Search Results (90)

Background: The main “peptic” cells of the gastric glands provide the body’s only source of pepsinogen synthesis and incretion. Small amounts of endogenously supplied pepsinogen in biological fluids play an important role in anabolic processes in the mother and newborn. The aim: This work aimed to analyze the dynamics of pepsinogen activity in the blood serum, saliva, urine, and coprofiltrate in pregnant women in each trimester of pregnancy and in the postpartum period, taking into account the body weight of the newborn—normal weight, underweight, and overweight. Methods: Data from studies involving non-pregnant (n = 45) and pregnant (n = 152) women with newborns with different weights were analyzed. There were 86 women with a normal-weight newborn, 34 women with an underweight newborn, and 32 women with an overweight newborn. Total proteolytic activity in biological fluids was determined using the spectrophotometric tyrosine (tyr) Kunitz–Northrop method modified by Korot’ko. A 2% solution of dry plasma was used as a substrate. Outcomes: In non-pregnant women, the blood proteolytic activity was 58.1 ± 1.4 tyr U/mL, and saliva at 1520.9 ± 112.2 tyr U/mL, urine at 4520.3 ± 154.3 tyr U/mL, and coprofiltrate at 442.2 ± 20.5 tyr U/mL. We established that the pepsinogen activity during pregnancy is distributed unevenly, taking into account the body weight of the newborn, and changes significantly in women with an underweight or overweight newborn. Conclusions: Pepsinogen homeostasis in pregnant women is maintained by renal and extrarenal pathways, and an important role is played by the salivary glands, with the most significant changes occurring in women with overweight and underweight newborns. Full article

Tuberculosis remains one of the leading infectious causes of morbidity and mortality worldwide, disproportionately affecting women of reproductive age, particularly in low- and middle-income countries. Tuberculosis during pregnancy represents a major clinical challenge, as physiological and immunological changes associated with pregnancy may obscure symptoms, delay diagnosis, and contribute to adverse maternal and perinatal outcomes. This narrative review provides an updated and clinically oriented overview of tuberculosis during pregnancy, with particular emphasis on diagnostic challenges, imaging strategies, microbiological testing, maternal–fetal complications, and therapeutic management. Key topics include symptom-based screening, tuberculin skin test and interferon gamma release assays, as well as molecular diagnostic methods such as GeneXpert Mycobacterium tuberculosis/Rifampicin (MTB/RIF) and Xpert MTB/RIF Ultra, chest radiography, computed tomography, and emerging biomarkers. We also discuss the impact of tuberculosis on pregnancy outcomes, including prematurity, low birth weight, maternal morbidity, and neonatal complications, as well as the particular challenges posed by human immunodeficiency virus HIV coinfection and multidrug-resistant tuberculosis. Current treatment strategies, preventive approaches, postpartum care, neonatal management, and Bacille Calmette–Guérin vaccination are reviewed in light of contemporary evidence and international recommendations. Finally, we highlight practical diagnostic algorithms, current evidence gaps, and priorities for future research aimed at improving maternal and neonatal outcomes in both high- and low-resource settings. Full article

Aso limonite, a natural volcanic mineral, has been used as a cattle supplement in the Aso region of Japan; however, its effects have not been well-characterized. This study examined whether Aso limonite supplementation from 105 days prepartum to 90 days postpartum changed rumen-associated bacterial communities and calf growth in the Kumamoto strain of Japanese Brown cattle. Buccal swab-derived bacterial profiles were regarded as proxies of examining rumen-associated bacterial communities. Diversity analysis detected prepartum differences between the control and limonite groups. Primary longitudinal screening further identified rumen-associated, oral-associated and archaea subsets from buccal swab-derived microbiota. Within the rumen-associated subset, Blastomonas and Denitromonas emerged as representative taxa showing interaction-associated signals at day −45 in the limonite group, whereas Adlercreutzia showed different pattern at day −15 in the control group. Additionally, heatmap and network analyses showed that these taxa were found in distinct broader rumen-associated bacterial communities rather than a single common taxon. In parallel, calves born to limonite-fed dams were heavier than those from control dams between days 28 to 84 postpartum. These findings indicate that maternal limonite supplementation was associated with selective changes in rumen-associated bacterial communities together with greater early calf body weight. Full article

