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Frontiers in Endocrinology 2024The utilization of frozen embryo transfer not only enhances reproductive outcomes by elevating the likelihood of live birth and clinical pregnancy but also improves... (Comparative Study)
Comparative Study
INTRODUCTION
The utilization of frozen embryo transfer not only enhances reproductive outcomes by elevating the likelihood of live birth and clinical pregnancy but also improves safety by mitigating the risks associated with ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies. There has been an increasing debate in recent years regarding the advisability of making elective frozen embryo transfer the standard practice. Our study aims to determine the optimal choice between fresh and frozen embryo transfer, as well as whether the transfer should occur at the cleavage or blastocyst stage.
METHOD
In this retrospective cohort study conducted in Taiwan, data from the national assisted reproductive technology (ART) database spanning from January 1st, 2013, to December 31st, 2017, were analyzed. The study included 51,762 eligible female participants who underwent ART and embryo transfer. Pregnancy outcomes, maternal complications, and singleton neonatal outcomes were evaluated using the National Health Insurance Database from January 1st, 2013, to December 31st, 2018. Cases were categorized into groups based on whether they underwent fresh or frozen embryo transfers, with further subdivision into cleavage stage and blastocyst stage transfers. Exposure variables encompassed clinical pregnancy rate, live birth rate, OHSS, pregnancy-induced hypertension, gestational diabetes mellitus (DM), placenta previa, placental abruption, preterm premature rupture of membranes (PPROM), gestational age, newborn body weight, and route of delivery.
RESULTS
Frozen blastocyst transfers showed higher rates of clinical pregnancy (CPR) and live births (LBR) compared to fresh blastocyst transfers. Conversely, frozen cleavage stage transfers demonstrated lower rates of clinical pregnancy and live birth compared to fresh cleavage stage transfers. Frozen embryo transfers were associated with reduced risks of OHSS but were linked to a higher risk of pregnancy-induced hypertension compared to fresh embryo transfers. Additionally, frozen embryo transfers were associated with a higher incidence of large for gestational age infants and a lower incidence of small for gestational age infants.
CONCLUSION
The freeze-all strategy may not be suitable for universal application. When embryos can develop to the blastocyst stage, FET is a favorable choice, but embryos can only develop to the cleavage stage, fresh embryo transfer becomes a more reasonable option.
Topics: Humans; Female; Pregnancy; Embryo Transfer; Adult; Retrospective Studies; Cryopreservation; Pregnancy Outcome; Infant, Newborn; Taiwan; Pregnancy Rate; Cohort Studies; Fertilization in Vitro; Live Birth; Blastocyst
PubMed: 38933826
DOI: 10.3389/fendo.2024.1400255 -
Frontiers in Endocrinology 2024To determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes.
AIMS
To determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes.
METHODS
Sub-analysis of two multi-centric prospective cohort studies (BEDIP-N and MELINDA) in 1008 women with gestational diabetes. Data were collected during pregnancy and at a mean of 12 weeks postpartum. Multivariate logistic regression was used to estimate the effect of breastfeeding on glucose intolerance, with adjustment for ethnicity, education, income, professional activity and BMI.
RESULTS
Of all participants, 56.3% (567) breastfed exclusively, 10.1% (102) gave mixed milk feeding and 33.6% (339) did not breastfeed. Mean breastfeeding duration was 3.8 ± 2.4 and 3.7 ± 2.1 months in the breastfeeding and mixed milk feeding groups (p=0.496). The rate of glucose intolerance was lower in both the breastfeeding [22.3% (126)] and mixed milk feeding [25.5% (26)] groups compared to the no breastfeeding group [29.5% (100)], with an adjusted OR of 0.7 (95% CI 0.5-1.0) for glucose intolerance in the breastfeeding group compared to no breastfeeding group and an adjusted OR of 0.7 (95% CI 0.4-1.2) for the mixed milk feeding group compared to the no breastfeeding group. Postpartum, breastfeeding women had a lower BMI, less often postpartum weight retention, lower fasting triglycerides, less insulin resistance and a higher insulin secretion-sensitivity index-2 than the mixed milk feeding and no breastfeeding group. The mixed milk feeding group was more often from an non-White background, had a lower blood pressure and lower fasting triglycerides compared to the no breastfeeding group.
