Neonatal Weight Research Articles

Comparative study on gene expression profiles in the liver of male neonatal mice prenatally exposed to PFOA and its alternative HFPO-DA.

Hexafluoropropylene oxide dimer acid (HFPO-DA), which belongs to the class of perfluoroalkyl ether carboxylic acid (PFECA), is a new alternative to perfluorooctanoic acid (PFOA). However, whether HFPO-DA is a safer alternative to PFOA in neonates remains unclear. In this study, we evaluated neonatal hepatic toxicity on postnatal days 9-10 by orally exposing pregnant CD-1 mice to 0.3 or 3.0mg/kg/day (low or high doses) of HFPO-DA or PFOA from gestation days 15 to 17. The results showed that exposure of pregnant mice to HFPO-DA and PFOA induced similar phenotypic effects, including significant decreases in neonatal body weight (BW) and significant increases in liver weight relative to BW in the high-dose. Notably, HFPO-DA exposure significantly decreased in neonatal BW in the low-dose group, whereas PFOA did not. Comprehensive gene expression analysis revealed significant alterations in 408 and 1402 differentially expressed genes (DEGs) in the liver of neonates from the low- and high-dose HFPO-DA groups, respectively, while PFOA significantly altered 0 and 292 DEGs in the corresponding groups. Gene set enrichment analysis indicated that the DEGs induced by HFPO-DA and PFOA were enriched in pathway related to "PPAR signaling", "fatty acid metabolism", and "biological oxidations". In addition, transactivation assays revealed that mouse (m)PPARα and mPPARγ activity of HFPO-DA exceeds that of PFOA and molecular docking simulations analysis predicted that the binding conformation differ between PFOA and HFPO-DA. Overall, our findings demonstrate that HFPO-DA consistently affected neonatal phenotypes, liver gene expression and the molecular initiating events involving PPARα/γ, at lower concentrations than PFOA.

Impacts of Lifestyle Intervention by a Nurse-Led Smartphone Application on Blood Pressure, Weight, and Pregnancy Outcomes in Pregnant Women With Gestational Hypertension: A Randomized Controlled Trial.

High blood pressure and excess weight during pregnancy can have adverse outcomes. This randomized controlled trial evaluated the effects of a nurse-led smartphone application-based lifestyle intervention on blood pressure, body weight, and pregnancy outcomes in pregnant women with gestational hypertension between August and December 2023. Pregnant women, between 20 and 28 weeks of gestation, were allocated to the intervention or control group. Control group (n = 99) received standard high-risk pregnancy management, while intervention group (n = 96) also received lifestyle guidance via a nurse-led smartphone application. Intervention group experienced longer gestations (p = 0.007), higher neonatal weights (p = 0.028), and lower incidences of pre-eclampsia (p < 0.001), small for gestational age infants (p = 0.003), and preterm births (p = 0.023) compared to control group. The mixed-effect models for repeated measures showed that the nurse-led smartphone application intervention had no impact on body mass index, while significantly reducing systolic and diastolic blood pressure measurements (β = -1.666, 95% confidence interval, CI: -2.814 to -0.519, p = 0.005 and β = -2.247, 95% CI: -3.349 to -1.145, p < 0.001, respectively). Both systolic and diastolic blood pressures showed a downward trend from 28 weeks (p < 0.05). The nurse-led smartphone application-based lifestyle intervention significantly reduced adverse pregnancy outcomes and positively influenced blood pressure management in pregnant women with gestational hypertension.

Balloon atrioseptostomy for transposition of the great arteries in Europe: characteristics and outcomes.

