Pregnancy affects maternal performance, feed intake, and digestion kinetics parameters in beef heifers.

This study aimed to quantify the effects of physiological status (PS) and potential interaction of this factor with days of pregnancy (DOP) on beef heifers' weight variation, intake, and digestion kinetics. Twelve rumen-cannulated zebu beef heifers (n = 7 pregnant; n = 5 non-pregnant) were used. Heifers were placed in individual pens and fed medium-quality corn silage plus a protein-based supplement. Heifers' body weight was assessed at the beginning and end of each collection period. The feed intake was measured daily. Target outcomes were evaluated at 107, 170, 208, 240, 267, and 286 days of pregnancy. The apparent total-tract digestibility was determined considering the fecal spot collection, during five days within each collection period. Omasal and ruminal digesta samples were collected at 107, 208, and 267 days of pregnancy for determination of partial digestibilities and diet component outflow. For these purposes, Co-EDTA and indigestible neutral detergent fiber (iNDF) were used as indicators. All data were analyzed using a mixed model framework, considering the PS and DOP as fixed effects and the animal as a random effect. Significant differences were declared when P ≤ 0.05. Pregnant heifers showed an increase in body reserves (+35 kg) from 107 to 240 days of pregnancy, but experienced a decrease in shrunk body weight (-36 kg) from 240 to 286 days of pregnancy. The intake of dry matter (DM), organic matter (OM), crude protein (CP), and ash- and protein-free neutral detergent fiber (apNDF) increased as pregnancy progressed (P < 0.04). The apparent total-tract digestibility of DM tended to be lower (P = 0.09), and the apparent total-tract digestibility of apNDF was reduced (P < 0.01) in pregnant heifers. The digestibility of CP was higher (P < 0.01) on days 267 and 286 in pregnant cows compared to non-pregnant heifers. The ruminal digestibility of OM tended to be lower (P = 0.09) in pregnant beef heifers, while the ruminal digestibility of apNDF was lower (P = 0.02) in pregnant heifers compared to non-pregnant ones. The ruminal pool of wet matter and DM was lower (P ≤ 0.01) in pregnant heifers at 267 days of pregnancy. In all periods, the outflow tended to be greater (P = 0.06) in pregnant heifers compared to non-pregnant heifers. Pregnant beef heifers exhibited a faster (P = 0.01) digesta passage rate during late gestation. In conclusion, late-gestating beef heifers are less efficient in extracting energy from feed compared to non-pregnant animals.

Evaluating the Net Energy Requirements for Maintenance Based on Indirect Calorimetry and Heart Rate Monitoring in Gestating Sows.

The objectives of this study were (1) to determine the net energy requirements for the maintenance of gestating sows based on indirect calorimetry, and (2) to explore the feasibility of predicting the net energy requirements for the maintenance of gestating sows based on daily heart rate monitoring. In Exp. 1, six Landrace × Yorkshire crossbred reproductive sows with an initial body weight of 229.5 ± 14.9 kg at d 56 of gestation were randomly assigned to six diverse energy feeding levels using a 6 × 6 Latin square design. The experimental diet was formulated using corn, soybean meal, and wheat bran as major ingredients, and the six feeding levels were set as 1.2, 1.4, 1.6, 1.8, 2.0, and 2.2 times metabolizable energy for maintenance (100 kcal ME/kg BW0.75·d-1), respectively. The animal trial lasted for six periods with 9 days per period, encompassing 5 days of adaptation, 3 days of calorimetry in fed state, and 1 day of calorimetry in fasting state. In Exp. 2, six Landrace × Yorkshire crossbred pregnant sows with an initial body weight of 232.5 ± 12.5 kg at d 64 were fed a corn-soybean meal diet. All sows were tested in a respiratory calorimetry chamber for a 4 day calorimetry test. The heat production of the gestation sows was measured every 5 min using indirect calorimetry, and the heart rate of the gestating sows was recorded every minute using a belt-shape monitor. The results showed that the net energy requirements for the maintenance of gestating sows significant increased as the gestational stage progressed (p < 0.05), and a linear regression model revealed the average net energy requirement for the maintenance of gestating sows was 410 kJ/BW0.75 d-1 during late gestation (days 70-110). Moreover, the average heart rate of the gestating sows was 84 bpm, and the mathematical model developed to predict the net energy requirements for the maintenance of gestating sows was NEm(kcal/h)=19901+exp⁡[136-HR(bpm)43]. In conclusion, the average net energy requirement for the maintenance of sows during late gestation was 410 kJ/BW0.75 d-1, and the utilization of the heart rate monitoring method was found to provide a relevant, accurate prediction for the net energy requirements of sows.

