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Sabra S, Malmqvist E, Saborit A, Gratacós E, Gomez Roig MD. Heavy metals exposure levels and their correlation with different clinical forms of fetal growth restriction. PLoS One 2017; 12:e0185645. [PMID: 28985223 PMCID: PMC5630121 DOI: 10.1371/journal.pone.0185645] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/16/2017] [Indexed: 12/27/2022] Open
Abstract
Background Prenatal heavy metals exposure has shown a negative impact on birth weight. However, their influence on different clinical forms of fetal smallness was never assessed. Objectives To investigate whether there is a differential association between heavy metals exposure and fetal smallness subclassification into intrauterine growth restriction (IUGR) and small-for-gestational age (SGA). Method In this prospective case-control study, we included 178 mother–infant pairs; 96 of appropriate for gestational age (AGA) and 82 of small fetuses diagnosed in third trimester. The small ones were further subclassified into IUGR, n = 49 and SGA, n = 33. Cadmium (Cd), mercury (Hg), lead (Pb), arsenic (As) and zinc (Zn) levels were measured in the maternal and cord serum, and in the placentas of the three groups. Results Maternal serum level of Cd (p<0.001) was higher in the small fetuses compared to AGA. Fetal serum level of Cd (p<0.001) was increased in the small fetuses compared to AGA. Fetal serum level of Hg (p<0.05) showed an increase in SGA compared to both IUGR and AGA. Fetal serum level of Zn was increased in the AGA (p < 0.001) compared to each of the small fetuses groups. Only differences in the levels between the small fetuses’ subgroups were detected in the fetal serum levels of Cd and Hg. Fetal birth weight was negatively correlated with the fetal serum level of Cd (p < 0.001). No differences in the placental heavy metal levels were observed among the groups. Conclusion Fetal serum levels of Cd showed differential correlation between small fetuses' clinical subclassification, which together with the increased Cd levels in both maternal and fetal serum of the small fetuses reinforce the negative influence of heavy metals on birth weight. These findings provide more opportunities to verify the role of heavy metals exposure in relation to small fetuses’ subclassification.
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Affiliation(s)
- Sally Sabra
- BCNatal | Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain
| | - Ebba Malmqvist
- Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Alicia Saborit
- BCNatal | Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal | Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain
- IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain
| | - Maria Dolores Gomez Roig
- BCNatal | Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain
- Spanish Maternal and Child Health and Development Network Retics Red SAMID, Health Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39–57, Esplugues de Llobregat, Spain
- * E-mail:
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Kim SM, Lee SM, Kim SJ, Kim BJ, Shin S, Kim JR, Cho KH. Cord and maternal sera from small neonates share dysfunctional lipoproteins with proatherogenic properties: Evidence for Barker's hypothesis. J Clin Lipidol 2017; 11:1318-1328.e3. [PMID: 28966080 DOI: 10.1016/j.jacl.2017.08.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/26/2017] [Accepted: 08/31/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fetal growth restriction (GR) is associated with perinatal mortality and subsequent metabolic disorders in adulthood. Until now, there is little information regarding changes in the properties of lipoproteins from growth-restricted fetuses and their maternal sera. OBJECTIVE To identify unique lipoprotein biomarkers for fetal GR in maternal and cord sera from small neonates, we analyzed lipoprotein compositions and functions. METHODS Lipoprotein compositions and functions were compared between cord blood and maternal blood among small for gestational age neonates (SGA; n = 15, 2589 ± 50 g) and appropriate for gestational age neonates (AGA; n = 15) in Korea. RESULTS Cord blood from the SGA group showed 2-fold higher triglyceride (TG) and TG/high-density lipoprotein cholesterol levels than the AGA group as well as significantly lower (up to 20%) paraoxonase activity and apolipoprotein (apo) A-I content. The SGA group showed the highest cholesteryl ester transfer protein activities in both cord and maternal sera. SGA neonates showed elevated apo-B content in very low-density lipoprotein, 52% reduction of apo A-I content in high-density lipoprotein, and 30% increased glycation (P < .001) compared with AGA neonates. Especially, low-density lipoprotein from the SGA group showed 1.9-fold higher sensitivity to oxidation as well as 3-fold greater uptake into macrophages, suggesting stronger proatherosclerotic properties. Lipoproteins from maternal serum of SGA neonates showed greater oxidation along with TG enrichment and loss of antioxidant ability. On microinjection of cord serum (50 nL) into zebrafish embryos, the SGA group showed the most severe embryonic damage. CONCLUSIONS Lipoproteins from cord and maternal sera of SGA neonates resulted in severe impairment of functional and structural correlations accompanied by greater pro-oxidant and proatherosclerotic properties.
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Affiliation(s)
- Seong-Min Kim
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea; Research Institute of Protein Sensor, Yeungnam University, Gyeongsan, Republic of Korea; BK21Plus Program Serum Biomedical Research and Education Team, Yeungnam University, Gyeongsan, Republic of Korea
| | - Seung Mi Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Suk-Jeong Kim
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea; Research Institute of Protein Sensor, Yeungnam University, Gyeongsan, Republic of Korea; BK21Plus Program Serum Biomedical Research and Education Team, Yeungnam University, Gyeongsan, Republic of Korea
| | - Byoung Jae Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sue Shin
- Department of Laboratory Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea; Department of Laboratory Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jae-Ryong Kim
- Department of Biochemistry and Molecular Biology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Kyung-Hyun Cho
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea; Research Institute of Protein Sensor, Yeungnam University, Gyeongsan, Republic of Korea; BK21Plus Program Serum Biomedical Research and Education Team, Yeungnam University, Gyeongsan, Republic of Korea.
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53
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Mesdaghinia E, Rahavi A, Bahmani F, Sharifi N, Asemi Z. Clinical and Metabolic Response to Selenium Supplementation in Pregnant Women at Risk for Intrauterine Growth Restriction: Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 2017; 178:14-21. [PMID: 27928721 DOI: 10.1007/s12011-016-0911-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 11/30/2016] [Indexed: 12/14/2022]
Abstract
Data on the effects of selenium supplementation on clinical signs and metabolic profiles in women at risk for intrauterine growth restriction (IUGR) are scarce. This study was designed to assess the effects of selenium supplementation on clinical signs and metabolic status in pregnant women at risk for IUGR. This randomized double-blind placebo-controlled clinical trial was performed among 60 women at risk for IUGR according to abnormal uterine artery Doppler waveform. Participants were randomly assigned to intake either 100 μg selenium supplements as tablet (n = 30) or placebo (n = 30) for 10 weeks between 17 and 27 weeks of gestation. After 10 weeks of selenium administration, a higher percentage of women in the selenium group had pulsatility index (PI) of <1.45) (P = 0.002) than of those in the placebo group. In addition, changes in plasma levels of total antioxidant capacity (TAC) (P < 0.001), glutathione (GSH) (P = 0.008), and high-sensitivity C-reactive protein (hs-CRP) (P = 0.004) in the selenium group were significant compared with the placebo group. Additionally, selenium supplementation significantly decreased serum insulin (P = 0.02), homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (P = 0.02), and homeostatic model assessment for B-cell function (HOMA-B) (P = 0.02) and significantly increased quantitative insulin sensitivity check index (QUICKI) (P = 0.04) and HDL-C levels (P = 0.02) compared with the placebo. We did not find any significant effect of selenium administration on malondialdehyde (MDA), nitric oxide (NO), fasting plasma glucose (FPG), and other lipid profiles. Overall, selenium supplementation in pregnant women at risk for IUGR resulted in improved PI, TAC, GSH, hs-CRP, and markers of insulin metabolism and HDL-C levels, but it did not affect MDA, NO, FPG, and other lipid profiles.Clinical trial registration number http://www.irct.ir : IRCT201601045623N64.
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Affiliation(s)
- Elaheh Mesdaghinia
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Azam Rahavi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Nasrin Sharifi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran.
