We will discuss a recent case of unexplained neonatal cyanosis, evaluate its origin, clinical presentation, diagnosis, and treatment, and share with you some of our clinical insights. We report a transient cyanosis in a newborn due to a mutation in the globulin gene (HBG2), as well as diagnosis and treatment. Clinically, the infant was in good overall health, and despite low oxygen saturation, the arterial oxygen partial pressure was always normal. Early respiratory support includes mechanical ventilation, nasal tube oxygen, and eventually stopping oxygen therapy. With the above treatment measures, the blood oxygen saturation of the child always fluctuated at 85%, but the arterial blood oxygen partial pressure was up to 306 mmHg. Further improvement of laboratory tests revealed elevated methemoglobin levels, reticulocytosis, mild anemia, and basically normal on chest x-ray and echocardiography. To clarify the etiology, WES testing was performed. The results showed heterozygous variation in HBG2 gene (c.190C>T. p.H64Y). There is heterozygous variation at this site in the proband father, and no variation at this site in the proband mother. Given the age of the affected infants, we hypothesized that the mutation originated in the gamma peptide chain of the head protein. The baby was discharged from the hospital 10 days after birth, with blood oxygen saturation fluctuating around 90%. The cyanosis disappeared 2 months after discharge, and the blood oxygen saturation level returned to normal.

Reports on the influence of postnatal cytomegalovirus (pCMV) infection in neonatal outcomes of preterm babies vary while guidance on management including screening is lacking. We aim to determine the association between symptomatic pCMV infection and chronic lung disease (CLD) and mortality in preterm infants born less than 32 weeks gestation.
We used data from the Neonatal Intensive Care Units\' (NICUS) population-based prospective data registry of infants in 10 neonatal units in New South Wales and the Australian Capital Territory, Australia. De-identified perinatal and neonatal outcome data for 40,933 infants were examined. We identified 172 infants <32 weeks gestation with symptomatic pCMV infection. Each was matched with one control infant.
Infants with symptomatic pCMV infection were 2.7 times more likely to develop CLD (OR 2.7, 95% CI: 1.7-4.5) and spend 25.2 days more in hospital (95% CI: 15.2-35.2). Seventy-five percent (129/172) of infants with symptomatic pCMV were extremely preterm (<28 weeks). The mean age of symptomatic pCMV diagnosis was 62.5 ± 20.5 days or 34.7 ± 3.6 weeks-corrected gestational age. Ganciclovir treatment did not decrease CLD and death. CLD was 5.5 times predictive of death in patients with symptomatic pCMV infection. Symptomatic pCMV infection did not influence mortality nor increase neurologic impairment.
Symptomatic pCMV is a modifiable factor affecting extreme preterm infants with significant impact on CLD. Prospective study on screening and treatment will help unveil potential benefits in our already at-risk preterm infants.

Data from the literature show that prolonged-release injectable antipsychotics (LAIs) ensure constant blood drug levels better patient compliance and offer a simpler treatment regimen for both patients and caregivers. This observational-descriptive study aims to detect the possible complications found in newborns of women with bipolar or psychotic disorders and LAI therapy during pregnancy.
This study involved women with psychotic disorders during pregnancy who contacted the Teratology Information Center of Bergamo, Italy between 2016 and 2021 to receive counseling on the possible risks of exposure to LAI therapy. The follow-up procedure was carried out by telephone interview or direct contact with the patient and/or her physician.
In this study, LAI treatment in pregnancy was not associated with an increased risk of malformations. All but one of the children in the sample were born healthy and the mothers maintained psychopathological compensation during pregnancy.
This study showed that, despite the small size of the sample under examination, the administration of LAIs do not compromise the normal intrauterine development of the unborn child and there were no evident major malformations.

BACKGROUND: Hysteroscopic septum dissection (HSD) is thought to improve fertility and pregnancy outcomes. However, the available literature suggests that uterine surgery can cause placental abnormalities in subsequent pregnancies.
METHODS: A case-control study was performed at the University Medical Center of Ljubljana, Department of Human Reproduction, from 1 January 2016 to 31 December 2018. The primary outcome was the association between HSD and the occurrence of placental abnormalities. We included women who underwent HSD due to infertility. Age-matched women who underwent hysteroscopic surgery for other issues were considered as controls. In addition, we divided the groups according to conception method. Only singleton pregnancies and first delivery were considered.
RESULTS: A total of 1286 women (746 who underwent HSD and 540 controls) were included in the analysis. HSD had no influence on placental abnormalities since the ratio was comparable regardless of the method of conception (113/746 vs. 69/540; p = 0.515). Infertile women who conceived naturally after HSD had a normal placentation rate comparable to women who did not undergo HSD (380/427 vs. 280/312; p = 0.2104). The rate of placental abnormalities in women who achieved pregnancy with IVF/ICSI procedures following HSD was comparable to that of women who did not undergo HSD (52/319 vs. 33/228; p = 0.5478). Placenta previa occurred significantly more often in infertile women without HSD after IVF/ICSI compared to natural conception (2/312 vs. 7/228; p = 0.0401).
CONCLUSIONS: HSD was not associated with higher rate of placental abnormalities in the first singleton pregnancy compared with other hysteroscopic procedures. A higher rate of placenta previa in pregnancies following IVF/ICSI procedures, which was shown by our research, is corroborated by previous research findings.

