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ABSTRACT Doppler ultrasound is a commonly used method to assess hemodynamics of the fetal cardiovascular system and to monitor the well‐being of the fetus. Indices based on the velocity profile are often used for diagnosis. However, precisely linking these indices to specific underlying physiology factors is challenging. Several influences, including wave reflections, fetal growth, vessel stiffness, and resistance distal to the vessel, contribute to these indices. Understanding these data is essential for making informed clinical decisions. Mathematical models can be used to investigate the relation between velocity profiles and physiological properties. This study presents a mathematical model designed to simulate velocity wave propagation throughout the fetal cardiovascular system, facilitating the assessment of factors influencing velocity‐based indices. The model combines a one‐fiber model of the heart with a 1D wave propagation model describing the larger vessels of the circulatory system and a lumped parameter model for the microcirculation. Fetal growth from 20 to 40 weeks of gestational age is incorporated by adjusting cardiac and circulatory parameter settings according to scaling laws. The model's results, including cardiac function, cardiac output distribution, and volume distribution, show a good agreement with literature studies for a growing healthy fetus from 20 to 40 weeks. In addition, Doppler indices are simulated in various vessels and agree with literature as well. In conclusion, this study introduces a novel closed‐loop 0D‐1D mathematical model that has been verified against literature studies. This model offers a valuable platform for analyzing factors influencing velocity‐based indices in the fetal cardiovascular system. [ABSTRACT FROM AUTHOR]

Aim: To construct birthweight charts customised for maternal height and evaluate the effect of customization on SGA and LGA classification. Methods: Data were extracted (n = 21 350) from the MiCaS project in the Netherlands (2012–2020). We constructed the MiCaS‐birthweight chart customised for maternal height using Hadlock's method. We defined seven 5‐centimetre height categories from 153 to 157 cm until 183–187 cm and calculated SGA and LGA prevalences for each category, using MiCaS and current Dutch birthweight charts. Results: The MiCaS‐chart showed substantially higher birthweight values between identical percentiles with increasing maternal height. In the Dutch birthweight chart, not customised for maternal height, the prevalence of SGA (p90) increased with increasing height category, from 1.4% in the lowest height category to 21.8% in the highest category (range 20.4%). In the MiCaS‐birthweight chart, SGA and LGA prevalences were more constant across maternal heights, similar to overall prevalences (SGA range 3.3% and LGA range 1.7%). Conclusion: Compared to the current Dutch birthweight chart, the MiCaS‐birthweight chart customised for maternal height shows a more even distribution of SGA and LGA prevalences across maternal heights. [ABSTRACT FROM AUTHOR]

Aim: The objective of this meta‐analysis was to evaluate obstetric outcomes in gestational diabetes mellitus (GDM) patients treated with flexible management based on intrauterine ultrasound fetal growth (FMIUFG) or strict maternal glycemic adjustment (SMGA). Methods: We performed a comprehensive systematic review of electronic databases for randomized clinical trials (RCTs) comparing obstetrics outcomes of singleton GDM patients managed according to FMIUFG or SMGA. The review protocol was registered in PROSPERO (CRD497888). Searches were conducted in PubMed, Embase, Cochrane, and LILACS. Primary outcomes were gestational age at delivery and birth weight. Random‐effect model meta‐analyses were used to minimize the effects of uncertainty associated with inter‐study variability. Results are reported as standardized mean differences (SMDs) or as odds ratios (ORs) and their 95% confidence interval (CI). Heterogeneity between studies was estimated using the I2 statistic. The Cochrane Risk of Bias Scale was used to assess the quality of studies. There were five RCTs with low to moderate risk of bias, including 450 patients managed according to the FMIUFSG and 381 according to the SMGA. Results: The macrosomia (birthweight >4000 g) rate was lower in pregnancies managed according to FMIUFG than SMGA adjustments (OR: 0.34; 95%CI: 0.16, 0.71). There were no significant differences in hypertensive disorder, cesarean section, neonatal intensive care unit admission, and large newborn for gestational age rates. Conclusions: The macrosomia rate was lower in women managed with the FMIUFG. There were no significant differences in other obstetric and neonate outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between varying degrees of abnormality in the Doppler uterine artery pulsatility index (UtA‐PI) and adverse perinatal outcome. Methods: This was a prospective study of women with a singleton, non‐anomalous pregnancy in whom UtA‐PI was measured universally in midpregnancy and who gave birth in Oxford University Hospitals, Oxford, UK, between 2016 and 2023. Relative risk ratios (RRR) for the primary outcomes of extended perinatal mortality and live birth with a severe small‐for‐gestational‐age (SGA) neonate were calculated using multinomial logistic regression, for early preterm birth (before 34 + 0 weeks' gestation) and late preterm/term birth (at or after 34 + 0 weeks). Risks were also investigated for iatrogenic preterm birth and a composite adverse outcome before 34 + 0 weeks. Results: Overall, 33 364 pregnancies were included in the analysis. Compared to those with a normal UtA‐PI, the risk of extended perinatal mortality with delivery before 34 + 0 weeks was higher in women with UtA‐PI ≥ 90th percentile (RRR, 4.7 (95% CI, 2.7–8.0); P < 0.001), but this was not demonstrated in births at or after 34 + 0 weeks. The risk of live birth with severe SGA was associated strongly with abnormal UtA‐PI for early births (RRR, 26.0 (95% CI, 11.6–58.2); P < 0.001) and later births (RRR, 2.3 (95% CI, 1.8–2.9); P < 0.001). Women with raised UtA‐PI were more likely to have an early iatrogenic birth (RRR, 7.8 (95% CI, 5.5–11.2); P < 0.001). For each outcome before 34 + 0 weeks and the composite outcome, the risk increased significantly in association with the degree of abnormality in the UtA‐PI (from < 90th, 90–94th, 95–98th to ≥ 99th percentile) (Ptrend < 0.001). When using the 90th percentile as opposed to the 95th, there was a significant improvement in the overall predictive accuracy (as determined by the area under the receiver‐operating‐characteristics curve) for the composite adverse outcome (χ2 = 6.64, P = 0.01) and iatrogenic preterm birth (χ2 = 4.10, P = 0.04). Conclusions: Elevated UtA‐PI is a key predictor of iatrogenic preterm birth, severe SGA and perinatal loss up to 34 + 0 weeks' gestation. The 90th percentile for UtA‐PI should be used, and management should be tailored according to the degree of abnormality, as pregnancies with very raised UtA‐PI measurement constitute a group at extreme risk of adverse outcome. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Aims/BackgroundDesign/MethodsResultsConclusionRoutine third-trimester ultrasonography is increasingly conducted to screen for foetal growth restriction (FGR) and reduce adverse perinatal and child neurodevelopmental outcomes using timely obstetric management. While it did not reduce adverse perinatal outcomes in previous trials, evidence regarding its association with child neurodevelopmental outcome is absent. We examined whether routine third-trimester ultrasonography is positively associated with child developmental and behavioural/emotional outcomes compared to usual care.Dutch mothers with a low-risk pregnancy participating in a subsample (n = 1070) of a nationwide cluster-randomised trial reported infant (age 6 months) and toddler (age 28 months) developmental milestones (Ages and Stages Questionnaire) and toddlers’ internalising and externalising problems (Child Behavior Checklist). Usual care (n = 380) comprised selective ultrasonography. The intervention strategy (n = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management.Adjusted linear mixed-level regressions revealed that routine third-trimester ultrasonography was positively but modestly related to z-standardised infant developmental milestones at 6-month follow-up, B = 0.20, 95%CI [0.07; 0.32], p = 0.003, compared to usual care. At 28-month follow-up, these strategies did not differ in child developmental outcome and internalising and externalising problems.Routine third-trimester ultrasonography was positively but modestly associated with infant development. In toddlerhood, routine ultrasonography was not related to child developmental and behavioural/emotional outcomes. Overall, these findings do not support the implementation of routine third-trimester ultrasonography for low-risk pregnant women for reasons concerning children’s early neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

The impacts of maternal depression during mid-to-late pregnancy on fetal growth have been extensively investigated. However, the association between maternal depression during early pregnancy and fetal intrauterine growth are less clear. A prospective study comprised 23,465 eligible pregnant women and their offspring was conducted at a hospital-based center in Shanghai. Prenatal depression was assessed used using Patient Health Questionnaire (PHQ-9) before 14 gestational weeks. Differences in fetal growth trajectory of different maternal depressive statuses during three periods (16–23, 24–31, and 32–41 gestational weeks) were compared using a multilevel model with fractional polynomials. Women with depressive symptoms during early pregnancy had higher longitudinal fetal trajectories, with an estimated increase in fetal weight (β = 0.33; 95 % CI, 0.06–0.61), compared to those without depressive symptoms. Increases in fetal abdominal circumference among women with depressive symptoms were observed before 23 gestational weeks. Offspring born to mothers with early pregnancy depression had a significantly higher birth weight of 14.13 g (95 % CI, 1.33–27.81 g) and an increased risk of severe large size for gestational age (adjusted odds ratio [aOR], 1.64; 95 % CI, 1.32–2.04) and macrosomia (aOR, 1.21; 95 % CI, 1.02–1.43). Self-rated scale was used to assess depressive symptoms rather than clinical diagnosis. And Long-term effects of early pregnancy depression on offspring were not explored. The study revealed an association between maternal depression during early pregnancy and increased fetal biometrics, higher birth weight, and an elevated risk of severe large size for gestational age and macrosomia. • Maternal depression during early pregnancy is associated with excessive fetal growth and increased birth weight. • The effect of early pregnancy depression on fetal growth is strongest in late pregnancy. • Prenatal depression screening should be taken in early stages of pregnancy. [ABSTRACT FROM AUTHOR]

