Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsinyS M Gadzhieva
The global transformations in health care system, directed from reactive medicine to proactive and preventive model bring to the forefront issues of protection of female health. The health of woman is not only fundamental basis, but also key factor of social economic well-being of society, demographic stability and health of future generations. The traditional fragmented model of provision of obstetric gynecological care, focused mainly on treatment of already occurred pathologies and pregnancy management, demonstrates its inefficiency in the context of modern challenges: increase of chronic noncommunicable diseases, psycho-emotional loads and need of integration of reproductive health into general context of well-being of woman at all stages of her life. In the Russian Federation, the problem of modernization of obstetric gynecological service and, in particular, women consultations, is especially acute. Historically, The historically established system is often criticized for bureaucratization, insufficient focus on prevention and disparity between various levels of medical care. In this regard, emergence and implementation of new regional standards, in particular, metropolitan standard of obstetric gynecological care and Centers of Female Health is unique case requiring detailed scientific analysis and comparison with international advanced experience. The actuality of the study is conditioned by increasing need in developing new paradigm of medical care support of women, built on principles of complexity, continuity, personalization and orientation on prevention. The Centers of Female Health, integrating large spectrum of services, from screenings and diagnostics to psychological support and training programs, are considered by world community as gold standard of organization of such care.
Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsinyN V Batrak, I V Ivanova
The pregnancy that occurred due to in vitro fertilization is characterized by higher risk of development of gestational diabetes mellitus. The purpose of the study was to investigate course and outcomes of pregnancy resulted from in vitro fertilization in women with gestational diabetes mellitus, depending on time of its manifestation. The analysis of course of pregnancy, childbirth and condition of newborns in 179 women with gestational diabetes mellitus under pregnancy resulted from in vitro fertilization was carried out. It is established that early manifestation of gestational diabetes mellitus is associated with older age of pregnant women, higher rate of birth of large fetus in anamnesis, higher body mass index, more frequent prescription of insulin therapy to treat gestational diabetes mellitus, higher rate of development of early threatened miscarriage, isthmic cervical insufficiency, anemia, chronic arterial hypertension, gestational arterial hypertension, moderate preeclampsia, severe preeclampsia, premature normally placed placenta detachment, fetal growth retardation, chronic intrauterine fetal hypoxia, diabetic fetopathy, prenatal rupture of amniotic fluid, premature birth, more frequent birth of large fetus, development of fetal renal pyelectasia. The female patients with late manifestation of gestational diabetes mellitus had higher level of fasting plasma glycemia, frequent development of placenta previa, polyhydramnios, pathological and insufficient gain of body mass during pregnancy, dis-coordination of labor and clinically narrow pelvis during labor, more frequent operative delivery and early delivery. The gestational diabetes mellitus, developed both in early and late periods, complicates the course and childbirth under pregnancy resulted from in vitro fertilization, adversely affects state of the newborn. The study in depth is needed to establish possible mechanisms of development of gestational diabetes mellitus in this cohort of women with implementation of screening examinations and determination of further tactics of management of pregnancy depending on time of its manifestation.
Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsinyO N Bobrovskaya, A D Skvortsova
The problem of availability of abortion services for women in countries of world community is not only not losing its importance, but is undergoing new stage of actualization, since it has no clear understanding and is often raised in the context of solving demographic problems of aging society. At the same time, analysis reveals vulnerability of position of those using religious context in womans self-determination regarding disposal of her own body and right to refuse compulsion to terminate her pregnancy by physiological childbirth without her psychological, social and economic readiness and public support. Referring to various testimonies and sources, we appeal to necessity of working out common criteria to ensure womens access to medical care related to procedure of abortion in order to reduce mortality from diseases associated with self-abortions menacing live and health of women. The issues considered in the study may affect various spheres of social, medical and legal field and have wide area of practical implementation. The purpose of the study is to identify causes and to establish consequences of womens limited access to abortion services, as well as legal and ethical aspects of overcoming these restrictions.
