Search Results (301)

Background/Objectives: Histological chorioamnionitis (HCAM) is a risk factor of chronic lung disease (CLD) in preterm neonates. Funisitis, an indicator of fetal inflammatory response, has been linked to adverse neonatal outcomes, but its impact on respiratory outcomes in extremely preterm neonates remains uncertain. In this study, we investigated whether HCAM with funisitis is associated with poorer respiratory outcomes when compared with HCAM alone in preterm (gestational age 22–36 weeks) neonates. Methods: This was a retrospective cohort study. We divided very low-birth weight (VLBW) preterm neonates with placenta histopathology examinations into three groups—normal, isolated HCAM, and HCAM with funisitis. Perinatal characteristics, radiographic findings, morbidities, and respiratory outcomes were compared. Results: Among 244 VLBW neonates, 25 (10.2%) had HCAM with funisitis, 88 (36.1%) had isolated HCAM, and the remaining 131 were in the normal group. Neonates with HCAM and funisitis had a significantly lower gestational age (26.44 ± 2.1 weeks) but a higher incidence of clinical chorioamnionitis (40.0%) than those with isolated HCAM (12.5%) or normal placentas (6.9%). Moreover, the incidence of cystic–interstitial lung changes before 2 weeks of postnatal age was higher in the HCAM with funisitis group (56.5%) than in the isolated HCAM group (25.0%), and the normal group (4.4%). CLD occurred in 66.7%, 37.7%, and 1.3% of these groups, respectively, and the need for home oxygen at follow-up was 26.1%, 13.7%, and 6.4%. Both isolated HCAM and HCAM with funisitis protected against severe respiratory distress syndrome. However, extremely preterm birth and funisitis had a more adverse impact on CLD development than HCAM alone (adjusted odds ratio 15.259 vs. 3.841). Conclusions: Funisitis independently predicts poor respiratory outcomes in extremely preterm infants. The long-term clinical impacts of funisitis in preterm infants should be further investigated. Full article

Background: Low birth weight (LBW) is correlated with gut microbiota dysbiosis and intestinal barrier function disruption, increasing susceptibility to enteric diseases. These alterations underscore the critical need to identify key regulators of gut homeostasis, among which bile acids are increasingly recognized as pivotal for barrier integrity, microbial ecology, and host metabolism. Methods: Eight pairs of LBW (the initial BW was 0.850 ± 0.053 kg) and normal-birth-weight (NBW; 1.488 ± 0.083 kg) piglets were compared to evaluate cecal morphology and bile acid profiles. Subsequently, sixteen LBW piglets and eight NBW piglets were allocated into three groups: NBW (1.563 ± 0.052 kg), LBW control (LBW-CON; 0.950 ± 0.120 kg), and LBW with bile acid supplementation (LBW-bile powder; 0.925 ± 0.116 kg). Piglets in the LBW-bile powder group received 25 mg/kg BW of bile powder (hyodeoxycholic acid-enriched) by daily oral gavage for 14 days. Results: LBW piglets exhibited retarded cecal development and lower abundance of hyocholic acid species (p = 0.006). Importantly, bile powder supplementation significantly improved cecal length (p = 0.009) and mucosal thickness (p = 0.020) compared with LBW-CON piglets. Microbial analysis showed that the microbial dysbiosis index was restored to near-normal levels. Transcriptomic analysis revealed impaired extracellular matrix structure and mucus secretion in LBW piglets. Notably, bile powder supplementation markedly upregulated the protein expression of WNT8B (p < 0.001) and the bile acid receptors (i.e., GPBAR1 and FXR), alongside enhanced tight junctions and the goblet cell marker mucin-2 expression (p < 0.05). Conclusions: These findings suggest that specific bile acid supplementation improves gut barrier function and partially supports cecal development in LBW piglets. Full article

