Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Changes in short-term variation of antenatal cardiotocography to identify intraamniotic infection: a historical cohort study.","authors":"Brynhildur Tinna Birgisdottir, Tomas Andersson, Ingela Hulthén Varli, Sissel Saltvedt, Ke Lu, Farhad Abtahi, Ulrika Åden, Malin Holzmann","doi":"10.1080/14767058.2024.2434059","DOIUrl":"https://doi.org/10.1080/14767058.2024.2434059","url":null,"abstract":"<p><strong>Introduction: </strong>Intraamniotic infection (IAI) is one of the main possible complications of preterm prelabor rupture of membranes (PPROM) and can lead to severe consequences for the neonate, such as early onset neonatal sepsis (EONS). Available diagnostic tools for IAI have poor diagnostic performance, which may result in both over- and underdiagnoses of IAI. In a search for better diagnostic tools, we have examined short-term variation (STV) in fetal heart rate. We have previously shown that in IAI exposed pregnancies, the STV was more than 20% lower in the last cardiotocography trace before the start of labor, as compared to those not exposed to IAI. The association between IAI and STV needs further evaluation and we therefore continued by examining the longitudinal change in STV in association with IAI.</p><p><strong>Material and methods: </strong>We performed a historical cohort study on 628 singleton pregnancies with PPROM, delivering between 24 + 0 to 33 + 6 gestational weeks. The main exposure of the study was IAI, using EONS as a proxy as no easily available method exists for confirming IAI antepartum, and IAI and EONS are strongly associated. The main outcome was STV in fetal heart rate. At least two available cardiotocography traces per fetus were required as a minimum, from PPROM or from seven days before birth, whichever came later, until the start of labor or planned cesarean birth. A total of 9 690 cardiotocography traces were analyzed.</p><p><strong>Results: </strong>Fetuses exposed to IAI had a 26.5% steeper decline in their STV during the last 24 h before the start of labor when compared to fetuses not exposed (95% CI -32.9% to -19.4%; <i>p</i> < 0.001). After adjustment for antenatal corticosteroids, the decline remained significant. The decline became less prominent but the significance remained when also adjusting for the baseline frequency (-12.7% [95% CI -19.3% to -5.5%], <i>p</i> < 0.001). In the IAI-exposed group, the baseline frequency increased by 11.1 bpm during the last 12 h before the start of labor, beyond those who were not exposed (95% CI 8.3 bpm to 13.8 bpm; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In pregnancies affected by IAI the STV declines steeper in the last 24 h before the start of labor as compared to pregnancies not affected by IAI, even after adjustment for increasing baseline frequency. The association of STV in relation to IAI needs to be further studied in order to evaluate and establish STVs usefulness in monitoring patients for IAI.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2434059"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the clinical efficacy of one-day outpatient management of patients with gestational diabetes mellitus.","authors":"Jingwen Xu, Qian Jing, Huixia Shi, Hui Qian, Li Shi","doi":"10.1080/14767058.2024.2436086","DOIUrl":"https://doi.org/10.1080/14767058.2024.2436086","url":null,"abstract":"<p><strong>Objective: </strong>A comprehensive management model called the one-day care clinic has been established and implemented throughout the hospitals as well as maternal and child health care centers for gestational diabetes mellitus (GDM) in China. However, there is still a lack of high-level evidence for this management model. The objective of this study was to describe the one-day outpatient management model and assess its efficacy in managing GDM.