Background: The growth factor receptor bound protein 7 (Grb7) family of signalling adaptor proteins comprises Grb7, Grb10 and Grb14. Each can interact with the insulin receptor and other receptor tyrosine kinases, where Grb10 and Grb14 inhibit insulin receptor activity. In cell culture studies they mediate functions including cell survival, proliferation, and migration. Mouse knockout (KO) studies have revealed physiological roles for Grb10 and Grb14 in glucose-regulated energy homeostasis. Both Grb10 KO and Grb14 KO mice exhibit increased insulin signalling in peripheral tissues, with increased glucose and insulin sensitivity and a modestly increased ability to clear a glucose load. In addition, Grb10 strongly inhibits fetal growth such that at birth Grb10 KO mice are 30% larger by weight than wild type littermates. Results: Here, we generate a Grb7 KO mouse model. We show that during fetal development the expression patterns of Grb7 and Grb14 each overlap with that of Grb10. Despite this, Grb7 and Grb14 did not have a major role in influencing fetal growth, either alone or in combination with Grb10. At birth, in most respects both Grb7 KO and Grb14 KO single mutants were indistinguishable from wild type, while Grb7:Grb10 double knockout (DKO) were near identical to Grb10 KO single mutants and Grb10:Grb14 DKO mutants were slightly smaller than Grb10 KO single mutants. In the developing kidney Grb7 had a subtle positive influence on growth. An initial characterisation of Grb7 KO adult mice revealed sexually dimorphic effects on energy homeostasis, with females having a significantly smaller renal white adipose tissue depot and an enhanced ability to clear glucose from the circulation, compared to wild type littermates. Males had elevated fasted glucose levels with a trend towards smaller white adipose depots, without improved glucose clearance. Conclusions: Grb7 and Grb14 do not have significant roles as inhibitors of fetal growth, unlike Grb10, and instead Grb7 may promote growth of the developing kidney. In adulthood, Grb7 contributes subtly to glucose mediated energy homeostasis, raising the possibility of redundancy between all three adaptors in physiological regulation of insulin signalling and glucose handling. [ABSTRACT FROM AUTHOR]

Chronic placental inflammation is a routinely diagnosed group of placental lesions that reflect immunologic dysfunction of the mother, fetus, or both. Complete placental pathology examinations were performed for all term births at New York Presbyterian- Brooklyn Methodist Hospital from January 2010–August 2016. Diagnoses were blinded except to gestational age. CPI lesions were marked as chronic choriodeciduitis, decidual plasma cells, chronic inflammation of basal plate with anchoring villitis, and chronic villitis. In this cohort of term pregnancies, 257 (11.6 %) males and 218 (9.8 %) females had ≥1 CPI lesions. Chronic villitis was the most common (319 or 14 %), with chronic choriodeciduitis, decidual plasma cells, and chronic inflammation of basal plate with anchoring villitis in 94 (4 %), 69 (3 %) and 170 (8 %), respectively. In males, chronic villitis was associated with lower gestational adjusted birthweight and had no association with placental weight. In females, chronic villitis was associated with lower gestational adjusted birthweight, but the effect became nonsignificant after adjustment for placental weight. In summary, CPI lesions' incidence and association with birth weight vary by sex. Chronic villitis is associated with lower birthweight in females; this effect is completely mediated by placental weight. Chronic villitis showed a weak direct association of chronic villitis in males, but no association with lower placental weight in males. We suggest that differences between our results and previous publications reflect effects of sampling bias. • Chronic placental inflammation is common in low-risk term pregnancies. • Chronic placental inflammation has sex-specific associations with fetal growth restriction. • Chronic villitis is the most common type of chronic placental inflammation in term pregnancies. [ABSTRACT FROM AUTHOR]

Background: Carnitine is essential for fatty acid metabolism. Free carnitine (FCA) is excreted in the urine in the glomerulus, but is partly reabsorbed by a carnitine transporter. The mechanism underlying the decrease in serum carnitine level during pregnancy is unclear. Objective: To investigate whether low carnitine level is associated with increased renal excretion in pregnant women. Methods: We recruited 43 healthy pregnant and 25 non-pregnant women. Total carnitine (TCA) and FCA levels were measured using the enzymatic cycling method, and the acylcarnitine (ACA) level was calculated. Fractional excretion (FE) was calculated as carnitine clearance divided by creatinine clearance. Results: The mean TCA, FCA, and ACA levels were lower at 12 weeks of gestation in pregnant than non-pregnant women (P <.001); the levels decreased further at 36 weeks, reaching 39%, 36%, and 52% of those in non-pregnant women, respectively (P <.001). The FEs were 3–4-fold higher in pregnant women than non-pregnant women. Pregnant women had a lower serum FCA/TCA ratio than non-pregnant women (0.788 ± 0.098 vs 0.830 ± 0.074, respectively; P <.05), whereas the urine FCA/TCA ratio was similar between the groups. Conclusion: Low carnitine level is associated with increased renal excretion during late pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the trimester‐specific associations between maternal total physical activity level vs moderate‐to‐vigorous exercise and fetal growth disorders. Methods: We analyzed 2062 mother–neonate pairs participating in the longitudinal China Medical University Birth Cohort Study. The Pregnancy Physical Activity Questionnaire was used to assess the physical activity level of women during the three trimesters. A higher level of total physical activity was defined as meeting or exceeding the cohort‐specific 75th percentile, and a higher level of exercise was defined according to the Physical Activity Guidelines for Americans. Fetal growth disorder was defined as small‐for‐gestational age (SGA) or large‐for‐gestational age (LGA) at birth. Results: Of the neonates included in this study, 7.1% were SGA and 15.5% were LGA. A higher level of total physical activity during the first trimester (adjusted relative risk (aRR), 0.62 (95% CI, 0.42–0.91)) and second trimester (aRR, 0.62 (95% CI, 0.41–0.95)) was associated with a lower risk of SGA, and a higher level of total physical activity during the third trimester was associated with a lower risk of LGA (aRR, 0.73 (95% CI, 0.54–0.97)). When analyzing physical activity by subtype, a higher level of occupational physical activity during the first and second trimesters was associated negatively with SGA risk, and higher levels of occupational and low‐intensity physical activity during the first trimester were associated negatively with LGA risk. No significant association was found between maternal adherence to the Physical Activity Guidelines for Americans and risk of fetal growth disorders. Conclusions: A higher total physical activity level during the first and second trimesters was associated with a decreased risk of SGA, whereas a higher total physical activity level in the third trimester was associated with a decreased risk of LGA. Pregnant women should be advised to increase their total physical activity levels instead of focusing on engaging in only moderate‐to‐vigorous exercise. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: To develop a semi‐automated tool for measuring fetal abdominal wall thickness (AWT). To validate the software using images captured by other centers and create a nomogram for fetal AWT between 18 and 20 weeks. Methods: A semiautomated tool that measured AWT was developed using images captured at the routine 20‐week morphology scan. The software was developed using digital images captured routinely during scans of low‐risk women. Inter‐ and intraobserver reliability was assessed between manual and semi‐automated measures. The tool was validated using images acquired from other centers. Linear regression and quadratic polynomials were used to create a nomogram for AWT. Results: The semi‐automated tool was able to measure AWT in all images. Interoperator reliability was 0.90 and 0.97 (P < 0.05) for manual and semi‐automated methods, respectively. Measurement agreement varied between three operators from moderate to excellent (0.77, 0.87, 0.92), with overall agreement being good (0.85). The tool could be successfully applied to 89% of images from other centers. A nomogram was generated for AWT measurements of fetuses at 18–20 weeks in normal, low risk mothers. Conclusion: Semi‐automated measurement of AWT was feasible using images captured during the routine 20‐week scan. This approach had lower inter‐ and intraobserver variability compared to manual measurement. Synopsis: A semiautomated measurement of abdominal wall thickness (AWT) is being reported to measure fetal adiposity. This would have clinical application in gestational diabetes and fetal growth restriction. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the impact of both maternal psychopathological factors and adaptive psychological changes within the couple on fetal growth, emphasizing the importance of evaluating pregnancy from the perspectives of the couple, the mother, and the fetus collectively. A "couple" in this context refers to heterosexual partners engaged in the pregnancy process together, whether married or in a stable relationship. Methods: We included 189 pregnant women in their first trimester, tracking maternal depression, anxiety, body appreciation, prenatal attachment, and the couple's adjustment level across each trimester. Fetal growth parameters measured include biparietal diameter, femur length, humerus length, abdomen circumference, head circumference, β-HCG, and amniotic fluid levels, with relationships between these variables being modeled accordingly. Results: Our findings indicate stable levels of maternal depression, anxiety, body appreciation, and couple's adjustment throughout the pregnancy, with a significant increase in prenatal attachment levels in each subsequent trimester. Prenatal attachment in the first trimester and maternal depression levels in the second and third trimesters were found to directly influence fetal growth, while other variables exhibited indirect effects. Conclusions: Fetal growth is influenced by a myriad of biopsychosocial factors. Ensuring healthy pregnancy and fetal development necessitates close monitoring and support of the mother's adaptive psychological changes, early identification and treatment of potential psychopathologies, and maintenance of the psychosocial health of the couple. Significance: Although there are studies on the effects of maternal psychopathology on fetal growth, there are few studies that study the effects of adaptive psychological changes during pregnancy and the couple's relationship on fetal growth together with maternal psychopathology. With this study, it was understood that there was only a change in the prenatal attachment levels of the mother during pregnancy, there was no significant change in anxiety, depression, body appreciation and dyadic adjustment, but the mutual interactions of these factors during each trimester had important effects on fetal growth. For a healthy pregnancy and healthy fetal development, it is necessary to closely monitor and support the adaptive psychological changes of the mother, early recognition and appropriate treatment of possible psychopathologies, and the psychosocial health of the couple. [ABSTRACT FROM AUTHOR]

