Search

Background: Gestational weight gain (GWG) is a critical factor influencing maternal and fetal health. Excessive or insufficient GWG can lead to various complications, including gestational diabetes, hypertension, cesarean delivery, low birth weight, and preterm birth. This study aims to develop and evaluate machine learning models to predict GWG categories: below, within, or above recommended guidelines. Methods: We analyzed data from the Araraquara Cohort, Brazil, which comprised 1557 pregnant women with a gestational age of 19 weeks or less. Predictors included socioeconomic, demographic, lifestyle, morbidity, and anthropometric factors. Five machine learning algorithms (Random Forest, LightGBM, AdaBoost, CatBoost, and XGBoost) were employed for model development. The models were trained and evaluated using a multiclass classification approach. Model performance was assessed using metrics such as area under the ROC curve (AUC-ROC), F1 score and Matthew's correlation coefficient (MCC). Results: The outcomes were categorized as follows: GWG within recommendations (28.7%), GWG below (32.5%), and GWG above recommendations (38.7%). The XGBoost presented the best overall model, achieving an AUC-ROC of 0.79 for GWG within, 0.76 for GWG below, and 0.65 for GWG above. The LightGBM also performed well with an AUC-ROC of 0.79 for predicting GWG within recommendations, 0.76 for GWG below, and 0.624 for GWG above. The most important predictors of GWG were pre-gestational BMI, maternal age, glycemic profile, hemoglobin levels, and arm circumference. Conclusion: Machine learning models can effectively predict GWG categories, offering a valuable tool for early identification of at-risk pregnancies. This approach can enhance personalized prenatal care and interventions to promote optimal pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cardiovascular disease risk can exist in utero, influenced by maternal health factors. This study evaluates maternal characteristics and biochemical markers that correlate with the fetal intima–media thickness (IMT), aiming to identify interventions that could minimize prenatal influences on later cardiovascular disease. Methods: In this observational study approved by the Institutional Review Board at The Obstetrics and Gynecology Clinic of the Timisoara Municipal Emergency Hospital, we recruited pregnant women aged 15–40 years, divided into groups based on their lipid profiles and gestational diabetes risk. The data collection had, as its main focus, ultrasound measurements, along with demographic, clinical, and biochemical parameters. The IMT of the fetal abdominal aorta was measured at 28 weeks of gestation. Results: Notable differences were observed in the TNF-alpha levels (8.66 ± 3.87 pg/mL vs. 4.96 ± 3.37 pg/mL), hsCRP levels (0.94 ± 0.46 mg/L vs. 0.60 ± 0.52 mg/L), and the area under the curve (AUC) for hsCRP at 0.738 with a sensitivity of 84.41% and specificity of 79.01%. Compound score 2, integrating inflammatory markers and lipid profiles, exhibited a good diagnostic accuracy (AUC = 0.789) with a sensitivity of 86.35% and specificity of 81.42%. A regression analysis indicated strong associations of TNF-alpha and hsCRP with an increased fetal IMT, suggesting potential early markers of cardiovascular risk, presenting hazard ratios (HRs) of 2.21 (95% CI: 1.15–5.28) and 2.87 (95% CI: 1.11–4.23), respectively, both with p-values of less than 0.0001. Compound score 2 further indicated an increased risk (HR = 4.27; 95% CI: 1.19–8.32). Conclusions: Statistically significant correlations were found between an increased fetal IMT and elevated maternal inflammatory markers (TNF-alpha and hsCRP), suggesting that these could serve as early indicators of cardiovascular risk. This study supports the potential for targeted prenatal interventions to reduce cardiovascular risk factors from the fetal stage, emphasizing the importance of monitoring inflammatory markers in pregnant women at risk. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy (HDP), such as preeclampsia and eclampsia, present significant risks to maternal and fetal health. While immediate complications are well-documented, emerging research highlights potential neurocognitive impacts on both mothers and their offspring. This narrative review synthesizes evidence on these neurocognitive outcomes associated with HDP, focusing on preeclampsia and eclampsia. A literature search was conducted for studies published from 2000 to February 2024. Maternal outcomes, including memory, executive function, and psychosocial well-being, were assessed across 11 studies, while fetal and neonatal neurocognitive outcomes were explored in five studies. Consistent findings indicate that preeclampsia and eclampsia are linked to impairments in maternal cognitive functions and psychosocial health. Offspring exposed to these conditions in utero also show cognitive deficits and alterations in brain connectivity. Contributing factors include placental dysfunction, altered angiokine levels, maternal stress, and socioeconomic variables. To mitigate these impacts, future research should focus on clarifying the underlying mechanisms and developing early interventions. This review emphasizes the necessity of multidisciplinary approaches to improve neurocognitive outcomes for both mothers and their children affected by preeclampsia and eclampsia. [ABSTRACT FROM AUTHOR]

Copyright of Lege Artis Medicine (LAM) is the property of LifeTime Media Kft. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Modern management of preeclampsia can be optimized by tailoring the targeted treatment of hypertension to an individual's hemodynamic profile. Growing evidence suggests different phenotypes of preeclampsia, including those with a hyperdynamic profile and those complicated by uteroplacental insufficiency. Fetal growth restriction (FGR) is believed to be a result of uteroplacental insufficiency. There is a paucity of research examining the characteristics of patients with severe preeclampsia who do and who do not develop FGR. We aimed to elucidate which hemodynamic parameters differed between these two groups. Methods: All patients admitted to a single referral center with severe preeclampsia were identified. Patients were included if they had a live birth at 23 weeks of gestation or higher. Multiple gestations and pregnancies complicated by fetal congenital anomalies and/or HELLP syndrome were excluded. FGR was defined as a sonographic estimation of fetal weight (EFW) < 10th percentile or abdominal circumference (AC) < 10th percentile. Results: There were 76% significantly lower odds of overall pulse pressure upon admission for those with severe preeclampsia comorbid with FGR (aOR = 0.24, 95% CI = 0.07–0.83). Advanced gestational age on admission was associated with lower odds of severely abnormal labs and severely elevated diastolic blood pressure in preeclampsia also complicated by FGR. Conclusions: Subtypes of preeclampsia with and without FGR may be hemodynamically evaluated by assessing pulse pressure on admission. [ABSTRACT FROM AUTHOR]

Fetal health care is vital in ensuring the health of pregnant women and the fetus. Regular check-ups need to be taken by the mother to determine the status of the fetus' growth and identify any potential problems. To know the status of the fetus, doctors monitor blood reports, Ultrasounds, cardiotocography (CTG) data, etc. Still, in this research, we have considered CTG data, which provides information on heart rate and uterine contractions during pregnancy. Several researchers have proposed various methods for classifying the status of fetus growth. Manual processing of CTG data is time-consuming and unreliable. So, automated tools should be used to classify fetal health. This study proposes a novel neural network-based architecture, the Dynamic Multi-Layer Perceptron model, evaluated from a single layer to several layers to classify fetal health. Various strategies were applied, including pre-processing data using techniques like Balancing, Scaling, Normalization hyperparameter tuning, batch normalization, early stopping, etc. to enhance the model's performance. A comparative analysis of the proposed method is done against the traditional machine learning models to showcase its accuracy (97%). An ablation study without any pre-processing techniques is also illustrated. This study easily provides valuable interpretations for healthcare professionals in the decision-making process. [ABSTRACT FROM AUTHOR]

