Search Results (84)

Introduction: Human breast milk (HBM) is a critical source of nourishment for newborns, containing bioactive compounds that influence infant growth and metabolic programming. Among these compounds, leptin—a hormone primarily produced by adipocytes but also synthesized in the mammary gland—has gathered attention for its potential role in regulating energy balance and body weight. This study investigates the influence of maternal factors on HBM leptin concentrations and explores their associations with neonatal growth parameters. Material and Methods: 262 HBM samples were collected from healthy lactating mothers through Spanish Biobanks during the first six months postpartum. Data on maternal characteristics (body mass index (BMI), age, physical activity, parity, and delivery type) and neonatal measurements (weight, length, and head circumference) were collected. Leptin concentrations in skimmed HBM were measured using the ELISA technique (R&D Systems™, Minneapolis, MN, USA). Statistical analyses were conducted using R version 4.3.1 and MATLAB R2023a, with significance set at p < 0.05. Results: Leptin levels were highest in and declined over time, reaching a stable level after the first month of lactation. Preterm deliveries exhibited significantly higher leptin concentrations than term deliveries (0.42 vs. 0.07 ng/mL). Higher leptin levels were also observed in younger and primiparous mothers. Maternal BMI was positively associated with leptin concentration, with mothers who had elevated BMI showing higher levels than those with optimal BMI (0.36 vs. 0.05 ng/mL). Maternal physical activity was not associated with leptin concentrations in univariate analyses; although greater self-reported physical activity appeared associated with lower leptin concentrations in regression models, this finding should be interpreted cautiously and should not be considered evidence of an independent or consistent effect. Neonatal growth parameters (weight, length, and head circumference) were negatively correlated with HBM leptin concentrations. Conclusions: Our findings indicate that leptin levels in breast milk reflect both maternal metabolic status and neonatal characteristics and may represent a compensatory mechanism in preterm infants. HBM leptin levels are modulated by maternal BMI, age, parity, and delivery type, and are associated with neonatal growth parameters. Full article

Objective: To investigate the impact of proteinuria severity on obstetric and neonatal outcomes and to assess the predictive value of 24 h urinary protein excretion, both alone and within a multivariable model, for adverse pregnancy outcomes. Methods: This retrospective cohort study included 203 pregnant women with proteinuria who were classified into mild (≥0.3 g/day and <3.0 g/day, n = 50), severe (≥3.0 g/day and <5.0 g/day, n = 67), and massive (≥5.0 g/day; n = 86) groups based on 24 h urine protein levels. Maternal and neonatal outcomes were compared between these groups. Correlation analysis, receiver operating characteristic (ROC) curve analysis, and multivariable logistic regression were used to evaluate the predictive value of proteinuria for obstetric complications and identification of increased risk of early delivery. The AUC values of the proteinuria-only model and the multivariable model were compared using the DeLong test, as both models were derived from the same dataset and therefore represented correlated ROC curves. Results: The incidence of obstetric complications was significantly higher in the severe (68.7%) and massive (81.4%) proteinuria groups compared with the mild group (32.0%; p < 0.001). Increasing proteinuria severity was associated with earlier gestational age at delivery, lower birth weight, and higher rates of fetal growth restriction (all p < 0.001). The 24 h proteinuria level demonstrated moderate predictive ability for obstetric complications (AUC 0.73; 95% CI 0.66–0.80). A multivariable model including nephrotic-range proteinuria (≥3 g/day) and gestational age at diagnosis showed improved discriminatory performance compared with proteinuria alone (AUC 0.81; 95% CI 0.75–0.88). The model based on continuous 24 h proteinuria yielded an AUC of 0.73 (95% CI, 0.66–0.80) for identifying pregnancies at increased risk of obstetric complications. The multivariable model showed a numerically higher AUC of 0.81 (95% CI, 0.73–0.86); however, the difference between the two AUCs was not statistically significant according to the DeLong test (z = 0.82, p = 0.41). Conclusions: The severity of maternal proteinuria is associated with a higher likelihood of adverse maternal and neonatal outcomes, and higher proteinuria levels appear to show a graded association with increasing risk. A multivariable model integrating proteinuria with key clinical parameters demonstrated moderate discriminatory ability for obstetric complications, may support a more holistic approach to risk stratification in clinical practice. Full article

