Search Results (70)

Background/Objectives: Inguinal hernia and hydrocele are common pediatric surgical conditions resulting from failed obliteration of the processus vaginalis during fetal development. Although prenatal exposure to fine particulate matter (PM2.5) has been linked to adverse perinatal outcomes and congenital anomalies, its role in structurally defined pediatric surgical diseases remains unclear. We examined the association between maternal PM2.5 exposure during pregnancy and the risk of inguinal hernia or hydrocele in offspring. Methods: We performed a retrospective cohort study of 1093 mother–offspring pairs delivering at a tertiary referral center (July 2016–June 2019). Monthly residential PM2.5 levels were estimated at geocoded maternal addresses using kriging interpolation from fixed-site monitoring stations. Offspring diagnosed with inguinal hernia or hydrocele through March 2024 were identified using ICD-10 codes. Perinatal characteristics were compared using t-tests and chi-square tests, and multivariable logistic regression assessed trimester-specific PM2.5 exposure and risk. Results: During follow-up, 53 offspring (4.85%) developed inguinal hernia or hydrocele. Male sex (odds ratio [OR], 24.71; 95% CI, 5.95–102.54; p < 0.001) and second-trimester PM2.5 exposure (OR, 1.07 per µg/m³; 95% CI, 1.01–1.14; p = 0.028) were independent risk factors. A dose–response pattern was observed across quartiles of second-trimester exposure; an interquartile range increase was associated with a 64% higher risk (OR, 1.64). The model showed good discrimination (AUC, 0.804). Conclusions: Elevated maternal PM2.5 exposure during the second trimester was independently associated with increased risk of inguinal hernia or hydrocele in offspring. Prenatal air pollution may contribute to persistence of the processus vaginalis and represents a potentially modifiable environmental risk factor. Full article

Background/Objectives: Cortisol has become established as a relevant biomarker due to its association with various pathologies, including its potential utility in mental health research. However, regarding the techniques employed for its analysis, the available literature shows a certain degree of heterogeneity both in the methods used to obtain cortisol and in the analytical techniques employed for its measurement. This makes it difficult to compare results across specific populations, particularly in pregnant women, who experience metabolic and physiological changes characteristic of gestation. Therefore, the aim of this study was to describe the procedure for the extraction and analysis of cortisol in hair samples from pregnant women throughout gestation. Methods: Hair samples, three centimeters in length, were obtained from women during the first, second, and third trimesters of pregnancy. These samples underwent a standardized isopropanol washing step, followed by milling in a laboratory mill using zirconium balls of varying diameters. The resulting hair powder was then weighed and subjected to four incubation cycles using HPLC-grade methanol. Cortisol levels were detected using chemiluminescence immunoassay. Results: Mean hair cortisol levels were 4.1 μg/L (ng/mL) in the first trimester, 11.5 μg/L (ng/mL) in the second trimester, and 6.6 μg/L (ng/mL) in the third trimester. Conclusions: Standardizing the methodology for cortisol extraction improves the reproducibility of results and, in the long term, may support its incorporation into clinical practice as a useful tool for assessing cortisol levels in both pregnant women and the general population, since hair cortisol enables retrospective evaluation of its cumulative exposure over time, approximately on a monthly basis. Full article

