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INTRODUCTION: Obstetric history and maternal body composition and lifestyle may be associated with serious complications both for the mother, such as gestational diabetes mellitus (GDM), and for the fetus, including congenital malformations such as neural tube defects (NTDs). AREAS COVERED: In view of the recent knowledge, changes of nutritional and physical activity habits ameliorate glycemic control during pregnancy and in turn improve maternal and neonatal health outcomes. Recently, a series of small clinical and experimental studies indicated that supplementation with inositols, a family of insulin sensitizers, was associated with beneficial impact for both GDM and NTDs. EXPERT OPINION: Herein, we discuss the most significant scientific evidence supporting myo-inositol administration as a prophylaxis for the above-mentioned conditions.

Maternal BMI has been shown to be inversely correlated with vitamin D status (25-hydroxyvitamin D (25(OH)D) concentrations) during pregnancy. Pregnant women with obesity and with vitamin D deficiency are at risk of many adverse health outcomes in pregnancy.The aim of this study was to examine differences in maternal vitamin D status across normal weight, overweight and obese pregnant women in early pregnancy.Data collected at baseline from a double-blind randomised vitamin D intervention study (MO-VITD) were used. Pregnant women without pregnancy complications, aged > 18 years and having a singleton pregnancy were recruited between January 2016 and August 2017 at antenatal clinics in the Western Health and Social Care Trust, Northern Ireland. Non-fasting blood samples were collected at 12 weeks gestation and analysed for total serum 25(OH)D, using liquid chromatography tandem mass spectrometry. Data from 239 pregnant women (80 normal weight, 79 overweight, 80 obese) were included in the current analysis.The mean ± SD 25(OH)D concentration of all pregnant women at 12 weeks gestation was 52.0 ± 21.6 nmol/L. Women classed as obese or overweight had significantly lower 25(OH)D concentrations compared to women of normal weight (48.8 ± 20.3 vs 49.8 ± 20.4 vs. 57.5 ± 23.1 nmol/L, P = 0.019; obese, overweight, normal weight respectively). A total of 45% of all pregnant women were found to be either vitamin D deficient (25(OH)D < 25nmol/L; 13%) or insufficient (25–50 nmol/L; 32%) in early pregnancy. BMI was significantly negatively correlated with 25(OH)D concentrations (r = -0.168; P = 0.009). Regression analyses showed that BMI (β = -0.165; P = 0.006), season (β = 0.220; P = < 0.0001), supplement use (β = -0.268; P < 0.0001) and a sun holiday within the previous 6 months (β = -0.180; P = 0.010) were significant predictors of 25(OH)D concentrations. In early pregnancy, 62% of pregnant women reported using a supplement containing vitamin D and 38% reported no supplement use. Supplement users had a significantly higher vitamin D status than non-supplement users in all BMI categories but overall, 37% of supplement users were still classified as vitamin D insufficient. Vitamin D status was significantly lower in winter months compared to summer months. In early pregnancy, especially during winter months, pregnant women with obesity, particularly non-supplement users, are at higher risk of low vitamin D status. Based on the lower vitamin D status observed in early pregnancy in obese women, the effect of BMI on vitamin D supplementation throughout pregnancy needs to be examined.

Objective:The aim of this study was to evaluate the association between possible covariates, with emphasis on maternal body mass index (BMI), on exclusive breastfeeding and on total breastfeeding during the first postnatal year. Design:A longitudinal study encompassing 723 women who were followed during the first postnatal year Methods:Data concerning pregnancy, delivery, neonatal period, and breastfeeding were extracted from respective medical records. Sociodemographic data on the participants were self-reported. The Cox Proportional Hazard Model was used for investigating the effects of different covariates. Results:Compared with women with BMI

Objective: To investigate the effects of maternal body mass index (BMI) and total weight gain during the pregnancy (WGDP) on all stages of labor. Material and Methods: This is a prospective case-control study carried out at a tertiary referral hospital during 1-year period of time. We divided study population into 4 groups according to BMI and classified women according to WGDP; inadequate, optimum, excessive. Then we assessed the maternal characteristics, cesarean rate, all variables of labor stages, delivery complications, operative delivery rates, and interventions such as; induction rate and episiotomy. Results: A total of 523 women were included in the study [n=55 (10.5%) cesarean section and n=468 (89.5%) vaginal delivery]. There were 435 pregnant Turkish women and 88 Syrian Refugees in the study population. Younger maternal age and need for episiotomy was more common in low-weight group than others. All stages of labor except transition stages (duration between 7 and 10 cm of cervical dilatation) was longer in obese group (222.9±35.6 min, 195.8±29.6 min, 200.6±30.4 min, 255.8±38.2 min in group 1,2,3 and 4, respectively) (p

Low birth weight is one of the determinants of infant mortality, morbidity, and disability, which can even have an impact on the future. Several studies have suggested that the condition of low birth weight (LBW) infants is influenced by the lack of maternal nutritional status in early pregnancy. Moreover, the prevalence of malnutrition in Indonesia is still high. Therefore, this study attempted to analyze the relationship of maternal nutritional status in early pregnancy as a predictor of LBW infants. Using a cross-sectional study design, this study involved 62 pregnant patients aged 20–35 years who had antenatal visits and a term delivery at Puskesmas Kecamatan Cakung. The measurements of body mass index (BMI) and mid-upper arm circumference (MUAC) in early pregnancy are used to determine the maternal nutritional status. Pregnant women with BMI

