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Breastfeeding is the healthiest way to feed newborns and infants. Breast milk is a unique biological fluid, a source of nutrients, immune factors and bacterial flora. Although we know breast milk is one of the factors influencing bacterial flora of the newborn's gastrointestinal tract, the diversity of factors affecting the composition of the microbiota and the biological role of bacteria in human milk is poorly understood. There are several potential factors that influence the composition of the flora of breast milk: immunological disorder of the mother, her diet, antibiotic treatments, birth type, and lactation duration. Currently, there are three known hypothesis about how milk becomes colonized: bacterial transfer from the mother's intestines (endogenous road), colonization after exposure to the bacteria in the birth canal during delivery and the transfer of bacteria from the skin to the breast during breastfeeding. Further research is needed to confirm the validity of the presented hypotheses. [ABSTRACT FROM AUTHOR]

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Introduction: This study aimed to evaluate the occurrence of clinically relevant (sub)microscopic chromosomal aberrations in fetuses with the nuchal translucency (NT) range from 3.0 to 3.4 mm, which would be potentially missed by cfDNA testing. Methods: A retrospective data analysis of 271 fetuses with NT between 3.0 and 3.4 mm and increased first trimester combined test (CT) risk in five cohorts of pregnant women referred for invasive testing and chromosomal microarray was performed. Results: A chromosomal aberration was identified in 18.8% fetuses (1:5; 51/271). In 15% (41/271) of cases, trisomy 21, 18, or 13 were found. In 0.7% (2/271) of cases, sex chromosome aneuploidy was found. In 1.1% (3/271) of cases, CNV >10 Mb was detected, which would potentially also be detected by genome-wide cfDNA testing. The residual risk for missing a submicroscopic chromosome aberration in the presented cohorts is 1.8% (1:54; 5/271). Conclusion: Our results indicate that a significant number of fetuses with increased CT risk and presenting NT of 3.0–3.4 mm carry a clinically relevant chromosomal abnormality other than common trisomy. Invasive testing should be offered, and counseling on NIPT should include the test limitations that may result in NIPT false-negative results in a substantial percentage of fetuses. [ABSTRACT FROM AUTHOR]

Introduction Material and Methods Results Conclusions Placenta accreta spectrum disorders (PAS) lead to major complications in pregnancy. While the maternal morbidity associated with PAS is well known, there is less information regarding neonatal morbidity in this setting.The aim of this study is to describe the neonatal outcomes (fetal malformations, neonatal morbidity, twin births, stillbirth, and neonatal death), using an international multicenter database of PAS cases.This was a prospective, multicenter cohort study based on prospectively collected cases, using the international multicenter database of the International Society for PAS, carried out between January 2020 and June 2022 by 23 centers with experience in PAS care. All PAS cases were included, regardless of whether singleton or multiple pregnancies and were managed in each center according to their own protocols. Data were collected via chart review. Local Ethical Committee approval and Data Use Agreements were obtained according to local policies.There were 315 pregnancies eligible for inclusion, with 12 twin pregnancies, comprising 329 fetuses/newborns; 2 cases were excluded due to inconsistency of data regarding fetal abnormalities. For the calculation of neonatal morbidity and mortality, all elective pregnancy terminations were excluded, hence 311 pregnancies with 323 newborns were analyzed. In our cohort, 3 neonates (0.93%) were stillborn; of the 320 newborns delivered, there were 10 cases (3.13%) of neonatal death. The prevalence of major congenital malformations was 4.64% (15/323 newborns), most commonly, cardiovascular, central nervous system, and gastrointestinal tract malformations. The overall prevalence of major neonatal morbidity in pregnancies complicated by PAS was 47/311 (15.1%). There were no stillbirths, neonatal deaths, or fetal malformations in reported twin gestations.Although some outcomes may be too rare to detect within our cohort and data should be interpreted with caution, our observational data supports reassuring neonatal outcomes for women with PAS. [ABSTRACT FROM AUTHOR]

