Dietary patterns and birth outcomes in the ELSPAC pregnancy cohort

ObjectivesThe aim of this study was to identify dietary patterns in a Czech pregnancy cohort established in the early postcommunist era and investigate associations between dietary patterns, maternal characteristics and birth outcomes.MethodsPregnant women were recruited for the Czech part of the European Longitudinal Study of Pregnancy and Childhood. A self-reported questionnaire answered in late pregnancy was used to assess information about the weekly intake of 43 food items. Information about birth outcomes (birth weight, height, ponderal index, head circumference, cephalisation index, gestational length and Apgar score) was obtained from the National Registry of Newborns. Complete details on diet and birth outcomes were available for 4320 mother–infant pairs.Results and conclusionThe food items were aggregated into 28 variables and used for extraction of two dietary patterns by principal component factor analysis. The patterns were denoted ‘unhealthy’ and ‘healthy/traditional’ based on the food items with the highest factor loadings on each pattern. The ‘unhealthy’ pattern had high positive loadings on meat, processed food and confectionaries. In contrast, the ‘healthy/traditional’ pattern had high positive loadings on vegetables, dairy, fruits and wholemeal bread. Following adjustment for covariates, we found that high adherence to the unhealthy pattern (expressed as beta for 1 unit increase in pattern score), that is, the higher consumption of less healthy foods, was associated with lower birth weight: −23.8 g (95% CI −44.4 to −3.2) and length: −0.10 cm (95% CI −0.19 to −0.01) and increased cephalisation index: 0.91 μm/g (95% CI 0.23 to 1.60). The ‘healthy/traditional’ pattern was not associated with any birth outcomes. This study supports the recommendation to eat a healthy and balanced diet during pregnancy.

Factors affecting gestation length in small sized breeds of dogs.

A large variation in the gestation length can be expected when the gestation is calculated from the day of mating to birth. The present study was designed to assess the influence of different factors like litter size, breed, parity and age on gestation length in bitches. A total of 89 small sized bitches of different breeds having different age, parity and body weight, were selected for the study. The mean age, body weight and parity of the animals included in the present study were 3.00 ± 0.15 years (1 to 8 years), 9.9 ± 0.25 Kg (6 to 15kg) and 1.14 ± 0.10 (0-4th parity) respectively. The mean gestation lengths observed in different small sized breeds were 60.68 ± 0.55, 59.82 ± 0.54, 60.78 ± 1.74, 58.83 ± 1.35 and 58.17 ± 0.74 in the Pug, Beagle, Dachshund, French Bulldog and the Spitz, respectively. The mean litter size in the study was 4.34 ± 0.13 with a range of 2-8. The mean gestational length in animals having ? 3 litter size was 60.83 ± 0.64 days and 59.90 ± 0.43 days in animals having >3 litter size. Age limit of the animals ranged from 1 to 8 years with a mean of 3 ± 0.15 years. The mean gestation length in bitches aged ?3 years was 60.21 ± 0.23 days (n=63) and this was 60.15 ± 0.3 (n=26) days in bitches in the >3 years group. Mean gestational length observed in nulliparous bitches was 60.86 ± 0.4 days (n=29), while in multiparous bitches it was 59.90 ± 0.5 days (n=60). From the present investigation it could be concluded that no significant difference exists in gestational length between different breeds, litter size, age group and parity.

Associations of COVID-19 lockdown with gestational length and preterm birth in China

Background The effects of COVID-19 lockdown measures on maternal and fetal health remain unclear. We examined the associations of COVID-19 lockdown with gestational length and preterm birth (PTB) in a Chinese population. Methods We obtained medical records of 595,396 singleton live infants born between 2015 and 2020 in 5 cities in Guangdong Province, South China. The exposed group (N = 101,900) included women who experienced the COVID-19 Level I lockdown (1/23–2/24/2020) during pregnancy, while the unexposed group (N = 493,496) included women who were pregnant during the same calendar months in 2015–2019. Cumulative exposure was calculated based on days exposed to different levels of emergency responses with different weighting. Generalized linear regression models were applied to estimate the associations of lockdown exposure with gestational length and risk of PTB (< 37 weeks). Results The exposed group had a shorter mean gestational length than the unexposed group (38.66 vs 38.74 weeks: adjusted β = − 0.06 week [95%CI, − 0.07, − 0.05 week]). The exposed group also had a higher risk of PTB (5.7% vs 5.3%; adjusted OR = 1.08 [95%CI, 1.05, 1.11]). These associations seemed to be stronger when exposure occurred before or during the 23rd gestational week (GW) than during or after the 24th GW. Similarly, higher cumulative lockdown exposure was associated with a shorter gestational length and a higher risk of PTB. Conclusions The COVID-19 lockdown measures were associated with a slightly shorter gestational length and a moderately higher risk of PTB. Early and middle pregnancy periods may be a more susceptible exposure window.

Age at First Gestation in Beef Heifers Affects Fetal and Postnatal Growth, Glucose Metabolism and IGF1 Concentration

This study aimed to determine the effects of age at first gestation on offspring growth performance, glucose metabolism, and IGF1 concentration. Heifers impregnated by AI from a single bull at 15 months of age (15 M, n = 20), or 27 months of age (27 M, n = 20), and multiparous cows (adult, n = 20) were used. Dams from all groups were managed in a single group during gestation and lactation. Gestational length was longer in the 15 M and 27 M than in adult dams (p = 0.009). Bodyweight at birth, at weaning and ADG during lactation were higher in calves from adult dams than in those from 27 M dams, and higher in calves from the latter than in 15 M calves (p < 0.001). Calves from 15 M dams had an increased head circumference/BW ratio compared to calves from 27 M dams, while calves from this latter group had an increased ratio compared to calves from adults (p = 0.005). Body mass index was greater in calves from adults than in those from 15 M and 27 M dams (p = 0.002). Milk production from 15 M and 27 M dams was similar but lower than that from adults (p = 0.03). Calves born from adult dams had greater blood glucose concentrations than those from 15 M and 27 M dams (p < 0.05). Serum IGF1 concentrations were higher in calves from adults than in calves from 15 M and 27 M dams (p = 0.01). This study showed that age at first gestation affects offspring postnatal growth performance, glucose metabolism and IGF1 concentration.