Does Exposure to Summer Season at Different Stages of Intrauterine Development and Maternal Parity Affect Health and First-Lactation Milk Production of Female Offspring of Holstein Cows?

A suboptimal intrauterine environment during gestation may result in the programming of long-lasting structural and physiological alterations in the developing fetus, leading to health and production complications in adulthood. This observational study aimed to identify the impact of exposure to the summer season at different trimesters of gestation, dam parity, and their interaction on the postpartum disease incidence, first-lactation milk production, and herd lifespan of the offspring (F1 generation). Using a dataset collected from two commercial herds, the female offspring were categorized into three groups based on the trimester their dams experienced summer season during pregnancy: (1) first trimester (n = 2345), (2) second trimester (n = 3513), and (3) final trimester (n = 4988). The estimated 305-day milk production was lower in daughters (as a first-lactation cow) born to dams exposed to summer season during the first vs. third trimester. Summer season exposure during the first vs. third trimester resulted in the offspring that were less likely to remain in the herd (hazard ratio = 0.90; 95% CI = 0.84-0.95). Daughters of parous vs. nulliparous dams were more likely to experience dystocia and metritis but less likely to experience retained placenta. The risk of culling was higher in daughters of parous vs. nulliparous dams. Our preliminary findings suggest that the first trimester is a critical determinant of the female progeny's future productive performance and survivability. Dam parity was also identified as an influential factor affecting offspring health, as dystocia and metritis were more prevalent, and the culling risk was greater in daughters born to parous dams.

Increased offspring size and reduced gestation length in an ectothermic vertebrate under a worst-case climate change scenario.

As global temperatures continue to rise, understanding the impacts of warming environments has become increasingly important. Temperature is especially relevant for ectothermic organisms which depend upon consistent and predictable annual temperature cycles for reproduction and development. However, additional research is required in this area to elucidate the potential impacts of climate change on future generations. To understand how projected increases in environmental temperatures may impact reproductive outcomes within natural populations of ectothermic vertebrates, we manipulated minimum ambient temperatures during gestation in Red-sided garter snakes (Thamnophis sirtalis parietalis). Wild snakes were collected in the Interlake region of Manitoba, Canada during their spring mating season and allowed to mate in controlled conditions. For the duration of gestation, mated females were placed into one of two ambient thermal conditions: temperatures emulating those found in the species' natural habitat or temperatures with a consistent 5 °C increase to match end-of-century climate change projections. We recorded observations for each litter and all neonates resulting from controlled mating trials. We observed no difference in litter sizes or birth rates between thermal conditions. However, we observed a significant reduction in gestation length and significant increase to neonate body mass and body condition associated with increased ambient temperatures. These results suggest that increased minimum temperatures during gestation may confer reproductive benefits for the northern populations of this species even under the most extreme current modeled warming predictions. We discuss the broader implications of this effect, including possible negative ecological outcomes.

A genome-wide association study reveals fetal genetic factor for gestation length on chromosome 21 in Japanese Black cattle.

Gestation length (GL) in cattle is associated with neonatal health and the subsequent reproductive performance of dams. We performed a genome-wide association study (GWAS) using 25,144 single nucleotide polymorphisms (SNPs) in 4373 animals to detect genetic variants associated with GL as a fetal trait in Japanese Black cattle in Gifu Prefecture. We identified four significant SNPs on chromosome 21 in moderate linkage disequilibrium (LD). The minor allele of the most significant SNP has the effect on -2.47 days GL with a 0.019 allele frequency. Of the 4373 animals, 140 heterozygotes and one homozygote with the minor allele were traced back to a heterozygous sire. The 7.2 Mb LD region harbors three genes: gamma-aminobutyric acid type A receptor subunit beta3 (GABRB3), arrestin domain containing 4 (ARRDC4), and nuclear receptor subfamily 2 group F member 2 (NR2F2, also known as COUP-TFII). RNA expression analysis and its functions suggest that GABRB3, ARRDC4, and NR2F2 (COUP-TFII) are involved in glucose production via the hypothalamic-pituitary-adrenal axis during the fetal stress response at gestation period termination. These results suggest that an increase in the allele frequency of the associated SNPs has an impact on genetic improvement by shortening the GL in the population.