Objective (s): Prenatal care is essential for the birth of healthy babies and the maintenance of mothers' health. This study was conducted to explore the experiences of mothers regarding prenatal care at the Sureshjan Health Center. Methods: This was a qualitative study using conventional analysis of the data. The study population consisted of 20 pregnant women from Sureshjan, Chaharmahal, and Bakhtiari province. A semi-structure in-depth interviews conducted to collect the data. Interviews continued until data saturation. The data were analyzed using an inductive method that involved open coding, category creation, and abstraction. Results: The results showed that participants pay serious attention to prenatal care and see it as a vital necessity for that period. The following three categories emerged from the analysis: maintaining and promoting maternal health, supporting fetal health, and maternal care literacy. Conclusion: The pregnant mothers were aware of the importance of prenatal care and considered it necessary to maintain their health and the fetus, as well as to learn important skills related to pregnancy and infancy. [ABSTRACT FROM AUTHOR]

Obstetricians utilize cardiotocography (CTG) to assess the fetal heart and lungs during pregnancy. It can help determine if the foetus is healthy, in doubt, or suffering from disease by providing data on the fetal heart rate and uterine breathing. The analysis of CTG data has typically made use of machine learning (ML) techniques such as support vector machines and decision trees to forecast fetal health and enhance the detection procedure. Fetal heart rate and uterine contraction timing were recorded by CTG. Monitoring fetal health and ensuring normal fetal growth and development throughout pregnancy rely heavily on CTG intelligent categorization. Pregnancies with a higher risk of problems are the most common cases in which CTG is used to evaluate the health of the fetus. ML algorithms are utilized to evaluate state of the foetal health based on CTG-obtained factors. Compared to ML techniques, ensemble models have been shown to increase detection speed and effectiveness. Ensemble modeling refers to the practice of combining the scores or distributions from multiple related but distinct analytical models. In order to predict foetal health, ensemble models such as Boosting, AdaBoost, Extreme Gradient Boosting, Light gradient boost method (LightGBM), and stack models were used in the paper. When the outcomes are compared, the proposed stack model using logistic regression, decision tree, random forest and LightGBM proved to obtain the best performance with 96.71% success rate. The proposed methodology, which can be used to classify foetal health based on Fetal Heart Rate (FHR) data, is more efficient and superior to existing machine learning models, which have already been taken into consideration. [ABSTRACT FROM AUTHOR]

Copyright of Bezmialem Science is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Hemolytic disease of the fetus and newborn (HDFN) occurs as a result of maternal sensitization to paternal antigens. Studies have shown that the immunoglobulin G (IgG) subclass in maternal serum - particularly the presence of IgG1 and IgG3 either singly or in combination, has an impact on the presence and severity of HDFN. The column agglutination technology is used for the identification of IgG1 and IgG3 subclasses. Therefore, the prevalence of IgG1 and IgG3 subclasses in a cohort of alloimmunized Rh (D) antenatal women at our center was studied and was correlated with severity of HDFN. The aims of this study were as follows: (1) to find out the prevalence of IgG1 and IgG3 subclasses among Rh (D) alloimmunized women and (2) to assess the clinical outcome of newborns born to mothers with respect to IgG subclass. Methodology: This was a descriptive study done on 75 antenatal Rh (D) alloimmunized women who fulfilled the inclusion criteria. Blood samples from study participants were subjected to IgG subtyping using the "DAT IgG1/IgG3 ID card" (Bio-Rad, Switzerland), and the outcome of pregnancy was assessed by categorizing the newborns into mild, moderate, and severe HDFN. The data obtained were analyzed using SPSS version 16. Prevalence was calculated and severity of HDFN was correlated with subclass. Results: Among the study population, 23% of mothers had IgG1 alone. Majority (72%) had both IgG1 + IgG3 subclasses and a few (5%) had IgG2 + IgG4. When the mother had both IgG1 + IgG3 subclasses in their body most newborns had only mild HDFN. Few cases of moderate-to-severe cases of HDFN were seen. Most newborns had only mild HDFN even though there were few moderate-to-severe cases of HDFN. No significant association could be demonstrated between severity of HDFN and type of IgG subclasses. Conclusion: Majority of maternal IgG found in HDFN was a combination of IgG1+IgG3.Such cases exhibited stronger grades of reaction in Indirect Coombs Test. A significant association could not be demonstrated between severity of HDFN and type of IgG subclasses. [ABSTRACT FROM AUTHOR]

Amniotic fluid is essential for fetus wellbeing and is used to monitor pregnancy and predict fetal outcomes. Sex affects health and medicine from the beginning of life, but knowledge of its influence on cell-depleted amniotic fluid (AF) and amniotic fluid cells (AFCs) is still neglected. We evaluated sex-related differences in AF and in AFCs to extend personalized medicine to prenatal life. AFCs and AF were obtained from healthy Caucasian pregnant women who underwent amniocentesis at the 16th–18th week of gestation for advanced maternal age. In the AF, inflammation biomarkers (TNFα, IL6, IL8, and IL4), malondialdehyde, nitrites, amino acids, and acylcarnitines were measured. Estrogen receptors and cell fate (autophagy, apoptosis, senescence) were measured in AFCs. TNFα, IL8, and IL4 were higher in female AF, whereas IL6, nitrites, and MDA were similar. Valine was higher in male AF, whereas several acylcarnitines were sexually different, suggesting a mitochondrial involvement in establishing sex differences. Female AFCs displayed higher expression of ERα protein and a higher ERα/ERβ ratio. The ratio of LC3II/I, an index of autophagy, was higher in female AFCs, while LC3 gene was similar in both sexes. No significant sex differences were found in the expression of the lysosomal protein LAMP1, while p62 was higher in male AFCs. LAMP1 gene was upregulated in male AFCs, while p62 gene was upregulated in female ones. Finally, caspase 9 activity and senescence linked to telomeres were higher in female AFCs, while caspase 3 and β-galactosidase activities were similar. This study supports the idea that sex differences start very early in prenatal life and influence specific parameters, suggesting that it may be relevant to appreciate sex differences to cover knowledge gaps. This might lead to improving the diagnosis of risk prediction for pregnancy complications and achieving a more satisfactory monitoring of fetus health, even preventing future diseases in adulthood. [ABSTRACT FROM AUTHOR]

