Second Trimester Of Pregnancy Research Articles

Maternal Serum Catestatin Levels in Gestational Diabetes Mellitus: A Potential Biomarker for Risk Assessment and Diagnosis

Background/Objectives: Gestational diabetes mellitus (GDM) presents significant risks for both maternal and neonatal health, affecting fetal growth and increasing the likelihood of future diabetes mellitus (DM) development in affected women. The dysregulation of metabolic biomarkers, including catestatin, has been implicated in GDM pathophysiology. However, the clinical significance of catestatin in GDM remains poorly understood, particularly in the context of different therapeutic approaches. Methods: This observational, prospective, and cross-sectional study was conducted to evaluate maternal serum catestatin levels in gestational diabetes mellitus (GDM) patients and healthy controls. Data were collected at a single time point during the second trimester of pregnancy (24 to 28 weeks). Participants were categorized based on their glucose tolerance and GDM management strategies (diet regulation or insulin therapy). Results: Receiver Operating Characteristic (ROC) analysis demonstrated the diagnostic significance of serum catestatin levels in GDM, suggesting a cut-off value of >9.61 ng/mL for discriminating between women with and without GDM. However, further research is needed to elucidate the mechanistic role of catestatin in GDM and its utility in guiding therapeutic interventions. Conclusions: Our study highlights the potential of catestatin as a biomarker for GDM risk stratification and monitoring, complementing existing diagnostic tools. Integrating metabolic biomarkers like catestatin into clinical management approaches may optimize maternal and neonatal health outcomes in GDM. However, the limitations of our study, including its cross-sectional design and sample size, underscore the need for future multicenter studies to validate our findings comprehensively.

Early-life sodium restriction programs autonomic dysfunction and salt sensitivity in male C57BL/6J mice.

Preterm birth increases the risk of cardiometabolic disease in adulthood. Infants born during the second trimester of pregnancy, a critical period of hypothalamic development, are at risk of sodium (Na) depletion due to renal immaturity and large urine Na losses. We previously demonstrated in male mice that Na restriction during the equivalent mouse hypothalamic development period [postnatal day (PD)21-PD42] programs long-term changes in energy balance via increased thermogenic sympathetic nervous activity. We therefore hypothesized that early-life Na restriction programs changes in cardiovascular control via altered autonomic activity. C57BL/6J male mice were supplied a low (0.04%) Na or supplemented (0.30%) Na diet from PD21 to PD42, before return to standard (0.15%) Na diet. Hemodynamic and autonomic functions were assessed by radiotelemetry and acute administration of autonomic antagonists before and after all animals were switched to a high Na diet (HSD; 1% Na) at 12 wk of age. Mice were additionally treated with the angiotensin II type 1 receptor antagonist losartan for 2 wk. On standard diet, early-life Na restriction resulted in small but significantly different hemodynamic responses to autonomic blockers without any effect on systolic blood pressure (SBP) or heart rate. HSD increased SBP in 0.04% but not 0.30% Na mice, accompanied by increased cardiac sympathetic activity. Losartan had a greater BP-lowering effect in early-life Na-restricted mice. Our findings suggest that Na restriction during a critical hypothalamic developmental period programs long-term changes in the autonomic control of cardiovascular functions and may offer insight into the increased risk of cardiovascular disease in former preterm infants.NEW & NOTEWORTHY Mechanisms by which preterm birth increases the risk of adult-onset cardiometabolic diseases are not well understood. The renin-angiotensin system (RAS) has been implicated in the programming of adult disease, although contributors to RAS dysregulation remain to be identified. Findings from this study suggest that failure to maintain postnatal sodium homeostasis during a critical developmental window may contribute to RAS dysregulation and the risk of salt sensitivity of autonomic and cardiovascular function.

