Publications by authors named "Nikolaos Antonakopoulos"

Introduction: The seasonality of human births has been studied globally for over two centuries, revealing diverse patterns across populations shaped by intricate interactions involving both biological and socio-cultural factors. This study offers a thorough examination of national birth data in Greece spanning from 1956 to 2022, aiming to elucidate long-term trends and changes in seasonal birth patterns.

Materials And Methods: Data on live births in Greece were categorized by month based on national registries, and the analysis of birth seasonality was conducted annually.

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Placental insufficiency and gestational diabetes, which are both serious pregnancy complications, are linked to altered fetal growth, whether restricted or excessive, and result in metabolic dysfunction, hypoxic/oxidative injury, and adverse perinatal outcomes. Although much research has been carried out in this field, the underlying pathogenetic mechanisms have not as yet been fully elucidated. Particularly because of the role it plays in cardiovascular performance, glucose metabolism, inflammation, and oxidative stress, the adipokine apelin was recently shown to be a potential regulator of fetal growth and metabolic programming.

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  • The study explores the relationship between the rising preterm birth rate (PBR) and the incidence of multiple births in Greece from 1991 to 2022, using official birth data.
  • Results showed a very strong positive correlation (rho = 0.950) between PBR and multiple birth rate (MBR), with MBR explaining 83.8% of the changes in PBR during this period.
  • While a perfect correlation was observed from 1991 to 2011 (rho = 0.987), the correlation weakened from 2011 to 2022 (rho = 0.655), indicating a shift in the dynamics influencing preterm births.
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Acute coronary syndrome due to a non-atherosclerotic, non-traumatic, or iatrogenic-induced spontaneous coronary artery dissection (SCAD) is a rare clinical condition that affects mostly young women of reproductive age. In this case, we present a 36-week-pregnant, 35-year-old G2P1 woman, with no previous medical history, who was admitted to our hospital with premature pre-labor contractions. During her hospitalization, she underwent a coronary artery percutaneous angiography revealing SCAD of the three coronary vessels, after an episode of acute-onset chest pain, tachypnea, EKG alterations, cardiac enzyme elevation, and bilateral pleural effusions.

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Introduction: Preterm labour is a serious pregnancy complication that is the primary cause of infant mortality, with detrimental impacts on the offspring and the mother in the short as well as the long term. This study aims to comprehensively present the time trends of national preterm birth rates (PBRs) in Greece.

Methods: Official national data regarding live births in Greece were acquired from the Hellenic Statistical Authority, and the annual total PBR and rates for gestational age groups were computed per 100 total live births spanning from 1980 to 2022.

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  • The study aims to investigate the rising cesarean section rates in Greece and implement interventions to promote vaginal delivery through a trial named ENGAGE, focusing on evidence-based practices.
  • Twenty-two maternity units across Greece will participate in a multicenter trial involving 20,000 to 25,000 births, employing a stepped-wedge design whereby units will gradually implement interventions over 8-18 months.
  • Key interventions include applying updated clinical guidelines, training on cardiotocography, and providing ongoing support to healthcare professionals, with data on cesarean rates and outcomes collected for analysis throughout the study.
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Introduction: Infant mortality is a crucial perinatal measure and is also regarded as an important public health indicator. This study aimed to comprehensively present time trends in infant, neonatal, and post-neonatal mortality in Greece.

Methods: The annual infant mortality rate (IMR), the neonatal mortality rate (NMR), and the post-neonatal mortality rate (PNMR) were calculated based on official national data obtained from the Hellenic Statistical Authority, spanning 67 years from 1956 to 2022.

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Caesarean scar pregnancy represents one of the rarest locations of ectopic pregnancies. It occurs when the blastocyst is implanted in a scar from a previous caesarean section. A dramatic increase of its prevalence has been observed for the last decades, reaching about 21% globally.

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  • Cytokines are proteins crucial for immune responses and influence various body functions, with genetic variations in their coding genes—known as cytokine polymorphisms—affecting their production and impacts.
  • Some cytokine polymorphisms increase the risk of diseases, and specific variations have been linked to recurrent pregnancy loss (RPL), defined as having two or more miscarriages before 20 weeks.
  • Research continues to explore how these genetic variations, particularly in genes for interleukin-6, tumor necrosis factor-alpha, and interleukin-10, contribute to the risk of RPL, highlighting the need for further investigation to clarify the mechanisms involved.
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  • Invasive prenatal testing methods like amniocentesis and chorionic villus sampling can provide important information about a fetus's health but come with small risks of miscarriage and infection, complicating parents' choices.
  • Various factors, including demographic, clinical, and psychological aspects, affect how parents decide to pursue these tests, emphasizing the need for informed decision-making aligned with personal values.
  • A systematic review of 17 articles revealed that factors such as maternal age, education, ethnicity, and attitudes toward pregnancy termination are significant in the decision-making process for invasive prenatal testing.
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Introduction Multiple pregnancy is an established risk factor for fetal death. This study aimed to examine the impact of multifetal pregnancies on stillbirth rates (SBRs) in the Greek population. Methods Data on live births and stillbirths by multiplicity were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021.

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Background: Despite the considerable progress made in recent years in fetal assessment, the etiology of fetal growth disturbances is not as yet well understood. In an effort to enhance our knowledge in this area, we investigated the associations of the amniotic fluid angiotensinogen of the renin-angiotensin system with fetal growth abnormalities.

Methods: We collected amniotic fluid samples from 70 pregnant women who underwent amniocentesis during their early second trimester.