Herpes simplex virus (HSV) infection is highly prevalent worldwide and poses important risks during pregnancy due to the potential for vertical transmission and severe neonatal disease. HSV-1 is traditionally associated with orofacial lesions and HSV-2 with genital infection; however, HSV-1 has emerged as a significant cause of genital and neonatal herpes. Physiological immunomodulation during pregnancy may facilitate viral reactivation and replication. Vertical transmission may occur intrauterinely, intrapartum, or postnatally, with approximately 85% of neonatal infections acquired during delivery through contact with infected genital secretions. The risk is highest when primary maternal infection occurs in the third trimester, before adequate transplacental transfer of protective antibodies. Neonatal infection may present as disease limited to the skin, eyes, and mouth; central nervous system involvement; or disseminated multiorgan disease, the latter associated with high morbidity and mortality. Maternal infection ranges from asymptomatic viral shedding to painful vesiculoulcerative lesions and, rarely, disseminated disease. Because asymptomatic shedding is common, diagnosis relies on laboratory confirmation using polymerase chain reaction (PCR) or viral culture, with type-specific serology aiding in distinguishing primary from recurrent infection. Management aims to reduce symptoms, viral shedding, recurrences near delivery, and vertical transmission. Acyclovir and valacyclovir are safe and effective in pregnancy. Suppressive therapy from 36 weeks’ gestation reduces recurrences and viral shedding at delivery and decreases the need for cesarean delivery, which is recommended when active lesions or prodromal symptoms are present at labor. Neonatal herpes requires prompt recognition and intravenous acyclovir therapy to reduce mortality and neurological sequelae. Preventive strategies include counseling, behavioral risk reduction, suppressive antiviral therapy, and avoidance of neonatal exposure to active lesions. Full article

Pregnancy in dairy cattle is characterized by marked metabolic adaptations that may influence oxidative balance. In this study, oxidative stress markers and thiol–disulfide homeostasis were evaluated in transported and non-transported Holstein heifers during the last trimester of gestation. Clinically healthy 2-year-old heifers were divided into transported pregnant (n = 21) and non-transported pregnant (n = 9) groups. Blood samples were collected from the jugular vein approximately 90 days (3 months) after the mid-gestation transport event. These samples were analyzed for total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA), native thiol (NTL), total thiol (TTL), and disulfide levels. Total oxidant status and oxidative stress index values were significantly higher in the non-transported group (p < 0.05). However, no significant differences were observed between groups in total antioxidant capacity, malondialdehyde, or thiol–disulfide parameters (p > 0.05). These findings suggest that metabolic adaptations specific to late gestation may influence systemic oxidant levels independently of transport exposure. Under the conditions of this study, transport did not induce a marked redox imbalance in pregnant Holstein heifers. Full article

Background: Presence of milk, fruits, eggs, fish, nuts and wheat antigens in the amniotic fluid is described in the literature. Studies show a contradictory relationship between maternal exposure to allergens and early sensitization of the fetus to allergens. Hemochorionic type of the human placenta allows for easier transfer of nutrients and antibodies from the mother’s blood to the fetal circulation through the direct contact of maternal blood with the fetal chorion. During the third trimester of pregnancy, immunoglobulin G (IgG) is actively transferred through the placenta into the fetal via neonatal FcRN receptor (FcRN). In addition, monomeric immunoglobulin E (IgE) cannot cross the placenta Aim: The objective of our study is to track intrauterine sensitization to essential food proteins at birth in umbilical cord blood in mothers with established peripheral blood eosinophilia and in their infants using allergen-specific IgE and IgG. Methods: An observational study was carried out in a cohort of 22 mothers with eosinophilia and their babies. Differences in expression between groups were assessed. Blood samples were collected to determine serum IgE and IgG specific to a set of inhalant and food allergens. Results: We did not find a significant correlation between specific IgE to cow’s milk (p = 0.857), egg white (p = 0.926) and egg yolk (p = 0.096) in umbilical cord blood and maternal blood samples taken immediately before birth. Spearman’s correlation of the specific IgE and IgG in umbilical cord blood showed no dependence between the two variables. In contrast, statistical analysis showed that maternal eosinophilia in peripheral blood could be a risk factor for the development of allergy in the offspring (χ², p = 0.0347). However, given the small number of patients, this claim needs to be confirmed with further studies. Conclusions: Due to the functional immaturity of the developing immune system of the fetus, the generation and maintenance of an independent immune response to allergens are incomplete. Maternal IgG (specific) passes to the baby and high maternal IG to a specific allergen reduces babies IgE production. In addition, low maternal specific IgG may promote IgE production in the baby under the influence of microenvironmental factors (cytokine background). The main limitation of our study is the small number of patients. Further research is needed in this direction to clarify the mechanisms and risk factors for early sensitization in newborns. Full article

