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Background/objectives Iodine is essential for foetal neurodevelopment and growth. Requirements increase in pregnancy to support increased thyroid hormone synthesis for maternal and foetal requirements, and for foetal transfer. Iodine deficiency in pregnancy is widely reported, and obesity has been associated with sub-optimal thyroid function. We evaluated iodine status and its relation with birthweight in a secondary analysis of pregnant women with obesity from multi-ethnic inner-city settings who participated in the UK Pregnancies Better Eating and Activity trial (UPBEAT). Subjects/methods Iodine and creatinine concentrations were evaluated in spot urine samples in the second (15.sup.+0-18.sup.+6 weeks, n = 954) trimester of pregnancy. We assessed iodine status as urinary iodine concentration (UIC) and urinary iodine-to-creatinine ratio (UI/Cr) and applied WHO/UNICEF/IGN population threshold of median UIC > 150 [micro]g/L for iodine sufficiency. Relationships between iodine status and birthweight were determined using linear and logistic regression with appropriate adjustment, including for maternal BMI and gestational age. Results Median (IQR) UIC and UI/Cr in the second trimester of pregnancy were 147 [micro]g/L (99-257) and 97 [micro]g/g (59-165), respectively. An UI/Cr 150 [micro]g/g, there was a trend for women with UI/Cr Conclusions Iodine status of pregnant women with obesity from this cohort of UK women was suboptimal. Lower iodine status was associated with lower birthweight., Author(s): Jessica Farebrother [sup.1] [sup.2] , Kathryn V. Dalrymple [sup.1] , Sara L. White [sup.1] , Carolyn Gill [sup.1] , Anna Brockbank [sup.1] , John H. Lazarus [sup.3] , Keith [...]

BACKGROUND: PlGF (placental growth factor)-based testing reduces severe maternal adverse outcomes. Repeat PlGF-based testing is not associated with improved perinatal or maternal outcomes. This planned secondary analysis aimed to determine whether there is a subgroup of women who benefit from repeat testing. METHODS: Pregnant individuals with suspected preterm preeclampsia were randomized to repeat revealed PlGF-based testing, compared with usual care where testing was concealed. Perinatal and maternal outcomes were stratified by trial group, by initial PlGF-based test result, and by PlGF-based test type (PlGF or sFlt-1 [soluble fms-like tyrosine kinase-1]/PlGF ratio). RESULTS: A total of 1252 pregnant individuals were included. Abnormal initial PlGF-based test identified a more severe phenotype of preeclampsia, at increased risk of adverse maternal and perinatal outcomes. Repeat testing was not significantly associated with clinical benefit in women with abnormal initial results. Of women with a normal initial result, 20% developed preeclampsia, with the majority at least 3 to 4 weeks after initial presentation. Repeat test results were more likely to change from normal to abnormal in symptomatic women (112/415; 27%) compared with asymptomatic women (163/890; 18%). A higher proportion of symptomatic women who changed from normal to abnormal were diagnosed with preeclampsia, compared with asymptomatic women. CONCLUSIONS: Our results do not demonstrate evidence of the clinical benefit of repeating PlGF-based testing if the initial result is abnormal. Judicious use of repeat PlGF-based testing to stratify risk may be considered at least 2 weeks after a normal initial test result, particularly in women who have symptoms or signs of preeclampsia. [ABSTRACT FROM AUTHOR]

Objective: To determine severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) seroprevalence in pregnancy in an inner‐city setting and assess associations with demographic factors and vaccination timing. Design: Repeated cross‐sectional surveillance study. Setting: London maternity centre. Sample: A total of 906 pregnant women attending nuchal scans, July 2020–January 2022. Methods: Blood samples were tested for IgG antibodies against SARS‐CoV‐2 nucleocapsid (N) and spike (S) proteins. Self‐reported vaccination status and coronavirus disease 2019 (COVID‐19) infection were recorded. Multivariable regression models determined demographic factors associated with seroprevalence and antibody titres. Main outcome measures: Immunoglobulin G N‐ and S‐protein antibody titres. Results: Of the 960 women, 196 (20.4%) were SARS‐CoV‐2 seropositive from previous infection. Of these, 70 (35.7%) self‐reported previous infection. Among unvaccinated women, women of black ethnic backgrounds were most likely to be SARS‐CoV‐2 seropositive (versus white adjusted risk ratio [aRR] 1.88, 95% CI 1.35–2.61, p < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S‐protein (versus white aRR 0.58, 95% CI 0.40–0.84, p = 0.004; aRR 0.56, 95% CI 0.34–0.92, p = 0.021, respectively). Double vaccinated, previously infected women had higher IgG S‐protein antibody titres than unvaccinated, previously infected women (mean difference 4.76 fold‐change, 95% CI 2.65–6.86, p < 0.001). Vaccination timing before versus during pregnancy did not affect IgG S‐antibody titres (mean difference −0.28 fold‐change, 95% CI −2.61 to 2.04, p = 0.785). Conclusions: This cross‐sectional study demonstrates high rates of asymptomatic SARS‐CoV‐2 infection with women of black ethnic backgrounds having higher infection risk and lower vaccine uptake. SARS‐CoV‐2 antibody titres were highest among double‐vaccinated, infected women. This article includes Author Insights, a video abstract available at: https://emckclac‐my.sharepoint.com/:v:/g/personal/k1888594_kcl_ac_uk/ESBeVJ8VdMtMtDOaAflgfLIBoKJ6i7g8v‐OkeQEc8cyTnA?e=v3fXo8. [ABSTRACT FROM AUTHOR]

Objective: To determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in pregnancy in an inner-city setting and assess associations with demographic factors and vaccination timing., Design: Repeated cross-sectional surveillance study., Setting: London maternity centre., Sample: A total of 906 pregnant women attending nuchal scans, July 2020-January 2022., Methods: Blood samples were tested for IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins. Self-reported vaccination status and coronavirus disease 2019 (COVID-19) infection were recorded. Multivariable regression models determined demographic factors associated with seroprevalence and antibody titres., Main Outcome Measures: Immunoglobulin G N- and S-protein antibody titres., Results: Of the 960 women, 196 (20.4%) were SARS-CoV-2 seropositive from previous infection. Of these, 70 (35.7%) self-reported previous infection. Among unvaccinated women, women of black ethnic backgrounds were most likely to be SARS-CoV-2 seropositive (versus white adjusted risk ratio [aRR] 1.88, 95% CI 1.35-2.61, p < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S-protein (versus white aRR 0.58, 95% CI 0.40-0.84, p = 0.004; aRR 0.56, 95% CI 0.34-0.92, p = 0.021, respectively). Double vaccinated, previously infected women had higher IgG S-protein antibody titres than unvaccinated, previously infected women (mean difference 4.76 fold-change, 95% CI 2.65-6.86, p < 0.001). Vaccination timing before versus during pregnancy did not affect IgG S-antibody titres (mean difference -0.28 fold-change, 95% CI -2.61 to 2.04, p = 0.785)., Conclusions: This cross-sectional study demonstrates high rates of asymptomatic SARS-CoV-2 infection with women of black ethnic backgrounds having higher infection risk and lower vaccine uptake. SARS-CoV-2 antibody titres were highest among double-vaccinated, infected women., (© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)