Risks of pregnancy and birth in obese primiparous women: an analysis of German perinatal statistics

Purpose: To compare risks of pregnancy and birth in obese (body mass index, BMI≥30) and normal weight women (BMI 18.5-24.99) giving birth to their first child. Methods: We analysed data of 243,571 pregnancies in primiparous women from the German perinatal statistics of 1998-2000. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) for selected pregnancy and birth risks. ORs were adjusted for the confounding factors age, smoking status, single mother status, and maternal education. Results: Obesity during pregnancy is common in primiparous women (n=19,130; 7.9% of all cases) and it is significantly associated with a number of risks of pregnancy and birth, including diabetes [OR 3.71 (95% CI 2.93; 4.71); p<0.001], hypertension [OR 8.44 (7.91; 9.00); p<0.001], preecalmpsia/eclampsia [OR 6.72 (6.30; 7.17); p<0.001], intraamniotic infection [OR 2.33 (2.05; 2.64); p<0.001], birth weight ≥4,000g [OR 2.16 (2.05; 2.28); p<0.001], and an increased rate of Caesarean section [OR 2.23 (2.15; 2.30); p<0.001]. Some risks were less frequent in the obese such as cervical incompetence [OR 0.55 (0.48; 0.63); p<0.001] and preterm labour [OR 0.47 (0.43; 0.51); p<0.001]. Conclusions: Obesity during pregnancy is an important clinical problem in primiparous women because it is common and it is associated with a number of risks of pregnancy and birth. Because of these increased risks, obese women need special attention clinically during the course of their first pregnancy. Weight reduction before the first pregnancy is generally indicated in obese women to prevent the above-mentioned complications of pregnancy and birt

Risks of pregnancy and birth in obese primiparous women: an analysis of German perinatal statistics

PURPOSE: To compare risks of pregnancy and birth in obese (body mass index, BMI ≥ 30) and normal weight women (BMI 18.5–24.99) giving birth to their first child. METHODS: We analysed data of 243,571 pregnancies in primiparous women from the German perinatal statistics of 1998–2000. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) for selected pregnancy and birth risks. ORs were adjusted for the confounding factors age, smoking status, single mother status, and maternal education. RESULTS: Obesity during pregnancy is common in primiparous women (n = 19,130; 7.9% of all cases) and it is significantly associated with a number of risks of pregnancy and birth, including diabetes [OR 3.71 (95% CI 2.93; 4.71); p &lt; 0.001], hypertension [OR 8.44 (7.91; 9.00); p &lt; 0.001], preecalmpsia/eclampsia [OR 6.72 (6.30; 7.17); p &lt; 0.001], intraamniotic infection [OR 2.33 (2.05; 2.64); p &lt; 0.001], birth weight ≥4,000 g [OR 2.16 (2.05; 2.28); p &lt; 0.001], and an increased rate of Caesarean section [OR 2.23 (2.15; 2.30); p &lt; 0.001]. Some risks were less frequent in the obese such as cervical incompetence [OR 0.55 (0.48; 0.63); p &lt; 0.001] and preterm labour [OR 0.47 (0.43; 0.51); p &lt; 0.001]. CONCLUSIONS: Obesity during pregnancy is an important clinical problem in primiparous women because it is common and it is associated with a number of risks of pregnancy and birth. Because of these increased risks, obese women need special attention clinically during the course of their first pregnancy. Weight reduction before the first pregnancy is generally indicated in obese women to prevent the above-mentioned complications of pregnancy and birth

Community engagement and data quality: best practices and lessons learned from a citizen science project on birdsong

