Nir Roguin

Objective: To determine the impact of minor trauma during pregnancy on adverse pregnancy outcome in primiparous women. Methods: A retrospective cohort study was conducted at a single, tertiary university‐affiliated medical center between 2012 and 2023. Primiparous women aged 18 to 45 years who experienced minor trauma (Injury Severity Score ≤ 9) during pregnancy after 28 + 0 weeks of gestation and subsequently delivered at our institution were included. Outcomes were compared with those of women without trauma using 1:1 propensity score matching. Outcomes included preterm delivery, cesarean delivery under general anesthesia, placental abruption, and need for blood transfusion. Results: Of 59 774 primiparous deliveries, 852 (1.4%) experienced minor trauma during pregnancy. After propensity score matching (727 pairs), no individual adverse outcome showed a clinically significant difference between the study and control groups (all standardized mean differences < 0.2). Findings were consistent among subgroups defined by mechanism of injury, gestational age at trauma, and propensity score stratum, and in a multiparous sensitivity analysis. Conclusion: Minor trauma during the third trimester of pregnancy in primiparous women was not associated with a clinically significant increase in adverse maternal and perinatal outcomes in this matched cohort. These findings may help reassure patients and clinicians following minor traumatic events during pregnancy, although appropriate clinical evaluation and monitoring remain warranted.

Background: Maternal hypertension has been linked to adverse pregnancy and neonatal outcomes, but long‐term effects on offspring, particularly gastrointestinal (GI) health, are less well studied. Chronic hypertension may impair uteroplacental perfusion and promote a pro‐inflammatory intrauterine environment, potentially disrupting foetal gut development; however, its independent effect on offspring GI health has not been examined. Objectives: To evaluate whether in utero exposure to maternal chronic hypertension, independent of preeclampsia, is associated with long‐term GI morbidity in offspring. Methods: This population‐based retrospective cohort study included all singleton deliveries at a tertiary medical centre over a 30‐year period (1991–2021). Offspring were followed until age 18 for GI diagnoses based on ICD‐9 codes from hospital and outpatient records. The primary exposure was maternal chronic hypertension, and the primary outcome was the incidence of GI morbidity in offspring. Piecewise Poisson log‐linear models estimated adjusted incidence rate ratios (IRR), controlling for maternal age, parity, ethnic origin, smoking, obesity, and pre‐gestational diabetes. Results: Among 342,635 singleton deliveries, 3097 (0.9%) were to mothers with chronic hypertension. The median follow‐up was 12.6 years (interquartile range 5.6, 18.0). GI incidence rates were 1903.0 and 1901.9 per 100,000 person‐years among chronic hypertension and normotensive groups. Offspring of mothers with chronic hypertension showed lower GI risk in early childhood (adjusted IRR < 1 year: 0.34, 95% confidence interval [CI] 0.11, 1.05; 1–3 years: 0.46, 95% CI 0.29, 0.73), with estimates consistent with no difference in late adolescence (15–18 years: adjusted IRR 1.09, 95% CI 0.98, 1.21). All‐cause mortality was low and similar between groups. Conclusions: The association between maternal chronic hypertension and offspring GI morbidity is time‐varying and non‐proportional, with lower risk in early childhood and no evidence of excess risk at later ages.

Background: Does maternal body mass index (BMI) influence embryo morphokinetics in fresh embryo transfer cycles, and how does this relate to clinical outcomes and obstetric complications? Methods: A retrospective cohort study was conducted on 2238 fresh embryo transfer (ET) cycles, categorized into four BMI groups: underweight, normal weight, overweight, and obese. Baseline characteristics, stimulation parameters, hormonal profiles, morphokinetic data, and pregnancy and delivery outcomes were analyzed. Results: Higher BMI was associated with more anovulatory infertility and greater endometrial thickness. Peak estradiol and estradiol-to-oocyte ratios declined progressively with increasing BMI, despite preserved oocyte yield and embryo quality scores. Interestingly, the underweight group exhibited a significantly distinct biphasic morphokinetics developmental pattern compared with the overweight and obese groups. Pregnancy rates, including clinical and live birth, did not differ significantly across BMI groups. However, obese women had markedly higher cesarean section rates (51.9% vs. ~25–28% in other groups) and a non-significant trend toward more gestational diabetes. Other perinatal outcomes, such as preeclampsia and preterm birth, were not significantly different. Conclusions: In fresh IVF cycles, a higher BMI does not impair pregnancy achievement but is linked to altered hormonal response and increased obstetric risk, particularly cesarean delivery. These findings highlight the importance of preconception counseling and targeted obstetric management for women with elevated BMI undergoing fresh ET.