Tomasz Maciejewski

Background/Objectives: In 2022, the full-scale invasion in Ukraine forced over 6 million Ukrainians, primarily mothers and children, to seek safety outside of the country. This massive influx has posed a significant challenge to the Polish healthcare system, particularly regarding routine vaccination for children. This study aims to examine the vaccination intentions of displaced Ukrainian mothers, their compliance with the Polish National Immunisation Programme (PNIP), and the factors that influence these intentions. Methods: A web-based survey (June–July 2023) was conducted among Ukrainian mothers in Poland. The questionnaire assessed the importance placed on vaccination, knowledge of PNIP, and concerns related to displacement and vaccination. Hierarchical logistic regression identified key determinants. Results: Among 2572 respondents, 64.5% reported that their children had received only some or none of the recommended vaccines. Key barriers included unfamiliarity with PNIP, limited knowledge of vaccines, and concerns about vaccine side effects. Of mothers whose children had not followed PNIP, 41.7% intended to vaccinate, 33.1% refused, and 25.2% were undecided. Regression analysis identified perception of vaccination importance as the strongest predictor. Partial adherence to PNIP doubled vaccination likelihood, while a firm plan to return to Ukraine reduced it 2.4 times. Mistrust in vaccines increased refusal risk tenfold. The final model confirmed mothers’ attitudes towards vaccination and future plans (return to Ukraine) as dominant factors. Conclusions: This study underscores the complex determinants shaping vaccination decisions in conflict-displaced communities. It provides insights for public health strategies to enhance vaccine uptake by reducing access barriers, restoring trust, and strengthening vaccine literacy.

Background/Objectives: Hypertensive disorders of pregnancy constitute one of the principal reasons for maternal and perinatal morbidity and mortality worldwide. Identification of molecular mechanisms causing placental dysfunction resulting in gestational hypertension is crucial in the development of new methods of prevention and treatment. The aim of this case-control study was to assess changes in miRNA expression, and biomarkers such as NT-proBNP and galectin-3, in women with uncomplicated pregnancies and hypertensive disorders of pregnancy. Methods: This was a case-control study. We included 61 women with uncomplicated pregnancies and 31 women with hypertensive disorders of pregnancy (21 women with gestational hypertension and 10 women with chronic hypertension). Blood sample collection was performed at 33 weeks of gestation. Expression and expression levels of 26 microRNAs, NTproBNP, and galectin-3 were measured. Results: Lower expression of microRNA 101a was observed in patients with hypertensive disorders of pregnancy. The expression of microRNA 101a was significantly lower in the group of patients with gestational hypertension, but not with chronic hypertension. Not only was the expression of microRNA 101a lower in all women with gestational hypertension but also in XYZ% it reached undetectable levels. Other studied microRNAs were similar in expression and concentration levels among both groups. In all women with hypertensive disorders of pregnancy, statistically significant correlations were detected between NT-proBNP concentrations and microRNA 133a (r = −0.68; p = 0.030) and microRNA 195 (r = 0.67; p = 0.030), and between galectin-3 and microRNA 195 (r = 0.46; p = 0.010), microRNA 133a (r = 0.44; p = 0.020), microRNA 222-2276 (r = 0.39; p = 0.050). Conclusions: microRNA 101a, a molecule associated with placental dysfunction in preeclampsia and with inhibition of cardiac fibrosis, has lower expression and concentration levels in gestational hypertension but not in chronic hypertension.

This research analysed early neonatal outcomes of complex and simple gastroschisis following planned elective preterm delivery in relation to prenatal ultrasound assessment of bowel conditions. A retrospective study of 61 neonates with prenatal gastroschisis diagnosis, birth, and management at a single tertiary centre from 2011 to 2021 showed a 96.72% survival rate with no intrauterine fatalities. Most cases (78.7%) were simple gastroschisis. Neonates with complex gastroschisis had longer hospital stays and time to full enteral feeding compared to those with simple gastroschisis—75.4 versus 35.1 days and 58.1 versus 24.1 days, respectively. A high concordance of 86.90% between the surgeon’s and perinatologist’s bowel condition assessments was achieved. The caesarean delivery protocol demonstrated safety, high survival rate, primary closure, and favourable outcomes compared to other reports. Prenatal ultrasound effectively evaluated bowel conditions and identified complex gastroschisis cases.

A strict correlation between gestational diabetes mellitus (GDM) and preeclampsia (PE) has been shown in previous studies. This case-control observational study evaluates the influence of concomitant GDM on the severity of PE. Ninety-nine patients were included: thirty-eight with PE without GDM (group 1), fourteen with PE and concomitant GDM (group 2), and forty-seven with uncomplicated pregnancies (group 3). Adverse maternal/fetal and neonatal outcomes were registered. Patients underwent blood sample analysis of serum PlGF, sFlt-1, creatinine levels, and platelet count (PLT). The incidence of preterm birth, FGR, HELLP syndrome, and NICU admission was significantly higher in group 1 in comparison to groups 2 and 3, whereas RDS was diagnosed most often in group 2 in comparison to groups 1 and 3. All studied biochemical parameters differed between the control group and both PE groups; however, there were no differences between patients with PE with and without GDM. The presented study indicates that the coexistence of GDM may mitigate the course of PE. The lack of differences between patients with PE with and without GDM in serum levels of studied biomarkers may also confirm its usefulness in the diagnosis and management of PE in patients with coexisting GDM.

Preeclampsia affects about 3–8% of all pregnancies. It represents a complex and multifaceted syndrome with at least several potential pathways leading to the development of disease. The main dogma in preeclampsia is the two-stage model of disease. Stage 1 (placental stage) takes place in early pregnancy and is thought to be impaired placentation due to inadequate trophoblastic invasion of the maternal spiral arteries that leads to reduced placental perfusion and release of numerous biological factors causing endothelial damage and development of acute maternal syndrome with systemic multiorgan failure (stage 2—the onset of maternal clinical symptoms, maternal stage). Recently, in the light of the vast body of evidence, two-stage model of preeclampsia has been updated with a few novel pathways leading to clinical manifestation in the second part of pregnancy. This paper reviews current state of knowledge about pathophysiology of preeclampsia and places particular focus on the recent advances in understanding of uterine artery remodeling alterations, as well as the role of microRNAs in preeclampsia.