</p><p><strong>Methods: </strong>A retrospective review was performed on patients who were admitted to the obstetrics clinic and diagnosed as GDM at our centers from July 2017 to June 2022. All enrolled patients were divided into two groups: the experimental group that participated in the one-day outpatient management and the control group that only received routine education on gestational diabetes in the outpatient department. Baseline characteristics and clinical data of enrolled patients were reviewed. Blood glucose level before and after attending one-day outpatient management, blood glucose and HbA1c before delivery, weight gain at the end of pregnancy, complications during pregnancy and pregnancy outcomes were collected.</p><p><strong>Results: </strong>A total of 546 patients were finally included in this study, with 276 in the experimental group and 270 in the control group. There were no significant differences between the two groups in terms of baseline characteristics. The 1h postprandial blood glucose (PBG) and 2h PBG levels were significantly lower after participating in the one-day outpatient management compared to before (all <i>p</i> value < 0.01). Before delivery, the FBG, 2hPBG, and HbA1c levels in the experimental group were significantly lower than those in the control group (all <i>p</i> value < 0.01). The experimental group experienced less weight gain and had a higher rate of achieving weight gain goals compared to the control group. In terms of complications during pregnancy, the incidence of premature rupture of fetal membranes, pregnancy induced hypertension, and hydramnion did not differ significantly between the two groups. In terms of pregnancy outcomes, the incidence of macrosomia and neonatal hypoglycemia in the experimental group was significantly lower than in the control group (all <i>p</i> value < 0.05).</p><p><strong>Conclusion: </strong>The adoption of the one-day outpatient management is more beneficial for controlling blood glucose levels and weight target during pregnancy in GDM patients. Additionally, this management can decrease the occurrence of adverse pregnancy outcomes, and improve the prognosis of both GDM patients and offspring.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2436086"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of duration of intrapartum maternal hyperglycemia in well-controlled gestational diabetes mellitus women and risks of neonatal hypoglycemia: a retrospective cohort study.","authors":"Yilin He, Yiwei Liu, Yiran Peng, Yang Xu, Jie Yan, Huixia Yang","doi":"10.1080/14767058.2024.2431617","DOIUrl":"https://doi.org/10.1080/14767058.2024.2431617","url":null,"abstract":"<p><strong>Objectives: </strong>Achieving intrapartum euglycemia is recommended to reduce the risk of neonatal hypoglycemia. However, recent research relating the association of maternal intrapartum glucose and neonatal hypoglycemia showed conflicting results, particularly in women with gestational diabetes mellitus (GDM). We aimed to assess the association between intrapartum maternal hyperglycemia and neonatal hypoglycemia in women with GDM.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 508 pairs of women with GDM and their neonates in Peking University First Hospital from 18 October 2020 to 18 October 2021. Our exposure was the maternal time above range (TAR) for glucose during labor, defined as the duration when glucose levels exceeded 126 mg/dL. We split the participants into four groups according to their TAR quantiles and employed natural spline regression using the LOESS method to illustrate the relationship between maternal TAR and neonates' lowest glucose level within 24-h postbirth.</p><p><strong>Results: </strong>Of the 508 women included, 37.8% (192/508) experienced hyperglycemia with a TAR over 25%. TAR quantiles were not significantly associated with neonates' lowest glucose levels (adjusted coefficients [95%CI], Q1: reference, Q2: 0.24 [-0.04, 0.54], Q3: 0.11[-0.21, 0.43], Q4: 0.18[-0.15, 0.52]). However, increased TAR >100 mg/dL resulted in higher neonatal glucose values (adjusted coefficients [95%CI]: Q1: reference, Q2: 0.33 [-0.04, 0.71], Q3: 0.47 [0.11, 0.82], Q4: 0.35 [0.07, 0.63]). Moreover, maternal hypoglycemia was association with neonatal hypoglycemia (adjusted coefficients [95%CI]: -0.67 [-1.15, -0.18]).