Perinatal Outcomes and Long-Term Infectious Morbidity of Offspring Born to Mothers with Familial Mediterranean Fever

Perinatal Outcomes and Long-Term Infectious Morbidity of Offspring Born to Mothers with Familial Mediterranean Fever | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Perinatal Outcomes and Long-Term Infectious Morbidity of Offspring Born to Mothers with Familial Mediterranean Fever Itay Asher, Eyal Sheiner, Nata Tifferet Willner, Lior Zeller, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3388223/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Dec, 2023 Read the published version in Archives of Gynecology and Obstetrics → Version 1 posted 5 You are reading this latest preprint version Abstract Purpose To investigate perinatal outcomes and long-term infectious morbidity in children of mothers with familial Mediterranean fever (FMF). Methods A population-based cohort study comparing perinatal outcomes and long-term infectious morbidity of offspring of mothers with and without FMF was conducted. All singleton deliveries between the years 1991–2021 in a tertiary medical center were included. The study groups were followed until 18 years of age for long-term infectious morbidity. A Kaplan-Meier survival curve was used to compare the cumulative incidence of long-term infectious morbidity, and generalized estimation equation (GEE) models as well as Cox proportional hazards models were constructed to control for confounders. Results During the study period, 356,356 deliveries met the inclusion criteria. 411 of them were women with FMF. Using GEE models, preterm delivery, cesarean delivery, and low birth weight were independently associated with maternal FMF. The total infectious-related hospitalization rate was significantly higher in offspring born to mothers with FMF compared to the comparison group (Kaplan–Meier survival curve, log-rank p < 0.001). Using a Cox proportional hazards model, controlling for gestational age, maternal age, diabetes mellitus, cesarean delivery, and hypertensive disorders, being born to a mother with FMF was found to be an independent risk factor for long-term infection-related hospitalization of the offspring. Conclusion Maternal FMF was found to be independently associated with long-term infection-related hospitalization of the offspring. This positive correlation may reflect an intra-uterine pro-inflammatory environment which may result in the offspring's long-term susceptibility to infection. Familial Mediterranean fever Inflammation Pregnancy complications Fetus Infection Figures Figure 1 What does this study add to the clinical work Mothers with FMF should consider consulting their physicians regarding the need for long-term follow-up of the newborns due to their susceptibility to infectious morbidity. although Further research is needed. INTRODUCTION Familial Mediterranean Fever (FMF) is an auto-inflammatory autosomal, recessively inherited disease, presented clinically with short-term recurrent flares of fever and serosal inflammation. In most patients, the primary symptoms and signs of the disease are fever, abdominal pain, chest pain, and arthritis [ 1 ]. This genetic disease affects roughly 150,000 people worldwide, primarily non-Ashkenazi Jewish, Turkish, Armenian, and Arab populations [ 2 , 3 ]. Although this disorder is diagnosed based on clinical findings, it is known to be caused by mutations in the MEFV gene located on chromosome 16p [ 4 ]. The MEFV gene encodes the protein pyrin, which regulates the innate immune response. The impaired protein produces an inappropriate and prolonged response to inflammatory stimuli and an increase in leukocyte migration to serosal sites [ 2 ]. FMF can have major implications for a female patient. Uncontrolled disease may impair female fertility. This decline in fertility may be a result of direct ovarian damage from amyloid deposits or abdominopelvic adhesions from recurrent peritonitis [ 5 ]. Untreated FMF patients also experience a high frequency of pregnancy losses, occurring in 20–30% of pregnancies of women with untreated FMF [ 6 ]. In another study, FMF was an independent risk factor for preterm delivery (OR = 1.52; 95% CI 1.13–2.23) [ 7 ]. A successful pregnancy requires adaptations of the maternal immune system to allow the growth of an antigenically foreign fetus. This involves an increase in the innate immune response and a decrease in the adaptive immune response. These changes may contribute to the maternal ability to protect against infections and exhibit tolerance toward the fetus at the same time [ 8 ]. Nevertheless, in some cases, an inadequate innate response can promote a severe clinical presentation of recurrent inflammation that has been associated with inflammatory-related adverse pregnancy outcomes such as preeclampsia [ 9 ]. Fetal programming is the hypothesis that describes the interaction between the offspring’s long-term health and its in-utero environmental conditions [ 10 ]. Studies have associated maternal exposures during pregnancy such as smoking, maternal obesity, and maternal urinary tract infection with long-term infectious morbidity of the offspring [ 10 – 13 ]. FMF is known to cause a pro-inflammatory state that increases the secretion of IL-1, IL-18, and other mediators of inflammation that enhance chemotaxis and neutrophilia, inducing an FMF flare [ 14 ]. A pro-inflammatory state, caused by recurrent inflammatory flares such as in FMF, may have a secondary effect on the infant, making it more prone to acquiring infections due to dysregulation in its immune system. In this large population-based study, we sought to investigate the long-term infectious morbidity of children to mothers with FMF, regardless of prematurity. MATERIALS AND METHODS Population and Settings The study was conducted at the Soroka University Medical Center (SUMC), a 1050 bed tertiary hospital, and the only major medical center in the Negev, the southern region of Israel, serving a population of over one million people. Thus, the study is based on nonselective population data. The study was approved by the local institutional ethics committee in accordance with the principles of the Declaration of Helsinki (IRB number 0357-19-SOR). The study population included all patients who delivered between the years 1991 and 2021 in SUMC. Multiple gestations and children with congenital malformations or chromosomal abnormalities were excluded from the study. Study Design A population-based retrospective cohort study was conducted. The primary exposure was defined as being born to a mother with FMF. Delivery of an infant to a mother without FMF comprised the comparison group. The main outcome was long-term infectious morbidity of the offspring up to the age of 18 years, documented in hospitalization records. All encounters with the hospital were analyzed so that multiple infectious diagnoses could be given to a single child. The date of the first infectious-related hospitalization was used to calculate time-to-event. Long-term infectious morbidity was based on any hospitalization in which an infectious diagnosis was made, either as the principal or the secondary diagnosis, and included: urological infections, ear, nose, and throat infections, gastrointestinal