UNASSIGNED: This study aims to evaluate neonatal and children growth outcomes of cryotransfer of embryos developed from frozen gametes [double frozen transfer (DFT)].
UNASSIGNED: This nested case-control study included 6,705 women who had a singleton live birth after embryo transfer at the Center for Reproductive Medicine, Shandong University, from 2008 to 2020. Of these, 745 women underwent frozen embryo transfer (FET) using embryos developed from frozen gametes (DFT). Propensity score methodology was used to balance the two groups by maternal age and body mass index (BMI) before evaluating outcomes. After age and BMI were matched using the propensity score methodology in a ratio of 1:4, the control groups enrolled 2,980 women who underwent fresh embryo transfer (ET) and 2,980 women underwent FET from fresh gametes. The children born were followed to at least 5 years of age, and some were followed up to 10 years. Neonatal outcomes and childhood growth measurements were compared among the three groups.
UNASSIGNED: The average birth weight of the DFT group (3,462 g) was significantly higher than the FET group (3,458 g) and ET group (3,412 g). The rate of large for gestational age (LGA) babies in the DFT and FET group was higher than that for the ET group (30.9% vs. 24.8%; 29.4% vs. 24.8%, respectively). After adjusting for different confounder combinations in the three models, the birth weight and risk of LGA in the DFT and FET groups were still higher than in the ET group, and the values group of P for trend in the models were significant. In multiple linear regression analysis of the children\'s development, the height Z-score of children born from the DFT and FET group was higher than that for children from the ET group (β = 0.21, 95% CI 0.07-0.35; b = 0.17, 95% CI 0.05-0.28, respectively). However, childhood growth measurements including body weight Z-score and BMI Z-score were not significantly different among the three groups. In addition, the proportion of male children born from DET was higher than that from ET.
UNASSIGNED: There is an increased risk of LGA babies associated with pregnancies conceived from DFT. Children are inclined to be taller in the future in this group than after FET. The related etiology and pathophysiology mechanisms still need to be revealed. In the future, well-designed, observational studies with in-depth collection of patients\' characteristics may shed more light on this issue.

OBJECTIVE: The objective of this study was to determine the relationship between the levels of stress biomarkers in cord blood and pre-eclampsia (PE) in a hospital-based population of pregnant patients and evaluate the effects on pregnancy outcomes.
METHODS: This was an observational, case-control study. Participants/Materials, Setting, Methods: This case-control study included 282 patients with severe PE and 534 women with normal pregnancy. The umbilical cord was collected at delivery and tested for malonaldehyde (MDA), reactive oxygen species (ROS), superoxide dismutase, and homocysteine (Hcy) analysis. We performed a univariate general linear regression model analysis to control potential confounders and determined the underlying influencing factors for high MDA and ROS. A receiver operating characteristic curve analysis was conducted to determine the cutoff values for identifying severe PE. Further, the severe PE group was divided into the low- or high-MDA and low- or high-ROS subgroups according to the cutoff values. Finally, we created logistic regression models to estimate the adjusted odds ratio for each perinatal outcome in the high-MDA and high-ROS subgroup.
RESULTS: The levels of MDA and ROS levels were higher in women with severe PE than in normotensive pregnant patients. However, when adjusted for cord blood Hcy levels, the difference was insignificant. Additionally, both MDA (r = 0.359, p < 0.001) and ROS (r = 0.473, p < 0.001) were positively correlated with the cord blood Hcy level. The areas under the curve of MDA and ROS levels were 0.65 (95% confidence interval [CI]: 0.60-0.69) and 0.88 (95% CI: 0.86-0.90), respectively. Higher MDA and ROS levels were associated with increased risks of a low Apgar score, admission to the NICU, and assisted ventilation for the newborn.
CONCLUSIONS: The study design led to the exclusion of several participants.
CONCLUSIONS: Increased levels of oxidative stress markers in the cord blood might be significantly associated with negative effects on newborns. High levels of Hcy in the cord blood might be associated with elevated MDA and ROS concentrations in women with severe PE.

A 31-year-old woman (gravida 3, para 2) presented at hospital in the 33rd week of gestation with concerns of general malaise, a productive cough, and impaired taste. She was diagnosed with coronavirus disease 2019 (COVID-19) after a nasal antigen test; a computed tomography (CT) scan of the chest showed pneumonia. The patient developed dyspnea on the third day of hospitalization, and it worsened the following day. Oxygen inhalation and steroid administration were started. Since the dyspnea was worsening, an emergency cesarean delivery was performed to allow intensification of maternal treatment. A postoperative CT scan showed that the pneumonia was getting worse, and the administration of remdesivir was started immediately. The dyspnea improved rapidly, and medication was discontinued on postoperative day 4. The patient was discharged on postoperative day 6. Thus, a patient in the third trimester of pregnancy with COVID-19 whose respiratory condition worsened was successfully treated by early delivery and subsequent intensive treatment.