Decidualized ovarian and rectouterine deep endometriosis disguised as malignancy in the second-trimester of pregnancy: A case report

Decidualized ovarian and rectouterine deep endometriosis disguised as malignancy in the second-trimester of pregnancy: A case report

The impact of Ramadan fasting on oxidative stress levels in the second trimester of pregnancy

Background The primary objective of this study was to assess the effect of fasting during Ramadan on maternal oxidative stress levels and foetal development; pregnant women with uncomplicated, singleton pregnancies in the second trimester. Methods During the month of Ramadan, 23 March 2023 to 20 April 2023, 50 fasting and 50 non-fasting healthy pregnant women were enrolled in this prospective study. The fasting hours were about 14 h per day in that season. Pregnant women in the second trimester were enrolled in the study. Total antioxidant status (TAS), total oxidant status (TOS) and the oxidative stress index (OSI) were measured from maternal serum samples taken on a fasting day at the end of Ramadan. To evaluate the impact of Ramadan on the foetus, Doppler ultrasonography was performed in the beginning and then at the end of Ramadan in all participants and was used for the following measurements: Increase of biparietal diameter, femur length, estimated foetal body weight, amniotic fluid index and umbilical artery systolic/diastolic ratio. To discern differences between distinct cohorts, independent t-tests and Mann–Whitney’s U-tests were employed based on the data distribution. A p value threshold of less than .05 was established to determine statistical significance. Results TAS level was found to be significantly lower in the group that fasted for more than 15 days compared to the non-fasting group that did not fast (p = .003), but no significant differences were found between the groups in terms of TOS and OSI (p < .05). Obstetric ultrasound parameters showed no significant differences between the two groups (p < .05). Conclusions The present study suggests that fasting during the second trimester of pregnancy does not substantially impact maternal or foetal health, as indicated by most oxidative stress markers and foetal parameters studied. However, the observed reduction in the TAS levels in the fasting group warrants further investigation.

Spontaneous haemoperitoneum in the second trimester of pregnancy

We report the case of a 34 year old woman who presented to secondary care at 18 weeks gestation with acute abdominal pain. A diagnosis of haemoperitoneum secondary to a ruptured ovarian cyst was made and conservative management undertaken.

Pathomorphological changes of the placenta in coronavirus disease (COVID-19) in pregnant women in the second and third trimesters of pregnancy

Despite the severity of the course of COVID-19 in pregnant women, COVID-19 remains a risk factor for perinatal losses. The aim of the study was to determine the pathomorphological changes in the placenta in pregnant women with COVID-19 during the second and third trimesters of gestation in cases of live birth and antenatal fetal asphyxia. Placentas of pregnant women with COVID-19 were examined: in cases of live birth (n=122; Group I), in cases of antenatal fetal asphyxia (n=27; Group II), and in a comparison group (n=40). Macroscopic, microscopic, immunohistochemical, morphometric, and statistical methods were used. Subgroups: I.1 (n=49) – COVID-19 in the mother at 19-34 weeks of gestation and I.2 (n=34) – at 35-40 weeks. Placentas in antenatal fetal asphyxia, depending on the duration of the post-COVID interval (the time interval from the diagnosis of COVID-19 to delivery), were divided into subgroups – II.1 (n=8) and II.2 (n=19). In subgroup II.1, the post-COVID interval was 5-17 weeks; in II.2 – 1-4 weeks. In the acute phase of the disease, placentas predominantly showed congestion, thrombosis, hemorrhages, and placentitis – 100% (95% CI: 94.5%-100%). An increase in the number of syncytial nodules was found in subgroup I.2: 12.7 [11; 14] compared to 5.8 [5; 7] in the control group, p&lt;0.0001. A decrease in the number of terminal villi was observed in subgroups I.1 and II.1 – 16.3 [10; 25]; 10.3 [8; 12] respectively; p&lt;0.0001, compared to 25.4 [20; 30] in the comparison group. All cases of COVID-19 in the mother were accompanied by edema of the stromal tissue of the terminal villi of the chorion, which led to a decrease in the percentage of blood vessels in the terminal villi: in subgroup I.2 – 29.4 [25.6; 34.2]; II.1 – 16.5 [10.34; 24.37], and II.2 – 14.71 [10.1; 19.4] compared to 67.6 [58.78; 73.7] in the comparison group; p&lt;0.0001. Proliferative changes in the wall of arterioles with subsequent arteriosclerosis were observed exclusively in subgroups I.1 and II.1 – 28.6% (95% CI: 16.6%-42.3%) and 100% (95% CI: 78.6%-100%) respectively. Pathomorphological changes in the placenta in COVID-19 during pregnancy are associated with the timing of infection and the phases of the inflammatory process, with an increase in the duration of the post-COVID interval – exudation (placentitis, edema of chorionic villi), proliferation followed by fibrosis. Factors that disrupt placental perfusion in the acute phase of COVID-19 include edema of the villous stroma, narrowing of the capillary lumen in the terminal chorionic villi, and the intervillous space. Compensatory mechanisms of the mature placenta include the appearance of a large number of syncytial bridges to increase the intervillous space and focal inflammation. Arteriolosclerosis, obliteration of the intervillous space, and hypoplasia of the terminal villi caused by SARS-CoV-2 damage to stem and semi-stem villi during COVID-19 in the second trimester of pregnancy are mechanisms of chronic placental insufficiency and a risk factor for intrauterine fetal hypoxia.