infections, ophthalmic infections, central nervous system infections, bacterial infections, respiratory infections, orthopedic infections, neonatal infections, viral infections, and skin infections. Data were collected from two databases: the first is the perinatal database of the division of Obstetrics and Gynecology in SUMC, including information that was documented by obstetricians following delivery. Skilled medical secretaries routinely review the information before entering it into the databases, ensuring its reliability and accuracy. The second source was the computerized SUMC children’s hospitalization records, including demographic information and all medical diagnoses made during hospitalization, according to the International Classification of Diseases, Ninth Revision codes. These databases were cross-linked and merged based on personal identification numbers. Each newborn in the country receives a national identification number before being discharged from the hospital. These numbers, as well as the mothers' identification numbers, were coded in the perinatal database and were used to cross-link with the pediatric database. Statistical Analysis Univariable analysis was performed to compare dependent and background characteristics between the two study groups. The univariable analysis included Chi-square tests for categorical variables, and t-tests or Man-Whitney U tests for continuous variables according to their distribution. To compare perinatal outcomes, generalized estimation equation (GEE) models were used to control for confounders and to account for maternal clusters. Cumulative incidence rates were compared using Kaplan-Meier, using the log-rank test to determine significant differences. The Cox proportional hazards model was conducted to compare infection-associated hospitalization risk among offspring born to mothers with or without FMF. The model adjusted for mothers occurring multiple times in the cohort, and the similarity among the siblings was accounted for. Additionally, the model adjusted for potential confounders based on the univariable analysis and clinical importance of the variables. The final model was chosen based on best fit and minimal − 2 log likelihood. All analyses were performed using SPSS (version 26 or higher) or STATA (version 12 or higher) software. All assumptions were 2-sided, and a p-value of < 0.05 was considered to be statistically significant. RESULTS During the 30-year study period, 356,356 deliveries met the inclusion criteria, of these 411 (0.001%) were women with FMF. Table 1 presents the demographic and clinical characteristics of women with and without FMF. Women with FMF were significantly older and had lower parity compared to women without FMF. Table 2 presents pregnancy and delivery outcomes of women with and without FMF. Using GEE models, controlling for maternal age, preterm delivery, cesarean delivery, and low birth weight, which were independently associated with maternal FMF (adjusted OR 1.52, 95% CI 1.08-2.13, p =0.01, adjusted OR 1.35, 95% CI 1.00-1.81, p =0.04, and adjusted OR 1.77, 95% CI 1.27-2.46, p =0.001 for preterm delivery, cesarean delivery, and low birth weight, respectively). The long-term infectious morbidity of offspring born to mothers with and without FMF is presented in Table 3. Total infection-related hospitalization rates were significantly higher in offspring born to mothers with FMF compared to the comparison group (37.2% vs. 24.1%, p <0.001). Likewise, the Kaplan–Meier survival curve (Fig1), demonstrated a significantly higher cumulative incidence of infection-related hospitalizations, in offspring born to mothers with FMF (log-rank, p <0.001). Specific morbidities as ear, nose, and throat (11.7% vs 6.4%, p <0.001), neonatal infections (2.4% vs 1.3%, p =0.04), ophthalmic infections (2.4% vs 1.3%, p =0.03), respiratory infections (22.4% vs 13.8%, p <0.001), and viral infections (6.3% vs 3.2%, p <0.001) were more prevalent in offspring of women with FMF as opposed to the comparison group. Using a Cox proportional hazards model controlling for gestational age, maternal age, maternal diabetes mellitus, cesarean section, and hypertensive disorders, being born to a mother with FMF was found to be an independent risk factor for long-term infection-related hospitalization of the offspring (adjusted HR 1.71, 95% CI 1.46–2.01, p <0.001). DISCUSSION In this large, nonselective, population-based study with a long follow-up period, mothers with FMF demonstrated a higher risk for immediate adverse perinatal outcomes such as preterm delivery, cesarean section, and low birth weight. Furthermore, offspring born to mothers with FMF had a significantly higher rate of long-term infection-related hospitalizations compared to mothers without FMF, regardless of prematurity status. Specific morbidities were found to be more prevalent, including ear, nose, and throat infections, neonatal infections, ophthalmic infections, respiratory infections, and viral infections. Immediate perinatal outcome of women with FMF Several previous studies have evaluated the association between maternal FMF and pregnancy and delivery outcomes. Our study demonstrates an independent association between maternal FMF, preterm delivery, and low birth weight. Other studies have shown similar results [15,16]. This association may either be attributed to recurrent peritonitis and fever flares, which may induce preterm labor, or to the signs and symptoms of an FMF attack that can mimic other adverse pregnancy incidents such as chorioamnionitis or placental abruption. Nevertheless, Iskender et al. have failed to demonstrate an association between maternal FMF and adverse immediate pregnancy outcomes, including preterm delivery. This discrepancy can be explained by the relatively low sample size [17]. Our study demonstrated higher rates of cesarean deliveries, even when controlling for maternal age. While some studies did not demonstrate higher rates of cesarean delivery in mothers with FMF [17], others did [18]. This discrepancy may be due to the different sample sizes of the studies. Long-term infection-related hospitalization of offspring to mothers with FMF While immediate adverse perinatal outcomes of women with FMF have been extensively examined prior to the current study [7,17,18], less is known regarding long-term infection-related hospitalizations of offspring to women with FMF. The major finding of our study is that FMF is an independent risk factor for long-term infection-related hospitalizations of the offspring. The results of our study are an imperative addition to current data on the relationship between in-utero exposure to an inflammatory environment and infectious morbidity of the offspring. Yong Hwan Park et al. showed that patients with FMF had increased secretion of IL-1, IL-18, and other mediators of inflammation [19]. This increase in inflammatory cytokines in mothers with FMF can affect also the intra-uterine environment [20]. Therefore, alterations in the maternal milieu of inflammatory cytokines, as seen in maternal FMF, may impact the prenatal course and subsequent health of the offspring [21]. Furthermore, Velten et al. showed that inflammation in-utero was a potent and independent modulator of lung development, leading