CONCLUSIONS
Breastfeeding (exclusive and mixed milk feeding) is associated with less glucose intolerance and a better metabolic profile in early postpartum in women with gestational diabetes.
Topics: Humans; Female; Diabetes, Gestational; Pregnancy; Breast Feeding; Glucose Intolerance; Adult; Postpartum Period; Prospective Studies; Risk Factors; Blood Glucose
PubMed: 38933819
DOI: 10.3389/fendo.2024.1374682 -
AJPM Focus Aug 2024Pregnancy complications, including high maternal BMI, are associated with altered early development and child health outcomes. A growing body of work links the prenatal... (Review)
Review
INTRODUCTION
Pregnancy complications, including high maternal BMI, are associated with altered early development and child health outcomes. A growing body of work links the prenatal environment, specifically maternal BMI, with respiratory infections in offspring. In this rapid review, the authors review the literature supporting the hypothesis that high maternal BMI during pregnancy is associated with childhood respiratory infection incidence.
METHODS
The authors employed systematic search criteria in known databases-EMBASE, EMCARE, MEDLINE, CINAHL, and PsychINFO-searching from inception to January 2023. Included were primary research studies that involved (1) human pregnancy, (2) pregravid or gestational overweight or obesity, and (3) childhood respiratory infection with or without hospitalization.
RESULTS
Only 7 population-based cohort studies met the criteria, investigating maternal BMI as an exposure and childhood respiratory infection as an outcome (age 6 months to 18 years). Therefore, the authors conducted a qualitative analysis, and outcomes were reported. The authors found that >85% of the albeit few published studies support the hypothesis that maternal BMI may have independent and profound consequences on respiratory infection risk across childhood.
DISCUSSION
This area of research needs large-scale, well-controlled studies to better understand the relationship between maternal BMI and childhood respiratory infection. Possible resources such as cohort catalogs and combined databases are discussed. These findings add to the growing evidence that early environmental factors influence lifelong respiratory health. By incorporating a life course approach to infectious disease risk, policy makers can put this research to work and target health vulnerabilities before they arise.
PubMed: 38933528
DOI: 10.1016/j.focus.2024.100234 -
The Pan African Medical Journal 2024Placenta accreta is a rare but serious placental attachment abnormality. The aim of this study is to analyze the epidemiological, clinical, para-clinical and...
[Placenta accreta: a retrospective descriptive study of 46 patients treated in the Obstetrics and Gynaecology Department of the Farhat Hached University Hospital in Sousse, Tunisia].
Placenta accreta is a rare but serious placental attachment abnormality. The aim of this study is to analyze the epidemiological, clinical, para-clinical and evolutionary features of placenta accreta, to investigate the therapeutic management and to assess maternal and neonatal morbidity and mortality. We conducted a retrospective, descriptive study of patients with histologically confirmed placenta accreta in the obstetrics and gynaecology department of the Farhat Hached University Hospital in Sousse, over a 4-year period from 1 January 2015 to 31 December 2019. The epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from patients´ medical records and operative reports. In our series, we identified 46 cases of placenta accreta. The average age of our patients was 35±4.61 years. Each of our patients had a scarred uterus. The average term of delivery was 34 weeks of amenorrhoea and the mode of delivery was caesarean section for all our patients. First-line hysterectomy was performed in 40 patients and conservative treatment in 6. Sixteen patients developed maternal complications. No maternal death was observed. Placenta accreta is a rare condition associated with significant maternal and foetal morbidity.
Topics: Humans; Female; Retrospective Studies; Tunisia; Placenta Accreta; Adult; Pregnancy; Hospitals, University; Hysterectomy; Cesarean Section; Young Adult; Infant, Newborn; Conservative Treatment
PubMed: 38933434
DOI: 10.11604/pamj.2024.47.147.38111 -
The Pan African Medical Journal 2024the provision of essential preconception care services for HIV-positive pregnant women is crucial to prevent HIV transmission to infants. This includes pregnancy...