Background/Objectives: Following a tailored curriculum, minimally invasive fetoscopic coverage for spina bifida aperta (SBA) was introduced in Poland in 2017. This study aims to present the results of the first patients that underwent this procedure in the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw and compare them with the results obtained in other studies. Methods: We reviewed our data of 38 expectant mothers whose fetuses with SBA and normal karyotype underwent minimally invasive fetoscopic coverage at our center between September 2017 and February 2022. All procedures were carried out between 24 + 4 and 28 + 1 weeks of gestation employing general materno-fetal anesthesia. New methods were implemented with time, moving from the patch technique to the skin-to-skin technique suture. The results of the study were compared with the available literature on fetoscopic and open surgeries. Results: In total, the procedure was attempted 38 times and completed in 34 cases. All lesions were lumbar, and the median width of the lateral ventricle was 12 mm (6–17 mm). The median age at surgery was 26 weeks and the median age at delivery was 32 weeks of gestation (26.1–37.5). The average birth weight was 1870 g (1070–3350g). From 34 patients to 31 at the one year follow-up, 13 out of 31 (41.9%) babies needed a shunt and more than 70% of babies had a functional motor level that was the same or better than the anatomical level. Conclusions: Minimally invasive surgery for SBA could successfully be implemented following a tailored curriculum at our university with encouraging maternal and neonatal outcomes. The fetoscopic approach permits the assessment of various closure approaches. Preterm delivery is common but usually occurs beyond 30 weeks of gestation. At this time relevant complications from prematurity are rare. Full article

Cryptorchidism in piglets, characterized by undescended testicles, causes economic losses and reduces consumer acceptance. Hyperprolific sows (HPS) have been hypothesized to produce a higher incidence of cryptorchid offspring. This study investigated the incidence of cryptorchidism in piglets born to HPS and its association with piglet birth weight and litter size in an observational study. Data from 276 litters (144 Landrace × Yorkshire sows; 4003 piglets) were analyzed. Sows were classified by genetic line (conventional: 68 litters; HPS: 208 litters) and parity (primiparous: 144; second parity: 132). At first parity, all gilts were inseminated with semen from a phenotypically unilateral cryptorchid Duroc boar, whereas at second parity, semen from three normal Duroc boars, which were full siblings, was used. The Landrace × Yorkshire HPS line produced more piglets per litter than the conventional Landrace × Yorkshire line (16.5 ± 0.3 vs. 12.4 ± 0.6; p < 0.001). Cryptorchidism occurred in 25.7% (37/144) of litters inseminated with semen from the cryptorchid boar, compared with 3.8% (5/132) of litters inseminated with semen from normal boars (p < 0.001). In total, 42 sows produced at least one cryptorchid piglet across both parities. Among affected sows (n = 42), the average number of cryptorchid piglets per litter was 1.3 ± 0.6 (range: 1–3). In the HPS line, cryptorchidism was detected in 24.1% (26/108) of litters, compared with 30.6% (11/36) in the conventional line (p = 0.441). HPS piglets had lower birth weights than conventional piglets (1.14 ± 0.01 vs. 1.30 ± 0.02 kg; p < 0.001). In the HPS line, litters with cryptorchid piglets had lower birth weights than those without (1.11 ± 0.02 vs. 1.18 ± 0.01 kg; p = 0.012), whereas no difference was observed in the conventional line (1.31 ± 0.04 vs. 1.28 ± 0.02 kg; p = 0.917). Litter size did not differ between litters with and without cryptorchid piglets in either genetic line. In conclusion, the lower average birth weight in cryptorchid litters of the HPS line, but not in conventional lines, suggests that HPS breeds may influence cryptorchidism incidence. These findings highlight the need to optimize fetal growth especially in the HPS to reduce this risk. Full article

Despite lower birth weight, Meishan piglets exhibit a notably higher pre-weaning survival rate compared to Western commercial breeds. This study aimed to evaluate the effect of low birth weight (LBW) on intestinal barrier function in Meishan neonates. Six pairs of neonatal piglets (one normal birth weight, NBW: 0.85 ± 0.06 kg; one LBW: 0.65 ± 0.02 kg) from the same sow were euthanized at birth prior to suckling. Morphological parameters, goblet cell density, antioxidant enzyme activities, cytokine gene expression, and tight junction protein levels in the small intestine (SI) were assessed. Results showed that LBW piglets had a significantly higher SI length-to-body weight ratio (p < 0.05), along with reduced villus height, villus height-to-crypt depth ratio, and villus surface area in the jejunum and ileum (p < 0.01). Notably, microvillus structure remained intact despite the presence of mitochondrial swelling. LBW piglets also exhibited decreased goblet cell numbers, lower antioxidant capacity, dysregulated expression of cytokines (CD8, IFNγ, IL4, IL2), and reduced levels of mucin 2, ZO-1, and occludin (p < 0.05). In conclusion, although LBW Meishan piglets showed impairments in multiple aspects of intestinal barrier function, the structural integrity of the microvillus was preserved, which may contribute to their higher survival rate and represents a key adaptive advantage over commercial pig breeds. Full article