Artificial cells, nanomedicine, and biotechnologyNi Li, Lin Tian, Haiyun Wei
Preeclampsia (PE) is a severe pregnancy-specific complication characterized by new-onset hypertension and proteinuria after 20 weeks of gestation, which can cause multi-organ damage and life-threatening outcomes for both mothers and foetuses. Its pathogenesis remains incompletely elucidated, with placental dysfunction widely recognized as a core pathogenic factor. This study integrated multiple placental transcriptome and single-cell sequencing datasets from the Gene Expression Omnibus (GEO) database, employing a multi-dimensional bioinformatics approach - including differential expression analysis, Weighted Gene Co-expression Network Analysis (WGCNA), machine learning, molecular subtype clustering, single-cell resolution analysis, and intercellular communication analysis - to systematically identify PE-related key genes, construct a diagnostic model, define molecular subtypes, and explore potential molecular mechanisms. Results showed 10 differentially expressed genes (DEGs) were identified in PE placental tissues; WGCNA pinpointed the turquoise module as the core PE-associated module. Further screening using 11 machine learning algorithms identified 9 feature genes with high diagnostic value (DDR1, DIO2, FSTL3, HK2, HTRA4, LEP, SERPINA3, TMEM45A, TREM1). A diagnostic model built with the 'Stepglm[forward]' algorithm exhibited excellent performance in both training and validation sets (average AUC = 0.865). Molecular subtype analysis classified PE samples into two subtypes (C1, C2) with significantly distinct immune infiltration profiles, where the C1 subtype showed higher immune cell infiltration. Single-cell analysis identified 11 cell types in PE placental tissue and highlighted TMEM45A as a key DEG. Intercellular communication analysis revealed the VEGF signalling pathway as the core driver of abnormal cellular crosstalk in PE, primarily mediating signal transduction between villous cytotrophoblast cells (VCT), extravillous trophoblast cells (EVT), and endothelial cells. Hypoxia scoring analysis demonstrated significantly higher hypoxia levels in the PE group compared to normal controls, with TMEM45A expression positively correlated with hypoxia scores. This study provides novel insights into the molecular pathogenesis of PE and offers potential biomarkers and a theoretical basis for its early diagnosis and targeted therapy.
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 ObstetriciansDilly O C Anumba, Cath M Harrison, Gian Carlo Di Renzo
AIM: Preterm birth, defined as delivery at gestational age less than 37 weeks, is a major contributor to neonatal morbidity, placing a significant burden on healthcare resources. This analysis explores the prevalence and patterns of critical care admissions among preterm neonates in England. METHODS: Hospital-level data were obtained from the Hospital Episode Statistics Data-NHS England 2022-2023 database. Data were analyzed for newborns in England for April 2022-March 2023, focusing on gestational age categories and the care level of facilities managing these infants. RESULTS: Among all 541,765 singleton births in England during the examined interval, 7.0% (37,815) were preterm. Of these preterm infants, 71.3% (26,965) had a recorded gestational age. Of those with recorded gestational ages, 0.6% (149) were born <28 weeks (extremely preterm), 10.5% (2,844) at 28-32 weeks (very preterm), and 88.9% (23,972) at 33-37 weeks (moderate and late preterm). While 58.4% (87) of extremely preterm neonates were delivered in a hospital with appropriate facilities, 32.2% (48) of extremely preterm neonates, and 4.3% (121) of very preterm neonates were born in hospitals without neonatal intensive care facilities. CONCLUSION: Persistent gaps in triage for women at risk of preterm birth highlights the need for improved early risk recognition and in utero referral systems to ensure appropriate delivery in recommended critical care facilities and to reduce postnatal transfers for babies.
