The promotion of physical activity (PA) in various subgroups of the population such as people with physical disabilities has been spotlighted in the revised guidelines of The World Health Organization (WHO), Geneva, Switzerland. In order to update public health interventions, there is a need to identify factors that may promote or prevent engagement in PA for special subgroups of the population. This study aims to calculate the PA levels of individuals with and without physical disabilities in Saudi Arabia, their assessment of the environmental (EQoL), and the predictive role of EQoL in PA. The International Physical Activity Questionnaire (IPAQ) and the EQoL domain in standardized WHOQoL Questionnaire were administered on both groups of the population. The study sample comprised 116 individuals with physical disabilities and 243 individuals without any form of disability as a control group. A regression analysis was performed to analyze the predictors of PA in both groups. Findings showed that among the individuals with disabilities, older people were more likely to engage in PA as compared to the younger age group (p < 0.05) and males were significantly less likely to meet the PA criteria. Some of the EQoL features such as safety increased the likelihood of PA up to 2.3 times (p < 0.05) in individuals with physical disabilities. In addition, opportunities for leisure activities were a significant predictor of PA among both groups of individuals with and without physical disabilities (p < 0.05). Our findings suggest that upcoming public health interventions should focus on improving various dimensions of EQoL for the promotion of physical activity among individuals with physical disabilities. Additional studies are needed to further explore various sociodemographic and environmental factors which can affect the PA status of disabled groups.

Preeclampsia is a complex hypertensive disorder of pregnancy characterized by systemic inflammation, endothelial dysfunction, and placental insufficiency, contributing significantly to maternal and fetal morbidity. Recent evidence underscores the role of adipokines—bioactive molecules secreted by adipose tissue and the placenta—in the pathophysiology of preeclampsia. This review explores the dysregulated expression and function of key adipokines, such as leptin, adiponectin, resistin, chemerin, visfatin, and omentin in preeclamptic pregnancies. Pro-inflammatory adipokines (leptin, resistin, chemerin, and visfatin) are consistently upregulated, amplifying inflammatory signaling (e.g., JAK/STAT, TLR4/NF-κB) and promoting endothelial dysfunction. Conversely, anti-inflammatory adipokines (adiponectin and omentin) are markedly downregulated, weakening vasoprotective and metabolic regulatory pathways. These alterations are closely linked to gene expression changes in placental and adipose tissues under hypoxic and inflammatory conditions, forming a feed-forward loop of vascular injury. Furthermore, adipokines are emerging as promising biomarkers for early diagnosis and risk stratification in preeclampsia, with clinical studies correlating their plasma levels to disease onset and severity. Therapeutic modulation of adipokine signaling pathways offers a novel approach to restoring metabolic-vascular homeostasis in high-risk pregnancies. By integrating current molecular insights, this review provides a comprehensive framework for understanding adipokine-mediated mechanisms in preeclampsia and highlights their potential in improving prediction, prevention, and management strategies.

Background: Treatment tolerability and treatment environment are two major spheres of infertility care that may associate with women’s emotional health and coping mechanisms. Aim: The present study aimed at assessing the relationship between infertility treatment quality and various aspects of emotion-focus coping, problem-focus coping, and avoidance coping mechanisms. Method: The study was completed by using standardized tools and data from this descriptive, cross-sectional, correlational study were collected from 350 women undergoing infertility treatments in private reproductive healthcare centers in Quetta, Pakistan. Findings: Treatment tolerability was found to be positively associated with positive reframing (p < 0.02) and negatively associated with the use of emotional support (p < 0.03); acceptance (p < 0.01); humor (p < 0.03); behavioral disengagement (p < 0.01) and venting (p < 0.01). The quality of the treatment environment demonstrated a negative correlation between religious coping (p < 0.02) and behavioral disengagement (p < 0.01), whereas it showed a positive correlation with active coping (p < 0.03) and planning (p < 0.02). The linear regression analysis demonstrated that treatment tolerability significantly increased with positive reframing (R2 = 0.118, F(304) = 2.22, p < 0.03). Behavioral disengagement significantly decreased with better treatment environment (R2 = 0.111, F(304) = 2.09, p < 0.02). Discussion: We discussed the findings keeping in view the role of social, cultural, and economic factors related to infertility care in the context South-Asian culture, and recommendations are made to promote women’s mental health and coping by improving some specific aspects of infertility treatment quality. Conclusions: High treatment tolerability may associate with some useful aspects of emotion-focus coping, such as positive reframing, whereas low treatment tolerability may associate with avoidance coping, such as behavioral disengagement and venting. Besides, the quality of the infertility treatment environment enables women to use problem-focus coping mechanisms, such as planning and active coping.