The effectiveness of vaginal progesterone to prevent preterm birth in singleton pregnant women with a short cervix at 18-32 weeks gestation.

Short cervix is a risk factor for preterm birth. Currently, both international and domestic studies about progesterone's effectiveness are limited to pregnant women at 18-24 weeks gestation. However, multiple studies indicated that cervical length was associated with preterm birth even before 32 weeks of gestation. Therefore, this study expanded the gestational week range to investigate whether progesterone can reduce the rate of preterm birth in singleton pregnant women with a short cervix at 18-32 weeks gestation.Pregnant women who underwent prenatal examination at Peking University First Hospital from January 2016 to August 2020 were prospectively followed. A total of 132 asymptomatic singleton pregnant women at 18-32 weeks gestation with a cervical length <25 mm were ultimately enrolled. According to the method of treatment, the participants were divided into progesterone group (80 patients) and control group (52 patients). The rate of preterm birth (PTB) at different stages was compared between two groups.(1) There was no significant difference in the total preterm birth rate (18.8% vs. 21.2%, RR 0.886[0.442-1.777], p = 0.734). (2) Stratified analysis found that, for pregnant women at <24 weeks gestation, there was a significant difference in the rate of PTB at <32 weeks (2.8% vs. 33.3%, p = 0.021). For women at 24-28weeks gestation, significant difference was not found in the rate of PTB at <37 weeks gestation (25% vs. 42.9%, RR = 0.583[0.186-1.831], p = 0.682), neither for women at after 28 weeks(12.5% vs. 11.1%,1.12[0.27-4.59], p = 1). (3) Vaginal progesterone was not associated with low birth weight (13.8% vs. 19.2%, p = 0.4), or preterm birth-related complications such as respiratory distress syndrome (3.8% vs. 7.7%, p = 0.555), aspiration pneumonia (22.5% vs. 19.2%, p = 0.653) and sepsis (2.5% vs. 7.7%, p = 0.331).For pregnant women with a short cervix at 18-24 weeks gestation, the rate of preterm birth before 32 weeks could be significantly reduced. For women with a short cervix at 24-28 weeks gestation, the rate of preterm birth could be reduced, while there was no significant effect for pregnant women. Further studies with a larger sample size and randomized controlled researches are needed.

Linking DNA damage and senescence to gestation period and lifespan in placental mammals.

The mechanism that synchronizes the timing of parturition remains a mystery. Each mammalian species has a specific duration of gestation that is determined by integrated interactions among the mother, placenta, and fetus. Senescence is primarily driven by DNA damage and is one of the critical factors influencing both parturition and lifespan. In this study, we investigated senescence as a physiological process during pregnancy and observed a gradual physiological increase in senescence in the maternal decidua and placental cells with gestation. This increase in senescence was associated with a gradual physiological increase in DNA damage during gestation. An analysis of the AnAge dataset revealed a positive correlation between the gestation period and maximum lifespan across 740 mammalian species. This finding supports the hypothesis that the rates of DNA damage and senescence may impact both the gestation period and lifespan. We suggest that the relationship between gestation period and lifespan in mammals is mediated by species-specific rates of DNA damage and senescence, necessitating further explorations into their causal roles.

Short-Half-Life Chemicals: Maternal Exposure and Offspring Health Consequences-The Case of Synthetic Phenols, Parabens, and Phthalates.

Phenols, parabens, and phthalates (PPPs) are suspected or known endocrine disruptors. They are used in consumer products that pregnant women and their progeny are exposed to daily through the placenta, which could affect offspring health. This review aims to compile data from cohort studies and in vitro and in vivo models to provide a summary regarding placental transfer, fetoplacental development, and the predisposition to adult diseases resulting from maternal exposure to PPPs during the gestational period. In humans, using the concentration of pollutants in maternal urine, and taking the offspring sex into account, positive or negative associations have been observed concerning placental or newborn weight, children's BMI, blood pressure, gonadal function, or age at puberty. In animal models, without taking sex into account, alterations of placental structure and gene expression linked to hormones or DNA methylation were related to phenol exposure. At the postnatal stage, pollutants affect the bodyweight, the carbohydrate metabolism, the cardiovascular system, gonadal development, the age of puberty, sex/thyroid hormones, and gamete quality, but these effects depend on the age and sex. Future challenges will be to explore the effects of pollutants in mixtures using models and to identify the early signatures of in utero exposure capable of predicting the health trajectory of the offspring.

