The latest medical research on Pregnancy

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about pregnancy gathered by our medical AI research bot.

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sFlt-1/PlGF ratio at 24 weeks gestation in twin pregnancies as a predictor of preeclampsia or fetal growth restriction.

Fetal Diagnosis Therapy

to elucidate if sFlt-1/PlGF ratio at 24 weeks in twin pregnancies could be useful to select patients who subsequently develop diseases related to placental dysfunction, such as preeclampsia or fetal growth restriction (FGR).

prospective study among all twin pregnancies followed up at a tertiary Hospital. The sFlt-1/PlGF ratio was determined at 24 weeks.

a total of 108 patients with a twin gestation were included. Pregnant women who developed preeclampsia and/or FGR displayed a significantly higher sFlt-1/PlGF ratio at 24 weeks, compared to those who did not develop these diseases (20.3 vs 4.3, p=0.002). Mean sFlt-1/PlGF ratio was not significantly different between patients who subsequently developed preeclampsia compared with those that developed FGR (29.8 vs 18.45, p=0.42). An sFlt-1/PlGF ratio ≥17 at 24 weeks is associated with a significant increase in the frequency of preeclampsia (odds ratio, 37.13 [95% confidence interval, 4.78-288.25]; p=0.002), and FGR (odds ratio, 39.58 [95% confidence interval, 6.31-248.17]; p<0.001). The addition of maternal characteristics, and mean pulsatility index of the uterine arteries to the sFlt-1/PlGF ratio at 24 weeks enhance the identification of patients who develop preeclampsia or FGR.

sFlt-1/PlGF ratio at 24 weeks in twin pregnancies, combined with mean pulsatility index of the uterine arteries and maternal characteristics, could select patients who develop preeclampsia or FGR. These patients might benefit from a close follow-up in order to avoid maternal-fetal adverse outcomes.

Avoiding the use of halogenated anesthetic agents for uterine relaxation in open mid-gestation fetal surgery: A case report.

Fetal Diagnosis Therapy

Profound uterine relaxation is required for open fetal surgery. This is typically achieved by the administration of high-dose halogenated anesthetic agents. However, this anesthetic technique is associated with adverse cardiovascular effects in the fetus and may have long-term neurocognitive effects as well.

We present reports for two patients in whom uterine relaxation was maintained with nitroglycerin and magnesium infusions without any exposures to halogenated anesthetic agents. There were no adverse fetal or maternal effects from this technique.

To the best of our knowledge, these are the first reports of open fetal surgery being performed without the use of halogenated anesthetic agents. This has potential short- and long-term benefits for the fetus, particularly as more complex and longer duration minimally invasive procedures are developed.

Mother-to-Child Transmission of HIV Through Breastfeeding Improving Awareness and Education: A Short Narrative Review.

International Journal of Epidemiology

Despite critical progress registered in the reduction of mother to child transmission (MTCT) of HIV worldwide, transmission through breastfeeding s...

Predictive Value of Serum Cholic Acid and Lithocholic Acid for the Diagnosis in an Intrahepatic Cholestasis of Pregnancy Population with High Levels of Total Bile Acids and the Correlation with Placental Hypoxia-Inducible Factor-1α.

International Journal of Epidemiology

This study aimed to investigate the ability of serum cholic acid (CA) and lithocholic acid (LCA) in the diagnosis and perinatal prognosis assessment of intrahepatic cholestasis of pregnancy (ICP), and the relationship between both indicators and hypoxia-inducible factor-1α (HIF-1α).

Between March 2020 and March 2021, pregnant women with high levels of total bile acid (TBA) in the late pregnancy with TBA ≥10 μmol/L and TBA <10 μmol/L (control group) were included for the retrospective study. Those with TBA ≥10 μmol/L were divided into the ICP group and the asymptomatic hypercholanaemia of pregnancy (AHP) group based on ICP symptoms. The comparison of the bile acid profiles, the receiver operating characteristic (ROC) curve analysis, and Pearson correlation analysis were conducted successively.

Nine types of bile acids were significantly higher in ICP and AHP than in the control group, while CA and LCA serum levels in the AHP group were significantly lower than those in the ICP group (P < 0.05). The ROC curve analysis showed that LCA, CA, and LCA+CA were all diagnostic indicators for ICP, and LCA+CA displayed the greatest diagnostic value (area under the curve (AUC), 0.923). Subgroup analysis using the LCA+CA cut-off point (3.28 μmol/L) as the subgroup indicator proved that the incidence of adverse perinatal outcomes and the placental HIF-1α positivity were significantly higher in the high LCA+CA group than in the low LCA+CA group (P < 0.05). Pearson correlation analysis revealed significant positive correlations of HIF-1α expression levels to LCA, CA and LCA+CA (r = 0.473, 0.537, 0.619, respectively. P < 0.05 in all).