Mobilisation and replenishment of phosphorus reserves in Bos indicus cows. 1. Mid-pregnant mature cows post-weaning

Context Lactating beef cows grazing phosphorus (P)-deficient pastures often mobilise body P to alleviate a P deficiency. Knowledge of the circumstances when body P is mobilised, and later replenished, is necessary for optimal management of the P nutrition of breeder herds. Aims To investigate mobilisation and replenishment of body P in mature Bos indicus-cross beef cows post-weaning. Methods Cows (n = 40) in their second trimester of pregnancy were individually fed ad libitum low-P (LP) or high-P (HP) diets containing moderate or high metabolisable energy (ModE-LP, HighE-LP, ModE-HP and HighE-HP) for 14 weeks. Key results Plasma inorganic P concentrations (Pi) in LP- or HP-diet cows (0.58 and 2.15 mmol/L respectively) indicated that diet P was deficient or adequate. Intakes of DM and metabolisable energy, liveweight gain, and P retention were higher (P &lt; 0.05 to P &lt; 0.001) in cows fed the HP diets, and were also increased in the high metabolisable-energy diets. Efficiency in use of metabolisable energy for slow growth was lower in the HighE-LP than the ModE-HP cows. The cows fed the LP diets mobilised 4–5 g body P/day. Cows fed the Mod-HP and HighE-HP diets retained 1.1 and 8.8 g body P/day, and those ModE-HP cows with low bone P reserves retained ~2.3 g P/day. Rib cortical bone P did not change in HP cows but decreased (P &lt; 0.05) in LP cows. The HP diets increased the bone volume, mineralised bone, and the thickness of the struts in trabecular bone in the tuber coxae. Osteoid tissue decreased (P &lt; 0.05) in HighE-HP cows. Changes in plasma concentrations of 1,25-dihydroxy vitamin D3, carboxy-terminal telopeptides of type I collagen (CTX-1) and bone alkaline phosphatase (BAP) were in accord with substantial bone mobilisation in cows fed LP diets, and bone replenishment with HP diets. Conclusions Cows that had ingested P-deficient diets during lactation were able to further mobilise body P when fed LP diets post-weaning, but cows replenished body P when fed HP diets. Implications Mature cows with low body P reserves can replenish these reserves more rapidly when consuming diets high in both P and metabolisable energy.

Global prevalence of constipation during pregnancy: a systematic review and meta-analysis

BackgroundConstipation is a common complication and an unpleasant experience during pregnancy. Due to hormonal factors, intestinal movements decrease during this time, causing the digestive system to malfunction. This study aims to explore the worldwide prevalence of constipation during pregnancy to prevent and minimize its complications.MethodResearchers conducted a meta-analysis of published data on the prevalence of constipation in pregnancy. The articles, which covered the period 1966 to 2024, were collected by searching Embase, PubMed, Scopus, Science Direct, Wos, and the Google Scholar search engine. The initial search was conducted on July 21, 2024, and the final update was made on August 10, 2024.ResultsThirteen studies were identified to determine the prevalence of constipation during pregnancy. The results show that the global prevalence of constipation throughout pregnancy is 32.4%, with the first trimester at 21.1%, the second trimester at 34%, and the third trimester at 30.3%.ConclusionAccording to a study, constipation is most common during the second trimester of pregnancy and the least common during the first trimester. Further research on the causes of constipation and prevention methods can help decrease its prevalence during pregnancy. Therefore, it is important to provide educational interventions on nutrition and encourage moderate physical activity during pregnancy to reduce the occurrence of constipation.

