Risk Of Preterm Labor Research Articles

The Impact of Climate Change on Maternal and Fetal Health: An Emerging Crisis

The health risks posed by climate change have extended into maternal and fetal health, with evidence linking changing environmental factors to a rise in conditions such as pregnancy-induced hypertension (PIH), cerebral venous thrombosis (CVT), and physiological jaundice, particularly in winter months. Additionally, post-viral infections and intrauterine infections have become more prominent in the post- COVID era, contributing to an increased risk of congenital anomalies, preterm labor, and intrauterine growth restriction (IUGR). The article also highlights the higher incidence of postpartum cardiomyopathy in African women and the challenges posed by long-distance travel during pregnancy. This article examines these trends and calls for more targeted research and interventions to mitigate these risks.

Immune Thrombocytopenic Purpura and Maternal and Neonatal Outcomes During Pregnancy: A Systematic Review and Meta-Analysis.

Immune thrombocytopenic purpura (ITP) affects 1-3 out of every 10000 pregnancies, posing significant risks to both mothers and newborns. The condition often requires careful management to prevent severe hemorrhagic events. PubMed, Embase, Scopus, and Web of Science searched for relevant literature until June 2024. A meta-analysis was performed to evaluate the effect of ITP on maternal and fetal outcomes. The results showed that antepartum hemorrhage occurred in 0.17 (95% CI = 0.12-0.25) of patients and postpartum hemorrhage occurred in 0.11 (95% CI = 0.07-0.16) of pregnant women with ITP. About 0.63 (95% CI = 0.50-0.74) of pregnant women needed treatment for ITP. The cesarean section (CS) rate was 0.48 (95% CI = 0.34-0.61), and the occurrence of preterm labor was 0.14 (95% CI = 0.07-0.24). A total of 0.32 of neonates had thrombocytopenia (95% CI = 0.18-0.52). The difference between the platelet count of those diagnosed with ITP before pregnancy and those diagnosed after pregnancy was significant (MD=-31.50, 95% CI=51.29-11.72, p<0.01). This meta-analysis highlights the significant impact of ITP on pregnancy, estimating risks of bleeding, CS, gestational diabetes, preterm labor, and neonatal thrombocytopenia. These findings underscore the need for vigilant monitoring and tailored management of pregnant women with ITP.

Preterm birth: associated risk factors in the tertiary care center

The study aimed at identifying the prevalence of preterm labor and the associated risk factors. Design A quantitative approach using a retrospective case-control study. Setting Tertiary care hospital of Udupi district Karnataka. Population or Sample Women delivered in tertiary care Hospital of Udupi district, Karnataka, were the sample; among them, the cases (250) were the records of the women who had delivered before 37 weeks of gestation, and controls (500) were the records of women who delivered after 37 weeks of gestation and without any complications. Method The study was conducted using a retrospective case-control design by reviewing the case records of women who had delivered in a tertiary care hospital. Main Outcome Measures Women delivered in tertiary care Hospital of Udupi district, Karnataka, and their inpatient records were assessed for risk factors during the antenatal and delivery periods. Results The study revealed that the prevalence of preterm labor was 356 (14.86%) Out of 2402 deliveries. Among them, only 250 were assessed. It was significantly correlated with age, place of residence, degree of education, occupation, marital status, gravid para, number of deliveries, type of deliveries, gap between births, blood type, and religion. Pregnant women who had been exposed or had a risk for preterm labor included those who had been diagnosed with pregnancy-induced hypertension, medication during pregnancy, history of abortion, intense physical labor, and conception dates older than 30 years. Conclusion The preterm labor prevalence can be minimized if the modifiable risk factors are in control. Non-modifiable risk factors require keen supervision. Thus, health professionals must be alert to all modifiable and non-modifiable risk factors.