Using alternative energy sources for animal feed, such as hybrid corn varieties rather than genetically modified ones, is important. Therefore, the objective of this work was to assess the effects of supplementation at the end of gestation with Mexican Puma hybrid corn grain on productive and behavioral parameters in sheep. Twenty Columbia multiparous ewes were used; along with their diet, they were provided 600 g/animal/day of cracked corn during the last 20 days of pregnancy and the first week of lactation. The animals were divided into two groups: one fed commercial cracked corn (n = 11) and the other Mexican Tlaoli Puma hybrid cracked corn (n = 9). The productive parameters evaluated in the mother were: body weight, body condition score (BCS), feed intake, weight change, glucose, and ketone body levels, as well as the estimated quality of milk using Brix refractometer values on days 15 and 30 of lactation. In lambs, their rectal and external temperature was measured 2 h after birth, while their weight was measured 2 h after birth and every week until week 6 postpartum. Behavioral parameters were measured in the first two hours postpartum, including the maternal latency of cleaning the offspring, duration of the first cleaning episode, the lamb’s latencies of standing and nursing, and vocalizations in mother and lamb. Weight, BCS and weight change were not affected by the group but were affected by time; these parameters increased at the end of gestation and decreased significantly after delivery (p < 0.05). Ketone body levels were not affected by group or time (p > 0.05) and remained at low values. Glucose levels were not affected by the group but were affected by time; they increased significantly after birth (p < 0.05). Feed intake was similar in both groups (p > 0.05) and decreased as parturition approached (p < 0.05). The estimated milk quality was not affected by the group, nor by the time (p > 0.05). Mothers in both groups began cleaning their offspring within the first three minutes after giving birth and emitted a similar frequency of vocalizations (p > 0.05). However, mothers in the commercial maize group had a longer cleaning episode than those in the hybrid maize group (p < 0.05). The lambs in both groups stood up within the first half hour of birth, suckled before one hour after birth and emitted a similar number of vocalizations (p > 0.05). Temperatures and lamb weight were similar in both groups (p > 0.05); however, lamb weight increased as they aged (p < 0.05). It is concluded that supplementing sheep at the end of gestation with Puma hybrid Mexican corn grain can yield similar productive and behavioral benefits as supplementing with commercial grain. Full article

Background/Objective: Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM), dysglycemia, and dyslipidemia. However, the role of postpartum weight change in long-term metabolic outcomes remains unclear. Here, we determined the long-term incidence of dysglycemia and dyslipidemia after GDM and evaluated whether postpartum changes in body mass index (BMI) independently predicted these outcomes. Methods: This single-center prospective cohort study included 205 Japanese women diagnosed with GDM. All participants underwent a 75 g oral glucose tolerance test at 6–12 weeks postpartum. The incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), T2DM, and dyslipidemia was evaluated over a median follow-up of 3.6 years. Cumulative incidence was estimated using the Kaplan–Meier method, and Cox proportional hazards models identified independent risk factors, particularly postpartum BMI change. Results: During follow-up, 42.4%, 6.3%, and 35.6% of women developed IFG or IGT (prediabetes), T2DM, and dyslipidemia, respectively. The estimated cumulative incidence rates at 6 years postpartum were 57.1% and 50% for IFG/IGT and dyslipidemia, respectively, whereas the 5-year incidence of T2DM was 10.3%. Postpartum BMI increase was independently associated with new-onset dysglycemia. No independent predictor of T2DM progression was identified. Dyslipidemia was independently associated with higher pre-pregnancy BMI and multiparity, whereas postpartum BMI change was not independently associated after multivariable adjustment. Conclusions: Postpartum BMI change was independently associated with dysglycemia in women with a history of GDM. These findings suggest that postpartum weight change may help identify women at higher risk of subsequent metabolic abnormalities, particularly dysglycemia, in this high-risk population, although causal relationships cannot be inferred from this observational study. Full article

