Pregnancy Complication and Precision Medicine 2.0

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 10541

Special Issue Editors


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Guest Editor
Department of Neurology, Rehabilitation, Ophtalmology, Genetics, Maternal and Infant Health (DiNOGMI), 16132 Genova, Italy
Interests: biostatistics; gynecological cancers; pregnancy complications
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Guest Editor
Department of Obstetrics and Gynecology, Cantonal Hospital Fribourg, 1708 Fribourg, Switzerland
Interests: endometriosis; elasticity imaging technology; pregnancy complications
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Department of Surgery, Breast Unit, DAME, University Hospital of “Santa Maria della Misericordia”, 33100 Udine, Italy
2. Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
Interests: breast cancer; nanotechnology; HIPEC; carcinosis; metastasis; surgery; skin cancer; endoscopy

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Guest Editor
1. Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA
2. Swansea University Medical School, Singleton Park, Swansea SA2 8PP, Wales, UK
Interests: immunotherapy; stem cells; immunomodulation; RNA therapeutics; exosomes; tissue engineering; ovarian cancer; macrophages

Special Issue Information

Dear Colleagues,

Precision medicine represents a bold research area with the potential to revolutionize the way we approach and treat diseases. Alongside nanotechnology and molecular medicine, precision medicine enables the specific delivery of therapeutic agents to cells and organs of interest, thus improving treatment outcomes and reducing side effects. In the obstetric field, several opportunities exist for existing diagnostic and treatment tools as well as for the development of innovative strategies that are driven by multiple factors, including fetal growth restriction, preterm birth, fetal abnormalities, and labor monitoring. In addition, maternal tumors in pregnancy could benefit from precise medicine development, reducing cancer treatment burden and improving pregnancy outcomes. This Special Issue aims to provide a collection of manuscripts providing an overview of the current status of precision medicine in pregnancy complications.

We welcome research articles or reviews on pregnancy complications and precision medicine. Topics of interest from the perspective of personalized medicine and pregnancy complication include (but are not limited to) the following:

  • Drug targeting and nanotechnology and integration with individualized therapy (i.e., novel therapeutics: genetic-based, nanotechnology, targeting strategies);
  • Omics-based studies of disease risk, disease prognosis, and response to therapy or prediction-based drug safety;
  • Biomarker identification and application;
  • Pharmacogenomics: genetics and biochemistry of drug uptake, action, and metabolism;
  • Advancements in technologies and resources (sequencing technologies, expression analysis, bioinformatics, and biostatistics);
  • Personalization of omics-based nondrug-related health interventions;
  • Regulation and bioethics in personalized medicine in obstetrics and gynecology.

Dr. Ambrogio P. Londero
Dr. Arrigo Fruscalzo
Dr. Serena Bertozzi
Dr. Bruna Corradetti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • precision medicine
  • nanomedicine
  • nanotechnology
  • growth-restricted fetuses
  • pre-eclampsia
  • preterm births
  • diabetes
  • ectopic pregnancy
  • maternal cancer

Published Papers (4 papers)

