Background: cervical cancer is one of the most common malignancies in women worldwide and its management remains challenging and complex. As Cytochrome4Z1 (CYP4Z1) is overexpressed in many tumours, its expression in cervical cancer is unknown. Therefore, the present study aimed to evaluate CYP4Z1 expression in cervical cancers. Methods: CYP4Z1 expression was immunohistochemically assessed in 100 cases of cervical cancers along with ten normal cervix tissues, and the enzyme’s relationship to several clinicopathological features and survival was explored. Results: CYP4Z1 was strongly expressed in 55% of cervical cancer patients. Normal cervix samples were negative for CYP4Z1 expression. Importantly, this expression was significantly found in patients with the late stage of the disease, lymph node metastasis, and high tumour invasion (p < 0.05). Interestingly, CYP4Z1 expression was significantly correlated with shorter survival times of cervical cancer patients. Univariate analysis showed that CYP4Z1 expression, tumour stage, lymph node metastasis, and tumour invasion were significantly correlated with patient survival (p < 0.05). The multivariate analysis revealed that only CYP4Z1 expression and tumour stage were significantly correlated with patient survival (p < 0.05). Conclusions: CYP4Z1 expression is associated with cervical cancer patients’ survival and may serve as an independent predictor of poor prognosis in cervical cancer patients.

Background and Objective: Ovarian cancer is a leading cause of death in females. Since its treatment is challenging and causes severe side effects, novel therapies are urgently needed. One of the potential enzymes implicated in the progression of cancers is Cytochrome 4Z1 (CYP4Z1). Its expression in ovarian cancer remains unknown. Therefore, the current study aims to assess CYP4Z1 expression in different subtypes of ovarian cancers. Materials and Methods: Immunohistochemistry was used to characterize CYP4Z1 expression in 192 cases of ovarian cancers along with eight normal ovarian tissues. The enzyme’s association with various clinicopathological characteristics and survival was determined. Results: CYP4Z1 was strongly expressed in 79% of ovarian cancers, compared to negative expression in normal ovarian samples. Importantly, significantly high CYP4Z1 expres-sion was determined in patients with advanced-stage cancer and a high depth of invasion (p < 0.05). Surprisingly, CYP4Z1 expression was significantly associated with a low patient survival rate. Univariate analysis revealed that patient survival was strongly associated with CYP4Z1 expression, tumor stage, depth of invasion, and lymph node metastasis (p < 0.05). Multivariate analysis showed that only CYP4Z1 expression was significantly associated with patient survival (p < 0.05). Conclusions: CYP4Z1 expression is correlated with shorter patient survival and has been identified as an independent indicator of a poor prognosis for ovarian cancer patients.

Background: The literature underrepresents maternal anemia in southern Jordan, and national studies often have small sample sizes. According to the 2019 Jordan National Micronutrient Survey, maternal anemia in Jordan accounted for 19.1% of cases, with the majority experiencing mild anemia (17.1%). Among the 29 pregnant women recruited from the southern region, 56.5% had anemia, of which 34.8% had mild and 21.7% had moderate anemia. The current study provides an update on the prevalence of anemia during pregnancy in southern Jordan. Methods: This cross-sectional study was conducted at a government referral hospital in southern Jordan. Pregnant women who visited outpatient clinics were included in the study. Data were collected through face-to-face interviews, and blood samples were collected to measure hemoglobin levels. Descriptive analyses of continuous and categorical variables were performed. Maternal anemia risk factors were assessed using the chi-square test, Fisher’s exact test, and multivariate logistic regression analysis. Statistical significance was defined at p < 0.05. Results: Of the 474 pregnant women who agreed to participate, 36.8% had anemia. Education, income, diet (number of meals and meat consumption), regularity of antenatal care, and supplement use were factors that significantly affected hemoglobin levels (p < 0.05). The adolescent pregnancy rate was 5.3%, and 48% had mild to moderate anemia. Conclusions: Maternal anemia rates in southern Jordan remained high, despite a slow decline. Reducing this burden requires improved access to healthcare and health education, particularly for rural residents who are at greater risk of disease.

Background/Objective: Congenital anomalies (CAs) are structural or functional abnormalities contributing to global neonatal morbidity and mortality. Data on antenatally diagnosed CAs in southern Jordan are limited. The present study reports their prevalence and patterns at the Maternal-Fetal Medicine Clinic of a governmental hospital and examines associated maternal, pregnancy, and delivery outcomes. Methods: This retrospective, hospital-based study involved all pregnant women who presented to the clinic between January 2022 to December 2023 and were diagnosed with congenital fetal anomalies. Data about maternal characteristics, classification of fetal anomalies, and pregnancy outcomes were retrieved from medical files. Statistical analyses comprised chi-square tests, Fisher’s exact tests, independent t-tests, and multiple binary logistic regressions. Results: Among the 750 pregnant women, 74 (9.9%) were diagnosed with CAs. Urinary system anomalies were the most common (54.1%), followed by central nervous system (CNS) anomalies (37.8%). Major anomalies constituted 59.5%, whereas 40.5% were minor anomalies. Gestational age at diagnosis and birthweight were significantly associated with major anomalies (p < 0.05). All stillbirths (10.8%) and pregnancy losses before 24 weeks of gestation (9.5%) occurred in cases with major anomalies (p < 0.05). Though preterm delivery rates were higher with major anomalies, this association was not statistically significant. Conclusions: Major CAs (59.5%) in this southern Jordan cohort were strongly linked to stillbirths and early pregnancy loss, highlighting the need for early diagnosis and improved prenatal care. Targeted interventions, including anomaly scans and risk factor (RF) screening, may reduce the 9.9% prevalence observed.

