The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians最新文献

{"title":"Factors affecting human milk lactoferrin.","authors":"Despina D Briana, Vassiliki Papaevangelou","doi":"10.1080/14767058.2021.1961731","DOIUrl":"https://doi.org/10.1080/14767058.2021.1961731","url":null,"abstract":"We thank the authors for commenting on our article [1]. Lactoferrin (Lf) is a multifunctional protein mainly secreted by the mammary and other exocrine glands, as well as secondarily by neutrophils. It is predominantly present in external secretions such as milk, saliva, tears, bile, and pancreatic fluids [2] and is particularly abundant in human colostrum [3]. Joob & Wiwanitkit point out that it would be interesting to discuss Lf in maternal blood, as “blood Lf is markedly increased in acute pneumonia and Lf might secret into breastmilk.” However, as far as we know, there is currently no evidence that maternal blood Lf concentrations correlate with respective breast milk concentrations. Therefore, the implication of maternal blood Lf does not add, in our opinion, anything further to the discussion or interpretation of our results. Furthermore, the determination of maternal blood Lf concentrations was beyond the purposes of this study. As Joob & Wiwanitkit state, several reports have suggested that both maternal and infantile factors may affect human milk Lf concentrations [4–7]. However, those reports produced highly inconsistent results. For instance, two of the studies that the authors cite demonstrated the lack [4] and presence [5] of an association between maternal milk Lf levels and maternal age, respectively. A systematic review investigated the correlation between breast milk Lf concentrations and lactation stage, as well as maternal/infantile factors, such as race/ ethnicity, parity, maternal age, socioeconomic and nutritional status, maternal/infantile infections, and prematurity [8]. The results demonstrated that milk Lf concentrations are consistently highest in colostrum and then gradually decrease, but, besides the stage of lactation, no other maternal or infant factor is consistently associated with Lf concentrations [8]. The authors claimed that a major limitation of the published studies is the small sample size and the different methods applied to determine Lf concentrations [8]. The need for multicenter studies with large sample sizes, as well as standardized design, sample collection, and Lf measurement methods was highlighted, in order to elucidate significant factors associated with breast milk Lf concentrations [8]. Nevertheless, our study population comprised of Caucasian, hospitalized women with similar nutritional status, living in Greece, who gave birth to full-term, appropriate-for-gestational age singletons and provided a milk sample on the 3rd day postpartum, under the same conditions.","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8111"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39296057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborn joint mechanics.","authors":"Rakesh Mondal,&nbsp;Arnab Nandy,&nbsp;Debadyuti Datta,&nbsp;Rahul Majumdar,&nbsp;Avijit Hazra,&nbsp;Sankar Kumar Das","doi":"10.1080/14767058.2021.1946784","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946784","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate joint mechanics in newborn by goniometric assessment of major joints in healthy babies born at different gestational ages (GAs).</p><p><strong>Materials and methods: </strong>An institution based observational study was carried out on healthy newborn babies within two days of birth. Study subjects were born at 28-41 completed weeks of gestation. The major joints of upper and lower limbs were assessed with manual goniometer for joint angles in relation to specific passive movements and range of motion (ROM) calculated where applicable. All measurements were made by a single observer with careful consideration of plane of movement and axes involved. Strength of association between joint angles and GA was quantified by Pearson's <i>r</i> coefficient.</p><p><strong>Results: </strong>Six major joints (shoulder, elbow, wrist, hip, knee, and ankle) were evaluated on either side in 433 babies. No significant differences were found between male and female babies and left or right side of the body. For most joints, a secular declining trend of joint angle or ROM was noted with good to strong inverse correlation with GA. The strongest associations were for flexion-extension ROM and adduction-abduction ROM at shoulder, palmar flexion at wrist and dorsiflexion at ankle joint with <i>r</i> values of -0.76, -0.75, -0.75, and -0.75, respectively.