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Litwińska E, Litwińska M, Oszukowski P, Szaflik K, Kaczmarek P. Combined screening for early and late pre-eclampsia and intrauterine growth restriction by maternal history, uterine artery Doppler, mean arterial pressure and biochemical markers. ADV CLIN EXP MED 2017; 26:439-448. [PMID: 28791818 DOI: 10.17219/acem/62214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pre-eclampsia is a systemic disease connected with high maternal and fetal morbidity and mortality. Despite significant progress achieved in perinatal medicine, pre-eclampsia is still one of the most significant current problems in obstetrics. OBJECTIVES The aim of the study was to establish diagnostic algorithms for early and late pre-eclampsia (PE) and intrauterine growth restriction (IUGR). MATERIAL AND METHODS A total of 320 pregnant women between 11 + 0 and 13 + 6 weeks of gestation were recruited for a case-control study. The study group consisted of 22 patients with early PE, 29 patients with late PE and 269 unaffected controls. The following parameters were recorded: maternal history, mean arterial pressure (MAP), mean uterine artery pulsatility index (UtA-PI), and the concentrations of placental growth factor (PlGF), pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (free β-hCG). RESULTS A multivariable stepwise logistic regression analysis indicated that the best screening model for the prediction of early PE is based on a combined analysis of maternal risk factors, UtA-PI and PlGF levels (sensitivity: 91%; specificity: 84%). The best screening model for the prediction of late PE is based on a combined analysis of maternal risk factors, UtA-PI and MAP (sensitivity: 85%; specificity: 83%). The most effective screening model for the prediction of IUGR is based on a combined analysis of maternal risk factors, UtA-PI and PlGF concentrations (sensitivity: 91%; specificity: 83%). CONCLUSIONS The integrated model of screening established in this study can be a valuable method to identify patients at increased risk of developing pre-eclampsia and related complications. The ability to predict the occurrence of pre-eclampsia in early pregnancy would enable maternal and fetal morbidity to be reduced through the introduction of strict obstetric surveillance as well as planned delivery in a reference center.
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Affiliation(s)
- Ewelina Litwińska
- Perinatology and Gynecology Department, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Magdalena Litwińska
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Przemysław Oszukowski
- Perinatology and Gynecology Department, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Krzysztof Szaflik
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Piotr Kaczmarek
- Department of Operative Gynecology and Oncological Gynecology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
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Rabajdová M, Dudič R, Urban P, Dudičová V, Urdzík P, Mareková M. Analysis of transcriptional activities of angiogenic biomarkers during intrauterine complications leading to preterm birth. Eur Rev Med Pharmacol Sci 2017; 21:1433-1442. [PMID: 28429366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Pre-eclampsia, growth retardation and preterm delivery are the most common reasons leading to increased maternal and perinatal mortality. The increased expression of hypoxia induced factors, such as HIF-1, triggers the overexpression of anti-angiogenic genes. The aim of this study was to determine the transcriptional activity of individual pro- and anti-angiogenic markers (VEGF, HIF-1, sEng, Flt-1, PlGF-1) in maternal blood samples from patients with spontaneous preterm labor, preterm labor in combination with pre-eclampsia and fetal growth restriction in comparison with physiologically terminated pregnancies. PATIENTS AND METHODS The transcriptional activity of specific genes was detected from the blood of patients using the chromatin immunoprecipitation capture method coupled with quantitative real-time PCR. RESULTS The maximum differences in mRNA levels of PlGF-1 and VEGF-A were detected in two groups: the group of normal-term birth with complications and the group of preterm labor with complications (both significantly lower than the control, p < 0.001). In contrast, a marked increase of mRNA levels was found in the same groups of patients for the HIF-1, endoglin and Flt-1 genes (p < 0.001). CONCLUSIONS According to our results, we can conclude that increased oxidative stress, increasing the expression levels of anti-angiogenic genes and reduction of the transcriptional activity of pro-angiogenic genes can provide additional information during diagnostics of pathological complications of labor.
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Affiliation(s)
- M Rabajdová
- Department of Medical and Clinical Biochemistry, P. J. Šafárik University in Košice, Faculty of Medicine, Košice, Slovakia.
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Saito-Sasaki N, Izu K, Sawada Y, Hino R, Nakano R, Shimajiri S, Nishimura I, Nakamura H, Sugiura K, Nakamura M. Impetigo Herpetiformis Complicated with Intrauterine Growth Restriction Treated Successfully with Granulocyte and Monocyte Apheresis. Acta Derm Venereol 2017; 97:410-411. [PMID: 27573023 DOI: 10.2340/00015555-2527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Natsuko Saito-Sasaki
- Department of Dermatology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu , 807-8555, Japan.
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MacDonald TM, Kaitu'u-Lino TJ, Walker SP, Dane KM, Lockie EB, Tong S, Whitehead CL, Hui L. Variable effect of maternal oral glucose load on circulating cell-free placental mRNAs. J Matern Fetal Neonatal Med 2017; 30:501-503. [PMID: 27073013 DOI: 10.1080/14767058.2016.1177815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND It is not known whether fasting affects levels of circulating placenta-specific transcripts. OBJECTIVE To assess whether a glucose load affects circulating placenta-specific transcripts. METHOD RNA was extracted from paired blood samples (fasting and 1-h post 75 g oral glucose) from 22 women. Placenta-specific genes were measured by RT-qPCR. RESULTS There was no change in ADM, CSH1, PAPPA2, PSG1 or TAC3 expression between fasting and post-glucose states. However, HTRA1 decreased after glucose load. CONCLUSION Maternal fasting state does not influence expression of the majority of placenta-specific genes but may need to be accounted for when validating biomarkers of placental disease.
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Affiliation(s)
- Teresa Mary MacDonald
- a Translational Obstetrics Group, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
- b Department of Obstetrics and Gynaecology , The University of Melbourne , Melbourne , Australia , and
- c Perinatal Department, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
| | - Tu'uhevaha Joy Kaitu'u-Lino
- a Translational Obstetrics Group, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
- b Department of Obstetrics and Gynaecology , The University of Melbourne , Melbourne , Australia , and
| | - Susan Philippa Walker
- b Department of Obstetrics and Gynaecology , The University of Melbourne , Melbourne , Australia , and
- c Perinatal Department, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
| | - Kirsten Margaret Dane
- c Perinatal Department, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
| | - Elizabeth Beatrice Lockie
- b Department of Obstetrics and Gynaecology , The University of Melbourne , Melbourne , Australia , and
- c Perinatal Department, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
| | - Stephen Tong
- a Translational Obstetrics Group, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
- b Department of Obstetrics and Gynaecology , The University of Melbourne , Melbourne , Australia , and
| | - Clare Louise Whitehead
- a Translational Obstetrics Group, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
| | - Lisa Hui
- a Translational Obstetrics Group, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
- b Department of Obstetrics and Gynaecology , The University of Melbourne , Melbourne , Australia , and
- c Perinatal Department, Mercy Hospital for Women , Melbourne , Heidelberg , Australia
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Komwilaisak R, Tangkiratichai P. Maternal Serum Angiogenic Growth Factors in Intrauterine Growth Restriction versus Normal Pregnancies. J Med Assoc Thai 2017; 100:119-124. [PMID: 29916230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To assess maternal serum angiogenic growth factors level of soluble fms-like tyrosine kinase-1 (sFlt-1), placenta growth factor (PlGF) and sFlt-1/PlGF ratio among pregnant women with intrauterine growth restriction (IUGR) compared to those with normal pregnancies. STUDY DESIGN A prospective cross-sectional study conducted at Srinagarind Hospital, Khon Kaen University, Thailand from July 2014 to April 2015. MATERIAL AND METHOD Twenty-one singleton pregnant women of gestational age between 26 to 39 weeks who had IUGR, and 21 normal pregnant women matched for gestational age were recruited. Descriptive statistics were used for demographic characteristics. Student t-test and Wilcoxon rank-sum test was used when appropriated to compare between the groups. Main outcome measures: Levels of sFlt-1 and PIGF and sFlt-1/PlGF ratio. RESULTS There were no statistical significant differences in gestational age, maternal age, parity status, maternal blood pressure level and hematocrit level between the groups. Median PlGF level among pregnant women with IUGR was significantly lower than that in control group (121 and 834.8 ng/ml respectively, p-value <0.01). The sFlt-1 level in pregnancies complicated by IUGR was slightly higher than that noted among normal pregnancies (2644 ng/ml and 2,136 ng/ml respectively, a p-value 0.105). The sFlt-1/PlGF ratio among pregnant women with IUGR was significant higher than that observed among normal pregnant women (34.1 and 2.6 respectively, p-value <0.01). CONCLUSION Pregnancy with IUGR had low level of PlGF and high sFlt-1/PlGF ratio when compare with normal pregnancy.