to interruption of alveolarization and microvascular development [22], which may explain the increased risk for respiratory infections among offspring to mothers with FMF found in our study. Strengths and limitations Our study has several strengths. SUMC, which provides both maternal and pediatric services, is the sole tertiary medical center in the Southern region of the country. The fact that both the mother and the child who live in this area would get care in the same medical facility enables us to combine databases from obstetric and pediatric departments and to follow children born in SUMC all the way to adulthood. Alongside its strengths, our study has several limitations, with the retrospective nature of our study being the main one. In addition, we were not able to include information regarding the severity of the disease and the selected treatment for each woman. Nevertheless, the first line of treatment, colchicine, is known to have a high safety profile for the fetus [18], and therefore we would not expect a change in outcomes depending on whether or not the mothers received treatment. Furthermore, we did not have information regarding the different mutations in the MEFV gene and the mode of inheritance, which may directly affect the patient's phenotype [23]. Finally, we were not able to include information about FMF morbidity in our offspring population. Theoretically, it could be assumed that offspring with FMF will present with an illness that is allegedly infectious but is actually an FMF manifestation that could change our outcomes. Nevertheless, the morbidity in our study is related to specific infectious pathogens; therefore, the likelihood of misidentifying the infectious-related morbidity as an episode of FMF is unlikely. Conclusion In conclusion, the results of this study show that maternal FMF was found to be an independent risk factor for adverse pregnancy outcomes including preterm delivery, cesarean delivery, and low birthweight. Also, and more importantly, maternal FMF was noted as a risk factor for long-term infection-related hospitalizations of the offspring. This positive correlation may reflect offspring susceptibility to infections and future child health. These findings may have clinical implications in the future, both in terms of the level of pregnancy surveillance needed due to the propensity for pregnancy complications and in terms of long-term follow-up of the newborns due to their susceptibility to infections. Further research is needed to establish this association. Declarations Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript . Competing Interests The authors have no relevant financial or non-financial interests to disclose. Author Contributions Study conception and design were performed by Itay Asher, Eyal Sheiner, and Gali Pariente. Data collection was performed by Itay Asher. Data analysis and drafting of the manuscript were completed by Itay Asher and Gali Pariente. All authors contributed to the manuscript editing and revision. All authors read and approved the final manuscript. Ethics approval The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Soroka University Medical Center (SUMC) (protocol code SOR-19-0357, date of approval 10 October 2019). Consent to participate Informed consent by the participants was waived since the data retrieved from the medical records were anonymous to the researchers. The data were handled in accordance with the principles of GCP. Consent to publish Informed consent by the participants was waived since the data retrieved from the medical records were anonymous to the researchers. The data were handled in accordance with the principles of GCP. References Sönmezgöz E, Özer S, Gül A, Yılmaz R, Kasap T, Takcı Ş, Gümüşer R, Demir O (2019) Clinical and Demographic Evaluation According to MEFV Genes in Patients with Familial Mediterranean Fever. Biochem Genet 57(2):289-300. https://doi.org/10.1007/s10528-018-9889-y Bakkaloglu A (2003) Familial Mediterranean fever. Pediatr Nephrol 18:853-9. https://doi.org/10.1007/s00467-003-1185-2 Dotters-Katz S, Kuller J, Price T (2012) The impact of familial Mediterranean fever on women's health. Obstet Gynecol Surv 67:357-64. https://doi.org/10.1097/OGX.0b013e318259ed3a. Yildirim ME, Kurtulgan HK, Ozdemir O, Kilicgun H, Aydemir DS, Baser B, Sezgin I (2019) Prevalence of MEFV gene mutations in a large cohort of patients with suspected familial Mediterranean fever in Central Anatolia. Ann Saudi Med 39:382-387. https://doi.org/10.5144/0256-4947.2019.382 Varan O, Kucuk H, Babaoglu H, Atas N, Salman RB, Satis H, Ozturk MA, Haznedaroglu S, Goker B, Tufan A (2019) Effect of interleukin-1 antagonists on the quality of life in familial Mediterranean fever patients. Clin Rheumatol 38:1125-1130. https://doi.org/10.1007/s10067-018-4384-8 Keriakos R, Roberts JK, Sidra L (1999) Familial Mediterranean fever in a pregnant woman. J Obstet Gynaecol 19:541-2. https://doi.org/10.1080/01443619964445 Ofir D, Levy A, Wiznitzer A, Mazor M, Sheiner E (2008) Familial Mediterranean fever during pregnancy: an independent risk factor for preterm delivery. Eur J Obstet Gynecol Reprod Biol 141:115-8. https://doi.org/10.1016/j.ejogrb.2008.07.025 Mazor-Dray E, Levy A, Schlaeffer F, Sheiner E (2009) Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome? J Matern Fetal Neonatal Med 22:124-8. https://doi.org/10.1080/14767050802488246 Sacks G, Sargent I, Redman C (1999) An innate view of human pregnancy. Immunol Today 20:114-8. https://doi.org/10.1016/s0167-5699(98)01393-0 Dan N, Sheiner E, Wainstock T, Marks K, Kessous R (2021) Maternal Smoking during Pregnancy and the Risk for Childhood Infectious Diseases in the Offspring: A Population-Based Cohort Study. Am J Perinatol 38:166-170. https://doi.org/10.1055/s-0039-1695773 Gutvirtz G, Wainstock T, Landau D, Sheiner E (2019) Maternal Obesity and Offspring Long-Term Infectious Morbidity. J Clin Med 8:1466. https://doi.org/10.3390/jcm8091466 Cohen R, Gutvirtz G, Wainstock T, Sheiner E (2019) Maternal urinary tract infection during pregnancy and long-term infectious morbidity of the offspring. Early Hum Dev 136:54-59. https://doi.org/10.1016/j.earlhumdev.2019.07.002 Nae B, Wainstock T, Sheiner E (2022) The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations. J Dev Orig Health Dis 13:508-513. https://doi.org/10.1017/S2040174421000593 Park YH, Wood G, Kastner DL, Chae JJ (2016) Pyrin inflammasome activation and RhoA signaling in the autoinflammatory diseases FMF and HIDS. Nat Immunol 17:914-21. https://doi.org/10.1038/ni.3457 Nabil H, Zayed A, State O, Badawy A (2012) Pregnancy outcome in women with familial Mediterranean fever. J Obstet Gynaecol 32:756-9. https://doi.org/10.3109/01443615 Yasar O, Iskender C, Kaymak O, Taflan Yaman S, Uygur D, Danisman N (2014) Retrospective evaluation of pregnancy outcomes in women with familial Mediterranean fever. J Matern Fetal Neonatal Med 27:733-6. https://doi.org/10.3109/14767058.2013.837446 Iskender D, Kara O, Ozturk Kaymak A, Daglar HK, Kirbas A, Iskender CT, Kaymak O, Celen S (2020) Association between basal proteinuria levels and pregnancy outcomes in familial Mediterranean fever. J Obstet Gynaecol 40:1102-1105. https://doi.org/10.1080/01443615.2019.1700944 Rabinovitch O, Zemer