Background/Objectives: Intrauterine growth restriction (IUGR) is a condition in which a fetus does not reach its normal growth potential and is associated with increased neonatal morbidity. Surveillance relies on cardiotocography, a biophysical ultrasound, and a Doppler assessment, but placental pathology remains insufficiently integrated into clinical evaluations. This study aimed to compare placentas from IUGR and normal pregnancies. Methods: This cohort included 34 pregnancies (16 IUGR, 18 controls) managed at Hunedoara County Hospital (Romania). The ultrasound and Doppler parameters were documented. The placentas were collected after delivery, fixed in formalin, and processed using standard histopathological protocols. The villous morphology and maternal vascular malperfusion features were assessed on H&E sections, focusing on syncytial knots, villous caliber reduction, stromal fibrosis, fibrin deposition, and infarctions. Immunohistochemistry for CD34, cytokeratin 7 (CK7), CD68, vascular endothelial growth factor (VEGF), and Hypoxian inducible factor 1 (HIF-1α)was performed using a semi-quantitative 0–3 scoring system. A statistical analysis was performed using chi-squared testing for categorical variables and t-tests for continuous variables. Results: The ultrasound evaluation showed an estimated fetal weight below the 10th percentile and abnormal Doppler indices in the IUGR group. The histopathology demonstrated a strong association between IUGR and villous abnormalities, including an increased number of syncytial knots, stromal fibrosis, a reduced villous caliber, and placental infarctions. The immunohistochemistry showed a marked overexpression of VEGF and HIF-1α and increased CD68-positive Hofbauer cells in IUGR placentas (p < 0.0001), while CD34 and CK7 displayed preserved strong staining in both groups. Conclusions: Placentas from IUGR pregnancies exhibited advanced maternal vascular malperfusion with consistent hypoxic and inflammatory changes, correlating with Doppler alterations. These findings highlight the diagnostic relevance of placental pathology in pregnancies with IUGR. Full article

Objective: To evaluate hepatic artery Doppler parameters in fetuses with fetal growth restriction (FGR) and to investigate their relationship with composite adverse neonatal outcomes (CANO). Methods: This prospective cohort study included 108 pregnancies (54 FGR; 54 appropriate-for-gestational-age controls) between 34 and 37 weeks’ gestation. Hepatic artery (HA), umbilical artery (UA), middle cerebral artery (MCA), and uterine artery Doppler indices were recorded. Logistic regression and ROC analyses were used to determine predictors of FGR and CANO. Results: HA pulsatility index (PI), systolic/diastolic ratio, and peak systolic velocity (PSV) were significantly higher in FGR fetuses (p < 0.05). In multivariate regression, HA-PI remained independently associated with FGR (aOR 1.74, 95% CI 1.07–2.87, p = 0.025). For predicting CANO, HA-PSV was the only independent predictor (aOR 1.05, 95% CI 1.00–1.10, p = 0.020). ROC analysis demonstrated moderate discriminative ability for HA-PI (AUC 0.681) and HA-PSV (AUC 0.703). Conclusions: Increased HA-PSV in FGR reflects activation of the hepatic arterial buffer response as an adaptive mechanism to maintain hepatic perfusion under hypoxic stress, whereas elevated HA-PI may represent evolving microvascular resistance. Hepatic artery Doppler evaluation may serve as a complementary tool for assessing fetal well-being and identifying fetuses at risk for adverse neonatal outcomes, particularly in late-onset FGR. Full article

