BackgroundExcess weight gain affects nearly half of all pregnancies in the United States and is a strong risk factor for adverse maternal and fetal outcomes, including long-term obesity. The Internet is a prominent source of information during pregnancy; however, the accuracy of this online information is unknown.ObjectiveTo identify, characterize, and assess the accuracy of frequently accessed webpages containing information about weight gain during pregnancy.MethodsA descriptive study was used to identify and search frequently used phrases related to weight gain during pregnancy on the Google search engine. The first 10 webpages of each query were characterized by type and then assessed for accuracy and completeness, as compared to Institute of Medicine guidelines, using crowdsourcing.ResultsA total of 114 queries were searched, yielding 305 unique webpages. Of these webpages, 181 (59.3%) included information regarding weight gain during pregnancy. Out of 181 webpages, 62 (34.3%) contained no specific recommendations, 48 (26.5%) contained accurate but incomplete recommendations, 41 (22.7%) contained complete and accurate recommendations, and 22 (12.2%) were inaccurate. Webpages were most commonly from for-profit websites (112/181, 61.9%), followed by government (19/181, 10.5%), medical organizations or associations (13/181, 7.2%), and news sites (12/181, 6.6%). The largest proportion of for-profit sites contained no specific recommendations (44/112, 39.3%). Among pages that provided inaccurate information (22/181, 12.2%), 68% (15/22) were from for-profit sites.ConclusionsFor-profit websites dominate the online space with regard to weight gain during pregnancy and largely contain incomplete, inaccurate, or no specific recommendations. This represents a significant information gap regarding an important risk factor for obesity among mothers and infants. Our findings suggest that greater clinical and public health efforts to disseminate accurate information regarding healthy weight gain during pregnancy may help prevent significant morbidity and may support healthier pregnancies among at-risk women and children.

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RESULTS: Gene expression associated with various cellular pathways were compared between the blastocoel fluid sample from each blastocyst which revealed a decreased level of gene expression associated with the protein deubiquitination pathway in the positive implantation embryo, and no other analyzed pathway yielded significant difference in gene expression between the two blastocoel fluid samples. Specifically, genes encoding SHMT2, KAT2A, ASXL1 were all downregulated in blastocoel fluid from the embryo associated with successful implantation.CONCLUSIONS: RNASeq analysis of media samples from two 46, XX embryos with the same morphology from the same patient but associated with different implantation outcomes yielded differences in gene expression. Knowledge of chromosomal status and morphology of a preimplantation blastocyst stage embryo did not provide a complete picture of the underlying biological processes taking place within the embryo, nor could these measures fully predict an embryo's implantation outcome. This case study provides evidence of a detectable difference in gene expression in blastocoel fluid obtained from embryos that would be considered indistinguishable by current methods employed by reproductive specialists. Moreover, this alteration in gene expression is associated with a difference in implantation outcome. While this case study identified the deubiquitination pathway as altered, further study is needed to determine if this difference in these euploid blastocysts is also found in embryos from other patients and/or with the same chromosomal status.

MZT is mediated by evolutionarily conserved microRNAs (miRNAs), such as miR-430 in zebrafish, miR-427 in Xenopus, and miR290-miR295 in mice. Using a bioinformatic approach, miR371-miR373 were identified as the human orthologues. In the current study, we investigated whether miR371-miR373 are expressed in human cleavage stage and blastocyst embryos and whether they can be detected in spent culture medium (SCM).DESIGN: Prospective cohort study. MATERIALS AND METHODS: To assess expression in cleavage stage embryos and blastocysts, discarded embryos (n¼4 for each developmental stage) were used. RNA was extracted using single cell RNA purification kit from Norgen Biotech. Additionally, SCM was collected from four different patients' embryos in the cleavage, morula, and blastocyst stages (n¼10 per stage). The media was centrifuged at 10,000 rpm for 5 minutes. RNA was extracted using miRNA easy kit and was converted to cDNA by the miRCURY LNA RT kit. Real time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis for miR-371-miR373 was performed using the MiRCURY LNA SYBR Green PCR kit from Qiagen. RNU6B (or U6 snRNA) expression was quantified in each sample for normalization. The fold change was calculated by 2^-(delta delta ct).RESULTS: The presence of miR371, miR372, and miR373 was confirmed in the embryos. There was no significant difference in their expression between cleavage stage embryos and blastocysts (p¼0.88, p¼0.85, p¼0.83). In contrast, there were differences found in miRNA concentrations with progressive embryonic development. miR371-3p and 372-3p were undetectable at the cleavage stage, but became detectable at the morula stage, with significantly increased levels at the blastocyst stage (miR371-3p (p<0.01) and 372-3p (p<0.001)). Expression of miR 373-3p in SCM was noted in all three developmental stages and relative concentrations increased from the cleavage stage to the morula stage (p<0.05) then further increased at the blastocyst stage (p<0.005).CONCLUSIONS: Our findings demonstrate that miR371, miR372, and miR373 are expressed in human pre-implantation embryos and that their secretion into culture media increases progressively with the stage of embryonic development. Further studies are now indicated to determine if the variability in these increases will prognosticate the ability of embryos to sustain implantation. This simple and inexpensive assessment will now progress to clinical trials.