Purpose: We generate 12 models from 4 pregnant individuals to evaluate individual differences in local specific absorption rate (SAR) for differing body habitus and fetal and maternal positions. Methods: Structural MR images from 4 pregnant subjects (including supine and left-lateral maternal positions) were manually segmented to create 12 body models by rotating the fetus, modifying the fat content, and altering the maternal arm position in 1 of the subjects. Electromagnetic simulations modeled at 3 Tesla determined the average and peak local SAR in the maternal trunk, fetus, fetal brain, and amniotic fluid. Results: We observed a significant range of fetal and maternal peak local SAR across the models (maternal trunk: 19.14-44.03 watts/kg, fetus: 9.93-18.79 watts/kg, fetal brain 3.36-10.3 watts/kg). We found that maternal body habitus changes introduced a significant variation in the maternal peak local SAR but not the fetal local SAR. However, the maternal position (either rotating the mother to left–lateral position or altering the arm position) introduced changes in fetal peak local SAR (range: 11.9-17.9 watts/kg). Rotating the fetus also introduced variation in the fetal and fetal brain peak local SAR. Conclusion: The observed variation in SAR emphasizes the need for more anatomical models to enable better safety management of individuals during fetal MRI, including a wider range of gestational ages., National Institutes of Health (Grants U01 HD087211, R01 EB017337)

Parasitoid researchers have generally thought that the body size of the mother parasitoid does not affect the fitness performance of the progeny during the immature stage, as long as the progeny develop in the same environment. We reveal for the first time that this is not true for the parasitoid Echthrodelphax fairchildii (Hymenoptera: Dryinidae), which is parasitic on planthoppers. Large females ensured an increased survival rate for their progeny during the immature stage and a large body size at adult emergence. Maternal body size differentially affected the body sizes and survival rates of male and female progeny. Small females did not produce female progeny, and the survival rate of the female progeny increased more steeply with increasing maternal body size than that of the male progeny. Meanwhile, the body size of male progeny increased more steeply with increasing maternal body size. The influence of maternal body size on progeny survival to adult emergence has never been reported in insects before. In addition, large females were more likely to lay female eggs, suggesting that females control the sex ratio of progeny in response to their own body size.

OBJECTIVE: To evaluate the association between birthweight and maternal heart rate (MHR) or heart rate variability (HRV) under resting conditions at 20–24 gestational weeks and 34 weeks or later (34+ weeks). METHODS: Data were retrospectively reviewed from the Safe Passage Study, a prospective longitudinal cohort study of alcohol use in pregnancy and birth outcomes in Cape Town, South Africa, between August 2007 and January 2015. Using custom-designed software, MHR and indicators of HRV were obtained from the recorded maternal electrocardiograms and compared with birthweight and z-scores of birthweight adjusted for gestation and gender. RESULTS: Data from 5655 women were included. MHR increased from 84.6 bpm at 20–24 weeks to 88.3 bpm at 34+ weeks. Increasing MHR from 70–80 to 80–90 and 90–100 bpm at 20–24–weeks was associated with increasing birthweight from 2940 to 2998 and 3032 g, respectively (P

The process of aging can be defined as the sum accumulation of damages and changes in metabolism during the life of an organism, due to both genetic predisposition and stochastic damage. During the gestational period and following parturition, similar damage can be seen due to the strenuous effect on the maternal body, exhibited on both the physiological and cellular level. In this review, we will focus on the similar physiological and cellular characteristics exhibited during pregnancy and aging, including induction of and response to oxidative stress, inflammation, and degradation of telomeres. We will evaluate any similar processes between aging and pregnancy by comparing common biomarkers, pathologies, and genetic and epigenetic effects, to establish the pregnant body as a model for aging. This review will approach the connection both in respect to current theories on aging as a byproduct of natural selection, and regarding unrelated biochemical similarities between the two, drawing on existing studies and models in humans and other species where relevant alike. Furthermore, we will show the response of the pregnant body to these changes, and through that illuminate unique areas of potential study to advance our knowledge of the maladies relating to aging and pregnancy, and an avenue for solutions.

This study examines the identity transition of women when they become mothers and return to work. Twenty‐two first‐time mothers were interviewed at two points in time: just after giving birth and on re‐entry into employment after maternity leave. The findings suggest that this transition is influenced by multiple factors on different levels which include individual factors, such as partner support and career aspirations, organizational factors such as family‐friendly work practices and role models, and societal factors such as social norms and attitudes towards the maternal body. The findings highlight the importance of context by stressing the interrelated nature of factors on the micro‐, meso‐ and macro‐level in order to better understand the identity transition to motherhood.