Balloon atrial septostomy (BAS) improves oxygenation in neonates with transposition of the great arteries (TGA) and restrictive foramen ovale. Currently, there is a global shortage of dedicated BAS catheters, while new unmarked catheters have recently become available at some European centers. This study aimed to characterize BAS outcomes using the currently available BAS catheters in Europe. A 2-year multicenter observational registry was conducted, including all neonates undergoing BAS for TGA. We report preliminary results (September 2022-February 2024) focusing on BAS characteristics and outcomes. A total of 250 BAS procedures were performed in 29 centers. The median neonatal weight was 3.16 kg, and 88% of neonates had a prenatal diagnosis. Most procedures were performed often on the first day of life during working hours (72.8%), mainly in catheterization laboratories (59.2%). Guidance primarily involved ultrasound with or without fluoroscopy. A guidewire was used in 41.2% of procedures. A total of 290 catheters (286 Z-5 or Z-6) were used, achieving an overall BAS success rate of 96%. Complete procedural failure was associated with the use of the umbilical venous route (OR, 3.62; P = .001) and lower-volume catheters (OR, 7.01; P < .001). The occurrence of significant complications (8%; OR, 9.33; P < .001) was associated with complete procedural failure. For complex procedures, significant risk factors were the absence of fluoroscopy (OR, 3.32; P = .001), use of the umbilical venous route (OR, 2.28; P = .005), and lower-volume catheters (OR, 2.43; P = .03). In the current era, BAS can be challenging, and significant complications and complete failures are not uncommon. The use of the umbilical venous route, low-volume BAS catheters, absence of fluoroscopy guidance, and the occurrence of complications negatively impact procedural outcomes.

Pregnancy Complications and Outcomes in Obese Women with Gestational Diabetes.

Background and Objectives: To assess pregnancy and delivery complications in obese women with gestational diabetes mellitus (GDM) and neonatal weight and condition after birth. Materials and Methods: A retrospective tertiary referral centre study included all cases of GDM in the Department of Obstetrics and Gynaecology of the Lithuanian University of Health Sciences (LUHS) Birth Registry from 1 January 2019 to 31 December 2019. We included 583 women with GDM and singleton pregnancies. Women were divided into two groups according to their pre-pregnancy weight: 202 were obese (BMI ≥ 30 kg/m2), and 381 were weight (BMI 18.5-24.9 kg/m2). Survey data were analysed using IBM SPSS Statistics 26.0 and MS Excel 2016 software. A value of p < 0.05 was considered significant. Results: Fasting glycaemia was significantly higher in obese women with GDM than in normal-weight women with GDM (p < 0.001). In addition, fasting glycaemia was higher in obese women with GDM requiring insulin correction than in normal-weight women (p = 0.006). OGTT 0-min glycaemia was higher in obese than in non-obese women with gestational diabetes (p < 0.001). Women with pre-pregnancy obesity had a higher incidence of primary hypertension (p < 0.001), hypertensive disorders in pregnancy (p < 0.001), gestational cholestasis (p = 0.002), polyhydramnios (p < 0.001), induced labour (p < 0.001), and caesarean section (p = 0.015), with emergency caesarean sections being more frequent than planned caesarean sections (p = 0.011) compared to normal-weight women with GDM. Labour dystocia (p = 0.003) and foetal distress (p = 0,019) were more common during labour in obese women. Neonates of these women more often had macrosomia (p < 0.001) and lower Apgar scores at 1 min (p = 0.024) and at 5 min (p = 0.024) compared to neonates of normal-weight women. Conclusions: Obese women with GDM experience more pregnancy complications than normal-weight women with GDM.

Maternal circadian rhythms during pregnancy dictate metabolic plasticity in offspring.

Tissue-level oscillation is achieved by tissue-intrinsic clocks along with network-dependent signals originating from distal organs and organismal behavior. Yet, it remains unexplored whether maternal circadian rhythms during pregnancy influence fetal rhythms and impact long-term susceptibility to dietary challenges in offspring. Here, we demonstrate that circadian disruption during pregnancy decreased placental and neonatal weight yet retained transcriptional and structural maturation. Intriguingly, diet-induced obesity was exacerbated in parallel with arrhythmic feeding behavior, hypothalamic leptin resistance, and hepatic circadian reprogramming in offspring of chronodisrupted mothers. In utero circadian desynchrony altered the phase-relationship between the mother and fetus and impacted placental efficiency. Temporal feeding restriction in offspring failed to fully prevent obesity, whereas the circadian alignment of caloric restriction with the onset of the active phase virtually ameliorated the phenotype. Thus, maternal circadian rhythms during pregnancy confer adaptive properties to metabolic functions in offspring and provide insights into the developmental origins of health and disease.