Appropriate assessment of fetal growth is essential for safe clinical care. There have been many recent strategies to improve the detection of aberrant fetal growth patterns, one of which has been to optimize fetal growth centile charts. Over recent years there has been ongoing debates regarding the optimal growth chart for clinical usage. Controversy can arise where growth charts have demonstrated wide variance in the proportion of fetuses classified within the extremities of growth. Standards for growth charts need to be evidenced based and validated against pregnancy outcomes to demonstrate clinical utility and widespread usage. They should be supplied by high quality methodological reasoning and ideally evidenced through large prospective multicentre studies. Given the variable terminology to classify growth centile charts, including the variety of charts available, a complete understanding by healthcare professional can be troublesome to achieve. This practical guide aims to provide clarity on this diverse subject. [ABSTRACT FROM AUTHOR]

Abstract Background The growth factor receptor bound protein 7 (Grb7) family of signalling adaptor proteins comprises Grb7, Grb10 and Grb14. Each can interact with the insulin receptor and other receptor tyrosine kinases, where Grb10 and Grb14 inhibit insulin receptor activity. In cell culture studies they mediate functions including cell survival, proliferation, and migration. Mouse knockout (KO) studies have revealed physiological roles for Grb10 and Grb14 in glucose-regulated energy homeostasis. Both Grb10 KO and Grb14 KO mice exhibit increased insulin signalling in peripheral tissues, with increased glucose and insulin sensitivity and a modestly increased ability to clear a glucose load. In addition, Grb10 strongly inhibits fetal growth such that at birth Grb10 KO mice are 30% larger by weight than wild type littermates. Results Here, we generate a Grb7 KO mouse model. We show that during fetal development the expression patterns of Grb7 and Grb14 each overlap with that of Grb10. Despite this, Grb7 and Grb14 did not have a major role in influencing fetal growth, either alone or in combination with Grb10. At birth, in most respects both Grb7 KO and Grb14 KO single mutants were indistinguishable from wild type, while Grb7:Grb10 double knockout (DKO) were near identical to Grb10 KO single mutants and Grb10:Grb14 DKO mutants were slightly smaller than Grb10 KO single mutants. In the developing kidney Grb7 had a subtle positive influence on growth. An initial characterisation of Grb7 KO adult mice revealed sexually dimorphic effects on energy homeostasis, with females having a significantly smaller renal white adipose tissue depot and an enhanced ability to clear glucose from the circulation, compared to wild type littermates. Males had elevated fasted glucose levels with a trend towards smaller white adipose depots, without improved glucose clearance. Conclusions Grb7 and Grb14 do not have significant roles as inhibitors of fetal growth, unlike Grb10, and instead Grb7 may promote growth of the developing kidney. In adulthood, Grb7 contributes subtly to glucose mediated energy homeostasis, raising the possibility of redundancy between all three adaptors in physiological regulation of insulin signalling and glucose handling.

Abstract It remains unclear whether and how maternal exposure to biomass fuel influences infant anthropometry or body proportionality at birth, which are linked to their survival, physical growth, and neurodevelopment. Therefore, this study seeks to explore the association between household-level exposure to biomass cooking fuels and infant size and body proportionality at birth among women in rural Bangladesh. A total of 909 women were derived from the Pregnancy Weight Gain study, which was conducted in Matlab, a rural area of Bangladesh. Infant’s weight (g), length (cm), head circumference (cm), small for gestational age (SGAW), short for gestational age (SGAL), low head circumference for gestational age (SGAHC), ponderal index, and cephalization index at birth were the outcomes studied. Of the women, 721 (79.3%) were dependent on biomass fuel. Compared to infants born to mothers who used gas for cooking, those born to biomass users had lower weight (β − 94.3, CI − 155.9, − 32.6), length (β − 0.36, 95% CI − 0.68, − 0.04), head circumference (β − 0.24, CI − 0.47, − 0.02) and higher cephalization index (β 0.03, CI 0.01, 0.05) at birth. Maternal biomass exposure is more likely to lead to symmetric SGA, although there is evidence for some brain-sparing effects.

Abstract Background Maternal genetic risk of type 2 diabetes (T2D) has been associated with fetal growth, but the influence of genetic ancestry is not yet fully understood. We aimed to investigate the influence of genetic distance (GD) and genetic ancestry proportion (GAP) on the association of maternal genetic risk score of T2D (GRST2D) with fetal weight and birthweight. Methods Multi-ancestral pregnant women (n = 1,837) from the NICHD Fetal Growth Studies – Singletons cohort were included in the current analyses. Fetal weight (in grams, g) was estimated from ultrasound measurements of fetal biometry, and birthweight (g) was measured at delivery. GRS T2D was calculated using T2D-associated variants identified in the latest trans-ancestral genome-wide association study and was categorized into quartiles. GD and GAP were estimated using genotype data of four reference populations. GD was categorized into closest, middle, and farthest tertiles, and GAP was categorized as highest, medium, and lowest. Linear regression analyses were performed to test the association of GRST2D with fetal weight and birthweight, adjusted for covariates, in each GD and GAP category. Results Among women with the closest GD from African and Amerindigenous ancestries, the fourth and third GRS T2D quartile was significantly associated with 5.18 to 7.48 g (weeks 17–20) and 6.83 to 25.44 g (weeks 19–27) larger fetal weight compared to the first quartile, respectively. Among women with middle GD from European ancestry, the fourth GRS T2D quartile was significantly associated with 5.73 to 21.21 g (weeks 18–26) larger fetal weight. Furthermore, among women with middle GD from European and African ancestries, the fourth and second GRS T2D quartiles were significantly associated with 117.04 g (95% CI = 23.88–210.20, p = 0.014) and 95.05 g (95% CI = 4.73–185.36, p = 0.039) larger birthweight compared to the first quartile, respectively. The absence of significant association among women with the closest GD from East Asian ancestry was complemented by a positive significant association among women with the highest East Asian GAP. Conclusions The association between maternal GRS T2D and fetal growth began in early-second trimester and was influenced by GD and GAP. The results suggest the use of genetic GD and GAP could improve the generalizability of GRS.

Abstract Background In recent years, with benefits from the continuous improvement of clinical technology and the advantage of fertility preservation, the application of embryo cryopreservation has been growing rapidly worldwide. However, amidst this growth, concerns about its safety persist. Numerous studies have highlighted the elevated risk of perinatal complications linked to frozen embryo transfer (FET), such as large for gestational age (LGA) and hypertensive disorders during pregnancy. Thus, it is imperative to explore the potential risk of embryo cryopreservation and its related mechanisms. Methods Given the strict ethical constraints on clinical samples, we employed mouse models in this study. Three experimental groups were established: the naturally conceived (NC) group, the fresh embryo transfer (Fresh-ET) group, and the FET group. Blastocyst formation rates and implantation rates were calculated post-embryo cryopreservation. The impact of FET on fetal growth was evaluated upon fetal and placental weight. Placental RNA-seq was conducted, encompassing comprehensive analyses of various comparisons (Fresh-ET vs. NC, FET vs. NC, and FET vs. Fresh-ET). Results Reduced rates of blastocyst formation and implantation were observed post-embryo cryopreservation. Fresh-ET resulted in a significant decrease in fetal weight compared to NC group, whereas FET reversed this decline. RNA-seq analysis indicated that the majority of the expression changes in FET were inherited from Fresh-ET, and alterations solely attributed to embryo cryopreservation were moderate. Unexpectedly, certain genes that showed alterations in Fresh-ET tended to be restored in FET. Further analysis suggested that this regression may underlie the improvement of fetal growth restriction in FET. The expression of imprinted genes was disrupted in both FET and Fresh-ET groups. Conclusion Based on our experimental data on mouse models, the impact of embryo cryopreservation is less pronounced than other in vitro manipulations in Fresh-ET. However, the impairment of the embryonic developmental potential and the gene alterations in placenta still suggested it to be a risky operation.

Abstract Background Gestational exposure to toxic environmental chemicals and maternal social hardships are individually associated with impaired fetal growth, but it is unclear whether the effects of environmental chemical exposure on infant birth weight are modified by maternal hardships. Methods We used data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pan-Canadian cohort of 1982 pregnant females enrolled between 2008 and 2011. We quantified eleven environmental chemical concentrations from two chemical classes – six organochlorine compounds (OCs) and five metals – that were detected in ≥ 70% of blood samples collected during the first trimester. We examined fetal growth using birth weight adjusted for gestational age and assessed nine maternal hardships by questionnaire. Each maternal hardship variable was dichotomized to indicate whether the females experienced the hardship. In our analysis, we used elastic net to select the environmental chemicals, maternal hardships, and 2-way interactions between maternal hardships and environmental chemicals that were most predictive of birth weight. Next, we obtained effect estimates using multiple linear regression, and plotted the relationships by hardship status for visual interpretation. Results Elastic net selected trans-nonachlor, lead, low educational status, racially minoritized background, and low supplemental folic acid intake. All were inversely associated with birth weight. Elastic net also selected interaction terms. Among those with increasing environmental chemical exposures and reported hardships, we observed stronger negative associations and a few positive associations. For example, every two-fold increase in lead concentrations was more strongly associated with reduced infant birth weight among participants with low educational status (β = -100 g (g); 95% confidence interval (CI): -215, 16), than those with higher educational status (β = -34 g; 95% CI: -63, -3). In contrast, every two-fold increase in mercury concentrations was associated with slightly higher birth weight among participants with low educational status (β = 23 g; 95% CI: -25, 71) compared to those with higher educational status (β = -9 g; 95% CI: -24, 6). Conclusions Our findings suggest that maternal hardships can modify the associations of gestational exposure to some OCs and metals with infant birth weight.

