Diet, particularly vitamin deficiency, is associated with the risk of birth defects. The aim of this review paper is to show the characteristics of common and severe neural-tube defects together with congenital heart defects (CHD) as vitamin deficiencies play a role in their origin. The findings of the Hungarian intervention (randomized double-blind and cohort controlled) trials indicated that periconceptional folic acid (FA)-containing multivitamin supplementation prevented the major proportion (about 90%) of neural-tube defects (NTD) as well as a certain proportion (about 40%) of congenital heart defects. Finally the benefits and drawbacks of three main practical applications of folic acid/multivitamin treatment such as (i) dietary intake; (ii) periconceptional supplementation; and (iii) flour fortification are discussed. The conclusion arrived at is indeed confirmation of Benjamin Franklin’s statement: “An ounce of prevention is better than a pound of care”.

Introduction: The lifetime prevalence of human papillomavirus infection (HPV) is estimated to be around 80% and it is the most common sexually transmitted infection. Despite being well known for its oncologic relevance, it has been associated with adverse pregnancy outcomes, though available evidence is contradicting. Previous meta‐analyses involved articles which based HPV infection on Pap smear results, leading to a significant source of bias. Therefore, we aimed to assess the burden of genetically proven HPV infection on adverse pregnancy outcomes.Material and Methods: In our meta‐analysis, pregnant women tested for HPV DNA were only considered eligible. We conducted a systematic search in three major databases (PubMed, Embase, and CENTRAL) on September 22, 2023. Cohort, cross‐sectional, and case‐control studies were eligible for the analysis. The exposed group consisted of HPV‐infected patients. We assessed the odds ratios (OR) with a confidence interval (CI) of 95%. In order to reduce the heterogeneity, we performed subgroup analyses based on different strains (high risk HPV, HPV 16/18, study design). The study was prospectively registered on PROSPERO (CRD42022370228).Results: Our study involved 14 articles with 7008 women. A significant association was found between preterm delivery and HPV infection (OR: 1.94, CI: 1.31–2.87). No significant association was found when separately examining high‐risk HPV‐infected women (OR: 1.94, CI: 0.82–4.59), and HPV 16 or 18‐infected women (OR: 2.08, CI: 0.50–8.63) in terms of preterm delivery. No significant association was found between spontaneous abortion and HPV infection (OR: 1.02, CI: 0.16–6.31).Conclusions: Our analysis indicates an association between HPV infection and preterm delivery. It is imperative that future studies consider confounding variables more comprehensively. Additionally, the global implementation of HPV vaccination programs holds significance not only in oncology but also in obstetrics.

The objective of the present study was to check the efficacy of progress in the medical care of epileptic pregnant women on the basis of the reduction of different congenital abnormalities (CAs) in their offspring. First, the prevalence of medically recorded epilepsy was compared in 95 pregnant women who later had offspring with different CAs (case group) and 90 pregnant women who later delivered newborn infants without CA (control group) and matched to cases in the Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. Second, the rate of different CAs was compared in the offspring of epileptic pregnant women between 1980 and 1989 and 1990-1996. Cleft lip with or without cleft palate, cleft palate, cardiovascular CAs, oesophageal atresia/stenosis, hypospadias and multiple CAs showed a higher risk in the offspring of pregnant women with epilepsy treated with different antiepileptic drugs, explained mainly by polytherapy. There was no higher risk for total CAs after monotherapy. There was no significantly lower rate of total CAs in the offspring of epileptic pregnant women during the second period of the study. The efficacy of special medical care of epileptic pregnant women was not shown on the basis of decrease in the rate of CAs in the offspring of epileptic pregnant women

Objectives. To study the possible association of common dyspepsia including heartburn and gastro‐esophageal reflux disease and its related drug treatments in pregnant women with congenital anomalies (CAs) in their offspring. Design. Comparison of cases affected with different CAs and matched controls without defects in a ratio of 1:2 born to mothers affected with severe chronic dyspepsia in early pregnancy. Setting. Hungarian Case–Control Surveillance System of Congenital Abnormalities. Population. CAs were evaluated in informative offspring: live‐born infants, stillborn fetuses, and malformed fetuses after prenatal diagnosis followed by elective termination of pregnancy in the population‐based Hungarian material. Methods. Prospectively and medically recorded severe chronic dyspepsia recorded in the prenatal maternity logbook was compared among women who later delivered babies with different CAs (cases) and matched women who delivered newborns without any defect (controls). Main outcome measures. Different CAs, gestational age and birthweight, rates of preterm birth, and low birthweight newborns. Results. Of 22,843 cases with CAs, 148 (0.65%) had mothers with severe chronic dyspepsia, compared to 214 (0.56%) of 38,151 controls (adjusted OR with 95% CI = 1.2, 0.9–1.4). Specific groups of CAs assessed vs. controls showed that only isolated rectal/anal atresia/stenosis was associated with a higher risk of severe maternal dyspepsia in early pregnancy (adjusted OR with 95% CI: 4.3, 1.7–10.5). Conclusions. Severe chronic dyspepsia in early pregnancy and drug treatment for this was not associated with a higher risk of CAs, except possibly isolated rectal/anal atresia/stenosis.

Introduction: Topical Imiquimod is an immune response modifier approved for the off-label use of vulvar intraepithelial neoplasia. We conducted this systematic review and meta-analysis to investigate the efficacy and safety of Imiquimod in treating cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV)-positive patients. Methods: The study was prospectively registered (CRD420222870) and involved a comprehensive systematic search of five medical databases on 10 October 2022. We included articles that assessed the use of Imiquimod in cervical dysplasia and HPV-positive patients. Pooled proportions, risk ratios (RRs), and corresponding 95% confidence intervals (CIs) were calculated using a random effects model to generate summary estimates. Statistical heterogeneity was assessed using I² tested by the Cochran Q tests. Results: Eight articles reported on 398 patients who received Imiquimod out of 672 patients. Among CIN-2–3 patients, we observed a pooled regression rate of 61% (CI: 0.46–0.75; I²: 77%). When compared, Imiquimod was inferior to conization (RR: 0.62; CI: 0.42–0.92; I²: 64%). The HPV clearance rate in women who completed Imiquimod treatment was 60% (CI: 0.31–0.81; I²: 57%). The majority of side effects reported were mild to moderate in severity. Conclusions: Our findings indicate that topical Imiquimod is safe and effective in reducing cervical intraepithelial neoplasia and promoting HPV clearance. However, it was found to be inferior compared to conization. Imiquimod could be considered a potential medication for high-grade CIN patients and should be incorporated into guidelines for treating cervical dysplasia.