The relationship between excessive iodine during pregnancy and adverse pregnancy complications.

Iodine nutrition during pregnancy plays an important role in fetal development and maternal outcomes. Iodine deficiency has been proved to be associated with maternal thyroid dysfunction, adverse fetal outcomes and neurodevelopmental disorders in offspring. At present, there are few studies concentrate on the effects of iodine excess during pregnancy on thyroid function, maternal and neonatal outcomes, and the results are still controversial. The aim of this study was to evaluate the effects of excessive iodine status on thyroid function, glycolipid metabolism, and maternal and neonatal outcomes. A total of 595 pregnant women who gave birth at the First Affiliated Hospital of Nanjing Medical University from January 2023 to December 2023 were included in this study. Blood and urine samples were collected during the second trimester of pregnancy. Thyroid function include thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and urinary iodine concentrations (UIC) were measured. Maternal and neonatal outcomes were collected. Participants were divided into four groups based on UIC, with median UIC values of 100.5, 200, 314.2, and 655 μg/L, respectively. UIC was found to be positively associated with TSH, and negatively associated with FT3 and FT4. Fasting blood glucose (FBG) levels were elevated both in iodine deficiency and excess group. A U-shaped relationship between UIC and thyroid dysfunction were found. Iodine deficiency, excess iodine and even more than adequate iodine can lead to increased incidence of thyroid diseases such as isolated hypothyroxinaemia and overt hyperthyroidism. Importantly, iodine excess was found to be related with higher prevalence of umbilical cord around neck and eclampsia as well as higher blood glucose and low-density lipoprotein(LDL) level. Abnormal iodine status especially iodine excess during pregnancy was found to be related with higher prevalence of adverse mother and fetus outcomes, abnormal blood glucose and lipid level.

The Effect of Clinical Exercise Training on Plantar Pressure, the Subtalar Joint, and the Gait Cycle in Pregnant Women: Randomized Clinical Trial.

Background/Objectives: This study aims to examine the effects of clinical exercise training on foot plantar pressure, the subtalar joint, and the gait cycle during pregnancy. Methods: The study was planned as a randomized, controlled, and single-blind study. Participants' demographic information, obstetric evaluation, physical activity level, fall history, and pain evaluation were recorded. Foot plantar pressure, the subtalar joint, and the gait cycle were measured through pedobarography at Gait Laboratory. The control group was recommended walking. Clinical exercise training was given to the study group 2 days a week for eight weeks. Evaluations were made on day 0 and the day corresponding to the end of week 8. Results: The study was completed with 50 people in the study group (age: 29.7 ± 3.8 years) and 51 in the control group (age: 29.1 ± 6.1 years). As a result of the parametric and non-parametric tests performed before and after the exercise, it was observed that there was a statistically significant difference between the two groups in weight, BMI, pain score, static plantar pressure, dynamic plantar pressure, subtalar joint flexibility, duration of the walking period, and multistep walking speed (p < 0.01). The two groups had a significant difference only in the dominant midfoot plantar pressure (p > 0.05). Conclusions: According to our research, weight control and pain relief are observed in women who engage in clinical exercise in the second trimester of pregnancy; plantar pressure and subtalar joint flexibility are preserved, the walking period does not increase, and the multistep walking speed can be maintained after eight weeks.

