Gestational diabetes (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Although it is a well-known cause of pregnancy complications, its epidemiology has not been studied systematically. Our aim was to review the recent data on the epidemiology of GDM, and to describe the close relationship of GDM to prediabetic states, in addition to the risk of future deterioration in insulin resistance and development of overt Type 2 diabetes. We found that differences in screening programmes and diagnostic criteria make it difficult to compare frequencies of GDM among various populations. Nevertheless, ethnicity has been proven to be an independent risk factor for GDM, which varies in prevalence in direct proportion to the prevalence of Type 2 diabetes in a given population or ethnic group. There are several identifiable predisposing factors for GDM, and in the absence of risk factors, the incidence of GDM is low. Therefore, some authors suggest that selective screening may be cost-effective. Importantly, women with an early diagnosis of GDM, in the first half of pregnancy, represent a high-risk subgroup, with an increased incidence of obstetric complications, recurrent GDM in subsequent pregnancies, and future development of Type 2 diabetes. Other factors that place women with GDM at increased risk of Type 2 diabetes are obesity and need for insulin for glycaemic control. Furthermore, hypertensive disorders in pregnancy and afterwards may be more prevalent in women with GDM. We conclude that the epidemiological data suggest an association between several high-risk prediabetic states, GDM, and Type 2 diabetes. Insulin resistance is suggested as a pathogenic linkage. It is possible that improving insulin sensitivity with diet, exercise and drugs such as metformin may reduce the risk of diabetes in individuals at high risk, such as women with polycystic ovary syndrome, impaired glucose tolerance, and a history of GDM. Large controlled studies are needed to clarify this issue and to develop appropriate diabetic prevention strategies that address the potentially modifiable risk factors.

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The findings suggest that host treatment with melatonin or graft incubation with HA-rich biological glue, especially when combined with VEGF-A and vitamin E improves graft survival. This protocol can be applied and holds promise in ovarian autotransplantation for fertility restoration.

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The authors concluded that delivery at 37, 38, or Z42 weeks was associated with an increased risk of CP when compared to delivery at 40 weeks' gestation. This suggests that intervention at 40 weeks might reduce CP risk, while elective delivery at 37 or 38 weeks might increase it. Until the biological mechanisms for patterns of risk for CP in term and postterm births are better understood, interventions based on gestational age at delivery to reduce the incidence of CP should be not be performed.A lthough increased maternal age has a negative impact on the risk of fetal death, recent findings have suggested that the risk varies considerably according to gestational age at birth. Fetal deaths in older mothers are reportedly high at 20 to 22 weeks' gestation, lowest at 27 to 33 weeks, and increase from 37 to 43 weeks' gestation. Knowledge of the impact of maternal age at different gestational ages, however, is limited. This Norwegian retrospective, population-based report studied the association of fetal death with maternal age by length of gestation and investigated whether fetal death risk at term in older mothers has decreased since ultrasonographic obstetric examinations were introduced (mid-1980s in Norway).From the nationwide, compulsory Medical Birth Registry of Norway, all ongoing pregnancies Z16 weeks from 1967 to 2006 were reviewed. Excluded were 28,595 gestations Z43 weeks and 125,041 pregnancies with missing information, which left 2,182,756 births for multivariable analyses. Pregnancies lasting Z38 weeks were subdivided into groups of 2-week intervals: 38 to 39, 40 to 41, and 42 to 43, and the risk of fetal death was determined for gestational lengths of 16 to 22, 23 to 29, 30 to 36, and Z37 weeks. Maternal age at delivery was coded as <20, 20 to 24 (reference), 25 to 29, 30 to 34, 35 to 39, 40 to 44, and Z45 years (the Z45 years group were not analyzed separately due to lack of statistical power in postterm pregnancies). Parity, plurality, year of delivery, paternal age, and preeclampsia were potential confounders or which adjustments were made. The year of delivery was coded for every 4-year period. The association of fetal death with maternal age at term and postterm was also estimated separately for 1967 to 1986 and 1987 to 2006 to assess changes in risk.A total of 22,754 fetal deaths (1.04% of all births Z16 weeks) occurred during the study period. Of all

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The ability to mature human primordial follicles in vitro would assist fertility restoration. However, the signals initiating growth of primordial follicles are unknown. Growth factors such as nerve growth factor (NGF) may play a role in this process. To investigate the expression of NGF and its receptors, p75 and TrkA, in early developing follicles (mostly primordial, primary and secondary follicles), ten ovarian samples from adolescents/adults aged 13-39 and 33 ovaries from human fetuses aged 19-33 gestational weeks (GW) were obtained and immediately fixed or frozen. The fixed samples were prepared for a study of immunocytochemical staining of NGF and its two receptors. Total RNA was extracted from the frozen ovarian samples, and the expression of NGF, TrkA and p75 was investigated by RT-PCR. Products were resolved by 1% agarose gel electrophoresis and image analysis. Immunocytochemical staining revealed the expression of NGF in granulosa cells (GC) and oocytes; TrkA was mainly in oocytes and in GC in minority of the samples; and p75 was in some of the stroma cells from fetuses aged less than 22 GW. Transcripts of NGF and TrkA were identified by RT-PCR in all samples, while those for p75 were detected only in ovarian samples from fetuses aged less than 22 GW. To elucidate if NGF is indeed involved in growth initiation of human primordial follicles, it should be added to their culture medium. The immunocytochemical detection of p75 in some of the stroma cells and transcripts in ovarian samples of fetuses less than 22 GW may suggest its role in follicular assembly.