Background/Objectives: The management of high-risk pregnancies remains a major clinical challenge, particularly regarding the optimal timing of delivery, which has significant implications for both perinatal outcomes and healthcare costs. In this context, computerized cardiotocography (cCTG) offers an objective, non-invasive and cost-effective method for fetal surveillance, providing quantitative measures of heart rate dynamics that reflect autonomic regulation and oxygenation status. This study aimed to develop and validate regression-based machine learning models capable of predicting the duration of neonatal hospitalization—an objective and quantifiable indicator of neonatal well-being—using cCTG parameters obtained outside of labor, binary clinical variables describing the presence or absence of pregnancy pathologies, and gestational age at monitoring and at delivery. Methods: A total of 694 singleton high-risk pregnancies complicated by gestational diabetes, preexisting diabetes, intrahepatic cholestasis of pregnancy, pregnancy-induced or preexisting hypertension, or fetal growth restriction were enrolled. Twenty clinically relevant features derived from cCTG recordings and perinatal data were used to train and evaluate four regression algorithms: Random Forest, CatBoost, XGBoost, and LightGBM against a linear regression model with Ridge regularization serving as a benchmark. Results: Random Forest achieved the highest generalization performance (test R² = 0.8226; RMSE = 3.41 days; MAE = 2.02 days), outperforming CatBoost (R² = 0.7059), XGBoost (R² = 0.6911), LightGBM (R² = 0.6851) and the linear regression benchmark with Ridge regularization (R² = 0.5699) while showing a consistent train–validation–test profile (0.9428 → 0.8042 → 0.8226). The error magnitude (≈2 days on average) is clinically interpretable for neonatal resource planning, supporting the model’s practical utility. These findings justify selecting Random Forest as the final predictor and its integration into a clinician-facing application for real-time length-of-stay estimation. Conclusions: Machine learning models integrating cCTG features with maternal clinical factors can accurately predict neonatal hospitalization duration in pregnancies complicated by maternal or fetal disease. This approach provides a clinically interpretable and non-invasive decision support tool that may enhance delivery planning, optimize neonatal resource allocation, and improve perinatal care outcomes. Full article

Background and Objectives: Maternal telomere length (TL) has been proposed as a potential biomarker of biological aging and pregnancy outcomes, yet evidence in Central and Eastern European populations remains scarce. This study aimed to investigate the association between maternal TL and neonatal parameters in a clinically healthy cohort. Materials and Methods: We conducted a prospective observational study including 134 mother–infant pairs at the “Pius Brînzeu” Emergency County Clinical Hospital, Timișoara. All deliveries were performed by cesarean section for maternal indications unrelated to fetal condition. Maternal blood samples were collected at admission, and relative TL was measured by quantitative PCR. Neonatal outcomes included birth weight, length, head circumference, gestational age, and Apgar scores. Results: Longer maternal TL was positively correlated with birth weight (r = 0.515, p < 0.001), length (r = 0.559, p < 0.001), head circumference (r = 0.468, p < 0.001), gestational age (r = 0.444, p < 0.001), and Apgar scores at 1 (r = 0.714, p < 0.001) and 5 min (r = 0.684, p < 0.001). Logistic regression showed that shorter maternal TL independently predicted suboptimal 1 min Apgar (<8), with an adjusted odds ratio of 0.68 (95% CI: 0.51–0.91). Conclusions: Maternal TL is strongly associated with neonatal growth and vitality measures, supporting its potential as a simple, non-invasive biomarker for perinatal risk assessment. Full article

A healthy gut microbiota in calves is necessary for optimal performance and development. Considering that probiotics have been shown to improve gut microbiota, the aim of this study was to investigate the effects of Clostridium butyricum on growth performance, blood parameters, and gut microbiota in Hanwoo calves. In total, 92 calves from two farms were randomly assigned to four groups: a control and three treatment groups that received increasing doses of C. butyricum (CB1, CB2, and CB3) during the first 5 days after birth. Independent experiments were conducted at each farm with different measurements, where body weight was monitored and blood, rumen, and fecal samples were collected to assess physiological responses and microbial profiles. Notably, significant differences were observed in blood amylase and acid–base parameters, suggesting that C. butyricum supplementation may enhance metabolic stability and buffering capacity. Microbial profiling revealed preserved alpha diversity and compositional shifts in both the rumen and fecal microbiota. Particularly, there was an increase in the relative abundances of Prevotella and Muribaculaceae and a decrease in the abundances of the pathogenic genera Escherichia and Shigella in calves fed C. butyricum-supplemented diets. These changes, along with a trend toward a reduced frequency and severity of diarrhea, suggest that C. butyricum supplementation may support gut health and promote stable early growth in neonatal calves. Full article

