Maternal telomere length is shorter in intrauterine growth restriction versus uncomplicated pregnancies, but not in the offspring or in IVF-conceived newborns.

RESEARCH QUESTION: The study aimed to determine whether IVF or intrauterine growth restriction (IUGR) result in short neonatal telomeres, which could explain the higher risk of cardiovascular and metabolic disease described in these populations. DESIGN: This was an observational, analytical, cross-sectional, prospective study with controls in a tertiary hospital. The main outcome was to determine the leukocyte telomere length in 126 newborns and their mothers (n = 109). Newborns were conceived spontaneously or by IVF, and uncomplicated and IUGR pregnancies were studied. Telomere lengths were measured using high-throughput telomere quantitative fluorescent in-situ hybridization. RESULTS: There was no difference in average telomere length between newborns conceived by IVF or those with IUGR and spontaneously conceived healthy newborns (P = 0.466 and P = 0.732, respectively); this remained after controlling for confounders (P = 0.218 and P = 0.991, respectively). Mothers of newborns with IUGR had a shorter average telomere length than women with uncomplicated pregnancies (P = 0.023), which was confirmed after controlling for age, body mass index and smoking habit (P = 0.034). CONCLUSIONS: The results support the safety of IVF and IUGR in terms of the postnatal health of the newborns. The shorter telomeres of IUGR mothers may represent a higher cardiovascular risk, which would have clinical implications under the stress of pregnancy in otherwise healthy adults.

Prediction of labor onset type: Spontaneous vs induced; role of electrohysterography?

BACKGROUND AND OBJECTIVE: Induction of labor (IOL) is a medical procedure used to initiate uterine contractions to achieve delivery. IOL entails medical risks and has a significant impact on both the mother's and newborn's well-being. The assistance provided by an automatic system to help distinguish patients that will achieve labor spontaneously from those that will need late-term IOL would help clinicians and mothers to take an informed decision about prolonging pregnancy. With this aim, we developed and evaluated predictive models using not only traditional obstetrical data but also electrophysiological parameters derived from the electrohysterogram (EHG). METHODS: EHG recordings were made on singleton term pregnancies. A set of 10 temporal and spectral parameters was calculated to characterize EHG bursts and a further set of 6 common obstetrical parameters was also considered in the predictive models design. Different models were implemented based on single layer Support Vector Machines (SVM) and with aggregation of majority voting of SVM (double layer), to distinguish between the two groups: term spontaneous labor (≤41 weeks of gestation) and IOL late-term labor. The areas under the curve (AUC) of the models were compared. RESULTS: The obstetrical and EHG parameters of the two groups did not show statistically significant differences. The best results of non-contextualized single input parameter SVM models were achieved by the Bishop Score (AUC= 0.65) and GA at recording time (AUC= 0.68) obstetrical parameters. The EHG parameter median frequency, when contextualized with the two obstetrical parameters improved these results, reaching AUC= 0.76. Multiple input SVM obtained AUC= 0.70 for all EHG parameters. Aggregation of majority voting of SVM models using contextualized EHG parameters achieved the best result AUC= 0.93. CONCLUSIONS: Measuring the electrophysiological uterine condition by means of electrohysterographic recordings yielded a promising clinical decision support system for distinguishing patients that will spontaneously achieve active labor before the end of full term from those who will require late term IOL. The importance of considering these EHG measurements in the patient's individual context was also shown by combining EHG parameters with obstetrical parameters. Clinicians considering elective labor induction would benefit from this technique.

Effect of delayed umbilical cord clamping on blood gas analysis.

OBJECTIVE: To ascertain if there are differences in umbilical cord blood gas analysis between immediate and delayed cord clamping. STUDY DESIGN: In a prospective observational study on 60 vaginally delivered healthy term newborns, we sampled umbilical cord blood immediately after delivery and at the time umbilical cord pulsation spontaneously ceased. RESULTS: There were significant decreases in pH, oxygen saturation (sO(2)), glycemia, oxygen content (ctO(2)), bicarbonate (HCO(3)(-)) and base excess (BE). Lactate and [Formula: see text] increased. Delayed cord clamping pH correlated with immediate cord clamping pH, [Formula: see text] , ctHb, sO(2) and time (r(2)=0.77, p<0.000). Delayed cord clamping lactate was associated with immediate cord clamping lactate and time (r(2)=0.83, p<0.000). Delayed BE was associated with previous pH, lactate, glycemia, ctHb and time (r(2)=0.83, p<0.000). CONCLUSIONS: Delayed cord clamping alters acid-base parameters and lactate values compared to immediate cord clamping. Those variations depend mainly on time, prior pH and lactate.