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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]

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]

Abstract 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.

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.

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.

Objectives Fetal health locus of control has been indicated to effect how mothers approach their health beliefs and health-related decisions. The purpose of this study was to determine the fetal health locus of control (FHLC) level in high-risk pregnancies and to evaluate the factors affecting FHLC in high-risk pregnancies. Materials and Methods The descriptive cross-sectional study was conducted with highrisk pregnant women. A total of 221 participants were included. Results and Discussion It was shown that The Internality Locus of Control was low and The Chance-Based Locus of Control was high in high-risk pregnant women. The current age of women and the age of their first pregnancy had a positively relationship with Powerful Others Locus of Control (FHLC-P). Although FHLC scores of multigravidas were higher than primiparous, no significant difference was found. Besides, there was a significantly higher FHLC-C score in women who did not change their exercise habits during pregnancy (p=0.008). Although the FHLC-I score was higher in women, who made changes in nutrition habits, it was determined that it was not significant. Conclusion The results of fetal health locus of control in high-risk pregnancies will lead to women who have high-risk pregnancies taking responsibility for adapting to the treatment process, taking into account the controls and making lifestyle changes, rather than leaving the situation to fate. [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]

Objective: In the present study, it was aimed to adapt the fetal health anxiety inventory (FHAI) into Turkish and to analyze the validity and reliability of the scale among pregnant women. Methods: Explanatory factor analysis (EFA) was applied to 370 pregnant women in Sample I and confirmatory factor analysis (CFA) was applied to 200 pregnant women in Sample II. The Prenatal Distress Questionnaire (NuPDQ) was used to test criterion-related validity of the FHAI. The reliability of the inventory was examined with Cronbach’s alpha reliability coefficient, item-total score correlation coefficient and test-retest analysis. Results: As a result of EFA applied to Sample I, it was determined that the 14-item FHAI covered a single factor, and the scale demonstrated good fit indices (χ2/standard deviation =3.148, comparative fit index =0.907, standardized root mean squared residual =0.000, root mean square error of approximation =0.089, and p value =0.000) as a result of the CFA applied to Sample II. A statistically significant positive correlation was found between the FHAI and NuPDQ (r=0.851, p

Objective: In the present study, it was aimed to adapt the fetal health anxiety inventory (FHAI) into Turkish and to analyze the validity and reliability of the scale among pregnant women. Methods: Explanatory factor analysis (EFA) was applied to 370 pregnant women in Sample I and confirmatory factor analysis (CFA) was applied to 200 pregnant women in Sample II. The Prenatal Distress Questionnaire (NuPDQ) was used to test criterion-related validity of the FHAI. The reliability of the inventory was examined with Cronbach’s alpha reliability coefficient, item-total score correlation coefficient and test-retest analysis. Results: As a result of EFA applied to Sample I, it was determined that the 14-item FHAI covered a single factor, and the scale demonstrated good fit indices (χ²/standard deviation =3.148, comparative fit index =0.907, standardized root mean squared residual =0.000, root mean square error of approximation =0.089, and p value =0.000) as a result of the CFA applied to Sample II. A statistically significant positive correlation was found between the FHAI and NuPDQ (r=0.851, p<0.01). Cronbach’s alpha internal consistency coefficient of the inventory was 0.85, and item-total score correlation coefficients were found to range between r=0.34- 0.59 (p<0.001). In the test-retest analysis, a statistically significant and positive correlation was found between the total scores of the inventory obtained in two different applications (r=0.568, p=0.001). Conclusion: The current study supported the use of 14-item FHAI as a valid and reliable tool to measure fetal health anxiety of Turkish pregnant women. [ABSTRACT FROM AUTHOR]

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]

Government policies often target vulnerable communities on the premise of their socioeconomic status, race, gender, etc., and hinder their ability to attain proper resources. These discriminatory practices can have consequences that span generations when enforced upon expecting mothers that lack access to preventative care. Whether it be for education, basic needs, or even health, access is undoubtedly disproportionate. Redlining is a specific policy that has seeped its way into communities and continues to affect the socioeconomic status of hundreds of thousands of families. One aspect of health that is especially impacted is maternal and fetal health. Findings show increased health risks for mothers and an increase in potential fetal mortality in these areas. Expanding research on the topic is crucial to promoting policies and the expansion of programs that will help subside these harmful effects that pose a risk to these communities. Our environments, both physical and social, are determinants of our health and in reviewing existing literature, it is clear that where we live is vital to our livelihoods.

Abstract 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.

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.