7589 A Survey On the Current Status of Universal Screening Thyroid Indicators During Pregnancy in Real World Study

Abstract Disclosure: N. Zhou: None. W. Sun: None. H. Meng: None. Y. Huang: None. J. Zhao: None. Y. Gao: None. H. Yang: None. Y. Zhang: None. A Survey on the current status of universal screening thyroid indicators during pregnancy in real world study Background: Thyroid dysfunction and thyroid auto-immunity (TAI) are common in women of childbearing age, which have been proven to increase the risk of maternal and fetal adverse pregnancy outcomes. China has adhered to the strategy of universal screening for early pregnancy thyroid indicators since 2012, and is currently the only country that recommends universal screening. This study aimed to investigate the implementation situation of universal screening for thyroid indicators during pregnancy in real world study. Methods: We retrospectively collected medical record information from 18,932 women who underwent regular prenatal examinations at Peking University First Hospital from January 2014 to December 2016 until the end of pregnancy, grouping based on whether thyroid indicators were screened during pregnancy, and comparing the general characteristics and pregnancy outcomes. Furthermore, the treatment compliance status of women who took levothyroxine and antithyroid drugs (ATD) before pregnancy was also analyzed. Results: The screening rate for thyroid indicators in pregnancy was 88.7% in our hospital, 93.3% of pregnant women underwent screening in early pregnancy, with a median gestational age of 7.0 (6.6, 10.1) weeks. Non-screening ones were more inclined to be aged&amp;gt;40 years or &amp;lt;25 years, with a BMI ≥24 kg/m2, pluriparity (≥2), and without thyroid disease history prior to conception (P &amp;lt; 0.05). After correcting covariates, the risks of early miscarriage (8-12 weeks) (OR=21.96, 95% CI: 19.2, 25.1) and late miscarriage (12-28 weeks) (OR=3.0, 95% CI: 2.5, 3.6) were significantly higher in non-screening group than in the screening group, but there was no significant difference in the risk of preterm labor between the two groups (P=0.985). The achievement rate (0.23≤TSH&amp;lt;2.5uIU/mL, FT4 within normal range, 53.7%-64.2%) of early pregnancy thyroid function among levothyroxine intervention participants increased from 2014 to 2016. Compared with those in the thyroid function controlled group, the patients in the uncontrolled group had earlier screening gestational weeks (6.7 vs. 8.0 weeks), higher TPOAb positivity (58.6% vs. 44%), and a greater incidence of other autoimmune disorders (14.2% vs. 9.8%) (P&amp;lt;0.05). The achievement rate of early pregnancy thyroid function among ATD intervention participants ranged from 63.6 to 71.2%. Conclusions: The screening rate for thyroid indicators in pregnancy is nearly 90% in comprehensive hospitals. The lack of screening may be related to miscarriage to some extent. The current treatment compliance status pre-pregnancy neither for levothyroxine nor ATDs was not satisfactory. Presentation: 6/2/2024

Impact of isolated fetal congenital heart disease on pregnancy and perinatal outcomes.

The aim of the present study was to evaluate the obstetric complications associated with isolated fetal congenital heart disease (CHD) by comparing pregnancies with and without this condition. In this retrospective matched comparative study at Siriraj Hospital, Thailand, we included 233 postnatally confirmed fetal CHD cases and 466 unaffected fetuses. Controls were selected at a 2:1 ratio, ensuring that they matched the cases in terms of maternal age, parity, and history of preterm deliveries. Fetal CHD was significantly associated with an increased risk of spontaneous preterm labor (30% vs 9.7%; adjusted odds ratio [aOR] 2.42; 95% confidence interval [CI]: 1.35-4.36; P = 0.003), delivery before 34 gestational weeks (11.6% vs 0.6%; aOR 12.33; 95% CI: 3.32-45.78; P < 0.001), and pre-eclampsia (11.6% vs 2.8%; aOR 2.19; 95% CI: 1.01-4.76; P = 0.047). Newborns with CHD were significantly more likely to be small for gestational age (10.7% vs 5.2%; aOR 2.09; 95% CI: 1.11-3.94; P = 0.022). Intriguingly, a prenatal diagnosis of CHD was associated with a reduced risk of preterm delivery in affected pregnancies (P = 0.002). Pregnancies affected by isolated fetal CHD demonstrated a higher propensity for several adverse outcomes. These findings underscore the importance of prenatal CHD detection and tailored perinatal care to potentially improve both pregnancy outcomes and neonatal health.

