Natural history of fetal trisomy 13 after prenatal diagnosis.

There are currently limited data describing the natural history and outcome for fetal trisomy 13 diagnosed prenatally. The aim of this study was to evaluate the fetal and neonatal outcome for pregnancies with an established prenatal diagnosis of fetal trisomy 13, and a parental decision for continuation of the pregnancy. To this end, the obstetric and neonatal outcome data for such pregnancies, diagnosed at two referral Fetal Medicine Centers, were retrospectively obtained and examined.

Early pregnancy maternal urinary metabolomic profile and later insulin resistance and fetal adiposity.

Objective: Our objective was to determine if early pregnancy urinary metabolomic profiles could predict fetal adiposity and macrosomia.

Methods: This is a prospective study of 50 healthy women in their second pregnancy. Fasting urine samples taken during early pregnancy were analyzed using NMR spectroscopy.

The East Timorese: a high-risk ethnic minority in UK obstetrics: a cohort study.

Objective: To observe the incidence of antenatal risk-factors and adverse maternal outcome in women of East Timorese origin within a UK population.

Methods: This retrospective cohort study assessed a sample of women of East Timorese Origin (N = 42) attending UK maternity services from 01/2011 to 09/2012 compared to a control group of a standard UK maternity population (N = 7210). Data on the rate of pregnancy related risk-factors and complications were obtained from a computerized patient note database (NIMATS).

Prediction of gestational weight gain - a biopsychosocial model.

Objective: To examine the influence of health behaviours and psychological well-being on gestational weight gain using a biopsychosocial model.

Design: A prospective cohort study of pregnant women consecutively recruited at their first antenatal care visit. A self-administered questionnaire was used to collect data on health behaviours and psychological well-being in early pregnancy.

Maternal low glycaemic index diet, fat intake and postprandial glucose influences neonatal adiposity--secondary analysis from the ROLO study.

Background: The in utero environment is known to affect fetal development however many of the mechanisms by which this occurs remain unknown. The aim of this study was to examine the association between maternal dietary macronutrient intake and lifestyle throughout pregnancy and neonatal weight and adiposity.

Methods: This was an analysis of 542 mother and infant pairs from the ROLO study (Randomised cOntrol trial of LOw glycaemic index diet versus no dietary intervention to prevent recurrence of fetal macrosomia).

Defining the residual risk of adverse perinatal outcome in growth-restricted fetuses with normal umbilical artery blood flow.

Objective: We sought to determine the cause of adverse perinatal outcome in fetal growth restriction (FGR) where umbilical artery (UA) Doppler was normal, as identified from the Prospective Observational Trial to Optimize Pediatric Health (PORTO). We compared cases of adverse outcome where UA Doppler was normal and abnormal.

Study Design: The PORTO study was a national multicenter study of >1100 ultrasound-dated singleton pregnancies with an estimated fetal weight <10th centile.

Maternal diet and weight at 3 months postpartum following a pregnancy intervention with a low glycaemic index diet: results from the ROLO randomised control trial.

Unlabelled: Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum.

Aim: To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum.

Cardiomyopathy in offspring of pregestational diabetic mouse pregnancy.

Purpose: To investigate cardiomyopathy in offspring in a mouse model of pregestational type 1 diabetic pregnancy.

Methods: Pregestational diabetes was induced with STZ administration in female C57BL6/J mice that were subsequently mated with healthy C57BL6/J males. Offspring were sacrificed at embryonic day 18.

Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.

The present study is a secondary analysis of the ROLO study, a randomised control trial of a low-glycaemic index (GI) diet in pregnancy to prevent the recurrence of fetal macrosomia. The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures: birth weight; maternal glucose intolerance; gestational weight gain (GWG). In early pregnancy, 372 women had their mid-upper arm circumference recorded and BMI calculated.

The role of brain sparing in the prediction of adverse outcomes in intrauterine growth restriction: results of the multicenter PORTO Study.

Objective: The aim of the Prospective Observational Trial to Optimize Pediatric Health in IUGR Study was to evaluate the optimal management of fetuses with an estimated fetal weight less than the 10th centile. The objective of this secondary analysis was to describe the role of the cerebroplacental ratio (CPR) in the prediction of adverse perinatal outcome.

Study Design: More than 1100 consecutive singleton pregnancies with intrauterine growth restriction (IUGR) were recruited over 2 years at 7 centers, undergoing serial sonographic evaluation including multivessel Doppler measurement.

Lifestyle and dietary habits of an obese pregnant cohort.

Obese pregnant women are the focus of numerous dietary and lifestyle intervention studies, however there is a paucity of literature examining the habitual dietary and lifestyle habits of this population. This paper aims to assess maternal dietary and lifestyle habits in an obese cohort, in order to identify priority areas to be addressed in future studies and in clinical practice. This prospective observational study recruited 100 pregnant women with a body mass index 30.

Obstetric and metabolic implications of excessive gestational weight gain in pregnancy.