[Clinical Validation of a Prototype Smart Non-Invasive Pregnancy Glucose Monitor].

The aim of this study is to evaluate the effectiveness of a smart non-invasive blood glucose monitor prototype during pregnancy through clinical validation. The monitor utilizes near-infrared spectroscopy combined with AI big data analysis of photoelectric volumetric pulse wave data to achieve non-invasive monitoring of blood glucose in women during pregnancy. The research team developed a monitor that employs a sensing chip, effectively overcoming the problems of weak signals and individual differences in non-invasive blood glucose monitoring. The user experience is enhanced by visualizing the test results on the accompanying cell phone APP (application) of the smart non-invasive pregnancy blood glucose monitor. Clinical validation revealed that the non-invasive monitoring data for pregnant women aged 20~30 years significantly differed from those obtained via traditional blood glucose measurement methods, whereas no significant difference ( P<0.05) was observed for pregnant women aged 31~42 years. The study concluded that further calibration of the monitor and an expansion of the sample size are necessary to enhance consistency with invasive glucose monitoring results.

Maternal alcohol consumption up to mouse organogenesis disrupts fetal-placental interface at mid-gestation associated with dysregulation of AQP3 immunoexpression.

Adequate trophoblast development during placentation involves the AQP3 regulation. The link between potential placental fetal-maternal interface abnormalities and AQP3 expression after perigestational alcohol intake was not explored yet. Female mice were treated (TF) with 10 % ethanol in drinking water before and up to day 10 of gestation, and control females (CF) with ethanol-free water. At gestational day 13, TFs showed increased fetal/placental weight ratio and reduced histological placental thickness compared to CFs. TF-placentas had disorganized fetal face layers, increased junctional zone (JZ), and decreased labyrinth (Lab). Concomitantly, immunoexpression of cleaved caspase-3 significantly increased in TF-JZ and Lab vs controls. Consistent with placental changes, AQP3 expression was higher in junctional trophoblast giant cells (TGCs), glycogen cells (GCs), spongiotrophoblasts (spg), and lab-syncytiotrophoblasts compared to CF-placentas. This study reveals, for the first time, that perigestational alcohol consumption up to organogenesis causes abnormal placental development associated with dysregulation of AQP3 expression.

Pelvic Floor Ultrasound Findings and Symptoms of Pelvic Floor Dysfunction During Pregnancy.

INTRODUCTION AND HYPOTHESIS: Pregnancy and childbirth predispose to pelvic floor dysfunction (PFD), coinciding with functional and anatomical changes in the pelvic floor. To some extent, these can be assessed by transperineal ultrasound (TPUS), yet the correlation between ultrasound findings and symptoms has not been well elucidated. We hypothesised that pregnant women with PFD would show different findings at TPUS. METHODS: This is a planned secondary analysis of a prospective cohort study. Pregnant women were asked to fill out standardised questionnaires on PFD and undergo TPUS at 12-14 weeks and 28-32 weeks of gestation. We compared bladder neck descent, urethral rotation, retrovesical angle, pelvic organ descent, genital hiatus dimensions and the presence of anal sphincter defects between women with and those without PFD using t test and Fisher's exact test. Linear mixed-effects models were used to assess the correlation between TPUS findings and PFD severity. As this is a secondary subgroup analysis of participants who underwent TPUS, no sample size was determined upfront. RESULTS: At Valsalva, women with urinary incontinence had more pronounced bladder neck descent (p = 0.02) and urethral rotation (p < 0.01), as well as wider retrovesical angles (p = 0.04) and larger genital hiatus areas (p < 0.01). After controlling for age, BMI and parity, the retrovesical angle was the only persistent predictor of urinary incontinence. No correlation was observed between any TPUS marker and symptoms of either prolapse or anorectal dysfunction. CONCLUSIONS: In pregnant women, symptoms of urinary incontinence, but not of prolapse and anorectal dysfunction, are associated with differences in pelvic floor anatomy at TPUS.

Comparative Study of the Safety and Efficacy of Intramuscular Dexamethasone, Betamethasone Phosphate, and Standard Management Protocol in Early-Term Scheduled Caesarean Delivery.