Cool mama: Temperature regulation during high-intensity interval running in pregnant elite and recreational athletes

BackgroundRegular exercise during pregnancy is beneficial, but athletes often exceed the recommended 150 min of moderate-intensity activity, incorporate high-intensity exercises. The upper limit for exercise intensity and duration on fetal and maternal safety remains uncertain. A concern is a maternal core body temperature of >39.0 °C, potentially increase the risk of heat-related fetal malformations and complications during pregnancy. Blood flow redirection for thermoregulation could compromise fetal cardiovascular function, increasing the risk of miscarriage and preterm labor. This study evaluated whether pregnant women (gestational weeks 25–35) were at risk of exceeding a core body temperature of 39.0 °C during high-intensity running. We also investigated effects on skin temperature, fluid loss, and thermal sensation, comparing pregnant athletes to non-pregnant controls. MethodsIn this comparative cross-sectional study, 30 elite and recreational athletes (pregnant n = 15) completed up to five high-intensity treadmill-intervals. Core and skin temperature were continuously measured. Body weight was utilized to calculate the amount of fluid loss. ResultsHighest core body temperature were 38.76 °C and 39.56 °C in one pregnant and non-pregnant participant, respectively. Pregnant participants had lower core body temperatures (mean difference −0.47 °C, p ≤ 0.001) initially and a smaller increase (0.10 °C, p ≤ 0.003) during later intervals compared with the non-pregnant controls. Pregnant participants also showed a greater increase in skin temperature (4.08 ± 0.72 °C vs. 3.25 ± 0.86 °C, p = 0.008) and fluid loss (0.81 ± 0.19 L vs. 0.50 ± 0.12 L, p˂0.001). ConclusionPhysiological changes in pregnancy may enhance thermoregulation, indicating that high-intensity interval runs are unlikely to pose a risk of exceeding a core body temperature of 39 °C for pregnant athletes.

Association of Preterm Delivery with Urinary Tract Infection and Preventive Role of Ceftriaxone

Urinary tract infections (UTIs) are the leading cause of maternal morbidity and poor birth outcomes. Pregnancy changes increase UTI risk. A larger bladder, less tone, and a shift in vaginal flora are changes. Eradicating pathogens in the urogenital tract can lower the risk of infection-related preterm labor by stopping the progression of asymptomatic bacteriuria into a more serious infection. Objective: To determine the association of preterm labor with urinary tract infection and the preventive role of ceftriaxone. Methods: A case-control study was conducted at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar, from 14 December 2021 to 10 June 2022. 130 pregnant women who met the selection criteria were recruited from the hospital's post-delivery wards. The participants were then separated into a case group and a control group. Protocols for treating UTIs in female were followed. Ceftriaxone was administered to the group of participants who were UTI-positive. Results: The mean age of female in the case group was 28.88 ± 7.18 and in the controls group was 28.97 ± 6.85 years. The mean gestational age at delivery in cases was 34.28 ± 1.34 weeks and in controls 39.4 ± 1.11 weeks. There was a significant association between preterm labor and urinary tract infection (p= &lt;0.05). Administration of ceftriaxone reduced the risk of preterm labor (p=0.001). Conclusions: It was concluded that there is a significant correlation between UTIs and premature labor and ceftriaxone plays an important role in reducing preterm delivery of UTI patients.

Clinical Manifestations and Health Impact of Malaria in Pregnant Women

Malaria during pregnancy poses significant health risks, both to mothers and their unborn children, due to the unique physiological and immunological changes occurring during this period. This review provides a comprehensive examination of the clinical manifestations and health impacts of malaria in pregnant women, highlighting the severity of the disease across different trimesters and its implications for maternal and fetal health. Malaria during pregnancy can cause symptoms like fever, anemia, headaches, fatigue, and nausea, with complications varying by trimester. In the first trimester, malaria can lead to early pregnancy loss and congenital anomalies, while in the second trimester, it can exacerbate maternal anemia and affect fetal growth. The third trimester is associated with an increased risk of preterm labor and adverse fetal outcomes. Placental malaria, characterized by parasite accumulation in the placenta, impairs nutrient and oxygen transfer to the fetus, leading to intrauterine growth restriction, low birth weight, and increased stillbirth risk. Maternal complications include severe anemia, acute respiratory distress syndrome, and potential long-term health effects. HIV infection further complicates malaria during pregnancy, increasing risks for both mother and fetus. Age-related variations and socioeconomic factors also impact malaria severity and management. Effective management strategies include intermittent preventive treatment, insecticide-treated nets, and indoor residual spraying. Addressing malaria during pregnancy requires a multifaceted approach, including enhancing diagnostic tools, improving preventive measures, and ensuring equitable healthcare access. Keywords: Clinical Manifestations, Health, Malaria, Pregnant Women