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Xue HF, Wu WG, Yan HL, She Y, Ge HY. Ghrelin to obestatin ratio in maternal serum in pregnancies complicated by intrauterine growth restriction. CLIN EXP OBSTET GYN 2017; 44:364-369. [PMID: 29949274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ghrelin, an endogenous for the growth hormone secretagogue receptor, has been shown to participate in fetal growth. Obestatin, encoded by the same gene as ghrelin, is described as a physiological opponent of ghrelin. This study was designed to determine the changes of ghrelin/obestatin ratio in maternal serum in pregnancies with intrauterine growth restriction (IUGR). The authors found that the ghrelin levels in maternal serum were significent lower in IUGR group than in control group (236.34 ± 14.58 pg/ml vs. 321.49 ± 18.19 pg/ml, p = 0.003). However, the difference of obestatin levels in maternal serum in IUGR group than in control group was not significent (276.25, ±20.54 pg/ml vs. 256.34 ± 21.21 pg/ml, p = 0.308). The ratio of ghrelin to obestatin in maternal serum were significent lower in UGR group than in control group (1.05 ± 0.09 vs. 0.82 ± 0.08, p = 0.03). Meanwhile, the maternal serum growth hormone (GH) concentration in IUGR group was lower than that in control group (1.08 ± 0.08 pg/ml vs. 1.41 ± 0.09 pg/ml, p = 0.009), and the maternal serum pla- cental growth hormone (PGH) concentration in IUGR group was lower than that in control group (2.21 ± 1.24 pg/ml vs. 2.92 ± 0.27 pg/ml,p = 0.031). The ratio of ghrelin to obestatin in maternal serum were positively correlation with GH and PGH concentrations in IUGR group (r = 0.876, p = 0.52; r = 0.764, p = 0.64). The findings of this study suggest that the ratio of ghrelin to obestatin in maternal serum were low, and were positively correlated with GH and PGH concentration in IUGR group, which can been considered as evidencees of ghrelin/obestatin balance disorder role in pathogenesis of IUGR.
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Al-Azemi M, Raghupathy R, Azizieh F. Pro-inflammatory and anti-inflammatory cytokine profiles in fetal growth restriction. CLIN EXP OBSTET GYN 2017; 44:98-103. [PMID: 29714875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of this investigation was to measure cytokine production by maternal peripheral blood lymphocytes from women with intrauterine growth restriction (IUGR) and from healthy pregnant women, and to investigate the relationship between cytokine profiles and IUGR. Thirty-six women with IUGR and 22 control healthy pregnant women with normal fetal growth were studied. Levels of pro-inflammatory cytokines (IFNy, TNFa, IL-8, IL-12, IL-18, IL-23) and anti-inflammatory cytokines (IL-4, IL- 10, IL-13) produced by mitogen-stimulated peripheral blood mononuclear cells were measured by ELISA. Levels of the anti-inflammatory cytokine IL-4 were higher in normal pregnancy compared to IUGR, indicating an anti-inflammatory bias. Levels of the pro-inflammatory cytokines IL-6, TNFα, and IL-12 were significantly higher and levels of the anti-inflammatory cytokine IL- 10 lower in IUGR with placental insufficiency than in IUGR without placental insufficiency, suggesting a stronger pro-inflammatory bias in IUGR with placental insufficiency. Ratios of pro- to anti-inflammatory cytokines suggest a dominance of pro-inflammatory cytokines. The authors conclude that an increased pro-inflammatory cytokine bias is observed in IUGR compared to normal pregnancy, and an increased pro-inflammatory cytokine dominance is seen in IUGR with placental insufficiency compared to IUGR without placental insufficiency.
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Basystyi O. [POLYAMINE CONCENTRATION IN ERYTHROCYTES IN THE BLOOD OF PREGNANT WOMEN WITH INTRAUTERINE GROWTH RETARDATION]. Georgian Med News 2016:22-26. [PMID: 28132037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of the study was to determine polyamine concentration in erythrocytes in the blood of pregnant women with intrauterine growth retardation of different severity. The study included 100 pregnant women (from 23 to 40 weeks of gestation). The main group consisted of 80 pregnant women with intrauterine growth retardation. The control group consisted of 20 women with physiological course of pregnancy. The patients of the main group were divided into three clinical groups regarding intrauterine growth retardation staging. Group I included 38 pregnant women with stage I IUGR, 22 pregnant women with stage II IUGR were in group II and 20 pregnant women with stage III IUGR - in group III.Polyamine concentration in erythrocytes in the blood of pregnant women with intrauterine growth retardation was determined by using Agilent 1200 series (USA) high performance liquid chromatography [4]. The standards of polyamine hydrochlorides were obtained from Sigma-Aldrich Company (USA). The variational methods were used to make the statistical analysis of outcomes by standard licensed computer programs: STATISTICA 6.0, Microsoft Excel, ANOVA «Statistica». The study results were presented in the form of M±m and differences were considered reliable at р<0,05 by Student's t-criterion. The conducted study has revealed that polyamine concentration in erythrocytes in the blood of pregnant women with intrauterine growth retardation is drastically lower if compared with pregnant women with physiological course of pregnancy. At the same time the putrescine concentration is higher, andspermidineandspermine concentrations are significantly reduced in the pregnant women with intrauterine growth retardation in comparison with the control group.According to the obtained results the polyamine exchange proves to be disturbed in pregnant women with intrauterine growth retardation. The progression of polyamine imbalance depends on the severity of fetal growth retardation in pregnant women.
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Affiliation(s)
- O Basystyi
- State Institution "Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine", Kyiv, Ukraine
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Pecks U, Rath W, Maass N, Berger B, Lueg I, Farrokh A, Farrokh S, Eckmann-Scholz C. Fetal gender and gestational age differentially affect PCSK9 levels in intrauterine growth restriction. Lipids Health Dis 2016; 15:193. [PMID: 27842594 PMCID: PMC5109703 DOI: 10.1186/s12944-016-0365-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 11/08/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Maternal and fetal Low Density Lipoprotein-Cholesterol (LDL-C) concentrations are compromised in intrauterine growth restriction (IUGR). Generally, LDL-C catabolism is under control of PCSK9 by binding to the LDL-receptor leading to its degradation. Hence, we hypothesized a role for PCSK9 in the modulation of lipid metabolism and placental transport in IUGR. METHODS 172 women, 70 IUGR and 102 controls were included in the study. Maternal and fetal serum PCSK9 levels and lipid profiles including LDL-C were measured. Placental LDL-receptor and PCSK9 expressions were estimated by tissue microarray immunohistochemistry, and analyzed by two blinded observers using an immunoreactivity score. Non-parametric tests and multivariate regression analyses were used for statistical estimations. RESULTS PCSK9 levels in the maternal and fetal compartment independently predicted LDL-C levels (maternal compartment: adjusted R 2 = 0.2526; coefficient b i = 0.0938, standard error s bi =0.0217, rpartial = 0.4420, t-value = 4.323, p < 0.0001; fetal compartment: adjusted R 2 = 0.2929; b i = 0.1156, s bi =0.020, rpartial = 0.5494, t-value = 5.81, p < 0.0001). We did not find significant differences in maternal PCSK9 concentrations between IUGR and controls. However, we found lower fetal serum PCSK9 concentrations in IUGR than in controls (IUGR median 137.1 ng/mL (95% CI 94.8-160.0) vs. controls 176.8 (154.6-202.5), p = 0.0005). When subgrouping according to early onset, late onset IUGR, and fetal gender differences remained consistent only for male neonates born before 34 weeks of gestation. In the placenta we found no correlation between PCSK9 and LDL-receptor expression patterns. However, the LDL-receptor was significantly upregulated in IUGR when compared to controls (p = 0.0063). CONCLUSIONS Our results suggest that PCSK9 play a role in impaired fetal growth by controlling fetal LDL-C metabolism, which seems to be dependent on gestational age and fetal gender. This underlines the need to identify subgroups of IUGR that may benefit from individualized and gender-specific pharmacotherapy in future studies.