Introduction Material and Methods Results Conclusions Placenta accreta spectrum (PAS) can lead to major peripartum morbidity. Appropriate management approaches depend on the clinical severity, each individual's preference, and the treating team's expertise. Peripartum hysterectomy is the most frequently used treatment option. However, it can impact psychological well‐being and fertility. We investigated whether conservative treatment with focal resection or leaving the placenta in situ is associated with comparable or lower maternal morbidity than hysterectomy in centers of excellence within the International Society for placenta accreta spectrum (IS‐PAS). Furthermore, a survey was conducted to explore potential barriers to conservative management in antenatal counseling and intraoperative decision‐making.Confirmed PAS cases in the prospective IS‐PAS database from 22 registered centers between January 2020 and June 2022 were included in the analysis. A separate online survey with 21 questions was answered by the IS‐PAS center experts about indications, diagnostic criteria, patient counseling, surgical practice, changes from the preoperative treatment plan, and why conservative management may not be offered.A total of 234 cases were included in the analysis: 186 women received hysterectomy and 38 women were treated by focal resection, and 10 by leaving the placenta in situ. Blood loss was lower in the focal resection group and in the placenta in situ group compared to the hysterectomy group (p = 0.04). 46.4% of the women initially planned for focal resection, and 35.7% of those initially planned for leaving the placenta in situ were ultimately treated by hysterectomy. Our survey showed that the IS‐PAS centers preferred hysterectomy according to a woman's wishes (64%) and when they expected less blood loss and morbidity (41%). Eighteen percent of centers did not offer focal resection at all due to a lack of experience with this technique. Reasons for not offering to leave the placenta in situ were avoidance of unexpected reoperation (36%), puerperal infection (32%), or skepticism about the method (23%).Uterus‐preserving treatment strategies such as focal resection appear to be safe alternatives to peripartum hysterectomy. However, less than half of the IS‐PAS centers perform them. Acceptance of conservative treatments could be increased by standardized criteria for their implementation and by systematic training for PAS experts. [ABSTRACT FROM AUTHOR]

Background: Although preeclampsia has long been recognized as a condition affecting late pregnancy, little is known of its pathogenesis or treatment. The placenta releases a number of hormones and molecules that influence the course of pregnancy, one of which is chromogranin A, a soluble protein secreted mainly from the chromaffin cells of the adrenal medulla. Its role in pregnancy and pregnancy-related disorders remains unclear. Therefore, the main aim of the proposed study is to determine whether chromogranin A is related with the occurrence of preeclampsia.Methods: Placental samples were collected from 102 preeclamptic patients and 103 healthy controls, and Chromogranin A gene (CHGA) expression was measured using real-time RT-PCR, The RT-PCR results were verified on the protein level using ELISA. The normal distribution of the data was tested using the Shapiro-Wilk test. The clinical and personal characteristics of the groups were compared using the Student's t-test for normally-distributed data, and the χ2 test for categorical variables. The Mann-Whitney U test was used for non-normally distributed data. As the log- transformation was not suitable for the given outcomes, the Box- Cox Transformation was used to normalize data from ELISA tests and CHGA expression. Values of P < .05 were considered statistically significant.Results: Chromogranin A gene expression was found to be significantly higher in the study group than in controls. Protein analyses showed that although the CgA concentration in placental samples did not differ significantly, the catestatin (CST) level was significantly lower in samples obtained from women with preeclampsia, according to the controls.Conclusions For Practice: This study for the first time reveals that chromogranin A gene expression level is associated with preeclampsia. Moreover, the depletion in catestatin level, which plays a protective role in hypertension development, might be a marker of developing preeclampsia. Further studies may unravel role of Chromogranin A in the discussed disease. [ABSTRACT FROM AUTHOR]

Objectives. The COVID-19 pandemic has forced a rapid adaptation of healthcare services to secure care for many patient groups. This includes women with gestational diabetes mellitus (GDM). We evaluated the impacts of the first COVID-19 wave on parameters such as the GDM treatment, glycemic control, and pregnancy outcomes. Methods. In this retrospective study from a reference diabetes center (Krakow, Poland), we compared patient data from two different time periods: the first wave of the COVID-19 pandemic (March 2020–June 2020) and the preceding five months (October 2019–February 2020). Data was collected from the medical records and telephone surveys. Results. We included 155 consecutive women (group N 1 = 73 and group N 2 = 82 from the COVID-19 pandemic period and non-COVID-19 period, respectively). During the COVID-19 pandemic, almost half of all GDM women (N 1 = 36 , 49.3%) used telemedicine as a method of contacting their diabetic specialists while this tool was not utilized in the earlier period. Moreover, these patients reported difficulties in performing blood glucose self-control more often (N 1 = 20 , 27.4%, vs N 2 = 7 , 8.5%; p ≤ 0.01) and spent less time on diabetes education than the control group on average (N 1 = 39 , 53.4%, vs N 2 = 9 , 9.8% below 2 hours of training; p ≤ 0.01). Most analyzed glycemic parameters and pregnancy outcomes were similar. Differences were found with respect to the incidence of prolonged labor (N 1 = 12 , 16.4%, vs N 2 = 3 , 3.7%; p ≤ 0.01) and preeclampsia (N 1 = 0 vs N 2 = 7 , 8.5%; p = 0.01). Conclusion. In this single-center observational study, the first wave of the COVID-19 pandemic did not seem to have a negative impact on pregnancy outcomes in GDM women, despite the difficulties in diabetes management delivery. [ABSTRACT FROM AUTHOR]