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]

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]

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]

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]

In today’s medical field, doctors rely on electrocardiograms (ECG) to monitor fetal heart rate and overall fetal health during labor. ECG readings, although accurate, tend to be very difficult to interpret and consequently tell doctors very little in terms of fetal distress levels during labor. Due to this lack of specificity, physicians often turn to emergency intervention by performing Cesarean sections (C-sections). Nearly half of these C-sections are unnecessary which poses extreme risks to the fetus and the mother, and is a financial burden on insurance companies as well. To combat these issues, our team proposes pHetal Meter, a handheld device that can give a rapid, bedside reading of fetal blood pH. Fetal blood pH levels are currently the gold standard for early detection of fetal distress during labor. The device will be able to quickly and accurately detect whether or not the fetus is in distress. Our device will be nurse-operable, cause little to no pain or discomfort to the mother, and allow for faster and more direct results. When used alongside current technology, physicians will no longer need to guess whether an emergency C-section is necessary, and will be able to rapidly determine fetal distress levels. pHetal Meter uniquely bridges an unmet medical need by quickly and accurately determining intrapartum fetal health, and drastically lowering the risks and costs incurred by unnecessary C-sections. Advisors: Christine King, Ph.D. Department of Biomedical EngineeringDinh Vu, MD, MBA, Department of Obstetrics and Gynecology, Saddleback Medical CenterDepartment of Biomedical engineering and material Science Engineering, University of California Irvine

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.

Metallic elements play a pivotal role in maternal and fetal health. Metals can cross the placental barrier and be absorbed by fetuses, where they may affect closure of the neural tube during embryonic development. Neural tube defects (NTDs), which result from aberrant closure of the neural tube three to four weeks post-conception, have a multifactorial and complex etiology that combines genetic variants and environmental exposure. Recent advances in population-level association studies have investigated the link between maternal environmental exposure and NTDs, particularly the influence of metals on the incidence of NTDs. Herein, we present a broad and qualitative review of current literature on the association between maternal and prenatal metal exposure via the maternal peripheral blood, amniotic fluid, placenta, umbilical cord, and maternal hair, and the risk of developing NTDs. Specifically, we identify the various aggravating or attenuating effects of metallic exposure on the risk of NTD formation. This review provides novel insights into the association between environmental metals and NTDs and has important applications for NTD prevention and mitigating environmental exposure to metals.

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]

Chronic kidney disease (CKD) presents significant challenges in the management of pregnant women due to its impact on renal function and cardiovascular stability. This review examines the crucial role of anesthesia management in antenatal care for women with CKD, focusing on the complexities introduced by renal dysfunction and the implications for maternal and fetal health outcomes. The review discusses the physiological changes in CKD during pregnancy, highlighting the increased risks of hypertension, proteinuria, and adverse fetal outcomes. Anesthesia considerations, including the choice of anesthesia techniques (general anesthesia, regional anesthesia), perioperative monitoring, and management of fluid and electrolyte balance, are analyzed in the context of CKD-specific challenges. Clinical outcomes and current evidence regarding anesthesia efficacy and safety in CKD patients are reviewed, emphasizing the need for tailored anesthesia protocols to ensure optimal maternal comfort and fetal safety. The review concludes by identifying research gaps and proposing future directions to enhance anesthesia practices and improve outcomes for pregnant women with CKD undergoing surgical interventions or labor management., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ghosh et al.)

(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.

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]

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.

Cardiotocogram (CTG) is one of the monitoring tools to estimate the fetus health in womb. CTG mainly yields two results fetal health rate (FHR) and uterine contractions (UC). In total, there are 21 attributes in the measurement of FHR and UC on CTG. These attributes can help obstreticians to clasify whether the fetus health is normal, suspected, or pathological. This paper compares 7 algorithms to predict the fetus health: Artificial Neural Network (ANN), Long-short Term Memory (LSTM), XG Boost (XGB), Support Vector Machine (SVM), K-Nearest Neighbour (KNN), Light GBM (LGBM), and Random Forest (RF). By employing three scenarios, this paper reports the performance measurements among those algorithms. The results show that 5 out of 7 algorithms perform very well (89-99% accurate). Those five algorithms are XGB, SVM, KNN, LGBM, RF. Furthermore, only one from five algorithm that always performs well through three scenarios: LGBM. [ABSTRACT FROM AUTHOR]

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 review discusses the impact of nutrients on women’s health before and during pregnancy and on the health of their babies. Considerable attention is paid to the short-term and long-term effects of malnutrition or overeating of pregnant women. The article also discusses the need for the use of vitamin-mineral complexes during pregnancy to replenish nutrient stores. The issue of the relationships between the diet and early pregnancy outcomes is considered. Based on the conducted thorough analysis, it is concluded that doctors should inform future mothers about the importance of a balanced diet and additional intake of microelements and vitamins. Although this topic has been extensively studied, it requires further research for working out optimal clinical recommendations regarding the nutritional behavior of pregnant women.