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 ObstetriciansYun Zhong, Lan Peng
BACKGROUND: Listeriosis during pregnancy is a rare but life-threatening infection that often presents with nonspecific symptoms, making timely diagnosis difficult. This article reports a case in which the clinical presentation and immune profile were highly consistent with Listeria monocytogenes infection, leading to a presumptive clinical diagnosis. The patient was successfully treated following a diagnostic approach that integrated host immune profiling with AI-assisted decision-making, despite dual interference from Ureaplasma urealyticum detected by metagenomic next-generation sequencing (mNGS) and Staphylococcus capitis detected by blood culture. CASE PRESENTATION: A 25-year-old female patient, at 37+6 weeks of gestation, presented with persistent high fever following induced labor due to intrauterine fetal death. External hospital blood culture and our hospital's reproductive tract mNGS suggested Staphylococcus capitis and Ureaplasma urealyticum, respectively. However, intensified treatment targeting these pathogens was ineffective. DIAGNOSTIC PROCESS: Further investigation revealed a characteristic immune imbalance in the patient: a concurrent significant elevation of IFN-γ and IL-10, accompanied by activated CD8+ T cells. With AI-assisted analysis, this immune profile was found to be highly consistent with Listeria monocytogenes infection. TREATMENT AND OUTCOME: After switching to ampicillin combined with gentamicin, the patient's body temperature rapidly normalized, and she recovered and was discharged. CONCLUSION: When etiological diagnosis reaches an impasse, integrating host immune characteristics with AI-assisted decision-making can provide crucial diagnostic clues for infections caused by rare pathogens when microbiological confirmation is unavailable.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and GynaecologyMinjie Zhao, Xiaoyu Yang, Heding Zhang, Wenjing Hu, Xiaojuan Wang, Huimin Xing, Peng An
BACKGROUND: To investigate whether serum micro (miR)-145-5p for postoperative complications in patients with scarred uterus undergoing caesarean section, suggesting its potential as an adjunctive molecular biomarker for clinical preoperative risk assessment. METHODS: A total of 198 women were divided into high-expression and low-expression groups based on the mean relative serum miR-145-5p level. Pelvic floor function, vaginal microecology, and abdominal adhesion status were assessed, and postoperative complications were monitored. Spearman's rank correlation was used to analyse the correlation between miR-145-5p expression and scar scores, while Receiver operating characteristic (ROC) curves were employed to evaluate its predictive efficacy for complications. RESULTS: Serum miR-145-5p was negatively correlated with abdominal scar Patient-Observation Scar Assessment Scale (POSAS) scores. The level of miR-145-5p was lower in the moderate-to-severe pelvic floor dysfunction (PFD) group, vaginal microecological disorder group, abdominal adhesion group, and postoperative complication group compared with the corresponding control groups. ROC curve analysis showed that miR-145-5p had good predictive value for these complications. CONCLUSIONS: miR-145-5p is closely correlated with abdominal scar, PFD, vaginal microecological disorders, abdominal adhesions, and other postoperative complications in patients with scarred uterus after caesarean section, which may serve as a potential molecular biomarker for preoperative risk assessment.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and GynaecologyYing Hu, Shuqi Zhu, Jia Liu, Die Hong, Hong Wen, Lu Chen, Xixi Chen, Yuqing Zou, Jingjing Liu, Danqing Chen, Lu Qi, Zhaoxia Liang
BACKGROUND: To evaluate the association between the weight-gain-for-gestational-age z-score and preterm birth (PTB) in a large Chinese twin pregnancy cohort. METHODS: A hospital-based retrospective study included 2832 twin pregnancies between January 1, 2015, and December 31, 2019. The primary composite outcome was defined as PTB. The total gestational weight gain was converted into z-score, and logistic regression models were used to examine the associations between z-scores and PTB. RESULTS: We developed a weight-gain-for-gestational-age z-score to determine the gestational weight gain during twin pregnancies in Chinese women. Low (<P25) and high (≥P75) z-scores were associated with a higher risk for spontaneous PTB (SPTB) than scores between the 25th and 75th percentiles (adjusted odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.05-1.74; 1.28, 0.99-1.66; respectively). Similarly, low z-scores (1.40, 1.12-1.76) and high z-scores (1.97, 1.57-2.47) were also associated with an increased risk for iatrogenic PTB (IPTB). Normal weight subgroups exhibited comparable outcomes. In addition, z-scores between the 25th and 75th percentiles indicated an equivalent total gestational weight gain at 37 weeks of 15.8-20.9 kg for underweight, 14.6-20.3 kg for normal weight, and 11.8-18.6 kg for overweight or obese women, which are narrower than the 2009 IOM recommendation. CONCLUSIONS: Our findings indicate that inadequate gestational weight gain, as evaluated by the z-score, is associated with a significantly increased risk for SPTB, whereas inadequate and excessive gestational weight gain are associated with a significantly increased risk for IPTB, in a large Chinese twin pregnancy cohort.