ABSTRACT Objective Methods Results Conclusion The length of newborns shows seasonal fluctuations, but the patterns of these fluctuations vary greatly. This study analyses the fluctuation in birth length by birth month and temporal changes in Austrian newborns from the 1984 to 2021 birth cohorts.A total of 2 317 927 singleton‐term births between 1984 and 2021 in Austria were included in this retrospective population‐based cohort study. A strict inclusion criterion was the Austrian citizenship of the mother. The effect of month of birth (MOB) on birth length was estimated using a multivariable linear model adjusting for maternal educational level, newborn sex, gestational age, year of birth (YOB) of the newborn, and parity of the mother.Newborn length varied by MOB, but there was also a temporal trend. In the birth cohorts up to 2004, the longest newborns were born in February, while from 2008 onward, the longest birth lengths were observed in the summer months.In this Austrian population‐based sample, birth length shows nonrandom fluctuations by birth month. These patterns, however, varied considerably over time. [ABSTRACT FROM AUTHOR]

Aims: The aim of our study is to evaluate the effect of electromagnetic field exposure during pregnancy on fetal anthropometric measurements by means of ultrasonography. Methods: This is a cross sectional study. The study was conducted among 261 pregnant women who applied to the Obstetrics and Gynecology outpatient clinic. A face-to-face questionnaire was applied to 261 volunteer pregnant women and fetal anthropometric measurements (head circumference (HC), abdominal circumference (AC), femur length (FL), biparietal diameter (BPD)) were performed by transabdominal ultrasound. Results: The mean age of the pregnant women in this study was 29.65 ± 6. Of the pregnant women 140 (53.6%) were between the ages of 25-34, 260 (99.6%) were married, 85 (32.6%) were high school graduates and 184 (70.5%) were housewives. The income of 116 (44.4%) pregnant women was equal to their expenses. The frequency of those exposed to electromagnetic fields at home is 98.5%. There was no difference between FL, AC, HC and BPD values and electromagnetic field exposure at home, exposure to x-ray or tomography (p>0.05). It was observed that FL, HC, BPD ultrasonographic measurement values were significantly lower in people exposed to electromagnetic field at work compared to those not exposed to electromagnetic field at work. Conclusion: It was observed that FL, HC, BPD ultrasonographic measurement values were significantly lower in people exposed to electromagnetic field at work. There are studies that show the negative effects of electromagnetic field on the fetus, especially during pregnancy, although there is no definitive evidence. Studies to be carried out on this subject can be a guide for protection from the negative effects of electromagnetic field. [ABSTRACT FROM AUTHOR]

Background/Objectives: The utility of shear wave elastography (SWE) as an adjunct to ultrasound biometry and Doppler velocimetry for the examination of placental dysfunction and suboptimal fetal growth is unclear. To date, limited data exist correlating the mechanical properties of placentae with fetal growth. This study aimed to investigate the relationship between placental shear wave velocity (SWV) and ultrasound estimated fetal weight (EFW), and to ascertain if placental SWV is a suitable proxy measure of placental function in the surveillance of small-for-gestational-age (SGA) pregnancies. Methods: This prospective, observational cohort study compared the difference in placental SWV between SGA and appropriate-for-gestational-age (AGA) pregnancies. There were 221 women with singleton pregnancies in the study cohort—136 (61.5%) AGA and 85 (38.5%) SGA. Fetal biometry, Doppler velocimetry, the deepest vertical pocket of amniotic fluid, and mean SWV were measured at 2–4-weekly intervals from recruitment to birth. Results: There was no difference in mean placental SWV in SGA pregnancies compared to AGA pregnancies, nor was there any relationship to EFW. Conclusions: Although other studies have shown some correlation between increased placental stiffness and SGA pregnancies, our investigation did not support this. The mechanical properties of placental tissue in SGA pregnancies do not result in placental SWVs that are apparently different from those of AGA controls. As this study did not differentiate between constitutionally or pathologically small fetuses, further studies in growth-restricted cohorts would be of benefit. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: To compare glycemic metrics during pregnancy between women with type 1 diabetes (T1D) delivering large-for-gestational-age (LGA) and appropriate-for-gestational-age (AGA) infants, and to identify predictors of LGA infants. Materials and Methods: A cohort study including 111 women with T1D using intermittently scanned continuous glucose monitoring from conception until delivery. Average sensor-derived metrics: mean glucose, time in range in pregnancy (TIRp), time above range in pregnancy, time below range in pregnancy, and coefficient of variation throughout pregnancy and in pregnancy intervals of 0–10, 11–21, 22–33, and 34–37 weeks were compared between women delivering LGA and AGA infants. Predictors of LGA infants were sought for. Infant growth was followed until 3 months postdelivery. Results: In total, 53% (n = 59) delivered LGA infants. Mean glucose decreased during pregnancy in both groups, with women delivering LGA infants having a 0.4 mmol/L higher mean glucose from 11–33 weeks (P = 0.01) compared with women delivering AGA infants. Mean TIRp >70% was obtained from 34 weeks in women delivering LGA infants and from 22–33 weeks in women delivering AGA infants. Independent predictors for delivering LGA infants were mean glucose throughout pregnancy and gestational weight gain. At 3 months postdelivery, infant weight was higher in infants born LGA compared with infants born AGA (6360 g ± 784 and 5988 ± 894, P = 0.04). Conclusions/interpretations: Women with T1D delivering LGA infants achieved glycemic targets later than women delivering AGA infants. Mean glucose and gestational weight gain were independent predictors for delivering LGA infants. Infants born LGA remained larger postdelivery compared with infants born AGA. [ABSTRACT FROM AUTHOR]

Objective: To investigate fetal growth trajectories and risks of small and large for gestational age (SGA and LGA), and macrosomia in pregnancies after fresh and frozen embryo transfer (ET), and natural conception (NC). Design: Longitudinal population‐based cohort study. Setting: Swedish national registers. Population: A total of 196 008 singleton pregnancies between 2013 and 2017. Methods: Of all singleton pregnancies resulting in live births in the Swedish Pregnancy Register, 10 970 fresh ET, 6520 frozen ET, and 178 518 NC pregnancies with ultrasound data were included. A general least squares model was used to examine the effect of fresh or frozen ET on fetal growth while adjusting for confounders. Main Outcome Measures: Fetal growth velocity. SGA, LGA and macrosomia. Results: At 120 days, fetal weights were lower in fresh ET pregnancies compared with NC pregnancies. Thereafter fresh ET as well as FET fetuses had higher fetal weights than NC fetuses, with no differences between themselves until the second trimester. From 210 days, FET fetuses were heavier than fresh ET fetuses, whereas fresh ET fetuses had lower fetal weights than NC fetuses from 245 days. After fresh ET, SGA was more frequent, whereas LGA and macrosomia were less frequent, than after FET. Conclusions: This study gives new insights into the differences in fetal growth dynamics between fresh and frozen ET and NC pregnancies. Clinically relevant differences in proportions of SGA, LGA and macrosomia were observed. Linked article: This article is commented on by Paolo Ivo Cavoretto pp. 1238–1239 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471‐0528.17810. [ABSTRACT FROM AUTHOR]

Purpose: It is unclear whether common maternal infections during pregnancy are risk factors for adverse birth outcomes. We assessed the association between self-reported infections during pregnancy with preterm birth and small-for-gestational-age (SGA) in an international cohort consortium. Methods: Data on 120,507 pregnant women were obtained from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA. Self-reported common infections during pregnancy included influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections, cystitis, urinary tract infection, and the symptoms fever and diarrhoea. Birth outcomes included preterm birth, low birth weight and SGA. Associations between maternal infections and birth outcomes were first assessed using Poisson regression in each cohort and then pooled using random-effect meta-analysis. Risk ratios (RR) and 95% confidence intervals (CI) were calculated, adjusted for potential confounders. Results: Vaginal infections (pooled RR, 1.10; 95% CI, 1.02–1.20) and urinary tract infections (pooled RR, 1.17; 95% CI, 1.09–1.26) during pregnancy were associated with higher risk of preterm birth. Similar associations with low birth weight were also observed for these two infections. Fever during pregnancy was associated with higher risk of SGA (pooled RR, 1.07; 95% CI, 1.02–1.12). No other significant associations were observed between maternal infections/symptoms and birth outcomes. Conclusion: Vaginal infections and urinary infections during pregnancy were associated with a small increased risk of preterm birth and low birth weight, whereas fever was associated with SGA. These findings require confirmation in future studies with laboratory-confirmed infection diagnosis. [ABSTRACT FROM AUTHOR]