Background and Objectives: Antiretroviral therapy used during pregnancy in HIV infected women effectively reduces vertical transmission, though concerns about potential adverse newborn outcomes persists. This study focused on prematurity and low birth weight in antiretroviral HIV-exposed children in two major Romanian centers, Bucharest and Constanța, in the context of free access to antiretroviral treatment for pregnant women in Romania since 2001. Materials and Methods: A retrospective observational study was performed including couples of HIV-infected women and their live singleton newborns from 2006 and 2012. Preterm delivery was defined as birth before week 37 and low birth weight was defined as birth weight less than 2500 g in full-term babies. Results: A total number of 352 children and 313 women were enrolled. Mean maternal age at delivery was 23.1 years. Mean newborn birth weight was 2726 g. In the children group, 191 (54.2%) were boys, and the rate of HIV transmission was 13.9%. The prematurity rate was 21.5% and low birth weight rate was 25.56%. Preterm birth was associated with high HIV RNA in the third trimester, HIV-positive final status in infants, and vaginal delivery. Low birth weight was associated with lack of antiretroviral treatment during pregnancy and HIV-positive status in infants. No association was found between prematurity and low birth weight in full-term newborns and exposure to any antiretroviral class, any specific antiviral drug, or with any number of maternal regimens, duration of antiretroviral treatment prior to conception, or maternal exposure during puberty. Conclusions: In our study, preterm birth was significantly associated with HIV vertical transmission in newborns and with exposure to high maternal viral replication during the last trimester of pregnancy. Low birth weight in full-term babies was significantly associated with lack of antiretroviral exposure in utero in our analysis. Full article

Associations between prenatal exposure to phthalates, bisphenols and their mixtures and early childhood allergic conditions and asthma were examined. Five hundred and fifty-six mother–child pairs from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort participated. Urine samples collected from mothers during the second trimester of pregnancy were analyzed for phthalates and bisphenols. A child health questionnaire, completed by mothers when children were 12, 24, and 36 months, asked whether children had experienced allergic conditions (i.e., food allergies, eczema, rash) or asthma. In single-chemical models, associations varied with child age. Higher prenatal concentrations of mono-benzyl phthalate (MBzP) were associated with lower odds of eczema at 12 months. At 36 months, higher mono-methyl phthalate (MMP) was associated with increased odds of eczema, whereas higher mono-carboxy-octyl phthalate (MCOP) was associated with reduced odds. Higher prenatal MCOP was also associated with higher odds of rash at 12 months, and higher MMP was associated with higher odds of rash at 36 months. Higher bisphenol S (BPS) was associated with increased odds of asthma at 12 months but decreased odds of eczema and rash at 36 months. Sex-specific effects were also noted. In multi-chemical exposure least absolute shrinkage and selection operator (LASSO) models, several phthalate metabolites and BPS were selected as the best predictors of eczema and rash at 36 months of age. Bayesian kernel machine regression (BKMR) mixture models suggested that BPS was the most important chemical in predicting eczema in children at 36 months, while MMP and BPS were the most important chemicals in predicting rash at 36 months. Prenatal exposure to certain phthalate metabolites and BPS predicted allergic conditions and asthma in young children, with patterns varying by age and sex. Prenatal exposure to these chemicals may differentially influence immune development and contribute to the development of early-life allergic conditions, with potentially sex-specific susceptibility. Full article

