Fetal Death

NIH findings may lead to insights on pregnancy complications, adult health BETHESDA, Md., May 2, 2025 /PRNewswire-HISPANIC PR WIRE/ -- What: The genes of male and female placentas have marked differences in how they are expressed, according to a study by researchers at the National Institutes of Health (NIH) and other institutions. These differences involve the presence or absence of tags on DNA known as methyl groups, which switch genes on or off without changing their structure. Understanding these DNA methylation patterns may inform future research on the higher risk for pregnancy complications involving male fetuses, such as stillbirth and prematurity, as well as later life health conditions that occur in adults who were born after a complicated pregnancy. Researchers analyzed male and female placental samples from a larger study for differences in their methylation patterns, and found differences in gene activity between male and female placentas that may play a role in birthweight and adult diseases. The study identified 2,497 previously unreported DNA sites that had different methylation patterns for males and females. Of these and more than 2,500 sites that had also been identified by previous studies, 66.9% of large increases in methylation occurred in DNA from male placentas and 33.1% from female placentas. Increases in methylation in male placentas was linked with greater neonatal size whereas those in females was linked with greater placental size. Some increases in methylation found in male placentas were located near the CCDC6 gene. Lower activation of CCDC6 has been linked with preterm birth in previous studies. Higher methylation near the FNDC5 gene was associated with lower expression of the gene in male placentas but not in female placentas. FNDC5 is involved with the manufacture of irisin, which protects the placenta from damage by reactive oxygen molecules and insulin resistance (cells' difficulty in using insulin to lower blood sugar.) Lower irisin levels have been associated with the pregnancy-related high blood pressure disorder, known as preeclampsia. Variations in the genes ATP5MG and FAM83A, expressed in female placentas, have been associated with asthma, hay fever, eczema (dry, itchy, inflamed skin) and higher risk for breast cancer later in life. Genetic factors influence the health differences between males and females, from before birth to later in life. Male fetuses grow faster than female fetuses and their pregnancies are more likely to be complicated by such conditions as preeclampsia (a hypertensive disorder of pregnancy), failure to grow at an adequate rate, and preterm birth. They also are more likely to die in the year after birth. Dysfunction of the placenta underlies many pregnancy complications and is thought to set the stage for male and female health differences that occur later in life. Variations in methylation patterns are thought to underlie many of these differences. The study was conducted by Fasil Tekola-Ayele, Ph.D., of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and colleagues at other institutions. It appears in Nature Communications. Who: Fasil Tekola-Ayele, Ph.D., is available for comment on this study. Reference Tekola-Ayele F, et al. Sex-differentiated placental methylation and gene expression regulation has implications for neonatal traits and adult diseases. Nature Communications. DOI: 10.1038/s41467-025-58128-3 (2025) SOURCE Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institutes of Health (NIH) WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

MONDAY, March 17, 2025 -- Pregnant women can get the COVID-19 vaccine without any fear of causing birth defects in their unborn child, a new study says. Researchers found no link between COVID vaccination in early pregnancy and birth defects, results show. There were also no differences in birth defect risk between either the Moderna and the Pfizer/BioNTech vaccines, researchers reported in the journal Pediatrics . “These results support the safety of COVID-19 vaccination in early pregnancy,” concluded the research team led by Stacey Rowe , a postdoctoral fellow in infectious diseases at the University of California-San Francisco. The vaccine is recommended for pregnant women, because COVID infection during pregnancy has been linked to an increased risk of preterm birth, stillbirth and newborns requiring care in a neonatal intensive care unit, researchers said in background notes. However, some resistance to the vaccine has been reported due to concerns that it might cause birth defects, researchers noted. For the new study, researchers examined more than 78,000 pregnancies detailed in claims data from public and private health insurance providers. In all, 1,248 birth defects were noted among unvaccinated people and 199 among vaccinated folks, results show. Overall, there were no significant differences between birth defects in vaccinated and unvaccinated women. There were a little more than 160 birth defects per 10,000 live births among the unvaccinated, compared with 156 per 10,000 for women who were vaccinated, results show. The rate