 0.2691 with a 95 % CI (0.2306, 0.3076) and in the preeclampsia group it was 0.2615 with a 95 % CI (0.1859, 0.3370). Conclusions: A high prevalence of subclinical hypothyroidism was identified among pregnant women, which often goes undiagnosed in the early stages of pregnancy due to the lack of thyroid profile screening protocols for all pregnant women. Regarding the TSH cut-off levels 3mIUI/L there was no statistically significant difference of subclinical hypothyroidism among normotensive pregnant women and preeclampsia women, as literature suggests that TSH levels above 4mIU/L are associated with hypertensive diseases

Design of a targeted blood transcriptional panel for monitoring immunological changes accompanying pregnancy.

Immunomodulatory processes exert steering functions throughout pregnancy. Detecting diversions from this physiologic immune clock may help identify pregnant women at risk for pregnancy-associated complications. We present results from a data-driven selection process to develop a targeted panel of mRNAs that may prove effective in detecting pregnancies diverting from the norm. Based on a de novo dataset from a resource-constrained setting and a dataset from a resource-rich area readily available in the public domain, whole blood gene expression profiles of uneventful pregnancies were captured at multiple time points during pregnancy. BloodGen3, a fixed blood transcriptional module repertoire, was employed to analyze and visualize gene expression patterns in the two datasets. Differentially expressed genes were identified by comparing their abundance to non-pregnant postpartum controls. The selection process for a targeted gene panel considered (i) transcript abundance in whole blood; (ii) degree of correlation with the BloodGen3 module; and (iii) pregnancy biology. We identified 176 transcripts that were complemented with eight housekeeping genes. Changes in transcript abundance were seen in the early stages of pregnancy and similar patterns were observed in both datasets. Functional gene annotation suggested significant changes in the lymphoid, prostaglandin and inflammation-associated compartments, when compared to the postpartum controls. The gene panel presented here holds promise for the development of predictive, targeted, transcriptional profiling assays. Such assays might become useful for monitoring of pregnant women, specifically to detect potential adverse events early. Prospective validation of this targeted assay, in-depth investigation of functional annotations of differentially expressed genes, and assessment of common pregnancy-associated complications with the aim to identify these early in pregnancy to improve pregnancy outcomes are the next steps.

Effectiveness of acupressure therapy against nausea and vomiting in pregnancy

Background: Nausea and vomiting, commonly known as morning sickness, pose significant discomfort and distress to many expectant mothers during early pregnancy stages. While various remedies and medications exist, concerns regarding their safety and potential side effects prompt exploration into alternative therapies. This study aims to evaluate the effectiveness of acupressure therapy in reducing the symptoms of nausea and vomiting in pregnant women. The research involved a group of pregnant women divided into several groups. The effectiveness of the therapy was assessed by monitoring the frequency and severity of nausea and vomiting before and after the intervention. The results of this study indicate that acupressure therapy significantly reduces the symptoms of nausea and vomiting in pregnant women compared to the placebo group. Thus, acupressure therapy can be an effective and safe approach to managing nausea and vomiting during pregnancy, improving the quality of life for pregnant women, and promoting a more natural and sustainable treatment approach during pregnancy.

Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature.

Selection of antiretroviral therapy during pregnancy must consider maternal physiology and resulting pharmacokinetic changes in pregnancy, resistance and efficacy profiles, tolerability and frequency of adverse effects, teratogenicity, and maternal, neonatal, and pregnancy outcomes. The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA. Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.

Proteomics Analysis of Pregnancy in Ewes under Heat Stress Conditions and Melatonin Administration