Background/Objectives: Sodium (Na) concentration and the sodium-to-potassium (Na/K) ratio in human milk reflect epithelial tight junction integrity and have been proposed as non-invasive biomarkers of lactational dysfunction, including subclinical mastitis and ductal obstruction. However, their discriminative performance across varied mammary duct conditions, as well as their relevance to milk quality and nutritional integrity, remain underexplored. This study aimed to evaluate the ability of Na, K and the Na/K ratio to discriminate ductal obstruction from non-obstructed lactation—including normal, mixed, and donor milk—and to assess their applicability as nutritional and clinical screening biomarkers. Methods: The study analyzed 635 human milk samples from four groups: obstructed ducts (n = 94), mixed ducts (n = 39), normal ducts (n = 102), and donor milk (n = 400). Na and K concentrations were measured using validated handheld ion-selective electrode analyzers. Statistical analyses included Quade’s ANCOVA and receiver operating characteristic curve analysis, adjusting for infant age, gestational age, birth body weight, maternal age and storage duration. Results: Na concentrations were highest in obstructed ducts (Group A: median 810 ppm, IQR 368–1725) compared with normal ducts (Group C: 220 ppm, IQR 140–283) and donor milk (Group D: 98 ppm, IQR 80–130) (p < 0.001). A similar pattern was observed for the Na/K ratio (Group A: 1.5, IQR 0.6–3.1 vs. Group C: 0.3, IQR 0.2–0.5; Group D: 0.3, IQR 0.2–0.3). After adjusting, both Na and the Na/K ratio remained significantly elevated in milk from obstructed ducts compared to non-obstructed samples (p < 0.001). Donor milk exhibited the lowest and most stable electrolyte levels. Na demonstrated excellent discriminative performance (area under the curve = 0.96), slightly outperforming the Na/K ratio (area under the curve = 0.92). Conclusions: Na concentration and the Na/K ratio in human milk are sensitive and practical biomarkers of mammary gland integrity. Given that Na alone can be measured without additional calculations, its simplicity and strong performance support its application as a potential biomarker for ductal obstruction, with implications for both lactation support and nutritional science. Full article

Background: Human milk (HM) is the optimal nutrition for preterm infants, but supplementation is often required to meet their unique nutritional needs. Donor human milk (DHM) and preterm formula are commonly used alternatives, yet their impacts on bone metabolism and clinical outcomes remain incompletely defined. Objective: To compare the effects of exclusive mother’s own milk (MOM), MOM supplemented with DHM, and MOM supplemented with preterm formula on bone metabolism markers, growth milestones, and clinical outcomes in very preterm and very low birth weight (VLBW) infants. Methods: We conducted a retrospective review of medical records for infants born at <32 weeks’ gestation or <1500 g birth weight between January 2018 and June 2023. Feeding groups included exclusive MOM (N = 135), MOM + DHM (N = 74), and MOM + Formula (N = 54). Biochemical markers were assessed at baseline and on days 7, 14, and 28. Multivariate regression analyses evaluated predictors of growth and clinical outcomes. Results: Infants in the MOM group had significantly lower gestational age and birth weight, with higher rates of respiratory morbidity. Time to full enteral feeding and duration of parenteral nutrition were longer in the MOM group, but feeding regimen was not an independent predictor of these outcomes. By day 14, the MOM group had higher alkaline phosphatase levels and lower phosphorus levels compared to mix feeding groups, but these differences resolved by day 28. Calcium levels varied between groups but remained within normal ranges. Necrotizing Enterocolitis (NEC) incidence did not differ significantly across feeding regimens and was primarily associated with longer parenteral nutrition duration. Conclusions: Supplementation of MOM with either DHM or preterm formula supported adequate growth and bone metabolism without increasing NEC risk. Feeding regimen did not independently influence time to full enteral feeding or length of hospitalization, which were driven primarily by infant maturity and clinical status. Both DHM and preterm formula are viable supplements to MOM, ensuring nutritional adequacy without adverse bone health effects. Prospective studies are needed to evaluate long-term outcomes of these feeding strategies. Full article

