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Background The adverse effects of smoking on neonatal outcomes, such as small-for-gestational-age (SGA), has been extensively studied however, the consequences of smoking combined with alcohol and/or drug use is less clear. Methods This retrospective observational study analyzed clinical and sociodemographic details of 40156 women who delivered a singleton baby between the years 2011 and 2015. Results Compared with women who had never smoked, smokers who did not engage in alcohol or drug use had an odds ratio (OR) of delivering a baby who was SGA of 3.2 (95% CI: 3.1–3.5). Smokers who used illicit drugs in isolation or in combination with alcohol during pregnancy had higher ORs for SGA (1.4, 95% CI: 1.1–1.7, P = 0.006 and 1.8, 95% CI: 1.2–2.7, P = 0.007) compared to women who smoked but did not engage in alcohol or drug use in pregnancy. These women also delivered babies with lower mean birthweights (125 g, P < 0.001 and 181.4 g, P = 0.003) and head circumferences (0.4 cm, P < 0.001 and 0.3 cm, P = 0.048). Women who smoked and used alcohol, but not illicit drugs were not associated adverse outcomes above that of smoking in isolation. Conclusion Illicit drug use combined with maternal smoking during pregnancy increases the risk of adverse neonatal outcomes above that of smoking in isolation. [ABSTRACT FROM AUTHOR]

The Mexico City Prospective Study is a prospective cohort of more than 150,000 adults recruited two decades ago from the urban districts of Coyoacán and Iztapalapa in Mexico City 1 . Here we generated genotype and exome-sequencing data for all individuals and whole-genome sequencing data for 9,950 selected individuals. We describe high levels of relatedness and substantial heterogeneity in ancestry composition across individuals. Most sequenced individuals had admixed Indigenous American, European and African ancestry, with extensive admixture from Indigenous populations in central, southern and southeastern Mexico. Indigenous Mexican segments of the genome had lower levels of coding variation but an excess of homozygous loss-of-function variants compared with segments of African and European origin. We estimated ancestry-specific allele frequencies at 142 million genomic variants, with an effective sample size of 91,856 for Indigenous Mexican ancestry at exome variants, all available through a public browser. Using whole-genome sequencing, we developed an imputation reference panel that outperforms existing panels at common variants in individuals with high proportions of central, southern and southeastern Indigenous Mexican ancestry. Our work illustrates the value of genetic studies in diverse populations and provides foundational imputation and allele frequency resources for future genetic studies in Mexico and in the United States, where the Hispanic/Latino population is predominantly of Mexican descent., (© 2023. The Author(s).)

Introduction: It is established globally that a healthy maternal diet during pregnancy is important in programming fetal growth and development. The assessment of maternal dietary intake, however, is challenging both in clinical practice and in research studies. The aim of this study was to compare three individual dietary quality scores in early pregnancy based on European, American and World Health Organization (WHO) nutrient recommendations for the identification of suboptimal fetal growth., Material and Methods: Women were recruited conveniently at their first antenatal hospital visit and completed a supervised 4-day diet history. The results were dichotomized into those women meeting and those not meeting macronutrient and micronutrient recommendations from the European Food Safety Authority (EFSA), WHO and the Institute of Medicine (USA). Composite nutrient scores were derived. The relation between the three individual dietary scores in early pregnancy and subsequent birthweight and small-for-gestational-age was compared using regression analyses., Results: Of the 202 women, the mean age was 32.2 (SD 5.0) years and 44.6% were nulliparas. The mean dietary quality scores were: EFSA 9.4 (SD 3.1), WHO 8.5 (SD 3.7) and USA 9.6 (SD 3.6). On multivariable regression, there was a positive relationship between the EFSA (β = 44.7, 95% CI 17.0-72.4, P = 0.002), WHO (β = 39.2, 95% CI 17.2-61.1, P = 0.001), and USA (β = 40.0 95% CI 17.6-62.3, P = 0.001) score and birthweight. All 3 scores were positively associated with birthweight centiles. However, only those in the lowest quartile of the EFSA score were more likely to be small-for-gestational-age (odds ratio 2.8, 95% CI 1.1-7.4, P = 0.03)., Conclusions: This study found that a dietary quality score based on European nutrient recommendations was better than other international recommendations at identifying in early pregnancy those women at risk of suboptimal fetal growth., (© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.)

Objective: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe., Methods: Morbid obesity was defined as a BMI > or =40.0 kg/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital's computerised database., Results: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%., Conclusions: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women., (Copyright 2009 S. Karger AG, Basel.)