Neonatal outcomes for women diagnosed with cancer during pregnancy — single-center study

Pregnancy complicated by cancer is one of the most serious challenges of modern perinatology. The increasing number of cancers diagnosed and treated during pregnancy requires a multidisciplinary approach to optimize the treatment of the person who is pregnant and deliver a healthy child. The aim of the study is to analyze the course of the neonatal period in children of mothers suffering from cancer during pregnancy, treated in a specialist hospital for women and children. Being diagnosed with cancer during pregnancy significantly increases the risk of premature delivery, prematurity and intrauterine growth restriction. Our own observations show no significant differences during the neonatal period in children of mothers suffering from a malignant tumor during pregnancy compared to children of healthy mothers. This applies to both full-term and premature babies. Modern treatment of malignant tumors during pregnancy seems to be safe for the fetus and newborn. It is optimal to conduct oncological, obstetric and neonatological treatment in one center. It seems advisable to conduct long-term follow-up observations in children of pregnant people with cancer. Since the described groups of patients and their newborns are small and heterogeneous, in order to develop appropriate standards, it is recommended to report these cases to central registers

Birth body length, birth body weight and birth head circumference in neonates born in a single centre between 2011 and 2016

   Objectives: Access to updated and accurate standards for local populations is important for the interpretation of body measurements in neonates and may have an impact on the doctor’s recommendations for monitoring early childhood development. Study aim: to present individual mean values for the most prevalent body measurements (i.e. birth body length (BBL), birth body weight (BBW) and birth head circumference (BHC)) in neonates and compare them to the duration of pregnancy. Material and methods: The measurements (BBL, BBW and BHC) were collected and analyzed from over 27,000 neonates born in a single center. All women with single pregnancies with gestation ranging from 33 to 42 weeks were included in the study. Results: Mean values and statistically significant standard deviation values from population standards of BBL, BBW, and BHC were evaluated for neonates that were born between the 33rd and 42nd week of gestation. Analysis was conducted for the lower limit (10th percentile), average (50th percentile) and upper limit (90th percentile). Conclusions: This was the first time in Polish literature when population standards were presented for three body meas­urements of neonates. With the size of the cohort, these standards can be successfully implemented into routine clinical practice, especially for screening children with body size deficits.

Zachowanie się dyspersji QT pod wpływem angioplastyki wieńcowej w chorobie niedokrwiennej serca

Wstęp: Dyspersja QT jest to zróżnicowanie czasu trwania odstępu QT w zapisie EKG. Wynika ona z niejednorodności procesu repolaryzacji. Zwraca się uwagę na występowanie groźnych dla życia arytmii komorowych i nagłego zgonu sercowego u pacjentów z chorobą niedokrwienną serca, u których obserwuje się zwiększoną dyspersję QT. Celem pracy była analiza dyspersji QT u pacjentów ze stabilną chorobą wieńcową przed zabiegiem angioplastyki wieńcowej w porównaniu z osobami zdrowymi oraz osobami z chorobą wieńcową po wykonaniu angioplastyki. Materiał i metody: Badaniem objęto 120 osób z potwierdzoną koronarograficznie stabilną chorobą wieńcową. Wszystkich chorych zakwafilikowano do zabiegu angioplastyki wieńcowej. Dyspersję odstępu QT oceniono na podstawie jednoczesnego 12-odprowadzeniowego standardowego zapisu EKG. Wnioski: Skuteczna rewaskularyzacja w stabilnej chorobie wieńcowej korzystnie wpływa na dyspersję QT. Niezależnie od liczby poszerzanych tętnic i ich rodzaju wpływ na dyspersję QT jest podobny. (Folia Cardiol. 2003; 10: 475–479

Zachowanie się dyspersji QT pod wpływem angioplastyki wieńcowej w chorobie niedokrwiennej serca

Wstęp: Dyspersja QT jest to zróżnicowanie czasu trwania odstępu QT w zapisie EKG. Wynika ona z niejednorodności procesu repolaryzacji. Zwraca się uwagę na występowanie groźnych dla życia arytmii komorowych i nagłego zgonu sercowego u pacjentów z chorobą niedokrwienną serca, u których obserwuje się zwiększoną dyspersję QT. Celem pracy była analiza dyspersji QT u pacjentów ze stabilną chorobą wieńcową przed zabiegiem angioplastyki wieńcowej w porównaniu z osobami zdrowymi oraz osobami z chorobą wieńcową po wykonaniu angioplastyki. Materiał i metody: Badaniem objęto 120 osób z potwierdzoną koronarograficznie stabilną chorobą wieńcową. Wszystkich chorych zakwafilikowano do zabiegu angioplastyki wieńcowej. Dyspersję odstępu QT oceniono na podstawie jednoczesnego 12-odprowadzeniowego standardowego zapisu EKG. Wnioski: Skuteczna rewaskularyzacja w stabilnej chorobie wieńcowej korzystnie wpływa na dyspersję QT. Niezależnie od liczby poszerzanych tętnic i ich rodzaju wpływ na dyspersję QT jest podobny. (Folia Cardiol. 2003; 10: 475–479