</p><p><strong>Conclusions: </strong>The reading of a specific joint angle in the newborn infants was found to be dependent on GA. Precise calibration of gestation appropriate joint angles had laid down the foundation for functional assessment of multimodal joint mechanics.HighlightsEvaluation of newborn joint angles require stringent attention toward the plane and axis of the particular joint movement being assessed.Major joint angles and range of motion in newborn infants were observed to follow a secular declining trend according to the gestational age.Precise estimation of gestation appropriate joint angle will be helpful to understand the mechanics of musculoskeletal medicine in newborn.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7259-7266"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39298427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and placental DNA methylation: newborn prediction and molecular mechanisms of autism in preterm children.","authors":"Ray O Bahado-Singh,&nbsp;Sangeetha Vishweswaraiah,&nbsp;Buket Aydas,&nbsp;Uppala Radhakrishna","doi":"10.1080/14767058.2021.1963704","DOIUrl":"https://doi.org/10.1080/14767058.2021.1963704","url":null,"abstract":"<p><strong>Background: </strong>Autism Spectrum Disorder (ASD) represents a heterogeneous group of disorders with a complex genetic and epigenomic etiology. DNA methylation is the most extensively studied epigenomic mechanism and correlates with altered gene expression. Artificial intelligence (AI) is a powerful tool for group segregation and for handling the large volume of data generated in omics experiments.</p><p><strong>Methods: </strong>We performed genome-wide methylation analysis for differential methylation of cytosine nucleotide (CpG) was performed in 20 postpartum placental tissue samples from preterm births. Ten newborns went on to develop autism (Autistic Disorder subtype) and there were 10 unaffected controls. AI including Deep Learning (AI-DL) platforms were used to identify and rank cytosine methylation markers for ASD detection. Ingenuity Pathway Analysis (IPA) to identify genes and molecular pathways that were dysregulated in autism.</p><p><strong>Results: </strong>We identified 4870 CpG loci comprising 2868 genes that were significantly differentially methylated in ASD compared to controls. Of these 431 CpGs met the stringent EWAS threshold (<i>p</i>-value <5 × 10^-8) along with ≥10% methylation difference between CpGs in cases and controls. DL accurately predicted autism with an AUC (95% CI) of 1.00 (1-1) and sensitivity and specificity of 100% using a combination of 5 CpGs [cg13858611 (<i>NRN1</i>), cg09228833 (<i>ZNF217</i>), cg06179765 (<i>GPNMB</i>), cg08814105 (<i>NKX2-5</i>), cg27092191 (<i>ZNF267</i>)] CpG markers. IPA identified five prenatally dysregulated molecular pathways linked to ASD.</p><p><strong>Conclusions: </strong>The present study provides substantial evidence that epigenetic differences in placental tissue are associated with autism development and raises the prospect of early and accurate detection of the disorder.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8150-8159"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices for RhD alloimmunization prevention: a vignette-based survey of midwives.","authors":"Guenola Jourdren,&nbsp;Paul Berveiller,&nbsp;Anne Rousseau","doi":"10.1080/14767058.2021.1957822","DOIUrl":"https://doi.org/10.1080/14767058.2021.1957822","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the availability guidelines to prevent RhD alloimmunization, severe hemolytic disease of fetus and newborn still occurs in high-income countries. The aim of the study was (1) To assess variations in practices for the prevention of RhD alloimmunization, and (2) to understand midwives' acceptance and appropriation of fetal RhD genotyping.</p><p><strong>Methods: </strong>Descriptive cross-sectional survey of French midwives from September 2017 through January 2018. Participants were asked to complete an internet-based questionnaire that included three clinical vignettes. They were questioned about their practices concerning early pregnancy visit by RhD-negative women, prevention of RhD alloimmunization in women with second-trimester metrorrhagia, and RhD fetal genotyping.</p><p><strong>Results: </strong>A total of 827 midwives completed the questionnaire. Only 21.1% reported that they practice all the preventive measures recommended in early pregnancy. In a situation at high risk of RhD alloimmunization during pregnancy, 97.2% of midwives would perform immunoprophylaxis. Nearly, all midwives reported providing information about RhD alloimmunization (92.4%) at the beginning of pregnancy, although only 11.3% offered both written and verbal information; at the time of systematic anti-D immunoprophylaxis (28 weeks), 78% provided information, but only 2.7% both verbally and in writing. Finally, only 50.8% of midwives preferred to include RhD fetal genotyping in routine prenatal prophylaxis.