INTRODUCTION
the provision of essential preconception care services for HIV-positive pregnant women is crucial to prevent HIV transmission to infants. This includes pregnancy intention screening services, adequate viral load monitoring and suppression before conception, and necessary nutritional support. In Nyeri County, the prevalence of Mother-to-Child Transmission (MTCT) of HIV is 5.3%, which is higher than the global threshold of 5%. This study aims to evaluate the impact of pre-conception care services in preventing HIV transmission to infants in Nyeri County. The study objectives are to assess the utilization of pre-conception care services among HIV-positive women, specifically focusing on pregnancy intention screening, viral load monitoring and suppression, and access to nutritional assessment services before pregnancy. Additionally, the study aims to investigate the relationship between the provision of pre-conception care services and infant HIV outcomes.
METHODS
this cross-sectional retrospective descriptive study employed stratified sampling to select eight level 4 and level 5 hospitals in Nyeri County. The target population consisted of HIV-infected women seeking postnatal care in these facilities, with a sample size of 252 women who had HIV-exposed infants under two years old and were receiving post-natal care at the respective hospitals. Sociodemographic characteristics, including age, marital status, and education level, were collected. Data analysis involved both descriptive and inferential statistics.
RESULTS
our findings revealed that only 34.2% of HIV-positive women seeking postnatal care had received information or services related to pregnancy intention screening, a crucial aspect of pre-conception care. Almost half (46.4%) of the women who participated in the study had undergone viral load measurements before pregnancy, which is another critical component of preconception care. Additionally, 85.6% of these women had received nutritional services during pregnancy from their healthcare providers. Interestingly, all women who received any pre-conception care services reported that their infants were alive and tested HIV-negative.
CONCLUSION
preconception care is crucial in preventing mother-to-child transmission of HIV. Efforts should be made to ensure that all HIV-infected women planning to conceive have access to preconception care services.
Topics: Humans; Infectious Disease Transmission, Vertical; Female; HIV Infections; Pregnancy; Adult; Pregnancy Complications, Infectious; Preconception Care; Cross-Sectional Studies; Retrospective Studies; Young Adult; Viral Load; Infant, Newborn; Infant; Mass Screening; Adolescent; Postnatal Care; Prevalence; Pregnancy Outcome
PubMed: 38933429
DOI: 10.11604/pamj.2024.47.144.37196 -
Journal of Diabetes and Metabolic... Jun 2024Microgravity, characterized by gravity levels of 10-10g, has been found to significantly impair various physiological systems in astronauts, including cardiovascular... (Review)
Review
PURPOSE
Microgravity, characterized by gravity levels of 10-10g, has been found to significantly impair various physiological systems in astronauts, including cardiovascular function, bone density, and metabolism. With the recent surge in human spaceflight, understanding the impact of microgravity on biological health has become paramount.
METHODS
A comprehensive literature search was performed using the PubMed database to identify relevant publications pertaining to the interplay between gut microbiome, microgravity, space environment, and metabolic diseases.
RESULTS
This comprehensive review primarily focuses on the progress made in investigating the gut microbiome and its association with metabolic diseases under microgravity conditions. Microgravity induces notable alterations in the composition, diversity, and functionality of the gut microbiome. These changes hold direct implications for metabolic disorders such as cardiovascular disease (CVD), bone metabolism disorders, energy metabolism dysregulation, liver dysfunction, and complications during pregnancy.
CONCLUSION
This novel perspective is crucial for preparing for deep space exploration and interstellar migration, where understanding the complex interplay between the gut microbiome and metabolic health becomes indispensable.
PubMed: 38932858
DOI: 10.1007/s40200-024-01394-7 -
AIDS (London, England) Jul 2024
Topics: Humans; Female; Pregnancy; Pyridones; HIV Infections; Pregnancy Complications, Infectious; Tenofovir; Anti-HIV Agents; Oxazines; Heterocyclic Compounds, 3-Ring; Lamivudine; Piperazines; Treatment Outcome
PubMed: 38932745
DOI: 10.1097/QAD.0000000000003911 -
Human Vaccines & Immunotherapeutics Dec 2024This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey...