D, Kukia E, Sohar E, Mashiach S (1992) Colchicine treatment in conception and pregnancy: two hundred thirty-one pregnancies in patients with familial Mediterranean fever. Am J Reprod Immunol 28:245-6. https://doi.org/10.1111/j.1600-0897.1992.tb00805.x Alghamdi M. Familial Mediterranean fever, review of the literature (2017) Clin Rheumatol 36:1707-1713. https://doi.org/10.1007/s10067-017-3715-5 Zaretsky MV, Alexander JM, Byrd W, Bawdon RE (2004) Transfer of inflammatory cytokines across the placenta. Obstet Gynecol 103:546-50. https://doi.org/ 10.1097/01.AOG.0000114980.40445.83 Ratnayake U, Quinn T, Walker DW, Dickinson H (2013) Cytokines and the neurodevelopmental basis of mental illness. Front Neurosci 7:180. https://doi.org/10.3389/fnins.2013.00180 Velten M, Heyob KM, Rogers LK, Welty SE (2010) Deficits in lung alveolarization and function after systemic maternal inflammation and neonatal hyperoxia exposure. J Appl Physiol 108:1347-56. https://doi.org/10.1152/japplphysiol.01392.2009 Shinar Y, Livneh A, Langevitz P, Zaks N, Aksentijevich I, Koziol DE, Kastner DL, Pras M, Pras E (2000) Genotype-phenotype assessment of common genotypes among patients with familial Mediterranean fever. J Rheumatol 27:1703-7. Tables Table 3: Long-term infectious morbidity of the study groups Infectious morbidity Offspring born to mothers with FMF (n=411) (0.001%) Offspring born to mothers without FMF (n=355,945) (0.99%) P value Bacterial infections 5 (1.2%) 5,186 (1.5%) 0.68 Central nervous system infections 4 (1.0%) 1,853 (0.5%) 0.20 Ear, nose, and throat infections 48 (11.7%) 22,850 (6.4%) <0.001 Neonatal infections 10 (2.4%) 4,642 (1.3%) 0.04 Skin infections 8 (1.9%) 8,260 (2.3%) 0.61 Ophthalmic infections 10 (2.4%) 4,470 (1.3%) 0.03 Orthopedic infections 2 (0.5%) 1,038 (0.3%) 0.46 Urological infections 1 (0.2%) 279 (0.2%) 0.23 Gastrointestinal infections 17 (4.1%) 10,510 (3.0%) 0.15 Respiratory infections 92 (22.4%) 49,157 (13.8%) <0.001 Viral infections 26 (6.3%) 11,470 (3.2%) <0.001 Total infectious-related hospitalizations 153 (37.2%) 85,639 (24.1%) <0.001 Table 4 : Cox proportional hazards model for the association between maternal FMF and offspring long-term infectious morbidity Variables Adjusted HR 95%CI P value Maternal FMF (vs. no maternal FMF) 1.71 1.46-2.01 <0.001 Gestational age 0.95 0.95-0.96 <0.001 Maternal age 0.98 0.98-0.99 <0.001 Cesarean section 1.12 1.09-1.14 <0.001 Maternal diabetes mellitus 1.08 0.99-1.11 <0.001 Hypertensive disorders 1.03 1.04-1.11 0.02 Cite Share Download PDF Status: Published Journal Publication published 21 Dec, 2023 Read the published version in Archives of Gynecology and Obstetrics → Version 1 posted Reviewers agreed at journal 04 Oct, 2023 Reviewers invited by journal 29 Sep, 2023 Editor invited by journal 27 Sep, 2023 Editor assigned by journal 26 Sep, 2023 First submitted to journal 25 Sep, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3388223","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":236819537,"identity":"c35b4c50-f777-4fec-a678-936b6ee48b0c","order_by":0,"name":"Itay Asher","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA70lEQVRIiWNgGAWjYBACNgh1gIGBvbHxAZDFw0dQCxtMC8/hwwYgLWxEWgPUIpGWJoFkL27AJ9/8TOLHnzty5jNyzCq/5tjJsDEwP3x0A6/D2Mwke9ueGcuceWN2W3ZbMtBhbMbGOfj9YibB23A4cQZ7jtltyW3MQC08bNL4tbB/k/zz53D9DIYcs2LJbfXEaOExk+ZhO5wgwZGWxvhx22FitOQUW8u2HTacAQxkacZtx3nYmAn4Rb75+Mabb/4clpcARuXHn9uq7fnZmx8+xqcFCFgkYCxmHjCJXzlYyQcYi/EHYdWjYBSMglEwAgEAbyxDd1RiV+gAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-4751-6242","institution":"Kaplan Medical Center","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Itay","middleName":"","lastName":"Asher","suffix":""},{"id":236819538,"identity":"4c2a4625-5c86-42a9-95a1-31dd27cf70b1","order_by":1,"name":"Eyal Sheiner","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Eyal","middleName":"","lastName":"Sheiner","suffix":""},{"id":236819539,"identity":"7f02cfb9-48c8-4f40-972f-77c388a7cce2","order_by":2,"name":"Nata Tifferet Willner","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Nata","middleName":"Tifferet","lastName":"Willner","suffix":""},{"id":236819540,"identity":"de5898df-1ac1-4533-bf32-136f45fba8e1","order_by":3,"name":"Lior Zeller","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lior","middleName":"","lastName":"Zeller","suffix":""},{"id":236819541,"identity":"dd39b1ae-960f-46ac-9180-b04b09cdea0c","order_by":4,"name":"Gali Pariente","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Gali","middleName":"","lastName":"Pariente","suffix":""}],"badges":[],"createdAt":"2023-09-26 10:19:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3388223/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3388223/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00404-023-07317-w","type":"published","date":"2023-12-21T15:00:51+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":44137298,"identity":"53ef0786-df33-42cd-bfd3-adea90f1b35e","added_by":"auto","created_at":"2023-10-05 14:10:28","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":55742,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meier survival curve demonstrating the cumulative incidence of hospitalizations involving infectious morbidity in offspring born to mothers with and without FMF (log-rank test, \u003cem\u003ep\u003c/em\u003e value=\u0026lt;0.001)\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3388223/v1/8f32025d04399fb2ff3d31bc.jpg"},{"id":48776665,"identity":"2593fb62-f2f2-44fe-9174-f4f8963cc6f1","added_by":"auto","created_at":"2023-12-25 15:06:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":415679,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3388223/v1/db38156c-1fb2-45aa-be22-1db4e3e0f60d.pdf"}],"financialInterests":"","formattedTitle":"Perinatal Outcomes and Long-Term Infectious Morbidity of Offspring Born to Mothers with Familial Mediterranean Fever","fulltext":[{"header":"What does this study add to the clinical work","content":"\u003cp\u003eMothers with FMF should consider consulting their physicians regarding the need for long-term follow-up of the newborns due to their susceptibility to infectious morbidity. although Further research is needed.\u003c/p\u003e"},{"header":"INTRODUCTION","content":"\u003cp\u003eFamilial Mediterranean Fever (FMF) is an auto-inflammatory autosomal, recessively inherited disease, presented clinically with short-term recurrent flares of fever and serosal inflammation. In most patients, the primary symptoms and signs of the disease are fever, abdominal pain, chest pain, and arthritis [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This genetic disease affects roughly 150,000 people worldwide, primarily non-Ashkenazi Jewish, Turkish, Armenian, and Arab populations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Although this disorder is diagnosed based on clinical findings, it is known to be caused by mutations in the MEFV gene located on chromosome 16p [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The MEFV gene encodes the protein pyrin, which regulates the innate immune response. The impaired protein produces an inappropriate and prolonged response to inflammatory stimuli and an increase in leukocyte migration to serosal sites [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFMF can have major