Problem Preeclampsia has a multifactorial origin with genetic, immunological, and environmental factors described as main contributors to its onset. This study aimed to investigate glutathione‐S‐transferase M1 (GSTM1) and glutathione‐S‐transferase T1 (GSTT1) gene polymorphisms, the expression of pro‐inflammatory cytokines (TNF‐α, IL‐1β, IL‐6), and the potential relationship between GST polymorphisms and cytokine expression levels in preeclampsia and uncomplicated pregnancy. Method of Study This prospective case‐control study included 50 women with preeclampsia and 50 healthy pregnant women. DNA and RNA were extracted from women leukocytes. Deletion polymorphisms were analyzed by PCR, while cytokine mRNA expression was analyzed by real‐time PCR. Results GSTM1 null genotype with present GSTT1 increased the risk for preeclampsia development. Deletion of GSTT1 without deletion of GSTM1 increased the risk for early preeclampsia. Relative mRNA expression of TNF‐α was significantly higher in preeclampsia compared to healthy pregnant women (P = 0.006). Expression of IL‐1β was significantly higher in severe and late preeclampsia compared to the control group (P = 0.005, P = 0.007, respectively). A significant positive correlation between TNF‐α and IL‐1β was observed (Spearman's ρ = 0.312, P = 0.028) and between IL‐1β and IL‐6, in preeclampsia group (Spearman's ρ = 0.296, P = 0.037). IL‐1β was significantly increased in patients with GSTT1 null genotype (P = 0.015) while IL‐6 was increased in patients with GSTM1 null genotype (P = 0.015). Conclusions GSTM1 null genotype represents a risk factor for preeclampsia development, while GSTT1 null genotype favors early preeclampsia. Preeclampsia is also associated with increased expression of pro‐inflammatory cytokines, predominantly TNF‐α and IL‐1β.

Healthy diet in pregnancy should guarantee proper fetal growth and development, maintain (and promote) maternal health and enable lactation. Nutritional counseling and interventions need to be an integral part of antenatal care and continue during pregnancy in order to reduce the risk of maternal, fetal and neonatal complications, as well as the short- and long-term adverse outcomes. Adverse pregnancy outcomes are more common in women who begin the gestation as undernourished or obese in comparison to pregnant women whose weight is within normal ranges. Increased nutritional and energy needs in pregnancy are met through numerous metabolic adaptations; pregnancy is successfully achieved within wide range of variations in energy supply and weight gain. However, if nutrient restriction exceeds the limits of adaptive responses, evidence indicates that fetus will develop the alternative metabolic competence that might emerge as a disease (type 2 diabetes, hypertension, coronary heart disease and stroke) in adult life.

In this study population, the frequency of CHDs in IVF pregnancies was higher than early historical population data; however, it was similar to that of a more contemporary general population. Further analysis showed that this increase was mainly driven by IVF twin gestations. Previous reports of increased CHD risk in pregnancies conceived via IVF may have been due, in part, to an increased frequency of higher-order pregnancies seen among these patients.

Preeclampsia (PE) is an important and a leading cause of both maternal morbidity and adverse perinatal outcomes. Despite progress in perinatal medicine for patients with an established diagnosis of PE, a therapeutic approach other than termination of pregnancy was unsuccessful. Women predisposed to PE begin pregnancy with a certain degree of endothelial dysfunction, a lesion that precedes shallow placentation. The proposed sequence of events comprises endothelial dysfunction, defective trophoblast invasion, and consequential impaired placental perfusion, immune maladaptation and inflammation. The possible link between these could be oxidative stress by excessive production of reactive oxygen species coupled with inadequate or overwhelmed antioxidant defense mechanisms. These defense mechanisms, involving antioxidant vitamins and enzyme systems, may restrain the extent of damage caused by oxidative stress. Markers of oxidative stress in women with established PE were confirmed. Accordingly, these findings support an expected beneficial effect of antioxidant therapy in the prevention of PE and other pregnancy-related disorders. Numerous studies have been carried out in order to investigate this possible and simple prophylactic and/or therapeutic approach in prevention of oxidative stress and eventual reduction of PE and its perinatal complications. In this review the role of vitamin antioxidants in prevention and treatment of PE is discussed. Despite the logic behind using antioxidant vitamins, the data, thus far, are at best conflicting.

As good predictors of maternal glycoregulation, BMI and HbA1c levels determine fetal echography findings as well as neonatal outcomes in pregnancies complicated by DM.

Recent epidemiological studies showed significantly higher incidence of perinatal complications in newborns and women after the use of assisted reproductive technologies (ART). Multiple pregnancies are more frequent after the use of ART. Singleton pregnancies following ART are more prone to preterm birth, low and very low birth weight (LBW and VLBW), small for gestational age (SGA) and perinatal mortality. ObjectiveThe aim of this study was to summarize the results of relevant articles and to evaluate whether the mode of conception is the determining factor for different pregnancy outcomes after assisted and natural conceptions. Methods Eleven studies were included in this review. The following outcomes were observed: preterm and very preterm birth, SGA, LBW, VLBW, perinatal mortality, admission to neonatal intensive care unit (NICU), and Apgar score (As) ≤7 at fifth minute. Qualitative analysis nd quantitative assessment were performed. Results For singletons, odds ratios were 1.794 (95% confidence interval 1.660-1.939) for preterm birth, 1.649 (1.301-2.089) for LBW, 1.265 (1.048-1.527) for SGA. Admission to NICU, As≤7 at fifth minute and perinatal mortality showed significantly different frequency after assisted conception. Summary of results for twin gestations showed no significant difference between ART and spontaneous conception for preterm birth (32-36 weeks), very preterm birth (<32 weeks), LBW and VLBW. Conclusion Analyzed studies showed that infants from ART have significantly worse perinatal outcome compared with natural conception. More observational studies should be conducted in order to establish

No abstract

Objective: To measure fetal and maternal plasma homocysteine (Hcy) concentrations in uncomplicated pregnancies. Methods: Paired maternal venous and fetal umbilical cord blood (n = 81) samples were evaluated for plasma Hcy and vitamin B levels, in addition to eight neonatal umbilical cord blood samples obtained immediately following delivery. Results: Both fetal and maternal Hcy concentrations were positively correlated with advancing gestational age (ρ = 0.44, p < 0.0001; and ρ = 0.27, p < 0.05, respectively). Fetal plasma Hcy concentrations [2.2 µmol/l (IQR: 2.0-3.2)] were significantly lower than both neonatal umbilical vein [5.0 µmol/l (IQR: 4.4-6.5); p < 0.001] and maternal plasma Hcy levels [4.4 μmo/l (IQR: 3.4-5.4); p < 0.001]. In addition, Hcy values at term were higher in the umbilical vein compared with the umbilical artery [5.0 μmol/l (IQR: 3.4-5.4) versus 4.2 μmol/l (IQR: 3.7-5.5), respectively; p = 0.016]. Significant correlation was noted and between fetal and maternal Hcy levels (ρ = 0.50, p < 0.0001), while fetal Hcy was negatively correlated with maternal B concentrations (ρ = -0.32, p < 0.001). Conclusions: Fetal Hcy levels were significantly lower than maternal and neonatal levels and correlated with gestational age across the second half of pregnancy.