Background Babies born between 37 weeks +0 days and 38 weeks +6 days by scheduled caesarean delivery before the onset of labour are more prone to developing respiratory complications than babies delivered between 39 weeks +0 days and 40 weeks +0 days. Antenatal corticosteroids have been used in preterm births for lung maturity. The advantages of administering antenatal corticosteroids before a scheduled caesarean delivery in the early term remain a subject of debate. While some studies have reported benefits, including a reduction in respiratory issues, the evidence is still inconclusive. The study's main objective is to compare the efficacy and safety of intramuscular dexamethasone and betamethasone phosphate with standard treatment protocols in early-term infants. Methodology A total of 241 pregnant women scheduled for caesarean delivery were screened for eligibility to participate in the study. Out of these, 192 women met the inclusion criteria and were enrolled in the study after providing written informed consent; they were randomised into three groups, with 64 in each group, and were given either betamethasone phosphate or dexamethasone intramuscularly or were considered under standard management protocol (no administration of corticosteroids). The primary comparison was done to observe the development of respiratory distress syndrome, transient tachypnoea in newborns, and the need for neonatal intensive care unit (NICU) admission. Results Among 192 pregnant females observed, the incidence of development of respiratory distress syndrome did not differ significantly between the betamethasone, dexamethasone, and standard management groups, with rates of 6.25%, 7.81%, and 4.7%, respectively. Additionally, out of the 192 infants, 15 required neonatal intensive care, including 6 (9.4%) from the betamethasone group, 5 (7.8%) from the dexamethasone group, and 4 (6.3%) from the standard management group. All of these infants had a maximum stay of four days in the NICU, did not require mechanical support, and improved with oxygen therapy. Conclusion In our study, in early-term gestation, both the corticosteroid groups showed similar effects to those of the standard management group in reducing neonatal morbidity, with no significant statistical difference. Hence, the choice lies with the treating obstetrician to consider the administration of corticosteroids in early-term caesarean deliveries.

A maternal low-protein diet results in sex-specific differences in synaptophysin expression and milk fatty acid profiles in neonatal rats.

The developmental origins of health and disease hypothesis have highlighted the link between early life environment and long-term health outcomes in offspring. For example, maternal protein restriction during pregnancy and lactation can result in adverse metabolic and cognitive outcomes in offspring postnatal. Hence, in the present study, we assess whether an isocaloric low-protein diet (ILPD) affects the fatty acid profile in breast milk, the hippocampal synaptophysin (Syn) ratio, and the oxidative stress markers in the neonatal stage of male and female offspring. The aim of this work was to assess the effect of an ILPD on the fatty acid profile in breast milk, quantified the hippocampal synaptophysin (Syn) ratio and oxidative stress markers in neonatal stage of male and female offspring. Female Wistar rats were fed with either a control diet or an ILPD during gestation to day 10 of lactation. Oxidative stress markers were assessed in serum and liver. All quantifications were done at postnatal day 10. The results showed: ILPD led to decreases of 38.5% and 17.4% in breast milk volume and polyunsaturated fatty acids content. Significant decreases of hippocampal Syn ratio in male offspring (decreases of 98% in hippocampal CA1 pyramidal and CA1 oriens, 83%, stratum pyramidal in CA3, 80%, stratum lucidum in CA3, and 81% stratum oriens in CA3). Male offspring showed an increase in pro-oxidant status in serum and liver. Thus, the data suggest that male offspring are more vulnerable than females to an ILPD during gestation and lactation.

Impact of polyunsaturated fatty acids during and pregnancy and lactation: A comprehensive review.

BACKGROUND: Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are relevant polyunsaturated fatty acids (PUFA) derived from alpha-linolenic acid (ALA) and linoleic acid (LA), respectively. These are important in pregnancy and lactation periods because of their benefits to the developing fetus and infant. Currently, the high prevalence of gestational obesity has led to a revision of PUFAs recommendations in these periods, due to changes in the lipid profile of women marked by a higher consumption of n-6 PUFA. OBJECTIVE: This review aims to present an updated compilation of evidence on DHA and ARA during gestation and lactation. METHODS: The literature review was performed in different databases, PubMed, Scopus, Web of Science, Scielo, ISI, and Ovid MedLine, highlighting the importance of DHA and ARA for newborn development. RESULTS: An adequate intake of n-3 PUFA, especially DHA, in the mother during pregnancy and the postnatal period is important for the normal development of the child's brain. Maternal DHA supplementation increases DHA levels in mothers, but its direct link to infant neurodevelopment remains unclear. Obesity generates changes in the FA profile of pregnant women, causing an imbalance of n-3 and n-6 PUFA. An adequate level of DHA benefits children's cognitive function. However, a potential connection exists to the infants' inflammatory profile. CONCLUSION: During gestation and lactation periods, an adequate DHA intake and n-6/ n-3 PUFA ratio (especially for obese women) are important for the optimal growth and brain development of the child.