Melatonin is an indoleamine with broad spectrum properties that acts as a regulator of antioxidant and immune response in organisms. In our previous studies, melatonin improved redox status and inflammatory response in pregnant ewes under heat stress conditions. In the present study, using proteomics, the proteins regulated by melatonin during different stages of pregnancy and lambing were assessed. Twenty-two ewes equally divided into two groups, the melatonin (M) (n = 11) and control (C) group (n = 11), participated in the study and were exposed to heat stress during the first months of pregnancy. In the M group, melatonin implants were administered throughout pregnancy, every 40 days, until parturition (a total of four implants per ewe). Blood samples were collected at the beginning of the study simultaneously with the administration of the first melatonin implant (blood samples M1, C1), mating (M2, C2), second implant (M3, C3), fourth implant (M4, C4) and parturition (M5, C5), and MALDI-TOF analysis was performed. The results revealed the existence of 42 extra proteins in samples M2, M3 and M4 and 53 in M5 (sample at parturition) that are linked to melatonin. The biological processes of these proteins refer to boosted immune response, the alleviation of oxidative and endoplasmic reticulum stress, energy metabolism, the protection of the maternal organism and embryo development. This proteomics analysis indicates that melatonin regulates protective mechanisms and controls cell proliferation under exogenous or endogenous stressful stimuli during pregnancy and parturition.

Hubungan Kecemasan, Peran Suami, Dan Peran Bidan Terhadap Kejadian Ketuban Pecah Dini Di Rumah Sakit Tugu Ibu Cimanggis Kota Depok

Introduction: Premature rupture of membranes is the rupture of the membranes before labor begins at any stage of pregnancy. Anxiety, the role of the husband, and the role of the midwife are factors that can influence the incidence of premature rupture of membranes. This study aims to determine the relationship between anxiety, the husband's role, and the midwife's role in the incidence of premature rupture of membranes at Tugu Ibu Cimanggis Hospital, Depok City in 2022. Methods: Using descriptive analytics with a cross-sectional approach. The sampling technique used was total sampling with a total of 21 postpartum mothers. Results: The results showed that there was a relationship between anxiety and the incidence of premature rupture of membranes with a p-value of 0.000, the role of the husband in the incidence of premature rupture of membranes with a p-value of 0.008, and the role of midwives with premature rupture of membranes obtained a p-value of 0.021. Discussion: This study is a relationship between anxiety the husband's support and the role of the midwife on the incidence of premature rupture of membranes at Tugu Ibu Cimanggis Hospital, Depok City. Advice for mothers giving birth is to be able to increase their knowledge and understanding of tips for having a healthy pregnancy and preparing for safe and comfortable deliveries so that they are free from complications and emergencies in labor.

VEDOLIZUMAB DOES NOT ALTER IMMUNOGLOBULIN LEVELS IN BREASTMILK OF MOTHERS WITH IBD

Abstract Diarrheal diseases are a major cause of infant mortality worldwide. Breastfeeding helps prevent such diseases by passive transfer of maternal antibodies against gastrointestinal pathogens previously encountered by the mother. The antibody secreting cells (ASC) that populate the lactating mammary gland (LMG) are educated in gastrointestinal lymphoid tissues, thus they express integrin a4b7. To recruit these ASC, the LMG expresses MAdCAM-1 and CCL28. Vedolizumab (vedo) blocks a combinatorial epitope on integrin a4b7, interfering with lymphocyte recruitment to the gut. Given the shared homing determinants between the gut and LMG, we investigated whether vedo might interfere with ASC trafficking to the LMG, therefore decreasing immunoglobulin (Ig) levels in breast milk. We measured Ig levels by ELISA in cryopreserved breast milk from mothers enrolled in Mommy’s Milk biorepository at the University of California, San Diego without and with Ulcerative Colitis(UC) or Crohn’s Disease(CD) and lactating mothers with UC and CD treated with vedo for more than 18 months. Milk samples were collected between 1 month and 15.45 months after childbirth. The levels of secretory IgA (SIgA) in breast milk of mothers without IBD (n=45) was not different from those of mothers with CD not on vedo (n=15) (301 ± 147 ug/mL vs. 322 ± 207 ug/mL). However, milk SIgA from mothers with UC not on vedo (n=7) were lower than non-IBD controls (213 ± 149 ug/mL vs. 301 ± 147ug/mL, p&amp;lt;0.01). We then compared milk SIgA from patients with CD and UC treated with vedo (CD: n= 9; 256 ± 80ug/mL, UC: n=10; 283 ± 87 ug/mL) with those from non-IBD controls (n=45; 301 ± 147ug/mL) and found no differences. Similarly, SIgA levels were not different between CD with or without vedo (256 ± 80 ug/mL vs. 322 ± 207 ug/mL) and as compared with non-IBD controls SIgA in patients with UC with vedo were unexpectedly higher than UC without vedo (283 ±87 ug/mL vs 213 ± 149 ug/mL, p&amp;lt;0.05). The levels of secretory IgM (SIgM) in milk were not different between mothers with UC or CD treated with vedo compared with non-IBD controls (65 ± 34 ug/mL, 69 ± 32 ug/mL, and 56 ± 37 ug/mL, respectively). Similarly, no significant difference was seen between patients with UC or CD not treated with vedo compared with the non-IBD controls (58±26 ug/mL, and 46 ± 24 ug/mL respectively). We conclude that vedo does not reduce SIgA nor SIgM levels in lactating mothers with IBD. We speculate that the higher SIgA in patients with UC treated with vedo is due to the small sample size. Vedo does not interfere with passive immunity during the lactation period, thus ASC must be able to use another integrin to arrest on microvessels of the LMG during the final stages of pregnancy.