Personal growth during early and advanced pregnancy according to women’s mode of conception

ABSTRACT Background Pregnancy can be a complex and stressful period, especially for women conceiving through fertility treatment, but this can foster the experience of personal growth (PG). Most of the knowledge on women’s PG during pregnancy is based on a single measurement and relates to conceiving achieved through fertility treatments in general. Relying on Schaefer and Moos’s PG model, the current prospective study sought to (1) investigate the differences in PG according to women’s mode of conception (spontaneous; first-line fertility treatment; IVF) and (2) examine the contribution of the mode of conception, perceived stress, self-mastery, and cognitive appraisal (threat, challenge, and self-efficacy) to PG in two phases during pregnancy. Methods Israeli pregnant women (Mean age = 32) recruited through a convenience sample, completed self-report questionnaires twice: the first or second trimester of pregnancy (Phase 1; n = 400) and the third trimester (Phase 2; n = 268). A total of 268 participants completed both assessments. Results Women who conceived through IVF experienced higher PG and lower self-mastery than women who conceived spontaneously. Regression analyses indicated that IVF, being primiparous, lower self-mastery, lower threat appraisal, and higher challenge appraisal were related to greater PG in Phase 1. Only expecting the first child and challenge appraisal predicted women’s PG in Phase 2. Conclusions The study highlights that women who conceive through IVF experience greater PG than other women and the significant role of cognitive appraisal in PG over time during pregnancy. These findings may inform focused-based interventions to enhance women’s mental health during this period.

False-positive dengue non-structural protein 1 in pregnancy.

Dengue is a vector-borne infection, which contributes to significant morbidity and mortality in endemic areas. It manifests rapidly within 2 wk from febrile, critical to recovery phase. The point-of-care test (POCT) comprises the non-structural protein 1 (NS1) antigen, IgM and IgG, which aids rapid diagnosis, leading to timely treatment. Despite the high specificity of various POCTs, a few false-positive NS1 cases have been reported. We report the first case of false-positive NS1 antigen in pregnancy. A 24-y-old female in her second trimester of pregnancy presented with fever and chills for 9 d and a non-productive cough for 3 d. The dengue POCT showed NS1 antigen positive, IgM and IgG negative. Her symptoms were resolved with treatment of urinary tract infection with cefuroxime. Urine culture subsequently yielded Escherichia coli. Her recovery and delivery were uneventful. Her NS1 antigen was persistently positive for 18 d. The confirmatory real time-PCR for dengue and pan-Flaviviruses was negative.

Case Report of a Second Trimester Diagnosis of Binder Syndrome

ABinder’s facies is a rare congenital malformation that has multifactorial aetiologies. This anomaly affects the anterior part of the maxilla and the nasal cavity. A 30-year-old primigravida with a non-consanguineous marriage presented for a second opinion regarding an anomaly scan at the fetal medicine department of our institute at 21 weeks. Her scan performed elsewhere suggested a flat and short nasal bridge. A thorough 2D and 3D examination of the fetus was carried out. The midsagittal view of the face showed a flat nose with an increased fronto-nasal angle. In this study, we discuss the diagnosis of Binder syndrome during the second trimester of pregnancy.

Prospective study on the impact of cervical cerclage in patients with cervical insufficiency: a quantitative analysis of preterm birth rates and gestational complications

Cervical insufficiency, a condition marked by premature cervical dilation, poses a significant risk for preterm birth and second-trimester pregnancy loss. This review systematically evaluates the effectiveness of cervical cerclage and its alternatives in managing cervical insufficiency to improve perinatal outcomes. The study’s objective is to analyze various techniques, including single and double cerclage, elective versus emergency interventions, and non-surgical alternatives such as the cervical pessary and vaginal progesterone. A systematic literature review was conducted using databases such as PubMed, Scopus, and Embase, focusing on studies from the last 10 years. Of the 50 articles reviewed, 26 met the inclusion criteria and provided quantitative or qualitative data on perinatal outcomes and complications. The findings underscore the importance of personalized intervention methods, revealing that certain techniques may be more effective in high-risk populations. This review contributes to both clinical and theoretical discussions, emphasizing early intervention and tailored treatment plans. Further research should include diverse populations and examine long-term neonatal outcomes. Limitations of the study include potential selection bias and language restrictions.