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Affiliation(s)
- Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of the RWTH, Aachen, Germany
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Werner Rath
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Bartlomiej Berger
- Department of Obstetrics and Gynecology, University Hospital of the RWTH, Aachen, Germany
| | - Imke Lueg
- Department of Obstetrics and Gynecology, University Hospital of the RWTH, Aachen, Germany
| | - André Farrokh
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sabrina Farrokh
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christel Eckmann-Scholz
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
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Hansen YB, Myrhøj V, Jørgensen FS, Oxvig C, Sørensen S. First trimester PAPP-A2, PAPP-A and hCGβ in small-for-gestational-age pregnancies. Clin Chem Lab Med 2016; 54:117-23. [PMID: 26544105 DOI: 10.1515/cclm-2015-0230] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/04/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pregnancy-associated plasma protein-A2 (PAPP-A2) is a recently discovered protease that cleaves a subset of insulin-like growth factor binding proteins (IGFBP). The molecular function suggests its involvement in the IGF system that is vital for fetal growth and development. Our objectives were to establish first trimester median curves of PAPP-A2, PAPP-A and hCGβ for singleton normal pregnancies and to investigate whether an altered level of one or more of the biomarkers is associated with small-for-gestational-age (SGA) neonates before and after stratification according to maternal hypertension and/or proteinuria. METHODS This was a case-control study based on 985 pregnant women delivering normal-weighted neonates and 170 pregnant women delivering SGA neonates. PAPP-A2 was measured by ELISA. PAPP-A and hCGβ were measured by an automatic analyzer. Median curves from 8+1 to 14+0 were established and all concentration values were converted to multiples of the median (MoM) values. RESULTS Before stratification the SGA cases had unaffected PAPP-A2 MoM and hCGβ MoM levels but lower PAPP-A MoM compared with normal controls. After stratification the SGA normotensive subgroup had lower PAPP-A2 MoM and PAPP-A MoM levels than the normal normotensive subgroup. Severe preeclamptic women delivering SGA neonates had higher PAPP-A2 MoM compared to the normotensive women delivering SGA neonates. CONCLUSIONS Pregnant women delivering SGA neonates did not have altered levels of PAPP-A2 or hCGβ but had lower PAPP-A level in the first trimester compared with pregnant women delivering normal-weighted neonates. Pregnancies complicated with severe preeclampsia and SGA may be associated with high PAPP-A2 level.
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Malamitsi-Puchner A, Briana DD, Kontara L, Boutsikou M, Baka S, Hassiakos D, Marmarinos A, Gourgiotis D. Serum Cystatin C in Pregnancies With Normal and Restricted Fetal Growth. Reprod Sci 2016; 14:37-42. [PMID: 17636214 DOI: 10.1177/1933719106298196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate circulating levels of cystatin C (an important endogenous marker of renal function) in mothers, fetuses, and neonates from intrauterine growth-restricted (IUGR; characterized by impaired nephrogenesis) and appropriate-for-gestational-age (AGA) pregnancies. Serum cystatin C levels were measured by enzyme immunoassay in 40 parturients and their 20 IUGR (<or=3rd customized centile, due to gestational pathology) and 20 AGA fetuses and neonates on postnatal day 1 (N1) and 4 (N4). Comparatively, creatinine and urea concentrations were determined in the same samples. Fetal cystatin C levels were higher in the AGA than the IUGR group (P = .001). In both groups, maternal cystatin C levels were lower than fetal (P < .001), N1 (P < .001), and N4 (P < .001) levels. Fetal levels were higher than N1 (P < .001) and N4 (P < .001), and N1 levels were higher than N4 (P = .007) ones. In both groups, no correlation existed between maternal and fetal levels, but positive correlations were found between cystatin C, creatinine, and urea levels in maternal and neonatal samples (in all cases, r >or= 0.376 and P <or= .045). Cystatin C levels did not correlate with gestational age and did not differ between males and females. Fetal cystatin C serum levels are lower in the IUGR group, significantly decrease after birth, and do not correlate with maternal levels in both groups. In addition, serum cystatin C levels positively correlate with respective creatinine and urea levels in the perinatal period.
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Affiliation(s)
- Ariadne Malamitsi-Puchner
- Neonatal Division, Second Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece. @aias.gr
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Aydin HI, Eser A, Kaygusuz I, Yildirim S, Celik T, Gunduz S, Kalman S. Adipokine, adropin and endothelin-1 levels in intrauterine growth restricted neonates and their mothers. J Perinat Med 2016; 44:669-76. [PMID: 26352058 DOI: 10.1515/jpm-2014-0353] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 07/09/2015] [Indexed: 12/28/2022]
Abstract
Intrauterine growth retardation/restriction (IUGR) is associated with fetal malnutrition. It has consequences for later life including increased incidence of obesity, diabetes mellitus, cardiovascular disease (CVD), and metabolic syndrome. Adipokines (adiponectin and leptin), adropin, and endothelin-1 are associated with obesity and metabolic syndrome regulation. Intrauterine changes in these mediators could affect programming of later adult obesity and metabolic syndrome. Our objectives were to compare the levels of these mediators in both cord and maternal blood between IUGR pregnancies and control, healthy pregnancies, and to study the correlation of adipokines with adropin and endothelin-1 in maternal and cord blood in IUGR pregnancies as well as in healthy control pregnancies. Maternal and cord blood samples were taken from 16 women with IUGR pregnancies and 16 women with healthy pregnancies. Serum levels of leptin, adiponectin, adropin, and endothelin-1 were measured by ELISA. Maternal blood adropin levels were significantly lower in the IUGR group than in the control group; the other mediators did not differ significantly. There was a positive correlation between maternal blood adropin and endothelin levels. (r=0.731, P=0.001) in the control but not the IUGR group. Cord blood adropin and adiponectin levels were significantly lower in the IUGR group compared with the control group, while leptin or endothelin-1 did not differ significantly. There was a negative correlation between adropin and leptin (r=-0.704, P=0.001) in the IUGR but not the control group cord blood. There were also positive correlations between endothelin and adropin for both groups (r=0.594, P=0.006; r=0.560, P=0.010, respectively); to the best of our knowledge, this is the first report of such a correlation. Differences in fetal expression of adropin and adiponectin in IUGR could influence programming of obesity, metabolic syndrome, diabetes, and CVD in later life.
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Abstract
This prospective study aimed to evaluate pregnancy outcome and complications in women with recurrent pregnancy loss (RPL) and protein S (PS) deficiency, who received low dose aspirin (LDA) or LDA plus heparin (LDA/H) therapies. Clinical characteristics, pregnancy outcome and complications of 38 women with two or more RPL and <60% of plasma free PS antigen were compared among three groups: antiphospholipid antibody (aPL)-negative women who received LDA (group A), aPL-negative women who received LDA/H (group B) and aPL-positive women who received LDA/H (group C). Gestational weeks (GW) at delivery in group C (median 32 GW) were earlier than 40 GW in group A and 38.5 GW in group B (p < 0.05). The birth weight in group C (median 1794 g) was less than 2855 g in group B (p < 0.05). The incidences of fetal growth restriction (37.5%), pregnancy-induced hypertension (37.5%), and preterm delivery (62.5%) in group C were higher than those (4.5%, 0%, and 4.5%, respectively) in group B (p<0.05). Women with RPL, PS deficiency, and positive aPL had high risks for adverse pregnancy outcome and complications, even when they received LDA/H therapy. Among women with RPL, PS, and negative aPL, there was no difference in these risks between LDA alone and LDA/H therapies.
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Affiliation(s)
- Nanae Shinozaki
- a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Yasuhiko Ebina
- a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Masashi Deguchi
- a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Kenji Tanimura
- a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Mayumi Morizane
- a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Hideto Yamada
- a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan
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Maisonneuve E, Delvin E, Edgard A, Morin L, Dubé J, Boucoiran I, Moutquin JM, Fouron JC, Klam S, Levy E, Leduc L. Oxidative conditions prevail in severe IUGR with vascular disease and Doppler anomalies. J Matern Fetal Neonatal Med 2016; 28:1471-5. [PMID: 25163402 DOI: 10.3109/14767058.2014.957670] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Intrauterine growth restriction (IUGR) and prenatal exposure to oxidative stress are thought to lead to increased risks of cardiovascular disease later in life. The objective of the present study was to document whether cord blood oxidative stress biomarkers vary with the severity of IUGR and of vascular disease in the twin pregnancy model in which both fetuses share the same maternal environment. METHODS This prospective cohort study involved dichorionic twin pairs, with one co-twin with IUGR. Oxidative stress biomarkers were measured in venous cord blood samples from each neonate of 32 twin pairs, and compared, according to severity of IUGR (IUGR <5th percentile), Doppler anomalies of the umbilical artery and early onset IUGR (in the second trimester) of the growth restricted twin. RESULTS Oxidized Low-Density Lipoproteins (oxLDL) and Malondialdehyde (MDA) concentrations were increased proportionally in cases of severe IUGR. OxLDL concentrations were also increased in cases of IUGR with Doppler anomaly. CONCLUSION Our data indicate that severe IUGR, is related to a derangement in redox balance, illustrated by increased venous cord blood oxidative stress biomarkers concentrations. Severe IUGR and IUGR with abnormal Doppler can be translated into conditions with intense oxidative stress.