</p><p><strong>Discussion: </strong>This study showed significant variations in French midwives' practices to prevent RhD alloimmunization. Better dissemination of guidelines is needed to improve both consistent use of these practices and the quality of information delivered to RhD-negative pregnant women.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7629-7639"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39343178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost implication of CPAP use in low resource settings, surmounting the oxygen administration challenge.","authors":"Ikechukwu R Okonkwo,&nbsp;Chiamaka Aneji,&nbsp;Osayame A Ekhaguere,&nbsp;Emmanuel U Eyo-Ita,&nbsp;Angela A Okolo","doi":"10.1080/14767058.2021.1949278","DOIUrl":"https://doi.org/10.1080/14767058.2021.1949278","url":null,"abstract":"<p><strong>Purpose: </strong>Newborn respiratory support using Bubble Continuous positive airway pressure (bCPAP) has become acceptable in Nigeria as many centers are increasingly reporting its usefulness. There is increasing access to CPAP devices although the use of 100% oxygen for bCPAP administration is on the rise as oxygen/air blenders are not commonly available or insufficient. The cost of oxygen has become a significant contributor to hospital bills. The oxygen concentrator driven bCPAP device with blending capacity is expected to save lives and reduce cost of care.</p><p><strong>Objective: </strong>To compare the cost saving benefit of the use of oxygen concentrator bCPAP devices for CPAP administration to oxygen based devices in a resource limited setting.</p><p><strong>Methods: </strong>This prospective cross sectional study was done between February and December 2019. The oxygen use by CPAP devices-Improvised (IbCPAP), Fisher and Paykel and T-piece were quantified, costed, documented and compared with the same duration of use of concentrator CPAP-Diamedica.</p><p><strong>Results: </strong>CPAP services was accessed by 357 babies, 154 males and 203 females of GA range from 22 to 42 weeks and Birthweights range from 264 to 4400 grams. The main indication for CPAP was respiratory distress syndrome 201(56.3%). Oxygen supply were by oxygen pipeline 250 (70%), cylinders 39 (10.9%), concentrator CPAP 44 (12.3%) mixed source 24 (6.7%). Mean duration on the CPAP devices was 5.4 days, mean cost ₦37,645 ($104) or ₦6,971 ($20)/day, highest with IbCPAP, non-existent with concentrator bCPAP.</p><p><strong>Conclusion: </strong>The high running cost implication of CPAP use in low resource settings could deter transitioning to quality devices hence the need for non-oxygen dependent devices.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7368-7374"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39374713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Krukenberg tumor in pregnancy: a rare case and review of the literature.","authors":"Iulian G Goidescu,&nbsp;Georgiana Nemeti,&nbsp;Andreia Preda,&nbsp;Tunde Kovacs,&nbsp;Mihai Surcel,&nbsp;Dan T Eniu,&nbsp;Gheorghe Cruciat,&nbsp;Daniel Mureșan","doi":"10.1080/14767058.2021.1946788","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946788","url":null,"abstract":"<p><p>Krukenberg's tumor diagnosed in pregnancy is an uncommon situation that raises both diagnosis and medical management issues. We performed a review of the existing literature regarding this pathology, diagnostic means and therapeutic approaches, motivated by a case in our own practice. A 35-year-old primigravida was diagnosed with an adnexal mass during the first trimester prenatal ultrasound. Ultrasound revealed a 10 cm right adnexal mass with multiple septae, richly vascularized, whose presence and characteristics were confirmed by magnetic resonance imaging. Due to the progressively increasing tumor size, laparoscopy was performed with right adnexectomy and peritoneal biopsies. Histopathology diagnosed a metastatic ovarian tumor from a mucinous colorectal adenocarcinoma. After delivery the patient was further investigated and diagnosed with sigmoid cancer. Even though ovarian cancer in pregnancy is rare, adnexal ultrasound is mandatory when scanning during the first trimester to rule out the presence of associated fallopian or ovarian masses.