Health Effects of Carotenoids during Pregnancy and Lactation

Adequate nutrition is particularly important during pregnancy since it is needed not only for maintaining the health of the mother, but also determines the course of pregnancy and its outcome, fetus development as well as the child’s health after birth and during the later period of life. Data coming from epidemiological and interventions studies support the observation that carotenoids intake provide positive health effects in adults and the elderly population. These health effects are the result of their antioxidant and anti-inflammatory properties. Recent studies have also demonstrated the significant role of carotenoids during pregnancy and infancy. Some studies indicate a correlation between carotenoid status and lower risk of pregnancy pathologies induced by intensified oxidative stress, but results of these investigations are equivocal. Carotenoids have been well studied in relation to their beneficial role in the prevention of preeclampsia. It is currently hypothesized that carotenoids can play an important role in the prevention of preterm birth and intrauterine growth restriction. Carotenoid status in the newborn depends on the nutritional status of the mother, but little is known about the transfer of carotenoids from the mother to the fetus. Carotenoids are among the few nutrients found in breast milk, in which the levels are determined by the mother’s diet. Nutritional status of the newborn directly depends on its diet. Both mix feeding and artificial feeding may cause depletion of carotenoids since infant formulas contain only trace amounts of these compounds. Carotenoids, particularly lutein and zeaxanthin play a significant role in the development of vision and nervous system (among others, they are important for the development of retina as well as energy metabolism and brain electrical activity). Furthermore, more scientific evidence is emerging on the role of carotenoids in the prevention of disorders affecting preterm infants, who are susceptible to oxidative stress, particularly retinopathy of prematurity

Impact of Vitamin D Supplementation during Lactation on Vitamin D Status and Body Composition of Mother-Infant Pairs: A MAVID Randomized Controlled Trial

<div><p>Objective</p><p>The optimal vitamin D intake for nursing women is controversial. Deterioration, at least in bone mass, is reported during lactation. This study evaluated whether vitamin D supplementation during lactation enhances the maternal and infant’s vitamin D status, bone mass and body composition.</p><p>Design and Methods</p><p>After term delivery, 174 healthy mothers were randomized to receive 1200 IU/d (800 IU/d+400 IU/d from multivitamins) or 400 IU/d (placebo+400 IU/d from multivitamins) of cholecalciferol for 6 months while breastfeeding. All infants received 400 IU/d of cholecalciferol. Serum 25-hydroxyvitamin D [25(OH)D], iPTH, calcium, urinary calcium, and densitometry were performed in mother-offspring pairs after delivery, and at 3 and 6 months later.</p><p>Results</p><p>A total of 137 (79%) (n = 70; 1200 IU/d, n = 67; 400 IU/d) completed the study. 25(OH)D was similar in both groups at baseline (13.7 ng/ml vs. 16.1 ng/ml; <i>P = </i>0.09) and at 3 months (25.7 ng/ml vs. 24.5 ng/ml; <i>P</i> = 0.09), but appeared higher in the 1200 IU/d group at 6 months of supplementation (25.6 ng/ml vs. 23.1 ng/ml; <i>P</i> = 0.009). The prevalence of 25(OH)D <20 ng/ml was comparable between groups at baseline (71% vs. 64%, <i>P</i> = 0.36) but lower in the 1200 IU/d group after 3 months (9% vs. 25%, <i>P</i> = 0.009) and 6 months (14% vs. 30%, <i>P</i> = 0.03). Maternal and infants’ iPTH, calciuria, bone mass and body composition as well as infants’ 25(OH)D levels were not significantly different between groups during the study. Significant negative correlations were noted between maternal 25(OH)D and fat mass (R = −0.49, <i>P</i> = 0.00001), android fat mass (R = −0.53, <i>P</i> = 0.00001), and gynoid fat mass (R = −0.43, <i>P</i> = 0.00001) after 6 months of supplementation.</p><p>Conclusions</p><p>Vitamin D supplementation at a dose of 400 IU/d was not sufficient to maintain 25(OH)D >20 ng/ml in nursing women, while 1200 IU/d appeared more effective, but had no effect on breastfed offspring vitamin D status, or changes in the bone mass and the body composition observed in both during breastfeeding.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="http://clinicaltrials.gov/" target="_blank">NCT01506557</a></p></div

Maternal (A) and infants’ (B) vitamin D status.

<p>Percentage of participants with serum 25(OH)D level <20 ng/ml, 20–29.9 ng/ml and >30 ng/ml in both study groups (maternal vitamin D intake 400 IU/d vs. 1200 IU/d). Significant (<i>P<0.05</i>) differences between the study groups are shown on the figures.</p

Comparison of ITT population with participants lost to follow-up.

<p>Data are presented as median and interquartile range (Q1–Q3) or number and (%). <i>P-value</i><0.05 are highlighted.</p><p>Comparison of ITT population with participants lost to follow-up.</p

Maternal anthropometry and body composition throughout the study.

<p>Data presented as median (interquartile range: Q1–Q3). No significant differences between groups, all <i>P-value></i>0.05. (<i>BMD -</i> bone mineral density, less head BMD - total body less head mineral density, BMC -bone mineral content, less head BMC - total body less head mineral content, LBM - total lean body mass, BMI - body mass index, FM- total fat, android FM – android fat mass, gynoid FM – gynoid fat mass).</p><p>Maternal anthropometry and body composition throughout the study.</p