Background and Objectives: Sexual function often fluctuates during pregnancy, yet the contributions of body image-related quality of life (BI-QoL)—operationalized via body image instruments such as the Body Exposure during Sexual Activities Questionnaire (BESAQ) and pregnancy-specific body image scales—and relationship satisfaction remain inconsistently quantified. This systematic review aimed to synthesize evidence on the associations between BI-QoL, relationship satisfaction, and female sexual function in pregnant women. Methods: Following PRISMA 2020, PubMed/MEDLINE, Scopus, and Web of Science were searched up to 23 August 2025. Eligible studies enrolled pregnant women and reported quantitative data on BI-QoL and/or relationship satisfaction alongside sexual outcomes. Risk-of-bias used design-appropriate tools; findings were narratively synthesized due to heterogeneity. Results: Thirteen studies met criteria (predominantly cross-sectional; sample sizes 107–472; one RCT; several couples/longitudinal cohorts). Female Sexual Function Index (FSFI) means clustered in the mid-20s; in a randomized trial, the intervention arm improved FSFI by +1.76 points (22.95 → 24.71; p = 0.002). Overall female sexual dysfunction reached 54.7% in the largest cross-sectional sample. Higher body exposure anxiety was associated with ~4.24-fold greater odds of dysfunction across trimesters. Marital satisfaction explained ≈36% of FSFI variance in multivariable models. Pregnancy context factors related to BI-QoL included planned pregnancy (β = −0.273) and third trimester (β = −0.280) indicating better BI-QoL, while more children predicted worse BI-QoL (β = +0.317). In one cohort, BI during sexual activity worsened postpartum versus pregnancy (p = 0.01). Conclusions: Across diverse settings, poorer BI-QoL and lower relationship satisfaction were consistently linked to reduced sexual function during pregnancy, with desire/arousal most affected. Routine screening and couple-sensitive counseling should be considered as promising, yet still under-tested, strategies that warrant further evaluation in intervention studies. Full article

Background: Physiologically based pharmacokinetic (PBPK) modeling is applied to address clinical pharmacology issues including dose selection and exposure assessments for special populations (e.g., pediatrics, and renally or hepatically impaired patients). The objective of this study was to evaluate the predictive performance of a PBPK model for dosing assessment of intravenous immunoglobulin (IVIG) and anti-D immunoglobulin (anti-D Ig) products in pregnant women. Methods: A minimal PBPK (mPBPK) model that incorporates pregnancy-specific physiological parameters and allometric scaling approaches was developed and evaluated for predicting the exposure of IVIG and anti-D Ig in pregnant women. The concentration versus time data were obtained from the published literature. Results: The IVIG (n = 22) and anti-D Ig (n = 29) concentrations were predicted using the mPBPK model with an average fold error of 1.17 and 1.22, respectively. A total of 100% and 95% of IVIG concentrations were predicted within the 0.5–2-fold and 0.5–1.5-fold prediction error ranges, respectively. For anti-D Ig, predictions fell within the 0.5–2-fold and 0.5–1.5-fold ranges for 93% and 76% concentrations, respectively. A mPBPK model-based simulation following administration of 0.5 g/kg IVIG in 100 virtual nonpregnant and pregnant subjects revealed that the maximum plasma concentration (Cmax) was 15% lower and trough concentration (Ctrough) was 8% lower during the third trimester of pregnancy compared to nonpregnant subjects. In contrast, with flat dosing, Cmax and Ctrough were 32% and 26% lower in pregnant subjects, respectively. Overall, the model demonstrated reasonable predictive performance, and bodyweight-based dosing regimen is an acceptable approach that results in minimal change in exposure of IVIG in pregnant women. Full article

Alcohol (ethanol; EtOH) intake affects one in ten pregnancies in the United States and is a leading cause of developmental defects collectively known as fetal alcohol spectrum disorders (FASDs). Cerebral circulation is a critical target of prenatal ethanol exposure (PEE), yet the target(s) involved remain poorly understood. In adult cerebral circulation, mitochondrial function is essential in regulating smooth muscle contractility, suggesting mitochondria as a potential target of alcohol in the developing cerebral arteries. In this study, pregnant C57BL/6J mice were administered ethanol (3, 4.5, 6, or 7 g/kg) during either the second trimester equivalent of human pregnancy (gestational days 9–19), or the third trimester equivalent during postnatal days 1–10. Maternal and progeny blood ethanol concentrations, progeny brain weight, cerebral artery oxygen consumption, and corticosterone levels were measured. At lower ethanol concentrations (3 g and 4.5 g/kg), no significant alterations in fetal cerebral artery mitochondrial function were detected. In contrast, heavy maternal ethanol exposure (6 g/kg) significantly increased mitochondrial respiratory parameters in developing cerebral arteries during the third trimester equivalent of human pregnancy. Sex-specific dimorphism was also observed at this developmental stage. Corticosterone was not elevated in fetuses and pups. In summary, our findings demonstrate developmental stage- and sex-dependent vulnerabilities of cerebrovascular oxygen consumption to ethanol exposure. Full article