Knowledge, attitude, practice and influencing factors on influenza and influenza vaccine among pregnant women in Suzhou

Objective: To understand the current knowledge, attitude, and practice (KAP) on influenza and influenza vaccine among pregnant women in Suzhou and to analyze its influencing factors to provide technical support data for public health strategies for promoting influenza vaccination in pregnant women. Methods: A questionnaire was designed, and a stratified sampling method was used to conduct a face-to-face survey among pregnant women at different stages of pregnancy who received antenatal examinations at different levels of medical institutions in Suzhou, Jiangsu Province, in 2023. KAP status and influencing factors were analyzed by χ² test and logistic regression analysis. Results: A total of 2 195 valid questionnaires were collected in this survey. The M(Q1, Q3) of knowledge about influenza and influenza vaccine among pregnant women in Suzhou was 7.60 (5.23, 9.80) points, and the score range was 0.20-14.71 points, the passing rate was 34.12%, the awareness rate of influenza vaccine was 57.45%, and the vaccination rate of influenza vaccine was 1.91% within one year before the survey. The willingness to receive influenza vaccine during pregnancy was only 3.57%. Multivariate analysis of influenza and influenza vaccine-related knowledge scores showed that the passing rate was positively correlated with education level and gestational age. In contrast, family income was negatively correlated with living in rural areas, working as migrant workers, and having no medical insurance. Multivariate analysis of vaccination intention showed that decreased effectiveness of influenza vaccine and increased adverse reactions decreased vaccination intention during pregnancy. Conclusions: The pregnant women in Suzhou pay more attention to influenza, and vaccination rates and intentions are generally low. Pregnant women with early and second trimester of pregnancy, low education, living in rural areas, working as migrant workers, and not purchasing medical insurance are the key groups to popularize the knowledge about influenza and influenza vaccine.

Association between consumption of ultra-processed foods and glycemic self-monitoring in women with gestational diabetes mellitus and their newborns: A cohort study.

To evaluate the association between the consumption of ultra-processed foods (UPFs) and outcomes of self-monitoring of blood glucose in pregnant woman with gestational diabetes mellitus (GDM) and the occurrence of hypoglycemia in their newborns. Prospective cohort study of pregnant woman with GDM who were followed up from the second trimester of pregnancy in high-risk prenatal care until the immediate postpartum period. Dietary intake was assessed using 24-h recalls and analyzed according to the Nova Classification. The glycemic profile was assessed by self-monitoring of fasting and postprandial capillary glycemia (pregnant) and by capillary glycemia in the first 48 h of life (neonate). Multilevel binary logistic regression models were used to assess the relationship between increasing UPF intake, considering the highest tertile of UPF consumption, and women's glycemic control and the occurrence of neonatal hypoglycemia. UPFs provided 15% of calories consumed; 33.3% (n = 30) and 52.3% (n = 45) of the women had hyperglycemia in the second and third trimesters of pregnancy, respectively. After adjustment it was observed that UPF consumption had no significant association with maternal glycemic control but it showed a positive association with the occurrence of neonatal hypoglycemia (odds ratio [OR] 1.144, 95% confidence interval [CI] 1.037-1.262, p = 0.007). These data reinforce the need to address food processing during high-risk prenatal care in order to help reduce the negative impacts of UPF consumption on the mother-infant dyad.

Maternal organokines throughout pregnancy as predictors of neonatal anthropometric characteristics and adiposity.