implications for a female patient. Uncontrolled disease may impair female fertility. This decline in fertility may be a result of direct ovarian damage from amyloid deposits or abdominopelvic adhesions from recurrent peritonitis [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Untreated FMF patients also experience a high frequency of pregnancy losses, occurring in 20\u0026ndash;30% of pregnancies of women with untreated FMF [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In another study, FMF was an independent risk factor for preterm delivery (OR\u0026thinsp;=\u0026thinsp;1.52; 95% CI 1.13\u0026ndash;2.23) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA successful pregnancy requires adaptations of the maternal immune system to allow the growth of an antigenically foreign fetus. This involves an increase in the innate immune response and a decrease in the adaptive immune response. These changes may contribute to the maternal ability to protect against infections and exhibit tolerance toward the fetus at the same time [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Nevertheless, in some cases, an inadequate innate response can promote a severe clinical presentation of recurrent inflammation that has been associated with inflammatory-related adverse pregnancy outcomes such as preeclampsia [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFetal programming is the hypothesis that describes the interaction between the offspring\u0026rsquo;s long-term health and its in-utero environmental conditions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Studies have associated maternal exposures during pregnancy such as smoking, maternal obesity, and maternal urinary tract infection with long-term infectious morbidity of the offspring [\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. FMF is known to cause a pro-inflammatory state that increases the secretion of IL-1, IL-18, and other mediators of inflammation that enhance chemotaxis and neutrophilia, inducing an FMF flare [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. A pro-inflammatory state, caused by recurrent inflammatory flares such as in FMF, may have a secondary effect on the infant, making it more prone to acquiring infections due to dysregulation in its immune system. In this large population-based study, we sought to investigate the long-term infectious morbidity of children to mothers with FMF, regardless of prematurity.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePopulation and Settings\u003c/h2\u003e \u003cp\u003eThe study was conducted at the Soroka University Medical Center (SUMC), a 1050 bed tertiary hospital, and the only major medical center in the Negev, the southern region of Israel, serving a population of over one million people. Thus, the study is based on nonselective population data. The study was approved by the local institutional ethics committee in accordance with the principles of the Declaration of Helsinki (IRB number 0357-19-SOR). The study population included all patients who delivered between the years 1991 and 2021 in SUMC. Multiple gestations and children with congenital malformations or chromosomal abnormalities were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eA population-based retrospective cohort study was conducted. The primary exposure was defined as being born to a mother with FMF. Delivery of an infant to a mother without FMF comprised the comparison group. The main outcome was long-term infectious morbidity of the offspring up to the age of 18 years, documented in hospitalization records. All encounters with the hospital were analyzed so that multiple infectious diagnoses could be given to a single child. The date of the first infectious-related hospitalization was used to calculate time-to-event. Long-term infectious morbidity was based on any hospitalization in which an infectious diagnosis was made, either as the principal or the secondary diagnosis, and included: urological infections, ear, nose, and throat infections, gastrointestinal infections, ophthalmic infections, central nervous system infections, bacterial infections, respiratory infections, orthopedic infections, neonatal infections, viral infections, and skin infections. Data were collected from two databases: the first is the perinatal database of the division of Obstetrics and Gynecology in SUMC, including information that was documented by obstetricians following delivery. Skilled medical secretaries routinely review the information before entering it into the databases, ensuring its reliability and accuracy. The second source was the computerized SUMC children\u0026rsquo;s hospitalization records, including demographic information and all medical diagnoses made during hospitalization, according to the International Classification of Diseases, Ninth Revision codes. These databases were cross-linked and merged based on personal identification numbers. Each newborn in the country receives a national identification number before being discharged from the hospital. These numbers, as well as the mothers' identification numbers, were coded in the perinatal database and were used to cross-link with the pediatric database.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eUnivariable analysis was performed to compare dependent and background characteristics between the two study groups. The univariable analysis included Chi-square tests for categorical variables, and t-tests or Man-Whitney U tests for continuous variables according to their distribution. To compare perinatal outcomes, generalized estimation equation (GEE) models were used to control for confounders and to account for maternal clusters. Cumulative incidence rates were compared using Kaplan-Meier, using the log-rank test to determine significant differences. The Cox proportional hazards model was conducted to compare infection-associated hospitalization risk among offspring born to mothers with or without FMF. The model adjusted for mothers occurring multiple times in the cohort, and the similarity among the siblings was accounted for. Additionally, the model adjusted for potential confounders based on the univariable analysis and clinical importance of the variables. The final model was chosen based on best fit and minimal \u0026minus;\u0026thinsp;2 log likelihood. All analyses were performed using SPSS (version 26 or higher) or STATA (version 12 or higher) software. All assumptions were 2-sided, and a p-value of \u0026lt;\u0026thinsp;0.05 was considered to be statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eDuring the 30-year study period, 356,356 deliveries met the inclusion criteria, of these 411 (0.001%) were women with FMF. Table 1 presents the demographic and clinical characteristics of women with and without FMF. Women with FMF were significantly older and had lower parity compared to women without FMF. Table 2 presents pregnancy and delivery outcomes of women with and without FMF. Using GEE models, controlling for maternal age, preterm delivery, cesarean delivery, and low birth weight, which were independently associated with maternal FMF (adjusted OR 1.52, 95% CI 1.08-2.13, \u003cem\u003ep\u003c/em\u003e=0.01, adjusted OR 1.35, 95% CI 1.00-1.81, \u003cem\u003ep\u003c/em\u003e=0.04, and adjusted OR 1.77, 95% CI 1.27-2.46, \u003cem\u003ep\u003c/em\u003e=0.001 for preterm delivery, cesarean delivery, and low birth weight, respectively).