Background/Objectives: There are limited data on the dynamic changes in daily composition of movement behaviors (sleep; moderate-to-vigorous physical activity, MVPA; light physical activity, LPA; and sedentary time, SED) and their associations with body weight in postpartum women. The purpose of this study was to examine associations of reallocating time in one behavior to another with body weight, at different times in the first year postpartum. Methods: The study included 86 women who delivered a singleton infant at ≥37 weeks gestation. Physical activity and sleep were measured via actigraphy in early, mid-, and late postpartum. Body weight was measured at each timepoint. Isotemporal substitution models were used to examine the association of reallocating ten minutes of one behavior (MVPA, LPA, SED, or sleep) to another, with body weight. Results: Participants spent most of their day in SED (~52–53%), followed by sleep (~30%), LPA (~12–13%), and then MVPA (~2%) throughout the first year postpartum. In early and mid-postpartum, but not late postpartum, reallocating 10 min of MVPA to LPA, SED, or sleep was associated with lower body weight (range: 3.07–4.03 kg lower). In early and late postpartum, reallocating 10 min of SED to LPA was associated with a lower body weight (4.03 kg and 1.04 kg, respectively). In participants who slept ≥7 h per day, reallocating sleep to LPA in early postpartum, and MVPA time to LPA in mid-postpartum was associated with lower body weight. In those who slept <7 h, no significant associations with body weight were found when reallocating time from one behavior to another. Conclusions: Encouraging LPA throughout the postpartum period may be beneficial for weight loss, and having enough sleep may be especially important for early to mid-postpartum. Future research examining the impact of changes in LPA on body weight in the postpartum period are needed, along with postpartum specific 24 h movement guidelines. Full article

Normal pregnancy is associated with uterine and vascular remodeling by matrix metalloproteinases (MMPs) to facilitate placental blood flow and uterine expansion for the growing fetus. Increases in MMP-2 and MMP-9 in response to estrogen and progesterone promote placentation, uteroplacental vascularization and fetal growth during healthy pregnancy, but are altered in preeclampsia (PE). PE is characterized by hypertension in pregnancy (HTN-Preg) and fetal growth restriction (FGR). Predisposing genetic, demographic and environmental factors alter uteroplacental MMPs, immune response and integrins leading to apoptosis of invasive trophoblasts, inadequate spiral arteries remodeling, and reduced uteroplacental perfusion pressure (RUPP). Ensuing placental ischemia causes imbalance between anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt-1) and pro-angiogenic placental growth factor (PlGF) and promotes the release of tumor necrosis factor-α (TNF-α), hypoxia-inducible factor, reactive oxygen species, and angiotensin AT₁ receptor agonistic autoantibodies. Systemically, these bioactive factors target vascular endothelial cells, smooth muscle cells, and extracellular matrix, causing endothelial dysfunction, vasoconstriction, inadequate vascular remodeling, and HTN-Preg, while locally they diminish uteroplacental remodeling and cause FGR. In support, animal models of HTN-Preg induced by RUPP or infusion of sFlt-1 or TNF-α show decreases in vascular MMP-2, MMP-9 and vasodilation, increases in MMP-1, MMP-7 and vasoconstriction, collagen accumulation, and arterial stiffness. Also, decreases in uterine MMP-2 and MMP-9 could impede uterine expansion and lead to preterm birth. Conversely, PlGF and TNF-α antagonist reversed MMPs imbalance and collagen accumulation, and improved vascular function, blood pressure, and pup weight in HTN-Preg models. Persistent postpartum changes in MMPs could affect maternal hemorrhage, future pregnancies, and HTN, and cause fetal programming of cardiovascular and metabolic diseases. Understanding the aberrant uteroplacental and vascular signaling and remodeling by MMPs could help design new biomarkers and remedies for PE. Targeting bioactive factors and rectifying MMP imbalance could improve vascular and uteroplacental remodeling, and manage HTN-Preg, FGR and PE. Full article