• HPLC-DAD method can be used to determine short-chain organic acids in neonatal meconium. • Meconium samples were collected from healthy children born either via cesarian section or through vaginal delivery. • The concentrations of organic acids in meconium varied in wide ranges. The purpose of this study was to develop and validate a high-performance liquid chromatography with a diode-array detector (HPLC-DAD) method for the determination of short-chain fatty acids (SCFAs) such as: acetic, propionic, butyric, valeric and isovaleric acids in meconium. Additionally, the proposed analytical procedure was used to determine SCFAs in meconium obtained from 17 neonates. All determined organic acids in meconium samples were separated with good resolution. The HPLC system was characterized by high precision (the coefficient of variance ≤ 2.5%), high determination coefficients of calibration curves (R2>0.997) and low limits of detection (LOD) and quantification (LOQ). For all investigated organic acids, LOD ranged from 0.01 to 0.80 mmol/ kg and LOQ values ranged between 0.04 and 2.64 mmol/ kg. Recovery of the HPLC assay for individual analytes comprised the range of 90±2 - 106±2%. Concentrations of acids in meconium collected from healthy children varied in wide ranges (CV within the range 0.79–2.47%) and no regularity was found in the molar ratios of the individual acids. The validation parameters obtained in this study, made the HPLC-DAD method reliable and useful tool for the determination of short-chain fatty acids in meconium samples. [ABSTRACT FROM AUTHOR]

[Display omitted] • SCFAs, crucial for health, result from bacterial fermentation of dietary fibres. • CE-C4D method for SCFAs analysis in infants' faeces was developed. • Polybrene dynamic capillary coating enables the separation of SCFAs isomers. • Analysis of faeces gives insight into microbial metabolism in infants' intestines. Short-chain fatty acids (SCFAs) are a major group of products produced during colonic bacterial fermentation of nondigestible carbohydrates demonstrating several important functions, e.g. regulating the immune system activity or the lipid metabolism. A detailed profile and concentration characterization of SCFAs in infant faeces is essential for expanding knowledge regarding the role of SCFAs in infant physiology and pathophysiology. This research presents the development and validation of a capillary electrophoresis method with a contactless capacitively coupled conductivity detector (CE-C4D) for the analysis of SCFAs and succinic and lactic acids in infant faeces. The study focused on optimizing the background electrolyte, mainly dynamic capillary coating with polybrene, and utilizing cyclodextrins to achieve efficient separation. Validation parameters, such as linearity (0.993 – 0.998), limits of detection and quantification (LOD: 0.10 – 0.89 μg/mL; LOQ: 0.35 – 2.97 μg/mL), intra- and inter-day precision (1.71 – 5.69 % and 1.11 – 12.5 %, respectively), injection repeatability (0.91 – 5.70 %), trueness (-12.8 – 3.80 %), and matrix effect (78.8 – 108.6 %), were assessed and the method was found suitable for the purpose. The demonstrated method was successfully applied to determine nine organic acids in faecal samples. [ABSTRACT FROM AUTHOR]

Hypertriglyceridemia, related with triglyceride (TG) in plasma above 1.7 mmol/L is one of the cardiovascular risk factors. Very low density lipoproteins (VLDL) are the main TG carriers. Despite being time consuming, demanding well-qualified staff and expensive instrumentation, ultracentrifugation technique still remains the gold standard for the VLDL isolation. Therefore faster and simpler method of VLDL-TG determination is needed. Vibrational spectroscopy, including FT-IR and Raman, is widely used technique in lipid and protein research. The aim of this study was assessment of Raman and FT-IR spectroscopy in determination of VLDL-TG directly in serum with the isolation step omitted. TG concentration in serum and in ultracentrifugated VLDL fractions from 32 patients were measured with reference colorimetric method. FT-IR and Raman spectra of VLDL and serum samples were acquired. Partial least square (PLS) regression was used for calibration and leave-one-out cross validation. Our results confirmed possibility of reagent-free determination of VLDL-TG directly in serum with both Raman and FT-IR spectroscopy. Quantitative VLDL testing by FT-IR and/or Raman spectroscopy applied directly to maternal serum seems to be promising screening test to identify women with increased risk of adverse pregnancy outcomes and patient friendly method of choice based on ease of performance, accuracy and efficiency. [ABSTRACT FROM AUTHOR]