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Abstract
BACKGROUND Renal failure is common in the NICU; Acute Kidney Injury (AKI) occurs in 8-24% of admissions. Although AKI is preventable with early diagnosis, no reliable AKI biomarkers exist. Endothelin-1 (ET-1) has been implicated in renal pathogenesis, and elevated urinary ET-1 (uET-1) levels may correlate with progression of renal dysfunction. The study objectives were to determine whether uET-1 levels correlate with renal function parameters and/or fetal growth restriction, and if uET-1 is a potential neonatal AKI biomarker. METHODS Sixty-three neonates were enrolled and divided into gestational age (GA) groups by weeks: 1) (24-30 6/7; n = 24); 2) (31-36 6/7; n = 26); and 3) (37-42; n = 13). Additional preterm subgroups for fetal growth restriction analysis included: 1) Appropriate for GA (AGA; n = 40), and 2) Small for GA (SGA; n = 10). ET-1 levels, measured using enzyme linked immunosorbent assay, were collected at birth (cord blood) and 24 h ( ± 4) of life (blood/urine). RESULTS No correlation was found between uET-1 and blood plasma levels at birth (r = 0.15; p > 0.05) or 24 h (r = 0.17; p > 0.05). uET-1 negatively correlated with GA (r = -0.44; p < 0.001) and GFR (r = -0.34; p < 0.01). uET-1 levels did not correlate with creatinine (r = 0.13; p > 0.05), BUN (r = 0.19; p > 0.05), BUN/Cr ratio (r = 0.15; p > 0.05), or urinary output (r = 0.12; p > 0.05). In fetal growth restriction subgroup analyses: uET-1 levels negatively correlated with GFR in the PT-AGA subgroup (r = -0.38; p = 0.017), but not with PT-SGA (r = 0.01; p > 0.05). CONCLUSION Plasma and uET-1 levels did not correlate; therefore, renal ET-1 excretion may reflect renal ET-1 production. uET-1 levels correlated negatively with GA and GFR. uET-1 may be a marker of impaired neonatal circulatory regulation and consequent renal injury.
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Affiliation(s)
- G Stefanov
- Department of Pediatrics, Division of Neonatology, Advocate Lutheran General Hospital/Advocate Children's Hospital, Park Ridge, IL, USA
- Advocate Medical Group, Park Ridge, IL, USA
| | - B L Puppala
- Department of Pediatrics, Division of Neonatology, Advocate Lutheran General Hospital/Advocate Children's Hospital, Park Ridge, IL, USA
- Advocate Medical Group, Park Ridge, IL, USA
| | - G Pais
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, USA
| | - A Gulati
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, USA
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Macko AR, Yates DT, Chen X, Shelton LA, Kelly AC, Davis MA, Camacho LE, Anderson MJ, Limesand SW. Adrenal Demedullation and Oxygen Supplementation Independently Increase Glucose-Stimulated Insulin Concentrations in Fetal Sheep With Intrauterine Growth Restriction. Endocrinology 2016; 157:2104-15. [PMID: 26937714 PMCID: PMC4870878 DOI: 10.1210/en.2015-1850] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In pregnancies complicated by placental insufficiency and intrauterine growth restriction (IUGR), fetal glucose and oxygen concentrations are reduced, whereas plasma norepinephrine and epinephrine concentrations are elevated throughout the final third of gestation. Here we study the effects of chronic hypoxemia and hypercatecholaminemia on β-cell function in fetal sheep with placental insufficiency-induced IUGR that is produced by maternal hyperthermia. IUGR and control fetuses underwent a sham (intact) or bilateral adrenal demedullation (AD) surgical procedure at 0.65 gestation. As expected, AD-IUGR fetuses had lower norepinephrine concentrations than intact-IUGR fetuses despite being hypoxemic and hypoglycemic. Placental insufficiency reduced fetal weights, but the severity of IUGR was less with AD. Although basal plasma insulin concentrations were lower in intact-IUGR and AD-IUGR fetuses compared with intact-controls, glucose-stimulated insulin concentrations were greater in AD-IUGR fetuses compared with intact-IUGR fetuses. Interestingly, AD-controls had lower glucose- and arginine-stimulated insulin concentrations than intact-controls, but AD-IUGR and AD-control insulin responses were not different. To investigate chronic hypoxemia in the IUGR fetus, arterial oxygen tension was increased to normal levels by increasing the maternal inspired oxygen fraction. Oxygenation of IUGR fetuses enhanced glucose-stimulated insulin concentrations 3.3-fold in intact-IUGR and 1.7-fold in AD-IUGR fetuses but did not lower norepinephrine and epinephrine concentrations. Together these findings show that chronic hypoxemia and hypercatecholaminemia have distinct but complementary roles in the suppression of β-cell responsiveness in IUGR fetuses.
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Affiliation(s)
- Antoni R Macko
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Dustin T Yates
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Xiaochuan Chen
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Leslie A Shelton
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Amy C Kelly
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Melissa A Davis
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Leticia E Camacho
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Miranda J Anderson
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
| | - Sean W Limesand
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, Arizona 85719
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Ojeda N, Hall S, Lasley CJ, Rudsenske B, Dixit M, Arany I. Prenatal Nicotine Exposure Augments Renal Oxidative Stress in Embryos of Pregnant Rats with Reduced Uterine Perfusion Pressure. In Vivo 2016; 30:219-224. [PMID: 27107078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/08/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIM Both maternal nicotine (NIC) exposure and placental insufficiency increase oxidative stress in the fetal kidney ensuing fetal programming of renal diseases in adult life. Their combined effects, however, are unknown. We tested the hypothesis that maternal NIC exposure exacerbates renal oxidative stress and injury in fetuses of pregnant rats with placental insufficiency. MATERIALS AND METHODS Fourteen-day-pregnant rats were subjected to sham operation or reduced uterine perfusion pressure (RUPP) that received either nicotine (20 μg/ml in 1% saccharine) or vehicle (1% saccharine) in their drinking water. At gestational age of 21 days, male fetuses were collected by C-section and sacrificed: plasma and renal cotinine content, extent of renal oxidative stress (4-hydroxynonenal [HNE] and HO-1) and injury (KIM-1) were determined together with the weight of the fetal kidney and fetus. RESULTS Prenatal NIC exposure resulted in cotinine accumulation in the plasma and kidney of the fetuses, augmented RUPP-associated increase in renal HNE content and HO-1 expression as well as KIM-1 expression. NIC also enhanced RUPP-induced reduction in fetal and fetal kidney weight. CONCLUSION Prenatal NIC exposure augments the existing renal risk in the growth-restricted fetus, which may contribute to worsening in fetal programming of renal disease.
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Affiliation(s)
- Norma Ojeda
- Division of Pediatric Neonatology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, U.S.A
| | - Samuel Hall
- Division of Pediatric Nephrology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, U.S.A
| | - Cara J Lasley
- Division of Pediatric Neonatology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, U.S.A
| | - Benjamin Rudsenske
- Division of Pediatric Neonatology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, U.S.A
| | - Mehul Dixit
- Division of Pediatric Nephrology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, U.S.A
| | - Istvan Arany
- Division of Pediatric Nephrology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, U.S.A.
