Background: Preoperative fasting and surgery cause metabolic stress, insulin resistance with ketosis, and postoperative nausea and vomiting (PONV). Oral carbohydrate loading strategy (CHO) improves outcomes in labor and general surgery. We aimed to compare the effectiveness of CHO with standard fasting in patients undergoing elective cesarean delivery (CD) under spinal anesthesia. Methods: A single-center, parallel, prospective randomized controlled trial (RCT) was conducted in a tertiary university obstetrics department at Pomeranian Medical University in Szczecin, Poland. Patients were randomly assigned (1:1 ratio) to the CHO group (oral carbohydrate 2 h before elective CD, n = 75) or the SF group (control—standard fasting, n = 73). The main outcome measures were incidence and severity of PONV at 6 and 24 h after CD, time to the first peristalsis, time to first bowel movement, and biochemical parameters indicating ketosis in mothers and their children. Results: A total of 148 adult females with singleton pregnancies undergoing elective CD under spinal anesthesia (ASA I and II) were included in the final analysis. At 24 h after CD, 8.0% from the CHO group vs. 20.55% reported three or more episodes of vomiting or dry retching as compared to patients in the SF group (p = 0.041). Preoperative CHO supplementation decreased preoperative feelings of hunger (p < 0.001) and thirst (p < 0.001). Laboratory results in the CHO group showed higher plasma pH (p = 0.001) and glucose (p < 0.001), lower F2-isoprostane in plasma (p = 0.049) and urine (p = 0.018), lower urine F2-isoprostane/creatinine ratio (p = 0.045) than in the SF group. HOMA-IR (p < 0.001) and lactate (p < 0.001) were higher in the CHO group than in the control group. Conclusions: There was no significant difference in the incidence or severity of early PONV at 6 h. The incidence of vomiting or dry retching at 24 h after cesarean delivery was lower in the CHO group as compared to standard starvation, but the combined results of PONV frequency and severity on the Wengritzky scale did not differ between the two study groups. Preoperative CHO supplementation decreased preoperative feelings of hunger and thirst, enhancing the comfort of pregnant women. Trial registration: ClinicalTrials.gov identifier: NCT04069806.

Appropriate gestational weight gain (GWG) favors fewer complications related to pregnancy, delivery, puerperium, and the condition of the fetus and newborn baby. The aim of this study was to evaluate weight gain in women during and after pregnancy, including both women with and without gestational diabetes mellitus (GDM). Materials and methods: The study involved 42 singleton pregnant women diagnosed with GDM between the 24th and 28th week of pregnancy. The control group consisted of 28 nondiabetic women with a singleton pregnancy. The pre-pregnancy BMI, intra-pregnancy weight gain, and postpartum body weight were assessed in the participants. Results: There were no statistically significant differences in the values of intra-pregnancy weight gain. Only diabetic women who were also overweight or obese had a significantly higher percentage of weight gain during pregnancy. The analysis of the percentage of weight gain during the entire pregnancy showed differences only in the group of women with pre-pregnancy BMI over 30. Conclusions: There were no significant differences in total pregnancy or mid-pregnancy weight gain between women with and without GDM. Most of the women had too high or too low total-pregnancy and mid-pregnancy weight gain. Therefore it is necessary to control GWG and educate pregnant women about it.

Breastfeeding may have a positive effect on glucose metabolism and insulin sensitivity, which may reduce the risk of developing diabetes following gestational diabetes mellitus (GDM). This study aimed to evaluate the effect of breastfeeding and GDM on the body mass composition of the studied women, the levels of leptin, ghrelin, adiponectin, resistin, and insulin, and weight loss during the 6–8-week postpartum period and 1 year after childbirth. Materials and methods: The study group included 42 women with a singleton pregnancy, diagnosed with GDM between the 24th and 28th week of gestation. The control group consisted of 28 non-diabetic women with a singleton pregnancy. This study was carried out at 6–8 weeks as well as at 1 year postpartum. The women were subjected to body weight measurements and body composition analysis performed using a professional body composition analyzer TANITA DC-430 S MA. Waist circumference and subcutaneous fat was measured. Blood for laboratory tests was taken in the morning, on an empty stomach. Results: It was shown that, regardless of diabetes, exclusive breastfeeding had a significant impact on weight loss at 6–8 weeks postpartum (p = 0.014785) and lower insulin levels (p = 0.047). However, there was no effect of breastfeeding on the women’s anthropometric measurements or hormone levels one year after delivery, except for the thickness of subcutaneous adipose tissue, which was significantly lower in breastfeeding women (p = 0.03). One year after delivery, breastfeeding women had a lower BMI (p = 0.0014), less-thick subcutaneous adipose tissue (p < 0.001), and a lower risk of obesity (p = 0.016). There were also higher insulin and ghrelin levels in both breastfeeding and non-breastfeeding women (p < 0.001), and lower resistin levels in non-breastfeeding women (p = 0.004). Women who had diabetes during pregnancy had a significantly reduced waist circumference and subcutaneous fat thickness after one year (p < 0.001 and p = 0.05, respectively). Conclusions: Having diabetes during pregnancy did not significantly affect the results of anthropometric measurements and hormone levels noted at 6–8 weeks after delivery (the only exception was the thickness of subcutaneous fat tissue, which was greater in women without GDM). This may indicate normalization of carbohydrate metabolism after childbirth; however, the observation period is too short to elucidate long-term metabolic effects. This suggests the need for further research related to GDM and breastfeeding.