This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey was conducted among pregnant women receiving prenatal care at various medical institutions in Minhang District, Shanghai, from March to June 2023. The survey included inquiries about demographic information, knowledge, and perception of influenza disease and influenza vaccine. Logistic regression models and chi-square tests were used to analyze the data. 6.9% (78/1125) of participants considered receiving the influenza vaccine during pregnancy. Participants with graduate education or above (OR = 4.632, 95%CI: 1.046-20.517), non-office workers (OR = 2.784, 95%CI: 1.560-4.970), and participants whose spouses were not office workers (OR = 0.518, 95% CI: 0.294-0.913) were significantly associated with high intent to vaccinate. Participants with superior knowledge (>30 points) exhibited greater willingness ( < .001). Participants who viewed post-influenza symptoms as mild had a significantly lower willingness to vaccinate during pregnancy (2.3%), compared to those who disagreed ( = .015). Conversely, those recognizing a heightened risk of hospitalization due to respiratory diseases in pregnant women post-influenza were significantly more inclined to vaccinate during pregnancy (8.8%) ( = .007). Participants recognizing benefits uniformly expressed willingness to receive the influenza vaccine during pregnancy ( < .001), while those perceiving barriers uniformly rejected vaccination ( < .001). Higher education, non-office worker status, and having an office worker spouse correlate with greater willingness to receive the influenza vaccine during pregnancy. Enhanced knowledge and accurate perceptions of influenza and its vaccine influenced willingness. Accumulating knowledge about influenza and its vaccine fosters accurate perceptions. Notably, overall willingness to vaccinate during pregnancy remains low, likely due to safety concerns, and lack of accurate perceptions. Targeted health education, improved communication between healthcare providers and pregnant women, and campaigns highlighting vaccine benefits for mothers and children are essential.
Topics: Humans; Female; Health Knowledge, Attitudes, Practice; Pregnancy; China; Adult; Influenza Vaccines; Influenza, Human; Pregnant Women; Patient Acceptance of Health Care; Young Adult; Surveys and Questionnaires; Vaccination; Pregnancy Complications, Infectious; Prenatal Care; Cross-Sectional Studies; Adolescent
PubMed: 38932738
DOI: 10.1080/21645515.2024.2368944 -
Tidsskrift For Den Norske Laegeforening... Feb 2024
Topics: Humans; Female; Depression, Postpartum; Antidepressive Agents; Pregnancy
PubMed: 38932736
DOI: 10.4045/tidsskr.24.0035 -
Viruses May 2024Congenital cytomegalovirus (cCMV) infection poses significant risks to fetal development, particularly affecting the nervous system. This study reports a fetal autopsy...
Congenital cytomegalovirus (cCMV) infection poses significant risks to fetal development, particularly affecting the nervous system. This study reports a fetal autopsy case, examining cCMV infection and focusing on CMV DNA measurements in various fetal organs before formalin fixation, a novel approach for comprehensive CMV DNA evaluations in fetal organs affected by cCMV. A 20-week-old male fetus was diagnosed with cCMV following the detection of CMV DNA in ascites obtained via abdominocentesis in utero. After the termination of pregnancy, multiple organs of the fetus, including the cerebrum, thyroid gland, heart, lungs, liver, spleen, kidneys, and adrenal glands, were extracted and examined for CMV DNA loads using a real-time polymerase chain reaction. Histopathological examination involved hematoxylin-eosin and CMV-specific immunostaining. A correlation was found between CMV DNA loads and pathology, with higher CMV-infected cell numbers observed in organs positively identified with both staining methods, exhibiting CMV DNA levels of ≥1.0 × 10 copies/mL, compared to those detected solely by CMV-specific immunostaining, where CMV DNA levels ranged from 1.0 × 10 to 1.0 × 10 copies/mL. These results highlight a quantifiable relationship between the organ infection extent and CMV DNA concentration, providing insights into cCMV pathogenesis and potentially informing future diagnostic and therapeutic strategies for cCMV infection.
Topics: Cytomegalovirus Infections; Humans; Cytomegalovirus; DNA, Viral; Viral Load; Male; Female; Fetus; Pregnancy; Adult; Autopsy; Pregnancy Complications, Infectious
PubMed: 38932183
DOI: 10.3390/v16060891