Background: Maternal genetic risk of type 2 diabetes (T2D) has been associated with fetal growth, but the influence of genetic ancestry is not yet fully understood. We aimed to investigate the influence of genetic distance (GD) and genetic ancestry proportion (GAP) on the association of maternal genetic risk score of T2D (GRST2D) with fetal weight and birthweight. Methods: Multi-ancestral pregnant women (n = 1,837) from the NICHD Fetal Growth Studies – Singletons cohort were included in the current analyses. Fetal weight (in grams, g) was estimated from ultrasound measurements of fetal biometry, and birthweight (g) was measured at delivery. GRST2D was calculated using T2D-associated variants identified in the latest trans-ancestral genome-wide association study and was categorized into quartiles. GD and GAP were estimated using genotype data of four reference populations. GD was categorized into closest, middle, and farthest tertiles, and GAP was categorized as highest, medium, and lowest. Linear regression analyses were performed to test the association of GRST2D with fetal weight and birthweight, adjusted for covariates, in each GD and GAP category. Results: Among women with the closest GD from African and Amerindigenous ancestries, the fourth and third GRST2D quartile was significantly associated with 5.18 to 7.48 g (weeks 17–20) and 6.83 to 25.44 g (weeks 19–27) larger fetal weight compared to the first quartile, respectively. Among women with middle GD from European ancestry, the fourth GRST2D quartile was significantly associated with 5.73 to 21.21 g (weeks 18–26) larger fetal weight. Furthermore, among women with middle GD from European and African ancestries, the fourth and second GRST2D quartiles were significantly associated with 117.04 g (95% CI = 23.88–210.20, p = 0.014) and 95.05 g (95% CI = 4.73–185.36, p = 0.039) larger birthweight compared to the first quartile, respectively. The absence of significant association among women with the closest GD from East Asian ancestry was complemented by a positive significant association among women with the highest East Asian GAP. Conclusions: The association between maternal GRST2D and fetal growth began in early-second trimester and was influenced by GD and GAP. The results suggest the use of genetic GD and GAP could improve the generalizability of GRS. [ABSTRACT FROM AUTHOR]

Background: In recent years, with benefits from the continuous improvement of clinical technology and the advantage of fertility preservation, the application of embryo cryopreservation has been growing rapidly worldwide. However, amidst this growth, concerns about its safety persist. Numerous studies have highlighted the elevated risk of perinatal complications linked to frozen embryo transfer (FET), such as large for gestational age (LGA) and hypertensive disorders during pregnancy. Thus, it is imperative to explore the potential risk of embryo cryopreservation and its related mechanisms. Methods: Given the strict ethical constraints on clinical samples, we employed mouse models in this study. Three experimental groups were established: the naturally conceived (NC) group, the fresh embryo transfer (Fresh-ET) group, and the FET group. Blastocyst formation rates and implantation rates were calculated post-embryo cryopreservation. The impact of FET on fetal growth was evaluated upon fetal and placental weight. Placental RNA-seq was conducted, encompassing comprehensive analyses of various comparisons (Fresh-ET vs. NC, FET vs. NC, and FET vs. Fresh-ET). Results: Reduced rates of blastocyst formation and implantation were observed post-embryo cryopreservation. Fresh-ET resulted in a significant decrease in fetal weight compared to NC group, whereas FET reversed this decline. RNA-seq analysis indicated that the majority of the expression changes in FET were inherited from Fresh-ET, and alterations solely attributed to embryo cryopreservation were moderate. Unexpectedly, certain genes that showed alterations in Fresh-ET tended to be restored in FET. Further analysis suggested that this regression may underlie the improvement of fetal growth restriction in FET. The expression of imprinted genes was disrupted in both FET and Fresh-ET groups. Conclusion: Based on our experimental data on mouse models, the impact of embryo cryopreservation is less pronounced than other in vitro manipulations in Fresh-ET. However, the impairment of the embryonic developmental potential and the gene alterations in placenta still suggested it to be a risky operation. [ABSTRACT FROM AUTHOR]

Insulin-like growth factor 1 (IGF-1) is a critical fetal anabolic hormone. IGF-1 infusion to the normally growing sheep fetus increases the weight of some organs but does not consistently increase body weight. However, IGF-1 infusion profoundly decreases fetal plasma insulin concentrations, which may limit fetal growth potential. In this study, normally growing late-gestation fetal sheep received an intravenous infusion of either: IGF-1 (IGF), IGF-1 with insulin and dextrose to maintain fetal euinsulinemia and euglycemia (IGF+INS), or vehicle control (CON) for 1 week. The fetus underwent a metabolic study immediately prior to infusion start and after 1 week of the infusion to measure uterine and umbilical uptake rates of nutrients and oxygen. IGF+INS fetuses were 23% heavier than CON (P = 0.0081) and had heavier heart, liver, and adrenal glands than IGF and CON (P < 0.01). By design, final fetal insulin concentrations in IGF were 62% and 65% lower than IGF+INS and CON, respectively. Final glucose concentrations were similar in all groups. IGF+INS had lower final oxygen content than IGF and CON (P < 0.0001) and lower final amino acid concentrations than CON (P = 0.0002). Final umbilical oxygen uptake was higher in IGF+INS compared to IGF and CON (P < 0.05). Final umbilical uptake of several essential amino acids was higher in IGF+INS compared to CON (P < 0.05). In summary, maintaining euinsulinemia and euglycemia during fetal IGF-1 infusion is necessary to maximally support body growth. We speculate that IGF-1 and insulin stimulate placental nutrient transport to support fetal growth. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the association between first-trimester uterine artery pulsatility index (UtA-PI) and crown-rump length discordance (CRLD) with growth discordance (GD) in twins and analyze the influence of chorionicity in these parameters. This retrospective analysis integrated data from the twin pregnancy database of Centro Hospitalar São João (2019–2023), including 184 fetuses, with 19 monochorionic and 73 dichorionic gestations. To determine the association between UtA-PI and CRLD with GD, correlation analyses were computed and linear regression models were carried out. Separate analyses were conducted for each type of placentation. Logistic regression analysis was carried out to determine the association of mean UtA-PI and CRLD with severe GD, defined as discordance ≥25 %. GD≥25 % was detected in 9.80 % of pregnancies. A statistically significant difference between monochorionic and dichorionic gestations was found in crown-rump length (p=0.009), CRLD (p<0.001) and birth weight (p=0.025), but not in mean UtA-PI (p=0.853) or GD (p=0.556). Mean UtA-PI was significantly higher in discordant than in concordant pairs (p<0.001), but that association was not seen in CRLD (p=0.931). Mean UtA-PI and GD were correlated by the regression line "GD=3.844 × UtA-PI + 6.638", with R2 0.027. CRLD and GD were correlated by the regression line "GD=0.280 × CRLD + 10.79", with R2 0.010. Mean UtA-PI, but not CRLD, was significantly associated with severe GD (odds ratio, 22.753; p=0.002). Mean UtA-PI, but not CRLD, is associated with GD. The prevalence of severe GD increases significantly with increasing mean UtA-PI. [ABSTRACT FROM AUTHOR]

Background: Gestational exposure to toxic environmental chemicals and maternal social hardships are individually associated with impaired fetal growth, but it is unclear whether the effects of environmental chemical exposure on infant birth weight are modified by maternal hardships. Methods: We used data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pan-Canadian cohort of 1982 pregnant females enrolled between 2008 and 2011. We quantified eleven environmental chemical concentrations from two chemical classes – six organochlorine compounds (OCs) and five metals – that were detected in ≥ 70% of blood samples collected during the first trimester. We examined fetal growth using birth weight adjusted for gestational age and assessed nine maternal hardships by questionnaire. Each maternal hardship variable was dichotomized to indicate whether the females experienced the hardship. In our analysis, we used elastic net to select the environmental chemicals, maternal hardships, and 2-way interactions between maternal hardships and environmental chemicals that were most predictive of birth weight. Next, we obtained effect estimates using multiple linear regression, and plotted the relationships by hardship status for visual interpretation. Results: Elastic net selected trans-nonachlor, lead, low educational status, racially minoritized background, and low supplemental folic acid intake. All were inversely associated with birth weight. Elastic net also selected interaction terms. Among those with increasing environmental chemical exposures and reported hardships, we observed stronger negative associations and a few positive associations. For example, every two-fold increase in lead concentrations was more strongly associated with reduced infant birth weight among participants with low educational status (β = -100 g (g); 95% confidence interval (CI): -215, 16), than those with higher educational status (β = -34 g; 95% CI: -63, -3). In contrast, every two-fold increase in mercury concentrations was associated with slightly higher birth weight among participants with low educational status (β = 23 g; 95% CI: -25, 71) compared to those with higher educational status (β = -9 g; 95% CI: -24, 6). Conclusions: Our findings suggest that maternal hardships can modify the associations of gestational exposure to some OCs and metals with infant birth weight. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Children and adults born preterm have an increased risk of type 1 diabetes. However, there is limited information on risk patterns across the full range of gestational ages, especially after extremely preterm birth (23–27 weeks of gestation). We investigated the risk of type 1 diabetes in childhood and young adulthood across the full range of length of gestation at birth. Methods: Data were obtained from national registers in Finland, Norway and Sweden. In each country, information on study participants and gestational age was collected from the Medical Birth Registers, information on type 1 diabetes diagnoses was collected from the National Patient Registers, and information on education, emigration and death was collected from the respective national register sources. Individual-level data were linked using unique personal identity codes. The study population included all individuals born alive between 1987 and 2016 to mothers whose country of birth was the respective Nordic country. Individuals were followed until diagnosis of type 1 diabetes, death, emigration or end of follow-up (31 December 2016 in Finland, 31 December 2017 in Norway and Sweden). Gestational age was categorised as extremely preterm (23–27 completed weeks), very preterm (28–31 weeks), moderately preterm (32–33 weeks), late preterm (34–36 weeks), early term (37–38 weeks), full term (39–41 weeks; reference) and post term (42–45 weeks). HRs and 95% CIs from country-specific covariate-adjusted Cox regression models were combined in a meta-analysis using a common-effect inverse-variance model. Results: Among 5,501,276 individuals, 0.2% were born extremely preterm, 0.5% very preterm, 0.7% moderately preterm, 4.2% late preterm, 17.7% early term, 69.9% full term, and 6.7% post term. A type 1 diabetes diagnosis was recorded in 12,326 (0.8%), 6364 (0.5%) and 16,856 (0.7%) individuals at a median age of 8.2, 13.0 and 10.5 years in Finland, Norway and Sweden, respectively. Individuals born late preterm or early term had an increased risk of type 1 diabetes compared with their full-term-born peers (pooled, multiple confounder-adjusted HR 1.12, 95% CI 1.07, 1.18; and 1.15, 95% CI 1.11, 1.18, respectively). However, those born extremely preterm or very preterm had a decreased risk of type 1 diabetes (adjusted HR 0.63, 95% CI 0.45, 0.88; and 0.78, 95% CI 0.67, 0.92, respectively). These associations were similar across all three countries. Conclusions/interpretation: Individuals born late preterm and early term have an increased risk of type 1 diabetes while individuals born extremely preterm or very preterm have a decreased risk of type 1 diabetes compared with those born full term. [ABSTRACT FROM AUTHOR]