Effectiveness of Argymax spray in treating xerostomia in pregnant women with isthmic-cervical insufficiency

Relevance. Xerostomia, commonly known as dry mouth, is a prevalent orofacial disorder among pregnant women experiencing isthmic-cervical insufficiency. This condition manifests as a burning sensation in the mouth, pain, and discomfort during eating. A clear correlation exists between pain, taste alterations, and the perception of oral dryness, highlighting the multifaceted impact of xerostomia on affected individuals. Pregnant women with isthmic-cervical insufficiency, a complication that significantly increases the risk of preterm labor, are particularly susceptible to xerostomia. This condition is often accompanied by heightened psycho-emotional stress, which can exacerbate the symptoms of dry mouth. Despite the multitude of treatments available for xerostomia, the primary objective for dentists is to formulate an appropriate and effective treatment plan, tailored to the physiological needs of the patient. This study evaluates the efficacy of Argymax spray in alleviating xerostomia in pregnant women with isthmic-cervical insufficiency.Materials and methods. A study was conducted involving 84 pregnant women who were assessed and treated over a three-week period to evaluate the rate of mixed saliva secretion. Subjective data were collected using a five-point scale to analyze the reduction in pain potential, itching, and burning. Hygienic and periodontal indices were determined before therapy and three months after the use of the spray.Results. The study demonstrated that Argymax spray begins to act within seven days of initial application and maintains its effectiveness throughout the observation period.Conclusion. Hormonal changes during pregnancy affect both the overall body and the condition of the oral cavity, making it particularly vulnerable. Early diagnosis and appropriate management strategies can prevent the development of several oral mucosal diseases associated with xerostomia. Argymax spray is recommended as symptomatic therapy for the treatment of xerostomia in pregnant women with isthmic-cervical insufficiency.

Vasa Previa and the Role of Fetal Fibronectin and Cervical Length Surveillance: A Review.

Vasa previa is a pregnancy complication that occurs when unprotected fetal blood vessels traverse the cervical os, placing the fetus at high risk of exsanguination and fetal death. These fetal vessels may be compromised by fetal movement and compression, leading to poor oxygen distribution and asphyxiation. Diagnostic tools for vasa previa management and preterm labor (PTL) include transvaginal ultrasound, cervical length (CL) surveillance and use of fetal fibronectin (FFN) testing. These tools can prove to be quite useful as they allow for lead time in the prediction of PTL and spontaneous rupture of membranes which can result in devastating outcomes for pregnancies affected by vasa previa. We conducted a literature review on vasa previa management and the usefulness of FFN and CL surveillance in predicting PTL and found 36 related papers. Although there is limited research available to show the impact of FFN and CL surveillance in the management of vasa previa, there is sufficient evidence to support FFN and CL surveillance in predicting the onset of PTL, which can have devastating consequences for the pregnancies affected. It can be extrapolated that these tools, by helping to determine pregnancies at risk for PTL, could improve management and outcomes in patients with vasa previa. Future studies investigating the management of vasa previa with FFN and CL surveillance to reduce the burden of PTL and its associated comorbidities are warranted.

Factors associated with clinical nurses' preconception health behavior in Korea: a cross-sectional survey.

Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Age (р=.024), educational level (р=.010), marital status (р=.003), work experience (р=.003), satisfaction with the work department (р<.001), smoking status (р=. 039), and previous health problems related to pregnancy outcomes (р=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (р<.001), pregnancy anxiety (р=.011), nursing practice environment (р=.003), and social support (р<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, р=.001), satisfaction with the work department (β=.23, р=.032), marital status (β=.22, р=.002), and perceived health status (β=.23, р=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, р<.001). Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.

Differential DHA and EPA Levels in Women with Preterm and Term Births: A Tertiary Hospital Study in Indonesia.

