Chorionic thickness and PlGF concentrations as early predictors of small-for-gestational age birth weight in a low risk population.

OBJECTIVES: SGA is associated with higher incidence of postnatal complications, including suboptimal neurodevelopment and increased cardiovascular risk. Screening for SGA, carried out at 11-13 (+ 6d) gestational weeks enables to reduce or completely eliminate the above mentioned complications. The aim of this study was to assess the correlation between chorionic thickness, concentration of PIGF protein and foetal birth weight in a single low-risk pregnancy. MATERIAL AND METHODS: The study included 76 patients at 11-13 (+ 6d) gestational weeks, monitored throughout preg-nancy. Ultrasound examinations identified the location and thickness of the chorion by measuring it in its central part at its widest point in a sagittal section. Additionally, at each visit venous blood was collected to determine the level of PlGF, PAPP-A, and BhCG. RESULTS: A significant positive correlation (r = 0.37) was found between the foetal weight and chorionic thickness. This correlation was affected by the location of the chorion and a significant negative correlation was observed between the level of PLGF, FHR, weight and length of the newborn. Maternal early-pregnancy BMI did not affect neonatal weight and body length, FHR, chorionic thickness, and the levels of PlGF, PAPP-A, and BhCG. CONCLUSIONS: The preliminary analysis indicates an association between chorionic thickness assessed during ultrasound at 11-13 (+ 6d) gestational weeks, PIGF levels assayed at the same time and birth weight. Increasing chorion thickness was accompanied by increasing foetal birth weight. PlGF level showed an inversely proportional effect on the foetal weight. This correlation was significant for the posterior location of the chorion.

The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters.

PROBLEM: This study aims to investigate the role of the systemic immune-inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM). METHOD OF STUDY: Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group. RESULTS: When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd-trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket. CONCLUSION: SII levels were significantly higher in third-trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.

The Correlation between the First Trimester Combined Test Results and Thyroid Stimulating Hormone Levels as Well as Its Effect on Pregnancy Outcomes.

Background: Determining the pregnancy outcomes with independent prognostic factors in the first trimester combined screening test and thyroid stimulating hormone (TSH) is a concern for practitioners. We aimed to evaluate the correlation between TSH and first trimester combined screening test levels and examine their effects on pregnancy outcomes in healthy pregnant women. Methods: A total of 349 pregnant women in Izmir Ataturk Training and Research Hospital, Turkey with normal TSH values in the first trimester between 2015 and 2020 were enrolled. Patients were divided into two groups as 274 and 75 patients according to TSH values with 2,5 as cut-off value; their birth weights and weeks were compared. Patients were also divided into three groups according to gestational weeks; their TSH values and combined tests were compared. Results: When grouped based on the TSH threshold value (2.5uIU/ml), no significant relationship was found between the combined test parameters and TSH levels. In the combined test, after grouping according to the week of gestation, a negative correlation was observed between free beta-human chorionic gonadotropin (ß-hCG) and TSH measured at 11 weeks (P=0.040, r=-0.189). A significant negative correlation was found between free ß-hCG and newborn birth weight (P=0.032, r=-0.199), TSH and delivery time (P=0.011, r=-0.235). Conclusion: Free ß-hCG and TSH levels could guide practitioners for birth weight and early delivery, respectively. Postponing the combined test for patients with elevated serum TSH levels to between the 12th and 13th weeks of gestation may reduce false positives.

Residual risk associations between initial hyperglycemia and adverse pregnancy outcomes in a large cohort including 6709 women with gestational diabetes.

AIMS: To estimate the residual risk associations between hyperglycemia and adverse pregnancy outcomes after glycemia-controlling intervention. METHODS: Among 41,067 Chinese women, those with gestational diabetes mellitus (GDM), according to the IADPSG criteria, received standard interventions to control glycemia. Risk associations of plasma glucose (PG) levels with excess newborn birth weight, primary cesarean section, and preterm delivery were estimated and compared with those in the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study, where hyperglycemia was left untreated. RESULTS: A total of 6,709 (16.3%) women developed GDM and thus received predominantly lifestyle interventions. The incidence of excess newborn birth weight, primary cesarean section, and preterm delivery was 6.1%, 19.1%, and 4.0%, respectively. Higher fasting and higher post-load PG levels during 75-g oral glucose tolerance test (OGTT) were statistically significantly associated with increased risks of excess newborn birth weight and pre-term delivery. Compared with the HAPO study, the association of fasting PG level with excess newborn birth weight showed similar strength and dose-response pattern, contrasting with considerably weakened associations for post-load PG levels that involved glycemic control. Contrary risk associations were seen across GDM subtypes compared with non-GDM, isolated fasting GDM was associated with increased, whereas isolated post-load GDM was associated with decreased, risks of excess newborn birth weight and primary cesarean section. Limiting the analysis to non-GDM women and GDM women with low HbA1c (<6.0%) ≥30 days after interventions overall attenuated the risk associations. CONCLUSIONS: Residual risk associations exist between hyperglycemia and adverse pregnancy outcomes despite seemingly appropriate glycemic control.