Introduction: Urinary incontinence (UI) is one of the most common pelvic floor disorders after childbirth and depends on hormonal changes, anatomical damage that occurs after childbirth, muscle and connective tissue weakness, fascia and nerves. UI is distinguished into three subtypes, including stress urinary incontinence (SUI), urgent urinary incontinence (UUI) and mixed urinary incontinence (MUI). Aim: The purpose of this review is to collect and summarize the results of studies related to the risk factors of urinary incontinence, to disseminate this information to scientists so that this major issue can be prevented, identified and managed. Methodology: This review followed the methodology of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PECO eligibility criteria were used. We included studies published up to 2025 and not before 2019. The review was limited to studies published within the last six years in order to reflect contemporary diagnostic criteria, assessment tools and current postpartum care practices related to urinary incontinence. We searched PubMed, Google Scholar and Scopus for studies concerning the relationship between risk factors and postpartum UI. Results: A total of 1321 citations were identified. Following our exclusion criteria, 36 papers were selected to identify the risk factors for UI. All the research focused on the associated factors of any type of urinary incontinence. Vaginal and instrumental delivery, obesity, maternal age and the neonate’s birth weight were the main risk factors. The multiparity and incontinence symptoms before and during pregnancy were also strong risk factors. Heterogeneity across studies in assessment tools, in outcome measures and timing of postpartum assessment are some of the limitations of the study. Restriction to English-language publications and the absence of protocol registration were some of the additional limitations of the study. Conclusions: This problem affects the inclusion of women in society, the family, limits social activities and even their ability to work. Detection of the type of urinary incontinence by healthcare professionals, lifestyle modifications, monitoring women’s body weight and encouraging them to follow a program of pelvic floor muscle exercises should be a priority for professionals. The strategy of developing prognostic models in the coming years will be the only way to ensure the early identification and follow-up of women at high risk for urinary disorders. Full article

Approximately 40% of women start pregnancy with overweight or obesity, and around 70% retain weight in the postpartum period (PP). Obesity is related to low-grade systemic inflammation, primarily driven by the secretome of white adipose tissue (WAT), which includes dysfunctional adipocytes and immune cells that infiltrate WAT, releasing pro-inflammatory signals into the circulation. In women with obesity, the mammary gland undergoes structural and endocrine changes, such as reduced prolactin secretion, fewer mammary gland branches, and a higher abundance of adipocytes in mammary fat pad, which have not been studied under this condition. Maternal obesity during lactation also alters the composition of breast milk, promoting pro-inflammatory characteristics. The endocannabinoid system (ECS) is hyperactive in obesity, contributing to metabolic inflammation. Its primary receptors, cannabinoids 1 and 2, are expressed in the mammary gland and implicated in inflammation and weight gain. Endocannabinoids (ECs), the main ECS ligands, are typically not released into the bloodstream; however, their increased levels in obesity suggest upregulation in peripheral tissues. ECs are also present in breast milk, where their higher concentrations in women with obesity may influence infant food intake. Full article

C-C motif chemokine ligand 2 (CCL2) may reflect subtle metabolic–inflammatory changes in pregnancy. This study evaluated CCL2 concentrations and their peripartum changes in women with uncomplicated term pregnancies, focusing on associations with maternal metabolic status. Serum CCL2 was measured before delivery and 48 h postpartum; urinary CCL2 was assessed postpartum. Peripartum serum change (ΔCCL2) was calculated. BMI was recorded pre-pregnancy (or early pregnancy), at delivery, and 48 h postpartum; total BMI change (ΔBMI) was derived. Participants were stratified into two groups (ΔBMI > 1 kg/m² vs. ≤1 kg/m²). Peripartum serum CCL2 changes differed significantly between ΔBMI groups. In the total cohort, CCL2 correlated with HbA1c and selected body composition indices, including fat tissue index, lean tissue index, and body cell mass. In women with ΔBMI > 1 kg/m², additional associations were found with BMI, peripartum BMI change, HbA1c, ferritin, creatinine, and total body water. Among women with ΔBMI ≤ 1 kg/m², significant relationships were observed with uric acid and triglycerides. Peripartum CCL2 dynamics appear to reflect maternal metabolic status, even in metabolically “normal” pregnancies, but these findings are exploratory and should be interpreted cautiously. CCL2 is a promising marker of subtle metabolic alterations in late pregnancy and the early postpartum period, but further validation is required before clinical application. Full article