OBJECTIVES: Fatty acid esters of hydroxy fatty acids (FAHFAs) are a novel class of endogenous lipids with suspected anti-inflammatory and anti-diabetic properties in adults. They have been reported to be present in breast milk (BM), but there is no data about their role in infant growth and nutrition. Our objective was to determine the role of maternal body mass index (BMI) on BM FAHFA composition and to delineate the association of these BM fatty acids on infant growth and adiposity. METHODS: This is a secondary analysis of a randomized controlled trial of maternal vitamin D supplementation during lactation (NCT00412074). We included 40 control mother-infant dyads who had BM samples at one (V1) and four (V4) months and outcome data available. At V1 and V4, maternal and infant anthropometrics were measured, dual energy absorptiometry (DXA) scans conducted, and BM samples collected. BM lipids were measured using established methods of UHPLC-C30RP/HRAM mass spectrometry. Our primary infant growth outcomes were percentage of fat and lean mass, fat mass index, and fat-free mass index. Redundancy analysis (RDA) was used to analyze the relation between individual lipids, maternal BMI, and infant growth. Focusing on V1 measurements, we computed the unadjusted associations between maternal BMI with BM lipids; BM lipids with infant growth using Pearson's correlations; and the adjusted associations of BM lipids at V1 with infant growth using linear regression with adjustment for relevant covariates. RESULTS: The mean maternal BMI was 29 kg/m(2). There was no correlation between maternal BMI and reported dietary intake of fat. Higher maternal BMI was associated with a higher concentration of saturated and monounsaturated FAHFAs, and a lower concentration of polyunsaturated FAHFAs in BM at V1. In an unadjusted model, saturated and monounsaturated FAHFAs were associated with higher infant fat mass and lower lean mass. The converse was seen with polyunsaturated FAHFAs which were associated with lower infant fat mass and higher lean mass. In a fully adjusted model, these associations were attenuated but the overall pattern persisted (Table 1). CONCLUSIONS: Maternal BMI influences the FAHFA composition of BM. In turn, BM FAHFA composition may play a role in programming infant growth patterns. FUNDING SOURCES: The Nutritional Obesity Research Consortium Grant. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

Objective: We examined the influence of maternal body mass index (BMI), and of breast and nipple anatomic variations, on breastfeeding difficulties and duration. Methods: In this prospecti...

Objectives To assess the visualization rate and size of the frontal horns (FHs) and cavum septi pellucidi (CSP) in healthy fetuses throughout pregnancy. Methods After Institutional Review Board approval, 522 consecutive uncomplicated singleton pregnancies between 15 and 39 gestational weeks were enrolled in the study. Ultrasound measurements of the anterior horn width (AHW), center from the horn distance (CFHD), distance from the FHs to the CSP, and CSP width were retrospectively performed using axial transventricular or transcerebellar planes. Available maternal body mass indices were recorded. Results At least 1 FH was seen in 78% of the cases. The mean AHW decreased over the second trimester and plateaued in the third trimester. The CFHD plateaued in the second trimester and increased in the third trimester. Downside FHs were generally larger than upside FHs. More FHs were measured in transventricular (69%) than transcerebellar (31%) planes. Frontal horns were seen with high, low, and no confidence in 57%, 21%, and 22% of cases, respectively. No-confidence rates were 17% in the second trimester and 42% in the third trimester. The CSP was not visualized in 4% of cases; 15 of 19 cases of a nonvisualized CSP were scanned between 18 and 37 weeks. Mean body mass indices ± SDs were 27.6 ± 6.7 kg/m2 for the patients in cases of a visualized CSP and 32.4 ± 9.1 kg/m2 for the patients in cases of a nonvisualized CSP. Conclusions Normative data for the fetal FH and CSP width were established. Frontal horns are more frequently seen on transventricular views and are difficult to confidently assess in the late third trimester. This study challenges previously reported data that the CSP is seen in 100% of cases from 18 to 37 weeks.

In this essay, I analyze various ways in which pregnant bodies are rendered consumable. Tracing our preoccupation with pregnancy diets, I argue that a pregnant woman is made responsible for producing a consumable body. Indeed, producing and maintaining a consumable, fetus-friendly body is a responsibility that women carry before, during, and even after pregnancy. The sphere of this responsibility is also ever-expanding: it goes from detoxing the body to disinfecting the household, and even to protecting the environment at large. I examine two conditions that help construct the maternal body as consumable: 1) the invisibility of the consumed body, and 2) the appeal to “nature” as a justification for consumption. As I will show, the default position of women as consumable is reinforced both by erasing the maternal body and by appealing to the “naturalness” of breastfeeding.

Halima Bashir’s Tears of the Desert, a memoir co-authored with journalist Damien Lewis, has received critical acclaim for exposing the atrocities that the government of Sudan commits, by proxy, against African animists, Christians and Muslims in the Darfur region in western Sudan. In this article, I examine how Bashir bears witness to the use of wartime rape as a weapon for ethnic cleansing. Drawing on Julia Kristeva’s theorisation of the “abject” and on discourse on wartime rape by, among others, Catharine MacKinnon and Ruth Seifert, the article explores the precarious position of women and girls in warzones, highlighting the ways in which the maternal (and feminine) body is used as a site/sight of group struggles.Keywords: Bearing witness; wartime rape; ethnic cleansing; the abject; maternal body

Background There is widespread and some unexplained variation in induction of labour rates between hospitals. Some practice variation may stem from variability in clinical guidelines. This review aimed to identify to what extent induction of labour guidelines provide consistent recommendations in relation to reasons for, and timing of, induction of labour and ascertain whether inconsistencies can be explained by variability guideline quality. Method We conducted a systematic search of national and international English-language guidelines published between 2008 and 2018. General induction of labour guidelines and condition-specific guidelines containing induction of labour recommendations were searched. Guidelines were reviewed and extracted independently by two reviewers. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument. Findings Forty nine guidelines of varying quality were included. Indications where guidelines had mostly consistent advice included prolonged pregnancy (induction between 41 and 42 weeks), preterm premature rupture of membranes, and term preeclampsia (induction when preeclampsia diagnosed ≥37 weeks). Guidelines were also consistent in agreeing on decreased fetal movements and oligohydramnios as valid indications for induction, although timing recommendations were absent or inconsistent. Common indications where there was little consensus on validity and/or timing of induction included gestational diabetes, fetal macrosomia, elevated maternal body mass index, and twin pregnancy. Conclusion Substantial variation in clinical practice guidelines for indications for induction exists. As guidelines rated of similar quality presented conflicting recommendations, guideline variability was not explained by guideline quality. Guideline variability may partly account for unexplained variation in induction of labour rates.