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Research

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14 pages, 933 KiB  
Article
Assisted Reproductive Technology and Breech Delivery: A Nationwide Cohort Study in Singleton Pregnancies
by Ambrogio P. Londero, Claudia Massarotti, Anjeza Xholli, Arrigo Fruscalzo and Angelo Cagnacci
J. Pers. Med. 2023, 13(7), 1144; https://doi.org/10.3390/jpm13071144 - 16 Jul 2023
Cited by 1 | Viewed by 1071
Abstract
Since essential factors have changed in recent years in assisted reproduction technologies (ARTs), this study reassessed the association between ART and breech presentation. We primarily aimed to estimate the correlation between ART and breech at delivery. Secondary purposes were to evaluate the correlation [...] Read more.
Since essential factors have changed in recent years in assisted reproduction technologies (ARTs), this study reassessed the association between ART and breech presentation. We primarily aimed to estimate the correlation between ART and breech at delivery. Secondary purposes were to evaluate the correlation between other subfertility treatments (OSTs) and breech and to assess possible confounding factors and temporal trends. This study investigated the 31,692,729 live birth certificates from US states and territories in the 2009–2020 period. The inclusion criteria were singleton births reporting the method of conception and the presentation at delivery. The outcome was the breech presentation at delivery, while the primary exposure was ART, the secondary exposure was OST, and the potential confounding factors from the literature were considered. ART (OR 2.32 CI.95 2.23–2.41) and OST (OR 1.79 CI.95 1.71–1.87) were independent and significant risk factors for breech at delivery (p < 0.001). This study confirmed breech presentation risk factors maternal age, nulliparity, tobacco smoke, a previous cesarean delivery (CD), neonatal female sex, gestational age, and birth weight. Black race and Hispanic origin were verified to be protective factors. We found breech prevalence among ART and OST to be stable during the study period. Meanwhile, newborn birth weight was increased, and the gap between breech and other presentations in ART was reduced. Our results indicate that singleton pregnancies conceived by ART or OST were associated with a higher risk of breech at delivery. Well-known risk factors for the breech presentation were also confirmed. Some of these factors can be modified by implementing interventions to reduce their prevalence (e.g., tobacco smoke and previous CD). Full article
(This article belongs to the Special Issue Pregnancy Complication and Precision Medicine 2.0)
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10 pages, 1097 KiB  
Article
Using Fetal Fibronectin Test to Reduce Hospital Admissions with Diagnosis of Preterm Labor: An Economic Evaluation Study
by Bedayah Amro, Iman Alhalabi, Anila George, Hanan Haroun, Amar Hassan Khamis and Nadia Al Sawalhi
J. Pers. Med. 2023, 13(6), 894; https://doi.org/10.3390/jpm13060894 - 25 May 2023
Viewed by 1588
Abstract
Background: Preterm labor and delivery remain a major problem in obstetrics accounting for perinatal morbidity and mortality. The challenge is to identify those with true preterm labor to avoid unnecessary hospital admissions. The fetal fibronectin (FFN) test is a strong predictor of [...] Read more.
Background: Preterm labor and delivery remain a major problem in obstetrics accounting for perinatal morbidity and mortality. The challenge is to identify those with true preterm labor to avoid unnecessary hospital admissions. The fetal fibronectin (FFN) test is a strong predictor of preterm birth and can help identify women with true preterm labor. However, its cost-effectiveness as a strategy for triaging women with threatened preterm labor is still debatable. Objective: To evaluate the effect of FFN test implementation on hospital resources by reducing the admission rate of threatened preterm labor in a tertiary hospital, Latifa Hospital, UAE. Methods: A retrospective cohort study of singleton pregnancies between 24 and 34 weeks of gestation who attended Latifa Hospital in the period of September 2015–December 2016, complaining of threatened preterm labor after the availability of an FFN test, and a historical cohort study for those who attended with threatened preterm labor before the availability of an FFN test. Data analysis was performed using a Kruskal–Wallis test, Kaplan–Meier, Fischer exact chi-square and cost analysis. The significance was set at p-value < 0.05. Results: In total, 840 women met the inclusion criteria and were enrolled. The relative risk of FFN for delivery at term was 4.35 times higher among the negative-tested compared to preterm delivery (p-value < 0.001). A total of 134 (15.9%) women were unnecessarily admitted (FFN tested negative, delivered at term) which yielded $107,000 in extra costs. After the introduction of an FFN test, a 7% reduction of threatened preterm labor admissions was recorded. Full article
(This article belongs to the Special Issue Pregnancy Complication and Precision Medicine 2.0)
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11 pages, 265 KiB  
Article
Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
by Daniela-Loredana Bujorescu, Adrian Ratiu, Cosmin Citu, Florin Gorun, Oana Maria Gorun, Doru Ciprian Crisan, Alina-Ramona Cozlac, Ioana Chiorean-Cojocaru, Mihaela Tunescu, Zoran Laurentiu Popa, Roxana Folescu and Andrei Motoc
J. Pers. Med. 2023, 13(4), 645; https://doi.org/10.3390/jpm13040645 - 08 Apr 2023
Viewed by 1437
Abstract
(1) Background: The main challenge in cases of early onset fetal growth restriction is management (i.e., timing of delivery), trying to determine the optimal balance between the opposing risks of stillbirth and prematurity. The aim of this study is to determine the likelihood [...] Read more.
(1) Background: The main challenge in cases of early onset fetal growth restriction is management (i.e., timing of delivery), trying to determine the optimal balance between the opposing risks of stillbirth and prematurity. The aim of this study is to determine the likelihood of neonatal complications depending on the time of birth based on Doppler parameters in fetuses with early onset fetal growth restriction; (2) Methods: A case–control study of 205 consecutive pregnant women diagnosed with early onset FGR was conducted at the Obstetrics Clinic of the Municipal Emergency Hospital in Timisoara, Romania; The case group included newborns who were delivered at the onset of umbilical arteries absent/reversed end-diastolic flow, and the control included infants delivered at the onset of reversed/absent ductus venosus A-wave. (3) Results: The overall neonatal mortality rate was 2.0%, and there was no significant statistical difference between the two study groups. In infants delivered up to 30 gestational weeks, grades III/IV intraventricular hemorrhage and bronchopulmonary dysplasia were statistically significantly more frequent in the control group. Moreover, univariate binomial logistic regression analysis on fetuses born under 30 gestational weeks shows that those included in the control group are 30 times more likely to develop bronchopulmonary dysplasia and 14 times more likely to develop intraventricular hemorrhage grades III/IV; (4) Conclusions: Infants delivered according to the occurrence of umbilical arteries absent/reversed end-diastolic flow are less likely to develop intraventricular hemorrhage grades III/IV and bronchopulmonary dysplasia. Full article
(This article belongs to the Special Issue Pregnancy Complication and Precision Medicine 2.0)