The effect of secretor status and the vaginal microbiome on birth outcome

Mutations in the FUT2 gene that result in a lack of expression of histo-blood group antigens on secreted glycoproteins may shape the vaginal microbiota with consequences for birth outcome. To test this, we analysed the relationship between secretor status, vaginal microbiota and gestational length in an ethnically diverse cohort of 313 pregnant women, including 91 who delivered prematurely. Lactobacillus species were found to co-occur less often with other microbial taxa in non-secretors. Moreover, non-secretors with Lactobacillus spp. depleted vaginal microbiota in early pregnancy had significantly shorter gestational length than Lactobacillus spp. dominated non-secretors (mean of 245.5 (SD=44.5) versus 265.9 (23.6)); p=0.045), but not compared to Lactobacillus spp. dominated (261.8 (27.5)) and depleted (264.3 days (21.2)) secretors. In identifying a relationship between blood-group antigen expression and vaginal microbiota-host interactions, our results point towards stratification by secretor status as an important factor for considering preterm birth risk and prevention.

Routinely collected antenatal data for longitudinal prediction of preeclampsia in nulliparous women: a population-based study

The objective was to evaluate the sequentially updated predictive capacity for preeclampsia during pregnancy, using multivariable longitudinal models including data from antenatal care. This population-based cohort study in the Stockholm-Gotland Counties, Sweden, included 58,899 pregnancies of nulliparous women 2008–2013. Prospectively collected data from each antenatal care visit was used, including maternal characteristics, reproductive and medical history, and repeated measurements of blood pressure, weight, symphysis-fundal height, proteinuria, hemoglobin and blood glucose levels. We used a shared-effects joint longitudinal model including all available information up until a given gestational length (week 24, 28, 32, 34 and 36), to update preeclampsia prediction sequentially. Outcome measures were prediction of preeclampsia, preeclampsia with delivery < 37, and preeclampsia with delivery ≥ 37 weeks’ gestation. The area under the curve (AUC) increased with gestational length. AUC for preeclampsia with delivery < 37 weeks’ gestation was 0.73 (95% CI 0.68–0.79) at week 24, and increased to 0.87 (95% CI 0.84–0.90) in week 34. For preeclampsia with delivery ≥ 37 weeks’ gestation, the AUC in week 24 was 0.65 (95% CI 0.63–0.68), but increased to 0.79 (95% CI 0.78–0.80) in week 36. The addition of routinely collected clinical measurements throughout pregnancy improve preeclampsia prediction and may be useful to individualize antenatal care.

Reproductive History in Takotsubo Syndrome, A Register-Based Cohort Study

Background: Takotsubo syndrome (TS) is a recently recognized serious heart condition that mainly affects women. Despite that 80–90% of the patients are women, few studies have focused on sex-specific characteristics such as female sex hormones and reproductive history. The aim of the study was to compare reproductive history in patients with TS with controls.Methods: This register-based cohort study compared reproductive history and off-spring birth characteristics between 158 TS patients without coronary artery stenoses and 236 age- and sex-matched controls (C) with coronary artery stenoses because of acute coronary syndrome (ACS-C), respectively, 285 without coronary artery stenoses with chest pain (CP-C).Results: There were no differences in pregnancy complications between TS and CP-C. Gestational length did not differ, but infants born to TS patients had lower birth weight for gestational age than CP-C with an odds ratio of 1.7 (95% confidence interval 1.2–2.5) for infants born small.Conclusion: The results showing an association between birth weight for gestational age and TS later in life are hypothesis-generating. The association is not likely causal and before delivery of small for gestational age infants can be considered as a risk marker for TS later in life the results need to be confirmed in independent studies

Assessing Disparity Using Measures of Racial and Educational Isolation

We develop a local, spatial measure of educational isolation (EI) and characterize the relationship between EI and our previously developed measure of racial isolation (RI). EI measures the extent to which non-college educated individuals are exposed primarily to other non-college educated individuals. To characterize how the RI-EI relationship varies across space, we propose a novel measure of local correlation. Using birth records from the State of Michigan (2005–2012), we estimate associations between RI, EI, and birth outcomes. EI was lower in urban communities and higher in rural communities, while RI was highest in urban areas and parts of the southeastern United States (US). We observed greater heterogeneity in EI in low RI tracts, especially in non-urban tracts; residents of high RI tracts are likely to be both educationally and racially isolated. Associations were also observed between RI, EI, and gestational length (weeks) and preterm birth (PTB). For example, moving from the lowest to the highest quintile of RI was associated with a 1.11 (1.07, 1.15) and 1.16 (1.10, 1.22) increase in odds of PTB among NHB and NHW women, respectively. Moving from the lowest to the highest quintile of EI was associated with a 1.07 (1.02, 1.12) and 1.03 (1.00, 1.05) increase in odds of PTB among NHB and NHW women, respectively. This work provides three tools (RI, EI, and the local correlation measure) to researchers and policymakers interested in how residential isolation shapes disparate outcomes.