Cardiotocography (CTG) represents the fetus's health inside the womb during labor. However, assessment of its readings can be a highly subjective process depending on the expertise of the obstetrician. Digital signals from fetal monitors acquire parameters (i.e., fetal heart rate, contractions, acceleration). Objective: This paper aims to classify the CTG readings containing imbalanced healthy, suspected, and pathological fetus readings. Method: We perform two sets of experiments. Firstly, we employ five classifiers: Random Forest (RF), Adaptive Boosting (AdaBoost), Categorical Boosting (CatBoost), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LGBM) without over-sampling to classify CTG readings into three categories: healthy, suspected, and pathological. Secondly, we employ an ensemble of the above-described classifiers with the oversamplingmethod. We use a random over-sampling technique to balance CTG records to train the ensemble models. We use 3602 CTG readings to train the ensemble classifiers and 1201 records to evaluate them. The outcomes of these classifiers are then fed into the soft voting classifier to obtain the most accurate results. Results: Each classifier evaluates accuracy, Precision, Recall, F1-scores, and Area Under the Receiver Operating Curve (AUROC) values. Results reveal that the XGBoost, LGBM, and CatBoost classifiers yielded 99% accuracy. Conclusion: Using ensemble classifiers over a balanced CTG dataset improves the detection accuracy compared to the previous studies and our first experiment. A soft voting classifier then eliminates the weakness of one individual classifier to yield superior performance of the overall model. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder (BD) is a mental disorder characterized by mood shifts from severe depression to mania. Pregnant women with BD may experience manic or depressive episodes, so they are usually concerned about the effects of BD on their pregnancy. The aim of this systematic review is to determine the effects of BD on maternal health and fetal health, weight, and development. It also addresses how BD affects the probability of incidence of pregnancy complications in women with bipolar compared with healthy controls. Methods: Seven electronic databases (Ovid MEDLINE, Embase, MIDRIS, APA PsychINFO, Scopus, Web of Science, and ScienceOpen) were searched, and 1728 eligible studies were identified. After deduplication, screening, and manual search processes, we included only 15 studies. Descriptive analysis, and calculation of the probability of incidence for each pregnancy outcome were used to analyze the results. Results: The findings of the included studies suggest that BD during pregnancy may affect both fetal growth and maternal health by increasing the risk of giving birth to an infant with some birth defects such as microcephaly, CNS problems, small for gestational age, and other congenital anomalies, in addition to causing some obstetric complications such as gestational hypertension, preterm labor, need for assisted delivery, hospital readmission, and others. Conclusion: Bipolar disorder during pregnancy negatively affects mothers and their fetuses and increases the probability of incidence of obstetrics complications. [ABSTRACT FROM AUTHOR]

(1) Background: According to the World Health Organization (WHO), 6.3 million intrauterine fetal deaths occur every year. The most common method of diagnosing perinatal death and taking early precautions for maternal and fetal health is a nonstress test (NST). Data on the fetal heart rate and uterus contractions from an NST device are interpreted based on a trace printer's output, allowing for a diagnosis of fetal health to be made by an expert. (2) Methods: in this study, a predictive method based on ensemble learning is proposed for the classification of fetal health (normal, suspicious, pathology) using a cardiotocography dataset of fetal movements and fetal heart rate acceleration from NST tests. (3) Results: the proposed predictor achieved an accuracy level above 99.5% on the test dataset. (4) Conclusions: from the experimental results, it was observed that a fetal health diagnosis can be made during NST using machine learning. [ABSTRACT FROM AUTHOR]

Excessive accumulation of advanced glycation end products (AGEs) in the body has been associated with many adverse health conditions. The common point of the pathologies associated at this point is oxidative stress and inflammation. Pregnancy is an important period in which many physiological, psychological, and biological changes are experienced. Along with the physiological changes that occur during this period, the mother maintaining an AGE-rich diet may cause an increase in the body's AGE pool and may increase oxidative stress and inflammation, as seen in healthy individuals. Studies have reported the negative effects of maternal AGE levels on maternal and fetal health during pregnancy. Although gestational diabetes, preeclampsia, endothelial dysfunction, and pelvic diseases constitute maternal complications, a number of pathological conditions such as intrauterine growth retardation, premature birth, neural tube defect, neurobehavioral developmental disorders, fetal death, and neonatal asphyxia constitute fetal complications. It is thought that the mechanisms of these complications have not been confirmed yet and more clinical studies are needed on this subject. The possible effects of dietary AGE levels during pregnancy on maternal and fetal health are examined in this review. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate how women of child-bearing age perceive the use of remote fetal ECG monitoring technologies. Telemedicine has advanced to the forefront of healthcare delivery, including maternal–fetal medicine. Smart wearable electrocardiogram (ECG) devices can enable pregnant women to monitor their health and that of their fetuses. Such technology would be a logical extension of the telemedicine ecosystem. Methods: We conducted an observational cross-sectional study via online surveying in the United States. Study participants were recruited using the SurveyMonkey Audience Polling system and responded virtually. In all, the sample consisted of 507 women, aged 18–45 from 45 states, who are expecting to become pregnant in the next five years. Women were asked to identify their willingness to use a wearable ECG device the size of a patch-sized large band-aid on their abdomen. Ten binary or multiple-choice questions were used to gauge population interest and related demographics toward the usage of a wearable ECG device. Results: Of the 507 participants, 461 (91%) women expressed an acceptance of wearable ECG technology throughout the pregnancy as a mechanism for increased frequency of monitoring of maternal and fetal health outside the hospital. 395 (78%) women demonstrated a willingness to wear devices day and night or at least during sleep and 213 (42%) of the women would spend up to $200 on such a device. Conclusion: Even though conducted prior to the COVID-19 pandemic, this study clearly indicates a high degree of readiness of prospective pregnant women for telemedicine with continuous health monitoring of the mother-fetus dyad. [ABSTRACT FROM AUTHOR]

Persistent organic pollutants (POPs) are toxic chemicals with demonstrable effects on pregnancy and neonatal outcomes. The associations of early pregnancy body mass index (BMI) and antenatal weight changes with circulating POP concentrations are poorly understood in the Canadian context. The aim of this study was to explore the relationship between maternal BMI in the first trimester, weight change from pre-pregnancy to 6–13 weeks of pregnancy, and first-trimester plasma POP concentrations among Canadian pregnant women. We analyzed data collected as part of the Maternal-Infant Research on Environmental Chemicals (MIREC) study and evaluated POP concentrations based on first-trimester BMI and early gestational weight change categories. We tested for overall differences using Kruskal-Wallis tests. The associations between first-trimester maternal BMI, weight change, and plasma concentrations of 41 POPs were evaluated using censored regression models. After controlling for potential confounders, first-trimester plasma levels of multiple POPs differed significantly across BMI categories, with the highest concentrations in underweight/normal-weight individuals and the lowest in class III obese individuals. Our findings provide preliminary evidence of higher circulating POP levels in individuals with obesity and align with previous findings of an inverse relationship between circulating POP concentrations and BMI in pregnancy. Future studies should prospectively evaluate the interplay between weight change and POP concentrations throughout pregnancy to inform gestational weight gain recommendations for pregnant individuals with obesity. [ABSTRACT FROM AUTHOR]