BACKGROUND Preterm birth is one of the main causes of neonatal death worldwide. One strategy focused on preventing preterm birth is the administration of long chain polyunsaturated fatty acids (LCPUFAs) during pregnancy. Omega-3 LCPUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential in metabolic and physiological processes during embryonic and fetal development. This study aimed to compare DHA and EPA levels in 44 women with preterm births and 44 women with term births at a tertiary hospital in West Java Province, Indonesia, between November 2022 and March 2023. MATERIAL AND METHODS A total of 88 patients in this study consisted of 44 patients with term births (≥37 gestational weeks) and 44 patients with preterm births (<37 gestational weeks) at a tertiary hospital in West Java Province, Indonesia. This observational, cross-sectional study was conducted from November 2022 to March 2023. Using the enzyme-linked immunosorbent assay test, maternal DHA and EPA levels were investigated. IBM SPSS 24.0 was used to statistically measure outcomes. RESULTS Average maternal DHA and EPA levels in patients with preterm births were significantly lower than those in term births. Preterm labor risk was further increased by DHA levels of ≤5.70 µg/mL (OR=441.00, P=0.000) and EPA levels ≤3971.54 µg/mL (OR=441.00, P=0.000). CONCLUSIONS Since the average maternal DHA and EPA levels were significantly lower in patients with preterm births, adequate intake of omega-3 LCPUFA in early pregnancy and consistency with existing nutritional guidelines was associated with a lower risk of preterm delivery for pregnant women.

Gestational diabetes mellitus aggravates adverse perinatal outcomes in women with intrahepatic cholestasis of pregnancy

PurposeTo evaluate the effect of intrahepatic cholestasis of pregnancy (ICP) with gestational diabetes mellitus (GDM) on perinatal outcomes and establish a prediction model of adverse perinatal outcomes in women with ICP.MethodsThis multicenter retrospective cohort study included the clinical data of 2,178 pregnant women with ICP, including 1,788 women with ICP and 390 co-occurrence ICP and GDM. The data of all subjects were collected from hospital electronic medical records. Univariate and multivariate logistic regression analysis were used to compare the incidence of perinatal outcomes between ICP with GDM group and ICP alone group.ResultsBaseline characteristics of the population revealed that maternal age (p < 0.001), pregestational weight (p = 0.01), pre-pregnancy BMI (p < 0.001), gestational weight gain (p < 0.001), assisted reproductive technology (ART) (p < 0.001), and total bile acid concentration (p = 0.024) may be risk factors for ICP with GDM. Furthermore, ICP with GDM demonstrated a higher association with both polyhydramnios (OR 2.66) and preterm labor (OR 1.67) compared to ICP alone. Further subgroup analysis based on the severity of ICP showed that elevated total bile acid concentrations were closely associated with an increased risk of preterm labour, meconium-stained amniotic fluid, and low birth weight in both ICP alone and ICP with GDM groups. ICP with GDM further worsened these outcomes, especially in women with severe ICP. The nomogram prediction model effectively predicted the occurrence of preterm labour in the ICP population.ConclusionsICP with GDM may result in more adverse pregnancy outcomes, which are associated with bile acid concentrations.

Risk Factors and Pregnancy Outcomes After SARS-CoV-2 in Pregnancy According to Disease Severity: A Nationwide Cohort Study With Validation of the SARS-CoV-2 Diagnosis

(Acta Obstet Gynecol Scand. 2023;102:282–293) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to increase a patient’s risk of preterm labor, pre-eclampsia, the need for cesarean delivery, and stillbirth. This study aimed to analyze and better understand the risk factors and complications that relate to SARS-CoV-2 during pregnancy and delivery.

Challenges in Diagnosing and Managing Uterus Didelphys: A Case Report

Background: This medical case report provides an insightful examination of a 22-year-old pregnant woman with uterus didelphys, a rare congenital anomaly of the Müllerian ducts. The introduction section sets the stage by discussing the embryological origins of congenital uterine anomalies and their varied clinical manifestations. It emphasizes the challenges in detecting these conditions due to their often asymptomatic nature and highlights their significant impact on reproductive health, including increased risks of miscarriage, preterm labor, and perinatal mortality.&#x0D; Case presentation: The case report segment details the patient’s clinical presentation, initially misdiagnosed as an ectopic pregnancy, later revealed to be an intrauterine pregnancy coexisting with uterus didelphys. The diagnosis was substantiated by her history of irregular menstruation, lower abdominal pain since menarche, and a previously diagnosed ovarian cyst, illustrating the critical role of a thorough medical history in guiding diagnosis. The discussion section delves into the implications of uterus didelphys on fertility and pregnancy outcomes, advocating for individualized management strategies and highlighting the psychological impact of such congenital anomalies. It underscores the necessity of a multidisciplinary approach to care involving obstetricians, radiologists, and reproductive specialists.&#x0D; Conclusion: The conclusion emphasizes the importance of clinical awareness, meticulous history-taking, and personalized care in the management of uterus didelphys. It calls for further research to enhance understanding and improve outcomes in reproductive medicine, stressing the complexity of diagnosing and managing pregnancies in women with Müllerian anomalies and the need to consider congenital uterine anomalies in differential diagnoses, particularly in young women with atypical gynecological histories.