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7290-7295"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39377334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal cardiovascular dysfunction in women with early onset preeclampsia: a cross-sectional study.","authors":"Ajith Ananthakrishna Pillai,&nbsp;Monica Thiyagarajan,&nbsp;Devendra Kishanlal Sharma,&nbsp;Bhagwati Prasad Pant,&nbsp;S B Keerti Priya,&nbsp;Anish Keepanasseril","doi":"10.1080/14767058.2021.1974834","DOIUrl":"https://doi.org/10.1080/14767058.2021.1974834","url":null,"abstract":"Abstract Background Cardiac remodeling and diastolic dysfunction may occur, in women with early-onset preeclampsia, following raised total vascular resistance in response to the impaired placentation. These changes can increase the risk of premature cardiac morbidity and mortality later in life. According to updated guidelines by the American and European Societies of Echocardiography (ASE/ESE) to diagnose diastolic dysfunction, using a simpler criterion is not yet used in pregnant women. Objective To compare the maternal cardiovascular changes and the variation in the diastolic dysfunction using the 2009 and 2016 criteria by ASE/ESE among women with early onset preeclampsia and gestational age-matched normotensive controls. Methods A prospective matched cross-sectional study conducted in a tertiary hospital in South India, involving 40 women with early and 40 women with gestational age-matched normotensive controls. Cardiac function and remodeling were assessed by conventional 2D, M-mode, and Doppler echocardiography. Results Compared to the controls, women with early-onset preeclampsia had significantly higher. Total vascular resistance index (2867.6 vs. 2277.2 dynes/s/cm5/m2, p = .035) and median end-systolic stress index (5.2 vs. 9.2 dyne/cm2/m2), suggesting a higher afterload. Cases had a significant rate of left ventricular diastolic dysfunction using the 2009 criteria (grade II/III: 21 (52%) vs. 0 (0%), p<.001) whereas the rates were much lower when the updated 2016 guidelines were used (grade II/III: 9 (22.5%) vs. 1 (2.5%), p<.001). Conclusions In women with early-onset preeclampsia, cardiovascular adaption occurs to minimize wall stress and myocardial oxygenation. The prevalence of diastolic dysfunction was observed to be lower with the 2016 criteria. Further studies involving pregnant women are required to assess the impact of newer guidelines on association with short- and long-term cardiovascular outcomes in high-risk women.","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8394-8399"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of uterine niche following single-layer locked versus unlocked uterine closure: a randomized study.","authors":"Recep Bayraktar,&nbsp;Baris Mulayim,&nbsp;Esra Tamburaci,&nbsp;Ceyda Karadag,&nbsp;Burak Karadag","doi":"10.1080/14767058.2021.1966763","DOIUrl":"https://doi.org/10.1080/14767058.2021.1966763","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective of the present study is to evaluate the effect of single-layer locked versus single-layer unlocked uterine closure techniques on the development of uterine niche. The secondary objective is to evaluate the effect of the ratio of lower uterine segment (LUS) to upper uterine segment (UUS) on the development of uterine niche, which was not previously investigated in literature but which the authors consider to be a major risk factor for the development of uterine niche.</p><p><strong>Methods: </strong>Included in this randomized study were 194 patients who were admitted to the Department of Obstetrics and Gynecology at Health Sciences University Antalya Training and Research Hospital and who underwent cesarean section (CS) due to any reason between October 2017 and May 2018. Two different techniques were used in the closure of hysterotomy: Single-layer locked continuous suturing (Group 1) and single-layer unlocked continuous suturing (Group 2). During surgery, the thicknesses of the LUS and UUS were measured using a sterile scale prior to hysterotomy closure. The patients were evaluated for the development of uterine niche at postoperative six months by transvaginal ultrasound.</p><p><strong>Results: </strong>Control transvaginal ultrasound performed at six months after surgery revealed uterine niches in 58 out of 194 patients (29.29%; 34 patients in Group 1 [34.3%] and 24 patients in Group 2 [25.3%]). No significant difference was noted in terms of the development of uterine niche between the two groups (<i>p</i> = .167). The mean LUS and UUS in patients without uterine niche development were 6.81 ± 1.26 mm and 9.38 ± 1.26 mm, whereas the mean LUS and UUS in patients with uterine niche development were 4.24 ± 1.15 mm and 9.21 ± 2.15, respectively (<i>p</i> = .001 and <i>p</i> = .236). The mean UUS/LUS ratio is 1.4 ± 0.16 among patients without uterine niche and 2.21 ± 0.31 in patients with uterine niche (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>The present study found no statistically significant difference in niche size between the two groups. However, the study reports that the ratio of upper to lower uterine segment that was not previously investigated in literature is a major risk factor for the development of uterine niche.