Comparison of pregnancy and neonatal outcomes of intracytoplasmic sperm injection performed with frozen versus fresh testicular sperm.

Background: It remains controversial whether there is a difference in the prognosis of intracytoplasmic sperm injection (ICSI) using frozen or fresh testicular sperm in patients with obstructive azoospermia (OA). Moreover, in the available studies, few have tracked neonatal outcomes. This study aimed to compare the pregnancy and neonatal outcomes of ICSI using cryopreserved sperm versus fresh sperm collected by testicular sperm aspiration (TESA). Methods: A total of 317 OA patients treated with ICSI in a university affiliated hospital from January 2016 to December 2020 were included in this study. The participants were divided into two groups according to the type of sperm used for ICSI: frozen sperm group (n=154) and fresh sperm group (n=163). The pregnancy and neonatal outcomes of the two groups were compared. Results: The data produced by this study showed no significant statistical difference in the 2 pronuclei (2PN) fertilization rate, 2PN cleavage rate, high-quality blastocyst rate, and the average number of transferred embryos in the frozen and fresh sperm groups. Similarly, no difference was found in implantation rate, clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, premature delivery rate, live birth rate, and gender ratio at birth (P>0.05). The average newborn birth weight was similar in both groups (2,932.61±728.40 vs. 3,100.32±515.64 g, respectively) (P>0.05). A higher incidence of low birthweight (LBW) newborns was found in the frozen sperm group (20.91% vs. 8.49%) (P<0.05). Multiple logistic regression analysis showed that LBW is related to single or twin pregnancies (P<0.01), but not sperm (frozen or fresh) (P>0.05). We further analyzed the twin and single pregnancies in the two groups separately, and found that the incidences of LBW were both similar (P>0.05). There was no difference in the Apgar scores at 1 min and 5 min after birth between the two groups (P>0.05). Conclusions: The use of frozen testicular sperm by TESA was efficient for men with OA. There were similar pregnancy and neonatal outcomes following TESA-ICSI using frozen or fresh sperm in this retrospective study. Prospective investigations are needed for further validation.

Effect of Probiotic Supplementation on Newborn Birth Weight for Mother with Gestational Diabetes Mellitus or Overweight/Obesity: A Systematic Review and Meta-Analysis.

High birth weight indicates the future risk of obesity and increased fat mass in childhood. Maternal gestational diabetes mellitus (GDM) or overweight are powerful predictors of high birth weight. Studies on probiotic supplementation during pregnancy have reported its benefits in modulating gut microbiota composition and improving glucose and lipid metabolism in pregnant women. Therefore, probiotic intervention during pregnancy was proposed to interrupt the transmission of obesity from mothers to newborns. Thus, we performed a meta-analysis to investigate the effect of probiotic intervention in pregnant women with GDM or overweight on newborn birth weight. We searched PubMed, EMBASE, Cochrane Library, and Web of Science databases up to 18 December 2019. Randomized controlled trials (RCTs) comparing pregnant women with GDM or overweight who received probiotic intervention during pregnancy with those receiving placebo were eligible for the analysis. Newborn birth weights were pooled to calculate the mean difference with a 95% confidence interval (CI). Two reviewers assessed the trial quality and extracted data independently. Seven RCTs involving 1093 participants were included in the analysis. Compared with the placebo, probiotics had little effect on newborn birth weight of pregnant women with GDM or overweight (mean difference = -10.27, 95% CI = -90.17 to 69.63, p = 0.801). The subgroup analysis revealed that probiotic intake by women with GDM decreased newborn birth weight, whereas probiotic intake by obese pregnant women increased newborn birth weight. Thus, no evidence indicates that probiotic intake by pregnant women with GDM or overweight can control newborn birth weight.

Maternal smoking and newborn sex, birth weight and breastfeeding: a population-based study.