Background and Objectives: Vernix caseosa peritonitis (VCP) is rare. Nonspecific symptoms of acute abdomen during early puerperium make preoperative diagnosis of VCP challenging. We aimed to identify risk factors, early diagnosis and treatment options, and the association between the timing and severity of VCP diagnosis and maternal outcomes. Materials and Methods: We searched PubMed, PubMed Central, and Google Scholar. Articles were analyzed according to the PRISMA guidelines. The search items included: ‘vernix caseosa peritonitis, ‘vernix caseosa granuloma, ‘maternal meconium peritonitis’, ‘maternal meconium granuloma’, ‘vernix caseosa’, ‘peritonitis’, ‘pregnancy’, ‘puerperium’, ‘postpartum’, and ‘gravid’. Additional studies were extracted by reviewing the reference lists of retrieved studies. Demographic, clinical, obstetric, diagnostic, and treatment parameters, and outcomes were collected. Results: Out of 55 published VCP case reports, 46 were available. Most involved term pregnancies (84.8%) and were delivered by Cesarean section (CS) (87%), with no difference in parity distribution (χ²(2) = 1.1875, p = 0.5523) or fetal sex (m: f = 53.3%: 46.7%). Common symptoms included abdominal pain and fever over 38 °C, while dyspnea or tachypnea was unexpectedly frequent (23.9%/15.2%). The interval from delivery to surgery ranged from 4 to 13 days (average 8 days), with no difference between CS and vaginal deliveries. Preoperative VCP was diagnosed in only 4.3% of cases, and intraoperative diagnosis occurred in 60.9%. Intraoperative microbiology and histopathology (vernix components) were positive in 6.5% and 89.1%, respectively. The birth weight was normal (3656 ± 509 g), with no maternal or neonatal deaths. Conclusions: VCP primarily develops in term pregnancies delivered by CS, without other risk factors. Despite extremely low preoperative and unexpectedly low intraoperative diagnosis and treatment delay of several days, there is no maternal or fetal mortality. The time to symptom onset is similar between women who delivered vaginally and those who had a CS. All women with VCP after vaginal delivery had previous deliveries. Abdominal pain with a fever over 38 °C and dyspnea or tachypnea in the early puerperium suggests VCP. Surgical lavage is the primary treatment, while corticosteroids have been reported to be beneficial in several cases, and antibiotics seem to have a limited role. Full article

Background/Objectives: Freeze-dried high-temperature short-time pasteurized human milk fortifiers offer potential for exclusive human milk feeding in preterm infants while providing necessary nutritional supplementation. However, clinical data on safety, tolerability, and growth outcomes remain limited. This study evaluated donor milk fortification compared to conventional bovine protein-based fortification. Methods: We conducted a prospective non-interventional observational cohort study with a retrospectively matched comparison cohort at University Children’s Hospital of Nuremberg. Preterm infants ≥ 30 weeks gestational age requiring mother’s own milk fortification were included. The exposed cohort (n = 32) received freeze-dried high-temperature short-time pasteurized donor milk fortifier at 1.6–4.8 g/100 mL of mother’s own milk; the matched comparison cohort (n = 32) received bovine protein-based fortifier. Primary outcomes included feeding tolerance, safety parameters, and anthropometric measurements. Cohorts were matched for birth weight (±10%), gestational age (±5 days), and fortified feeding. Results: Baseline characteristics were not significantly different: gestational ages 32.8 ± 1.0 versus 33.0 ± 1.2 weeks; birth weights 1900 ± 380 g versus 1840 ± 370 g. Excellent feeding tolerance was demonstrated across >3100 feedings. No necrotizing enterocolitis, abdominal complications, or serious adverse events occurred. Blood glucose, triglycerides, and urea remained normal. Birth weights, lengths, and head circumferences showed no significant differences. Discharge parameters including weight, length, head circumference, and length of stay were also not significantly different. Conclusions: Freeze-dried human milk fortification demonstrates excellent safety and tolerability in preterm infants ≥ 30 weeks gestational age, achieving anthropometric outcomes not significantly different to bovine protein-based fortification. However, the suboptimal protein-to-energy ratio may limit applicability for very low birth weight infants. Therefore, freeze-dried high-temperature short-time pasteurized human milk fortification is suggested to provide appropriate nutritional supplementation for preterm infants with a birth weight over 1500 g. Full article