Pregnancy outcomes of cerclage in twin gestations: a multicenter retrospective cohort study

Objectives To determine the effects of cerclage on twin pregnancies. Methods A multicenter, retrospective, cohort study was conducted at 10 tertiary centers using a web-based data collection platform. The study population included twin pregnancies delivered after 20 weeks of gestation. Patients with one or two fetal deaths before 20 weeks of gestation were excluded. Maternal characteristics, including prenatal cervical length (CL) and obstetric outcomes, were retrieved from the electronic medical records. Results A total of 1,473 patients had available data regarding the CL measured before 24 weeks of gestation. Seven patients without CL data obtained prior to cerclage were excluded from the analysis. The study population was divided into two groups according to the CL measured during the mid-trimester: the CL ≤2.5 cm group (n = 127) and the CL >2.5 cm group (n = 1,339). A total of 127 patients (8.7%) were included in the CL ≤2.5 cm group, including 41.7% (53/127) who received cerclage. Patients in the CL >2.5 cm group who received cerclage had significantly lower gestational age at delivery than the control group (hazard ratio (HR): 1.8; 95% confidence interval (CI): 1.11–2.87; p = .016). Patients in the CL ≤2.5 cm group who received cerclage had a significantly higher gestational age at delivery than the control group (HR: 0.5; 95% CI: 0.30–0.82; p value = .006). Conclusions In twin pregnancies with a CL ≤2.5 cm, cerclage significantly prolongs gestation. However, unnecessary cerclage in women with a CL >2.5 cm may result in a higher risk of preterm labor and histologic chorioamnionitis although this study has a limitation originated from retrospective design.

The effects of endometrial thickness on outcomes of pregnancy following embryo transfer: A retrospective cohort.

The safety of assisted reproductive technology can be assessed by examining birth weight as an outcome measure. The objective of this study was to evaluate the effect of endometrial thickness during embryo transfer on newborn birth weight and preterm labor. We conducted a retrospective cohort study at the infertility department of a teaching hospital affiliated with a university of medical sciences. Eligible women were ≥18 years old and conceived a singleton pregnancy with embryo transfer and an endometrial thickness of ≥7 mm. None of the patients had diabetes, blood hypertension, and polycystic ovarian syndrome. We assessed maternal and newborn characteristics and perinatal pregnancy outcomes. In total, 100 eligible patients with a mean (SD) age of 32.8 (6.2) years were included. The mean endometrial thickness during embryo transfer was 9.1 (1.2) mm, and the mean birth weight was 3040.7 (565.3)g. There were no statistically significant associations between endometrial thickness and preterm labor (p=0.215) and between endometrial thickness and stillbirth or intra-uterine fetal death (p=0.880). However, after adjusting for confounding factors, the association of endometrial thickness with birth weight was statistically significant [b=124.6 (51.6), p=0.018]. Within the range of ≥7mm, endometrial thickness during embryo transfer is a predictor of newborn weight; however, it is not related to the risk of preterm labor, stillbirth, or intra-uterine fetal death.

Preterm Labor and Hypertensive Disorders in Adolescent Pregnancies With Diabetes Between 2006 and 2019