OBJECTIVE: Today, it is acknowledged that smoking during pregnancy and/or the postnatal period has significant risks for a foetus and newborn child. This research examines the relationship between smoking only postnatally, both during pregnancy and postnatally, and the newborn sex, birth weight and breastfeeding. METHODS: Total 664 women of randomly selected five primary healthcare centres between the dates 20 February 2010 and 20 July 2010 were included in the research. Statistical analyses were performed with SPSS for Windows 19.0 (Statistical Package for Social Sciences software package). Data were described as mean, standard deviation, percentages and Chi-square tests and backward stepwise logistic regression were analysed. RESULTS: It was found that the percentage of smoking women with daughters is 2.5 times higher than women with sons. Women who smoke are 3.9 times more likely to start feeding their baby with supplementary infant foods at 4 months or earlier than those who do not smoke. Finally, the risk of a birth weight under 2500 g is 3.8 times higher for maternal smokers. CONCLUSIONS: This study suggests that women who expect a girl smoke more heavily than those who expect a boy. The birth weight of maternal smokers' newborns is lower. Those women who smoke while breastfeeding start feeding their babies with supplementary infant foods at an earlier age.

Curvas de Crecimiento Intrauterino Calculadas a Partir de Peso, Talla y Perímetro Cefálico en Recién Nacidos del Hospital de Especialidades José Carrasco Arteaga. Cuenca, 2014 - 2015 / Intrauterine Growth Curves Calculated from Weight, Size and Cephalic Perimeter in Newborns of Hospital de Especialidades José Carrasco Arteaga. Cuenca, 2014 ­ 2015

INTRODUCCIÓN: La determinación de la normalidad y morbimortalidad en recién nacidos se fundamenta en clasificarlos usando curvas de crecimiento intrauterino basadas en la antropometría neonatal; estos datos varían según factores raciales, genéticos, ambientales y estilos de vida maternos, por este motivo la OMS recomienda la construcción de curvas propias de cada comunidad. El objetivo del estudio fue determinar curvas de crecimiento intrauterino calculadas a partir de peso, talla y perímetro cefálico en recién nacidos del Hospital de Especialidades José Carrasco Arteaga, de enero 2014 a junio 2015. MÉTODOS: Se realizó un estudio descriptivo, de corte transversal con recién nacidos vivos, sin malformaciones congénitas o genéticas y procedentes todos ellos de gestaciones únicas, atendidos en el Hospital de Especialidades José Carrasco Arteaga, durante el periodo enero 2014 a junio 2015. Los datos se obtuvieron mediante la observación indirecta, basada en los datos de las historias clínicas y se analizaron en los programas Excel 2010 y SPSS versión 15. RESULTADOS: 2 165 recién nacidos cumplieron criterios de inclusión, con ligero predominio de recién nacidos de sexo masculino (50.07% versus 49.93%). El mayor número de nacimientos se registraron durante las 38 y 39 semanas de gestación. Se obtuvo para un recién nacido a término peso promedio 3 070.7 gramos, talla 48.6 centímetros y perímetro cefálico 34.2 centímetros. CONCLUSIONES: Las curvas que se emplean actualmente para la estratificación de los recién nacidos, podrían no ser representativas de la realidad local, por lo que sería necesario el desarrollo de curvas con las poblaciones de cada sector para evitar sesgos erróneos por la variabilidad étnica.(AU)

BACKGROUND: Determination of normality or morbidity in newborns is based on the classification using intrauterine growth curves based on neonatal anthropometry. Data may vary according to race, genetics, environmental exposures and maternal lifestyles. For that reason, the WHO recommends the construction of community specific growth curves. The aim of this study was to determine intrauterine growth curves calculated from weight, height and cephalic perimeter in newborns of Hospital José Carrasco Arteaga, from January 2014 to June 2015. METHODS: A descriptive, cross-sectional study was performed; the universe included newborns without congenital or genetic malformations and from single gestations, attended at Hospital José Carrasco Arteaga, from January 2014 to June 2015. Data was obtained through indirect observation; information was analyzed in Excel 2010 and SPSS 15. RESULTS: 2 165 newborns met inclusion criteria, with a slight predominance of male newborns (50.07% versus 49.93%). The highest number of births was registered during 38 and 39 weeks of gestation. An average full-term weight of 3 070.7 grams, size 48.6 centimeters and head circumference of 34.2 centimeters was obtained. CONCLUSIÓN: The curves currently used for the stratification of newborns, may not be representative of local population; so, it would be necessary to develop specific growth curves to avoid erroneous biases due to ethnic variability.(AU)