Colostrum is the milk harvested during the first few hours after calving, which contains high levels of immunoglobulins, antimicrobial peptides, and growth factors essential for the health of neonates. The primary objective of this study was to investigate the genetic background of colostrum quality traits (based on Brix percentage) in Holstein cows. Using phenotypic records of 58,338 Holstein cows from 37 dairy farms, we identified significant systematic effects influencing colostrum quality measured by digital Brix refractometer, estimated genetic parameters, and performed weighted single-step genome-wide association studies (WssGWAS) to identify genomic regions and candidate genes associated with these traits. The average (±SD) Brix percentage was 23.76 ± 3.25%. With heritability values ranging from 0.21 ± 0.03 (Brix in third parity) to 0.30 ± 0.02 (Brix in second parity), colostrum quality was determined to be moderately heritable. Genetic correlations between colostrum quality across parities ranged from 0.37 ± 0.14 to 0.81 ± 0.13. For colostrum quality from cows in the first, second, and third parities, WssGWAS enabled the identification of 30, 32, and 38 genomic regions explaining 4.18%, 4.42%, and 5.58% of the total additive genetic variance, respectively. Two immune-related genes (CNR1 and ZXDC) were identified as promising candidate genes for colostrum quality traits. In summary, colostrum quality measured in first parity cows should be evaluated as a different trait from measurements in later parities in breeding programs. These findings provide useful information for dairy breeders to genetically improve colostrum quality in dairy cattle populations. Full article

Artificial insemination (AI) is essential in intensive pig production, which significantly depends on semen quality from boars selected for health, genetics, and fertility. While AI aims to improve productivity, larger litters often result in smaller and less resistant piglets. Beyond fertility and genetic traits, boars also influence offspring health. This study investigated the relationship between sperm parameters of highly fertile boars and both reproductive outcomes and piglet physiological indicators. Multivariate analysis revealed significant paternal effects on blood markers reflecting organ function, including those of the pancreas, liver, and kidneys, as well as on glucose homeostasis, lipid metabolism, oxidative stress, protein and carbohydrate metabolism, muscle contraction, and neural signaling. Notably, sperm velocity was correlated with mitochondrial function, which is crucial for sperm motility, capacitation, DNA integrity, and embryo development—factors likely linked to healthier, more resilient offspring. Boars transmitting superior sperm velocity, erythropoiesis efficiency, and oxygen transport capacities produced piglets with better glucose regulation, growth, and resistance to neonatal hypoglycemia. These findings underscore the broader impact of sperm quality on offspring vitality and suggest that advanced sperm analysis could improve boar selection and enable more effective, health-oriented breeding strategies. Full article