Sonographic assessment of umbilical cord diameter as an indicator of fetal growth and perinatal outcome

Background The umbilical cord represents a physiological and genetic part of the fetus, containing two arteries and one vein buried in a special mucous connective tissue type, namely Wharton’s jelly. Aim The umbilical cord diameter (UCD) will be assessed using ultrasound as an indicator of fetal growth and perinatal outcomes. Patients and methods This cross-sectional study involved 150 females with a gestational age (GA) of 20–27 weeks, reliable dates of last menstrual period, singleton pregnancy, and living fetus. All participants underwent comprehensive medical history taking, and clinical and ultrasound assessments. Results There was a positive correlation between UCD at first visit (20–27 weeks) and delivery (38–40 weeks) and (GA, femur length, biparietal diameter, head circumference and estimated fetal weight) and appearance, pulse, grimace, activity, and respiration (APGAR) score at 1 and 5 min. There was a significant relationship between UCD at the first visit and delivery and intrauterine growth restriction (IUGR) cases. There was a highly significant difference between IUGR in neonatal intensive care unit admission and delivery weight, APGAR 1 min, and APGAR 5 min. There was a statistically insignificant difference between IUGR and GA at delivery. Conclusion The UCD exhibited a substantial fetal growth restriction predictor when implemented during antenatal care visits. A replication and broader research of umbilical cord morphometry is required. This research might be beneficial in validating a strategy for detecting a specific group of individuals who are at risk of intrauterine fetal demise or an unfavorable fetal outcome.

Effects of thalassemia minor on umbilical artery blood flow and perinatal outcomes in pregnancy: A retrospective cohort study.

The aim of the present study was to compare the fetal umbilical artery blood flow parameters in the third trimester and perinatal outcomes between pregnant women with and without thalassemia minorin South China. This was a retrospective cohort study. Doppler ultrasound was used to detect fetal umbilical artery hemodynamics in pregnant women with or without thalassemia minor during the third trimester. The main parameters assessed were umbilical artery peak systolic flow velocity/end-diastolic flow velocity (S/D), resistance index (RI), pulsation index (PI), and relevant perinatal outcomes. This study included 540 pregnant women, 180 with thalassemia minor and 360 being healthy controls. In the third trimester, the thalassemia minor group had higher umbilical artery S/D (P = 0.002), RI (P = 0.002), and PI (P = 0.012) than healthy pregnant women, as well as lower levels of hemoglobin (Hb) (P < 0.001) and higher ferritin levels (P < 0.001). Compared to the non-thalassemia group, neonatal body weight in the thalassemia minor group was significantly lower (P = 0.001). Additionally, the incidence of maternal anemia (odds ratio [OR] 3.92; 95% confidence interval [CI]: 2.57-5.99, P < 0.001), low birth weight (OR 15.35; 95% CI: 1.71-137.93, P = 0.015), fetal distress (OR 2.18; 95% CI: 1.12-4.26, P = 0.023), neonatal asphyxia (OR 12.81; 95% CI: 1.40-117.33, P = 0.024), oligohydramnios (OR 18.25; 95% CI: 2.21-150.36, P = 0.007) and Apgar score <7 at 1 min after birth (OR 7.97; 95% CI: 1.53-41.54, P = 0.014) was significantly higher in the thalassemia minor group. Pregnant women with thalassemia minor have higher umbilical artery S/D, RI and PI during the third trimester and a higher risk of adverse perinatal outcomes.

Models for predicting vaginal birth after cesarean section: scoping review

BackgroundWomen who are pregnant again after a prior cesarean section are faced with the choice between a vaginal trial and another cesarean section. Vaginal delivery is safer for mothers and babies, but face the risk of trial labor failure. Predictive models can evaluate the success rate of vaginal trial labor after cesarean section, which will help obstetricians and pregnant women choose the appropriate delivery method.ObjectiveTo review the existing prediction models of vaginal delivery after cesaean.MethodsSeven databases, including CNKI, Wanfang Data, Chinese Science and Technology Periodical Database, China Biomedical Literature Database, PubMed, Embase, and Web of Science, were searched for studies on the predictive model of VBAC from inception to July 20, 2022. Two researchers independently screened the literature and extracted the data. The risk of bias and applicability of the included researches was evaluated using the Prediction model Risk of Bias Assessment Tool.ResultsTwenty-six studies that covered 26 models were included. The overall property of the included models was good, but validation of the included models was insufficient. The methodological quality of the included studies was generally low, with 3 studies rated as having a low risk of bias and 23 studies rated as having a high risk of bias. The main predictors in the models were the Bishop score, history of vaginal delivery, neonatal weight, maternal age, and BMI.ConclusionsAlthough a variety of prediction models have been developed globally, the methodology of these studies has limitations and the models have not been adequately validated. In the future, more prospective and high-quality research is needed to develop visual models to serve clinical work more effectively and conveniently. Obstetricians or midwives could use predictive models to help a woman choose the right delivery method.