Objective: To compare maternal characteristics, obstetric outcomes and insulin resistance in a cohort of women subdivided into those who did and those who did not exceed the Institute of Medicine (IOM) gestational weight gain guidelines.

Methods: This is a prospective study of 621 women without diabetes. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks.

Leptin, fetal growth and insulin resistance in non-diabetic pregnancies.

Background: Interrogation of the association between leptin, insulin resistance and fetal growth may provide a biological link for the fetal programming of later metabolic health.

Aims: Our aim was to clarify the relationship between maternal and fetal leptin, insulin resistance and fetal growth.

Study Design: Maternal leptin, glucose and insulin were measured in early pregnancy and at 28weeks and the HOMA index calculated.

Umbilical cord shortening: quantification postdelivery and postfixation.

The length of the umbilical cord is an important data item, and little is known about the effects of time and fixation on measurement. Such a change has implications for the diagnosis of a long and short cord. This study was conducted to examine the effects of time and formalin fixation on cord length in a routine practice setting.

Probiotics in obese pregnancy do not reduce maternal fasting glucose: a double-blind, placebo-controlled, randomized trial (Probiotics in Pregnancy Study).

Background: Recent studies have reported beneficial effects of probiotics on maternal glycemia in healthy pregnant women. Obesity significantly increases risk of impaired glucose tolerance in pregnancy, but glycemic effects of probiotics in this specific obstetric group require additional investigation.

Objective: The aim of the Probiotics in Pregnancy Study was to investigate the effect of a probiotic capsule on maternal fasting glucose in obese pregnant women.

Impact of a low glycemic index diet in pregnancy on markers of maternal and fetal metabolism and inflammation.

This is a secondary analysis of 621 women in ROLO study, a randomized control trial of low glycemic index (GI) diet in pregnancy to prevent the recurrence of macrosomia, which aims to assess the effect of the diet on maternal and fetal insulin resistance, leptin, and markers of inflammation. In early pregnancy and at 28 weeks, serum was analyzed for insulin, leptin, tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6). At delivery, cord blood concentrations of leptin, TNF-α, IL-6, and C-peptide were recorded.

Fetal growth restriction and the risk of perinatal mortality-case studies from the multicentre PORTO study.

Background: Intrauterine growth restriction (IUGR) is the single largest contributing factor to perinatal mortality in non-anomalous fetuses. Advances in antenatal and neonatal critical care have resulted in a reduction in neonatal deaths over the past decades, while stillbirth rates have remained unchanged. Antenatal detection rates of fetal growth failure are low, and these pregnancies carry a high risk of perinatal death.

Public-private collaboration in clinical research during pregnancy, lactation, and childhood: joint position statement of the Early Nutrition Academy and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

This position statement summarises a view of academia regarding standards for clinical research in collaboration with commercial enterprises, focussing on trials in pregnant women, breast-feeding women, and children. It is based on a review of the available literature and an expert workshop cosponsored by the Early Nutrition Academy and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Clinical research collaborations between academic investigators and commercial enterprises are encouraged by universities, public funding agencies, and governmental organisations.

Definition and management of fetal growth restriction: a survey of contemporary attitudes.

Objective: To evaluate opinions among Irish obstetricians and obstetric trainees regarding the optimal definition, assessment and management of pregnancies affected by intrauterine growth restriction (IUGR).

Study Design: An anonymous, structured, web-based survey that comprised 14 questions was sent to 200 obstetricians and obstetric trainees in Ireland.

Results: Of the 113 participants (57% response rate), the majority (50%) were consultants, with over 10 years' clinical experience (46%), who worked in large maternity units (58%) with neonatal units providing care for preterm IUGR fetuses (94%).

(1)H NMR based metabolic profiling of day 2 spent embryo media correlates with implantation potential.

Morphological assessment is currently the primary technique for selection of viable embryos for uterine transfer during assisted reproductive techniques, however this method has limited predictive power. The objective of this study was to employ NMR based metabolic profiling analysis of spent embryo culture media to identify novel biomarkers of embryo viability and provide insight into the metabolism of a viable embryo. A total of 37 patients undergoing IVF/ICSI treatment were recruited and 58 media samples were collected from embryos that were transferred back to the uterus.

The influence of maternal body mass index on fetal weight estimation in twin pregnancy.

Objective: Sonographic estimated fetal weight (EFW) is important in the management of high-risk pregnancies. The possibility that increased maternal body mass index (BMI) adversely affects EFW assessments in twin pregnancies is controversial. The aim of this study was to investigate the effect of maternal BMI on the accuracy of EFW assessments in twin gestations prospectively recruited for the ESPRiT (Evaluation of Sonographic Predictors of Restricted growth in Twins) study.

Perspectives on weight gain and lifestyle practices during pregnancy among women with a history of macrosomia: a qualitative study in the Republic of Ireland.

Background: Excessive weight gain during pregnancy is a major risk factor for macrosomia (high birth weight delivery). This study aimed to explore views about weight gain and lifestyle practices during pregnancy among women with a history of macrosomia.

Methods: A qualitative descriptive study was conducted.