The increase in substance use, whether legal or illegal, represents a growing global public health problem, affecting various social groups, including pregnant women. The main objective of this research is to describe the use of drugs during pregnancy and to analyze the harmful effects that these substances can cause both in the mother and in the fetus. To carry out this study, a qualitative research methodology of exploratory documentary type was used. Relevant data was collected and selected by reviewing documents, books, and journals published from 2015 to the present. This exhaustive bibliographical review provided us with the necessary support to develop this research work. The findings showed that the consumption of illicit drugs during pregnancy entails a high-risk situation both for the health of the mother and for the development of the fetus. In addition, it was possible to establish that the onset and duration of the neonatal abstinence syndrome vary depending on the type of drug consumed, the amount ingested, and the time of consumption in relation to the date of delivery. In the conclusions of the study, it has been shown that the use of drugs, both legal and illegal, is more frequent in pregnant women. There are many complications that can arise because of drug use during pregnancy, affecting both the mother and the fetus. [ABSTRACT FROM AUTHOR]

Normal pregnancy relies on inflammation for implantation, placentation, and parturition, but uncontrolled inflammation can lead to poor maternal and infant outcomes. Maternal diet is one modifiable factor that can impact inflammation. Omega-3 and -6 fatty acids obtained through the diet are metabolized into bioactive compounds that effect inflammation. Recent evidence has shown that the downstream products of omega-3 and -6 fatty acids may influence physiology during pregnancy. In this review, the current knowledge relating to omega-3 and omega-6 metabolites during pregnancy will be summarized. [ABSTRACT FROM AUTHOR]

The productive replication of human influenza viruses is almost exclusively restricted to cells in the respiratory tract. However, a key aspect of the host response to viral infection is the production of inflammatory cytokines and chemokines that are not similarly tissue restricted. As such, circulating inflammatory mediators, as well as the resulting activated immune cells, can induce damage throughout the body, particularly in individuals with underlying conditions. As a result, more holistic experimental approaches are required to fully understand the pathogenesis and scope of influenza virus‐induced disease. This review summarizes what is known about some of the most well‐appreciated nonrespiratory tract sites of influenza virus‐induced disease, including neurological, cardiovascular, gastrointestinal, muscular and fetal developmental phenotypes. In the context of this discussion, we describe the in vivo experimental systems currently being used to study nonrespiratory symptoms. Finally, we highlight important future questions and potential models that can be used for a more complete understanding of influenza virus‐induced disease. [ABSTRACT FROM AUTHOR]

Health complications during the gestation period have evolved as a global issue. These complications sometimes result in the mortality of the fetus, which is more prevalent in developing and underdeveloped countries. The genesis of machine learning (ML) algorithms in the healthcare domain have brought remarkable progress in disease diagnosis, treatment, and prognosis. This research deploys various ML algorithms to predict fetal health from the cardiotocographic (CTG) data by labelling the health state into normal, needs guarantee, and pathology. This work assesses the influence of various factors measured through CTG to predict the health state of the fetus through algorithms like support vector machine, random forest (RF), multi‐layer perceptron, and K‐nearest neighbours. In addition to this, the regression analysis and correlation analysis revealed the influence of the attributes on fetal health. The results of the algorithms show that RF performs better than its peers in terms of accuracy, precision, recall, F1‐score, and support. This work can further enhance more promising results by performing suitable feature engineering in the CTG data. [ABSTRACT FROM AUTHOR]

Copyright of Gynäkologische Endokrinologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objective: Although pregnancy is a pleasurable period for most women, but generally, it is a stressful period with physical and psychological changes. Mothers’ worries during pregnancy are associated with more problems in pregnancy. Improving well-being is one of the important goals for pregnant women. The aim of this study was to explore the concerns of pregnancy in nulliparous women. Materials and Methods: This qualitative study was performed through the conventional content analysis via using Granhiem and Landman method. Data were collected through semi-structured interviews with 24 primiparous mothers in Kashan and data saturation was obtained. Data analysis was performed using the MAXQDA 10 software. Results: Data analysis led to two categories and subclasses. The first category was the mother’s concerns about her health during pregnancy, which included the following categories: changes in physical and mental conditions during pregnancy and coping with its, healthy childbirth, family and social support, role playing as a spouse, and Parental role challenges. The second category was the mother’s concerns about the health of fetus in pregnancy, which included the following categories: Unpleasant thoughts about fetal formation, responsibility for fetal health, and Fear of fetal injury during pregnancy and childbirth. Conclusion: Pregnant women during pregnancy suffer from a number of concerns about their own health and their fetus, which can threaten the health of both. Therefore, it seems that mothers ‘health care providers can help mothers to experience a safer pregnancy by reducing negative thoughts by holding training classes. [ABSTRACT FROM AUTHOR]

A method for the automatic determination of the fetus health status using Cardiotocography (CTG) and computer-based machine learning algorithms was developed. Five computation friendly machine learning algorithms were used to create multiclass classification models to predict the fetus health status from secondary CTG dataset containing normal, suspected and pathologic data available at University California Irvine Machine Learning Repository. Furthermore, a comparative analysis among the built models was executed. According to the comparative analysis, the best model to automatically detect fetal health was the extreme gradient boosting algorithm-based model with an accuracy of 96.7% and an F1-Score of 0.963 in the pathologic class. This finding thus has the potential to diagnose fetal heart conditions unsupervised, and more efficiently and effectively. [ABSTRACT FROM AUTHOR]