BACKGROUND: Gestational diabetes mellitus (GDM) has a high global prevalence and arises from complex interactions between genetic predisposition and environmental factors. GDM is associated with metabolic disturbances and chronic low-grade inflammation, both of which contribute to its pathogenesis. This study aimed to investigate the association between GDM and 135 single-nucleotide polymorphisms (SNPs) across 20 genes related to metabolic traits. METHODS: In this case-control study, 152 pregnant women with GDM and 684 pregnant women with normal glucose tolerance (NGT) who underwent antenatal examination at Siriraj Hospital, Bangkok, were enrolled. Clinical data and blood samples were collected from all participants. Genomic DNA was isolated and subjected to whole-genome sequencing using the DNBSEQ-T7RS high-throughput sequencing platform. Genotype analyses were performed using R software, and haplotype analyses were conducted using the online SNPStats software. RESULTS: After adjusting for maternal age and pre-pregnancy body mass index, polymorphisms in TCF7L2 (rs34872471, rs7901695, rs4506565, rs7903146, rs12243326, and rs12255372), NEDD1 (rs10431408, rs11830756, rs249579, rs249585, and rs4762339), CMIP (rs2306115 and rs201681534), CDKAL1 (rs4710942), GCKR (rs2293572 and rs2293571), and GCK (rs5883890) were significantly associated with the risk of GDM. Haplotype analysis demonstrated that the TCF7L2 rs12243326-rs12255372 CA haplotype was associated with a decreased risk of GDM (OR = 0.44, 95% CI: 0.23-0.81), while the NEDD1 rs249579-rs249585-rs4762339 GGT haplotype was associated with an increased risk of GDM (OR = 1.40, 95% CI: 1.08-1.82). CONCLUSIONS: These findings suggest that genetic variations in TCF7L2, NEDD1, CMIP, CDKAL1, GCK, and GCKR contribute to GDM susceptibility in the Thai population.
European journal of psychotraumatologyRebecca Lipschutz, Sriya Karra, Kaitlyn K Stanhope, Nicole R Nugent, Merom Arthur, Shimarith Wallace, Elizabeth E Mcafee, Meghna Ravi, Emma C Lathan, Abby Brit…
Background: Black women in the USA, who face disproportionate risks of obstetric complications and adverse birth outcomes, may be at heightened risk of birth-related post-traumatic stress symptoms. However, the City Birth Trauma Scale (BiTS) has not yet been psychometrically evaluated in this population.Objective: This study examined the psychometric properties of the BiTS, including internal consistency, convergent and divergent validity, and factor structure, among Black postpartum trauma-exposed women.Method: In total, 130 women who were 6-8 weeks postpartum completed the BiTS, along with validated measures of post-traumatic stress disorder (PTSD), depression, and anxiety. Confirmatory factor analysis (CFA) was conducted to assess BiTS factor structure. Internal consistency, convergent and divergent validity, and PTSD diagnostic prevalence were also examined.Results: The BiTS demonstrated excellent internal consistency (α = 0.91) and strong convergent and divergent validity with PTSD, depression, and anxiety measures. CFA supported a two-factor model (birth-related symptoms and general symptoms subscales) with good model fit. One-third (33.6%) of women reported their birth as traumatic and met criterion A (e.g. the belief that she or her baby would die during childbirth). Using the BiTS, 4.6% of women met full DSM-5 diagnostic criteria for PTSD, while 7.6% were above the established BiTS diagnostic cut-off for probable PTSD diagnosis.Conclusion: The BiTS demonstrates strong psychometric properties in Black postpartum trauma-exposed women.