Role of Metformin in Reducing the Incidence of Gestational Diabetes Mellitus in Obese Women

Objective: To evaluate whether metformin administration reduces the incidence of gestational diabetes mellitus in obese women and to examine its impact on the incidence of preeclampsia, birth weight, and the APGAR scores of newborns. Methods: This experimental study was done at Shalamar Hospital, affiliated with Shalamar Medical &amp; Dental College, Lahore, Pakistan, from May1st 2022 to June 30, 2024. A total of 150 women with a BMI ≥ 30kg/m2, aged 18-40 years, between 11 to 14 weeks pregnant, were included. Those with contraindications to metformin, pre-existing diabetes, or any co-morbid medical disorder were excluded. The participants were divided into two groups with 75 in each: Group A the control group with only standard care. and Group B receiving metformin 250mg three times daily orally in addition to standard care. The oral glucose tolerance test was performed between 24 to 28 weeks and later at 32 weeks. The participants were followed till delivery to record preeclampsia, neonatal birth weight, and APGAR score. Results: The mean age, gestational age, and BMI were similar between Group A (32.37 years, 11.37 weeks, 32.37 kg/m²) and Group B (31.35 years, 11.27 weeks, 32.3 kg/m²). The incidence of GDM (10% vs. 42%) and preeclampsia (13% vs. 74%) was significantly lower in the metformin group (p = 0.000). However, no significant differences were observed in birth weights or APGAR scores. Conclusion: Metformin reduces the incidence of GDM and preeclampsia in obese women when started at 11 to 14 weeks of gestation, without affecting birth weight and APGAR score of neonates.

Systematic review and Meta-analysis of the impact of the re-freezing and re- biopsy embryos on reproductive outcomes in patients undergoing freeze-thaw embryo transfer.

During FET cycles in IVF/ICSI patients (including PGT patients), transfer of embryos that have been thawed may be abandoned for medical or personal reasons, resulting in the need to refreeze embryos. Typically, embryos from patients undergoing preimplantation genetic testing (PGT) are cryopreserved after biopsy, pending test results. However, in the absence of a clear result, another biopsy is required and the embryo is frozen again to await the results for future use. To explore whether refreezing and re-biopsy affect reproductive outcomes DATA SOURCES: Computer search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP databases and searched until May, 2023. STATA/MP software was utilized for conducting data analysis. Dichotomous outcome data were pooled to calculate odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Continuous outcome data were combined using an inverse variance model to determine the mean difference (MD) between the two groups. Random-effects and fixed-effects meta-analysis models were employed to assess heterogeneity. Subgroup analysis was conducted based on different freezing methods and various embryo types. The primary outcome measure was the live birthrate, with secondary indicators including clinical pregnancy rate, implantation rate, miscarriage rate, ectopic pregnancy, preterm delivery, average birth weight of neonates, and neonatal malformation. This study included 19 retrospective studies with a total of 11,024 FET cycles. Across the FET cycles, re-cryopreservation, compared to once-cryopreservation demonstrated reduced live birthrates (OR=0.79; 95% CI: 0.60 to 0.92; I2=21.7%, P=0.000), reduced clinical pregnancy rates (OR=0.74; 95% CI: 0.60 to 0.92, I2=56.9%, P=0.006), and increased miscarriage rates (OR=1.27; 95% CI: 1.03 to 1.55, I2=37.1%, P=0.024). Pregnancy outcomes following re-biopsies, revealing significantly lower live birth rates after re-biopsies compared with single biopsy (OR = 0.65; 95%CI: 0.45 to 0.94, I2=43.5%; P=0.024). Similarly, re-biopsies were associated with reduced clinical pregnancy rates (OR = 0.75; 95%CI: 0.54 to 1.03, I2=29.6%) and increased miscarriage rates (OR= 1.54; 95%CI: 0.89 to 2.66, I2=13.0%) compared to single-biopsy. Re-frozen embryos compared to once-frozen embryos suggests a decrease in live birth rates and clinical pregnancy rates, coupled with an increase in miscarriage rates, with negligible influence on neonatal outcomes. Similarly, re-biopsy yields comparable results, leading to a reduction in live birth rates.

