Abstract Objective The objective of this prospective study was to assess the concentration and impact of maternal 25(OH)D status on neonatal vitamin D concentrations and early neonatal outcomes in the newborns of mothers who did not take vitamin D supplements during pregnancy. Methods and participants The study is a cohort prospective study of the correlation of VD concentrations in mothers and their newborns. The study included 100 pairs. Results Only 16 mothers had a VD concentration in the reference interval (75–100 nmol/L), while 84 mothers had values less than 75 nmol/L (p<0.001). A significant difference in maternal VD concentration was determined in relation to tobacco consumption habits during pregnancy and placental condition (p<0.001). 95% of the neonates (95/100) of older, obese multigravida, who had hypovitaminosis D and inadequate exposure to sunshine, had normal VD concentrations (the mean=49.27 nmol/L) on the first day of life. The majority of the mothers gave birth to full-termnewborns with normal vitality scores and CRP and bilirubin levels in the reference interval. Conclusion The conclusion of this prospective study is that 84% of the healthy pregnant women had hypovitaminosis D. However 95% of their newborns were born full term, with normal anthropometric measurements, normal vitality scores, and normal VD concentrations. This study also confirmed that there is still no cause-and-effect association between hypovitaminosis D in pregnant women and their offspring with outcome parameters for both.

Abstract Background To examine correlation between elevated levels of thyrotropin with the frequency of miscarriages. Methods A cross-sectional study was conducted on the 380 respondents and it investigated TSH (thyrotropin), thyroid peroxidase antibody(anti-TPO) and free thyroxine (FT4) in pregnant women who had a miscarriage (N = 179) and pregnant women with normal pregnancies (N = 201). Results The incidence of subclinical hypothyroidism in the miscarriages group was higher than in control group (61.4% vrs 15.79% (p < 0.001). In the miscarriages group with hypothyroidism (first trimester) mean value of TSH was significantly higher 4.31 ± 2.55 mIU/L compared to the control group 1.95 ± 0.86mIU/L (p < 0.001). Logistic multivariate regression revealed that TSH and body mass index (BMI) have a significant influence on the miscarriage; TSH level has a higher odds ratio (OR) 1.47 CI (95% 1.22–1.78) than BMI (OR) 1.14 CI (95% 1.06–1.23)) (p < 0.001). The combination of thyroid autoimmunity and TSH > 2.5mIU/L increase the risk of miscarriage (65.75%) compared to positive anti-TPO antibodies and TSH < 2.5mIU/L(14.15%)(p < 0.001). Conclusions Higher TSH levels correspond with obesity during early pregnancy and may be a sign of maternal thyroid dysfunction. Physiological thyroid function in the first trimester of pregnancy is important for perinatal outcome.

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.

Background : This study conducted at the Clinic for Children’s Diseases of the University Clinical Hospital Mostar, aims to highlight the characteristics, frequency, course, most common complications and treatment outcomes of pregnant women and their late preterm infants according to gestational age. Methods : This study is a retrospective epidemiologic study for the period from 1/1/2018 to 31/12/2021. The study included all the preterm infants who were born at a gestational age from 34 +0/7 to 36 +6/7 weeks and their mothers. Results : In the period under study, a total of 7178 infants were born, of which 253 (3.52%) were late preterm infants. The results show that most mothers were between 30 and 39 years of age, pregnant for the first time with a single pregnancy, delivered by caesarean section, with complications in 53.1% of the pregnancies. All the analyzed pathological conditions were more common in the pregnancies which ended at 34 weeks. Our results indicate that the late preterm babies had a good birth weight (53.8%) and high vitality scores (93%) at birth, but these scores were not confirmed on the first day of life. A significant number of late preterm infants had some pathological condition which was treated in the intensive care units (ICU) ( p < 0.001). Conclusions : The study concludes that half of the pregnant women had risk factors which were the basis for the preterm births and the development of complications in the late preterm infants. Furthermore, despite good birth weight and vitality scores at birth, only one fifth of the late preterm infants were not treated with medications or developed pathological conditions, whereas only one third required no intensive care treatment. It is, therefore, necessary to improve the monitoring and understanding of such pregnancies, implement antenatal corticosteroid therapy, and increase parental awareness to ensure long-term and frequent monitoring of late preterm infants by pediatricians.