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 ObstetriciansMaría De la Calle, Eva Manuela Pena-Burgos, Sara Ruiz Martínez, Ana Gallardo Navarro, Jose Luis Bartha
INTRODUCTION: Fetal presentation of the first twin plays a key role in delivery planning. While vertex presentation is considered favorable for vaginal delivery, presentation changes may occur during the third trimester. However, the factors influencing these changes-particularly in relation to chorionicity-remain poorly defined. MATERIAL AND METHODS: This was a retrospective cohort study including 263 twin pregnancies (166 dichorionic diamniotic (DCDA), 97 monochorionic diamniotic (MCDA)) followed at a tertiary center between 2000 and 2025. Third-trimester ultrasounds were performed at 32 weeks and prior to delivery. We evaluated changes in the presentation of the first twin and analyzed variables that may be associated with fetal dynamics or stability, including parity, amniotic fluid volume, placental location, estimated fetal weight, and second twin presentation. RESULTS: The first twin maintained the same presentation in 53.6% of DCDA and 57.7% of MCDA pregnancies. Among those initially non-vertex, a spontaneous change to vertex presentation occurred in 53.4% of DCDA and 71.4% of MCDA cases. No statistically significant associations were found between presentation changes and the maternal or ultrasound-related variables studied. When vertex presentation was observed in the third trimester, it remained stable in over 95% of cases. CONCLUSIONS: The presentation of the first twin remains dynamic throughout until delivery, especially in non-vertex cases. However, a vertex presentation after 32 weeks is highly predictive of stability until delivery. Serial third-trimester ultrasound are essential for accurate delivery planning and should guide shared decision-making with expectant parents.
Gut microbesK M Kennedy, S Fernando, S A Atkinson, M G Surette, P Jeganathan, D M Sloboda
BACKGROUND: Dysregulation of maternal adaptations to pregnancy due to high pre-pregnancy BMI (pBMI) is associated with worsened health outcomes for mothers and children. The role of the gut microbiome in these adaptations remains unclear. METHODS: Stool samples were collected from pregnant participants (n = 52) enrolled in the Be Healthy in Pregnancy study (NCT01689961) during first, second, and third trimesters, and 6-months postpartum, along with samples from their infants at 6 months of age. Following 16S rRNA gene sequencing, we implemented time-aligned LDA (TALDA) using a time-weighted sampling strategy with exponentially decaying weights to construct time-proximal cohorts, applied LDA to each cohort independently, and aligned resulting topics using the alto R package. Infant samples were analyzed using standard LDA. RESULTS: Seven distinct subcommunities were identified, one of which represented perineal contamination and was excluded from further analysis. Remaining subcommunities had distinct taxonomic definitions which remained stable throughout pregnancy (mean cross-cohort stability 0.899) while subcommunity proportions within individuals varied. Multiparous individuals showed greater shifts in subcommunity proportions during early pregnancy, while primiparous individuals displayed progressively increasing shifts with the largest changes during the transition from pregnancy to postpartum. High pBMI was associated with reduced microbiome remodelling, particularly among multiparous individuals. In exploratory analyses, maternal SCFA-producing subcommunity abundance at late pregnancy was positively associated with infant Bifidobacterium-dominated subcommunity proportions at 6 months, while pBMI > 25 was independently associated with lower infant Bifidobacterium. CONCLUSION: TALDA effectively distinguished between stable subcommunity definitions and dynamic subcommunity proportions, revealing that the microbiome maintains functional organization while subcommunity proportional contributions shift over the course of pregnancy and postpartum. These maternal dynamics may have intergenerational consequences through their influence on infant gut colonization. This work demonstrates that maternal factors modify microbiome trajectories and supports the existence of an ecological memory of pregnancy history within the maternal gut microbiome.
