New imaging markers for preconceptional and first-trimester utero-placental vascularization

Introduction: The availability of imaging makers of early placental circulation development is limited. This study aims to develop a reliable and accurate method to assess preconceptional and early first-trimester utero-placental vascular volumes using three-dimensional power Doppler ultrasound (3D PD US) on two different Virtual Reality (VR) systems. Methods: 3D PD US images of the uterine and placental vasculature were obtained in 35 women, either preconceptionally (n=5), or during pregnancy at 7 (n=10), 9 (n=10) or 11 (n=10) weeks of gestation. Preconceptional uterine vascular volume (UVV), and first-trimester placental vascular volume (PVV) and embryonic vascular volume (EVV) were measured by two observers on two VR systems, i.e., a Barco I-Space and VR desktop. Intra- and inter-observer agreement and intersystem agreement were assessed by intra-class correlation coefficients (ICC) and absolute and relative differences. Results: Uterine- , fetal- and placental vascular volume measurements showed good to excellent intra- and inter-observer agreement and inter-system reproducibility with most ICC above 0.80 and relative differences of less than 20% preconceptionally and almost throughout the entire gestational age range. Inter-observer agreement of PVV at 11 weeks gestation was suboptimal (ICC 0.69, relative difference 50.1%). Discussion: Preconceptional and first-trimester 3D PD US utero-placental and fetal vascular volume measurements using VR are feasible and reliable. Longitudinal cohort studies with repeated measurements are needed to further validate these this and assess their value as new imaging markers for placental vascular development and ultimately for the prediction of placenta-related pregnancy complications.This research was funded by the Department of Obstetrics and Gynecology of the Erasmus MC, University Medical Centre, Rotterdam, The Netherlands

Preconception nutritional intake and lifestyle factors: First results of an explorative study

Objective: To describe nutritional intake and lifestyle factors in women planning pregnancy. Study design: A semi-quantitative, 1-month food frequency questionnaire and a questionnaire on health practices and personal views were filled out at home and verified by telephone interview. Results: One hundred and one women agreed to participate and data of 69 women were eligible for evaluation. Women planning pregnancy (n=46) consumed significantly more saturated fats and proteins, less carbohydrates and higher median intakes of Vitamin A, thiamin, riboflavin, calcium, selenium, magnesium and iron than controls (n=23; P<0.05). However, the percentage of women

A Mobile App Lifestyle Intervention to Improve Healthy Nutrition in Women Before and During Early Pregnancy

BACKGROUND: Unhealthy nutrition contributes to the worldwide rising prevalence of noncommunicable diseases. As most adverse reproductive outcomes originate during the periconception period, effective interventions targeting this period are needed. Therefore, we developed the lifestyle intervention Smarter Pregnancy to empower women to adapt a healthy diet prior to conception and during early pregnancy and performed a randomized controlled trial. OBJECTIVE: The objectives of this trial were to investigate compliance and effectiveness in women using the Smarter Pregnancy program. METHODS: Women aged between 18 and 45 years who were contemplating pregnancy or <13 weeks pregnant and their male partners living in the urban area of Rotterdam, the Netherlands, were eligible for participation. After baseline screening, the intervention group received personal online coaching based on identified inadequate intakes of vegetables, fruits, and folic acid supplements. The sum of these risk factors was used as a dietary risk score (DRS), ranging from 0 (healthy) to 9 (unhealthy). The control group did not receive coaching. We applied an intention-to-treat principle and used a multivariable linear regression model to evaluate the change in DRS after 24 weeks. Compliance was defined as the percentage of women who completed the screening questionnaire at 24 weeks. RESULTS: Of women recruited, 81.2% (177/218) completed the program (intervention: 91/218, 83.5%; control: 86/218, 78.9%; P=.95). After 24 weeks, the reduction in DRS of women in the intervention group was significantly larger than in the control group (β=.75, 95% CI 0.18-1.34). This reduction was mainly due to increased vegetable intake (β=.55, 95% CI 0.25-0.86). CONCLUSIONS: The high compliance and the larger improvements in nutritional behaviors, especially vegetable intake, in women in the intervention group emphasizes the effectiveness of empowering women by using the lifestyle change intervention Smarter Pregnancy. TRIAL REGISTRATION: Netherlands Trial Register: NL3927; https://www.trialregister.nl/trial/3927. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12884-017-1228-5

Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands

Objectives Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in the Netherlands. The purpose of this study was to identify facilitators and barriers for implementation of interconception care in Preventive Child Health Care services. Methods We organized four focus groups in which Preventive Child Health Care physicians and nurses, related health care professionals and policymakers participated. A semi-structured interview approach was used to guide the discussion. The transcribed discussions were analyzed. Results All four groups agreed that several facilitators are present, such as the unique position to reach women and the expertise in preventive health care. Identified barriers include unfamiliarity with interconception care among patients and health care providers, as well as lack of consensus about the concept of interconception care and how it should be organized. A broad educational campaign, local adaptation, and general agreement or a guideline for standard procedures were recognized as important for future implementation. Conclusionsfor practice This study identifies potentially important facilitators and barriers for the implementation of interconception care in Preventive Child Health Care services or comparable pediatric settings. These factors should be considered and strategies developed to achieve successful implementation of interconception care

Towards segmentation and spatial alignment of the human embryonic brain using deep learning for atlas-based registration

We propose an unsupervised deep learning method for atlas based registration to achieve segmentation and spatial alignment of the embryonic brain in a single framework. Our approach consists of two sequential networks with a specifically designed loss function to address the challenges in 3D first trimester ultrasound. The first part learns the affine transformation and the second part learns the voxelwise nonrigid deformation between the target image and the atlas. We trained this network end-to-end and validated it against a ground truth on synthetic datasets designed to resemble the challenges present in 3D first trimester ultrasound. The method was tested on a dataset of human embryonic ultrasound volumes acquired at 9 weeks gestational age, which showed alignment of the brain in some cases and gave insight in open challenges for the proposed method. We conclude that our method is a promising approach towards fully automated spatial alignment and segmentation of embryonic brains in 3D ultrasound

Smoking cessation in early-pregnancy, gestational weight gain and subsequent risks of pregnancy complications

OBJECTIVE: Smoking cessation is associated with weight gain. We first examined the associations of smoking cessation in early-pregnancy with gestational weight gain and subsequently evaluated the risks of pregnancy complications among women who quit smoking in early-pregnancy according to their gestational weight gain. METHODS: In a population-based prospective cohort study among 7,389 women, we measured weight in each pregnancy period. Information on smoking and pregnancy complications was obtained from questionnaires and medical records. RESULTS: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy was not associated with gestational weight gain. Smoking cessation in early-pregnancy was associated with decreased risks of delivering small-for-gestational-age infants (Odds Ratio (OR) 0.52 (95% Confidence Interval (CI) 0.37, 0.75)), but with increased risks of pre-eclampsia (OR 2.07 (95 % CI 1.01, 4.27)) and delivering large-for-gestational-age infants (OR 2.11 (95 % CI 1.45, 3.09)). Among women who quit smoking in early-pregnancy with >12 kg weight gain, the risks of pre-eclampsia and delivering large-for-gestational-age infants were slightly increased. CONCLUSION: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy is not associated with increased gestational weight gain. Among women who quit smoking in early-pregnancy, higher gestational weight gain does not strongly affect their risks of pregnancy complications

Оценка человеческого капитала промышленного предприятия в условиях инновационного развития

Запропоновано методичний підхід до оцінки людського капіталу промислового підприємства для різних видів інновацій. Обґрунтовано вибір методів оцінки елементів людського капіталу для різних категорій персоналу промислового підприємства. Ключові слова: оцінка, людський капітал, метод, вид інновації, елемент.Предложен методический подход к оценке человеческого капитала промышленного предприятия для различных видов инноваций. Обоснован выбор методов оценки элементов человеческого капитала для различных категорий персонала промышленного предприятия. Ключевые слова: оценка, человеческий капитал, метод, вид инновации, элемент.The methodical approach to evaluation of an industrial enterprise’s human capital under different types of innovations is offered. The choice of methods for evaluating human capital’s elements is grounded considering different categories of personnel of the industrial enterprise. Keywords: evaluation, human capital, method, type of innovations, element