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.

Correlation between optimal PICC insertion depth and neonatal weight: A regression model approach

Correlation between optimal PICC insertion depth and neonatal weight: A regression model approach

Melatonin Attenuates PFOS-Induced Reproductive Toxicity of Pregnant Mice due to Placental Damage Via Antioxidant, Anti-Aging and Anti-Inflammatory Pathways.

Perfluorooctane sulfonate (PFOS), an industrially synthesized persistent organic pollutant (POP), is intricately intertwined with human production and daily life. It has been discovered that PFOS is related to an elevated incidence of birth defects in fetuses. In contrast, melatonin (MLT), a hormone secreted by the pineal gland, has been demonstrated to exert a protective effect on reproductive development. This paper investigates the protective effect of MLT against PFOS-induced reproductive toxicity by simultaneously orally administering MLT to pregnant mice exposed to PFOS. The therapeutic effect was evaluated through the monitoring of pregnancy outcomes, histological changes in the placenta, apoptosis and proliferation of placental spongiotrophoblast, as well as the expression of antioxidant enzyme genes, anti-aging genes, anti-inflammatory genes and other relevant genes. The results of the study demonstrated that MLT treatment reversed the adverse pregnancy outcomes caused by toxic PFOS, including a low number of implanted fetuses, low neonatal fetal weight, and an increased number of resorbed fetuses. MLT treatment decreased the levels of MDA, an oxidation product generated by PFOS in the placenta of pregnant mice, and increased the levels of the antioxidant enzyme SOD. Additionally, MLT was able to maintain the normalization of placental structure, reduce apoptosis and sustain the proliferation of placental spongiotrophoblast by upregulating the expression of antioxidant genes (Nrf2, CAT) and anti-aging gene (Klotho), anti-inflammatory gene (Hsd11b2), thereby counteracting the oxidative stress caused by PFOS in the placenta, moreover, it also reduced the expression of inflammatory genes (Pycard) in the placenta. The findings firmly establish the effectiveness of MLT in mitigating the harmful impacts of tainted PFOS on reproductive development during pregnancy. This provides a novel therapeutic approach for addressing PFOS-induced birth defects in fetuses.

A simplified pre-conceptional laparoscopic cervical cerclage for cervical insufficiency: a retrospective study from a single center

BackgroundCervical insufficiency is a pathological condition in obstetrics in which the cervix fails to retain the fetus before uterine contractions or labor (painless cervical dilatation). Patients usually have fetal loss in the mid-trimester or spontaneous pre-term birth due to painless cervical dilation. For non-pregnant women with cervical insufficiency, prophylactic laparoscopic abdominal cerclage (LAC) has been reported to improve pregnancy outcomes, such as live birth, neonatal survival, and full-term delivery rate. Conventional LAC involves opening the vesicular space and separating the anterior broad ligament leaves. In our surgical procedure, these two steps were omitted.MethodsAn observational study was conducted retrospectively on patients who underwent a simplified pre-conceptional LAC between January 2015 and December 2022 at West China Second University Hospital, Sichuan University. Follow-ups for all the patients ended at the delivery of the fetus. Subsequently, clinical characteristics, perioperative data, and obstetric outcomes were recorded and analyzed.ResultsIn total, 108 patients were included in a pre-conception LAC group Mean operation time was 56.8 ± 22.8 min, and mean estimated blood loss was 21.4 ± 23.6 mL. Only one case of urinary retention was classified as a grade I postoperative complication, according to the Clavien–Dindo classification. No severe complications or sequelae were observed during the perioperative period. Obstetric outcomes from 98 patients were collected: three patients had miscarriages, and 95 had live births. Of the 95 live births, 4 were twins and 91 were singletons. Two patients had vaginal delivery, and 93 underwent Cesarean section; mean neonatal weight was 3310.2 ± 382.1 g.ConclusionA simplified pre-conceptional LAC is a simple, safe, and effective method for women with cervical insufficiency. Thus, it is worthy of promotion to assist women with cervical insufficiency in achieving improved obstetric outcomes. Vaginal delivery after LAC is possible once the tape is removed before labor.