Citizen Science (CS) is a research approach that has become popular in recent years and offers innovative potential for dialect research in ornithology. As the scepticism about CS data is still widespread, we analysed the development of a 3-year CS project based on the song of the Common Nightingale (Luscinia megarhynchos) to share best practices and lessons learned. We focused on the data scope, individual engagement, spatial distribution and species misidentifications from recordings generated before (2018, 2019) and during the COVID-19 outbreak (2020) with a smartphone using the ‘Naturblick’ app. The number of nightingale song recordings and individual engagement increased steadily and peaked in the season during the pandemic. 13,991 nightingale song recordings were generated by anonymous (64%) and non-anonymous participants (36%). As the project developed, the spatial distribution of recordings expanded (from Berlin based to nationwide). The rates of species misidentifications were low, decreased in the course of the project (10–1%) and were mainly affected by vocal similarities with other bird species. This study further showed that community engagement and data quality were not directly affected by dissemination activities, but that the former was influenced by external factors and the latter benefited from the app. We conclude that CS projects using smartphone apps with an integrated pattern recognition algorithm are well suited to support bioacoustic research in ornithology. Based on our findings, we recommend setting up CS projects over the long term to build an engaged community which generates high data quality for robust scientific conclusions.Gesellschaftliches Engagement und Datenqualität: Bewährte Praktiken und Erfahrungen aus einem bürgerwissenschaftlichen Projekt zum Vogelgesang Citizen Science (CS) ist eine Forschungsmethode, die in den letzten Jahren an Bedeutung gewonnen hat und innovatives Potenzial für die Dialektforschung in der Ornithologie bietet. Da die Vorbehalte gegenüber CS-Daten immer noch weit verbreitet sind, haben wir die Entwicklung eines dreijährigen CS-Projekts zum Gesang der Nachtigall (Luscinia megarhynchos) analysiert, um bewährte Praktiken und gewonnene Erfahrungen darzustellen. Wir fokussierten uns auf den Datenumfang, das individuelle Engagement von Teilnehmenden, die räumliche Verteilung und die Fehlbestimmungen von Arten aus Aufnahmen, die vor (2018, 2019) und während des COVID-19-Ausbruchs (2020) mit einem Smartphone unter Verwendung der "Naturblick" App erstellt wurden. Die Anzahl der Aufnahmen von Nachtigallgesängen und das individuelle Engagement stiegen stetig an und erreichten ihren Höhepunkt in der Saison während der Pandemie. 13.991 Aufnahmen von Nachtigallgesängen wurden von anonymen (64%) und nicht-anonymen Teilnehmenden (36%) erstellt. Im Laufe des Projekts weitete sich die räumliche Verteilung der Aufnahmen aus (von Berlin auf bundesweit). Die Rate der Fehlbestimmungen war gering, ging im Laufe des Projekts zurück (von 10% auf 1%) und wurde hauptsächlich von gesanglichen Ähnlichkeiten mit anderen Vogelarten beeinflusst. Unsere Studie zeigte außerdem, dass das gesellschaftliche Engagement und die Datenqualität nicht direkt von den durchgeführten Disseminationsaktivitäten beeinflusst wurden, sondern dass erstere von externen Faktoren abhingen und letztere von der App profitierte. Wir schließen daraus, dass CS-Projekte, die Smartphone-Apps mit einem integrierten Mustererkennungsalgorithmus verwenden, gut geeignet sind, um die bioakustische Forschung in der Ornithologie zu unterstützen. Auf der Grundlage unserer Ergebnisse empfehlen wir, CS-Projekte langfristig zu etablieren, um eine aktive Teilnehmergemeinschaft (Community) aufzubauen, die qualitativ hochwertige Daten für fundierte wissenschaftliche Schlussfolgerungen generiert

Coupling aerosols to (cirrus) clouds in the global EMAC-MADE3 aerosol–climate model