Journal of psychosomatic obstetrics and gynaecologyJorina Holtrop, Amber A A Ten Buuren, Noralie N Schonewille, Carlinde W Broeks, Maria G van Pampus, Birit F P Broekman
OBJECTIVE: Maternal mental health during pregnancy may influence obstetric outcomes. This study examines associations between psychiatric vulnerability [PV]-defined as current or past psychiatric disorder-and mode of delivery and its indication. METHODS: A retrospective cohort study was conducted in a large Dutch maternity hospital. Primiparous women aged ≥ 18 with singleton pregnancies were included between January 2015 and March 2020. RESULTS: In total, 705 women with and 837 women without PV were included. No differences in delivery method were found between these groups. However, women using psychotropic medication had significantly higher odds of undergoing an assisted vaginal delivery [AVD] than a spontaneous vaginal delivery [SVD] (aOR = 2.00). Indications related to maternal mental health for unplanned caesarean section [CS] were exclusively observed in the group with PV (3.4%). No differences were observed in obstetric or fetal indications. CONCLUSIONS: Although mode of delivery did not differ between women with and without PV, women using psychotropic medications had higher risks for undergoing an AVD than a SVD. Only in a small proportion of women with PV, maternal mental health constituted an indication for unplanned CS. Further research is warranted to better understand the intersection of PV and psychotropic medication on delivery method.
Gynecological endocrinology : the official journal of the International Society of Gynecological EndocrinologyQiu-Feng Xiao, Xiao-Hong Xie, Chong-Zhi Wen, Zhou-Lan Li
OBJECTIVE: To explore the relationship between the C-reactive protein-triglyceride-glucose index (CTI) and the risk of type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM). METHODS: Logistic regression and restricted cubic spline (RCS) analyses were used to explore the relationship between CTI and the risk of T2DM. Subgroup and interaction analyses were conducted to examine the sensitivity of CTI to T2DM risk and its interaction with confounding factors, respectively. Machine learning algorithms were employed to rank variable importance in T2DM. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were employed to investigate the clinical value of CTI. RESULTS: CTI showed a significant positive linear association with T2DM, influenced by hyperlipidemia and BMI. CTI was related to T2DM risk among individuals with low-density lipoprotein cholesterol (LDL-C) >130 mg/dL. CTI ranked as the top predictor of T2DM risk. The area under the curve (AUC) of CTI was 0.767 in predicting T2DM. CTI provided a clinical net benefit for predicting T2DM when the threshold probability ranged from 0.18 to 0.64. CONCLUSION: CTI is associated with future T2DM in women with prior GDM, showing a continuous dose-response relationship. Elevated LDL-C may enhance CTI's predictive power.
Journal of psychosomatic obstetrics and gynaecologyBushra M Abdallah, Aml M Erhuma
Miscarriage is a common obstetric complication that can have significant emotional and psychological consequences for affected women and their families. Despite its frequency, the emotional impact of pregnancy loss is often underestimated, and the quality of care provided during this vulnerable period can strongly influence how patients cope with the experience. Empathetic and patient-centred communication plays a critical role in supporting individuals following miscarriage. This paper examines the emotional burden associated with pregnancy loss, highlights the importance of empathy in clinical care, and discusses common barriers that may hinder compassionate practice, including time constraints, systemic pressures, and the use of overly clinical language. Strategies to enhance empathetic care are also explored, such as improving communication training for healthcare providers, encouraging active listening, using sensitive language, and ensuring appropriate follow-up support. Strengthening empathy in miscarriage care may improve patient experiences and promote emotional recovery after pregnancy loss.
