دکتر حمیرا وفایی

Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses. This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher’s exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden’s Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests. FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased. UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.

No vertical transmission has been reported for Severe Acute Respiratory Syndrome (SARS-CoV-2); Yet, Immunoglobulin G (IgG) antibody was detected against SARS-CoV-2 amongst infants. The present study aimed to compare maternal IgG antibody concentration from infected SARS-CoV-2 mothers to newborns in the 2nd and 3rd trimesters. As a secondary outcome, the interval between the onset of infection and delivery and COVID-19 severity were compared. An observational cohort study was conducted on COVID-19 positive pregnant women in the 2nd and 3rd trimesters in Fars province, Iran between 21 March and 22 October 2021. A questionnaire was completed to record background characteristics of the study participants. Real-time Reverse Transcription Polymerase Chain Reaction tests were taken from newborns immediately after birth to diagnose COVID-19. Maternal and cord blood specimen were taken to measure IgG concentrations; generalized linear models were used to report the crude and adjusted Rate Ratios with 95% confidence interval (cRR and aRR (95% C.I)), and IBM SPSS Statistics version 22 was used, at the significance level of 0.05. From 37 patients, 15 and 22 patients were in the 2nd and 3rd trimesters of pregnancy, respectively. After adjusting on maternal age, Cord IgG concentration was positively associated with maternal IgG concentration and interval between the onset of infection and delivery in the 3rd trimester (aRR (95% CI); 2.86 (2.27-3.6) and 1.23 (1.01-1.51)); however, no association was observed with COVID-19 severity (aRR (95% CI); 0.88 (0.09-8.66)). A positive association was also seen between high levels of cord IgG and maternal IgG (≥1.1 U/mL) (aRR (95% CI); 2.31 (1.05-5.09)). No significant associations were seen in the 2nd trimester of pregnancy (P>0.05 for all). In late pregnancy, Cord IgG concentration was positively associated with maternal IgG and interval between the onset of infection and delivery. Also, high levels of IgG antibody (≥1.1 U/mL) resulted in significantly higher level of cord IgG (≥1.1 U/mL).

Single umbilical artery (SUA) is found in 0.5-6% of all pregnancies, worldwide. Although the association of SUA with some of congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial.

This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well.

In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetus, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients’ medical records.

The prevalence of SUA was 3.47% (95% CI: 2.6-4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44-0.98).

A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard.

The placenta provides nutrients and oxygen to embryo and removes waste products from embryo’s blood. As far as we know, the effects of exposure to Wi-Fi (2.4 GHz) signals on placenta have not been evaluated. Hence, we examined the effect of prenatal exposure to Wi-Fi signals on anti-oxidant capacity, expressions of CDKNA1, and GADD45a as well as apoptosis in placenta and pregnancy outcome.

Pregnant mice were exposed to Wi-Fi signal (2.4 GHz) for 2 and 4 hr. Placenta tissues were examined to measure the MDA and SOD levels. To measure SOD, CDKNA1, GADD45a, Bax, and Bcl-2 expressions were compared by real-time PCR analysis. TUNEL assay was used to assess apoptosis in placenta tissues. The results were analyzed by one-way analysis of variance (ANOVA) using Prism version 6.0 software.

MDA and SOD levels had significantly increased in exposed Wi-Fi signal groups (P-value< 0.05). Also, quantitative PCR experiment showed that SOD mRNA expression significantly increased in Wi-Fi signal groups. The data showed that CDKN1A and GADD45a genes were increased in Wi-Fi groups (P-value<0.05). The quantitative PCR and the TUNEL assay showed that apoptosis increased in Wi-Fi groups (P-value<0.05).

Our results provide evidence that Wi-Fi signals increase lipid peroxidation, SOD activity (oxidative stres), apoptosis and CDKN1A and GADD45a overexpression in mice placenta tissue. However, further experimental studies are warranted to investigate other genes and aspects of pregnancy to determine the role of Wi-Fi radiation on fertility and pregnancy.