Microvascular-Flow Imaging for Assessing Placental Blood Perfusion in the First-Trimester of Pregnancy during the Omicron Epidemic: Correlation with Pregnancy Outcomes

Background: Microvascular-flow (MV-Flow) imaging (Samsung Medison Co., Ltd., Seoul, Korea) was utilized to assess placental perfusion in the first-trimester of pregnancy during the Omicron epidemic. The correlation between placental vascular index with microvascular flow (VIMV) and uterine artery (UtA) Doppler parameters, as well as pregnancy outcomes, was examined. Methods: A total of 37 pregnant women who underwent early fetal screening ultrasound examinations at the First Affiliated Hospital of Zhejiang University School of Medicine from December 2022 to February 2023 were analyzed. Among them, 30 were infected with coronavirus disease 2019 (COVID-19) and 16 were delivered, while 7 were not infected. General information about the pregnant women, including age, gestational age, nuchal translucency (NT), maternal history, and placental location, was collected. MV-Flow technology was used to measure VIMV. Simultaneously, the systolic/diastolic (S/D) maximum blood flow velocity, resistance index (RI), and pulsatile index (PI) were measured. The differences in the ultrasound parameters mentioned above were compared among the various groups. The infection group was further categorized into good pregnancy outcome and adverse pregnancy outcome groups based on pregnancy results. The general data and ultrasound parameters of the adverse pregnancy outcome group were then compared and analyzed. Results: There were no statistically significant differences between the infection group and the normal group in terms of age, gestational age, parity, gestational number, placental position, placental thickness, and other factors (p &gt; 0.05). The VIMV values obtained by elliptical, rectangular, and manual tracing methods at the same placental level in the MV-Flow mode showed no statistically significant differences (p &gt; 0.05). Except for PI of right UtA, The VIMV values and the S/D, PI, and RI of UtA were not significantly different between the infection group and the normal group (p &gt; 0.05). Within the infection group, no significant differences were observed in VIMV value, placental thickness, S/D ratio, PI, RI of UtA, or neonatal weight between the adverse pregnancy outcome good pregnancy outcome group (p &gt; 0.05). Conclusions: MV-Flow technology can quantitatively evaluate placental microvascular perfusion, and the VIMV is not influenced by the tracing method, making it a reliable indicator for monitoring the intrauterine status of the fetus. No significant differences in VIMV values were observed between the infection group and the normal group. The findings suggest that early infection with the Omicron variant does not impact placental blood perfusion. Infection with the Omicron variant during the first-trimester of pregnancy does not increase the risk of adverse pregnancy outcomes for the fetus. However, further studies are needed to reach a definitive conclusion on this topic.

Implementation of a crash cesarean section policy and its impact on maternal and neonatal outcomes at King Abdulaziz University Hospital: A retrospective study.