Hypertension in pregnancyAdili Adilan, Haoran Zhan, Yanan Hu, Lana McClements, Emily J Callander
OBJECTIVE: Preeclampsia is a serious pregnancy complication associated with substantial maternal and infant morbidity worldwide. The adverse outcomes related to preeclampsia increase healthcare costs, highlighting the importance of quantifying its economic burden to inform healthcare policy and resource allocation. This systematic review aimed to synthesize evidence on the economic burden of preeclampsia and identify key cost drivers. METHODS: MEDLINE, PubMed, Web of Science, and the Cochrane Library were searched for English-language studies published between 2014 and 2024. Studies reporting healthcare resource utilization or costs associated with preeclampsia were included. The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025650091). RESULTS: Of 3,107 records identified, 12 studies were included; most were conducted in high-income countries. All cost estimates were converted to 2024 US dollars for comparability. Direct medical costs ranged from US$109.84 to US$87,339.71, with a mean cost of US$33,585.48 per patient. National healthcare system costs were estimated at €6.5-€9.1 million in Ireland and US$2.18 billion in the United States. CONCLUSION: Preterm birth was identified as a major driver of economic burden, with earlier gestational age significantly increasing maternal and infant costs. Indirect costs and regional disparities remain underexplored, highlighting important gaps for future research.
Gut microbesGautham Siddarth Ragunagam, Anand Anbarasu, Gothandam Kodiveri Muthukaliannan
Fusobacterium nucleatum has emerged as a pathobiont that associates oral dysbiosis with systemic diseases through coaggregation, hematogenous dissemination, and immune modulation. This review provides molecular insights through which they are involved in systemic diseases such as colorectal cancer, adverse pregnancy outcomes, cardiovascular diseases, neurodegenerative disorders, and diabetes mellitus. Key virulence factors include the adhesins of FadA, Fap2, and RadD, lipopolysaccharides, and outer membrane vesicles, which mediate epithelial invasion and endothelial permeafbility and facilitate immune suppression through TLR4-NF-κB, β-catenin/Wnt, and MAPK signaling pathways. These interactions result in impaired tissue homeostasis, propagate chronic inflammation, and promote oncogenic and metabolic modulation. Systemic pleiotropy of F. nucleatum is further substantiated by its involvement in chemoresistance, placental dysfunction, vascular inflammation, and neuronal injury, substantiating its systemic pleiotropy. Emerging therapeutic strategies, such as blocking adhesins, neutralizing outer membrane vesicles, microbiome manipulation, and using CRISPR-based clearance, provide precision techniques for mitigating diseases. Therefore, this review identifies F. nucleatum as the primary microbial mediator of oral-systemic pathology and its translational significance in the development of targeted antimicrobial and host-directed therapies.
Gut microbesSimone Zuffa, Sydney P Thomas, Abubaker Patan, Ipsita Mohanty, Yasin El Abiead, Victoria Deleray, Kine Eide Kvitne, Armin Kousha, Emi Suzuki, Chih Ming Tsai, G…
Maternal intrapartum antibiotic prophylaxis (IAP) and postpartum maternal antibiotic usage are increasingly common and have been linked to altered growth and immune development in offspring. However, the mechanisms underlying these effects, particularly those arising from indirect early-life exposure to antibiotics, remain poorly understood. Here, using a preclinical murine model, we examined the impact of in vivo antepartum and postpartum maternal ampicillin administration on the maternal fecal microbiome and metabolome. Ampicillin treatment resulted in a significant depletion of bacterial species belonging to the Muribaculaceae family, including Muribaculum intestinale and Duncaniella dubosii, accompanied by a cohort-dependent enrichment of Enterococcus and Prevotella species. These microbial shifts coincided with substantial and reproducible metabolic remodeling, including elevated fecal acylcarnitines and altered bile acid profiles. Notably, we identified two previously uncharacterized trihydroxylated bile acids conjugated to a hexose moiety, which we annotated as cholic acid-galactose and taurocholic acid-galactose and synthesized. These metabolites were consistently associated with antibiotic exposure across public metabolomics data repositories. Finally, alterations in the maternal fecal microbiome and metabolome were associated with increased weight gain in offspring, suggesting potential pathways by which maternal antibiotic exposure may influence early developmental outcomes. These findings highlight microbial and metabolic signatures linked to perinatal antibiotic use and underscore the need to balance infection control with long-term infant health considerations.