The present study was performed to investigate whether maternal body mass index (BMI) affected the live birth (LB) outcomes of frozen embryo transfers (FET) in patients who underwent freeze-all treatment cycles. The autologous intracytoplasmic sperm injection (ICSI) cycles with blastocyst freeze-all cycles performed between February 2015 and January 2016 were retrospectively investigated. The 1188 subsequent FET performed were grouped according to maternal BMI classes for analysis; underweight (

Intrapartum fever is a common perinatal complication, associated with short- and long-term adverse outcomes. Limited data exist regarding the association between the peak and duration of maternal fever and the extent and severity of maternal and neonatal complications.This study aimed to examine the association between maternal intrapartum fever peak and duration and perinatal outcomes.A retrospective cohort analysis of term singleton live births in 2 medical centers between the years 2003 and 2015 was conducted. The study group included parturients who experienced intrapartum fever, defined as a temperature of ≥38.0°C (100.4°F). Fever duration was defined as the time elapsed between the first documented fever and subsequent first documented normal body temperature (38°C or100.4°F) or if the temperature did not return to normal until delivery. Adjusted risks for adverse perinatal outcomes were calculated using multiple logistic regression models to control for confounders.A cohort study of 85,713 deliveries was analyzed, of which 1517 (1.8%) parturients experienced fever during delivery. Adverse composite neonatal outcome gradually worsens, in a dose-response manner, with higher maximal maternal temperature. Similar dose-response deterioration was found when maximal parturient temperature was combined with fever duration (P=.015). Higher or longer maternal fever was not independently associated with cesarean or instrumental deliveries (P=.648). Duration alone was not significantly associated with worsening neonatal outcomes (P=.711).Maximal intrapartum maternal fever, solely and when combined with fever duration, is correlated with neonatal complications in a dose-dependent manner. Further prospective studies are needed to examine the potential benefit of rigorous maternal body temperature control on perinatal outcomes.

Introdução: No período gestacional o corpo materno sofre inúmeras alterações fisiológicas em um curto espaço de tempo. O uso de produtos farmacoterapêuticos na gestação deve ser cauteloso já que muitas substâncias encontradas nesses produtos podem trazer riscos gravíssimos para a gestante. Objetivo: Avaliar o uso de plantas medicinais por gestantes atendidas em uma unidade básica de saúde de Juazeiro do Norte-CE. Método: O presente estudo é caracterizado como transversal e observacional de caráter quantitativo. Realizado com 15 gestantes de uma UBS de juazeiro do norte no período de outubro de 2019 a novembro de 2019. Resultados: No presente estudo foi avaliado o uso de produtos farmacoterapêuticos por gestantes atendidas em uma Unidade Básica de Saúde de Juazeiro do Norte, de início caracterizou-se o perfil socioeconômico, em seguida o histórico gestacional, e por fim verificou-se o uso de plantas medicinais pelas gestantes, onde notou-se que 20% das gestantes utilizavam algum tipo de planta medicinal. Conclusão: Foi possível observar as plantas medicinais utilizadas pelas gestantes em uma Unidade Básica de Saúde de juazeiro do Norte-CE, podendo verificar que mesmo sendo realizada pela minoria das gestantes a prática de uso de produtos farmacoterapêuticos continua em alta atualmente. Desse modo, é de extrema importância que as mulheres em estado gestacional tenham o devido cuidado com a sua saúde quando se trata do uso de plantas medicinais, pois muitas das plantas medicinais não possuem estudos que indiquem sua eficácia e segurança, assim como os seus efeitos tóxicos.

There is controversy as to whether maternal body mass index (BMI) influences the contractility of human myometrium in pregnancy. The aim of this study was to examine spontaneous contractile activity of human pregnant myometrium in vitro, with respect to maternal BMI. Myometrial tissue specimens were obtained at cesarean delivery from 74 women with BMI values ranging from 19 to 50.1 kg m–2. By recording in vitro from eight strips per donor (590 strips in total), several parameters of spontaneous contractile activity were monitored. The relationship between BMI and contractility was evaluated using linear regression analysis. There was a significant correlation between maximum amplitude (P=0.007) and mean contractile force (P=0.001) with increasing BMI. However, the time to onset of contractions (P=0.009), and time taken to reach maximal amplitude (P=0.020) also increased with increasing BMI. No significant correlation was observed with BMI for other parameters studied. The mean maximum amplitude value for spontaneous contractions was 37±1 mN, the mean contractile force for spontaneous contractions was 4.1±0.1 mN, the average time to the first spontaneous contraction was 11.3±0.6 min and the average frequency of contractions was 6.5±0.2 per hour. These results suggest that the time to onset of contractions is increased with increasing maternal BMI, but that the force developed is greater. In all other respects, human uterine contractility is unaffected by increasing BMI. These findings underline the complexity of regulation of uterine contractility in labor with elevated maternal BMI.