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe long-term infectious morbidity of offspring born to mothers with and without FMF is presented in Table 3. Total infection-related hospitalization rates were significantly higher in offspring born to mothers with FMF compared to the comparison group (37.2% vs. 24.1%, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). Likewise, the Kaplan\u0026ndash;Meier survival curve (Fig1), demonstrated a significantly higher cumulative incidence of infection-related hospitalizations, in offspring born to mothers with FMF (log-rank, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). Specific morbidities as ear, nose, and throat (11.7% vs 6.4%, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001), neonatal infections (2.4% vs 1.3%, \u003cem\u003ep\u003c/em\u003e=0.04), ophthalmic infections (2.4% vs 1.3%, \u003cem\u003ep\u003c/em\u003e=0.03), respiratory infections (22.4% vs 13.8%, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001), and viral infections (6.3% vs 3.2%, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001) were more prevalent in offspring of women with FMF as opposed to the comparison group. Using a Cox proportional hazards model controlling for gestational age, maternal age, maternal diabetes mellitus, cesarean section, and hypertensive disorders, being born to a mother with FMF was found to be an independent risk factor for long-term infection-related hospitalization of the offspring (adjusted HR 1.71, 95% CI 1.46\u0026ndash;2.01, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn this large, nonselective, population-based study with a long follow-up period, mothers with FMF demonstrated a higher risk for immediate adverse perinatal outcomes such as preterm delivery, cesarean section, and low birth weight. Furthermore, offspring born to mothers with FMF had a significantly higher rate of long-term infection-related hospitalizations compared to mothers without FMF, regardless of prematurity status. Specific morbidities were found to be more prevalent, including ear, nose, and throat infections, neonatal infections, ophthalmic infections, respiratory infections, and viral infections.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImmediate perinatal outcome of women with FMF\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSeveral previous studies have evaluated the association between maternal FMF and pregnancy and delivery outcomes. Our study demonstrates an independent association between maternal FMF, preterm delivery, and low birth weight. Other studies have shown similar results [15,16]. This association may either be attributed to recurrent peritonitis and fever flares, which may induce preterm labor, or to the signs and symptoms of an FMF attack that can mimic other adverse pregnancy incidents such as chorioamnionitis or placental abruption. Nevertheless, Iskender et al. have failed to demonstrate an association between maternal FMF and adverse immediate pregnancy outcomes, including preterm delivery. This discrepancy can be explained by the relatively low sample size [17].\u003c/p\u003e\n\u003cp\u003eOur study demonstrated higher rates of cesarean deliveries, even when controlling for maternal age. While some studies did not demonstrate higher rates of cesarean delivery in mothers with FMF [17], others did [18]. This discrepancy may be due to the different sample sizes of the studies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLong-term infection-related hospitalization of offspring to mothers with FMF\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile immediate adverse perinatal outcomes of women with FMF have been extensively examined prior to the current study [7,17,18], less is known regarding long-term infection-related hospitalizations of offspring to women with FMF.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe major finding of our study is that FMF is an independent risk factor for long-term infection-related hospitalizations of the offspring.\u003c/p\u003e\n\u003cp\u003eThe results of our study are an imperative addition to current data on the relationship between in-utero exposure to an inflammatory environment and infectious morbidity of the offspring.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Yong Hwan Park et al. showed that patients with FMF had increased secretion of IL-1, IL-18, and other mediators of inflammation [19]. This increase in inflammatory cytokines in mothers with FMF can affect also the intra-uterine environment [20]. Therefore, alterations in the maternal milieu of inflammatory cytokines, as seen in maternal FMF, may impact the prenatal course and subsequent health of the offspring [21].\u003c/p\u003e\n\u003cp\u003eFurthermore, Velten et al. showed that inflammation in-utero was a potent and independent modulator of lung development, leading to interruption of alveolarization and microvascular development [22], which may explain the increased risk for respiratory infections among offspring to mothers with FMF found in our study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study has several strengths. SUMC, which provides both maternal and pediatric services, is the sole tertiary medical center in the Southern region of the country. The fact that both the mother and the child who live in this area would get care in the same medical facility enables us to combine databases from obstetric and pediatric departments and to follow children born in SUMC all the way to adulthood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAlongside its strengths, our study has several limitations, with the retrospective nature of our study being the main one. In addition, we were not able to include information regarding the severity of the disease and the selected treatment for each woman. Nevertheless, the first line of treatment, colchicine, is known to have a high safety profile for the fetus [18], and therefore we would not expect a change in outcomes depending on whether or not the mothers received treatment. Furthermore, we did not have information regarding the different mutations in the MEFV gene and the mode of inheritance, which may directly affect the patient\u0026apos;s phenotype [23]. Finally, we were not able to include information about FMF morbidity in our offspring population. Theoretically, it could be assumed that offspring with FMF will present with an illness that is allegedly infectious but is actually an FMF manifestation that could change our outcomes. Nevertheless, the morbidity in our study is related to specific infectious pathogens; therefore, the likelihood of misidentifying the infectious-related morbidity as an episode of FMF is unlikely.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, the results of this study show that maternal FMF was found to be an independent risk factor for adverse pregnancy outcomes including preterm delivery, cesarean delivery, and low birthweight. Also, and more importantly, maternal FMF was noted as a risk factor for long-term infection-related hospitalizations of the offspring. This positive correlation may reflect offspring susceptibility to infections and future child health. These findings may have clinical implications in the future, both in terms of the level of pregnancy surveillance needed due to the propensity for pregnancy complications and in terms of long-term follow-up of the newborns due to their susceptibility to infections. Further research is needed to establish this association.