Objective: We sought to evaluate the risk of preterm labor and hypertensive disorders in adolescent pregnancies with and without diabetes.Methods: We evaluated 1,843,139 adolescents (≤20 years old) with labor and delivery admissions in the national Kids’ Inpatient Database (KID) in years 2006, 2009, 2012, 2016, and 2019. International classification of disease codes was used to identify diabetes and medical factors affecting pregnancy. Weighted logistic regression was used to evaluate the association between diabetes and complications.Results: Among admissions, 0.2% had type 1 diabetes (T1D), 0.2% had type 2 diabetes (T2D), and 0.7% had gestational diabetes (GDM); 10.1% of admissions were complicated by hypertensive disorders and 5.8% by preterm labor. Compared to adolescents without diabetes, those with diabetes had a higher prevalence of hypertensive disorders (T1D: 35.4%, T2D: 37.8%, GDM: 24.9%, None: 9.9%; p &lt; 0.001) and preterm labor (T1D: 21.5%, T2D: 16.8%, GDM: 6.8%, none: 5.7%; p &lt; 0.001). In adjusted models, odds of hypertensive disorders were higher in later study years (2019 vs. 2006 OR 1.85, 95% CI 1.77–1.94), among those with T1D (OR 4.32, 95% CI 3.94–4.74), with T2D (OR 4.18, 95% CI 3.79–4.61), and with GDM (OR 1.99, 95% CI 1.89–2.10). Adjusted odds of preterm labor were higher among those with T1D (OR 4.53, 95% CI 4.09–5.02), with T2D (OR 3.35, 95% CI 2.96–3.78), and with GDM (OR 1.18, 95% CI 1.08–1.28); disparities were seen by race/ethnicity, insurance, and income.Conclusions: Diabetes, which is increasing among adolescents, is a significant risk factor for preterm labor and hypertensive disorders. Though the absolute number of adolescent pregnancies is decreasing, rates of hypertensive disorders have increased. Appropriate interventions are needed to ensure healthy outcomes for adolescents who are pregnant.

Development of progesterone electrospun nanofibers to coat Arabin pessaries as a dual preventive and therapeutic approach for preterm labor

Preterm labor is a growing health problem that causes newborn death, and safe and effective therapy is significantly needed. Arabin pessaries and progesterone are preventive and therapeutic approaches that can be applied to managing the short cervix; hence, reducing the risk of preterm labor. The main goal of current work is to fabricate a novel nanofiber formulation based on polycaprolactone (PCL) and loaded with progesterone to coat for Arabin pessaries to be used as dual preventive and therapeutic approaches for local vaginal delivery. Several important criteria were considered in this study to assess the prepared nanofibers (i.e.; nanofiber diameter, progesterone loading efficiency, progesterone release profiles and in vitro cytotoxicity assessment). The results showed a dimeter of 397 ± 88 nm, drug loading of 142 ± 3 µg/mg and encapsulation efficiency of 99 ± 2 % for the progesterone-loaded nanofibers. Approximately, 17 % of progesterone was released from the nanofibers after 90 days. The in vitro assessment showed that the application of progesterone is safe upon 24 and 48-hours incubation on HFF-1 cell line at concentrations ≤ 32 µg/mL and within 72-hours at a dose of ≤ 8 µg/mL. To conclude, the data recommended that progesterone-loaded nanofibers can coat the Arabin pessaries with the potential of being a safe and effective dual preventive and therapeutic tool for preterm labor.

Mendelian randomization reveals systemic lupus erythematosus and rheumatoid arthritis and risk of adverse pregnancy outcomes

BackgroundThe effect of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) on adverse pregnancy outcomes is a controversial topic. This study aimed to use Mendelian randomization (MR) analysis to assess the causal relationship between SLE, RA and adverse pregnancy outcomes. MethodsGenetic variants for SLE and RA, as well as adverse pregnancy outcomes, were derived from pooled statistics from large public genome-wide association studies. Several methods, such as inverse variance weighting (IVW), MR-Egger, weighted median and MR-Pleiotropic Residuals Sum and Outliers, were employed to estimate two-sample causality. ResultsGenetic prediction of SLE was associated with higher odds of preterm labour [odds ratio (OR) 1.03, 95 % confidence interval (CI) 1.01–1.05; p = 0.008]. RA was associated with higher odds of preterm labour (OR 1.03, 95 % CI 1.01–1.06; p = 0.009), pre-eclampsia or eclampsia (OR 1.04, 95 % CI 1.01–1.07; p = 0.005), and poor fetal growth (OR 1.08, 95 % CI 1.04–1.12; p = 2.91 × 10−5). The results of bidirectional MR analysis did not indicate that SLE was associated with spontaneous abortion, pre-eclampsia or eclampsia, preterm rupture of membranes, or poor fetal growth (p-value for IVW 0.13–0.97). ConclusionsThis study found a genetic association between SLE and the risk of preterm labour, and highlights the importance of perinatal care and monitoring for patients with SLE. Furthermore, RA was found to be associated with a wide range of adverse outcomes, including preterm labour, pre-eclampsia or eclampsia, and poor fetal growth; as such, there is a need for more intensive therapeutic interventions and prenatal monitoring.