This essay suggests that despite the traditional viewpoint that it seemingly supplements patriarchy's consistent marginalization of maternal bodies, masochism, as formulated by Gilles Deleuze, offers the possibility of a maternal subjectivity beyond paternal domination. Deleuze's conception of masochism reveals an innovative way in which to view maternity as a tactical schema that operates through the perverse disavowal and resexualization of patriarchal law in order not only to destabilize its foundations, but to produce a maternal identity of the mother's own creation. This essay will use Ira Levin's horror novelRosemary's Babyto contextualize an adaptation of Deleuze's theory in order to account for the relationship between mother and child, and the emergent subjectivity the dyad produces. Levin's novel seamlessly showcases how the maternal body is observed and optimized by reproductive technologies in order to produce not only a heteronormative ideal of maternity, but a child who will reflect paternal law. This essay argues that the titular character, Rosemary Woodhouse, establishes a masochistic contract with her son whereby she reconfigures his identity through a perverse disavowal of the Law of the Father, replacing it with maternal authority. Most important, her performance of masochism results in the marginalization of the father, and the emergence of a new maternal identity.

The effects on fetal weights and maternal health of taking 32 μL blood microsamples at the end of organogenesis in a mouse embryofetal development (EFD) study design was investigated with the aim of reducing satellite animal usage. The effects of warming, handling and sampling either 3 or 6 times on gestation day 16 was evaluated. Maternal body weight gain was transiently reduced when animals underwent warming and handling with or without microsampling. Fetal weights on gestation day 18 were reduced after 6 occasion warming and handling alone or taking samples, but not when sampling was limited to 3 timepoints. Taking 3 microsamples of 32 μL had no permanent adverse effects on maternal health or toxicologically significant effects on fetal development (measured by fetal weights). This regimen could be used to generate composite toxicokinetic profiles using only 6 main test animals in mouse EFD studies provided sampling procedures were matched across groups.

The aim of this study was to examine relationships between sustainable energy intake (SusEI) and resting metabolic rate (RMR) in Eothenomys miletus and to understand the factors limiting maximum SusEI/RMR during lactation. Body mass, food intake, RMR, milk energy output (MEO), litter size, litter mass, and thermal conductance were measured. Body mass decreased during lactation, but food intake increased. RMR was positively related to the weight of the mammary glands and MEO. We conclude that SusEI is limited at the level of 3.59 × RMR in first-lactating E. miletus. There were no significant effects of litter size on maternal body mass, food intake, thermal conductance, RMR, or litter mass. There were significant effects of fur-shaving on food intake, RMR, and thermal conductance. Fur-shaving increased thermogenic capacity but had no significant effect on reproductive output. These observations provide support for the peripheral limitation hypothesis and argue against the heat dissipation limitation hypothesis.

Introduction. Undernutrition continues to be a major public health problem throughout the developing world, particularly in sub-Saharan Africa and Asia including India. Limited studies suggest associations between maternal body mass index (BMI) and child nutritional status. The present study aims to determine the relationship between maternal BMI and children nutritional status. Methods. The study was conducted among 246 mothers who had given birth to single children (n=246) and belonged to the Proto-Australoid population of North Bengal, India. The anthropometric measurements of height and weight were recorded following standard procedures. Overall body composition was evaluated using BMI. Result. The results showed that overall mean BMI among mothers was 20.63±2.53 kg/m2, while those among boys and girls were 15.19±1.62 kg/m2 and 14.86±1.37 kg/m2 (p<0.001), respectively. The BMI of mothers were significantly and highly correlated with HAZ (0.709) and BMIZ (0.748) (p<0.001) of children. These are indicative of a strong genetic component between maternal and child anthropometry. Conclusion. The results indicate significant associations between mothers’ and children’s nutritional status. Assessments of body composition and nutritional status using BMI, especially among mothers and their children, are recommended.

Objectives There have been several attempts to classify cause of death (CoD) in stillbirth; however, all such systems are subjective, allowing for observer bias and making comparisons between systems challenging. This study aimed to examine factors relating to determination of CoD using a large dataset from two specialist centers in which observer bias had been reduced by classifying findings objectively and assigning CoD based on predetermined criteria. Methods Detailed autopsy reports from intrauterine deaths in the second and third trimesters during 2005–2013 were reviewed and findings entered into a specially designed database, in which CoD was assigned using predefined objective criteria. Data regarding CoD categories and factors affecting determination of CoD were examined. Results There were 1064 intrauterine deaths, including 246 early intrauterine fetal deaths (IUFD) (< 20 weeks), 179 late IUFDs (20–23 weeks) and 639 stillbirths (≥ 24 weeks' gestation). Overall, around 40% (n = 412) had a clear CoD identified, whilst around 60% (n = 652) were classified as ‘unexplained’, including around half with identified risk factors or lesions of uncertain significance, with the remaining half (n = 292 (45%)) being entirely unexplained. A stepwise increase in the proportion of unexplained deaths was observed with increasing maceration. Black and Asian women had significantly greater proportions of deaths due to ascending infection, whilst women aged over 40 years had significantly increased placenta-related CoDs. There was no significant difference in CoD distribution according to maternal body mass index or with increasing postmortem interval. Around half of those with an identifiable CoD could be identified from clinical review and external fetal examination or imaging, with most of the remainder being determined following placental examination. Conclusions Based on objective criteria, many intrauterine deaths throughout gestation remain unexplained despite autopsy examination. The rate of unexplained death varies from around 30% to 60% depending on interpretation of the significance of features. CoD determination is dependent on both the classification system used and subjective interpretation, such that variation in the proportion of ‘unexplained’ cases is based largely on speculation regarding mechanisms of death. Novel methods to determine objectively the mechanism of death at postmortem examination are required. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