This study confirmed that CA and LCA have a predictive diagnostic value for ICP in pregnant women, and the combined evaluation is associated with adverse perinatal outcomes, and LCA+CA positively correlates to placental HIF-1α expression levels.

mHealth Phone Intervention to Reduce Maternal Deaths and Morbidity in Cameroon: Protocol for Translational Adaptation.

International Journal of Epidemiology

The purpose of this NIH-funded protocol is to adapt (Aim 1) and pilot test (Aim 2) an mHealth intervention to improve maternal and child health in Cameroon. We will adapt the 24/7 University of Alabama at Birmingham Medical Information Service via Telephone (MIST) provider support system to mMIST (mobile MIST) for peripheral providers who provide healthcare to pregnant and postpartum women and newborns in Cameroon.

In Aim 1, we apply qualitative and participatory methods (in-depth interviews and focus groups with key stakeholders) to inform the adaptation of mMIST for use in Cameroon. We use the sequential phases of the ADAPT-ITT framework to iteratively adapt mMIST incorporating qualitative findings and tailoring for local contexts. In Aim 2, we test the adapted intervention for feasibility and acceptability in Ndop, Cameroon.

This study is ongoing at the time that this protocol is published.

The adaptation, refinement, and pilot testing of mMIST will be used to inform a larger-scale stepped wedged cluster randomized controlled effectiveness trial. If successful, this mHealth intervention could be a powerful tool enabling providers in low-resource settings to deliver improved pregnancy care, thereby reducing maternal and fetal deaths.

The Immunobiology of Preterm Labor and Birth: Intra-Amniotic Inflammation or Breakdown of Maternal-Fetal Homeostasis.

Reproduction

Preterm birth, the leading cause of neonatal morbidity and mortality worldwide, results from preterm labor, a syndrome that includes multiple etiol...

PLCzeta as the sperm factor that activates eggs: 20 years on.

Reproduction

One of the simplest and most significant questions that we can ask about fertilization is: how does the sperm activate the egg? It has been known s...

Serum IL-6 Level Predicts the Prognosis and Diagnosis in Cervical Cancer Patients.

International Journal of Epidemiology

Interleukin-6 (IL-6) has been reported to be associated with the prognosis of cancers. As for cervical cancer (CC), previous studies investigated the association between IL-6 expression in CC tumor tissue and CC prognosis; however, no studies assessed the effects of serum IL-6 levels on the survival of CC. This study aimed to explore the effects of serum IL-6 levels on prognosis in patients with CC.

In total, 327 patients with CC and 355 controls were recruited from this hospital from May 2015 to May 2016. Serum IL-6 levels were measured before treatment. The Kaplan-Meier method was utilized to estimate survival rates. The overall survival (OS) and disease-free survival (DFS) were evaluated. The univariate and multivariate Cox regression analyses were used to identify risk factors associated with the prognosis of CC.

We found that the serum IL-6 level in the CC group was significantly higher than that in the control group. The diagnostic value of serum IL-6 level in detecting CC patients was moderate, and the specificity and sensitivity were 77.46% and 47.09%, respectively. Data suggested that the serum IL-6 level was significantly linked with the smoking status, FIGO stage, tumor size, treatment methods, and HPV infection. The univariate and multivariate analysis indicated that FIGO stage IIB-IIIC, lymph node metastasis, and high serum IL-6 levels were negatively associated with the OS and DFS in patients with CC.

Serum IL-6 has a moderate diagnostic ability for detecting CC and may be a potential CC biomarker. High serum IL-6 level is associated with adverse prognosis in patients with CC and could be a prognosis indicator for CC patients.

Association of Premenstrual Syndrome with Adiposity and Nutrient Intake Among Young Indian Women.

International Journal of Epidemiology

Premenstrual syndrome (PMS) refers to a heterogenous group of symptoms occurring in luteal phase of the menstrual cycle. Women of childbearing age are affected by PMS, and it may impact their quality of life. Various factors related to the biology of menstruation, hormones, and lifestyle are associated with PMS.

To explore the incidence and severity of PMS among students in India and its correlation with nutrient intake, adiposity, and lifestyle factors.

A semi-structured questionnaire was used to collect data on menstrual pattern, nutrient intake, dietary habits, and physical activity. Moose's Menstrual Distress Questionnaire and Premenstrual Symptoms Screening Tool were employed for the identification and classification of PMS. Anthropometric indices included height, weight, body mass index, waist circumference, hip circumference, waist-to-hip ratio, and four-site skinfold thickness-tricep, bicep, subscapular, and suprailiac.

