Objectives: The frequency of GDM and vitamin D insufficiency in Mexico is high. Vitamin D supplementation in GDM patients has shown favorable but non-homogeneous results regarding improvement of glycemic profile. The aim of the study was to assess the effects of supplementing with 5,000 IU of vitamin D on the glycemic profile of women with GDM. Methods: A randomized clinical trial was conducted on women with GDM who received 5,000 IU of vitamin D (n=27) or a placebo (n=27) for eight weeks. Changes in vitamin D levels and metabolic parameters before and after the intervention were analyzed. Results: Vitamin D vs. placebo: 25-OHD (32 vs. 26 ng/mL, p=0.006), HbA_1c (6.0 vs. 6.1%, p=0.29), glucose (99 vs. 87 mg/dL, p=0.29), insulin (14 vs. 13 µIU/mL, p=0.79), HOMA-IR (3.6 vs. 2.6, p=0.55), QUICKI (0.31 vs. 0.33, p=0.55). Conclusions: Supplementation with 5,000 IU of vitamin D for eight weeks had no significant effect on the glycemic profile.

Toxoplasma gondii (T. gondii) is the causal agent of toxoplasmosis. It may produce severe damage in immunocompromised individuals, as well as congenital infection and intrauterine growth restriction (IUGR). Previous reports have associated interleukin IL-33 with miscarriage, fetal damage, and premature delivery due to infections with various microorganisms. However, IL-33 has not been associated with congenital toxoplasmosis. The sST2 receptor has been reported in patients who have had recurrent miscarriages. On the other hand, IL-1β was not found in acute Toxoplasma infection. Our aim was to analyze the associations between the serum levels of IL-33 and IL-1β in IUGR and toxoplasmosis during pregnancy. Eighty-four serum samples from pregnant women who had undergone 26 weeks of gestation were grouped as follows: with anti-Toxoplasma antibodies, without anti-Toxoplasma antibodies, IUGR, and the control group. IgG and IgM anti-T. gondii antibodies, as well as IL-33, ST2, and IL-1β, were determined using an ELISA assay. Statistical analyses were performed using the Pearson and Chi-square correlation coefficients, as well as the risk factors and Odds Ratios (ORs), with a confidence interval of 95% (CI 95). The results showed that 15/84 (17.8%) of cases were positive for IgG anti-Toxoplasma antibodies and 2/84 (2.38%) of cases were positive for IgM. A statistically significant difference was found between IUGR and IL-33 (p < 0.001), as well as between ST2 and IUGR (p < 0.001). In conclusion, IUGR was significantly associated with IL-33 and ST2 positivity based on the overall IUGR grade. No significant association was found between IUGR and the presence of anti-Toxoplasma antibodies. There was no association between IL-1β and IUGR. More research is needed to strengthen the utility of IL-33 and ST2 as biomarkers of IUGR.

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. One-third of the world’s population has come into contact with this parasite. In Mexico, the prevalence is between 15% and 50% in the general population and 34.9% in women with high-risk pregnancies. In pregnancy, the highest incidence of infection occurs in the third trimester and fetal damage is inversely proportional to gestational age. Maternal hormones play a fundamental role in the immune response. There are very few studies, with controversial results, on the levels of increased hormones and their relationship to the kinetics of T. gondii infections during pregnancy. The aim was to determine the serum levels of 17-β estradiol, prolactin, and progesterone, and their association with anti-T. gondii antibodies’ kinetics in pregnancy. Fifty-two pregnant patients were studied. A questionnaire with sociodemographic and clinical aspects was used. Afterward, 10 mL of venous blood was collected by venipuncture every trimester. The concentrations of 17-β estradiol, progesterone, and prolactin were measured, using the ELISA method. In addition, anti-Toxoplasma IgG and IgM antibodies were also determined in the first, second, and third trimester. The prevalence of anti-Toxoplasma IgG antibodies was 26.92% in the first and second trimester and 32.7% in the third trimester. In seropositive women, 17-β estradiol increased in the second and third trimesters of pregnancy. Progesterone increased significantly p < 0.039 in the third trimester in these women, while prolactin increased in the second trimester with a statistical significance of p < 0.021. In addition, 17-β estradiol, progesterone, and prolactin are associated with T. gondii infection during pregnancy. New studies are necessary to clarify the specific mechanisms of immune response related to these hormones during pregnancy.

Objectives: Pulmonary embolism (PE) is an important cause of maternal mortality. There are several guidelines for its diagnosis and management, but there is little information regarding follow-up and frequency of long-term complications. The aim of the study was to determine the frequency of long-term cardiovascular symptoms in patients who had obstetric PE. Methods: Cross-sectional study including patients who had PE during pregnancy or the puerperium. A telephone interview was conducted at least one year after PE, to determine the frequency of cardiovascular symptoms, general health, and COVID-19 infection, considering the study was conducted during the 2020 pandemic. Results: In five years (2015–2019) there were eleven patients with PE, two died during the acute phase, and the rest (nine) were alive and able to answer our interview. Cardiovascular symptoms were common (6, 67 %), the most frequent were fatigue, edema, and mild dyspnea. Four patients (44 %) had slight limitation of physical activity and one (11 %) had PE recurrence. Of the six symptomatic patients four had obesity and one was overweight. Conclusions: There is a high frequency of long-term cardiovascular symptoms in patients who had PE during pregnancy or the puerperium. Stronger evidence is needed to design a long-term care pathway after obstetric PE.

BACKGROUND: Understanding the lingering effects of child abuse may improve healthcare pathways with preventive and supportive strategies. OBJECTIVE: To compare adverse outcomes between survivors of child abuse and non-exposed subjects. DESIGN AND SETTING: This is a cohort study conducted at the Pediatric Emergency Department of the Nuevo Hospital Civil de Guadalajara, Guadalajara, Mexico. METHODS: This cohort study of Mexicans compared adverse outcomes between survivors of child abuse and non-exposed individuals from 2011 to 2018. Additionally, we contacted survivors in 2020 to collect additional data, including sociodemographic and study variable-related information. RESULTS: This study included 300 survivors of child abuse, paired by age with 300 non-exposed subjects. Neglect and sexual abuse were the most frequent types of abuse. Among the survivors, there was a higher risk of hyperactivity with attention deficit [Relative Risk (RR) = 4.65(2.06–10.51); P = 0.0001], drug abuse [RR = 3.09(1.25–7.63); P = 0.0001], mood disorders [RR = 2.97(1.81–4.86); P = 0.0001], tobacco use [RR = 2.79(1.60–4.88); P = 0.0001], and engagement with substance abuse and sexual intercourse at a younger age. Non-exposed subjects had a higher level of education [RR = 0.65(0.49–0.87); P = 0.0001] and were more engaged in sports [RR = 0.31(0.18–0.52); P = 0.0001]. CONCLUSION: Survivors of child abuse are at risk for psychological problems and substance abuse. Increasing sports engagement and school attendance may protect against adverse outcomes.