SummaryMarlene van Niekerk’s three novels, Triomf, Agaat and Memorandum: A Story with Paintings show a deliberate engagement with the abject and abjection in the Kristevan sense of the word. Kristeva examines abjection and its manifestations extensively in Powers of Horror (1982) and this text form the theoretical departure point for this analysis. Following Dovey (1988) my approach will be “drawing attention to the theoretical issues the novels articulate and to the modes of novelistic discourse with which they engage”. I will locate the traces of the abject in Van Niekerk’s novels and demonstrate to what extent the three texts under discussion reflect Kristeva’s viewpoints on abjection, the relationship with the maternal body and related themes within Kristeva’s critical project such as the boundary between the I as subject and the abject object, food loathing and the omnipresent struggle with the maternal hold over the subject.

Objective poor body image during pregnancy is a growing issue. Similarly, emerging evidence is suggesting that social media use may increase the risk of poor well-being e.g. depression, anxiety and body image concerns amongst users. Research has not examined how social media use may influence women during pregnancy. The aim of this study was to therefore to explore the relationship between body image during pregnancy and Facebook use. Design a cross sectional self-report questionnaire. Participants two hundred and sixty nine pregnant women. Setting community groups and online forums. Measurements a self-report questionnaire exploring maternal body image, use of Facebook and how mothers perceived Facebook affected their body image. Descriptive statistics were used to explore body image perceptions. Partial correlations (controlling for maternal age, education, parity and gestation) were used to explore the association between Facebook use and body image during pregnancy. Results negative body image was common in the sample, increased with gestation and was unrelated to pre pregnancy weight. Mothers with a Facebook account had higher body image concerns than those without a Facebook account. Of those with an account, increased Facebook use was associated with increased body image dissatisfaction, particularly in terms of postnatal concerns for how their body would look with 56.5% reporting that they frequently compared their pregnant body to other pregnant women on the site. Facebook access was frequent with 85% of participants checking it at least once per day and the average participant spending over an hour per day on the site. Key conclusion although causality cannot be fully explained, Facebook use may increase mother's risk of poor body image dissatisfaction during pregnancy. Mothers with already poor body image may also be drawn to the site in order to make comparisons of their appearance. Implications for practice the potential impact of Facebook on increasing the risk of, or promoting existing poor body image is an important message for those working to support mothers during pregnancy and the postnatal period. Care should be taken when directing mothers to use the site.

Lymphoma rarely occurs during pregnancy, making this condition difficult to define. Lymphomas that occur in reproductive organs during pregnancy exhibit unique clinical characteristics. Among the limited cases, non-Hodgkin's lymphoma (NHL) shows a considerably higher incidence rate than Hodgkin's lymphoma (HL); NHL also displays clinical characteristics, such as high aggressiveness, advanced stage, and poor outcome. This study reports on four cases of lymphomas in non-gonadal organs (HL, n=2; NHL, n=2) during pregnancy. The tumors rapidly progressed in all patients during pregnancy but remitted at the end of pregnancy and/or therapy. The two HL cases were nodular sclerosis classical HL and treated with chemotherapy after terminating the pregnancy. One of the NHL cases was primary cutaneous follicular center lymphoma, a B cell-derived indolent lymphoma. The patient was followed up without any therapy after terminating her pregnancy. The other case was a follicular lymphoma grade 3B, which was treated with chemotherapy after delivery. We also conducted a literature review of 165 lymphoma cases occurring during pregnancy reported from 1976 to 2013 to reveal the correlation between pregnancy and lymphoma progression. Immunohistochemistry studies were performed to determine the expression of estrogen/progesterone receptors (ER/PR), and ER was weakly positive and sporadic. We concluded that lymphomas occurring during pregnancy should be managed with a prompt and reasonable treatment. High estrogen level in maternal body may affect lymphoma progression.

Research on autism and environmental risk factors has expanded substantially in recent years. My analysis draws attention to the regimes of perceptibility that shape how the environment is materialized in post-genomic science. I focus on how more complex narratives of autism’s causes and social anxieties surrounding child development have helped situate autism risk in women’s bodies before and during pregnancy. This has resulted in what I call the maternal body as environment in autism science. I show that this figure involves three characteristics: the molecularization of the environment, an individualization of risk, and the internalization of responsibility. I argue that these three features point to a new spatial and temporal politics of risk and responsibility that may heighten social and medical surveillance of women’s bodies and decisions, eclipsing larger questions about the uneven distribution of exposures in society and more holistic understandings of health that include neurodiversity. I conclude by considering what the maternal body as environment signals for women, social justice, and the politics of environmental health in the post-genomic era.

In this study, a stable allotetraploid gibel carp strain was established from allogynogenetic populations of triploid gibel carp clone D. Its modal chromosome number was identified as 208, and the added chromosomes were demonstrated to originate from common carp by internal transcribed spacer-1 (ITS1) and transferrin (Tf) allele sequence analyses. Significantly, its morphological body type and morphometric traits were observed to be similar to that of the maternal gibel carp. And, the new allotetraploid showed remarkable growth superiority by growth rate comparison tests, in which an approximate 22.9-26.6% higher growth rate was found in the allotetraploid strain than that in the maternal allogynogenetic gibel carp. Overall, we have bred an allotetraploid strain that resembles a typical gibel carp body type, and possesses significant growth superiority. Therefore, this study provides an excellent material for fish polyploidy breeding and aquaculture practice. (C) 2016 Elsevier B.V. All rights reserved.