Navigating Reproductive Care in Patients With Inflammatory Bowel Disease: A Comprehensive Review.

Inflammatory bowel disease [IBD] is often diagnosed in patients during their reproductive years. It is crucial that both healthcare providers and patients are adequately informed to avoid misguided decisions regarding family planning. One of the most important aspects during conception and pregnancy is to maintain disease remission, as disease activity is associated with adverse pregnancy outcomes. Apart from methotrexate, most conventional drugs used in IBD are considered low risk during conception and pregnancy. For newer agents, evidence is still limited. If needed, surgery must not be postponed and should ideally be performed in specialized centres. In most patients, delivery should be vaginal except for patients with complex perianal disease, with an ileoanal pouch anastomosis, or if there is an obstetric contraindication. In children exposed to biological treatments during pregnancy, the risk of infections appears to be low, and psychomotor development is probably not affected. Regarding immunizations, the standard vaccination schedule for inactivated vaccines should be followed for children exposed to biologics in utero. In the case of live vaccines, such as rotavirus, decisions should be individualized and take into consideration the risk-benefit ratio, particularly in developing countries. In this review, we provide a comprehensive and updated overview of aspects related to fertility, pregnancy, breastfeeding, and the impact on the care of children born to mothers with IBD. Both the available evidence and areas of uncertainty are discussed, with the goal of assisting healthcare professionals caring for IBD patients during this important stage of their lives.

Individual variation in breeding phenology and postnatal development in northern bats (Eptesicus nilssonii).

Bats inhabiting northern latitudes are faced with short reproductive seasons during which they must produce and rear pups before fattening up in time to survive the winter hibernation. Therefore, the timing of parturition has considerable impacts on future fitness prospects for the mother and pup. However, little is known about individual variation in breeding phenology and its consequences for postnatal development within bat populations. Here, we studied the phenology of breeding in Eptesicus nilssonii across 7 years using data collected by day-to-day monitoring of a breeding colony in Norway (60.1° N) for which the identity and age of each mother (N = 8) and pup (N = 28) were known. Using mixed-effect models, we found that arrival at the colony was influenced by temperature conditions from mid-April to mid-May across all females, but that there were strong and consistent individual differences in arrival- and parturition time across years. Females generally arrived ~32.1 days before giving birth, but the gestation duration was reduced if females arrived late and prolonged if females left the colony when faced with cold weather conditions. Pups born later in the season were born smaller but had higher growth rates during the most rapid growth period (<10 days old). The within-individual effects suggest that the higher growth rates could be due to mothers compensating (e.g. through increased food intake) for late parturition rather than by improved food availability. Date of parturition did not influence adult body size in pups. Pups became volant at the earliest only 13.1 days after birth and approached adult flight patterns during their first flight week. Our results suggest that E. nilssonii is highly adapted to a short breeding season by producing large, fast developing and early volant pups, despite the environmental pressures bats face at northern latitudes.

Optimal days of application of kinesiotaping for the treatment of lumbo-pelvic pain during pregnancy. A systematic review and dose-response meta-analysis.