</p><p><strong>Conclusion: </strong>Intrapartum glycemic control may be considered not as critical, when the overall glucose control throughout pregnancy is optimized. As neonatal hypoglycemia shows association with maternal hypoglycemia, which may be induced by strict intrapartum glycemic control, a less stringent intrapartum glucose target is preferred.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2431617"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of pre-/early pregnancy high blood pressure and pregnancy outcomes: a systemic review and meta-analysis.","authors":"Ming Jin, Xiaowen Liu, Xiaojing Liu, Yaxian Wu, Yali Zhang, Le Zhang, Zhiwen Li, Rongwei Ye, Nan Li","doi":"10.1080/14767058.2023.2296366","DOIUrl":"10.1080/14767058.2023.2296366","url":null,"abstract":"<p><strong>Background: </strong>Maternal high blood pressure (BP) was associated with adverse pregnancy outcomes. This study aimed to synthesize evidence on the association between high BP prior to or in early pregnancy with maternal and fetal complications.</p><p><strong>Methods: </strong>We searched the cohort studies assessing the effect of high BP in the Medline, Embase, Web of Science and China National Knowledge Internet databases. A random-effects model was used to estimate the pooled odds ratios (ORs) with 95% confidence intervals (CIs). The protocol was registered in PROSPERRO (CRD 42023414945).</p><p><strong>Results: </strong>23 eligible studies were identified. High BP prior to or in early pregnancy was associated with higher odds of hypertensive disorders of pregnancy (OR 2.90, 95% CI 1.91-3.89), gestational hypertension (2.56, 2.01-3.12), preeclampsia (3.20, 2.66-3.74), gestational diabetes mellitus (1.71, 1.36-2.06), preterm birth (1.66, 1.39-1.93), stillbirth (2.01, 1.45-2.58) and neonatal intensive care unit admission (1.22, 1.08-1.37). Subgroup analyses indicated that pre-hypertension could significantly increase the odds of these outcomes except for stillbirth, though the odds were lower than hypertension.</p><p><strong>Conclusions: </strong>High BP prior to or in early pregnancy was associated with adverse pregnancy outcomes and this association increased with hypertension severity. The findings emphasized an urgent need for heightened surveillance for maternal BP, especially pre-hypertensive status.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2296366"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal congenital talipes equinovarus: genomic abnormalities and obstetric follow-up results.","authors":"Meiying Cai, Jiansong Lin, Yanting Que, Liangpu Xu, Na Lin, Hailong Huang","doi":"10.1080/14767058.2023.2299113","DOIUrl":"10.1080/14767058.2023.2299113","url":null,"abstract":"<p><strong>Objective: </strong>The etiology of congenital talipes equinovarus (CTEV) is unknown, and the relationship between chromosome microdeletion/microduplication and fetal CTEV is rarely reported. In this study, we retrospectively analyzed fetal CTEV to explore the relationship among the CTEV phenotype, chromosome microdeletion/microduplication, and obstetric outcomes.</p><p><strong>Methods: </strong>Chromosome karyotype analysis and single nucleotide polymorphism (SNP) array were performed for the 68 fetuses with CTEV.</p><p><strong>Results: </strong>An SNP array was performed for 68 fetuses with CTEV; pathogenic copy number variations (CNVs) were detected in eight cases (11.8%, 8/68). In addition to one case consistent with karyotype analysis, the SNP array revealed seven additional pathogenic CNVs, including three with 22q11.21 microdeletions, two with 17p12p11.2 microduplications, one with 15q11.2 microdeletions, and one with 7q11.23 microduplications. Of the seven cases carrying pathogenic CNVs, three were tested for family genetics; of these, one was <i>de novo</i>, and two were inherited from either the father or mother. In total, 68 fetuses with CTEV were initially identified, of which 66 cases successfully followed-up. Of these, 9 were terminated, 2 died in utero, and 55 were live births. In 9 cases, no clinical manifestations of CTEV were found at birth; the false-positive rate of prenatal ultrasound CTEVdiagnosis was thus 13.6% (9/66).