of birth defects didn’t change even if pregnant women received other recommended vaccines, such as the influenza or whooping cough shots, researchers said. The same was true if a pregnant woman caught COVID during pregnancy, researchers said. “The study’s findings are consistent with a growing body of literature supporting the safety of COVID-19 vaccines and their use in pregnancy, including in early periods of gestation,” researchers concluded. “Vaccine safety is a common concern for patients considering vaccination,” they wrote. “Provider recommendations are the most important predictors of person’s decision to vaccinate during pregnancy, even for those who have previously declined.” “Our findings can strengthen provider-to-patient discussions relating to the safety of COVID-19 vaccines during pregnancy,” the report continued. “Providers across all clinical and public health settings should recommend COVID-19 vaccination for their pregnant patients at any period of gestation.” Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

For two years, an ambitious initiative in sub-Saharan Africa has demonstrated how pocket-sized ultrasound technology can help bridge the gap in maternal care access. The implementation of point-of-care ultrasound (POCUS) across hundreds of healthcare facilities offers new insights into how the innovative deployment of technology, combined with comprehensive training, can transform maternal health outcomes in resource-limited settings. This initiative has resulted in over 1,000 healthcare workers trained, and over one million pregnancy scans and counting. The World Health Organization (WHO) recommends an ultrasound scan before 24 weeks gestation for all pregnancies, yet the stark reality of access to high-quality global maternal healthcare presents an immense challenge. Nearly 95% of maternal deaths occur in low and lower-middle-income countries (LMIC). And in low-resource settings like parts of sub-Saharan Africa and Asia, the high cost of equipment and the need for trained sonographers means that very few women have access to ultrasound. UNICEF’s 2021 report on child mortality trends and the WHO’s 2024 report on maternal mortality show that, in sub-Saharan Africa alone, approximately 202,000 mothers and 27 of every 1,000 infants die due to childbirth complications annually. While multiple factors contribute to these statistics, one significant barrier has been limited access to antenatal diagnostic imaging – a critical tool for identifying life-threatening complications during pregnancy. Many regions of the world, especially LMICs, are essentially diagnostic deserts. The lack of equitable, accessible primary healthcare for women, combined with higher disease burdens entering pregnancy, creates a perfect storm of risk factors that demands innovative solutions. Sponsored Post Mayo Clinic Platform Program to Help Clinical Digital Health Startups Succeed Mayo Clinic has developed a new tool that could speed up the time it takes for digital health companies to validate their tech to hospitals. By Mayo Clinic Platform Breaking new ground in Kenya The project began in Kenya in late 2022 and has resulted in deployment of 500 single-probe, whole-body portable ultrasound devices across 224 healthcare facilities in Kenya. This was combined with ultrasound training by Global Ultrasound Institute (GUSI) to over 500 frontline healthcare workers who provide care in counties in Kenya with disproportionately high rates of maternal and neonatal mortality and morbidity. Recruitment of the participants and evaluation of the implementation was conducted by Kenyatta University. Initial results from the evaluation conducted by Kenyatta University suggests that 90% of healthcare workers reported identifying high-risk conditions such as placenta previa or multiple gestations using their devices within one month of training. The findings from the research represent the largest impact study in Africa on point-of-care ultrasound to date and show that: Sponsored Post Webinar: Tips To Have Your Practice Succeed This Year This on-demand webinar will offer insights and share tips on helping practices run more efficiently. By Elation Health and MedCity News 95% of the participant providers are now using POCUS to detect high-risk conditions and inform treatment decisions 80% of the participant providers have trained at least two other providers at their hospital to drive further widescale use. In a survey of over 2,000 healthcare users or pregnant women, 48-55% reported receiving a POCUS scan during their visit (more than double than in their prior pregnancies). The training program, developed in partnership with GUSI, takes a comprehensive approach. It begins with creating a foundation of local expertise by training over 50 Kenyan clinicians and sonographers in International Society of Ultrasound in Obstetrics and Gynecology (ISUOG)-standard techniques, who become trainers. The curriculum covers operation, image acquisition and medical decision-making, with a specific focus on identifying high-risk conditions during pregnancy. Phase Two of the Kenya program included a