Synopsis This paper explores the construction of the Icelandic mother within the discourse of attachment, on Icelandic websites offering expert advice on pregnancy, birth, breastfeeding, and care. The paper examines whether attachment theory discourse in Iceland differs from the more traditional discourse of attachment theory and specifically, if the ideas of attachment and bonding have been modernized or recycled to be more inclusive of fathers and to the promotion of equality and shared parental responsibilities. The paper argues that the maternal body is constructed as a site of production and the maternal mind as (possibly) problematic, unnatural, and pathological. The discourse of attachment present on the Icelandic parenting websites incorporates classic ideas about the primacy of the mother and the intensification of motherhood, and little effort has been made to incorporate fathers into the discourse or to include them as meaningful agents when it comes to attachment and bonding.

Scaling studies on phenotypic characteristics like birth mass are useful to understanding life history attributes within species. The wide range in body mass of elk (Cervus elaphus) in North America and Europe allows robust estimation of scaling relationships. Our goal was to estimate the scaling relationship of maternal body mass and offspring birth mass. Data were extracted from the literature, which included captive elk fed a readily digestible diet rich in nutrients. The mass of the mother at birth and the birth mass of the young were recorded for 11 groups of mothers and their offspring. A simple linear regression was used to estimate an allometric relationship between maternal body mass and offspring birth mass (R2 = 0.90). Birth mass scaled to the 0.78 power of maternal body mass. Understanding scaling relationships affecting maternal investment might have implications for understanding body size variation across the geographic range of elk.

Rosa Montero's novel La hija del canibal (1997) presents the female body as a metaphor for a scarred, traumatized and amnesic Spanish culture that struggles to come to terms with its painful past and uncertain future. More specifically, Montero treats the maternal body not only as a locus of shame and suffering, marked by lack and repression, but also as a site of anxiety—even monstrosity—, ambivalence and innovation. Most explorations of La hija del canibal astutely address the strained relationship that exists between the father and daughter referenced in the title. Nevertheless, this article examines the problematic nature of the mother-daughter relationship and its intersections with the traumatic memories and the scarred body of the protagonist. As we shall see, it is the mother's ageing body and fate that disturb the daughter, who in her middle age finds it difficult to distinguish her own aging physique, professional and sentimental blunders, and life-experiences from those of her progenito...

Female yellow perch Perca flavescens exposed to three overwinter temperature regimes (4, 8 and 13° C) for 150 days spawned in markedly different proportions upon spring warming (37% of females in 4° C v. 64 and 91% in 8 and 13° C treatments, respectively), but exhibited no differences in fecundity, egg size or egg lipid content. Females held at 4° C also exhibited less within-clutch egg size variation than females held at 13° C. Moreover, eggs differed among temperature treatments in the overall proportions of 18 fatty acids, with the colder treatments resulting in potentially higher quality eggs containing more of the unsaturated fatty acids C16:1, C22:6-n3 and C18:2 cis. Female somatic condition also varied with temperature. Maternal somatic growth and protein content increased while lipid content decreased in 13° C compared to the colder treatments. There were, however, no differences among treatments in the fatty acid composition of maternal muscle. These results suggest that the temperatures experienced during winter may be less influential to P. flavescens egg size or number, which may exhibit relatively little plasticity in this species, but can alter both the number of females that spawn and the overall composition of eggs and maternal somatic tissues, which may have implications for future reproductive success.

Obesity in pregnancy confers morbidity to both the mother and neonate. Obese women are at increased risk of cesarean delivery, operative vaginal delivery, and failed trial of labor after cesarean delivery. In addition to impacting the mode of delivery, obesity is associated with hemorrhage, infection, and thromboembolic complications in the peripartum period. The risk of these complications increases with increasing maternal body mass index. In this chapter, we discuss evidence-based strategies to mitigate these risks and to manage complications that occur at the time of delivery in obese parturients.

World Health Organization breastfeeding guidelines for HIV-infected mothers are exclusive breastfeeding for 6 months and then continued breastfeeding for 12 months, provided the mother is receiving antiretroviral prophylaxis. Many African women perceive that breastmilk alone is not sufficient for their infant's nutritional requirements for the first 6 months of life, and mixed feeding is a common practice.A stable isotope technique was used to determine breastmilk output volumes and maternal body composition objectively at five different time points in the first year of the infant's life.Breastmilk output volumes were high for HIV-infected mothers: 831 ± 185 g/day at 6 weeks; 899 ± 188 g/day at 3 months; 871 ± 293 g/day at 6 months; 679 ± 281 g/day at 9 months; and 755 ± 287 g/day at 12 months. These high output volumes had no negative impact on the mother's fat-free mass. The breastmilk output volumes for HIV-uninfected mothers were not significantly different to the outputs for HIV-infected mothers at any of the time points (p0.05): 948 ± 223 g/day at 6 weeks; 925 ± 227 g/day at 3 months; 902 ± 286 g/day at 6 months; 746 ± 263 g/day at 9 months; and 713 ± 264 g/day at 12 months.This study using objective methodology shows that breastmilk outputs of HIV-infected mothers were relatively high (and within published reference ranges), and mothers are able to provide sufficient breastmilk for their infants without compromising their own fat-free mass.