The purpose of this study was to propose a model which is suitable for the actual delivery system by designing a fetal delivery hospital operation management and fetal health classification model. The number of deaths during childbirth is similar to the number of maternal mortality rate of 295,000 as of 2017. Among those numbers, 94% of deaths are preventable in most cases. Therefore, in this paper, we proposed a model that predicts the health condition of the fetus using data like heart rate of fetuses, fetal movements, uterine contractions, etc. that are extracted from the Cardiotocograms(CTG) test using a random forest. If the redundancy of the data is unbalanced, This proposed model guarantees a stable management of the fetal delivery health management system. To secure the accuracy of the fetal delivery health management system, we remove the outlier which embedded in the system, by setting thresholds for the upper and lower standard deviations. In addition, as the proportion of the sequence class uses the health status of fetus, a small number of classes were replicated by data-resampling to balance the classes. We had the 4~5% improvement and as the result we reached the accuracy of 97.75%. It is expected that the developed model will contribute to prevent death and effective fetal health management, also disease prevention by predicting and managing the fetus'deaths and diseases accurately in advance. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the frequency distribution of of ABO haemolytic disease of newborn (ABO‐HDN) and to know the predictive value of immunohaematological tests in identifying at risk neonates. Background: ABO incompatibility, although a common cause of haemolytic disease of newborn, has several unaddressed issues related to it. Material and methods: A prospective study over 20 months was carried out in a tertiary care centre in South India. Blood grouping, Direct Antiglobulin test (DAT) and elution studies were performed on neonatal samples, whereas blood grouping, antibody screening and antibody titration were performed on maternal samples. In suspected cases, ABO‐HDN was diagnosed after excluding other possible causes for haemolysis. The laboratory results were correlated with the clinical details to assess the predictive value of the tests. Results: Of the total 2856 pregnancies, 34% had ABO incompatibility. On testing with columnagglutination test (CAT), the overall DAT positivity and that among ABO‐incompatible cases were 3.8% and 11.2%, respectively,) whereas by conventinal tube technique (CTT) it was 0.6% and 2.4% respectively. CAT was found to have higher sensitivity, and the predictive value was higher for CTT. Maternal IgG titre showed a positive linear relationship with the DAT strength and the rise in indirect bilirubin levels. The positive predictive value of combination of tests such as DAT, elution and titation was 94.12%, which was much higher than that of the individual tests. Conclusion: DAT positivity is a predictor of early rise in serum bilirubin level, and a combination of tests has a better predictive value than individual tests towards development of clinically significant hyperbilirubinemia in ABO‐HDN. [ABSTRACT FROM AUTHOR]

Background and aims: Smoking in pregnancy causes substantial avoidable harm to mothers and offspring; nicotine replacement therapy (NRT) may prevent this, and is used to help women to quit. A recently updated Cochrane Review of randomized controlled trials (RCTs) investigating impacts of NRT in pregnancy focuses primarily on efficacy data, but also reports adverse impacts from NRT. Here we identify and summarize NRT impacts on adverse pregnancy outcomes reported in non‐randomized controlled trials (non‐RCTs). Methods: Systematic reviews and meta‐analyses of RCTs and non‐RCT studies of NRT in pregnancy, with design‐specific risk of bias assessment and grading of recommendations, assessment, development and evaluations (GRADE) criteria applied to selected outcomes. Findings Relevant Cochrane Review findings are reported alongside those from this new review. Seven RCTs were included; n = 2340. Nine meta‐analyses were performed; non‐statistically significant estimates indicated potentially reduced risk from NRT compared with smoking for mean birth weight, low birth weight, preterm birth, intensive care admissions, neonatal death, congenital anomalies and caesarean section and potentially increased risks for miscarriage and stillbirth. GRADE assessment for mean birth weight and miscarriage outcomes indicated 'low' confidence in findings. Twenty‐three non‐RCTs were included; n = 931 163. Eleven large studies from five routine health‐care cohorts reported clinical outcomes; 12 small studies investigated mainly physiological outcomes within in‐patient women given NRT. Findings from meta‐analyses for congenital anomalies, stillbirth and preterm birth were underpowered and not in a consistent direction; GRADE assessment of confidence in findings was 'very low'. Routine health‐care studies were of higher quality, but implications of reported findings were unclear as there was inadequate measurement and reporting of women's smoking. Conclusions: Available evidence from randomized controlled trials and non‐randomized comparative studies does not currently provide clear evidence as to whether maternal use of nicotine replacement therapy during pregnancy is harmful to the fetus. [ABSTRACT FROM AUTHOR]

Ultrasound growth measurements are monitored to evaluate if a fetus is growing normally compared with a defined standard chart at a specified gestational age. Using data from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st project, we have modelled the longitudinal dependence of fetal head circumference, biparietal diameter, occipito-frontal diameter, abdominal circumference, and femur length using a two-stage approach. The first stage involved finding a suitable transformation of the raw fetal measurements (as the marginal distributions of ultrasound measurements were non-normal) to standardized deviations (Z-scores). In the second stage, a correlation model for a Gaussian process is fitted, yielding a correlation for any pair of observations made between 14 and 40 weeks. The correlation structure of the fetal Z-score can be used to assess whether the growth, for example, between successive measurements is satisfactory. The paper is accompanied by a Shiny application, see https://lxiao5.shinyapps.io/shinycalculator/. [ABSTRACT FROM AUTHOR]

Objectives: Poor fetal growth is one of the most important findings on an obstetric ultrasound (US) examination. First‐trimester US is the most accurate means for dating pregnancies; however, dating based on last menstrual period remains the standard for determining gestational age. Discrepancies between menstrual and US dating can lead to the overdiagnosis of in utero growth restriction (IUGR). This article will demonstrate that as long as the fetal growth falls along a curve that parallels normal growth curves, appropriate growth has occurred regardless of the gestational age and weight percentile that has been assigned to the fetus. Methods: Following Institutional Review Board approval (HSD‐00002969), 860 third‐trimester fetal US examinations were retrospectively evaluated from January 1 through July 1, 2017, to determine whether they had normal growth curves. Outcome data on all cases were obtained from review of the medical records. Results: Of 216 fetuses (25%) suspected of IUGR based on a weight below the 10th percentile, 6 developed true IUGR: 5 that led to emergent delivery of fetuses weighing less than a 1000 g and 1 in utero fetal demise. The remaining 210 fetuses all had normal outcomes. Conclusions: As long as the fetal growth falls along a curve that parallels normal growth curves, appropriate growth has occurred regardless of the gestational age and weight percentile that has been assigned to the fetus. [ABSTRACT FROM AUTHOR]

Given the unexpected nature of the terrorist attacks of September 11, 2001, a specific cohort of children were exogenously exposed to increased maternal psychological stress in utero. Rich administrative data and the precise timing of the event allow this study to uniquely provide insights into the health effects of exposure to maternal psychological stress across gestation. Results suggest that children exposed in utero were born significantly smaller and earlier than previous cohorts. The timing of the effect provides evidence that intrauterine growth is specifically restricted by first trimester exposure to stress; reductions in gestational age and increases in the likelihood of being born at low (<2,500 grams) or very low (<1,500 grams) birth weight are induced by increased maternal psychological stress mid-pregnancy. This study also documents a positively selected post-attack fertility response, which would bias an evaluation that includes cohorts conceived after September 11, 2001, in the control group. [ABSTRACT FROM AUTHOR]