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy conception and design were performed by Itay Asher, Eyal Sheiner, and Gali Pariente. Data collection was performed by Itay Asher. Data analysis and drafting of the manuscript were completed by Itay Asher and Gali Pariente. All authors contributed to the manuscript editing and revision. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Soroka University Medical Center (SUMC) (protocol code SOR-19-0357, date of approval 10 October 2019).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent by the participants was waived since the data retrieved from the medical records were anonymous to the researchers. The data were handled in accordance with the principles of GCP.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent by the participants was waived since the data retrieved from the medical records were anonymous to the researchers. The data were handled in accordance with the principles of GCP.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eS\u0026ouml;nmezg\u0026ouml;z E, \u0026Ouml;zer S, G\u0026uuml;l A, Yılmaz R, Kasap T, Takcı Ş, G\u0026uuml;m\u0026uuml;şer R, Demir O (2019) Clinical and Demographic Evaluation According to MEFV Genes in Patients with Familial Mediterranean Fever. Biochem Genet 57(2):289-300. https://doi.org/10.1007/s10528-018-9889-y\u003c/li\u003e\n\u003cli\u003eBakkaloglu A (2003) Familial Mediterranean fever. Pediatr Nephrol 18:853-9. https://doi.org/10.1007/s00467-003-1185-2 \u003c/li\u003e\n\u003cli\u003eDotters-Katz S, Kuller J, Price T (2012) The impact of familial Mediterranean fever on women\u0026apos;s health. Obstet Gynecol Surv 67:357-64. https://doi.org/10.1097/OGX.0b013e318259ed3a.\u003c/li\u003e\n\u003cli\u003eYildirim ME, Kurtulgan HK, Ozdemir O, Kilicgun H, Aydemir DS, Baser B, Sezgin I (2019) Prevalence of MEFV gene mutations in a large cohort of patients with suspected familial Mediterranean fever in Central Anatolia. Ann Saudi Med 39:382-387. https://doi.org/10.5144/0256-4947.2019.382\u003c/li\u003e\n\u003cli\u003eVaran O, Kucuk H, Babaoglu H, Atas N, Salman RB, Satis H, Ozturk MA, Haznedaroglu S, Goker B, Tufan A (2019) Effect of interleukin-1 antagonists on the quality of life in familial Mediterranean fever patients. Clin Rheumatol 38:1125-1130. https://doi.org/10.1007/s10067-018-4384-8\u003c/li\u003e\n\u003cli\u003eKeriakos R, Roberts JK, Sidra L (1999) Familial Mediterranean fever in a pregnant woman. J Obstet Gynaecol 19:541-2. https://doi.org/10.1080/01443619964445\u003c/li\u003e\n\u003cli\u003eOfir D, Levy A, Wiznitzer A, Mazor M, Sheiner E (2008) Familial Mediterranean fever during pregnancy: an independent risk factor for preterm delivery. Eur J Obstet Gynecol Reprod Biol 141:115-8. https://doi.org/10.1016/j.ejogrb.2008.07.025\u003c/li\u003e\n\u003cli\u003eMazor-Dray E, Levy A, Schlaeffer F, Sheiner E (2009) Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome? J Matern Fetal Neonatal Med 22:124-8. https://doi.org/10.1080/14767050802488246\u003c/li\u003e\n\u003cli\u003eSacks G, Sargent I, Redman C (1999) An innate view of human pregnancy. Immunol Today 20:114-8. https://doi.org/10.1016/s0167-5699(98)01393-0 \u003c/li\u003e\n\u003cli\u003eDan N, Sheiner E, Wainstock T, Marks K, Kessous R (2021) Maternal Smoking during Pregnancy and the Risk for Childhood Infectious Diseases in the Offspring: A Population-Based Cohort Study. Am J Perinatol 38:166-170. https://doi.org/10.1055/s-0039-1695773 \u003c/li\u003e\n\u003cli\u003eGutvirtz G, Wainstock T, Landau D, Sheiner E (2019) Maternal Obesity and Offspring Long-Term Infectious Morbidity. J Clin Med 8:1466. https://doi.org/10.3390/jcm8091466\u003c/li\u003e\n\u003cli\u003eCohen R, Gutvirtz G, Wainstock T, Sheiner E (2019) Maternal urinary tract infection during pregnancy and long-term infectious morbidity of the offspring. Early Hum Dev 136:54-59. https://doi.org/10.1016/j.earlhumdev.2019.07.002\u003c/li\u003e\n\u003cli\u003eNae B, Wainstock T, Sheiner E (2022) The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations. J Dev Orig Health Dis 13:508-513. https://doi.org/10.1017/S2040174421000593\u003c/li\u003e\n\u003cli\u003ePark YH, Wood G, Kastner DL, Chae JJ (2016) Pyrin inflammasome activation and RhoA signaling in the autoinflammatory diseases FMF and HIDS. Nat Immunol 17:914-21. https://doi.org/10.1038/ni.3457\u003c/li\u003e\n\u003cli\u003eNabil H, Zayed A, State O, Badawy A (2012) Pregnancy outcome in women with familial Mediterranean fever. J Obstet Gynaecol 32:756-9. https://doi.org/10.3109/01443615\u003c/li\u003e\n\u003cli\u003eYasar O, Iskender C, Kaymak O, Taflan Yaman S, Uygur D, Danisman N (2014) Retrospective evaluation of pregnancy outcomes in women with familial Mediterranean fever. J Matern Fetal Neonatal Med 27:733-6. https://doi.org/10.3109/14767058.2013.837446\u003c/li\u003e\n\u003cli\u003eIskender D, Kara O, Ozturk Kaymak A, Daglar HK, Kirbas A, Iskender CT, Kaymak O, Celen S (2020) Association between basal proteinuria levels and pregnancy outcomes in familial Mediterranean fever. 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J Rheumatol 27:1703-7. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cimg 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\" style=\"width: 921px; height: 287.086px;\" width=\"921\" height=\"287.086\"\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3:\u0026nbsp;\u003c/strong\u003eLong-term infectious morbidity of the study groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfectious morbidity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOffspring born to mothers with FMF\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(n=411)\u0026nbsp;(0.001%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOffspring born to mothers without FMF\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=355,945) (0.99%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eBacterial infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e5 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e5,186 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eCentral nervous system infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e4 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e1,853 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eEar, nose, and throat infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e48 (11.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e22,850 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eNeonatal infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e10 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e4,642 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eSkin infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e8 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e8,260 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eOphthalmic infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e10 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e4,470 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eOrthopedic infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e1,038 (0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eUrological infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e279 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eGastrointestinal infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e17 (4.