Safety and efficacy of COVID-19 vaccine immunization during pregnancy in 1024 pregnant women infected with the SARS-CoV-2 Omicron virus in Shanghai, China.

Large sample of pregnant women vaccinated with COVID-19 vaccine has not been carried out in China. The objective of this study was to evaluate the safety and effectiveness of COVID-19 inactivated vaccine in pregnant women infected with the SARS-CoV-2 Omicron variant. A total of 1,024 pregnant women and 120 newborns were enrolled in this study. 707 pregnant women received one to three doses of the inactivated COVID-19 vaccine, and 317 unvaccinated patients served as the control group. A comparison was made between their clinical and laboratory data at different stages of pregnancy. The incidence rate of patients infected with Omicron variant in the first, the second, and the third trimesters of pregnancy was 27.5%, 27.0%, and 45.5% in patients during, respectively. The corresponding length of hospital stay was 8.7 ± 3.3 days, 9.5 ± 3.3 days, and 11 ± 4.3 days, respectively. The hospitalization time of pregnant women who received 3 doses of vaccine was (8.8 ± 3.3) days, which was significantly shorter than that of non-vaccinated women (11.0 ± 3.9) days. (P<0.0001). The positive rate of SARS-CoV-2 IgG in patients in the early stage of pregnancy was 28.8%, while that in patients in the late stage of pregnancy was 10.3%. However, three-doses of vaccination significantly increased the SARS-CoV-2 IgG positive rate to 49.5%. The hospitalization time of SARS-CoV-2 IgG-positive patients was shorter than that of negative patients (9.9 ± 3.5 days), which was 7.4 ± 2.0 days. 12.2% of vaccinated women experienced mild adverse reactions, manifested as fatigue (10.6%) and loss of appetite (1.6%). The vaccination of mother did not affect her choice of future delivery mode and the Apgar score of their newborn. All newborns tested negative for SARS-CoV-2 nucleic acid, as well as for IgG and IgM antibodies. Women in the third trimester of pregnancy are highly susceptible to infection with the Omicron strain. The vaccination of pregnant women with COVID-19 vaccine can accelerate the process of eliminating SARS-CoV-2 virus, and is considered safe for newborns. The recommended vaccination includes three doses.

Timing theory integrated nursing combined behavior change integrated theory of nursing on primiparous influence.

The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara. This has the potential to enhance the psychological well-being and overall quality of life for primipara, while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum. To explore the effect of timing theory combined with behavior change on self-efficacy, negative emotions and quality of life in patients with primipara. A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022. These cases were divided into two groups, namely the observation group and the control group, with 40 cases in each group. The nursing interventions differed between the two groups, with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change. The study aimed to compare the pre- and post-nursing scores of Chinese Perceived Stress Scale (CPSS), Edinburgh Postpartum Depression Scale (EPDS), Self-rating Anxiety Scale (SAS), breast milk knowledge, self-efficacy, and SF-36 quality of life in both groups. After nursing, the CPSS, EPDS, and SAS scores of the two groups was significantly lower than that before nursing, and the CPSS, EPDS, and SAS scores of the observation group was significantly lower than that of the control group (P = 0.002, P = 0.011, and P = 0.001 respectively). After nursing, the breastfeeding knowledge mastery, self-efficacy, and SF-36 quality of life scores was significantly higher than that before nursing, and the breastfeeding knowledge mastery (P = 0.013), self-efficacy (P = 0.008), and SF-36 quality of life (P = 0.011) scores of the observation group was significantly higher than that of the control group. The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals, while also enhancing their self-efficacy and overall quality of life. This study focuses on the key concepts of timing theory, behavior change, primipara individuals, negative mood, and quality of life.

