The effectiveness of integrated online health-coaching on physical activity and excessive gestational weight gain: a prospective randomized-controlled trial

PURPOSE

Low levels of physical activity during pregnancy go along with increased risks for numerous health complications. We investigated whether an integrated lifestyle intervention leads to higher levels of physical activity and reduces the rate of excessive gestational weight gain (EGWG).

METHODS

We conducted a randomized-controlled trial on 97 pregnant women, randomly assigned to receive an additional telehealth lifestyle intervention (experimental group, EG; n = 49) or conventional antenatal care (control group, CG; n = 48). The core lifestyle intervention comprised regular video calls, providing integrated personal support and motivation to physical activity. The primary outcome was change in physical activity measured in steps per day. An additional exploratory outcome was the proportion of participants with EGWG.

RESULTS

The mean step count during the third trimester was 6483 steps/day (EG) and 5957 steps/day (CG), respectively (p = 0.078). Repeated-measures ANOVA revealed a significant interaction effect (p = 0.045) reflecting an overall increase of 497 steps per day in the EG vs. a decrease of 300 steps per day in the CG. The proportion of participants who met the IOM recommendation for total weight gain during pregnancy was significantly higher in the EG (p = 0.048) and the ratio of women that gained excessively was higher in the CG (p = 0.026).

CONCLUSIONS

We assume that the personalized online intervention supports women in increasing or at least maintaining their level of physical activity during the course of pregnancy. Additionally, it reduces the rate of excessive weight gain.

Versorgungsrealität von Frauen nach hypertensiver Schwangerschaftserkrankung – eine monozentrische fragebogenbasierte Analyse

Einleitung Frauen nach einer hypertensiven Schwangerschaftserkrankung wird aufgrund ihres signifikant erhöhten kardiovaskulären Risikos zu Screeninguntersuchungen und primärer Prävention geraten. Diese Studie soll einen Beitrag zur Ermittlung der aktuellen Nachsorgepraxis leisten und aufzeigen, wie viele Frauen an den empfohlenen Nachsorgeuntersuchungen mit Beratung zur Reduktion von Risikofaktoren teilnehmen.

Material und Methoden Monozentrische Patientinnenbefragung von 113 Frauen, welche im Zeitraum von 2014 bis 2019 von einer hypertensiven Schwangerschaftserkrankung betroffen waren. Es erfolgte eine deskriptive statistische Auswertung.

Ergebnisse Eine Nachsorgeuntersuchung erfolgte bei 54% der Frauen. Es wurden 47% der Patientinnen im persönlichen Gespräch über ihre Erkrankung informiert und auf mögliche langfristige gesundheitliche Konsequenzen hingewiesen. Von 67 übergewichtigen Frauen (BMI≥25 kg/m2) erhielten 23% eine Empfehlung zur Steigerung der körperlichen Aktivität und 13% wurde zur Gewichtsreduktion geraten. Es stellten sich signifikant mehr Frauen mit höherer Krankheitslast (BMI, p=0,027; arterieller Hypertonus, p=0,016) und gravierender Ausprägung der Erkrankung (Eklampsie, Aufenthalt auf einer Intensivstation, jeweils p=0,049) zu weiteren Untersuchungen vor.

Schlussfolgerung Die vorliegenden Ergebnisse legen nahe, dass die Maßnahmen zur Prävention und Früherkennung von kardiovaskulären Erkrankungen in unserem Patientinnenkollektiv nicht ausgeschöpft wurden. Unabhängig des Ausprägungsgrades der Erkrankung sollten alle Frauen eine Empfehlung zur Teilnahme an Nachsorgeuntersuchung erhalten.

Position Paper of the Task Force for Obstetrics and Prenatal Medicine (AGG - Section Preterm Birth) on the Placement, Removal and Surveillance of the Arabin Cervical Pessary in Patients at Risk for Spontaneous Preterm Birth

This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.