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Oztas E, Ozler S, Ersoy AO, Iskender CT, Sucak A, Ergin M, Uygur D, Danisman N. Increased levels of serum clusterin is associated with intrauterine growth restriction and adverse pregnancy outcomes in preeclampsia. J Perinat Med 2016; 44:269-75. [PMID: 26352072 DOI: 10.1515/jpm-2015-0120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/09/2015] [Indexed: 01/12/2023]
Abstract
AIM Our aim was to investigate serum clusterin levels in preeclampsia and to determine whether any changes in clusterin levels are useful in distinguishing the presence of concomitant intrauterine growth restriction (IUGR) and in predicting adverse pregnancy outcomes. METHODS A prospective case-control study was carried out which included 86 pregnant women (47 patients with preeclampsia and 39 healthy controls). Maternal serum samples obtained from all participants and clusterin levels were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS Compared with controls, women with preeclampsia had significantly higher clusterin levels (mean 83.8±23.6 vs. 119.2±40.5, P<0.01). Further analysis revealed the highest clusterin levels were in patients with preeclampsia and IUGR (P<0.001). According to the receiver operating characteristic (ROC) analysis performed for the predictive value of clusterin levels for adverse maternal outcomes, the area under the curve (AUC) was 0.738 (95% CI: 0.616-0.859). The best clusterin cut-off value in predicting adverse maternal outcomes was 102.6 pg/mL with 75% sensitivity and 66% specifity. Multivariable logistic regression analysis revealed serum clusterin levels of >102.6 pg/mL was independently associated with preeclampsia (OR: 6.18, 95% CI: 2.41-15.9) and maternal adverse outcomes (OR: 5.13, 95% CI: 2.01-13.1) and also clusterin levels higher than 117.4 pg/mL were associated with adverse neonatal outcomes (OR: 5.02, 95% CI: 1.04-24.3). CONCLUSIONS The current study suggests that increased levels of clusterin is associated with IUGR and probably predictive for adverse pregnancy outcomes in preeclampsia.
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Dacaj R, Izetbegovic S, Stojkanovic G, Dreshaj S. Elevated Liver Enzymes in Cases of Preeclampsia and Intrauterine Growth Restriction. Med Arch 2016; 70:44-7. [PMID: 26980931 PMCID: PMC4779350 DOI: 10.5455/medarh.2016.70.44-47] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/16/2015] [Indexed: 11/06/2022] Open
Abstract
AIM The aim of this study was to evaluate biochemical parameters in serum of women with preeclampsia and IUGR. MATERIAL AND METHODS A clinical prospective study was conducted and included 120 pregnant women divided in two groups: non IUGR group included healthy pregnant women (n=60) and IUGR group included pregnant women with preeclampsia and IUGR (n=60). Outcome measures were following values of biochemical parameters in serum of mother and fetuses: aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), bilirubin (indirect and direct) and cholesterol. A blood for analysis was drawn from the cubital vein of mothers and the umbilical vein of the fetuses during delivery period. RESULTS The mean of maternal age was 30.0±6.1 years in women with preeclampsia and IUGR and 28.1±5.1 years in healthy pregnant women, p > 0.05. The most of women with preeclampsia and IUGR had grade III of placental maturation (48.3%). There is a significant association between the placental maturation and the diagnosis, p < 0.001. There was a statistically significant difference in body mass of newborns between IUGR and non IUGR groups, p < 0.001. There was a significant statistically difference in serum value of AST, ALT, LDH and total cholesterol between women with preeclampsia and IUGR and healthy pregnant women (all p < 0.001). CONCLUSION Measurement of AST, ALT, LDH, and total cholesterol in serum of pregnant women and newborns with IUGR allows the differentiation and threatening risk of perinatal complications due to hypoxia.
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Affiliation(s)
- Ramadan Dacaj
- Department of Obstetrics and Gynecology, Regional Hospital, Pec, Republic of Kosova
| | | | | | - Skender Dreshaj
- Department of Obstetrics and Gynecology, Regional Hospital, Pec, Republic of Kosova
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Cheng PJ, Huang SY, Su SY, Hsiao CH, Peng HH, Duan T. Prognostic Value of Cardiovascular Disease Risk Factors Measured in the First-Trimester on the Severity of Preeclampsia. Medicine (Baltimore) 2016; 95:e2653. [PMID: 26844488 PMCID: PMC4748905 DOI: 10.1097/md.0000000000002653] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recent studies have suggested that preeclampsia and cardiovascular disease may share common mechanisms. The purpose of this prospective nested case-controlled study was to characterize a variety of cardiovascular disease risk factors measured during the first trimester of pregnancy in predicting subsequent outcomes and the severity of preeclampsia.We ascertained the severity of preeclampsia at the onset of the disease, and the presence of intrauterine growth restriction (IUGR). We compared first trimester maternal serum cardiovascular disease risk factors in preeclampsia subjects versus normal pregnancies, early-onset versus late-onset preeclampsia, and preeclampsia with IUGR versus without IUGR. To identify the prognostic value of independent predictors on the severity of preeclampsia, we calculated the area under the receiver operating characteristics curve (AUC) using logistic regression analysis.There were 134 cases of preeclampsia and 150 uncomplicated pregnancies, and preeclampsia cases were classified as early-onset (53 cases) or late-onset (81 cases), or as with IUGR (44 cases) or without IUGR (90 cases). Among the cardiovascular disease risk factors, maternal serum high-sensitive C-reactive protein (hsCRP) and homocysteine were predictors of both early-onset preeclampsia and preeclampsia with IUGR. For the detection of early onset preeclampsia or preeclampsia with IUGR, the AUC for the combination model (0.943 and 0.952, respectively) was significantly higher than with serum hsCRP or serum homocysteine only.Patients with preeclampsia can be subdivided into different severities according to time of onset and fetal weight. Cardiovascular risk factors distinguish a subgroup of these patients.
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Affiliation(s)
- Po-Jen Cheng
- From the Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan (PJC, SYH, SYS, HHP); Department of Obstetrics and Gynecology, Taipei City Hospital, Taipei, Taiwan, R.O.C. (CHH); and Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China (TD)
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74
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Bibeau K, Sicotte B, Béland M, Bhat M, Gaboury L, Couture R, St-Louis J, Brochu M. Placental Underperfusion in a Rat Model of Intrauterine Growth Restriction Induced by a Reduced Plasma Volume Expansion. PLoS One 2016; 11:e0145982. [PMID: 26727492 PMCID: PMC4703198 DOI: 10.1371/journal.pone.0145982] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/11/2015] [Indexed: 12/20/2022] Open
Abstract
Lower maternal plasma volume expansion was found in idiopathic intrauterine growth restriction (IUGR) but the link remains to be elucidated. An animal model of IUGR was developed by giving a low-sodium diet to rats over the last week of gestation. This treatment prevents full expansion of maternal circulating volume and the increase in uterine artery diameter, leading to reduced placental weight compared to normal gestation. We aimed to verify whether this is associated with reduced remodeling of uteroplacental circulation and placental hypoxia. Dams were divided into two groups: IUGR group and normal-fed controls. Blood velocity waveforms in the main uterine artery were obtained by Doppler sonography on days 14, 18 and 21 of pregnancy. On day 22 (term = 23 days), rats were sacrificed and placentas and uterine radial arteries were collected. Diameter and myogenic response of uterine arteries supplying placentas were determined while expression of hypoxia-modulated genes (HIF-1α, VEGFA and VEGFR2), apoptotic enzyme (Caspase -3 and -9) and glycogen cells clusters were measured in control and IUGR term-placentas. In the IUGR group, impaired blood velocity in the main uterine artery along with increased resistance index was observed without alteration in umbilical artery blood velocity. Radial uterine artery diameter was reduced while myogenic response was increased. IUGR placentas displayed increased expression of hypoxia markers without change in the caspases and increased glycogen cells in the junctional zone. The present data suggest that reduced placental and fetal growth in our IUGR model may be mediated, in part, through reduced maternal uteroplacental blood flow and increased placental hypoxia.
