Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile

Objectives

To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant.

Methods

A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated.

Findings

The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%.

Conclusion

Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.     

Bio-magnetostratigraphy and environment of the oldest Eurasian hominoid from the Early Miocene of Engelswies (Germany)

The paleobiogeography of hominoids exhibits a puzzling pattern of migrations between and within Africa and Eurasia. A precise dating of hominoid-bearing localities is therefore essential to reveal the timing, direction and possible causes of dispersals. Here, we present a bio-magnetostratigraphic analysis of the section of Engelswies (Southern Germany, Upper Freshwater Molasse, North Alpine Foreland Basin) where the oldest Eurasian hominoid was found. Our paleomagnetic results reveal a very short normal and a reverse magnetic polarity for the entire section. The polarity record is correlated to the Astronomical Tuned Neogene Time Scale using an integrated stratigraphic approach. This approach follows the chronostratigraphic framework for the Upper Freshwater Molasse, which combines magnetostratigraphy with biostratigraphic, lithostratigraphic and ⁴⁰Ar/³⁹Ar dating results. According to this outcome, the reverse polarity of the Engelswies section most likely correlates to magnetochron C5Cr. The origin of the short normal polarity remains enigmatic. The magnetostratigraphic calibration and the evolutionary level of the Engelswies small mammal fauna suggest an age of 17.1-17.0 Ma (Early Karpatian, Early Miocene) for the oldest Eurasian hominoid, and roughly confirm the estimates of Heizmann and Begun (2001). The estimated age suggests that the first hominoids in Eurasia are contemporaneous with Afro-Arabian afropithecins, and dispersal may have been facilitated by intra-Burdigalian (∼18-17 Ma) sea-level low stands and the beginning of the Miocene Climate Optimum. The paleoclimatic and environmental reconstruction of the Engelswies locality indicates a lakeshore environment near dense subtropical rain forest vegetation, where paratropical temperatures (mean annual temperature around 20 °C) and humid conditions (mean annual precipitation > 1.100 mm) prevailed.     

An inexpensive alternative to routine section adhesives for histology: the mucilaginous substance of the Assyrian plum

We found that the mucilaginous substance of the Assyrian plum, Cordia myxa, can be used as an adhesive for attaching sections of animal tissues to slides. Unlike Mayer's albumen, this material left no stainable residue and had no noticeable effect on the histological structure of the tissue sections. The mucilaginous substance of C. myxa is a useful and inexpensive alternative to standard adhesives.     

Assessment of epigenetic alterations and in silico analysis of mutation affecting PTEN expression among Indian cervical cancer patients

Genetic and epigenetic anomalies accountable for genetic dysregulation are the most common aberrations that determine the underlying heterogeneity of the tumor cells. Currently, phosphatase and tensin homolog (PTEN) incongruity has emerged as potent and persuasive malfunctioning in varied human malignancies. In this study, we have analysed the promoter hypermethylation and expression status of PTEN. We identified different mutations in the exonic region of PTEN. Functional consequences of these mutations were explored using in silico techniques. Promoter hypermethylation of PTEN was detected using methylation-specific polymerase chain reaction (MS-PCR), expression analysis was performed with immunohistochemistry (IHC) and mutation by direct sequencing in a total of 168 uterine cervix tumor cases. The findings were statistically correlated with the clinical parameters. In addition, the effect of nonsynonymous mutations was studied with molecular dynamics simulations. PTEN promoter hypermethylation (45.8%) was found to be significantly associated with the of PTEN loss (57.14%, P < 0.0001). Tumor stages, tumor size, lymph node (LN) were found to be significantly correlated with both PTEN promoter hypermethylation and PTEN loss. Histological grade, however, showed a significant association with only PTEN loss. In total, 11.76% of tumors exhibited mutations in exon 5 and 7, out of which E150K of exon 5 showed the highest deviations in the crystal structure of PTEN by in silico analysis. This study provides valuable insights into oncology and paves the path in the development of efficient biomarker and/or imperative therapeutic tool for cervical cancer treatment.     

Pre-existing diabetes mellitus and adverse pregnancy outcomes

ABSTRACT: BACKGROUND: Pregnancies complicated by pre-existing diabetes mellitus (PDM) are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM. METHODS: This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH) during the period of January 1st to the 31st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period. RESULTS: A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7%) women had PDM. There were 66 (57%) women with T1DM and 50 (43%) women with T2DM. Compared to non-diabetic women those with PGMD were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S), OR 2.67, 95% confidence intervals (CI) (1.63-4.32), P < 0.001, or elective C/S, OR 6.73, 95% CI (3.99-11.31), P < 0.001. The neonates of the mothers with PDM were significantly heavier, P < 0.001; and more frequently macrosomic; OR 3.97, 95% CI (2.03-7.65), P = 0.002. They more frequently have APGAR scores <7 in 5 minutes, OR 2.61, 95% CI (0.89-7.05), P 0.057 and more likely to be delivered at <37 gestation weeks, OR 2.24, 95% CI (1.37- 3.67), P 0.003. The stillbirth rate was 2.6 times more among the women with PDM group; however the difference did not reach statistical significance, P 0.084. CONCLUSION: PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5 min.     

Early Miocene repetitive vegetation and climatic changes in the lacustrine deposits of the Rubielos de Mora Basin (Teruel, NE Spain)

Pollen analysis of a Lower Miocene succession from the Rubielos de Mora Basin (NE Spain) has been carried out with the aim of reconstructing the flora, vegetation and climatic changes. Previous paleobotanical studies on these sedimentary rocks and adjacent areas interpreted very diverse climates for the Early Miocene: from humid temperate to dry subtropical. In this study, a rich thermophilous pollen spectrum and a diverse subarid flora including Nitraria, Caesalpiniaceae, Ephedra and Acacia, indicative of a dry subtropical climate are identified. On the other hand, mesothermic taxa with high water requirements are also abundant. Therefore, the pollen assemblages evidence the juxtaposition of very contrasted environments: the presence of subdesertic taxa, typical of plants growing in the lowlands and conditioned by a long warm, dry season, together with others with very high water requirements, needing constant water. This can be explained by the presence of the Rubielos de Mora Lake providing local conditions for developing riparian forests. The vegetation was clearly controlled by the water availability under a subtropical and dry-seasonal climate. Pollen changes along the succession, which coincide with sedimentological changes, are related to climatic variations. Alternation in pollen taxa (thermophilous–dry vs. mesothermic–riparian) reflects the influence of the cyclicity of temperature and precipitation on the lake level and vegetation.