Background and Objectives: The aim was to compare body composition and levels of biochemical blood parameters and identify relationships between biochemical parameters and body composition of women with type 2 diabetes and healthy ones, both in perimenopausal period (172 women aged between 45 and 65 come from the West Pomeranian Voivodeship, Poland). Materials and Methods: The study consisted of an interview, body composition analysis with Jawon Medical IOI-353 (Yuseong, South Korea) analyser and venous blood biochemical analysis (lipid profile, levels of glucose, insulin, CRP, glycated haemoglobin). Results: The vast majority of body composition measurements varied between study and control groups in a statistically significant way (p < 0.05) except protein and soft lean mass of the torso. Statistically significant differences between the two groups have been observed in case of all biochemical parameters (p < 0.001). Conclusions: Body composition of women suffering from type 2 diabetes significantly varied from body composition of healthy women. Results of the first group were characterised by higher values, especially in case of general parameters, abdominal area, content of adipose tissue and soft tissues. Relationship between body composition and biochemical results may be observed, especially in level of triglycerides, CRP and insulin. Higher concentrations of these parameters were associated with increased values of majority of body composition measurements regardless of type 2 diabetes incidence.

Human leukocyte antigen G (HLA-G) is observed in immune system cells and other organs. It is a class Ib molecule, which plays a pivotal role in the implantation and maintenance of pregnancy. The aim of this study was to assess the relationship between serum sHLA-G levels and the HLA-G allele in parental pairs with complicated obstetric histories. The clinical material consisted of 210 women and 190 men with the experience of a complicated or an unsuccessful pregnancy. The control group included parents―89 women and 86 men―lacking complicated obstetric histories. We applied genetic analysis methods: isolation of genomic DNA, sequencing, and determination of serum sHLA-G levels. There were no statistically significant differences in the frequencies of the HLA-G −725 C>G polymorphism between particular experimental groups compared with the control group (p > 0.05). The median sHLA-G levels in the women with the HLA-G10101 allele (15.4 U/mL) were significantly higher than in the women with other alleles (p < 0.05). The HLA-G 10101 allele seems to protect against antiphospholipid syndrome, which may be associated with increased serum sHLA-G levels in its carriers. The relationship between serum sHLA-G levels and the HLA-G polymorphisms in the Polish population requires further investigation.

Breastfeeding is the optimal method of feeding infants during the first period of their lives. The aim of this study was to analyze the impact of hospital procedures on the onset of lactation, presenting the relationship between maintaining skin-to-skin contact and the time of attaching an infant to the mother’s breast, the course of first breastfeeding, feeding methods, suctioning an infant’s airway after birth and the type of delivery. The study was conducted using a diagnostic survey. The questionnaire contained 31 closed and semi-open questions concerning hospital procedures that could affect the lactation process. The respondents were primiparous and multiparous women in an early postpartum period who gave birth through the abdominal wall or vaginally. The study included 154 women aged 18–45 years who gave birth at the Department of Maternal-Fetal Medicine and Gynecology of Pomeranian Medical University in Szczecin, Hospital in Police (Poland). The collected material was analyzed statistically using the χ2 test. Based on the obtained results, the following conclusions were drawn: the onset of lactation was influenced by early skin-to-skin contact after birth with simultaneously attaching the baby to the breast, vaginal birth after the 37th week of pregnancy, and the duration of labor.