The purpose of this study is to identify the effect of religious beliefs on the attitudes of pregnant women toward the health of the fetus. Pregnancy, one of the important periods of life, is a special period in terms of affecting both the mother's and the baby's health. Health beliefs and attitudes are the factors that have effects on mother–baby death rates (mortality)—which is one of the most important criteria showing health level of societies. However, the literature has limited number of studies on this issue. Volunteer participants who applied to the Gynecology and Obstetrics Polyclinic were administered a questionnaire in order to identify the frequency of performing worship practices. Women's beliefs about their roles in determining their fetus's health were measured using Fetal Health Locus of Control (FHLC) scale. FHCL scale is composed of 3 sub-scales which include Internality Locus of Control (FHLC-I), Chance Locus of Control (FHLC-C), and Powerful Others Locus of Control (FHLC-P). Non-normally distributed scale scores were analyzed with Mann–Whitney U test for two independent groups and Kruskal–Wallis test for three independent groups. The scores obtained from all the sub-scales of the FHLC scale according to the praying groups were statistically significant (p = 0.008, p < 0.001, p < 0.001, respectively). The sub-scale scores were not statistically significant according to the tendency of giving alms (p = 0.269, p = 0.695, p = 0.079, respectively). The FHLC-I and FHLC-P scores did not indicate differences according to the tendency of going to pilgrimage (p = 0.914, p = 0.578), but FHLC-C scores were significantly higher in those who tended to go to pilgrimage (p = 0.004). There was a significant relationship between the tendency of performing prayer and going to pilgrimage and attitudes toward performing double–triple tests and oral glucose tolerance test (p = 0.002, p = 0.035, respectively). Religious beliefs were influential on the attitudes of pregnant women toward the health of the fetal. Gynecologists should consider patients' religious belief sensitivity while recommending them screening tests or planning their medication. [ABSTRACT FROM AUTHOR]

We examine birth order differences in health of newborns and follow the children throughout childhood using high-quality administrative data on individuals born in Denmark between 1981 and 2010. Family fixed effects models show a positive and robust effect of birth order on health at birth; firstborn children are less healthy at birth. During earlier pregnancies, women are more likely to smoke, receive more prenatal care, and are more likely to suffer a medical pregnancy complication, suggesting worse maternal health. We further show that the health disadvantage of firstborns persists in the first years of life, disappears by age seven, and becomes a health advantage in adolescence. In contrast, later-born children are throughout childhood more likely to suffer an injury. The results on health in adolescence are consistent with previous evidence of a firstborn advantage in education and with the hypothesis that postnatal investments differ between first- and later-born children. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study aimed at determining prognostic factors that paved the way for umbilical cord entanglement (UCE) and the effects of UCE upon labor management and fetal health.Methods: Sixty women who gave term birth with head presentation and received UCE diagnosis following birth composed the case group while another 60 women with the same characteristics who were selected with randomized sampling method and who did not develop UCE comprised the control group. The data obtained were processed with SPSS 22.0 statistical program. T test was used for comparing demographic and obstetric data and mean birth weight of babies in the case group and control group. For comparing data on active labor management and fetal health, numbers, percentages and chi-square test were used. Also for comparing values <5, Fisher's chi-square test was employed.Results: Emergent cesarean delivery (case: 58.3.0%; control: 21.7%), vacuum assisted vaginal delivery (case: 20.0%; control: 3.3%), forceps assisted vaginal delivery (case: 8.3%; control: 1.7%), fetal distress (case: 60.0%; control: 25.0%), amniotic fluid meconium (case: 58.3%; control: 21.7%), APGAR score less than 7 at the 1st minute (case: 58.3%; control: 21.7%) and APGAR score less than 7 at the 5th minute were higher in the women in the case group than the women in the control group (p < 0.05).Conclusion: UCE increased rates of interventional birth, emergent cesarean delivery, vacuum assisted vaginal delivery, forceps assisted vaginal delivery, amniotic fluid meconium and fetal distress. [ABSTRACT FROM AUTHOR]

As the rates of amphetamine use continue to rise, so do the significant social and health implications associated with substance abuse in communities. This presents unique challenges for women, newborns and providers of perinatal care. This article aims to explore amphetamine use among women of childbearing age, and the subsequent effects on the woman and fetus/newborn. The complexity of these cases require a collaborative, womancentred and multidisciplinary approach, in addition to specialised interventions and adjustments regarding routine antenatal, intrapartum and postnatal plans of care [ABSTRACT FROM AUTHOR]

Obesity is the major threat to social and medical wellbeing in Pakistan and worldwide. Increased BMI poses certain risks to mother as well as fetus. The objective of this study is to assess the maternal and fetal morbidities in women presenting with increased BMI during pregnancy. Study Design: Descriptive cross sectional study. Setting: Isra University Hospital. Period: 1st June 2017 till Nov 2017. Materials and Methods: 100 Patients with singleton pregnancy were included in this study. Results: Total 100 female patients were taken in this study and it was observed that 67% of them were in age limit between 21-30, 27% were above 31 yrs old and only 6% were found to be below 20 yrs. Amongst them 34% were diabetics, 29% hypertensive, 10% had UTI, 7% were suffering from asthma and remaining 10% had multiple problems. Conclusion: It was concluded that there are complex and noteworthy socio-statistic imbalances related to different age groups, parity status and BMI. It was also concluded that increased no of patients are at high risks of maternal and fetal complication rates and require proper access to antenatal care. Facilities and interventions should be provided to improve both maternal and fetal health care and reduce the risks of adverse effects of increased BMI. [ABSTRACT FROM AUTHOR]

Maternal nutrition plays a crucial role in influencing fertility, fetal development, birth outcomes, and breast milk composition. During the critical window of time from conception through the initiation of complementary feeding, the nutrition of the mother is the nutrition of the offspring—and a mother’s dietary choices can affect both the early health status and lifelong disease risk of the offspring. Most health expert recommendations and government-sponsored dietary guidelines agree that a healthy diet for children and adults (including those who are pregnant and/or lactating) should include an abundance of nutrient-rich foods such as fruits and vegetables. These foods should contain a variety of essential nutrients as well as other compounds that are associated with lower disease risk such as fiber and bioactives. However, the number and amounts of nutrients varies considerably among fruits and vegetables, and not all fruit and vegetable options are considered “nutrient-rich”. Avocados are unique among fruits and vegetables in that, by weight, they contain much higher amounts of the key nutrients folate and potassium, which are normally under-consumed in maternal diets. Avocados also contain higher amounts of several non-essential compounds, such as fiber, monounsaturated fats, and lipid-soluble antioxidants, which have all been linked to improvements in maternal health, birth outcomes and/or breast milk quality. The objective of this report is to review the evidence that avocados may be a unique nutrition source for pregnant and lactating women and, thus, should be considered for inclusion in future dietary recommendations for expecting and new mothers. [ABSTRACT FROM AUTHOR]