Recurrent or first preeclampsia in multiparae : a case-control study of singleton pregnancies in Reunion Island Phuong Lien Tran, Pierre-Yves Robillard, Coralie Dumont, Chloé Schweizer, Asma Omarjee, Glorianne Lazaro, Silvia Iacobelli, Malik Boukerrou OBJECTIVE: To compare multiparous women with a first occurrence of preeclampsia and those with recurrent preeclampsia in singleton pregnancies.
METHODS: a 17.5-year (2001-2018) case-control study conducted in the University\'s maternity of South Reunion (Indian Ocean), comparing 125 patients with recurrent preeclampsia and 742 patients with a first episode of the disease (controls). Statistical analyses were performed with use of the Student t-test for comparison of continuous data and the Chi-square or Fisher exact test for comparison of categorical variables.
RESULTS: There was no difference between the two groups concerning socio-demographic characteristics, post-partum haemorrhage, perinatal mortality rates. Nevertheless, recurrent preeclamptic women had a higher risk to present with prior chronic hypertension (OR 2.05 [1.30-3.23], p = 0.002), and to experience an early onset preeclampsia (< 34 weeks) compared to controls (OR 1.69 [1.15-2.48], p = 0.007). Women with recurrent preeclampsia were more prone to have C-sections (OR 1.63 [1.06-2.51], p = 0.024) mainly because of maternal indications (89.2% vs 76.4%, p = 0.008). Newborns from recurrent preeclampsia were more likely to have very low birthweight < 1500 g (OR 1.79 [1.16-2.77], p = 0.001), while there was no significant difference for gestational ages (34.1 vs 34.7 weeks).
CONCLUSIONS: Recurrent multiparous preeclamptic women presented more severe maternal disease (with a higher rate of early onset preeclampsia). Persistent hypertension in women with a history of preeclampsia is a risk factor for developing recurrent preeclampsia, and these patients should be monitored more closely.

OBJECTIVE: The aim is to examine risk factors and neonatal outcomes of preterm birth and to provide basis in preventing preterm birth.
METHODS: we carried out our study on 1328 term controls and 1328 preterm birth cases. By using multivariable logistic regression procedures we estimated odds ratio (OR) of potential preterm birth risk factors. T-test and chi-square test were used to estimate differences between groups.
RESULTS: Maternal age, prior history of pregnancy and abortion, prenatal care, complications of pregnancy (includes hypertension, intrahepatic cholestasis of pregnancy (ICP), fetal growth restriction (FGR), premature rupture of the membranes (PROM), placenta previa, abnormal presentation, abnormal S/D ratio et al.) were significantly associated with preterm birth. Several factors emerged as being statistically significant risk factors for preterm birth, such as prior history of pregnancy, hypertension, ICP, FGR, PROM, placenta previa and abnormal presentation. The time of prenatal care was shown to be a protective factor. Additionally, we observed evidence suggested that male babies are known to have a significant higher risk of preterm birth than female babies.
CONCLUSIONS: Prior history of pregnancy, hypertension, ICP, FGR, PROM, placenta previa and abnormal presentation were covariates identified in this study as risk factors for preterm birth. Preterm birth is an important reason of neonatal poor prognosis and death.

Purpose: Fetal growth restriction (FGR) is a concerning health issue. However, studies on FGR management are limited due to its rarity. We aimed to evaluate the efficacy of the contraction stress test (CST) for FGR management. Materials and methods: A case-control retrospective study design. Our institute innovated CST in FGR management in 2017. We included women in their 33rd-40th week of pregnancy with a diagnosis of FGR and retrospectively divided them into groups: the CST group (FGR management with CST) and no CST group (FGR management without CST) before and after CST development. Neonatal outcome, pH, and pO2 of umbilical artery (UA) were compared between the two groups. Results: No significant differences in the rate of birth weight, Apgar score <7 (5 minutes), neonatal death, hospitalization to newborn childhood intensive care unit (NICU), and UA pH were found between groups. Average UA pH was 7.29 ± 0.05 and 7.29 ± 0.04 in the CST and no CST groups, respectively (p = .864). Average UA pO2 values were 21.1 ± 8.6 and 15.7 ± 5.0 mmHg in the CST and no CST groups, respectively (p = .016), showing significant differences. Conclusions: Neonatal outcomes and UA pH were slightly different between the groups managed with and without CST. However, UA pO2 values significantly differed between the groups. For FGR management, the use of a CST may allow for early intervention before fetal acidemia and acidosis. For establishing the effects of a CST for FGR management, analysis including several cases and investigation of long-term outcomes of newborn infants is necessary.