Background: The prevalence of being overweight and of obesity among women of childbearing age is constantly increasing. Objectives: To analyze the critical periods and goals of women’s weight management from early pregnancy to 3 years postpartum. Methods: Women’s weight was tracked from the first trimester of pregnancy to 3 years postpartum. We calculated their gestational weight gain (GWG) and postpartum weight retention (PPWR), and used linear mixed models and logistic models to estimate weight change velocities and risk factors associated with overweight/obesity at 1–3 years postpartum. Results: The medians of pre-pregnancy BMI (pre-BMI) and GWG among the 641 participants were 20.1 kg/m² and 15.0 kg. Among women with pre-BMI < 24 kg/m², those with excessive GWG remained at higher weights within 1.5 years postpartum than those with appropriate GWG (p < 0.05). Women’s weight decreased from 42 days to 1 year postpartum (β = −0.31 for low pre-BMI, β = −0.24 for normal pre-BMI, both p < 0.05), and remained unchanged from 1 to 3 years (p > 0.05). The rate of being overweight/obese at one year postpartum was mainly associated with pre-pregnancy weight (as a continuous variable, aOR = 1.58, 95%CI: 1.44–1.74) and 1-year PPWR (aOR = 1.78, 95%CI: 1.48–2.15). Compared with women who maintained normal BMI, those who shifted to being overweight/obese had higher pre-BMI and 1-year PPWR (22.6 kg/m² vs. 20.3 kg/m², 7.0 kg vs. 1.0 kg, p < 0.01). Conclusions: Normal and relatively low pre-BMI (18.5–22.0 kg/m²) and less than 2.0 kg of 1-year PPWR are goals of women’s weight management. Full article

Background/Objectives: Successful and sustained breastfeeding depends on maternal, psychological, metabolic and obstetric factors including hydration status, body composition, gestational age at delivery and mode of delivery, which are rarely assessed together in routine postpartum care. Bioelectrical impedance analysis (BIA) provides a non-invasive assessment of hydration and tissue composition, yet its potential to support lactation outcomes remains insufficiently studied. This study aimed to evaluate the relationship between postpartum body composition, hydration status assessed with BIA, and breastfeeding duration. Methods: A total of 122 women in the early postpartum period after term singleton deliveries were enrolled, of whom 50 completed the full protocol, including a 7-month follow-up. BIA and anthropometric measurements were performed on postpartum days 2 and 3. Breastfeeding duration was assessed at 7 months via telephone interview and categorized as <6 months or ≥6 months. Two indices (PLBI and sPLBI) were calculated to describe BMI change from pre-pregnancy to 7 months postpartum. Results: Breastfeeding for ≥6 months was significantly associated with marital status, mode of delivery, lower BMI on postpartum day 2, and a positive change in the overhydration index (ΔOH). Women in this group exhibited significantly lower PLBI and sPLBI values, indicating more effective postpartum weight recovery and a greater return toward pre-pregnancy BMI. Hydration parameters derived from BIA differentiated between shorter and longer breastfeeding duration. Conclusions: Positive postpartum hydration balance (ΔOH ≥ 0) and efficient metabolic recovery, reflected by lower PLBI and sPLBI values, may support longer breastfeeding. BIA-based assessment of hydration and body composition could help identify women at higher risk of early breastfeeding cessation. Further longitudinal research is warranted to confirm the clinical utility of BIA in postpartum care and its potential role in early lactation support. Full article