Background/aim: To examine the relationship between sociodemographic and pregnancy features and fetal health locus of control (FHLC) in a sample of pregnant Turkish women. Materials and methods: The study was conducted with 256 pregnant women. Data were collected by demographic questionnaire and the FHLC Scale consisting of 3 components: 1) Internality Scale (FHLC-I), 2) Powerful Others Scale (FHLC-P), and 3) Chances Scale (FHLC-C). Results: The age of marriage was found to have a positive relation with FHLC-I (r = 0.141) and a negative relation with FHLC-C (r = -0.145) (P < 0.05). The age of first pregnancy was found to have a positive relation with FHLC-I (r = 0.127). Those who have a low educational level (r = -0.258) and income (r = -0.149), who are unemployed (r = -2.839), whose number of pregnancies is high (r = 0.152), who get pregnant unplanned (r = 3.839), and who come to their first prenatal examination late (r = -0.142) have a significantly high score of FHLC-C (P <0.05). Conclusion: It may be helpful for better outcomes of prenatal care to identify pregnant women who believe that their behavior has little effect on the health of their fetus and that it is controlled by chance. [ABSTRACT FROM AUTHOR]

Objective: Prenatal smoking, alcohol use, and obesity have significant effects on maternal and fetal health. However, not much is known about the genetic contributions to these risk factors among pregnant women. We evaluate the associations between several candidate genes and smoking, alcohol use, pre-pregnancy body weight, and weight gain during pregnancy in a sample of pregnant women. Methods: The study analyzes a sample of about 1900 mothers from the Danish National Birth Cohort. We test the association between 1450 SNPs in/near 117 genes/loci and various risk factor measures. Results: Only a few SNPs in FTO were significantly associated with pre-pregnancy obesity and body mass index (4 and 2 SNPs , respectively) after SNP-level correction for multiple testing. A few loci were significantly related to various smoking measures (any smoking, quitting and cigarette number) with gene/locus-level correction for multiple testing, but not after SNP-level correction. Similarly, some loci were significant for the alcohol measures at the gene/locus-level but not at SNP-level correction. Conclusion: The study suggests that the majority of the evaluated candidate genes may not play an important role in influencing these risk factors among pregnant women, highlighting the importance of other genetic factors and non-genetic contributors to their etiology. [ABSTRACT FROM AUTHOR]

Obesity has become an important public health globally. Being obese in reproductive period causes many problems related to both the baby and the mother. The risks associated with needs to be focus of public attention. Woman must first be aware of their body health and impacts of weight on this. Than after perception of their status they need to be given the consultation regarding their knowledge level, attitudes about their nutrition, breast feeding, preconception measures to be taken for their pre and postpartum health. In this review we intended to recognise the effects of obesity in this particular group of patients. [ABSTRACT FROM AUTHOR]

Introduction: We evaluated associations between ecological variables and the risk of very small for gestational age (VSGA) birth in Quebec in 2000-2008. Methods: Ecological variables came from the Canadian Community Health Survey, the Canadian census and Quebec's birth registry; individual variables also came from Quebec's birth registry. Odds ratios (ORs) adjusted for mother's age, academic qualification, parity, marital status and country of birth were estimated using multilevel logistic regression (generalized estimating equations method). Results: Births in neighbourhoods with a high proportion of people leading a sedentary lifestyle (OR: 1.07, 95% confidence interval [CI]: 1.01-1.11) and those with a high/middle proportion of residents with food insecurity (OR: 1.09, 95% CI: 1.05-1.15; OR: 1.05, 95% CI: 1.01-1.11) had higher odds of VSGA birth. Those with middle proportion of married residents had lower odds of VSGA birth (OR: 0.94, 95% CI: 0.90-0.98). [ABSTRACT FROM AUTHOR]

Background: Healthy post-pregnancy outcomes are contingent upon an informed regimen of prenatal care encouraging healthy maternal consumption habits. In this article, we describe aspects of maternal intake of food, drink, and medication in a population of predominantly Hispanic women in Southern California. Potential implications for unhealthy prenatal dietary choices are discussed. Methods: The Food, Beverage, and Medication Intake Questionnaire (FBMIQ) measures common practices of maternal consumption during pregnancy. The FBMIQ was administered to English and Spanish speaking pregnant and recently pregnant (36 weeks pregnant - 8 weeks post-partum) women over the age of 18 who were receiving care from a private medical group in Downey CA. Results: A total of 200 women completed the FBMIQ. Consumption habits of healthy foods and beverages, unhealthy foods, unhealthy beverages, and medication are characterized in this article. Data indicate widespread consumption of fresh fruit, meats, milk and juice and indicate most women used prenatal vitamin supplements. Studies in developmental neuroscience have shown that certain substances may cause teratogenic effects on the fetus when ingested by the mother during pregnancy. Those potentially harmful substances included in our study were Bisphenol-A (BPA), methylmercury, caffeine, alcohol and certain medications. Our results show that a proportion of the women surveyed in our study consumed BPA, methylmercury, caffeine, alcohol, and certain medications at varied levels during pregnancy. This represents an interesting finding and suggests a disconnect between scientific data and general recommendations provided to pregnant mothers by obstetricians. Conclusions: The results of our study demonstrate that a proportion of pregnant women consume substances that are potentially teratogenic and may impact the health and well being of the offspring. It is important to appraise healthy and unhealthy consumption habits in order to encourage healthy practices and alleviate future effects of preventable, toxin-induced developmental issues. Prenatal advising should discourage the consumption of dangerous foods, beverages, and medications that women commonly report eating during pregnancy. [ABSTRACT FROM AUTHOR]

The impact of maternal vitamin D status in pregnancy on the extraskeletal health of the offspring has become a 'hot topic' with a potential for cost-beneficial prevention. The objective of this study was to systematically review the level I and II evidence. PubMed, Embase and Cochrane databases were searched using the MeSH terms 'vitamin D' AND 'pregnancy' until 1 January 2012. The search was limited to randomized controlled trials (evidence level I) and observational studies (evidence level II) in humans and in the English language. Papers reporting on vitamin D supplementation in combination with other supplements, or not reporting on 25OHD or outcomes of the offspring were excluded. Six randomized controlled trials and 24 observational studies were finally included. In randomized controlled studies, vitamin D supplementation resulted in increased birthweight in one study, but showed no effect in five other studies. In cohort and case-control studies, higher vitamin D intake, or higher 25OHD, was associated with increased birthweight in large studies only, and modified by vitamin D receptor polymorphisms and by race (U-shaped in Caucasians in one unconfirmed study). The risks of HIV mother-to-child transmission, rhinitis symptoms and eczema were lower. Data were conflicting on the effect on respiratory infections and wheezing, whereas U-shaped associations to inhalant allergen-specific IgE at five years and to schizophrenia were reported in unconfirmed studies. The risk of type 1 diabetes at 15 years was lower or unchanged. It is concluded that observational studies suggest an effect of vitamin D on several outcomes. U-Shaped associations warrant caution. [ABSTRACT FROM AUTHOR]