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Affiliation(s)
- Karine Bibeau
- Department of Molecular and Integrative Physiology, Université de Montréal, Montréal, Québec, Canada
| | - Benoit Sicotte
- Department of Molecular and Integrative Physiology, Université de Montréal, Montréal, Québec, Canada
| | - Mélanie Béland
- Department of Pathology and Cellular Biology, Université de Montréal, Montréal, Québec, Canada
| | - Menakshi Bhat
- Department of Molecular and Integrative Physiology, Université de Montréal, Montréal, Québec, Canada
| | - Louis Gaboury
- Department of Pathology and Cellular Biology, Université de Montréal, Montréal, Québec, Canada
| | - Réjean Couture
- Department of Molecular and Integrative Physiology, Université de Montréal, Montréal, Québec, Canada
| | - Jean St-Louis
- Department of Obstetrics-Gynecology, Université de Montréal, Montréal, Québec, Canada
| | - Michèle Brochu
- Department of Molecular and Integrative Physiology, Université de Montréal, Montréal, Québec, Canada
- * E-mail:
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75
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Stratieva V, Chaveeva P, Yankova M, Shterev A. [Intrauterine Fetal Growth Restriction- Screening Model. Literature Review.]. Akush Ginekol (Sofiia) 2016; 55:31-35. [PMID: 29370504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Placental dysfunction is involved in a spectrum of obs.tetric conditions including preeclampsia, placental abrution and intrauterine fetal growth restriction. Their timely and accurate recognition is often a chalange since diagnostic criteria are dill based on nonspecific signs and symptomes. Fetal growth restriction (FGR) refers to a fetus that has failed to achieve its genetically determined growth potential and affects up to 5-10% of pregnancies. FRR is associated with an increase in perinatal mortality and morbidity. The diagnoslic challenge is in distinguishing SGA pregnancies from FGR pregnancies because the majority of SGA pregnancies are associated with a good prognosis compared to FGR pregnancies. Multifetal gegations have a high incidence of FGR. About 20-30% of dichorionic twins will suffer from FGR, as will 40% of monochorionic twins. Ultrasound is the benchmark for accurate pregnancy dating and diagnosis of FGR. However, there is room for error and FGR is undetected in about 30% of routinely scanned cases and incorrectly detected in 50% of cases. In recent years, the main priority of the leading obstetric clinics in Europe and the USA is drafting a universal screening model for selecting patients at high risk of developing placental dysfunction. Now, this model is part of the standard screening for chromosomal aneuploidies in the firs and second trimester of pregnancy and prolonged screening in the second and third trimester in patients at high risk.
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76
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Kasimis C, Evangelinakis N, Rotas M, Georgitsi M, Pelekanos N, Kassanos D. Predictive value of biochemical marker ADAM-12 at first trimester of pregnancy for hypertension and intrauterine growth restriction. CLIN EXP OBSTET GYN 2016; 43:43-47. [PMID: 27048016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Delineate whereas ADAM-12 levels at first trimester of pregnancy may be used as a marker for hypertension-preeclampsia (PE) and intrauterine growth restriction (IUGR). MATERIALS AND METHODS The present is a case control study. Serum ADAM-12 of women presenting for routine assessment of risk for chromosomal abnormalities at 11+0 to 13+6 weeks of gestation was measured. The study group comprised of 98 pregnancies that subsequently developed pregnancy-induced hypertension (PIH) or PE or small for gestational age fetuses (SGA), and were compared to 100 uncomplicated pregnancies. RESULTS There was no statistically significant difference of mean log multiple of the expected median (MoM) of ADAM12 between control group and the group that consisted of all women with complicated pregnancy (PE, PIH, and SGA). ADAM-12 levels in women who developed PE during pregnancy were significantly lower than in womien of control group (mean log MoM: 0.109 vs 0.008, p = 0.010). Similarly, ADAM-12 levels in women who developed PE and/or PIH were significantly lower than in women of control group (mean log MoM: 0.066 vs 0.008, p = 0.015). There was no significant difference of ADAM12 levels between controls and pregnancies with SGA fetuses. CONCLUSION Maternal serum levels of ADAM-12 at the first trimester are significantly lower in women who later develop PE when compared with women with uncomplicated pregnancies.
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Vişan V, Anghelache-Lupaşcu I, Sălăvăscu T, Rugină V, Socolov R, Socolov D, Cărăuleanu A. INTRAUTERINE GROWTH RESTRICTION--PREDICTIVE SERUM MARKERS. Rev Med Chir Soc Med Nat Iasi 2016; 120:173-177. [PMID: 27125092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To determine during the first trimester of pregnancy some serum and ultrasound markers that could improve perinatal morbidity and mortality in women with intrauterine growth restriction (IUGR). MATERIAL AND METHODS Prospective study of pregnant women gestational age 11 weeks and 0 days--13 weeks and 6 days, consisting in the determination of pregnancy associated plasma protein (PAPP-A), mean platelet volume (MPV), and ultrasound appearance of placenta. DISCUSSION AND CONCLUSIONS This study suggests that screening by detailed history and PAPP-A and MPV determination during the first trimester of pregnancy in women at risk for IUGR makes possible the prophylactic treatment and monitoring of pregnancy according to a given protocol and thus neonatal morbidity and mortality to be reduced.
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78
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Aksan Desteli G, Sahin-Uysal N, Cok T, Gulumser C, Kalayci H, Yanik FF. First trimester maternal serum PAPP-A levels and associated pregnancy complications in intrahepatic cholestasis of pregnancy. CLIN EXP OBSTET GYN 2016; 43:673-677. [PMID: 30074317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To investigate first trimester maternal serum pregnancy associated plasma protein A (PAPP-A) multiple of the median (MoM) in cases with intrahepatic cholestasis of pregnancy (ICP). Obstetric complications and relation with PAPP-A MoM were also evaluated. MATERIALS AND METHODS This was a retrospective case-control study. After exclusions, for each ICP case, two controls with uncomplicated singleton pregnancies were randomly selected. PAPP-A MoM of ICP cases with and without obstetric complications, and the control group were compared with each other. RESULTS Total incidence of ICP was 0.99 % (138/13988). The study included 113 singleton pregnant women. Rates of gestational diabetes mellitus (GDM), preeclampsia (PE), fetal growth restriction (FGR), preterm labor (PTL), and hypothyroidism in cases with ICP were 21.2%, 7.9%, 10.6%, 18.6%, and 5.3%, respectively. Median PAPP-A MoM were 0.93 in ICP group and 1.10 in control group (p > 0.05). PAPP-A MoM levels were not significantly different either between the ICP group with complicated pregnancies and the control group or between the ICP group without complicated pregnancies and the control group (p >0.05). CONCLUSION ICP incidence was similar to other European countries. Rates of obstetric complications expecially GDM were higher than expected in general pregnant population. ICP is not considered as pregnancy complications that have low PAPP-A MoM levels.
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79
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Bae JY, Seong WJ. Umbilical arterial N-terminal pro-B-type natriuretic peptide levels in preeclampsia, fetal growth restriction, preterm birth and fetal distress. CLIN EXP OBSTET GYN 2016; 43:393-396. [PMID: 27328498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate fetal cardiopulmonary stress in pregnancies complicated by preeclampsia (PE), fetal growth restriction (FGR), preterm birth (PT), and fetal distress (FD) using umbilical arterial blood N-terminal pro-B-type natriuretic peptide (NT-proBNP). MATERIALS AND METHODS The study included 146 blood samples that were drawn from umbilical arteries at the time of delivery (20 cases of PE, 11 cases of FGR, 31 cases of PT, 23 cases of FD, and 61 cases of gestational age-matched controls) and analyzed. The main outcome measures included neonatal birthweight, cord pH, and umbilical arterial NT-proBNP. RESULTS The umbilical arterial NT-proBNP levels were significantly higher in the PE, FGR, PT, and FD groups than in the control group. The umbilical arterial NT-proBNP levels were negatively correlated with gestational age, birthweight, and umbilical arterial pH. CONCLUSIONS Umbilical arterial NT-proBNP levels are elevated in stressful fetal conditions and have the potential to be considered as a marker for fetal cardiopulmonary stress.
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80
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Solé-Navais P, Cavallé-Busquets P, Fernandez-Ballart JD, Murphy MM. Early pregnancy B vitamin status, one carbon metabolism, pregnancy outcome and child development. Biochimie 2015; 126:91-6. [PMID: 26700149 DOI: 10.1016/j.biochi.2015.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/01/2015] [Indexed: 11/18/2022]
Abstract
Periconception supplementation with folic acid is recommended until 12 gestational weeks to prevent neural tube defects. Doses of folic acid contained in supplements and timing and length of use during pregnancy vary. The effects of status in periconception and pregnancy folate, cobalamin, betaine and their interactions on one carbon metabolism (1C), as well as the global effect of 1C on foetal growth and pregnancy outcome, are reviewed. Results from prospective studies are reviewed. Cessation of folic acid supplement use after the first trimester is associated with a sharp drop in plasma folate status and enhanced conversion of betaine to dimethylglycine. Dimethylglycine production is also higher in mothers with low folate status than in those with normal-high folate status. The effects of high doses of folic acid on one carbon metabolism in mothers with low early pregnancy cobalamin status and on foetal growth are also reviewed. Several studies report that moderately elevated early pregnancy fasting plasma total homocysteine (tHcy) is inversely associated with birth weight and a predictor of intrauterine growth retardation. There is also evidence for increased risk of preterm birth when maternal folate status is low.