Background: Thrombophilia is a prothrombotic disorder that can affect pregnancy outcomes, potentially leading to maternal complications, fetal growth restriction, and adverse perinatal events. However, the precise relationship between thrombophilia and these outcomes remains under investigation, and the impact of hematological, renal, hepatic, and coagulation alterations in thrombophilic pregnancies is not yet fully understood. This study aims to examine the maternal and neonatal consequences of thrombophilia by analyzing key laboratory parameters and perinatal outcomes in affected pregnancies. Methods: A retrospective observational study was conducted on 251 pregnant women, divided into thrombophilic (n = 226) and non-thrombophilic (n = 25) groups. Data on maternal demographics, laboratory parameters (hematological, metabolic, renal, hepatic, and coagulation markers), obstetric outcomes, and neonatal characteristics were extracted from medical records. Statistical analysis included t-tests, chi-square tests, and Pearson correlation analysis to assess the association between thrombophilia and clinical outcomes. Results: Thrombophilic pregnancies were associated with significantly lower fibrinogen levels (p = 0.036) and decreased INR (p = 0.006), suggesting a hypercoagulable state. Renal function was affected, as evidenced by elevated urea (p = 0.012) and creatinine (p = 0.009), indicating a predisposition to kidney dysfunction. Neonates from thrombophilic pregnancies exhibited slightly lower Apgar scores at 1 and 5 min, though the differences were not statistically significant (p = 0.101, p = 0.131). NICU admission rates were comparable between groups (p = 0.317), suggesting that thrombophilia may not be a major determinant of neonatal intensive care needs. However, gestational age and birth weight remained the strongest predictors of neonatal vitality (p < 0.001), while coagulation abnormalities and renal dysfunction correlated with poorer perinatal outcomes. Conclusions: Thrombophilia is associated with altered coagulation profiles, renal dysfunction, and potential risks for maternal complications. While neonatal outcomes were not significantly different, the observed trends suggest the need for enhanced monitoring in thrombophilic pregnancies. Early intervention, thromboprophylaxis, and individualized management strategies may improve maternal and neonatal prognosis. Further research is needed to refine preventive strategies and optimize therapeutic approaches in high-risk pregnancies. Full article

Background/Objectives: Intrauterine growth restriction (IUGR) is associated with enhanced inflammatory activity, poor skeletal muscle glucose metabolism, and pancreatic β cell dysfunction that persist in offspring. We hypothesized that targeting heightened inflammation in IUGR-born neonatal lambs by supplementing anti-inflammatory ω-3 polyunsaturated fatty acids (ω-3 PUFAs) would improve metabolic outcomes. Methods: Maternal heat stress was used to produce IUGR lambs, which received daily oral boluses of ω-3 PUFA Ca²⁺ salts or placebo for 30 days. Results: Greater circulating TNFα and semitendinosus IL6R in IUGR lambs were fully resolved by ω-3 PUFA, and impaired glucose-stimulated insulin secretion, muscle glucose oxidation, and hypertension were partially rescued. Impaired glucose oxidation by IUGR muscle coincided with a greater glycogen content that was completely reversed by ω-3 PUFA and greater lactate production that was partially reversed. Ex vivo O₂ consumption was increased in IUGR muscle, indicating compensatory lipid oxidation. This too was alleviated by ω-3 PUFA. Conversely, ω-3 PUFA had little effect on IUGR-induced changes in lipid flux and hematology parameters, did not resolve greater muscle TNFR1, and further reduced muscle β2-adrenoceptor content. Conclusions: These findings show that targeting elevated inflammatory activity in IUGR-born lambs in the early neonatal period improved metabolic outcomes, particularly muscle glucose metabolism and β cell function. Full article

Background/Objectives: Iodine deficiency disorders remain a global public health concern, as acknowledged by the World Health Organization (WHO). Adequate maternal iodine intake during pregnancy is essential for normal fetal development, yet the relationship between maternal iodine status and fetal growth remains controversial. Urinary Iodine Concentration (UIC) is a commonly used marker for assessing iodine status. This study evaluates the association between maternal UIC and neonatal anthropometric parameters. Methods: This prospective single-center cohort study included 202 pregnant women without known or reported thyroid disease, recruited between 2018 and 2021. Maternal iodine status was assessed by UIC from spot urine samples collected at the time of recruitment. Correlations were analyzed between maternal UIC and neonatal anthropometric measures, including birth weight (g), length (cm), and head circumference (cm). Analyses stratified by fetal sex were also performed. Results: No statistically significant association was found between UIC and neonatal anthropometric measures. Analysis of these correlations, stratified by fetal sex, did not reveal any statistically significant associations either. Conclusions: Maternal UIC showed no association with neonatal anthropometric outcomes in this study, regardless of fetal sex. Further research is needed to investigate the additional effects of maternal iodine status in healthy, euthyroid pregnant women on neonatal outcomes. Full article