Review

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14 pages, 337 KiB  
Review
Maternity Blues: A Narrative Review
by Valentina Tosto, Margherita Ceccobelli, Emanuela Lucarini, Alfonso Tortorella, Sandro Gerli, Fabio Parazzini and Alessandro Favilli
J. Pers. Med. 2023, 13(1), 154; https://doi.org/10.3390/jpm13010154 - 13 Jan 2023
Cited by 6 | Viewed by 5641
Abstract
Puerperium is a period of great vulnerability for the woman, associated with intense physical and emotional changes. Maternity blues (MB), also known as baby blues, postnatal blues, or post-partum blues, include low mood and mild, transient, self-limited depressive symptoms, which can be developed [...] Read more.
Puerperium is a period of great vulnerability for the woman, associated with intense physical and emotional changes. Maternity blues (MB), also known as baby blues, postnatal blues, or post-partum blues, include low mood and mild, transient, self-limited depressive symptoms, which can be developed in the first days after delivery. However, the correct identification of this condition is difficult because a shared definition and well-established diagnostic tools are not still available. A great heterogenicity has been reported worldwide regarding MB prevalence. Studies described an overall prevalence of 39%, ranging from 13.7% to 76%, according to the cultural and geographical contexts. MB is a well-established risk factor for shifting to more severe post-partum mood disorders, such as post-partum depression and postpartum psychosis. Several risk factors and pathophysiological mechanisms which could provide the foundation of MB have been the object of investigations, but only poor evidence and speculations are available until now. Taking into account its non-negligible prevalence after childbirth, making an early diagnosis of MB is important to provide adequate and prompt support to the mother, which may contribute to avoiding evolutions toward more serious post-partum disorders. In this paper, we aimed to offer an overview of the knowledge available of MB in terms of definitions, diagnosis tools, pathophysiological mechanisms, and all major clinical aspects. Clinicians should know MB and be aware of its potential evolutions in order to offer the most timely and effective evidence-based care. Full article
(This article belongs to the Special Issue Pregnancy Complication and Precision Medicine 2.0)
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