A typical surgical technique for pregnant women with potentially fatal problems affecting the mother or fetus is an emergency cesarean section (ECS). The decision-to-delivery interval (DDI) for ECS should be within 30 minutes. The objective of this study was to investigate crash ECS indications and effects on maternal and neonatal outcomes. In this retrospective study, all women undergoing crash cesarean section (CS) at Obstetrics and Gynecology department at King Abdulaziz University hospital, Jeddah, Saudi Arabia during 2022 and 2023 were evaluated. Data about demographic and obstetric characteristics of mother, ECS indications, DDI, and outcomes for mothers and newborns was gathered from the patient's sheet. One hundred 3 crash CS were performed during study period. Crash CS indications were fetal bradycardia (64.1%), prolapsed cord (24.3%), uterine rupture (6.8%), and severe antepartum hemorrhage (4.9%). D-D time range from 2 to 30 minutes. DDI was ≤15 minutes in 90 patients (87.4%) and >15 minutes in 13 patients (12.6%). Gestational age was <32 weeks (16.7%), between 32 and <37 weeks (15.5%), and ≥37 weeks (68.0%). Good maternal outcome was reported in 89 (86.4%), while 24 (13.6%) had complications. Intensive care unit maternal admission was significantly higher in gestational age 32 to <37 weeks versus <32 weeks and ≥37 weeks of gestation (18.8% vs 5.9% and 2.9%, P = .050). Fetal outcome was good in 69 (67.0%), while 34 (33.0%) had complications. Neonatal body weights, Apgar score at 1, 5, 10 minutes, and umbilical cord arterial pH were significantly decreased in preterm versus termed neonates (P < .0001, P < .0001, P < .0001, P = .014, and P = .003). Moreover, respiratory distress syndrome, jaundice, intubation, neonatal deaths, and sepsis were significantly higher in preterm versus term deliveries (P < .0001, P = .029, P < .0001, P = .010, and P = .031). Good neonatal outcome was significantly higher (P < .0001); while respiratory distress syndrome was significantly lower (P = .007) in deliveries with DDI ≤ 15 minutes versus > 15 minutes. The 30-minute standard for DDI time interval may be a feasible guideline at least for level-3 hospitals. Crash CS indication was mostly due to fetal bradycardia. The maternal and neonatal outcomes were better in term than preterm deliveries. The positive effect of very short intervals on neonatal outcome still needs to be proven.

Spectrum of Disease and Outcome in Neonates admitted in NICU in Federal Government Polyclinic (FGPC), Islamabad According to ICD-11

Objective: To determine the spectrum of diseases and outcome of neonates admitted in NICU of Federal Government Polyclinic (PGMI), according to ICD-11. Methodology: This cross-sectional retrospective study was conducted in neonatal intensive care unit of Federal Government Polyclinic (FGPC), Islamabad for a period of 12 months from 1st January 2022 to 31st December 2022 and included 894 neonates inborn and outpatient admitted in the study period. Demographic and clinical data about neonates (age, gender, weight, disease and outcome) was collected from hospital records and was analyzed by SPSS version 23 and tabulated according to the international classification of diseases 11(ICD-11) of WHO. Results: During the study period 894 neonates were admitted.795(88.9%) were discharged, 83(9.3%) neonates expired.538(60.2%) were males and 354(39.6%) were females. The common causes of admission in NICU were disorders related to length of gestation or fetal growth263(29.4%), respiratory disorders 243(27.2%), infections of newborn231(25.8%) and hemorrhagic or hematological disorders 59(6.65). The common causes of mortality in NICU were disorders related to length of gestation or fetal growth48(5.4%), respiratory disorders 16(1.8%), infections of newborn 11(1.2%) and developmental anomalies5(0.6%). Conclusion: Disorders related to length of gestation or fetal growth, respiratory disorders and infections of new born are the common causes of admission and mortality in the NICU. The morbidity and mortality data should be presented by International classification of diseases so that there is a uniform language internationally, helping in identifying and analyzing health trends and in turn reducing morbidity and mortality of neonates.

Alterations in maternal–fetal gut and amniotic fluid microbiota associated with fetal growth restriction

BackgroundFetal growth restriction (FGR) is typically characterised as the fetus’ inability to reach its inherent growth potential. A growing body of evidence points to the important role of the maternal gut microbiota in FGR development. However, comprehensive research on changes in maternal–fetal gut and intrauterine microbiota related to FGR is lacking.MethodsIn this case–control study, we sequenced bacterial 16S rRNA from 35 maternal faecal, 35 meconium, and 31 amniotic fluid samples collected from 19 pregnant women diagnosed with FGR and 16 healthy controls. We identified putative bacterial taxonomic and functional characteristics associated with FGR by comparing these to control samples.ResultsWe identified 34 differential operational taxonomic units (OTUs) in amniotic fluid, seven differential OTUs in maternal faecal matter, and two differential OTUs in meconium. Compared to controls, FGR subjects exhibited enriched bacterial OTUs of the genus Bacteroides in the maternal gut. They also had depleted OTUs of the order Enterobacterales and genus Pseudomonas in the amniotic fluid and genus Stenotrophomonas in the fetal gut. These altered bacterial OTUs showed a significant correlation with neonatal weight and fetal ultrasonographic indexes. Additionally, we identified differential microbial functional pathways related to glycan and lipid metabolism in the maternal gut. We developed diagnostic biomarkers for FGR based on the maternal–fetal gut and amniotic fluid microbiota.ConclusionsThis study offers a comprehensive overview of the shifts in microbial composition and functional pathways in the maternal–fetal gut and amniotic fluid microbiota related to FGR, and present novel insights into the development and screening of FGR. However, the assessment of contamination’s impact on meconium and amniotic fluid remains inconclusive, necessitating further rigorous experimentation to address this scientific inquiry in future studies.