Background: For appropriate management of hemolytic disease of the fetus and newborn (HDFN), it is important to detect irregular red cell antibody in the antenatal period. Though it is a simple one-step method, it is not part of routine antenatal screening in many developing countries. To reiterate the importance of antenatal antibody screening, we have assessed the frequency and clinical significance of irregular red cell antibodies in our patient population. Materials and Methods: A prospective study was carried out from October 2013 to May 2015 at a tertiary care center from south India. All antenatal samples received by the laboratory for red cell antibody screening were screened using a commercial three-cell screening panel. Antibody identification along with further Immunohematological techniques as required were performed for cases with positive screening results. Neonates of the alloimmunized cases were followed up to determine the clinical significance of the antibody. Results: A total of 2336 antenatal mothers were screened for red cell antibodies. The overall rate of alloimmunization in the study group was 2.27%. Alloimmunization rate among RhD-negative pregnancies was 6.9%. Other than anti-D (49%), we identified anti-D + anti-C (5%), anti-G (5%), anti-c (5%), anti-E (2%), anti-e (2%), anti-H (Bombay phenotype) (7%), anti-M (2%), anti-Lea (2%), anti-Leb (12%), and autoantibodies (9%) in the maternal serum. Anti-D, anti-D + anti-C, anti-G, anti-c, and anti-H were found to be clinically significant in this study. Conclusion: This study showed that 1 in 125 RhD-positive pregnancies can develop red cell alloantibodies. Hence, implementing routine antenatal antibody screening irrespective of RhD status is essential.

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.

Pregnancy is a time filled with uncertainties, which can be challenging and lead to fear or anxiety for expectant parents. Health monitoring technologies that allow monitoring of the vital signs of both the mother and fetus offer a way to address health-related uncertainties. But are smart health monitoring technologies (SHMTs) actually an effective means to reduce uncertainties during pregnancy, or do they have the opposite effect? Using conceptual reasoning and phenomenological approaches grounded in existing literature, this Viewpoint explores the effects of SHMTs on health-related uncertainties during pregnancy. The argument posits that while SHMTs can alleviate some health-related uncertainties, they may also create new ones. This is particularly the case when the abundance of vital data overwhelms pregnant persons, leads to false-positive diagnoses, or raises concerns about the accuracy and analysis of data. Consequently, it is concluded that the use of SHMTs is not a cure-all for overcoming health-related uncertainties during pregnancy. Since the use of such monitoring technologies can introduce new uncertainties, it is important to carefully consider where and for what purpose they are used, use them sparingly, and promote a pragmatic approach to uncertainties.Using conceptual reasoning and phenomenological approaches grounded in existing literature, the effects of SHMTs on health-related uncertainties during pregnancy are explored. The argument posits that while SHMTs can alleviate some health-related uncertainties, they may also create new ones. This is particularly the case when the abundance of vital data overwhelms pregnant persons, leads to false-positive diagnoses, or raises concerns about the accuracy and analysis of data. Consequently, it is concluded that the use of SHMTs is not a cure-all for overcoming health-related uncertainties during pregnancy. Since the use of such monitoring technologies can introduce new uncertainties, it is important to carefully consider where and for what purpose they are used, use them sparingly, and promote a pragmatic approach to uncertainties., (©Max Tretter. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 25.03.2024.)

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.

Pregnancy-related syncope presents special difficulties due to the rapid physiological changes that occur throughout gestation. This narrative review provides a thorough summary of the patterns and pregnancy outcomes secondary to syncope during pregnancy. There is an increase in syncope burden during pregnancy, and hence it is critical that medical professionals understand the significance of syncope during pregnancy. Syncope can have a negative impact on the health of the mother as well as the fetus. Therefore, this review summarizes data from studies on syncope in pregnancy. It includes observational studies, case reports, and review articles. Early detection and proper management are very important because pregnant women who experience cardiac syncope are at risk of unfavorable neonatal and maternal outcomes. The review reveals diverse trends in syncope incidence during pregnancy, emphasizing the need for a nuanced understanding of temporal variations. Risks of injury, uteroplacental insufficiency, psychological effects, interruptions in prenatal treatment, possible aggravation of pre-existing diseases, and lifestyle changes are examples of immediate maternal repercussions. Pregnancy-related syncope is a complex condition that affects the health of the mother and the fetus. The study stresses the need for careful clinical treatment due to the rapid results and the diversity in incidence patterns. The unique component of a possible relationship to the brain health of offspring justifies further investigation in this area., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Javier et al.)