Micromineral elements have a fundamental participation in the processes of organogenesis and fetal development. The objective of this study was to assess the effect of selenium (Se) injection in pregnant female rabbits, during organogenesis or rapid fetal growth, on the productive performance of their progeny. An experiment was carried out with 30 New Zealand female rabbits, with an average age of 6 months. At the end of mating (day 0), using a randomized complete design, the female rabbits were distributed into three experimental groups, which were assigned to the following treatments: Control, female rabbits were injected intramuscularly (IM) with 0.5 ml of saline on days 13 and 23 of gestation; Early administration, female rabbits that were injected IM with Se (0.10 mg/kg BW) on day 13 of gestation (organogenesis) and 0.5 ml of saline on day 23 of gestation; and Late administration, female rabbits that were injected IM with 0.5 ml of saline on day 13 of gestation and Se (0.10 mg/kg BW) on day 23 of gestation (rapid fetal growth). No differences were found on kindling performance of dams and pre-weaning growth of rabbit offspring. However, an injection of Se to pregnant rabbits affected the growth and development of their progeny, with the treatment leading to changes in the yield of some carcass traits (forelimb weight and forelimb muscle weight) and weights of some organs (liver, lungs, and spleen). The Se treatment (both early and late) also resulted in lower concentrations of glucose, triglycerides, and cholesterol when compared to the control group. These effects were different when Se injection was performed during organogenesis or rapid fetal development. The results from this study suggest that there are beneficial effects of gestational Se injection of rabbit dams on important productive traits of their progeny. [ABSTRACT FROM AUTHOR]

Clomiphene citrate is a common treatment for ovulation induction in subfertile women, but its use is associated with elevated risk of adverse perinatal outcomes and birth defects. To investigate the biological plausibility of a causal relationship, this study investigated the consequences in mice for fetal development and pregnancy outcome of periconception clomiphene citrate administration at doses approximating human exposures. A dose-dependent adverse effect of clomiphene citrate given twice in the 36 hours after mating was seen, with a moderate dose of 0.75 mg/kg sufficient to cause altered reproductive outcomes in 3 independent cohorts. Viable pregnancy was reduced by 30%, late gestation fetal weight was reduced by 16%, and ∼30% of fetuses exhibited delayed development and/or congenital abnormalities not seen in control dams, including defects of the lung, kidney, liver, eye, skin, limbs, and umbilicus. Clomiphene citrate also caused a 30-hour average delay in time of birth, and elevated rate of pup death in the early postnatal phase. In surviving offspring, growth trajectory tracking and body morphometry analysis at 20 weeks of age showed postweaning growth and development similar to controls. A dysregulated inflammatory response in the endometrium was observed and may contribute to the underlying pathophysiological mechanism. These results demonstrate that in utero exposure to clomiphene citrate during early pregnancy can compromise implantation and impact fetal growth and development, causing adverse perinatal outcomes. The findings raise the prospect of similar iatrogenic effects in women where clomiphene citrate may be present in the periconception phase unless its use is well-supervised. [ABSTRACT FROM AUTHOR]

Introduction: Cannabis potency and its use during pregnancy have increased in the last decade. The aim of this study was to investigate the impact of antenatal cannabis use on fetal growth, preterm birth and other perinatal outcomes. Material and methods: A propensity score‐matched analysis was performed in women with singleton pregnancies attending a tertiary care site in Barcelona. Women in the cannabis group were selected based on the results of a detection test. Primary outcomes were small for gestational age at birth (SGA), low birthweight and preterm birth. Secondary outcomes were other biometric parameters (neonatal length and head circumference), respiratory distress, admission to the neonatal intensive care unit and breastfeeding at discharge. A second propensity score‐matched analysis excluding other confounders (use of other recreational drugs and discontinuation of cannabis use during pregnancy) was performed. Results: Antenatal cannabis was associated with a higher odds ratio of SGA (OR 3.60, 95% CI: 1.68–7.69), low birthweight (OR 3.94, 95% CI: 2.17–7.13), preterm birth at 37 weeks (OR 2.07, 95% CI: 1.12–3.84) and 32 weeks of gestation (OR 4.13, 95% CI: 1.06–16.11), admission to the neonatal intensive care unit (OR 1.95, 95% CI: 1.03–3.71), respiratory distress (OR 2.77, 95% CI: 1.26–6.34), and lower breastfeeding rates at discharge (OR 0.10, 95% CI: 0.05–0.18). When excluding other confounders, no significant association between antenatal cannabis use and SGA was found. Conclusions: Antenatal cannabis use increases the risk of SGA, low birthweight, preterm birth and other adverse perinatal outcomes. However, when isolating the impact of cannabis use by excluding women who use other recreational drugs and those who discontinue cannabis during pregnancy, no significant association between antenatal cannabis use and SGA birth was found. [ABSTRACT FROM AUTHOR]

The nutritional status of the mother-to-be has a key impact on the proper development of the fetus. Although all nutrients are important for the developing baby, recent research indicates the importance of adequate choline intake during the periconceptional period, pregnancy, and lactation. Choline plays a key role in the biosynthesis of cell membranes, supporting liver function, neurotransmission, brain development, and DNA and histone methylation. Choline participates in the formation of a child's nervous system, supports its cognitive development, and reduces the risk of neural tube defects. The human body is incapable of producing sufficient choline to meet its needs; therefore, it must be obtained from the diet. Current data indicate that most women in their reproductive years do not achieve the recommended daily intake of choline. The presented narrative review indicates the importance of educating mothers-to-be and thereby increasing their awareness of the effects of choline on maternal and child health, which can lead to a more aware and healthy pregnancy and proper child development. [ABSTRACT FROM AUTHOR]

Despite the occurrence of wildfires quadrupling over the past four decades, the health effects associated with wildfire smoke exposures during pregnancy remains unknown. Particulate matter less than 2.5 μms (PM2.5) is among the major pollutants emitted in wildfire smoke. Previous studies found PM2.5 associated with lower birthweight, however, the relationship between wildfire-specific PM2.5 and birthweight is uncertain. Our study of 7923 singleton births in San Francisco between January 1, 2017 and March 12, 2020 examines associations between wildfire smoke exposure during pregnancy and birthweight. We linked daily estimates of wildfire-specific PM2.5 to maternal residence at the ZIP code level. We used linear and log-binomial regression to examine the relationship between wildfire smoke exposure by trimester and birthweight and adjusted for gestational age, maternal age, race/ethnicity, and educational attainment. We stratified by infant sex to examine potential effect modification. Exposure to wildfire-specific PM2.5 during the second trimester of pregnancy was positively associated with increased risk of large for gestational age (OR = 1.13; 95% CI: 1.03, 1.24), as was the number of days of wildfire-specific PM2.5 above 5 μg m-3 in the second trimester (OR = 1.03; 95% CI: 1.01, 1.06). We found consistent results with wildfire smoke exposure in the second trimester and increased continuous birthweight-for-gestational age z-score. Differences by infant sex were not consistent. Counter to our hypothesis, results suggest that wildfire smoke exposures are associated with increased risk for higher birthweight. We observed strongest associations during the second trimester. These investigations should be expanded to other populations exposed to wildfire smoke and aim to identify vulnerable communities. Additional research is needed to clarify the biological mechanisms in this relationship between wildfire smoke exposure and adverse birth outcomes.

Despite the fact that labor depends on too many interacting factors and no parameter can fully predict its outcome, fetal cerebral Doppler has emerged as the most reliable tool for prediction, in contrast with fetal weight, which performs significantly worse in the last weeks of pregnancy. The importance of the cerebral Doppler follows the inverse pathway of fetal weight increasing its performance in the last weeks of pregnancy and reaching its highest ability prior to labor. A combination of cerebral flow, fetal weight, and selected clinical information may obtain moderate predictions of labor outcome, provided the interval to labor is not long. [ABSTRACT FROM AUTHOR]

The article focuses on the effects of prenatal exposure to tetrahydrocannabinol (THC) on fetal cardiac development. Topics include the study's investigation into THC's impact on extracellular matrix composition in fetal hearts, transcriptomic profiling revealing changes in vascular gene expression, and potential long-term implications of altered gene expression on cardiovascular health.