Comparison of Coconut and Sunflower Seed Oils in Improving the Skin Integrity and Weight Gain of Infants in the Neonatal ICU.

To determine the effects of sunflower seed oil and coconut oil on the skin integrity and weight gain of preterm infants in the neonatal ICU. In this randomized controlled trial, 66 preterm neonates (34-37 weeks' gestation) in the neonatal ICU of a training and research hospital were equally divided into three groups: sunflower seed oil, coconut oil, and control. The weights of neonates in all three groups were measured at admission to the neonatal ICU, at discharge, and at 1 month postdischarge. Their skin conditions were evaluated using the Neonatal Skin Condition Score and the Revised Northampton Neonatal Skin Assessment Tool at the same three time points. At 1 month postdischarge, neonates in the sunflower seed oil and coconut oil groups weighed significantly more than those in the control group (P = .004). Mean Neonatal Skin Condition Score scores were significantly higher in the control group at 1 month postdischarge than in the sunflower seed oil and coconut oil groups (P = .000). Skin care with coconut oil and sunflower seed oil was effective in maintaining the skin integrity and weight of neonates at 1 month postdischarge. The authors recommend that randomized controlled trials on skin care in preterm infants using sunflower, coconut, and other oils be conducted with larger sample sizes.

Factors Predicting Fetal Growth Restriction and Fetal Cardiac Remodeling.

This study aimed to investigate factors influencing fetal growth restriction (FGR) occurrence and assess the clinical significance of fetal cardiac parameters in FGR prediction. Pregnant women with clinically suspected FGR (n=179) and uncomplicated pregnancies (n=53) were included. All had undergone routine obstetric ultrasonography and fetal echocardiography. Umbilical artery flow (UAF) and fetal cardiac parameters (left atrial transverse diameter (LAd), right atrial transverse diameter (RAd), left ventricular transverse diameter (LVd), right ventricular transverse diameter (RVd), foramen ovale width, atrial septum diameter, interventricular septal thickness, left ventricular posterior wall thickness, right ventricular free wall thickness, aortic diameter, pulmonary artery diameter, mitral E velocity, mitral A velocity, tricuspid E velocity, tricuspid A velocity, aortic valve peak flow velocity, and pulmonary valve peak flow velocity) were detected. Follow up was conducted until birth, various fetal clinical parameters were collected: maternal body mass index (BMI), hypertensive disorders complicating pregnancy (HDCP), abnormal umbilical artery flow, placental or umbilical cord anomalies, low amniotic fluid volume, preterm birth, emergency cesarean delivery, maternal height, maternal age, gestational diabetes mellitus (GDM), hypothyroidism, assisted reproductive technology (ART), parity, and neonatal gender. Participants were categorized into confirmed FGR (n=119) and control (n=113) groups based on neonatal birth weight. Significant differences were observed between groups in maternal BMI, HDCP, abnormal UAF, placental or umbilical cord anomalies, low amniotic fluid volume, preterm birth, and emergency cesarean delivery. FGR was positively related to abnormal UAF, placental or umbilical cord anomalies, preterm birth and emergency cesarean delivery and negatively to maternal BMI (r=-0.276). Compared to the control group, the FGR group exhibited significantly larger RAd, RVd, RA/LA, and RV/LV. Fetal growth-restricted fetuses have enlarged right heart structures. Fetal cardiac examinations are valuable for early FGR diagnosis, potentially improving neonatal body weight and reducing adverse pregnancy outcomes.