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8210-8216"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39391374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of small and large for gestational age newborns in women with gestational diabetes according to pre-gestational body mass index and weight gain.","authors":"Ronit Koren,&nbsp;Chen Idan,&nbsp;Matan Elkan,&nbsp;Shlomit Koren,&nbsp;Yifat Wiener","doi":"10.1080/14767058.2021.1974390","DOIUrl":"https://doi.org/10.1080/14767058.2021.1974390","url":null,"abstract":"<p><strong>Aim: </strong>To explore the effects of pregestational body mass index (BMI) and gestational weight gain (GWG) on maternal and neonatal outcomes of women with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>We conducted retrospective cohort analyses of outcomes among women with GDM who delivered at Shamir Medical Center, Israel (2017-2018).</p><p><strong>Results: </strong>We included 673 women with GDM in our analysis, 217 (32.24%) with appropriate GWG (aGWG), 247 (36.7%) with excessive GWG (eGWG), and 209 (31%) with insufficient GWG (iGWG). Cesarean section (CS) was less prevalent among women with iGWG (19.6%), compared with women with eGWG (31.2%) and aGWG (31.1%) (<i>p</i> = .008). Small for gestational weight (SGA) newborns were more prevalent in women with iGWG 9.1%, compared with 2% and 0.9% for women with eGWG and aGWG, respectively (<i>p</i><.001). Large for gestational age (LGA) newborns were significantly more prevalent in women with eGWG 17.4% compared with 4.8% and 9.7% in patients with iGWG and aGWG women, respectively (<i>p</i><.001). SGA and LGA newborns were more prevalent in women with iGWG and e-GWG across all pre-gestational BMI groups >18.5 kg/m².</p><p><strong>Conclusions: </strong>A complex interplay exists between pregestational weight, GWG, and GDM and pregnancy outcomes, specifically SGA and LGA newborns. A strict follow-up considering the pregestational BMI, GWG, blood glucose levels, treatment modality, and fetal abdominal circumference could assist in managing the complex interplay of patients with GDM for better neonatal outcomes.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8382-8387"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39433484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of pregnancy on cardiac structure and function in women with sickle cell anemia: a longitudinal comparative study.","authors":"Zubaida Aliyu,&nbsp;Oyewole A Kushimo,&nbsp;Ayodeji A Oluwole,&nbsp;Casmir Amadi,&nbsp;Nuvie Oyeyemi,&nbsp;Amam Mbakwem,&nbsp;Bosede B Afolabi","doi":"10.1080/14767058.2022.2089549","DOIUrl":"https://doi.org/10.1080/14767058.2022.2089549","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell anemia is the commonest hemoglobinopathy in pregnant Nigerian women, and cardiac manifestations are a significant feature of the disease especially in pregnancy. Pregnant women with sickle cell anemia are at high risk of morbidity and mortality and cardiac dysfunction in them increases this risk and may compromise their post-partum health.</p><p><strong>Objective: </strong>To evaluate the cardiac size and function in women with sickle cell anemia (HbSS) during late pregnancy and postpartum.</p><p><strong>Methodology: </strong>This was a longitudinal comparative study in which 40 women, consisting of 20 pregnant HBSS and 20 pregnant HBAA women controls, were recruited. Echocardiography was performed in the third trimester of pregnancy and 6 weeks postpartum.</p><p><strong>Results: </strong>There was a decrease in the mean left atrial diameter (<i>p</i> < .001), left ventricular diameter in diastole (<i>p</i> = .041), and left ventricular mass (<i>p</i> = .004) of HBSS women in the postpartum period compared to their antepartum state. In contrast, there was no significant difference in most cardiac dimensions of pregnant vs postpartum HBAA women. There was no significant change in cardiac function in the pregnant vs postpartum states in both study groups. There were significant differences in cardiac size but not function when comparing HBSS and HBAA women in pregnancy and postpartum.</p><p><strong>Conclusion: </strong>Changes in cardiac size of sickle cell women in pregnancy does not appear to affect cardiac function during pregnancy and in the puerperium, suggesting that the increased size may purely be a response to their chronic anemic state. Studies following women up for longer periods including those with co-morbidities are recommended.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"10049-10054"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40072535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}