Exercise and outcomes in macrosomic pregnancies.

OBJECTIVE: Pregnancy is generally known to be a period when physical activity is partially or totally restricted to avoid negative outcomes such as miscarriage or premature birth. The aim of this study was to evaluate the effect on maternal and fetal outcomes of exercise in pregnancies complicated by macrosomia. MATERIAL AND METHOD: In this retrospective study, the data were retrospectively screened of women who gave birth at ≥38 weeks with infant birthweight of ≥4000 gr. The patients were separated into two groups as those who followed an exercise program of walking regularly for 30-60 mins at least 1 day a week throughout pregnancy and those who did not. The maternal and fetal complications were compared between the groups. A total of 252 patients were included in the study as 84 women who exercised during pregnancy and 168 women selected at random in the ratio of 2:1 who did not exercise. RESULTS: When the gestational week at birth was examined, a statistically significantly higher rate of patients in the non-exercise group gave birth at ≥40 gestational weeks. Although not at a statistically significant level, maternal and fetal complications were observed more in the non-exercise group. CONCLUSIONS: The results of this study showed that excessive maternal weight gain was statistically significantly reduced, and although not at a statistically significant level, maternal and fetal trauma were reduced in macrosomic pregnancies with regular exercise. As recommended by ACOG, for pregnant women at risk of macrosomic fetus, exercise of walking for 30-60 mins several days a week will have positive effects on both the mother and infant.

Effect of the anterior uterocervical angle in unexplained infertility: a prospective cohort study.

OBJECTIVE: The present study aimed to evaluate an anatomical region, the anterior uterocervical angle (UCA), to determine whether it plays a role in unexplained infertility. METHODS: In this prospective, cross-sectional study, unexplained infertile and healthy fertile (controls) women were compared. The longitudinal and transverse axes of the uterine cervix and uterine corpus were measured by transvaginal ultrasonography. The UCA was determined as the angle between two lines. One line was drawn between the internal and the external os, and the other was drawn through the internal cervical os and was parallel to the lower side of the front part of the uterine wall in the internal os. Demographic characteristics and uterocervical ultrasonographic measurements were compared between the two groups. RESULTS: Eighty participants, aged from 20 to 35 years, were enrolled (unexplained infertile [n = 30] and healthy fertile women [n = 50)]. The mean lengths of the uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were similar between the groups. The mean UCA was significantly higher in healthy fertile women (131.9 ± 22.9 degrees) than in women with unexplained infertility (114.2 ± 17.3 degrees). CONCLUSION: The present study shows that a narrow anterior UCA is associated with unexplained infertility.

The Effect of Iron Deficiency Anemia Early in the Third Trimester on Small for Gestational Age and Birth Weight: A Retrospective Cohort Study on Iron Deficiency Anemia and Fetal Weight.

AIM: The aim of the present study was to evaluate the relationship between iron deficiency anemia and small for gestational age (SGA) in early third trimester pregnancies. METHODS: A total of 4800 pregnant women who met the inclusion criteria were analyzed retrospectively. We included pregnant women who had iron deficiency anemia between 26+0 and 30+0 weeks of gestation and delivered singletons between 37+0 and 41+6 weeks of gestation. Patients were divided into four groups according to anemia level: (1) hemoglobin (Hb) < 7 mg/dl (n = 80), (2) Hb 7-9.9 mg/dl (n = 320), (3) Hb 10-10.9 mg/dl (n = 1300), and (4) Hb > 11 mg/dl (n = 3100, control group). The primary outcome of this study was the presence of SGA. RESULTS: The demographic and obstetric characteristics were similar among all the groups. Maternal age, BMI <30 kg/m2, nulliparity rates, and previous cesarean delivery rates were similar among groups. Ethnicity was significantly different in the severe and moderate anemia groups (<0.001). Mean fetal weight was 2900 ± 80 g in the severe anemia group, 3050 ± 100 g in the moderate anemia group, 3350 ± 310 g in the mild anemia group, and 3400 ± 310 g in the control group. Fetal weight was significantly lower in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). The SGA rate was 18.7% in the severe anemia group, 12.1% in the moderate anemia group, 5.3% in the mild anemia group, and 4.9% in the control group. SGA was significantly higher in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). CONCLUSION: The results of this study indicated that early third trimester severe and moderate iron deficiency anemia was associated with SGA. Iron deficiency anemia in pregnant women may lead to low birth weight.

The Effect of Immigration on Adverse Perinatal Outcomes: Analysis of Experiences at a Turkish Tertiary Hospital.

INTRODUCTION: In literature, it is well documented that migration is associated with adverse perinatal outcomes in many countries over the world. But in Turkey, health care providers and obstetricians had to face the effects of migration for the first time after civil war in Syria. Hence, this situation motivated us to conduct the current research in Turkey. Also we aimed to evaluate the effect of immigration on adverse perinatal outcomes, comparing the obstetric results of a native population and an immigrant population, and focusing on relevant indicators of perinatal health. METHODS: Information from the hospital database of pregnant women who had vaginal or cesarean delivery was evaluated. The patients were divided into two groups, native women and immigrant women, according to their ethnic origin. Adverse perinatal outcomes were compared between groups using multivariate regression models. Adjusted odds ratio (aOR) and 95% confidence interval (CI) were calculated. RESULTS: A total of 6311 patients were evaluated, of which 4271 were classified as native and 2040 were classified as immigrants. Mean hemoglobin level before delivery was significantly lower in the immigrant group. Preterm delivery (aOR: 1.41; 95% CI: 1.19-1.65), stillbirth (aOR: 1.88; 95% CI: 1.09-3.23), red blood cell transfusion requirement (aOR: 3.12; 95% CI: 2.02-3.98), unplanned birth rates before hospital arrival (aOR: 2.25; 95% CI: 1.53-3.31), and postpartum infection rates (aOR:2.12; 95% CI: 1.48-3.08) were significantly increased in the immigrant group compared with native group, even considering adjustment for potential confounders. CONCLUSION: The immigration may be an important and independent risk factor for some adverse maternal and neonatal outcomes.