OBJECTIVE: To determine the optimal dose and short-term effectiveness of kinesiotaping (KT) on pain intensity and disability in pregnant women with lumbo-pelvic pain. DATA SOURCES: MEDLINE (via PubMed Central), CINAHL, Epistemonikos, Scopus, and Web of Science from inception to 21st March 2023. STUDY SELECTION: We included randomized controlled trials (RCT) conducted on pregnant women with lumbo-pelvic pain treated with KT. DATA EXTRACTION: The outcomes included pain intensity and disability. ROB-2 and GRADE were used to assess the risk of bias and the certainty of the evidence, respectively. A random effects meta-analysis was performed using the standardized mean difference (SMD) and the corresponding 95% confidence interval (CI). The dose-response association was evaluated using a restricted cubic spline model. DATA SYNTHESIS: Seven RCTs involving 527 patients were included. Meta-analysis revealed a statistically significant effect in favor of KT on pain intensity (SMD = -1.71; 95% CI = -2.51 to -0.90; P = <0.001) and on disability (SMD = -1.15; 95% CI = -2.29 to -0.02; P = <0.001). The total duration of KT use ranged from 5 to 35 days. It was estimated that a dose of 5-10 days exceeded the minimal clinically important difference (MCID) for pain intensity (mean difference at 10 days = -2.63; 95% CI = -3.05 to -2.22). Low certainty of evidence was identified for both outcomes. CONCLUSIONS: In pregnant women with lumbo-pelvic pain, the use of KT for 5 to 10 days produces a short-term reduction in pain intensity that exceeds the MCID, with a low certainty of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: Systematic Review Registration Number PROSPERO CRD42023388174. CONTRIBUTION OF PAPER.

The evolution of gestation length in eutherian mammals.

Eutherian mammals exhibit considerable variation in their gestation lengths, which has traditionally been linked to variation in other traits, including body mass and lifespan. To understand how gestation length variation, including its association with body mass and lifespan variation, changed over mammalian evolution, we conducted phylogeny-informed analyses of 845 representative extant species. We found that gestation length substantially differed in both whether and how strongly it was associated with body mass and lifespan across mammals. For example, gestation length was not associated with lifespan or body mass in Chiroptera and Cetacea but was strongly associated only with body mass in Carnivora. We also identified 52 evolutionary shifts in gestation length variation across the mammal phylogeny and 14 shifts when we jointly considered variation of all three traits; six shifts were shared. Notably, two of these shifts, both positive, occurred at the roots of Cetacea and Pinnipedia, respectively, coinciding with the transition of these clades to the marine environment, whereas a negative shift occurred at the root of Chiroptera, coinciding with the evolution of flight in this clade. These results suggest that the relationship between gestation length and the two other traits has varied substantially across mammalian phylogeny.

How can we reduce maternal mortality due to preeclampsia? The 4P rule.

In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention - Vigilant Prenatal Care - Timely Delivery (Parturition) - Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management.

Maternal Thyroid Function and Biochemical Markers of Placental Function in Early Pregnancy.

OBJECTIVE: A link between maternal thyroid function and the placental biomarkers, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), has been brought forward. This study aimed to describe their association in early pregnancy. DESIGN: Retrospective cohort study. PARTICIPANTS: Eight hundred and fifty-eight pregnant women from the North Denmark Region, 2013, with blood samples drawn in early pregnancy. MEASUREMENTS: Thyroid-stimulating hormone (TSH), free thyroxine (fT4), thyroid-peroxidase antibodies (TPO-Ab), thyroglobulin antibodies (Tg-Ab) (ADVIA Centaur XPT, Siemens Healthineers), sFlt-1 and PlGF (Kryptor Compact, ThermoFisher Scientific) were measured. The association between maternal TSH and fT4 and percentile (pc) levels of sFlt-1 and PlGF (< 25th pc, 25-75th pc, > 75th pc) was evaluated using regression analysis and reported as adjusted beta coefficient (aß). The frequency of maternal thyroid autoantibodies (TPO-Ab > 60 U/mL or Tg-Ab > 33 U/mL) by pc levels of sFlt-1 and PlGF was compared using chi-squared test. RESULTS: Higher levels (> 75th pc) of sFlt-1 associated with lower TSH (aß 0.62, 95% CI: 0.51-0.76) and higher fT4 (aß 1.03, 95% CI: 1.01-1.05). Higher levels of PlGF associated with lower TSH (aß 0.82, 95% CI: 0.69-0.98), but not with levels of fT4 (aß 1.00, 95% CI: 0.97-1.02). No association with maternal thyroid autoantibodies was found (TPO-Ab: sFlt-1: p-value 0.5 and PlGF: p-value 0.1; Tg-Ab: sFlt-1: p-value 0.7 and PlGF: p-value 0.1). CONCLUSIONS: In a large cohort of Danish pregnant women, higher levels of sFlt-1 and PlGF associated with maternal thyroid function in early pregnancy, while there was no association with maternal thyroid autoantibodies.