curriculum from GUSI, which included pre-tests and required participants to log at least 20 of five different types of scans over the course of the week. On the final day of the program, a post-test and final Objective Structured Clinical Examination (OSCE) were administered. Participants who passed all training and tests were given a certificate at a closing ceremony. As of December 2024, research outcomes from Phase Two were significant. Over the 24-month period from the start of training, Kenyan clinicians have performed over 496,000 scans, with more than 95% of the equipment continuing to function as a vital part of the care workflow for midwives in these facilities. These data demonstrate the sustainability of POCUS when the approach pairs easy-to-use equipment with focused training for midwives. Expanding impact: South Africa implementation Building on the success in Kenya, the program has expanded to South Africa, where maternal mortality rates and stillbirth rates remain disproportionately high, particularly in rural areas. The initiative rolled out across multiple provinces, starting in the Eastern Cape province in April 2024. In this phase of the training, learners received additional instruction in fetal biometry – an ultrasound test that provides rich detail on the health and growth of the fetus, in addition to confirming gestational age and an estimated due date for the pregnancy. Implementation and evaluation of this phase was led by the Clinton Health Access Initiative and University of Pretoria. While formal evaluation results are forthcoming, preliminary results are extremely promising. South African learners have performed more than 573,000 scans and completed over 41,000 instances of fetal biometry. Taken together, these scans represent thousands of opportunities for mothers to be educated on the status of their pregnancies, as well as for providers to make informed decisions about additional testing or referral if complications were suspected. Healthcare users need easier access to antenatal imaging, and clinicians need better capabilities for screening high-risk conditions that lead to disproportionately worse pregnancy outcomes, particularly in rural areas. When ultrasound becomes more accessible, high-risk conditions may be identified earlier, leading to improved outcomes. The technology and training equation What sets this initiative apart is its comprehensive approach to implementation. The program provides valuable insights into how to scale medical technology deployment in resource-limited settings effectively. But rather than simply distributing services, the program emphasizes sustainable integration into existing healthcare systems. This includes: Intensive training programs for healthcare workers Ongoing remote quality-assurance review and mentoring of the trained healthcare providers Partnership with local academic institutions for academic collaboration and impact evaluation Integration with existing maternal health protocols Collaboration with local distribution and support networks Collaboration with local government for supportive health policy development Looking ahead: implications for global health The collaboration among multiple stakeholders — including the Clinton Health Access Initiative, GUSI, Kenyatta University and local healthcare institutions – offers a model for future health technology implementations. It demonstrates how public-private partnerships can work together to address complex healthcare challenges while ensuring sustainability and local ownership. As the program continues to expand, (Kenyatta University’s College of Nursing in Kenya, CHAI and University of Pretoria in South Africa) researchers are evaluating its impact on broader health system metrics, including referral patterns and population-level maternal health outcomes. This data will be necessary for understanding how POCUS technology can be most effectively deployed to improve maternal health outcomes in similar settings around the world. The initiative extends beyond technology. It represents a comprehensive approach to addressing maternal health disparities through innovation, education and systematic support. We must advocate for earlier, better maternal and primary care for all, especially for mothers who reside in resource-limited settings as they enter pregnancy. We also need to address racial and socioeconomic disparities in healthcare access and improve the quality of healthcare across the entire continuum — and ultrasound plays a role in that every step of the way. Providing affordable point-of-care diagnostic tools can be instrumental in quickly and efficiently assessing the well-being of all people, especially pregnant mothers. This can empower healthcare providers to be better diagnosticians and improve overall patient care, particularly for those at risk. As global health leaders continue to seek solutions for reducing maternal mortality, this program offers valuable lessons on how to effectively bridge the healthcare access gap in resource-limited settings. The initiative described above was supported by a $5 million grant to Butterfly Network.