To evaluate the relation between maternal concentrations of progranulin (PGRN), adipocyte fatty acid-binding protein (AFABP), brain-derived neurotrophic factor (BDNF), and fibroblast growth factor 21 (FGF21) throughout pregnancy with neonatal weight and length at birth and at one month of age, as well as with the percentage of fat mass at one month of age. Besides, we evaluated the association between maternal organokine concentrations with pregestational nutritional status and gestational weight gain (GWG). Longitudinal study of 100 healthy pregnant women and their neonates. Conventional biochemical tests were performed and maternal organokine concentrations were measured by ELISA. Neonatal percent fat mass was determined using the PEA POD system, and weight and length were measured using a soft tape measure and a baby scale. Multiple linear regression models were made to predict neonatal anthropometric measurements and adiposity. In all women, PGRN concentrations significantly increased as pregnancy progressed, while AFABP concentrations increased until the third trimester and the highest BDNF concentrations were observed in the second trimester of pregnancy. In contrast, FGF21 concentrations did not change during pregnancy. Only maternal obesity was associated with some differences in AFABP and FGF21 concentrations. Gestational age at birth, maternal age and third-trimester PGRN concentrations predicted weight (gestational age at birth: β=0.11; maternal age: β=-0.033; PGRN: β=0.003, p<0.001) and, together with first-trimester BDNF concentrations, length (gestational age at birth: β=0.76; maternal age: β=-0.21; PGRN: β=0.24; BDNF: β=0.06, p<0.001) at birth. Maternal age and third-trimester BDNF concentrations predicted one-month-old neonate length (maternal age: β=-1.03; BDNF: β=0.45, p<0.001). Pregestational body mass index (pBMI), GWG, second-trimester FGF21 concentrations, and third-trimester AFABP concentrations predicted neonatal fat mass percentage (pBMI: β=-0.58; GWG: β=-0.32; FGF21: β=-0.004; AFABP: β=-1.27, p<0.001) at one month of age. Maternal PGRN, AFABP, and BDNF concentrations, but not FGF21, vary throughout pregnancy. These organokines and maternal characteristics can be useful in the prediction of neonatal weight, length, and percentage fat mass.

Retroverted Uterus in the First Trimester and Associated Pregnancy Outcomes.

This study aimed to investigate if retroverted (RV) uterus noted on nuchal translucency (NT) ultrasound is associated with second-trimester pregnancy loss and other adverse pregnancy outcomes. This was a retrospective cohort study of patients with RV uterus documented on NT ultrasound at a single academic medical center from October 2019 to March 2023. Subjects were identified using a query for "retroverted" uterine position within an obstetric ultrasound imaging program. For each RV case, two anteverted (AV) subjects were selected for comparison. Patients with multiple gestation, Mullerian anomalies, or fetal aneuploidy were excluded. Maternal demographics, obstetric, and neonatal outcomes were obtained by chart review. Fisher's exact test and Mann-Whitney test were used for categorical and continuous variables, respectively, with p-value <0.05 denoting significance. Multivariable logistic regression was used to adjust for possible confounding variables. Analysis included 249 patients-83 RV and 166 AV. RV patients were more likely to identify as Caucasian (71.1 vs. 49.4%, p = 0.001), have private insurance (80.7 vs. 59.4%, p = 0.001), lower body mass index (25.4 ± 5.1 vs 29.1 ± 7.2, p < 0.001), and conceive by in vitro fertilization (IVF, 11 vs. 3%, p = 0.018). Most RV subjects (98%) had a resolution of retroversion by the second trimester. There was no difference in second-trimester pregnancy loss (0 vs. 1.2%, p = 0.55). After adjusting for race and IVF, RV subjects were four times more likely to have first-trimester vaginal bleeding (16.9 vs. 4.2%, odds ratio = 4.1, p = 0.0056). No other differences in adverse outcomes were observed. Persistent RV uterus in the first trimester is associated with increased risk of first-trimester vaginal bleeding. However, rates of pregnancy loss were similar between groups, providing valuable information for patient counseling. Significantly more RV subjects conceived by IVF, highlighting the need for further study in this population. · Pregnancy outcomes of patients with retroverted uterus have not been widely studied.. · Significantly more patients with a retroverted uterus conceived by in vitro fertilization.. · Patients with retroverted uterus were four times more likely to have first-trimester bleeding.. · Despite increased rates of vaginal bleeding, there was no increased rate of pregnancy loss..

Postpartum maternal and infant haematological effects of second-trimester ferric carboxymaltose versus standard-of-care oral iron in Malawi: longitudinal follow-up of a randomised controlled trial