PBPK Modeling Approach to Predict the Behavior of Drugs Cleared by Metabolism in Pregnant Subjects and Fetuses.

This study aimed to develop a physiologically based pharmacokinetic (PBPK) model that simulates metabolically cleared compounds' pharmacokinetics (PK) in pregnant subjects and fetuses. This model accounts for the differences in tissue sizes, blood flow rates, enzyme expression levels, plasma protein binding, and other physiological factors affecting the drugs' PK in both the pregnant woman and the fetus. The PBPKPlus™ module in GastroPlus® was used to model the PK of metoprolol, midazolam, and metronidazole for both non-pregnant and pregnant groups. For each of the three compounds, the model was first developed and validated against PK data in healthy non-pregnant volunteers and then applied to predict the PK in the pregnant groups. The model accurately described the PK in both the non-pregnant and pregnant groups and explained well the differences in the plasma concentration due to pregnancy. When available, the fetal plasma concentration, placenta, and fetal tissue concentrations were also predicted reasonably well at different stages of pregnancy. The work described the use of a PBPK approach for drug development and demonstrates the ability to predict differences in PK in pregnant subjects and fetal exposure for metabolically cleared compounds.

Dose- and stage-dependent toxic effects of prenatal prednisone exposure on fetal articular cartilage development

Prednisone is frequently used to treat rheumatoid diseases in pregnant women because of its high degree of safety. Whether prenatal prednisone exposure (PPE) negatively impacts fetal articular cartilage development is unclear. In this study, we simulated a clinical prednisone treatment regimen to examine the effects of different timings and doses of PPE on cartilage development in female and male fetal mice. Prednisone doses (0.25, 0.5, and 1 mg/kg/d) was administered to Kunming mice at different gestational stages (0–9 gestational days, GD0–9), mid-late gestation (GD10–18), or during the entire gestation (GD0–18) by oral gavage. The amount of matrix aggrecan (ACAN) and collagen type II a1(COL2a1), and expression of transforming growth factor β1 (TGFβ1) signaling pathway also demonstrated that the chondrocyte count and ACAN and COL2a1 expression reduced in fetal mice with early and mid-late PPE, with the reduction being more significant in the mice with early PPE than that in those with PPE at other stages. Prenatal exposure to different prednisone doses prevented the reduction of TGFβ signaling pathway-related genes [TGFβR1, SMAD family member 3 (Smad3), SRY-box9 (SOX9)] as well as ACAN and COL2a1 mRNA expression levels in fetal mouse cartilage, with the most significant decrease after 1 mg/kg·d PPE. In conclusion, PPE can inhibit/restrain fetal cartilage development, with the greatest effect at higher clinical dose (1 mg/kg·d) and early stage of pregnancy (GD0–9), and the mechanism may be related to TGFβ signaling pathway inhibition. The result of this study provide a theoretical and experimental foundation for the rational clinical use of prednisone.

Oral health in pregnancy

The changes during pregnancy are of vital importance to maintain an optimal state of health in the mother and proper development for the fetus, however, some of these physiological, hormonal and dietary changes present in pregnancy, have an influence on the oral condition and in turn can alter and increase the risk of developing any oral disease or otherwise accelerate the evolution of any of them. Currently, scientific literature mentions a possible association between diseases and inflammatory conditions present in the oral cavity and the physiological state of pregnancy. Specifically, periodontal diseases such as gingivitis of pregnancy that can have a prevalence ranging from 35 to 100 %, periodontitis that occurs in a lower percentage, but is considerable and ranges from 30 to 40 % and granuloma of pregnancy occupying a prevalence of 1 to 5 %, which have the ability to influence conditions that are associated with pregnancy, such as eclampsia, preeclampsia, diabetes and gestational diabetes. The purpose of this article is to provide information on the complexity of maintaining oral health during this crucial stage of pregnancy and how they can influence both positively and negatively one with the other, as well as the most common diseases in this period and thus can share this information on the importance of maintaining oral health properly in the period of pregnancy.