</p><p><strong>Conclusion: </strong>CTEV was associated with chromosome microdeletion/microduplication, the most common of which was 22q11.21 microdeletion, followed by 17p12p11.2 microduplication. Thus, further genomic detection is recommended for fetuses with CTEV showing no abnormalities on conventional karyotype analysis.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2299113"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrinogen as a potential diagnostic marker for prediction and evaluation of postpartum hemorrhage: a retrospective study.","authors":"Yanke Zou, Yixiao Jiang, Dawei Zhu, Ling Liu, Xiuhui Zheng, Xing Gu, Changxiao Huang, Li Li","doi":"10.1080/14767058.2023.2300418","DOIUrl":"10.1080/14767058.2023.2300418","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether prenatal fibrinogen (FIB) or other related factors could be utilized to evaluate the risk of postpartum hemorrhage (PPH).</p><p><strong>Methods: </strong>A retrospective study was conducted in a database from January 2015 to December 2019. A total of 128 patients were enrolled and evaluated with FIB, in which 55 patients were assigned to low FIB and 73 in normal FIB.</p><p><strong>Results: </strong>According to the volume of blood loss, the mean of the low FIB group (<4 g/L) was markedly higher than that of the normal FIB group (≥4 g/L). Prenatal FIB was negatively correlated with PPH volume. The receiver operating characteristic (ROC) curve results indicated that the value of prenatal FIB was 0.701 to predict refractory PPH.</p><p><strong>Conclusions: </strong>Prenatal FIB was significantly related to thrombin time (TT), which may be an independent factor to predict the coagulation state of prenatal pregnancy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2300418"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of transvaginal cervical length and cervical angle ultrasonography in term delivery outcomes: a cohort study.","authors":"Ghazal Tajeran, Roya Derakhshan, Fatemeh Jayervand, Maryam Rahimi, Parisa Hajari, Neda Hashemi","doi":"10.1080/14767058.2024.2406344","DOIUrl":"https://doi.org/10.1080/14767058.2024.2406344","url":null,"abstract":"<p><strong>Background: </strong>Various techniques have been proposed to predict and evaluate the timing and conditions of childbirth in pregnant women at different stages of pregnancy. Providing precise methods for forecasting childbirth status can reduce the burden on the healthcare system. This study aimed to evaluate the predictive value of transvaginal sonography of cervical length (CL) and cervical angle (CA) on full-term delivery outcomes.</p><p><strong>Methods: </strong>This cohort study analyzed 151 pregnant women between 37 and 42 weeks of gestational age who were treated at Rasoul Akram Hospital affiliated with Iran University of Medical Sciences from June 2023 to January 2024. All Participants received transvaginal examinations. This study evaluated the accuracy of CL and CA by transvaginal sonography in predicting outcomes like vaginal delivery, cesarean section, necessity for labor induction, and the rate of Premature Rupture of Membranes (PROM). The study used the Receiver Operating Characteristic (ROC) curve to determine the optimal cutoff for predicting birth outcomes.</p><p><strong>Results: </strong>The mean age of the pregnant women was 28.9 ± 4.22 years, while the average duration of pregnancy was 39.8 ± 2.11 weeks. Cesarean delivery was performed on 45 individuals (29.8%) and 106 (70.1%) underwent vaginal delivery. The mean CL overall stood at 21.2 ± 6.4 mm. PROM was observed in 41 cases (27.1%) among full-term pregnancies. A significant difference was noted in mean CL between the cesarean and vaginal delivery groups (24.2 ± 2.4 vs. 20.1 ± 2.1 mm, <i>p</i> = 0.001). The predictive value of a CL measuring 21 mm for cesarean delivery was 72.2% sensitive and 79.1% specific. Similarly, a CL of 22 mm showed 66.6% sensitivity and 80.2% specificity for labor induction. Regarding PROM in full-term pregnancies, a CL assessment demonstrated 59.8% sensitivity and 69.1% specificity. Finally, a CA of 115.2° exhibited 70.3% sensitivity and 78.4% specificity in predicting vaginal delivery.