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e10,510 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eRespiratory infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e92 (22.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e49,157 (13.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003eViral infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e26 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e11,470 (3.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.437598736176934%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal infectious-related hospitalizations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.278041074249604%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e153\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(37.2%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.85781990521327%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e85,639 (24.1%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.42654028436019%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e: Cox proportional hazards model for the association between maternal FMF and offspring long-term infectious morbidity\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted HR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003eMaternal FMF (vs. no maternal FMF)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e1.46-2.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003eGestational age\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e0.95-0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003eMaternal age\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e0.98-0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003eCesarean section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e1.09-1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003eMaternal diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e0.99-1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.53623188405797%\" valign=\"top\"\u003e\n \u003cp\u003eHypertensive disorders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.47826086956522%\" valign=\"top\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003e1.04-1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.681159420289855%\" valign=\"top\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-gynecology-and-obstetrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"arch","sideBox":"Learn more about [Archives of Gynecology and Obstetrics](https://www.springer.com/journal/404)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/arch/default.aspx","title":"Archives of Gynecology and Obstetrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Familial Mediterranean fever, Inflammation, Pregnancy complications, Fetus, Infection","lastPublishedDoi":"10.21203/rs.3.rs-3388223/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3388223/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eTo investigate perinatal outcomes and long-term infectious morbidity in children of mothers with familial Mediterranean fever (FMF).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA population-based cohort study comparing perinatal outcomes and long-term infectious morbidity of offspring of mothers with and without FMF was conducted. All singleton deliveries between the years 1991\u0026ndash;2021 in a tertiary medical center were included. The study groups were followed until 18 years of age for long-term infectious morbidity. A Kaplan-Meier survival curve was used to compare the cumulative incidence of long-term infectious morbidity, and generalized estimation equation (GEE) models as well as Cox proportional hazards models were constructed to control for confounders.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eDuring the study period, 356,356 deliveries met the inclusion criteria. 411 of them were women with FMF. Using GEE models, preterm delivery, cesarean delivery, and low birth weight were independently associated with maternal FMF. The total infectious-related hospitalization rate was significantly higher in offspring born to mothers with FMF compared to the comparison group (Kaplan\u0026ndash;Meier survival curve, log-rank p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Using a Cox proportional hazards model, controlling for gestational age, maternal age, diabetes mellitus, cesarean delivery, and hypertensive disorders, being born to a mother with FMF was found to be an independent risk factor for long-term infection-related hospitalization of the offspring.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eMaternal FMF was found to be independently associated with long-term infection-related hospitalization of the offspring. This positive correlation may reflect an intra-uterine pro-inflammatory environment which may result in the offspring's long-term susceptibility to infection.\u003c/p\u003e","manuscriptTitle":"Perinatal Outcomes and Long-Term Infectious Morbidity of Offspring Born to Mothers with Familial Mediterranean Fever","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-10-05 14:10:23","doi":"10.21203/rs.3.rs-3388223/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2023-10-04T07:19:52+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-09-29T06:24:09+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"Archives of Gynecology and Obstetrics","date":"2023-09-27T08:29:29+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-09-26T10:19:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Gynecology and Obstetrics","date":"2023-09-26T03:58:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-gynecology-and-obstetrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"arch","sideBox":"Learn more about [Archives of Gynecology and Obstetrics](https://www.springer.com/journal/404)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/arch/default.aspx","title":"Archives of Gynecology and Obstetrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"54a01bfe-c54f-4d4a-bec9-31fe31698433","owner":[],"postedDate":"October 5th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-12-25T15:02:44+00:00","versionOfRecord":{"articleIdentity":"rs-3388223","link":"https://doi.org/10.1007/s00404-023-07317-w","journal":{"identity":"archives-of-gynecology-and-obstetrics","isVorOnly":false,"title":"Archives of Gynecology and Obstetrics"},"publishedOn":"2023-12-21 15:00:51","publishedOnDateReadable":"December 21st, 2023"},"versionCreatedAt":"2023-10-05 14:10:23","video":"","vorDoi":"10.1007/s00404-023-07317-w","vorDoiUrl":"https://doi.org/10.1007/s00404-023-07317-w","workflowStages":[]},"version":"v1","identity":"rs-3388223","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3388223","identity":"rs-3388223","version":["v1"]},"buildId":"iFTdqyg4nuje_uAy1AHro","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}