Background/Objectives: The relationship between ultrasound parameters and fetal health in the context of intrauterine growth restriction (IUGR) pregnancies constitutes a significant focus of scholarly research. A comprehensive range of Doppler and echocardiographic evaluations, encompassing the umbilical artery, middle cerebral artery, ductus venosus, uterine arteries, cardiac contractility, ventricular filling, and the thickness of the interventricular septum, has been proposed in pathological pregnancies. Methods: The aim of this paper is to present an examination of these metrics and their implications for fetal health within the framework of IUGR pregnancies and to report a case series in which we analyzed the correlation of these factors. The assessment of these ultrasound indicators can help in better management of the cases in order to obtain better fetal outcomes. Results: Our case study presented dynamics corelated to the after-birth evaluation of the neonate, reflecting the importance of complete ultrasound assessment in high-risk cases. Conclusions: Speckle tracking echocardiography has significantly advanced our understanding of cardiac function in IUGR fetuses. As shown in our cases, it can be used to detect early signs of cardiac dysfunction, differentiating between FGR and SGA. Full article

Maternal obesity is an escalating public health concern that adversely affects pregnancy outcomes. Adipokines play a key role in regulating metabolism and fetal development, but their dynamic changes during pregnancy remain inadequately understood. Objective: This study investigates maternal and fetal adipokine variations throughout pregnancy and their associations with maternal body mass index (BMI), abdominal wall thickness, and neonatal outcomes. Methods: A prospective case-control study was conducted involving 74 pregnant women categorized by BMI. Maternal blood samples were collected at mid-pregnancy and delivery, and additional analysis of umbilical-cord blood was performed. Clinical parameters such as BMI, abdominal wall thickness, and fetal growth metrics were also recorded. Results: Adiponectin levels were significantly lower in obese pregnancies, whereas leptin and visfatin levels increased with higher maternal BMI. Umbilical-cord blood leptin levels correlated positively with maternal BMI and neonatal birth weight, while ghrelin levels were reduced in neonates born to obese mothers. Significant adipokine fluctuations were observed between mid-pregnancy and delivery. Conclusions: Maternal obesity is associated with distinct alterations in adipokine profiles. These findings highlight the potential of maternal adipokines, given their links to maternal adiposity, as predictive biomarkers for adverse pregnancy outcomes and long-term metabolic risks in offspring. Further interventional research is warranted to evaluate targeted strategies aimed at improving perinatal metabolic health. Full article

Background: Breast milk is the most important nutrition for newborns. Growth factors such as insulin-like growth factor 1 (IGF-1), epidermal growth factor (EGF), transforming growth factor-β (TGF-β), and nerve growth factor (NGF) are among its components that play pivotal roles in neonatal development, immune system priming, and gastrointestinal maturation. This study examined the effects of gestational diabetes mellitus (GDM), maternal hypothyroidism, and method of delivery on the concentrations of these factors in colostrum collected at three distinct postpartum time points. Methods: A group of 39 women was included, 20 of whom gave birth vaginally, whereas caesarean section was performed in 19 patients. A total of 18 volunteers were diagnosed with GDM, and 17 suffered from hypothyroidism. Colostrum samples were collected from the volunteers in the first 3 days after birth under hospital conditions. Growth factors like IGF-1, EGF, NGF, and TGF-β were measured in the samples using commercial immunoenzymatic assays. Results: No significant differences were observed in the values of these parameters between the groups of women (with GDM or hypothyroidism and healthy, as well as giving birth naturally and by caesarean section). In addition, the growth factors exhibited good stability within the first few postpartum days (CVs for all studied parameters: in the range of 0.7–5.0%). Conclusions: The pregnancy disorders that were properly controlled and treated by specialists appeared not to affect the levels of the analyzed growth factors—just like the type of delivery and the day of colostrum collection. Full article