This study evaluated effects of Termin-8^®, a formaldehyde, propionic acid, and terpene-based feed sanitizer, on the performance, health, and gut microbiome of sows and nursing piglets. One hundred and seven mixed-parity sows were allocated to control diets (n = 53) or diets containing 0.55% sanitizer (n = 54) from day 80 of gestation until approximately day 19 postpartum. Performance metrics, scours, and fecal microbiome composition via 16S rRNA sequencing were assessed. Feed sanitizer supplementation had no significant effects on sow body weight, backfat depth, feed intake, wean-to-estrus interval, litter size or weight at weaning, or piglet diarrhea incidence. However, stillborn pig weight was significantly reduced in the sanitized group (p = 0.010). Gut microbiome changed drastically from gestation to weaning in both groups (R² > 0.20, p < 0.001), but the taxa and functions that fluctuated largely differed in each group. At weaning, both groups exhibited significantly different microbiome compositions (R² = 0.06, p < 0.001). Feed sanitizer in sows did not influence the piglet microbiome. Supplementing formaldehyde-based feed sanitizer to sow diets did not significantly impact overall performance or health but moderately influenced sow gut microbiome composition, warranting further investigation into its potential functional implications. Full article

Gestational obesity, defined as obesity during pregnancy or a pre-pregnancy BMI ≥30, is a growing global health challenge with profound implications for both maternal and offspring health. This narrative review synthesizes current evidence on the mechanistic pathways by which maternal obesity affects pregnancy outcomes and intergenerational health trajectories. For mothers, gestational obesity increases the risk of gestational diabetes, hypertensive disorders, cesarean delivery, and postpartum weight retention. Offspring exposed to maternal obesity face higher risks of obesity, metabolic syndrome, cardiovascular disease, and neurodevelopmental disorders, many of which persist across the lifespan. The underlying mechanisms include metabolic dysregulation, insulin resistance, chronic inflammation, oxidative stress, and alterations in placental function. Epigenetic modifications, such as DNA methylation, histone changes, and non-coding RNA expression, play central roles in fetal programming, while maternal gut dysbiosis and alterations in breast milk microbiota further shape infant health outcomes. Importantly, maternal obesity not only influences pregnancy and early life but also perpetuates an intergenerational cycle of obesity and related comorbidities. Preventive strategies targeting preconception and prenatal health, combined with interventions to optimize lactation and maternal diet, may mitigate long-term risks. Future research should prioritize longitudinal and mechanistic studies to refine interventions aimed at disrupting the transmission of obesity-related disease across generations. Full article

Benzophenone-3 (BP-3), a widely used ultraviolet absorber in various scenarios, exhibits estrogenic toxicity at environmental concentrations—as demonstrated in our prior work. Given the importance of hepatic metabolism and the limitations of previous hepatotoxicity research (high-dose models, lack of mammalian data, etc.), we evaluated BP-3’s hepatic effects on postpartum mice at environmentally relevant levels. Postpartum mice were exposed to BP-3 via drinking water from postpartum day 1 (PPD1) to PPD35. Groups solvent control (0.001% DMSO), 10–1000 nM BP-3, and diethylstilbestrol (DES) were established. Basic growth performance, histopathological changes, and a range of molecular indicators were assessed. The results showed that BP-3 exposure induced dose-dependent increases in liver weight, histopathological alterations (sinusoidal dilation, hepatocyte edema, and necrosis), and significant upregulation of oxidative stress markers (Ros, Mda), chemokines (Ccl27a/b), and inflammatory factors (Tnf-α, Il-6, Nf-κb) at the mRNA level (all p < 0.05). Conversely, levels of antioxidant enzymes (Cat, Sod1/2) and anti-inflammatory factor Ho-1 were markedly decreased (p < 0.05). A clear dose-effect relationship was confirmed using the Integrated Biomarker Response (IBR) framework. This pioneering study establishes the hepatotoxicity of environmentally relevant BP-3 levels in mammals and offers methodological insights for endocrine disruptor assessment. Full article