Anaemia is common in mothers and infants in the first year postpartum, especially in sub-Saharan Africa. We evaluated whether treating anaemia in the second trimester of pregnancy with a single dose of intravenous iron, ferric carboxymaltose, compared with standard-of-care oral iron could alleviate anaemia in postpartum women and their infants. REVAMP (ACTRN12618001268235), an open-label, individually randomised, controlled trial done across nine urban and five rural health centres in Malawi, recruited women if they were in the second trimester of singleton pregnancy, had a capillary haemoglobin concentration of less than 10·0 g/dL, and had a negative malaria rapid diagnostic test. Once enrolled, women were randomly assigned (1:1) to receive intravenous ferric carboxymaltose (20 mg/kg up to 1000 mg) or standard of care (60 mg oral elemental iron twice daily for 90 days); all women received preventive malaria treatment. The primary endpoint of REVAMP was anaemia prevalence at 36 weeks of gestation, with follow-up of mothers and infants until 1 month postpartum. In REVAMP-EXTENDED, women from REVAMP who gave consent, and their infants, were followed up at 3, 6, 9, and 12 months postpartum, and venous blood was collected for haemoglobin, ferritin, and C-reactive protein measurement. Maternal postpartum outcomes comprised prevalence of anaemia (venous haemoglobin concentration <11 g/dL up to and including delivery and <12·0 g/dL postpartum) and haemoglobin concentration, as well as iron status (iron deficiency, defined as serum ferritin <15 μg/L, or <30 μg/L if C-reactive protein >5 mg/L, and iron deficiency anaemia [both iron deficiency and anaemia]). Infant outcomes comprised cord ferritin concentration, and haemoglobin and ferritin concentrations at 1, 3, 6, 9, and 12 months of age. Between Nov 12, 2018, and March 2, 2021, 862 women were randomly assigned in REVAMP, of whom 793 (393 in the ferric carboxymaltose group [376 liveborn infants] and 400 [379 liveborn infants] in the standard-of-care group) provided consent for REVAMP-EXTENDED. At 12 months postpartum, ferritin concentrations were higher (geometric mean ratio 1·47 [95% CI 1·29-1·66], p<0·0001), and prevalence of iron deficiency was lower (prevalence ratio 0·65 [0·48-0·88], p=0·0050), in mothers receiving ferric carboxymaltose than in those receiving standard of care. Anaemia was less common in women who received ferric carboxymaltose than in those who received standard of care at 1 month (prevalence ratio 0·84 [95% CI 0·71-0·98], p=0·027), 3 months (0·75 [0·62-0·91], p=0·0029), and 6 months (0·78 [0·63-0·96], p=0·018) postpartum but not thereafter. There was no evidence of a difference between groups regarding cord ferritin, infant ferritin, or infant haemoglobin concentrations at any timepoint. Benefits on postpartum anaemia were restricted to mothers with baseline iron deficiency. Ferric carboxymaltose treatment in the second trimester protected women from postpartum anaemia and iron deficiency but did not affect infant haematological or iron status. Bill & Melinda Gates Foundation. For the Chichewa translation of the abstract see Supplementary Materials section.

Maternal and Neonatal Outcomes Based on Changes in Glycosylated Hemoglobin Levels During First and Second Trimesters of Pregnancy in Women with Pregestational Diabetes: Multicenter, Retrospective Cohort Study in South Korea.

This study compared glycosylated hemoglobin (HbA1c) levels in the first and second trimesters of pregnancy and assessed maternal and neonatal outcomes according to HbA1c variations among women with pregestational diabetes. This retrospective, multicenter Korean study involved mothers with diabetes who had given birth in 17 hospitals. A total of 292 women were divided into three groups based on HbA1c levels during the first and second trimesters: women with HbA1c levels maintained at <6.5% (well-controlled [WC] group); women with HbA1c ≥ 6.5% (poorly-controlled [PC] group); and women with HbA1c ≥ 6.5% in the first trimester but <6.5% in the second trimester (improved-control [IC] group). The PC group had the highest pregnancy-associated hypertension (PAH) incidence, while the incidence did not significantly differ between the WC and IC groups. The receiver operating characteristic (ROC) curve indicated that HbA1c in the second trimester could predict PAH with a cut-off value of 5.7%. The PC versus WC versus IC group showed statistically significantly higher neonatal birthweight and significantly higher rates of large for gestational age (LGA); however, those were not significantly different between the WC and IC groups. HbA1c levels in the second trimester could predict LGA, with a cut-off value of 5.4%. Therefore, the second trimester HbA1c levels were significantly associated with both maternal and neonatal outcomes.