Introduction. Excessive or inefficient body weight in pregnant women is a serious obstetric problem, associated with an increased risk of complications for the mother and child. Excessive birth weight of an infant carries the risk of emergency obstetric conditions, in turn, low birth weight of an infant may pose a risk of developmental disorders. Objectives. To evaluate the impact of nutritional condition of mothers on anthropometric parameters value of newborns. Material and methods. The study included 247 women and their newborns. The diagnostic survey method was applied. An original questionnaire was used and anthropometric measurements of women and newborns were taken. Results and Conclusions. Statistically significant differences were found in birth weight of newborns depending on the nutritional condition of women prior to pregnancy. The children of mothers with insufficient bodyweight had a significantly lower birth weight (p = 0.0079) than the children of mothers with normal weight, excessive weight and obesity. It was also demonstrated that the children of mothers with insufficient body weight had significantly lower (p < 0.0001) head circumference than the children of mothers with normal weight, excessive weight and obesity. The research revealed a correlation between maternal body mass index and neonatal anthropometric parameters. Mothers with insufficient weight gave birth to children with a significantly lower birth weight than the children of mothers with normal weight, excessive weight and obesity. Mothers with excessive weight and obesity gave birth to infants with significantly higher birth weight than mothers with normal or insufficient weight before pregnancy. Nursing Topics 2015; 23 (4): 490–495

Background: Exclusive breastfeeding during the first six months of an infant&rsquo, s life is an important factor for their optimal growth and health. Breastfeeding also has maternal benefits and can assist with postpartum weight loss. As shown by previous studies, postpartum weight retention can contribute to obesity. Objective: To quantify the human milk and evaluate the effect of breastfeeding on maternal weight loss during the 12 months postpartum. Method: This study included 70-mother&ndash, baby pairs. Infants&rsquo, intake of human milk and water from other sources, as well as the body composition of the mothers, were measured at the 1st, 3rd, 6th, 9th and 12th month postpartum by using the deuterium oxide dose-to-mother technique. Results: There was a significant change in the mothers&rsquo, body composition between the first and twelfth months in exclusive breastfeeding women compared to not-exclusive ones. Similarly, the difference between the quantities of human milk intake was highly significant in exclusive breastfeeding women compared to women who were not exclusively breastfeeding. Conclusion: Our results showed that exclusive breastfeeding for twelve months has a significant effect on postpartum weight loss among Moroccan women and that it is an effective way to control overweight and obesity among lactating women.

Objective It has been reported that gastroschisis is associated with low maternal body mass index (BMI). We tested this hypothesis in the UK. Study design We studied cases of gastroschisis ascertained from the regional fetal congenital anomaly register. We compared each affected mother with two controls from the birth register and maternity database. The first control was the next mother to deliver in the hospital, representing the normal population of mothers. The second control was the next mother to deliver an unaffected child whose age was within one year of that of the index case controlling for maternal age. Results There was a strong inverse association between maternal age and gastroschisis. An inverse association between gastroschisis and birth order was eliminated by adjustment for maternal age. The average age of mothers of affected children was 22.1 years; of the next delivery control was 28.8 years, and of the age matched control was 22.2 years. A weak non-statistically significant negative association between BMI and gastroschisis was further weakened by adjustment for maternal age. Conclusion Our results confirm the previously reported association between low maternal age and gastroschisis but suggest that within our UK population the link between low BMI and gastroschisis reported elsewhere is explained by younger mothers being thinner.

Este trabalho discute a política da narrativa sobre o corpo feminino no programa Bem Estar, da Rede Globo, especializado na cobertura de saúde. Voltado para um público majoritariamente composto por mulheres, é caracterizado por seu formato híbrido e pelo gênero utilitário, produzindo sentidos sobre o corpo, a saúde e a doença. A mulher, como centro destas matérias jornalísticas, surge com um corpo vigiado, tanto do ponto de vista ético, como estético, na perspectiva foucaultiana acerca do saber-poder da medicina e suas implicações na biopolítica. A partir da análise de dez edições do programa e de incursão etnográfica na redação, problematizamos três narrativas sobre o corpo feminino: a primeira mirando-o como objeto da higienização; a segunda como corpo suscetível à doença e a terceira como corpo materno. Conclui-se que a política da narrativa jornalística sobre o corpo feminino favorece o predomínio do discurso da ciência em detrimento de saberes outros, além de situar a mulher como eixo preferencial do biopoder.

Background: It is well established that maternal body mass index (BMI) and haemoglobin (Hb) level has an impact on foetal growth. Various studies have concluded that intrauterine growth as reflected by the Ponderal index (PI) is strongly influenced by various maternal factors. Therefore, we undertake this study to address the evidence gap to establish the strength of association between maternal nutritional status as indicated by her pre-pregnancy BMI and haemoglobin levels and neonatal PI.Methods: A hospital based cross-sectional, observational study was conducted that included 236 normal newborns and their mothers. A predesigned questionnaire was used to collect relevant socio-demographic data and obstetric history. Details regarding the maternal pre-pregnancy weight were collected from antenatal records, maternal height was measured and BMI was calculated. Neonatal birth weight and recumbent length was measured. PI was calculated and co-related with the maternal BMI and haemoglobin values.Results: 11.9% of the mothers were underweight and 51.3% had normal BMI. Majority of the mothers (62.7%) had normal Hb levels and 0.4% were found to have severe anemia (Hb