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Background: Infertility affects about 80 million individuals worldwide and 10-15% of couples at reproductive age will seek medical assistance. There is increasing evidence that pregnancies after Assisted Reproduction Techniques (ART) are associated with pre-term birth, low birthweight, congenital defects, and increased mortality rates. The aim of this review is to assess all the published literature and provide an updated review on the effect of assisted conception and perinatal and neonatal outcomes.

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  • Acrylamide is an organic compound used primarily for making polyacrylamides in products like plastics and cosmetics, and it can also form in certain foods when cooked at high temperatures.
  • A reliable method using multiple reaction monitoring mass spectrometry (MRM-MS) was developed to detect acrylamide in amniotic fluid, seeking to identify any links between maternal dietary exposure and fetal growth.
  • Out of 40 amniotic fluid samples tested, acrylamide was found in six, with concentrations ranging from 7.1 to 1468 ng/mL, and the technique showed good sensitivity and repeatability for measurement.
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  • - The study investigates how levels of nerve growth factor (NGF) and neurotrophin-3 (NT-3) in amniotic fluid during early pregnancy relate to fetal growth, particularly in detecting abnormalities like being small or large for gestational age (SGA or LGA).
  • - Through a collection of 51 amniotic fluid samples, no significant differences in NGF levels were found among SGA, LGA, and appropriate for gestational age (AGA) groups; however, NT-3 levels appeared to increase as fetal growth velocity decreased.
  • - The results imply that abnormal fetal growth does not significantly alter NGF and NT-3 production in early second trimester amniotic fluid, though a
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  • Fetal growth abnormalities can lead to serious health issues for infants, and exposure to Bisphenol A (BPA)—a common endocrine disruptor—might play a role in these growth issues.
  • In a study involving 35 pregnant women and their amniotic fluid, BPA was found in 80% of samples, with a wide range of concentrations, and while no overall link was found between BPA levels and fetal growth categories (AGA, SGA, LGA), some correlations were identified.
  • The results indicated that higher BPA levels in amniotic fluid were associated with increased birth weight percentiles and decreased gestational age, suggesting BPA exposure during the second trimester could influence fetal development outcomes.
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  • Fetal growth disturbances increase the risk of health complications for babies, and this study investigates the role of the protein apelin in early fetal growth patterns, measuring its levels in the amniotic fluid of 80 pregnant women.
  • The research found significant differences in apelin concentrations based on the fetus's growth classification, with lower levels in large for gestational age (LGA) fetuses compared to appropriate (AGA) or small for gestational age (SGA) ones.
  • Results suggest that measuring apelin in amniotic fluid during the early second trimester could help predict the likelihood of a fetus being born LGA, pointing to the need for further studies on apelin's interactions with other factors influencing fetal growth.
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Introduction: Stillbirths are a major public health issue and a key population health indicator. The aim of this study was to comprehensively investigate and present time trends in stillbirth in Greece.

Methods: Data on all live births and stillbirths were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021 and the annual stillbirth rate (SBR) was calculated, defined as the number of stillbirths per 1,000 live births and stillbirths (total births).

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Introduction Multiple births constitute the dominant adverse effect of fertility treatments and are associated with increased perinatal risks. The aim of this study was to comprehensively examine and present time trends in multiple births in Greece. Methods Data on live births by multiplicity were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021.

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  • A study was conducted in Greece to assess the effects of the drug apremilast on biologic-naïve patients with early active peripheral psoriatic arthritis (PsA) over 52 weeks.
  • * The study involved 167 patients, showing significant improvements in disease activity, skin and nail symptoms, and overall patient satisfaction, with notable response rates at various time points.
  • * Apremilast demonstrated a good safety profile, with a 75% drug survival rate and a manageable incidence of side effects among patients over the year-long treatment.
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Introduction The aim of this study was to comprehensively investigate and present time trends in births in Greece over the last seven decades. Methods Data on live births were derived from the Hellenic Statistical Authority, covering a 72-year period from 1950 to 2021. Trends in the number of births were assessed using joinpoint regression analysis.

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Background: Chromosomal microarray analysis (CMA) has gained acceptance in prenatal diagnosis, gradually replacing the traditional cytogenetic analysis following amniocentesis or chorionic villi sampling due to its higher resolution than traditional cytogenetics.

Objctive: The present study investigated the prevalence of major and sub-chromosomal abnormalities in fetuses with isolated ultrasound findings during routine anatomy scan or pregnancies of advanced maternal age after maternal request without medical indication.

Methods: Total number of 126 cases were included in total, consisted of two groups; the first group with isolated sonographic soft markers (84 fetuses) and the second group of advanced maternal age (42 fetuses).

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Narrow-band imaging (NBI), an on-demand, real-time endoscopic imaging technique, was developed to enhance visualization of the mucosal vascular network and surface texture. The present article provides a systematic review of studies that assessed the use of NBI in gynecological endoscopy. The following electronic databases were searched: PubMed (1950-2020), Google Scholar (2004-2020) and Cochrane Library (2010-2020).

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  • Altered fetal growth, whether reduced (SGA) or excessive (LGA), leads to negative outcomes, but the reasons behind this are not well understood.
  • The study focused on measuring amniotic fluid levels of fibroblast growth factor 21 (FGF21) and insulin in 80 fetuses with varying growth patterns.
  • Results showed that both FGF21 and insulin levels were higher in SGA and LGA cases compared to appropriate for gestational age (AGA) fetuses, with a significant correlation for FGF21 and severity of reduced growth.
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Bisphenol A (BPA), a ubiquitous endocrine-disrupting chemical (EDC), is increasingly hypothesized to be a factor contributing to changes in fetal growth velocity. BPA exposure may be environmental, occupational, and/or dietary, with canned foods and plastic bottles contributing significantly. Our systematic review aims to evaluate the current literature and to investigate the role of BPA in abnormal fetal growth patterns.

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