Of the 330 participants, 71.3% reported to have experienced at least one symptom of PMS. Furthermore, 46.9% had mild PMS, 31.5% had moderate PMS, 8.3% had strong PMS, and 13.3% had no symptoms. Anxiety and irritability were the most observed symptoms. The mean body mass index (BMI) of the participants was within the normal range (21.76 ± 4.81 kg/m2); however, body fat percentage was above the normal range (33.95% ± 4.89%). PMS severity was significantly correlated with body fat percentage and BMI. Nutrient intake was significantly lower than the recommended dietary allowance (RDA), but dietary fat consumption was higher than the RDA. Protein intake was higher in participants with mild PMS than those with moderate and severe PMS (p<0.05). An inverse association between oilseed consumption and PMS was observed.

PMS was associated with anthropometric parameters, nutrient intake, and dietary preference. PMS showed correlation with the intake of calorie-rich foods, sweets, and fried salted snacks, whereas consumption of oilseeds alleviated its incidence.

Promotion Preparation Tips for Academic Family Medicine Educators.

Fam Med

Promotion has historically valued the scholarship of discovery over the scholarship of teaching. The clinician-educator promotion pathway is an attractive option for academic family physicians engaged in significant teaching. However, clinician-educators are less often promoted than peers on other tracks. Family medicine educators face unique challenges in promotion due to clinical requirements and often less guidance on how to meet promotion criteria. Promotion recognizes achievements of faculty and is often tied to higher base salary. We aimed to identify promotion preparation tips for academic family medicine educators.

We surveyed members of the Society of Teachers of Family Medicine (STFM) Medical Student Education Collaborative electronically on promotion preparation lessons learned in (1) curriculum vitae preparation, (2) personal statement preparation, (3) selecting external reviewers, and (4) identifying measurable achievements. This qualitative study used grounded theory and constant comparison.

Fourteen individuals from 13 medical institutions responded with tips for success in promotion preparation. The tips identified actionable steps for promotion preparation of academic family medicine educators. Several main themes emerged, including the importance of timely and thorough documentation, detailed planning, and being knowledgeable about institutional-specific criteria early.

The tips provided in this study support family medicine educators in preparing for promotion and can be used as a tool for mentors, chairs and faculty development.

Training Family Medicine Residents to Address the COVID-19 Pandemic: A National Survey of Program Directors.

Fam Med

Public health training became particularly important for family medicine (FM) residency training programs amid the COVID-19 pandemic; the Accreditation Council for Graduate Medical Education (ACGME IV.C.19) requires a structured curriculum in which residents address population health. Our primary goal was to understand if, and to what extent, public health interventions trainings were incorporated into FM residency training programs amid the COVID-19 pandemic. We hypothesized programs with more resources (eg, university affiliates) would be better able to incorporate the training compared to those without such resources (ie, nonuniversity affiliates).

In 2021, we incorporated items addressing COVID-19 public health training competencies into the 2021 Council of Academic Family Medicine Educational Research Alliance national survey of FM residency program directors. The items addressed the type of training provided, mode of delivery, barriers to providing training, perceived importance of training, and support in delivering training.

The overall survey response rate was 46.4% (n=287/619). All programs offered at least some training to residents. There were no statistically significant differences in training intensity between university and nonuniversity affiliates. The length of time an FM residency director spent in their position was positively associated with training intensity (r=0.1430, P=.0252). The biggest barrier to providing the trainings was the need to devote time to other curriculum requirements.

FM residency programs were able to provide some public health interventions training during the pandemic. With increased support and resources, FM resident training curricula may better prepare FM residents now in anticipation of a future pandemic.

Delays in Children's Preventive Health Services During the COVID-19 Pandemic.

Fam Med

Stay-at-home orders, social isolation recommendations, and fear of COVID-19 exposure have led to delays in children's preventive health services during the pandemic. Delays can lead to missed opportunities for early screening and detection of health problems, and increased risks for outbreaks of vaccine-preventable diseases. Understanding prevalence of and reasons for missed, delayed, or skipped preventive health services is important for developing strategies to achieve rapid catch-up of essential health services.

Using the Household Pulse Survey (n=37,064), a large, nationally-representative household survey fielded from April 14 to May 10, 2021, we examined prevalence of households with children who have missed, delayed, or skipped preventive health services, and factors associated with and reasons contributing to missed, delayed, or skipped preventive health services.

About one-quarter of parents had children who missed, delayed, or skipped preventive check-ups in the past year. Delays in children's preventive health services were more common among respondents with higher education, households with greater numbers of children, and children who learned remotely or did not participate in formal education. Main reasons attributed to delayed preventive health services were limited appointments at health providers' offices (42.9%), concern about COVID-19 exposure at health providers' offices (42.2%), and closed health providers' offices due to the pandemic (29.0%).

Physician office closures and concern about COVID-19 exposure resulted in over one-quarter of parents delaying preventive services for their children since the pandemic began. Coordinated efforts are needed to achieve rapid catch-up of preventive services and routine vaccines.