</p><p><strong>Conclusion: </strong>The present study showed that evaluating CL and CA via transvaginal sonography demonstrated adequate diagnostic accuracy in predicting spontaneous birth, need for labor induction, cesarean delivery, and incidence of PROM in full-term pregnant women. This method is suggested to be an accurate and appropriate way to predict delivery results.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2406344"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dried blood spots-based metabolomic analysis in preterm infants with necrotizing enterocolitis.","authors":"Tiantian Zhang, Shimin Yang, Ruotong Li, Ruiqian Dong, Hui Zou","doi":"10.1080/14767058.2024.2416610","DOIUrl":"https://doi.org/10.1080/14767058.2024.2416610","url":null,"abstract":"<p><strong>Objective: </strong>Necrotizing enterocolitis (NEC) is the leading cause of death among premature infants, and there is a lack of specific early diagnostic markers. Blood sampling is expected to better reflect pathophysiological and metabolic changes in systematic illness, but there is a risk of iatrogenic anemia, especially in premature infants. Dried blood spots technique seems to have important advantages compared to whole blood sampling as it requires only 12-15 μL as sample volume. This study aimed to investigate the special metabolomics of preterm neonates at high risk of NEC using dried blood spots.</p><p><strong>Methods: </strong>Cases and controls were strictly matched 1:1. Dried blood spots (<i>n</i> = 32, 16 cases-16 controls) from newborn screening were subjected to LC-MS/MS. Metabolomic data were analyzed by orthogonal partial least squares-discriminant analysis (OPLS-DA) and univariate/multivariate statistical analysis.</p><p><strong>Results: </strong>Compared to the control group, the NEC group had a significant reduction in seven amino acids (glycine, alanine, threonine, proline, ornithine, lysine, and asparagine).</p><p><strong>Conclusions: </strong>The metabolic profile of neonates with NEC differs significantly from that of controls, making possible their separation with the use of targeted (LC-MS/MS) dried blood spots-based metabolomic analysis. Seven specific markers were identified for early detection and intervention.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2416610"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mitochondrial regulator protein, MNRR1, is elevated in the maternal blood of women with preeclampsia.","authors":"Manaphat Suksai, Roberto Romero, Mariachiara Bosco, Francesca Gotsch, Eunjung Jung, Piya Chaemsaithong, Adi L Tarca, Dereje W Gudicha, Nardhy Gomez-Lopez, Marcia Arenas-Hernandez, Arun Meyyazhagan, Lawrence I Grossman, Siddhesh Aras, Tinnakorn Chaiworapongsa","doi":"10.1080/14767058.2023.2297158","DOIUrl":"10.1080/14767058.2023.2297158","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Preeclampsia, one of the most serious obstetric complications, is a heterogenous disorder resulting from different pathologic processes. However, placental oxidative stress and an anti-angiogenic state play a crucial role. Mitochondria are a major source of cellular reactive oxygen species. Abnormalities in mitochondrial structures, proteins, and functions have been observed in the placentae of patients with preeclampsia, thus mitochondrial dysfunction has been implicated in the mechanism of the disease. Mitochondrial nuclear retrograde regulator 1 (MNRR1) is a newly characterized bi-organellar protein with pleiotropic functions. In the mitochondria, this protein regulates cytochrome &lt;i&gt;c&lt;/i&gt; oxidase activity and reactive oxygen species production, whereas in the nucleus, it regulates the transcription of a number of genes including response to tissue hypoxia and inflammatory signals. Since MNRR1 expression changes in response to hypoxia and to an inflammatory signal, MNRR1 could be a part of mitochondrial dysfunction and involved in the pathologic process of preeclampsia. This study aimed to determine whether the plasma MNRR1 concentration of women with preeclampsia differed from that of normal pregnant women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective case-control study included 97 women with preeclampsia, stratified by gestational age at delivery into early (&lt;34 weeks, &lt;i&gt;n&lt;/i&gt; = 40) and late (≥34 