Maternal egg and peanut loading does not prevent infant allergy

The edition in brief

The PrEggNut trial randomised 2,137 pregnant women whose unborn child had at least two close relatives with allergic disease to a high egg-and-peanut diet (at least 6 eggs and 60 peanuts weekly) or a standard diet from before 23 weeks until 4 months postnatally. IgE-mediated egg or peanut allergy at 1 year occurred in 7.8% versus 8.4% (relative risk 0.93, 95% CI 0.69 to 1.26). Maternal allergen loading is not a prevention strategy; timely infant introduction remains the one that works. Polycystic ovary syndrome has been renamed polyendocrine metabolic ovarian syndrome by international consensus endorsed by 56 organisations. Diagnostic criteria are unchanged; the clinical frame is not. The condition affects about 10-13% of reproductive-age women and carries higher risks of miscarriage, gestational diabetes, hypertensive disorders, preterm birth and growth restriction, which argues for recording it as an obstetric risk modifier at booking. A meta-analysis of 17 randomised trials found standalone physical activity associated with lower antenatal depressive symptom scores (SMD -0.52, 95% CI -0.75 to -0.30) and a smaller postpartum effect, with no clear effect on antenatal anxiety; certainty was low to very low. A prospective study of 14,114 pregnant women confirmed how rare the population at risk of HPA-1a alloimmunisation is: 1.7% were HPA-1b/1b, and only 24 met all higher-risk criteria. Finally, a cohort of 21,743 term pregnancies found third-trimester ultrasound detected only about a third of large-for-gestational-age infants, while a screen-positive label raised intrapartum caesarean (aRR 1.47) without neonatal benefit in false positives.