MORC1 exhibits cross-species differential methylation in association with early life stress as well as genome-wide association with MDD

Early life stress (ELS) is associated with increased vulnerability for diseases in later life, including psychiatric disorders. Animal models and human studies suggest that this effect is mediated by epigenetic mechanisms. In humans, epigenetic studies to investigate the influence of ELS on psychiatric phenotypes are limited by the inaccessibility of living brain tissue. Due to the tissue-specific nature of epigenetic signatures, it is impossible to determine whether ELS induced epigenetic changes in accessible peripheral cells, for example, blood lymphocytes, reflect epigenetic changes in the brain. To overcome these limitations, we applied a cross-species approach involving: (i) the analysis of CD34+ cells from human cord blood; (ii) the examination of blood-derived CD3+ T cells of newborn and adolescent nonhuman primates (Macaca mulatta); and (iii) the investigation of the prefrontal cortex of adult rats. Several regions in MORC1 (MORC family CW-type zinc finger 1; previously known as: microrchidia (mouse) homolog) were differentially methylated in response to ELS in CD34+ cells and CD3+ T cells derived from the blood of human and monkey neonates, as well as in CD3+ T cells derived from the blood of adolescent monkeys and in the prefrontal cortex of adult rats. MORC1 is thus the first identified epigenetic marker of ELS to be present in blood cell progenitors at birth and in the brain in adulthood. Interestingly, a gene-set-based analysis of data from a genome-wide association study of major depressive disorder (MDD) revealed an association of MORC1 with MDD.

Encouraging Early Clinical Experience with Deliberately Delayed Temporary Fetoscopic Tracheal Occlusion for the Prenatal Treatment of Life-Threatening Right and Left Congenital Diaphragmatic Hernias

OBJECTIVE

In order to assess the effect of deliberately delayed percutaneous fetoscopic tracheal occlusion on survival of fetuses with life-threatening congenital diaphragmatic hernia.

METHODS

Eight fetuses with life-threatening congenital diaphragmatic hernia underwent fetoscopic tracheal balloon occlusion between 29 + 0 and 32 + 4 weeks of gestation. Delayed occlusion was chosen in order to minimize potentially negative pulmonary effects from premature delivery as a result of fetal surgery. In addition, we wanted to become able to provide all available postnatal intensive care treatment means in these patients.

RESULTS

Six of the 8 fetuses survived to discharge from hospital.

CONCLUSION

Delayed fetoscopic tracheal balloon occlusion may be rewarded with lung growth sufficient to allow survival of fetuses with life-threatening congenital diaphragmatic hernia.

[Microbiological study of dehydrated garlic (Allium sativum L.) and onion (Allium cepa L.)]

A microbiological study during the process and the storage of garlic (Allium sativum L.) and onion (Allium cepa L.) dehydrated, with the additional barriers of blanching or brine immersion, was made. In all raw materials the average counts of aerobic mesophilic bacteria expressed in CFU/g ranged from 1.2 x 10(2) to 1.6 x 10(3), molds and yeasts from 60 to 1.6 x 10(3), Lactobacillus spp. and Leuconostoc mesenteroides subsp. mesenteroides between 10 and 50. Microorganisms identified were Penicillium spp., Monilia spp., Lactobacillus brevis, Leuconostoc mesenteroides subsp. mesenteroides and yeasts in garlic; Mucor spp., Penicillium spp., Monilia spp., Lactobacillus brevis and yeasts in both types of onions. Leuconostoc mesenteroides subsp. mesenteroides was detected in only kind of onion. In dehydrated garlic storage, Penicillium spp., Monilia spp., Lactobacillus brevis and yeasts were detected. In garlic, when a blanching step was carried out no microflora was detected. Mucor spp., Penicillium spp., Monilia spp. and Lactobacillus brevis were identified in both types of dehydrated onions. When brine immersion was included the microflora detected was significantly lower and only Penicillium spp. were found. The use of additional barriers such as blanching or brine immersion produces an important effect on the microbiological stability in these products.