A new cloud microphysical scheme including a detailed parameterization for aerosol-driven ice formation in cirrus clouds is implemented in the global ECHAM/MESSy Atmospheric Chemistry (EMAC) chemistry–climate model and coupled to the third generation of the Modal Aerosol Dynamics model for Europe adapted for global applications (MADE3) aerosol submodel. The new scheme is able to consistently simulate three regimes of stratiform clouds – liquid, mixed-, and ice-phase (cirrus) clouds – considering the activation of aerosol particles to form cloud droplets and the nucleation of ice crystals. In the cirrus regime, it allows for the competition between homogeneous and heterogeneous freezing for the available supersaturated water vapor, taking into account different types of ice-nucleating particles, whose specific ice-nucleating properties can be flexibly varied in the model setup. The new model configuration is tuned to find the optimal set of parameters that minimizes the model deviations with respect to observations. A detailed evaluation is also performed comparing the model results for standard cloud and radiation variables with a comprehensive set of observations from satellite retrievals and in situ measurements. The performance of EMAC-MADE3 in this new coupled configuration is in line with similar global coupled models and with other global aerosol models featuring ice cloud parameterizations. Some remaining discrepancies, namely a high positive bias in liquid water path in the Northern Hemisphere and overestimated (underestimated) cloud droplet number concentrations over the tropical oceans (in the extratropical regions), which are both a common problem in these kinds of models, need to be taken into account in future applications of the model. To further demonstrate the readiness of the new model system for application studies, an estimate of the anthropogenic aerosol effective radiative forcing (ERF) is provided, showing that EMAC-MADE3 simulates a relatively strong aerosol-induced cooling but within the range reported in the Intergovernmental Panel on Climate Change (IPCC) assessments

The impact of episporic modification of Lichtheimia corymbifera on virulence and interaction with phagocytes

Fungal infections caused by the ancient lineage Mucorales are emerging and increasingly reported in humans. Comprehensive surveys on promising attributes from a multitude of possible virulence factors are limited and so far, focused on Mucor and Rhizopus. This study addresses a systematic approach to monitor phagocytosis after physical and enzymatic modification of the outer spore wall of Lichtheimia corymbifera, one of the major causative agents of mucormycosis. Episporic modifications were performed and their consequences on phagocytosis, intracellular survival and virulence by murine alveolar macrophages and in an invertebrate infection model were elucidated. While depletion of lipids did not affect the phagocytosis of both strains, delipidation led to attenuation of LCA strain but appears to be dispensable for infection with LCV strain in the settings used in this study. Combined glucano-proteolytic treatment was necessary to achieve a significant decrease of virulence of the LCV strain in Galleria mellonella during maintenance of the full potential for spore germination as shown by a novel automated germination assay. Proteolytic and glucanolytic treatments largely increased phagocytosis compared to alive resting and swollen spores. Whilst resting spores barely (1-2%) fuse to lysosomes after invagination in to phagosomes, spore trypsinization led to a 10-fold increase of phagolysosomal fusion as measured by intracellular acidification. This is the first report of a polyphasic measurement of the consequences of episporic modification of a mucormycotic pathogen in spore germination, spore surface ultrastructure, phagocytosis, stimulation of Toll-like receptors (TLRs), phagolysosomal fusion and intracellular acidification, apoptosis, generation of reactive oxygen species (ROS) and virulence

Investigation of the association of Apgar score with maternal socio-economic and biological factors: an analysis of German perinatal statistics

PURPOSE: To examine the relationship of 5-min Apgar score with maternal socio-economic and biological factors. METHODS: We analyzed data from 465,964 singleton pregnancies (37–41 weeks’ gestation) from the German perinatal statistics of 1998–2000. Using a logistic regression model we analyzed the incidence of low (0–6) 5-min Apgar scores in relation to these maternal factors: body mass index (BMI), age, previous live births, country of origin, occupation, single mother status, working during pregnancy, and smoking. RESULTS: A low Apgar score was more common in overweight [adjusted odds ratio (OR) 1.24; 95% confidence interval (CI) 1.10–1.40; P &lt; 0.001] and obese [OR 1.92 (95% CI 1.67–2.20); P &lt; 0.001] compared to normal weight women. A low Apgar score was also more common for women aged &gt;35 years compared to those aged 20–35 years [OR 1.35 (95% CI 1.16–1.58); P &lt; 0.001]. Furthermore, odds of a low Apgar score were higher for women with no previous live births compared to those with one or more previous live births [OR 1.52 (95% CI 1.37–1.70); P &lt; 0.001]. Socio-economic factors did not convincingly influence Apgar scores. CONCLUSIONS: There was an influence of the biological maternal factors age, BMI, and parity on the 5-min Apgar score. There was no convincing effect of socio-economic factors on Apgar score in our study population. Possible reasons for this are discussed