weeks, &lt;i&gt;n&lt;/i&gt; = 57) preeclampsia and by the presence or absence of placental lesions consistent with maternal vascular malperfusion (MVM), the histologic counterpart of an anti-angiogenic state. Women with an uncomplicated pregnancy at various gestational ages who delivered at term served as controls (&lt;i&gt;n&lt;/i&gt; = 80) and were further stratified into early (&lt;i&gt;n&lt;/i&gt; = 25) and late (&lt;i&gt;n&lt;/i&gt; = 55) controls according to gestational age at venipuncture. Maternal plasma MNRR1 concentrations were determined by an enzyme-linked immunosorbent assay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;1) Women with preeclampsia at the time of diagnosis (either early or late disease) had a significantly higher median (interquartile range, IQR) plasma MNRR1 concentration than the controls [early preeclampsia: 1632 (924-2926) pg/mL vs. 630 (448-4002) pg/mL, &lt;i&gt;p&lt;/i&gt; = .026, and late preeclampsia: 1833 (1441-5534) pg/mL vs. 910 (526-6178) pg/mL, &lt;i&gt;p&lt;/i&gt; = .021]. Among women with early preeclampsia, those with MVM lesions in the placenta had the highest median (IQR) plasma MNRR1 concentration among the three groups [with MVM: 2066 (1070-3188) pg/mL vs. without MVM: 888 (812-1781) pg/mL, &lt;i&gt;p&lt;/i&gt; = .03; and with MVM vs. control: 630 (448-4002) pg/mL, &lt;i&gt;p&lt;/i&gt; = .04]. There was no significant difference in the median plasma MNRR1 concentration between women with early preeclampsia without MVM lesions and those with an uncomplicated pregnancy (&lt;i&gt;p&lt;/i&gt; = .3). By contrast, women with late preeclampsia, regardless of MVM lesions, had a significantl","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2297158"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of assisted reproductive technology with fetal malpresentation: a systematic review and meta-analysis.","authors":"Konstantinos Stavridis, Maria Pisimisi, Olga Triantafyllidou, Theodoros Kalampokas, Nikolaos Vlahos, Stavroula L Kastora","doi":"10.1080/14767058.2024.2313143","DOIUrl":"10.1080/14767058.2024.2313143","url":null,"abstract":"<p><strong>Background: </strong>Since its introduction, assisted reproductive technology (ART) has developed into a common clinical practice around the world; yet it still raises a lot of questions. Throughout time, many researchers have investigated its association with several obstetric incidences and its consequences on perinatal outcomes. The aim of the current meta-analysis was to estimate the correlation between ART procedures and malpresentation of the fetus in singleton pregnancies.</p><p><strong>Methods: </strong>The study was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) guidelines and prospectively registered under the PROSPERO database (CRD42023458084). Five databases (Embase, MEDLINE^®, APA PsycInfo, Global Health, Health Management Information Consortium (HMIC)) and two additional sources were searched from inception to 31 May 2023. Quality of the included studies was assessed using the ROBINS-1 scale, whilst quality of evidence by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Summative and subgroup data as well as heterogeneity were generated by the Cochrane platform RevMan Web.</p><p><strong>Results: </strong>Overall, 11 studies were included in the study with a total of 3,360,134 deliveries. Results indicate a higher risk of malpresentation at delivery in fetuses conceived through ART than those conceived naturally (RR: 1.50, (95% confidence interval (CI):1.30, 1.73)). This risk decreased when adjustments for potential confounders were applied (RR = 1.12, 95% CI 1.02, 1.23).</p><p><strong>Conclusions: </strong>Based on observational studies, this meta-analysis indicated that singleton pregnancies conceived through ART are associated with higher risk of malpresentation than those conceived naturally, albeit the difference was lower when potential confounders were examined. Thus, future large studies are required to better understand possible reversible and irreversible factors of this relationship.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2313143"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}