Background: Fetal exposure to maternal smoking has been implicated as a contributing factor to birth complications and subsequent developmental impairments in children. The aim of the present study was to investigate the association between maternal smoking and pregnancy outcomes in a sample of women giving birth at hospitals in southern Jordan. Methods: This observational study extracted data from the medical records of enrolled pregnant women, including demographic information, vital signs, and newborn measurements. Specific data included birth type (miscarriage or no miscarriage), birthweight, head circumference, Apgar score, and labor (term or pre-term). A two-tailed p-value of <0.05 was considered statistically significant. Results: The study sample consisted of 410 pregnant women, comprising 114 smokers (smoking group) and 296 non-smokers (control group). Smokers were more likely to have lower parity, a lower gestational age upon labor, a lower birthweight (<2.5 kg), and they were less likely to have a pre-term labor compared to non-smokers. However, logistic regression could not determine any significant association with smoking. Smoking during pregnancy was not associated with an increased likelihood of miscarriage (odds ratio (OR): 1.22, 95% confidence interval (CI): 0.68–2.18, p = 0.50), low birthweight (OR = 0.70, 95% CI: 0.34, 1.45), or pre-term delivery (OR = 4.13, 95% CI: 2.27, 7.52). No significant associations were observed between smoking status and head circumference or Apgar score. Conclusions: Maternal smoking carries risks for pregnancy outcomes. Pregnant women who smoke are more likely to have low fetal birthweight and pre-term birth compared to non-smoking pregnant women. Our results highlight the need for comprehensive smoking cessation strategies targeted at pregnant women.

Background: Gestational diabetes mellitus (GDM) in Jordan displays a considerable variable prevalence, with reported rates ranging from 1.2% to 13.5%. To address this, our institution established a dedicated GDM clinic. The primary goal was to develop an efficient management system that reduces hospital admissions and improves outpatient care for pregnant women with diabetes. The current study aims to assess the cost-benefit ratio of the clinic, determine the incidence of GDM at our hospital, identify its associated risk factors, assess pregnancy outcomes, and analyze the treatment regimens applied. Methods: From March to August 2023, data from newly diagnosed women with GDM attending outpatient clinics and the GDM clinic at Al Karak Governmental Hospital were retrospectively analyzed. Extraction of information on hospital admissions, baseline maternal characteristics, and perinatal outcomes from medical records was performed. The hospital’s accounting department provided daily cost details for the patient’s stay. We then used these details to calculate the average costs over a four-day period. Descriptive analysis was performed for the maternal sociodemographics, obstetric characteristics, and perinatal outcomes. The association between categorical variables was analyzed using Fisher’s exact test. We conducted a Mantel-Haenszel (MH) analysis to evaluate the associations between selected perinatal outcomes (large for gestational age (LGA), polyhydramnios, pregnancy-induced hypertension (PIH), and neonatal intensive care unit (NICU) admission rate) and two treatment regimens (metformin vs. metformin and insulin), while controlling for the gestational age at diagnosis. SPSS version 25 was used to complete the statistical analysis. Results: During the six-month study period, 75 women were diagnosed with GDM, yielding an incidence rate of 4.97%. Hospitalization for blood sugar management decreased from 81 admissions in the previous year to 16 during the study period. A mean age of 32.6 years (±5.47) was observed among the participants, and 46% were considered obese. Two-thirds of multiparous women had a first-degree relative with diabetes, and 45% reported prior GDM. At diagnosis, 60% were less than 24 weeks pregnant. Treatment modalities included metformin alone (25.3%) and combined metformin-insulin therapy (65.3%). LGA was the most prevalent antenatal complication (30.6%). After controlling for gestational age at diagnosis, no statistically significant differences were found between treatment groups for LGA, polyhydramnios, and pregnancy-induced hypertension (MH p values: 0.505, 0.971, and 0.737, respectively). However, the combined therapy group showed a tendency towards increased odds of polyhydramnios (odd ratio (OR) 1.431, 95% confidence interval (CI) 0.285–7.173) and PIH (OR 2.818, 95% CI 0.255–31.097), but decreased odds of LGA (OR 0.476, 95% CI 0.111–2.050). Compared to the metformin-only group, the combined therapy group had significantly higher rates of NICU admissions (87% vs. 13%, p value = 0.001). 66.7% of these admissions were for hypoglycemia screening. Conclusions: This study evaluated a clinic dedicated to managing GDM in a region with a high prevalence of diabetes. The clinic improved care and created a valuable research database. Our findings revealed no significant outcome differences between insulin-treated patients and those on metformin, though the former group had higher NICU admission rates due to logistical factors. As a result of this centralized approach, we may be able to develop population-specific protocols, enhance maternal and neonatal care, and advance the management of GDM in our community and the development of new research.