Women’s metabolism during pregnancy undergoes numerous changes that can lead to gestational diabetes mellitus (GDM). The cause and pathogenesis of GDM, a heterogeneous disease, are not completely clear, but GDM is increasing in prevalence and is associated with the modern lifestyle. Most diagnoses of GDM are made via the guidelines from the International Association of Diabetes and Pregnancy Study Groups (IADSPG), which involve an oral glucose tolerance test (OGTT) between 24 and 28 weeks of pregnancy. Diagnosis in this stage of pregnancy can lead to short- and long-term implications for the mother and child. Therefore, there is an urgent need for earlier GDM markers in order to enable prevention and earlier treatment. Routine GDM biomarkers (plasma glucose, insulin, C-peptide, homeostatic model assessment of insulin resistance, and sex hormone-binding globulin) can differentiate between healthy pregnant women and those with GDM but are not suitable for early GDM diagnosis. In this article, we present an overview of the potential early biomarkers for GDM that have been investigated recently. We also present our view of future developments in the laboratory diagnosis of GDM.

Aim: To evaluate the roles of four selected genetic variations in fetal and maternal progesterone receptor gene (PGR) and to identify women who may have higher or lower odds for spontaneous premature birth compared to the general population. Methods: A preliminary case-control study with two groups of pregnant women (with term and premature delivery, 218 in total) and two groups of newborns (term and preterm, 218 in total) was performed. Four single nucleotide polymorphisms (SNPs) of the progesterone receptor gene (rs1042838, rs1042839, rs10895068, and rs1942836) were genotyped. Results: There was statistically significant difference between cases and controls in the distribution of newborns' allele frequency of minor C allele of the PGR SNP rs1942836 (p = 0.03, Fishers' exact test) in favor of premature birth. A statistically significant difference between the frequency of the mothers' minor T allele of rs1042838 (p = 0.005; chi-squared test) and the mothers' minor T allele of rs1042839 (p = 0.005; chi-squared test) in favor of extremely premature birth has been found. There was a statistically significant difference between the frequency of the newborns' minor C allele of rs1942836 (p = 0.03; chi-squared test) and newborns' heterozygotes CT genotype of rs1942836 (p = 0.03; Fishers' exact test) when comparing the group of term births and the group of early premature birth. Conclusion: Our study suggests that patients with selected genetic variants of the progesterone receptor gene could have greater odds for premature birth compared to term birth. Replication studies with a larger population and different ethnicity are needed in order to confirm these findings.

Aim The aim of research was to evaluate the maternal serum concentration of selected endogenous steroid hormones during spontaneous parturition at term and to determinate their association with the need for oxytocin augmentation. Methods Blood of 108 healthy pregnant women whose parturition started with the regular spontaneous uterine contractions was drawn at the beginning of the labor. Liquid chromatography coupled to the tandem mass spectrometry device was utilized for measurement of sex hormone binding globulin, aldosterone, androstenedione, cortisol, cortisone, corticosterone, dehydroepiandrosterone, dehydroepiandrosteron sulphate, 17‐hydroxyprogesterone, progesterone, and testosterone. Mann–Whitney U test, chi‐square test, univariate and multivariate logistic regression, and receiver operating characteristic (ROC) analysis were used for the data analysis. Results Reference ranges of the selected hormones assessed by liquid chromatography coupled to the tandem mass spectrometry in maternal serum were established. Statistically significant differences in the serum concentration of corticosterone, dehydroepiandrosterone, and androstenedione between mothers requiring oxytocin augmentation and the rest of women having spontaneous parturition were found (p = 0.002, p = 0.008, and p = 0.04, respectively). Concentrations were lower in the group of mothers who required oxytocin infusion for progression of labor. ROC analysis showed that all the mothers with dehydroepiandrosterone serum concentration above 21.6 nmol/L have lower chance to use oxytocin infusion for the labor progression ( area under the curve (AUC)  = 0.649, sensitivity = 71.7%, specificity = 59.6%, p = 0.006). Conclusion This research provided reference ranges for the selected maternal serum steroid hormones at the beginning of parturition. Association of corticosterone, dehydroepiandrosterone, and androstenedione with the need for the oxytocin infusion usage has been established. Dehydroepiandrosterone could be potential predictor of oxytocin infusion augmentation for progression of the parturition.

Labour induction is the process in which labour is induced mechanically or pharmacologically. The percentage of induced labours is between 1.4% and 32% of the total number of births in the world. The aim of this research is to present the number of medically induced labours from 2012 to 2019 at the Clinic for Gynaecology and Obstetrics of the Clinical Hospital Center in Osijek and to present the success rate of medically induced labour and factors, both maternal and/or foetal which may affect it. Materials and methods: In the study 2361 subjects were included whose births were induced by medication regardless of the indication for medically induced labour, gestational age or mother’s age. χ2 test, Mann Whitney U test, Fisher’s exact test, Kruskal Wallis test (Pot Hoc Conover), and the univariate and multivariate logistic regression model were used. Results: The percentage of inductions was 13.8%. 81% of the child births was completed vaginally , while 19% was completed by the caesarean section. The univariate regression analysis found that meconium amniotic fluid increases the risk of the caesarean section after the labour has been induced. Factors decreasing the possibility of the caesarean section after induced labour include multiparity, women age between 25 and 35 years and women bearing female children. The multivariate statistical regression model found that women over the age of 36 are 1.58 times more likely to have the caesarean section. Women with meconium amniotic fluid are 1.47 times more likely to have the caesarean section. Multiparity in the mother and the female sex of the child reduce the probability of the caesarean section after induced labour (odds ratio (OR) 0.20, P=0.02 and OR 0.84, P=0.09, respectively). Conclusion: The study indicates that multiparity and female gender of child increase the probability of the vaginal birth after the induction, while the mother’s age over 36 and meconium amniotic fluid after the induction increase the risk of the caesarean section.