Estimation of genotype by environmental interaction for litter traits by reaction norm model in Taiwan Landrace sows.

The negative effects of heat stress on swine reproduction have been well documented and the recent global warming trend caused by climate change is leading to more days with high temperatures every year. This has caused a reduction in litter trait performance of Landrace sows in Taiwan, a country extending across tropical and subtropical oceanic zones. Therefore, this study developed a modified model to determine which stages of pregnancy, before, early, middle, and late, had the largest impacts of heat stress on litter traits. A reaction norm model (RNM) was used to identify sows with high resilience to heat stress for litter traits followed by analysis of the modified model. Data from Landrace sows were collected from 2 farms in Taiwan between 2008 and 2021. A total of 11,059 records were collected for total number born (TNB), number born alive (NBA), and stillborn rate (STBR). The results showed that the heritabilities of TNB, NBA, and STBR were 0.170, 0.115, and 0.077, respectively. These results were similar between the conventional model and the modified model. In the modified model, the before and early stages of sow pregnancy were the significant periods for TNB and NBA (P < 0.05), while the early and middle stages were significant for STBR (P < 0.05). According to the RNM results, the heritability estimates for TNB, NBA, and STBR were 0.23 to 0.11, 0.18 to 0.08, and 0.10 to 0.04, respectively, showing a decrease from low temperature-humidity index (THI) to high THI. The minimum genetic correlations between the highest and the lowest THI for TNB, NBA, and STBR were 0.85, 0.64, and 0.80, respectively. The results of the RNM for breeding value showed re-ranking across THI values. In conclusion, similar results were obtained for heritability when the model was modified for heat stress estimation. Yet re-ranking of breeding values across THI could help farmers to select not only for improved litter trait performance but also for heat stress resilience of Landrace sows in Taiwan.

Biological characteristics of pregnancy in captive Yangtze finless porpoises revealed by urinary metabolomics†.

The Yangtze finless porpoises (Neophocaena asiaeorientalis a.) are an endemic and critically endangered species in China. Intensive captive breeding is essential for understanding the biology of critically endangered species, especially their pregnancy characteristics, knowledge of which is crucial for effective breeding management. Urine metabolomics can reveal metabolic differences, arising from physiological changes across pregnancy stages. Therefore, we used the urinary metabolomic technology, to explore urinary metabolite changes in pregnant Yangtze finless porpoises. A total of 2281 metabolites were identified in all samples, which including organic acids and derivatives (24.45%), organoheterocyclic compounds (20.23%), benzenoids (18.05%), organic oxygen compounds (7.73%), and phenylpropanoids and polyketides (6.48%). There were 164, 387, and 522 metabolites demonstrating differential abundance during early pregnancy, mid pregnancy, and late pregnancy, respectively, from the levels observed in nonpregnancy. The levels of pregnenolone, 17α-hydroxyprogesterone, and tetrahydrocortisone were significantly higher during all pregnancy stages, indicating their important roles in fetal development. The differential metabolites between nonpregnancy and pregnancy were mainly associated with amino acid and carbohydrate metabolism. Moreover, metabolic activity varied across pregnancy stages; steroid hormone biosynthesis was predominant in early pregnancy, and amino acid biosynthesis and carbohydrate metabolism were predominant in mid pregnancy and late pregnancy, respectively. Our results provide new insights into metabolic characteristics in the Yangtze finless porpoises' urine during pregnancy, and indicate that the differential levels of urine metabolites can determine pregnancy in Yangtze finless porpoises, providing valuable information for the husbandry and management of pregnant Yangtze finless porpoises in captivity.