Abstract Background Optimal size at birth dictates perinatal survival and long-term risk of developing common disorders such as obesity, type 2 diabetes and cardiovascular disease. The imprinted Grb10 gene encodes a signalling adaptor protein capable of inhibiting receptor tyrosine kinases, including the insulin receptor (Insr) and insulin-like growth factor type 1 receptor (Igf1r). Grb10 restricts fetal growth such that Grb10 knockout (KO) mice are at birth some 25-35% larger than wild type. Using a mouse genetic approach, we test the widely held assumption that Grb10 influences growth through interaction with Igf1r, which has a highly conserved growth promoting role. Results Should Grb10 interact with Igf1r to regulate growth Grb10:Igf1r double mutant mice should be indistinguishable from Igf1r KO single mutants, which are around half normal size at birth. Instead, Grb10:Igf1r double mutants were intermediate in size between Grb10 KO and Igf1r KO single mutants, indicating additive effects of the two signalling proteins having opposite actions in separate pathways. Some organs examined followed a similar pattern, though Grb10 KO neonates exhibited sparing of the brain and kidneys, whereas the influence of Igf1r extended to all organs. An interaction between Grb10 and Insr was similarly investigated. While there was no general evidence for a major interaction for fetal growth regulation, the liver was an exception. The liver in Grb10 KO mutants was disproportionately overgrown with evidence of excess lipid storage in hepatocytes, whereas Grb10:Insr double mutants were indistinguishable from Insr single mutants or wild types. Conclusions Grb10 acts largely independently of Igf1r or Insr to control fetal growth and has a more variable influence on individual organs. Only the disproportionate overgrowth and excess lipid storage seen in the Grb10 KO neonatal liver can be explained through an interaction between Grb10 and the Insr. Our findings are important for understanding how positive and negative influences on fetal growth dictate size and tissue proportions at birth.

Abstract Background Maternal undernutrition during pregnancy is currently estimated at 23.5% in Africa, which is worrying given the negative impacts of malnutrition on maternal and fetal birth outcomes. The current study aimed at characterizing the associations of maternal dietary intake and nutritional status with fetal growth at 14–26 weeks gestation. It was hypothesized that maternal dietary intake was positively associated with maternal nutritional status and fetal growth both in early and late pregnancy. Methods This was a cross-sectional survey of 870 pregnant women in mid-western Uganda conducted in August 2013. Data were collected on women’s dietary intake (indicated by women’s dietary diversity and the diet quality score) and nutritional status (indicated by hemoglobin level and mid-upper arm circumference) at 14–26 weeks gestation. Fetal growth was determined by symphysis-fundal height Z-scores processed using the INTERGROWTH-21st calculator. Associations between maternal dietary intake and nutritional status with fetal growth were determined using correlations and chi-square tests. Results Overall, only 25% had adequate dietary diversity and the most utilized food groups were White tubers, roots and starchy vegetables; Pulses, nuts and seeds; Cereals and grains, Dark green leafy vegetables, and Fats and oils. A larger proportion of younger women (15–29 y) were classified as anemic (20.4% versus 4.4%) and underweight (23.7% versus 5.0%) compared to older women (30–43 y). Additionally, women aged 15 to 24 years had significantly lower mean SFH-for-gestation age Z-scores than women 36–43 years (F4, 783 = 3.129; p = 0.014). Consumption of legumes nuts and seeds was associated with reduced risk of anemia while consumption of dairy products (mostly milk) was positively associated with better fetal growth. Surprisingly, low Hb level was positively associated with normal fetal growth (rP = -0.133; p = 0.016) after 20 weeks gestation, possibly indicating normal fetal growth paralleled with physiologically necessary hemodilution. Conclusions Sub-optimal dietary patterns, characterized by limited dietary diversity and low protein intake, are likely to compromise maternal nutrition and fetal growth in limited resource settings. Improving pregnant women’s access to cheaper but nutrient-dense protein sources such as pulses, nuts and dairy products (mostly milk) has potential to improve women’s nutritional status and enhance fetal growth.

Qinzheng Chen,1 Zhen He,1 Yaxin Wang,2 Xuanjin Yang,2 Nana Liu,2 Suhan Zhang,2 Liangkun Ma,2 Xuezhong Shi,1 Xiaocan Jia,1 Yongli Yang,1 Yin Sun,2 Yuan He3 1Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People’s Republic of China; 2Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences (CAMS) and PUMC, Beijing, People’s Republic of China; 3National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, People’s Republic of ChinaCorrespondence: Yin Sun, Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences (CAMS) and PUMC, Beijing, 100730, People’s Republic of China, Email yinsun_pumch@163.com Yongli Yang, Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People’s Republic of China, Email ylyang377@zzu.edu.cnPurpose: To assess the impact of maternal pre-pregnancy body mass index (BMI) on longitudinal fetal growth, and the potential mediation effect of the maternal fasting plasma glucose in first trimester.Methods: In this retrospective cohort study, we collected pre-pregnancy BMI data and ultrasound measurements during pregnancy of 3879 singleton pregnant women who underwent antenatal examinations and delivered at Peking Union Medical College Hospital. Generalized estimation equations, linear regression, and logistic regression were used to examine the association between pre-pregnancy BMI with fetal growth and adverse neonatal outcomes. Mediation analyses were also used to examine the mediating role of maternal fasting plasma glucose (FPG) in first trimester.Results: A per 1 Kg/m² increase in pre-pregnancy BMI was associated with increase fetal body length Z-score (β 0.010, 95% CI 0.001, 0.019) and fetal body weight (β 0.017, 95% CI 0.008, 0.027). In mid pregnancy, pre-pregnancy BMI also correlated with an increase Z-score of fetal abdominal circumference, femur length (FL). Pre-pregnancy BMI was associated with an increased risk of large for gestational age and macrosomia. Mediation analysis indicated that the associations between pre-pregnancy BMI and fetal weight in mid and late pregnancy, and at birth were partially mediated by maternal FPG in first trimester (mediation proportion: 5.0%, 8.3%, 1.6%, respectively).Conclusion: Maternal pre-pregnancy BMI was associated with the longitudinal fetal growth, and the association was partly driven by maternal FPG in first trimester. The study emphasized the importance of identifying and managing mothers with higher pre-pregnancy BMI to prevent fetal overgrowth.Keywords: body mass index, fetal growth, adverse neonatal outcomes, fasting plasma glucose, mediation analysis, cohort study

Abstract The objective of this study was to evaluate the association of maternal cardiometabolic markers trajectories (glucose, triglycerides (TG), total cholesterol, systolic blood pressure (SBP) and diastolic blood pressure (DBP)) with estimated fetal weight trajectories and birth weight in Mexican pregnant women without medical complications. Cardiometabolic marker trajectories were characterized using group-based trajectory models. Mixed-effect and linear regression models were estimated to assess the association of maternal trajectories with estimated fetal weight and birth weight. The final sample comprised 606 mother–child dyads. Two trajectory groups of maternal cardiometabolic risk indicators during pregnancy were identified (high and low). Fetuses from women with higher values of TG had higher weight gain during pregnancy ( $$\hat{\beta }$$ β ^ = 24.00 g; 95%CI: 12.9, 35.3), were heavier at the sixth month ( $$\widehat{\beta }$$ β ^ =48.24 g; 95%CI: 7.2, 89.7) and had higher birth weight ( $$\widehat{\beta }$$ β ^ = 89.08 g; 95%CI: 20.8, 157.4) than fetuses in the low values trajectory. Fetuses from mothers with high SBP and DBP had less weight in the sixth month of pregnancy ( $$\widehat{\beta }$$ β ^ = − 42.4 g; 95%CI: − 82.7, − 2.1 and $$\widehat{\beta }$$ β ^ = − 50.35 g; 95%CI: − 94.2, − 6.4), and a higher DBP trajectory was associated with lower birth weight ( $$\widehat{\beta }$$ β ^ = − 101.48 g; 95%CI: − 176.5, − 26.4). In conclusion, a longitudinal exposition to high values of TG and BP was associated with potentially adverse effects on fetal growth. These findings support the potential modulation of children’s phenotype by maternal cardiometabolic conditions in pregnancies without medical complications.

Understanding the mechanisms by which environmental factors impact reproductive health is crucial for informing public health interventions and policy decisions. By elucidating the pathways through which environmental stressors exert their effects, we can develop targeted strategies to mitigate risks and promote reproductive well-being. In this lecture, we will delve into the latest research findings and emerging trends in the field of environmental reproductive health. By exploring the intricate interplay between environmental exposures and reproductive outcomes, we aim to broaden our understanding of this complex relationship and its implications for human health. Through collaborative efforts across disciplines, we can work towards safeguarding reproductive health for current and future generations.