Objective: To compare maternal complications and labor outcome in obese and non-obese women. Materials and methods: It is a retrospective comparative study conducted at the Department of obstetrics and gynecology, Unit 1, Civil Hospital, Karachi from December 2008 to December 2009. A sample size of 220 gravid women is selected by Non Probability Convenience sampling technique. In these 110 obese women as cases was compared with 110 non-obese women as controls, booked at <20 weeks of gestation. Data were collected regarding maternal complication, mode of delivery and neonatal outcome by trained medical officers. Data were entered and analyzed by SPSS version 11.0 through descriptive analysis, chi-square test and independent sample t test. The p-value of <0.05 was considered significant. Results: Pregnancy induced hypertension was present in 9 (8.2%) women in control group and 21 (19.1%) in cases (p=0.01). Gestational diabetes was seen in one (0.9%) in control compared to 8 (7.3%) in obese women (p=0.01). Obese women were found to be at increased risk of caesarean section [17 (15.5%) Vs. 39 (35.4%), p=0.002]. Apgar score at 1 and 10 minute were lower in cases compared to controls (p=0.0001). Conclusion: Obese women are at increased risk of pregnancy induced obesity and associated with an increased risk of hypertension, gestational diabetes mellitus, thromboembolic disease and urinary tract infection. [ABSTRACT FROM AUTHOR]

In a prospective study, 48 fetuses were evaluated with Doppler ultrasound after 34 weeks and classified, according to the cerebroplacental ratio (CPR) and estimated fetal weight (EFW), into fetuses with normal growth and fetuses with late-onset fetal growth restriction (LO-FGR). Overexpression of miRNAs from neonatal cord blood belonging to LO-FGR fetuses, was validated by real-time PCR. In addition, functional characterization of overexpressed miRNAs was performed by analyzing overrepresented pathways, gene ontologies, and prioritization of synergistically working miRNAs. Three miRNAs: miR-25-3p, miR-185-5p and miR-132-3p, were significantly overexpressed in cord blood of LO-FGR fetuses. Pathway and gene ontology analysis revealed over-representation of certain molecular pathways associated with cardiac development and neuron death. In addition, prioritization of synergistically working miRNAs highlighted the importance of miR-185-5p and miR-25-3p in cholesterol efflux and starvation responses associated with LO-FGR phenotypes. Evaluation of miR-25-3p; miR-132-3p and miR-185-5p might serve as molecular biomarkers for the diagnosis and management of LO-FGR; improving the understanding of its influence on adult disease. [ABSTRACT FROM AUTHOR]

Using a qualitative approach, this study sought to explore the role of ultrasound in fetal health anxiety. One semi-structured interview was conducted with 30 pregnant women. Data analysis was inductive, following the principles of the template and editing organizing styles of coding and analysis. Overall, 93 percent of the women reported anxiety over fetal health, with 96.5 percent of these women indicating that ultrasound played a role in their anxiety. The women reported heightened fetal health anxiety in anticipation of the ultrasound, as well as during the ultrasound due to the sonographer's behavior and an inability to see the monitor. Findings indicated that fetal health anxiety was relieved by the ultrasound, particularly when women had access to the visual image and received encouraging verbal feedback. The findings are discussed with regard to their implications for policy and obstetric practice. [ABSTRACT FROM AUTHOR]

Iodine is a trace element essential for synthesis of the thyroid hormones, triiodothyronine and thyroxine. These hormones play a vital role in the early growth and development stages of most organs, especially the brain. The World Health Organization (WHO) has declared that, after famine, iodine deficiency is the most avoidable cause of cerebral lesions including different degrees of mental retardation and cerebral paralysis. The main function of iodine in vertebrates is to interact with the thyroid hormones. During pregnancy sufficient quantities of iodine are required to prevent the appearance of hypothyroidism, trophoblastic and embryonic or fetal disorders, neonatal and maternal hypothyroidism, and permanent sequelae in infants. Thyroid hormone receptors and iodothyronine deiodinases are present in placenta and central nervous tissue of the fetus. A number of environmental factors influence the epidemiology of thyroid disorders, and even relatively small abnormalities and differences in the level of iodine intake in a population have profound effects on the occurrence of thyroid abnormalities. The prevalence of disorders related to iodine deficit during pregnancy and postpartum has increased. Iodine supplementation is an effective measure in the case of pregnant and lactating women. However, it is not implemented and the problem is still present even in societies with theoretically advanced health systems. During pregnancy and postpartum, the WHO recommends iodine intake be increased to at least 200 μg/day. Side-effects provoked by iodine supplementation are rare during pregnancy at the recommended doses. [ABSTRACT FROM AUTHOR]

Hyperemesis gravidarum (HG), a debilitating ailment characterized by severe nausea and vomiting, malnutrition, and weight loss during pregnancy, occurs to 1-2% of pregnant women globally. Although the medical community offers clinical and pharmaceutical intervention, the procedures are: (1) partially effective, if at all, (2) costly and unaffordable without health insurance, (3) questionable in their long-term safety for the fetus, as most have not been scientifically tested, and (4) in more severe cases, physically painful and psychologically disempowering for the pregnant woman. This study unveils the deep suffering endured by women undergoing HG from a folkloristic perspective and proposes the use of medical cannabis as an effective natural remedy for the symptoms of HG. Due to the criminalization of cannabis and the stigma of its use during pregnancy, no formalized testing has been conducted, thus far, to investigate such a claim. While a small, underground, pilot study of cannabis treatment for HG has proven relatively promising, clinical trials are necessary for a more conclusive answer. [ABSTRACT FROM PUBLISHER]

Omega (n)-3 fatty acids are vital to neonatal maturation, and recent investigations reveal n-3 fatty acids serve as substrates for the biosynthesis of specialized pro-resolving lipid mediators (SPM) that have anti-inflammatory and immune-stimulating effects. The role SPM play in the protection against negative maternal-fetal health outcomes is unclear, and there are no current biomarkers of n-3 fatty acid sufficiency. We sought to ascertain the relationships between n-3 fatty acid intake, SPM levels, and maternal-fetal health outcomes. We obtained n-3 fatty acid intake information from 136 mothers admitted for delivery using a food frequency questionnaire and measured docosahexaenoic acid (DHA)-derived SPMs resolvin D1 (RvD1) and RvD2 in maternal and cord plasma. We found significantly elevated SPM in maternal versus cord plasma, and increased SPM levels were associated with at-risk outcomes. We also identified that increased DHA intake was associated with elevated maternal plasma RvD1 (p = 0.03; R2 = 0.18) and RvD2 (p = 0.04; R2 = 0.20) in the setting of neonatal intensive care unit (NICU) admission. These findings indicate that increased n-3 fatty acid intake may provide increased substrate for the production of SPM during high-risk pregnancy/delivery conditions, and that increased maternal plasma SPM could serve as a biomarker for negative neonatal outcomes. [ABSTRACT FROM AUTHOR]