Experimental animal evidence and a growing body of observational studies suggest that prenatal exposure to phthalates may be a risk factor for childhood obesity. Using data from the Mount Sinai Children’s Environmental Health Study (MSCEHS), which measured urinary phthalate metabolites (including MEP, MnBP, MiBP, MCPP, MBzP, MEHP, MEHHP, MEOHP, and MECPP) during the third trimester of pregnancy (between 25 and 40 weeks) of 382 mothers, we examined adiposity outcomes—body mass index (BMI), fat mass percentage, waist-to-hip ratio, and waist circumference—of 180 children between ages 4 and 9. Our aim was to assess the effects of prenatal exposure to phthalates on these adiposity outcomes, with potential time-varying and sex-specific effects. We applied a novel Bayesian multivariate factor regression (BMFR) that (1) represents phthalate mixtures as latent factors—a DEHP and a non-DEHP factor, (2) borrows information across highly correlated adiposity outcomes to improve estimation precision, (3) models potentially non-linear time-varying effects of the latent factors on adiposity outcomes, and (4) fully quantifies uncertainty using state-of-the-art prior specifications. The results show that in boys, at younger ages (4–6), all phthalate components are associated with lower adiposity outcomes; however, after age 7, they are associated with higher outcomes. In girls, there is no evidence of associations between phthalate factors and adiposity outcomes. Full article

Prenatal exposure to air pollution is a major public health concern due to its potential to impair fetal brain development. This study examined whether maternal inflammatory and oxidative stress biomarkers mediate the association between trimester-specific air pollutant exposure during pregnancy and infant neurodevelopment at one year. We analyzed 87 mother–infant pairs from the OBESO perinatal cohort in Mexico City. Trimester-specific exposure to CO, PM₁₀, PM_2.5, SO₂, and O₃ was estimated using residential geolocation. Biomarkers were measured in the first and third trimesters by protocol, and intra-pregnancy change was calculated as Δ(3T–1T) for cytokines (IL-1β, IL-6, TNFα) and oxidative stress markers (malondialdehyde (MDA), protein carbonyls (PC), and total antioxidant capacity (TAC). Infant neurodevelopment at 12 months was assessed using Bayley-III. Exploratory mediation analyses were conducted, adjusting for gestational age at birth, pre-eclampsia, gestational diabetes, fetal growth restriction, marital status, mode of delivery, and infant sex; bootstrapping was applied to obtain robust estimates. Third-trimester CO exposure was associated with poorer receptive language (coef = 0.754, p = 0.02). PM_2.5 exposure showed direct effects on expressive language in the first (coef = 0.01, p = 0.04) and third trimesters (coef = 0.007, p = 0.015) in models including IL-1β. Third-trimester O₃ and SO₂ exposures were linked to lower expressive scores in models including TNFα (coef = 0.007, p = 0.02), MDA (coef = 0.008, p = 0.04), and PC (coef = 0.007, 95% p = 0.04). Meanwhile PM₁₀ exposure was associated with socio-emotional outcomes in models with IL-6 and TAC (coef = 0.003, p = 0.04). These findings indicate that maternal inflammation and oxidative stress biomarkers did not mediate the associations between prenatal air pollution exposure and infant neurodevelopment, and this study cannot elucidate their specific biological role in neurodevelopment. Full article