Background: The establishment of population-specific reference values for neonatal renal dimensions is essential for accurate assessment of kidney development. Currently, standardized reference data for renal volume in Romanian newborns are lacking. This study aims to establish normal renal dimensions and volumes in Romanian term newborns and evaluate their correlations with anthropometric characteristics. Methods: A prospective study was conducted at Polizu Maternity, Bucharest, Romania, involving a cohort of 100 term newborns with a gestational age (GA) between 37 and 42 weeks, all delivered at the INSMC “Alessandrescu-Rusescu” Polizu Maternity Hospital. Routine renal ultrasound was performed for all term newborns within the first 72 h of life. Renal dimensions were measured in the longitudinal and axial sections, and the volume was calculated. Results: The average kidney dimensions were as follows: length 42.0 ± 3.4 mm, width 22.6 ± 2.6 mm, and thickness 19.9 ± 2.5 mm. Renal volume ranged from 5.1 to 18.9 mL, with an average of 10.2 ± 2.5 mL. The kidney volume was significantly correlated with gestational age (r = 0.195; p = 0.05) and birth length (r = 0.267; p = 0.008), and most strongly with birth weight (r = 0.306; p = 0.002). Conclusions: This study provides the first reference values for renal dimensions in Romanian term newborns. Renal volume shows modest correlations with anthropometric characteristics, particularly birth weight. These reference values may serve as baseline measurements for future longitudinal studies investigating renal development and disease risk. Full article

Background: Fetal size is often dichotomized as normal or abnormal using the 10th percentile of estimated fetal weight (EFW) or abdominal circumference as a cutoff. While the risk of adverse perinatal outcomes decreases with increasing fetal weight percentile, no percentile completely eliminates that risk. Objective: The aim of this study was to compare perinatal outcomes between fetuses with an EFW between the 10th and 20th percentiles and those with an EFW between the 20th and 90th percentiles (i.e., >20 and <90) at the beginning of the accelerated growth stage (28.0–30.0 weeks’ gestation). Methods: We conducted a retrospective cohort study of singleton pregnancies managed at a quaternary center in Mexico City (2017–2024). Outcomes were compared based on EFW percentiles at 28.0–30.0 weeks. The primary outcome was adverse neonatal outcome (ANeO), defined as the presence of at least one of the following: umbilical artery pH ≤ 7.1, 5 min Apgar ≤ 7, NICU admission, early neonatal hypoglycemia, non-reassuring fetal status, respiratory distress syndrome, intraventricular hemorrhage, hypoxic–ischemic encephalopathy, or perinatal death. Secondary outcomes included progression to fetal growth restriction (FGR) and low birth weight. Modified Poisson regression was used to estimate adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Results: Among 650 cases, ANeO occurred in 45.8% of fetuses in the 10th–20th percentile group vs. 29.4% in the 20th–90th percentile group (aRR: 1.51, 95% CI: 1.22–1.86; p < 0.001). FGR and low birth weight were also more frequent in the 10th–20th percentile group (21.1% and 27.6% vs. 6.4% and 5.8%, respectively; p < 0.001). Conclusions: Fetuses between the 10th and 20th percentiles at 28–30 weeks have increased risks of neonatal morbidity, FGR, and low birth weight. Full article

Congenital heart disease (CHD) is the most prevalent birth defect. Ozone and heatwave exposure during pregnancy could increase the risk of adverse birth outcomes. Green space might be associated with beneficial birth outcomes. The research on the combined effects of those exposures on CHD is limited. Therefore, we conducted a multicenter case–control study based on a surveillance system in Zhejiang Province, China, to explore the effect of ozone, heatwave, and green space exposure during early pregnancy on CHD and their interaction. The inverse distance weighting method and normalized difference vegetation index were applied to assess maternal ozone and green space exposure, respectively. The heatwave definition is from the National Oceanic and Atmospheric Administration. Our study reveals positive associations of heatwave and ozone exposure with CHD (ozone: OR = 1.07, 95% CI: 1.02, 1.13; heatwave: OR = 1.29, 95% CI: 1.18, 1.40), and green space in different buffers around residence exerted protective effects on CHD, with ORs ranging from 0.93 to 0.94. Associations between ozone and CHD were weakened among participants with higher NDVI. Ozone’s effects on CHD were stronger with the increased duration of heatwave exposure. Our study indicates that ozone and heatwave exposure could increase the risk of CHD, and high green space is a protective factor for CHD. Meanwhile, high green space exposure could attenuate the effect of ozone on CHD, but heatwave exposure strengthened it. Full article