Background: We assessed risk factors, antenatal and intrapartum complications associated with early-onset Gestational diabetes mellitus (GDM) in comparison with late-onset GDM. Methods: This retrospective study included 161 GDM women having singleton pregnancies, without previous medical disorder and delivered at a tertiary care Hospital in Ha’il City, KSA from Dec 2020 till Jun 2021. Women diagnosed at < 24 weeks of pregnancy were grouped as early-onset GDM (n=71) and those diagnosed at ≥ 24 weeks as late-onset GDM (n=90). Both groups were matched for background variables. Chi-square and binary logistic regression analysis were applied with P-value significance at 0.05. Results: Past history of GDM, macrosomia and stillbirth were significant predictors for early-onset GDM (P value 0.000, 0.002 and 0.040 respectively). Regression analysis showed early-onset GDM significantly increases the risk for recurrent urinary tract infections (AOR 2.35), polyhydramnios (AOR 2.81), reduced fetal movements (AOR 2.13), intrauterine fetal demise (AOR 8.06), macrosomia (AOR 2.16), fetal birth trauma (2.58), low APGAR score at birth (AOR 8.06), and neonatal ICU admissions (AOR 2.65). Rate of preterm birth, hypertensive disorders, labor onset (natural vs. induced) and cesarean section and intrapartum maternal complications were same in both groups. Conclusion: Early-onset GDM significantly increases certain maternal (recurrent urinary tract infections, polyhydramnios and reduced fetal movements) and fetal complications (intrauterine fetal demise, macrosomia fetal birth trauma, low APGAR score at birth and neonatal ICU admissions). Most of these adverse pregnancy outcomes can be prevented through early registration and screening, close follow up, growth ultrasounds, and provision of efficient emergency and neonatal care services.

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Objectives: To determine the prevalence, risk factors for macrosomia and pregnancy outcome in women with gestational diabetes (GDM). Methods: In this prospective observational study, we included the data of 161 pregnant females diagnosed with GDM. The study was conducted from December 1st, 2020 to June 30, 2021, at the Maternity and Children Hospital (MCH) of Hail, Saudi Arabia. The data regarding risk factors of macrosomia was obtained from each patient. The patients were followed till the delivery of the baby. The data regarding the prevalence of fetal macrosomia and its associated outcomes was noted. Results: The prevalence of fetal macrosomia was 19.8%. Maternal obesity (OR 4.87), poorly controlled diabetes (OR 3.3), previous history of good-sized baby (OR 2.30), previous history of congenital abnormalities (OR 7.2) were the significant risk factors of fetal macrosomia. The prevalence of maternal and fetal complications was high among pregnancies complicated by fetal macrosomia. The prevalence of fetal macrosomia and other fetal complications was high in poorly controlled GDM patients in comparison to optimal control GDM patients. Conclusion: Fetal macrosomia is a common complication among GDM patients. Maternal obesity and poorly controlled diabetes are the common modifiable maternal factors contributing to macrosomia. doi: https://doi.org/10.12669/pjms.38.5.5809 How to cite this:Parveen N, Iqbal N, Batool A, Mahmoud T, Ali S. Macrosomia predictors and pregnancy outcomes in Gestational Diabetes patients: An observational study from Ha’il, Saudi Arabia. Pak J Med Sci. 2022;38(5):1126-1131. doi: https://doi.org/10.12669/pjms.38.5.5809 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.