Background: The global rise in atopic diseases, like atopic dermatitis and allergic rhinitis, may be linked to prenatal exposure to endocrine-disrupting chemicals like phthalates, with potential sex-specific effects. Methods: We analyzed 558 mother–child pairs from the PROGRESS birth cohort in Mexico City. Maternal urinary phthalate metabolites were measured during the 2nd and 3rd trimesters. Atopic dermatitis and allergic rhinitis symptoms were assessed at ages 4–6 and 6–8 years using the International Study of Asthma and Allergies in Childhood survey. Weighted Quantile Sum Regression (WQS) was used to assess sex-specific mixture associations. Individual sex-specific phthalate associations were examined using modified Poisson models with inclusion of product terms and stratification. Models were adjusted for maternal age, education, parity, pre-pregnancy body mass index, and prenatal tobacco exposure. Results: We found that child sex modified associations between the 2nd trimester phthalate mixture and current atopic dermatitis symptoms at both 4–6 years (WQS*sex OR: 1.23, 95% CI: 1.00–1.60) and 6–8 years (WQS*sex OR: 1.46, 95% CI: 1.01–2.10). Among males, higher phthalate concentrations were positively associated with symptoms at both ages (OR: 1.10, 95% CI: 0.92, 1.32; OR: 1.16, 95% CI: 0.92, 1.46), while associations were negative in females (OR: 0.87, 95% CI: 0.73, 1.04; OR: 0.79, 95% CI: 0.62, 1.02). No sex-specific associations were found for 3rd trimester exposures. Individual metabolite analyses also showed effect modification by sex for 2nd trimester exposures. Conclusions: Prenatal exposure to phthalates is associated with atopic dermatitis symptoms in childhood in a sex-specific manner. Full article

Twin pregnancies have a higher risk of preterm birth (PTB) than single pregnancies, but studies about prenatal air pollution exposure and PTB in twin pregnancies are still scarce. To explore associations of prenatal fine particulate matter (PM_2.5) exposure with PTB in twins, we collected birth data from 21 hospitals across China. Data on PM_2.5 and its compositions (NO₃⁻, BC, NH₄⁺, SO₄²⁻, and OM) were collected from Tracking Air Pollution. Generalized linear models were used to examine associations of air pollution with PTB. Each IQR increment in PM_2.5, NH₄⁺, SO₄²⁻, NO₃⁻, BC, and OM during entire pregnancy, the OR (95% CI) were 1.46 (1.34–1.59), 1.54 (1.39–1.70), 1.34 (1.25–1.44), 1.44 (1.30–1.59), 1.28 (1.20–1.37), and 1.28 (1.18–1.38), respectively. The results of trimester-specific analyses followed the patterns as seen during the entire pregnancy (all p < 0.05). The PAF of PTB attributable to PM_2.5 was 40.75% (95% CI: 32.5%, 48.26%) in the total population. Participants living in warmer regions and lower residential greenness were more susceptible to PM_2.5. Our findings suggest pregnant women should avoid severe air pollution exposure throughout pregnancy. Reducing heat exposure and increasing green spaces in communities can reduce PTB risk. Full article

Particulate matter with a diameter less than 2.5 µm (PM_2.5) and its chemical constituents—including ammonium (NH₄⁺), sulfate (SO₄²⁻), nitrate (NO₃⁻), organic carbon (OC), soil dust, and black carbon (BC)—have been increasingly recognized for their potential impact on fetal neurodevelopment. This systematic review aimed to synthesize current evidence on the relationship between prenatal exposure to PM_2.5 and its chemical components and neurodevelopmental outcomes in neonates, focusing on diagnoses such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Following PRISMA 2020 guidelines, a comprehensive literature search was conducted on PubMed and Embase databases from April to July 2025. Twenty-five studies meeting inclusion criteria were analyzed, of which sixteen addressed PM_2.5 exposure generally, and nine assessed specific chemical constituents. The findings indicate that increased exposure to PM_2.5, particularly during the third trimester, is associated with a higher risk of ASD. Additionally, prenatal exposure may adversely affect early neurodevelopmental domains including motor skills, problem-solving, and social interactions. Certain PM_2.5 components, notably sulfate ions (SO₄²⁻), were identified as important contributors to neurological health outcomes. These results underscore the importance of reducing prenatal exposure to PM_2.5 and its harmful constituents to protect neurodevelopment. Full article