Objective: This study investigated the association between paternal preconception paternal body mass index (BMI) categories and physical/neurodevelopmental outcomes in Chinese small-for-gestational-age (SGA) children. Methods: A prospective cohort study enrolled 412 singleton SGA infants born at Peking University People’s Hospital in 2020–2022. Fathers were stratified into underweight, normal-weight, overweight, and obese groups. Follow-up assessments at 24–36 months evaluated growth parameters weight, height, BMI Z-scores and neurodevelopment using the Ages and Stages Questionnaire-3 (ASQ-3) and ASQ: Social–Emotional (ASQ:SE). Multivariable regression was adjusted for paternal covariates. Results: In SGA offspring, paternal underweight correlated with lower birth weights vs. normal/obese paternal BMI and the highest severe SGA rates. Prospective monitoring identified elevated BMI Z-scores (ΔZ = +0.40) and 8.7-fold heightened obesity risk in the paternal obesity group versus normal-weight counterparts. Neurodevelopmental evaluations demonstrated gross motor impairments in both underweight (ΔZ = −0.22) and obese paternal subgroups (ΔZ = −0.25) compared with the normal-weight group, with the obesity cohort additionally exhibiting problem-solving deficiencies (ΔZ = −0.19). The paternal obesity group manifested three-fold greater likelihood of social–emotional delays than the normal-weight group. The underweight and obese paternal groups showed 3.46-fold and 2.73-fold higher probabilities of gross motor deficits, respectively, while obesity was linked to 3.27-fold elevated problem-solving impairment risk-all comparisons versus normal paternal BMI. Overweight status showed no significant links to growth or neurodevelopmental outcomes. Normal-weight fathers had lower risks of obesity and neurodevelopmental issues. Conclusions: This study revealed U-shaped paternal BMI–neurodevelopment links in SGA offspring. Paternal obesity raised offspring obesity/neurodevelopmental risks, while underweight linked to severe SGA and motor deficits, highlighting paternal weight optimization’s modifiable role. Full article

Background: Diabetes insipidus (DI) in newborns is an extremely rare condition, with the age of presentation strongly suggesting a genetic background of the disease. The differential diagnosis should include arginine vasopressin deficiency (AVD) and arginine vasopressin resistance (AVR). Some novel diagnostic tools such as copeptin evaluation and genetic tests are vital for early diagnosis. Case report: We present the case of a 1-month-old boy with polyuria observed since birth. Laboratory tests showed persistent hypernatremia, elevated plasma and low urine osmolality. An attempt at oral administration of desmopressin had no effect; additionally the copeptin level was increased. A genetic study (NGS of the AVP, AVPR2 and AQP2 genes) was considered and a new pathogenic variant in the AVPR2 gene (hemizygous c.157del) was detected. After the genetic test result was obtained, treatment with hydrochlorothiazide was started. The patient is now 3 months old, developing normally, and the weight and height are normal. Conclusions: Newborns with DI should be subjected to extensive multidisciplinary diagnostics, including endocrine and renal causes. Copeptin evaluation and prompt genetic diagnosis allows for the early diagnosis and implementation of appropriate treatment. Full article

Background: Pre-pregnancy overweight and obesity are established risk factors for adverse maternal and perinatal outcomes in the general obstetric population. However, data regarding their impact in female liver transplant recipients remain limited. This study aimed to evaluate the association between pre-pregnancy body mass index (BMI) and pregnancy-related complications and neonatal outcomes in this high-risk cohort. Methods: A retrospective cohort analysis was conducted on pregnancies in liver transplant recipients who delivered between 2001 and 2022 at a single tertiary referral center. Participants were stratified into two groups based on pre-pregnancy BMI: normal weight (18.5–24.9 kg/m²) and overweight/obese (≥25 kg/m²). Maternal characteristics, pregnancy complications, and perinatal outcomes were compared using appropriate statistical methods, with significance set at p < 0.05. Results: Among 72 pregnancies included in the analysis, 48 (66.7%) were in women with normal BMI, and 24 (33.3%) were in those with an elevated BMI. No statistically significant differences were observed in gestational age at delivery, neonatal birth weight, Apgar scores, or incidence of preterm birth. Although pregnancy-induced hypertension and cesarean delivery were more prevalent among overweight/obese individuals, these differences did not reach statistical significance (PIH: 28% vs. 10.4%, p = 0.112; cesarean delivery: 76% vs. 64.6%, p = 0.465). Conclusions: In conclusion, pre-pregnancy overweight and obesity were not significantly associated with adverse obstetric or neonatal outcomes in liver transplant recipients. Nevertheless, the observed trends suggest a potential predisposition to hypertensive disorders (PIH: 28% vs. 10.4%, p = 0.112), underscoring the importance of individualized preconception counseling and weight optimization strategies in this high-risk patient population. Full article