Objectives: Monitoring of fetal growth and estimation of birth weight is of clinical importance. During pregnancy, ultrasound fetal biometry values including femur length, head circumference, abdominal circumference, biparietal diameter are measured and used to place fetuses on “growth charts”. There is no simple growth-model-based, predictive formula in use for fetal biometry. Estimation of fetal weight at birth currently depends on ultrasound data taken a short time before birth. Study design: Our cohort (“Seethapathy cohort”) consists of ultrasound biometry measurements and other data for 774 pregnant women in Chennai, India, 2015–2017. We use the Gompertz model, a standard model for constrained growth, with just three intuitive parameters, to model the growth of fetal biometry, and a machine learning (ML) model trained on these parameters to predict birth weight (BW). Results: The Gompertz model convincingly fits the growth of fetal biometry values. Two Gompertz parameters—t0 (inflection time) and c (rate of decrease of growth rate)—seem universal to all fetuses, while the third, A, is an overall scale specific to each fetus, capturing individual variation. On the Seethapathy cohort we can infer A for each fetus from ultrasound data available by the 24 or 35 weeks. Our ML model predicts birth weight with

PURPOSE: Previous research suggests that job loss in a household during pregnancy may perturb fetal growth. However, this work often cannot rule out unmeasured confounding due to selection into job loss. Recent work using data on exogenous job loss (due to a plant closure) finds that a fathers unexpected job loss during his spouses pregnancy increases the risk of a low weight birth. Using a unique set of linked registries in Denmark, we build on this work and examine whether associations between a fathers unexpected job loss and low birthweight differ by trimester of in utero exposure. We additionally examine trimester-specific associations of job loss with small-for-gestational-age, a proxy for restricted fetal growth, which may cause low birthweight. METHODS: We apply a sibling control design to over 1.4 million live births in Denmark, 1980 to 2017, to examine whether this plausibly exogenous form of job loss corresponds with increased risk of low weight or small-for-gestational-age births, depending on the timing of displacement in the first, second, or third trimester. RESULTS: Results indicate an elevated risk of low birthweight (OR = 1.80, 95% CI: 1.24, 2.62) and small-for-gestational-age (OR = 1.40, 95% CI: 1.02, 1.93) among gestations exposed to job loss in the second trimester of pregnancy. Sensitivity analyses using continuous outcome measures (e.g., birthweight in grams, birthweight for gestational age percentile) and maternal fixed effects analyses produce substantively similar inference. CONCLUSIONS: Findings support the notion that unexpected job loss may affect fetal growth and that the second trimester in particular appears sensitive to this external stressor.

Background: Maternal undernutrition during pregnancy is currently estimated at 23.5% in Africa, which is worrying given the negative impacts of malnutrition on maternal and fetal birth outcomes. The current study aimed at characterizing the associations of maternal dietary intake and nutritional status with fetal growth at 14–26 weeks gestation. It was hypothesized that maternal dietary intake was positively associated with maternal nutritional status and fetal growth both in early and late pregnancy. Methods: This was a cross-sectional survey of 870 pregnant women in mid-western Uganda conducted in August 2013. Data were collected on women's dietary intake (indicated by women's dietary diversity and the diet quality score) and nutritional status (indicated by hemoglobin level and mid-upper arm circumference) at 14–26 weeks gestation. Fetal growth was determined by symphysis-fundal height Z-scores processed using the INTERGROWTH-21st calculator. Associations between maternal dietary intake and nutritional status with fetal growth were determined using correlations and chi-square tests. Results: Overall, only 25% had adequate dietary diversity and the most utilized food groups were White tubers, roots and starchy vegetables; Pulses, nuts and seeds; Cereals and grains, Dark green leafy vegetables, and Fats and oils. A larger proportion of younger women (15–29 y) were classified as anemic (20.4% versus 4.4%) and underweight (23.7% versus 5.0%) compared to older women (30–43 y). Additionally, women aged 15 to 24 years had significantly lower mean SFH-for-gestation age Z-scores than women 36–43 years (F4, 783 = 3.129; p = 0.014). Consumption of legumes nuts and seeds was associated with reduced risk of anemia while consumption of dairy products (mostly milk) was positively associated with better fetal growth. Surprisingly, low Hb level was positively associated with normal fetal growth (rP = -0.133; p = 0.016) after 20 weeks gestation, possibly indicating normal fetal growth paralleled with physiologically necessary hemodilution. Conclusions: Sub-optimal dietary patterns, characterized by limited dietary diversity and low protein intake, are likely to compromise maternal nutrition and fetal growth in limited resource settings. Improving pregnant women's access to cheaper but nutrient-dense protein sources such as pulses, nuts and dairy products (mostly milk) has potential to improve women's nutritional status and enhance fetal growth. [ABSTRACT FROM AUTHOR]

Summary The aim of this study is to investigate the association between sleep quality during pregnancy and fetal growth. Pregnant women and their fetuses at 16–20 gestational weeks in Nantong Maternal and Child Health Hospital were recruited. Women were classified as having “good sleep quality” (Pittsburgh Sleep Quality Index score ≤ 5) and “poor sleep quality” (Pittsburgh Sleep Quality Index score > 5) according to the Pittsburgh Sleep Quality Index scores. The fetal growth was evaluated by three ultrasonographic examinations, birth weight and birth length. We used general linear model and multiple linear regression models to estimate the associations. A total of 386 pairs of mother and infant were included in the data analysis. After adjusting for gestational weight gain, anxiety and depression, fetuses in the good sleep quality group had greater abdominal circumference (p = 0.039 for 28–31+6 weeks gestation, p = 0.012 for 37–40+6 weeks gestation) and femur length (p = 0.014 for 28–31+6 weeks gestation, p = 0.041for 37–40+6 weeks gestation) at 28–31+6 weeks gestation and 37–40+6 weeks gestation, and increased femur length (p = 0.007) at 28–31+6 weeks gestation. Birth weights (p = 0.018) were positively associated with sleep quality. Poor sleep quality was associated with poor intrauterine physical development, decreased abdominal circumference and femur length, and lower birth weight after adjusting for confounding factors. Attention to the fetal growth of pregnant women with poor sleep quality has the potential to decrease the risk of adverse fetal outcomes. [ABSTRACT FROM AUTHOR]

The placenta stands out as a unique, transitory, and multifaceted organ, essential to the optimal growth and maturation of the fetus. Functioning as a vital nexus between the maternal and fetal circulatory systems, it oversees the critical exchange of nutrients and waste. This exchange is facilitated by placental cells, known as trophoblasts, which adeptly invade and remodel uterine blood vessels. Deviations in placental development underpin a slew of pregnancy complications, notably fetal growth restriction (FGR), preeclampsia (PE), recurrent spontaneous abortions (RSA), and preterm birth. Central to placental function and development is epigenetic regulation. Despite its importance, the intricate mechanisms by which epigenetics influence the placenta are not entirely elucidated. Recently, the scientific community has turned its focus to parsing out the epigenetic alterations during placental development, such as variations in promoter DNA methylation, genomic imprints, and shifts in non-coding RNA expression. By establishing correlations between epigenetic shifts in the placenta and pregnancy complications, researchers are unearthing invaluable insights into the biology and pathophysiology of these conditions. This review seeks to synthesize the latest findings on placental epigenetic regulation, spotlighting its crucial role in shaping fetal growth trajectories and development. Through this lens, we underscore the overarching significance of the placenta in the larger narrative of gestational health. [ABSTRACT FROM AUTHOR]

The effects of gut microbiota on the association between carbohydrate intake during pregnancy and neonatal low birth weight (LBW) were investigated. A prospective cohort study was conducted with 257 singleton-born mother–child pairs in Taiwan, and maternal dietary intake was estimated using a questionnaire, with each macronutrient being classified as low, medium, or high. Maternal fecal samples were collected between 24 and 28 weeks of gestation, and gut microbiota composition and diversity were profiled using 16S rRNA amplicon gene sequencing. Carbohydrates were the major source of total energy (56.61%), followed by fat (27.92%) and protein (15.46%). The rate of infant LBW was 7.8%, which was positively correlated with maternal carbohydrate intake. In the pregnancy gut microbiota, Bacteroides ovatus and Dorea spp. were indirectly and directly negatively associated with fetal growth, respectively; Rosenburia faecis was directly positively associated with neonatal birth weight. Maternal hypertension during pregnancy altered the microbiota features and was associated with poor fetal growth. Microbiota-accessible carbohydrates can modify the composition and function of the pregnancy gut microbiota, thus providing a potential marker to modulate deviations from dietary patterns, particularly in women at risk of hypertension during pregnancy, to prevent neonatal LBW. [ABSTRACT FROM AUTHOR]

Background: There is currently no information on positional changes in the brachial nerve plexus during prenatal growth. The subclavian–axillary artery passing through the medianus nerve ansa is considered a good landmark for evaluating the height of the plexus. Materials and methods: We used histologic sections from 9 embryos and 17 fetuses (approximately 6–15 weeks of gestational age) to identify the height of the ansa by referring to the level of the rib and the glenohumeral joint. Results: The nerve ansa was usually (23 plexuses) observed at the level of the first and/or second ribs. However, it was sometimes observed above the first rib, at a distance equal to or more than an intercostal width (7 plexuses). In the latter group, the ansa was usually located below the glenohumeral joint. Thus, the joint was located higher than the first rib, although the upper extremities were in the anatomic position for all specimens. The left–right difference in the height of the plexus corresponded to or was less than the width of the first intercostal space. Despite the synchronized growth between the thorax and shoulder girdle, the brachial plexus showed a considerable variation in comparative height; the range corresponded to twice of an intercostal width. Whether the nerve plexus is located high or low is determined at an early developmental stage and is maintained during the later growth stages. Conclusion: The high-positioned plexus might cause nerve injury at delivery, followed by a glenohumeral joint deformity because of the fragility without fixation in the thorax. [ABSTRACT FROM AUTHOR]