Preeclampsia is a pregnancy disorder associated with shallow placentation, forcing placental cells to live in hypoxic conditions. This activates the transcription factor kappa B (NFκB) in maternal and placental cells. Although the role of NFκB in preeclampsia is well documented, its mechanism of activation in trophoblastic cells has been never studied. This study investigates the mechanism of NFκB activation in a first trimester trophoblastic cell line (HTR8/SVneo) stimulated by a medium containing serum from preeclamptic (PE) or normotensive (C) women in hypoxic (2% O2) or normoxic (8% O2) conditions. The results indicate that in HTR8/SVneo cells, the most widely studied NFκB pathways, i.e., canonical, non-canonical and atypical, are downregulated in environment PE 2% O2 in comparison to C 8% O2. Therefore, other pathways may be responsible for NFκB activation. One such pathway depends on the activation of NFκB by the p53/RSK1 complex through its phosphorylation at Serine 536 (pNFκB Ser536). The data generated by our study show that inhibition of the p53/RSK1 pathway by p53-targeted siRNA results in a depletion of pNFκB Ser536 in the nucleus, but only in cells incubated with PE serum at 2% O2. Thus, the p53/RSK1 complex might play a critical role in the activation of NFκB in trophoblastic cells and preeclamptic placentas. [ABSTRACT FROM AUTHOR]

Central nervous system (CNS) abnormalities cause about 40% of infant deaths in the first year of life. In case of the detection of abnormalities by ultrasound, a pregnant woman should be offered prenatal magnetic resonance imaging (pMRI). The aims of our study were: (1) to evaluate the effectiveness of pMRI in the diagnosis of selected fetal CNS defects; and (2) to assess the possibility of replacing postnatal tests with prenatal magnetic resonance. The prospective and observational study was conducted between 2014 and 2017 at the University Hospital in Krakow. Patients with suspected CNS defects of the fetus were qualified for pMRI in the third trimester of pregnancy. Sixty patients were included in the study group. Prenatal MRI was characterized by low accuracy in the diagnosis of complex brain defects. Cohen's kappa coefficient κ = 0.21 (95% CI 0.00–0.46). No evidence was found suggesting the replacement of postnatal tests with pMRI. MRI was characterized by low consistency of diagnoses in the case of complex brain defects. The possibility of replacing postnatal studies with pMRI was not supported. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced a rapid adaptation of healthcare services to secure medical care for many patients' groups. This includes women with Gestational diabetes mellitus (GDM). We evaluated the impacts of the first COVID-19 wave on parameters such as the GDM treatment, glycemic control and pregnancy outcomes. In this retrospective study from a reference diabetes centre (Krakow, Poland), we compared patient data from two different time periods: the first wave of COVID-19 pandemic (March 2020 - June 2020) and the preceding five months (October 2019 - February 2020). Data was collected from the medical records and telephone surveys. No patient was diagnosed with concomitant COVID-19. We included 155 women - Group 1 N=73 and Group 2 N= 82 from the COVID-19 pandemic period and non-COVID-19 period, respectively. During the COVID-19 pandemic, almost half of all GDM women (N1=36, 49.3%) used telemedicine as a method of contacting their diabetic specialist while this tool was not utilized in the earlier period. Moreover, these patients reported difficulties in performing blood glucose self-control more often (N1=20, 27.4% vs. N2=7, 8.5% p=0.002) and spent less time on diabetes education and training than the control group on average (N1=39, 53.4% vs. N2=9, 9.8% below 2 hours of training; p≤0.001). Glycemic control parameters were very similar and most analysed pregnancy outcomes occurred with comparable frequencies. Differences were found with respect to the incidence of prolonged labour which was more frequent in the COVID-19 period Group 1 (N1=12, 16.4% vs. N2=3, 3.7% p=0.007) whereas no episodes of pre-eclampsia were observed in this group (N1=0 vs. N2=7, 8.5% p=0.01) during this same time period. We report that the first wave of the COVID-19 pandemic did not seem to have a negative impact on glycemic control and pregnancy outcomes in GDM women, in spite of difficulties in diabetes management delivery. Disclosure: M. Wilk: None. P. Surowiec: None. B. Matejko: Other Relationship; Self; Ascensia Diabetes Care, Roche Diabetes Care. K. Cyganek: Advisory Panel; Self; Medtronic, Speaker's Bureau; Self; Lilly Diabetes, Novo Nordisk. H. Huras: None. M. Malecki: Advisory Panel; Self; Abbott Diabetes, Medtronic, Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Merck & Co., Inc., Mundipharma International, Novo Nordisk, Sanofi-Aventis, Servier Laboratories. [ABSTRACT FROM AUTHOR]