Global health actionNaiyuan Liang, Cheng Huang, Qiang Pan
BACKGROUND: Maternal folic acid supplementation is a cornerstone of public health for preventing neural tube defects (NTDs), yet its long-term impact on child development remains underexplored. OBJECTIVE: This study evaluates the long-term cognitive and mental health associations of maternal folic acid supplementation by utilising China's 2009 Folic Acid Supplementation Programme for rural women as a quasi-experimental framework. METHODS: We analysed 1,953 children aged 10-15 years from the 2020 China Family Panel Studies. Using provincial NTD prevalence in 2009 from the Maternal and Child Health Surveillance system as a proxy for intervention intensity, we employed difference-in-differences models to estimate associations, adjusting for demographic and parental covariates. RESULTS: Maternal folic acid supplementation was significantly associated with improved outcomes among girls: higher memory scores (β [95% CI], 0.232 [0.069, 0.394]), enhanced numerical reasoning skills (5.234, [2.188, 8.279]), lower Center for Epidemiological Studies Depression Scale score (-0.523 [-0.933, -0.113]), and reduced likelihood of depressive symptoms (-0.024 [-0.048, -0.001]). No comparable associations were observed in the boys. Although cognitive associations were observed across socioeconomic status (SES) groups among girls, the mental health associations were concentrated among girls from higher-SES families. Results were robust to adjustment for covariates. CONCLUSIONS: This study highlights sex-specific, long-term associations of maternal folic acid supplementation but reveals that socioeconomic disparities may constrain mental health gains. Thus, universal nutrition interventions alone may be insufficient to bridge health equity gaps. The findings should be interpreted within the broader nutritional ecology and alongside concurrent macro-social changes that shape child development outcomes.
OBJECTIVE: This study was initiated to resolve a discrepancy between conventional genetic findings and clinical presentation in a proband with α-thalassemia. The initial genotype (-α4.2/-α4.2) was inconsistent with the Hb H disease phenotype, suggesting the presence of an undetected pathogenic variant. METHODS: To characterize the underlying genetic defect, we employed a multi-technique approach. The proband's DNA was analyzed using multiplex ligation-dependent probe amplification (MLPA), third-generation sequencing (TGS), and copy number variation sequencing (CNV-seq). Prenatal diagnosis was performed because the husband carried the --SEA/αα genotype. RESULTS: Investigations revealed a novel, large deletion on the α-globin gene cluster. Unlike MLPA and TGS, which indicated a deletion but could not precisely define its breakpoints due to its telomeric location, CNV-seq successfully mapped the deletion to chr16:97840-230167. This represents a 132,327 bp (132 kb) deletion, which we designated the 'Dongxing' (--DX) deletion. The proband's corrected genotype was confirmed as --DX/-α4.2. Prenatal diagnosis revealed the fetus had Hb H disease (--SEA/-α4.2). CONCLUSIONS: We identified and characterized a novel α-thalassemia deletion (Dongxing deletion) using CNV-seq. This case highlights the limitations of conventional genotyping and underscores the importance of comprehensive genetic analysis in cases of genotype-phenotype discrepancy.