Relation between socioeconomic status and maternal serum lipids to infant lipid concentrations and anthropometry in the first year of life.

PURPOSE: The physical health and development of an individual are influenced by multiple parameters and shaped by internal and external factors during pregnancy. However, it is unclear whether there is an association between maternal lipid concentrations in the third trimester of pregnancy and infant serum lipids as well as anthropometric growth, and whether these factors are influenced by the socioeconomic status (SES) of the mothers. METHODS: Between 2011 and 2021, 982 mother-child pairs were recruited in the LIFE-Child study. To investigate the influence of prenatal factors, pregnant women at the 24th and 36th week of gestation as well as children at the age of 3, 6 and 12 months were examined and serum lipids determined. Socioeconomic status (SES) was assessed using the validated Winkler Index. RESULTS: A higher maternal BMI was associated with a significantly lower Winkler score and a higher infant weight, height, head circumference and BMI from birth up to the 4th-5th week of life. In addition, the Winkler Index correlates with maternal HDL cholesterol and ApoA1 levels. There was no relation between the delivery mode and the maternal BMI or SES. For the maternal HDL cholesterol concentration in the third trimester, an inverse relation to children's height, weight, head circumference and BMI up to the first year of life as well as the chest and abdominal circumference to an age of 3 months was found. Children born to mothers with dyslipidemia in pregnancy tended to have a worse lipid profile than those born to normolipidemic mothers. CONCLUSION: Serum lipid concentrations and anthropometric parameters of children in the first year of life are affected by multiple factors like maternal BMI, lipid levels and SES.

Novel Three-Dimensional Body Scan Anthropometry versus MR-Pelvimetry for Vaginal Breech Delivery Assessment.

In this prospective, monocentric study, we investigated the potency of a novel three-dimensional (3D) body scanner for external pelvic assessment in birth planning for intended vaginal breech delivery. Between April 2021 and June 2022, 73 singleton pregnancies with intended vaginal birth from breech presentation (>36.0 weeks of gestation) were measured using a pelvimeter by Martin, a three-dimensional body scanner, and MR-pelvimetry. Measures were related to vaginal birth and intrapartum cesarean section. A total of 26 outer pelvic dimensions and 7 inner pelvic measurements were determined. The rate of successful vaginal breech delivery was 56.9%. The AUC (area under the curve) of the obstetric conjugate (OC) measured by MRI for predicting the primary outcome was 0.62 (OR 0.63; p = 0.22), adjusted for neonatal birth weight 0.66 (OR 0.60; p = 0.19). Of the 22 measured 3D body scanner values, the ratio of waist girth to maternal height showed the best prediction (AUC = 0.71; OR 1.27; p = 0.015). The best predictive pelvimeter value was the distantia spinarum with an AUC of 0.65 (OR = 0.80). The 3D body scanner technique is at least equal to predict successful vaginal breech delivery compared to MRI diagnostics. Further large-scale, prospective studies are needed to verify these results.

sFlt-1/PlGF ratio for prediction of preeclampsia in clinical routine: A pragmatic real-world analysis of healthcare resource utilisation.

BACKGROUND: We investigated the impact of the soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio to predict short-term risk of preeclampsia on clinical utility and healthcare resource utilisation using real-world data (RWD), and compared findings with health economic modelling from previous studies. METHODS AND FINDINGS: This retrospective analysis compared data from the German population of a multicentre clinical study (PROGNOSIS, n = 203; sFlt-1/PlGF ratio blinded and unavailable for decision-making) with RWD from University Hospital Leipzig, Germany (n = 281; sFlt-1/PlGF ratio used to guide clinical decision-making). A subgroup of the RWD cohort with the same inclusion criteria as the PROGNOSIS trial (RWD prediction only, n = 99) was also included. sFlt-1/PlGF ratio was measured using fully automated Elecsys® sFlt-1 and PlGF immunoassays (cobas e analyser; Roche Diagnostics). A similar proportion of women in the RWD and PROGNOSIS cohorts experienced preeclampsia (14.95% vs. 13.79%; p = 0.7938); a smaller proportion of women in the RWD prediction only cohort experienced preeclampsia versus PROGNOSIS (6.06%; p = 0.0526). In women with preeclampsia, median gestational age at delivery (weeks) was comparable in the RWD and PROGNOSIS cohorts (34.0 vs. 34.3, p = 0.5895), but significantly reduced in the RWD prediction only cohort versus PROGNOSIS (27.1, p = 0.0038). sFlt-1/PlGF ratio at baseline visit was not statistically significantly different for the RWD and PROGNOSIS cohorts, irrespective of preeclampsia outcome. Hospitalisations for confirmed preeclampsia were significantly shorter in the RWD cohort versus PROGNOSIS (median 1 vs. 4 days, p = 0.0093); there was no significant difference between RWD prediction only and PROGNOSIS (3 days, p = 0.9638). All-cause hospitalisations were significantly shorter in the RWD (median 1 day; p<0.0001) and RWD prediction only (1 day; p<0.0001) cohorts versus PROGNOSIS (3 days). CONCLUSIONS: This study supports the findings of previous studies, showing that routine clinical use of the sFlt-1/PlGF ratio may result in shorter duration of hospitalisations, with potential economic benefits.

Serum lipid levels were related to socio-demographic characteristics in a German population-based child cohort.

AIM: Socio-demographic factors affect the development and lives of children and adolescents. We examined links between serum lipids and apolipoproteins and socio-demographic factors in the Leipzig Research Centre for Civilization Diseases Child (LIFE Child) study. METHODS: The Winkler index and the Family Affluence Scale were used to define characteristics of the social status of 938 boys and 860 girls aged from birth to 19 years. We then used univariate and multivariate regression analyses to examine the socio-demographic impact on total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL), cholesterol triglycerides and apolipoproteins A1 (ApoA1) and B (ApoB). RESULTS: No significant influences on the Winkler index or the Family Affluence Scale were observed regarding the concentrations of serum lipids for total cholesterol or LDL cholesterol. However, and most importantly, children and adolescents with high social status and high family affluence showed significantly higher HDL cholesterol and ApoA1 levels than those with lower individual totals. A higher Winkler index was associated with significantly lower values for triglycerides and ApoB. CONCLUSION: Adolescents with higher family wealth and social status showed a lower cardiovascular risk profile, as measured by the concentrations of HDL cholesterol and triglycerides as well as ApoA1 and B.