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Affiliation(s)
- Pol Solé-Navais
- Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), IISPV, Spain; CIBER (CB06/03) ISCIII, Spain
| | - Pere Cavallé-Busquets
- CIBER (CB06/03) ISCIII, Spain; Area of Obstetrics & Gynaecology, Hospital Universitari Sant Joan, Reus, Spain
| | - Joan D Fernandez-Ballart
- Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), IISPV, Spain; CIBER (CB06/03) ISCIII, Spain
| | - Michelle M Murphy
- Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), IISPV, Spain; CIBER (CB06/03) ISCIII, Spain.
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81
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Shen PJ, Gong B, Xu FY, Luo Y. Four trace elements in pregnant women and their relationships with adverse pregnancy outcomes. Eur Rev Med Pharmacol Sci 2015; 19:4690-4697. [PMID: 26744858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Lack of trace elements during pregnancy is detrimental to maternal and fetal health. Our aim is to study the changes in trace element levels in Chinese pregnant women and their association with adverse pregnancy outcomes. PATIENTS AND METHODS 1568 cases of Chinese pregnant women in remote areas were collected for a prospective cohort study. Serum copper, zinc, calcium and iron levels were measured at pre-pregnancy, 1st trimester (7w-12w), 2nd trimester (24w-28w) and 3rd trimester (35w-40w). RESULTS (1) Serum copper levels was significantly higher after pregnancy than before, calcium and iron levels decreased, but zinc levels did not change significantly. (2) Copper and zinc deficiency in pregnant women was not a common finding, but lack of iron and calcium was frequently encountered; iron deficiency was especially common in the 3rd trimester (42.27%). (3) Serum zinc and iron levels in patients who either had a miscarriage or a preterm delivery were significantly lower than in the control group (p < 0.05). In patients with premature rupture of membranes, serum zinc levels were significantly lower (p < 0.05). In patients with intrauterine growth restriction (IUGR), serum copper, zinc, calcium and iron were significantly lower (p < 0.05). CONCLUSIONS Trace elements is closely associated with fetal growth and development during pregnancy. Deficiency can lead to adverse pregnancy outcomes. Therefore, we should have a reasonable diet, replenish trace elements, therefore reducing the occurrence of adverse pregnancy outcomes.
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Affiliation(s)
- P-J Shen
- Qingpu Branch of Fudan University Affiliated Zhongshan Hospital, Shanghai, China.
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82
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Sohlberg S, Mulic-Lutvica A, Olovsson M, Weis J, Axelsson O, Wikström J, Wikström AK. Magnetic resonance imaging-estimated placental perfusion in fetal growth assessment. Ultrasound Obstet Gynecol 2015; 46:700-705. [PMID: 25640054 PMCID: PMC5063104 DOI: 10.1002/uog.14786] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/29/2014] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate in-vivo placental perfusion fraction, estimated by magnetic resonance imaging (MRI), as a marker of placental function. METHODS A study population of 35 pregnant women, of whom 13 had pre-eclampsia (PE), were examined at 22-40 weeks' gestation. Within a 24-h period, each woman underwent an MRI diffusion-weighted sequence (from which we calculated the placental perfusion fraction), venous blood sampling and an ultrasound examination including estimation of fetal weight, amniotic fluid index and Doppler velocity measurements. The perfusion fractions in pregnancies with and without fetal growth restriction were compared and correlations between the perfusion fraction and ultrasound estimates and plasma markers were estimated using linear regression. The associations between the placental perfusion fraction and ultrasound estimates were modified by the presence of PE (P < 0.05) and therefore we included an interaction term between PE and covariates in the models. RESULTS The median placental perfusion fractions in pregnancies with and without fetal growth restriction were 21% and 32%, respectively (P = 0.005). The correlations between placental perfusion fraction and ultrasound estimates and plasma markers were highly significant (P = 0.002 and P = 0.0001, respectively). The highest coefficient of determination (R(2) = 0.56) for placental perfusion fraction was found for a model that included pulsatility index in the ductus venosus, plasma level of soluble fms-like tyrosine kinase-1, estimated fetal weight and presence of PE. CONCLUSION The placental perfusion fraction has the potential to contribute to the clinical assessment of cases with placental insufficiency.
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Affiliation(s)
- S Sohlberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - A Mulic-Lutvica
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - M Olovsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - J Weis
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | - O Axelsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - J Wikström
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | - A-K Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Milnerowicz-Nabzdyk E, Bizoń A. How does tobacco smoke influence the morphometry of the fetus and the umbilical cord?-Research on pregnant women with intrauterine growth restriction exposed to tobacco smoke. Reprod Toxicol 2015; 58:79-84. [PMID: 26315940 DOI: 10.1016/j.reprotox.2015.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 08/05/2015] [Accepted: 08/21/2015] [Indexed: 12/27/2022]
Abstract
Proper structure of the umbilical cord is important for the fetal development. We evaluated effects of toxic factors from tobacco smoke on fetal and umbilical cord morphometry. 109 women in weeks 29-40 of pregnancy (31 smokers with intrauterine growth restriction (IUGR); 28 non-smoking women with IUGR; 50 healthy pregnancies) were included. In smokers with IUGR, cotinine, cadmium and lead concentrations were significantly higher than in controls (mean 55.23ng/l; 1.52ng/ml; 14.85ng/ml vs 1.07; 0.34; 9.42) and inverse correlation between lead concentration and uncoiled umbilical cord was significant (r=-0.80). In smokers with IUGR, area of Wharton's jelly was increased compared to nonsmokers and controls. Inverse correlations occurred between cotinine and cadmium concentration and fetal percentile in smokers (r=-0.87; r=-0.87) and non-smokers (r=-0.47; r=-0.78) with IUGR. Exposure to tobacco smoke measured by cotinine, cadmium and lead concentration has an impact on fetal growth and umbilical cord morphometry and correlates with intensity of IUGR.
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Affiliation(s)
- Ewa Milnerowicz-Nabzdyk
- 2nd Department and Clinic of Obstetrics and Gynaecology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland
| | - Anna Bizoń
- Department of Biomedical and Environmental Analysis, Wroclaw Medical University, Borowska 211, 50-556 Wrocław, Poland.
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Tzschoppe A, Riedel C, von Kries R, Struwe E, Rascher W, Dörr HG, Beckmann MW, Schild RL, Goecke TW, Flyvbjerg A, Frystyk J, Dötsch J. Differential effects of low birthweight and intrauterine growth restriction on umbilical cord blood insulin-like growth factor concentrations. Clin Endocrinol (Oxf) 2015; 83:739-45. [PMID: 26118397 DOI: 10.1111/cen.12844] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/28/2015] [Accepted: 06/10/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Alterations in the growth hormone-insulin-like growth factor (IGF) axis have been considered as a causal factor for intrauterine growth restriction (IUGR) and for the increased risk of metabolic disease in later life. We compared members of the IGF axis in umbilical cord blood between IUGR neonates, small for gestational age without foetal restriction (SGA) and appropriate for gestational age (AGA) neonates. DESIGN Prospective controlled multicenter study. PATIENTS Sixteen ultrasound-proven IUGR, 8 SGA and 40 AGA neonates. MEASUREMENTS Concentrations of total IGF-I and total IGF-II by immunoassays, bioactive IGF by cell-based bioassay and IGFBP-I in mixed venous and arterial umbilical cord blood samples at birth. Auxological parameters at birth. RESULTS IGF-I concentrations in IUGR [17·7 μg/l (CI 13·8;21·6)] were clearly below those in AGA [48·3 μg/l (CI 43·7;52·9)] and SGA neonates [36·0 μg/l (CI 26·6;45·4)]. IGF-II levels were significantly reduced in IUGR [201·4 μg/l (CI 190·2;212·6)] compared to AGA neonates [231·2 μg/l (CI 220·6;241·9)]. A trend for lower IGF-II concentrations was observed in IUGR when compared to SGA neonates [232·0 μg/l (CI 207·2;256·8)]. These differences could not be explained by confounding. For IGFBP-1, a trend towards higher values in IUGR was observed. CONCLUSIONS Low IGF-I cord blood concentrations in hypotrophic neonates after IUGR might not only result from low birthweight per se, but also reflect prenatal placental environment. Alterations of the IGF axis could be in the causal pathway of IUGR and thus constitute a potential surrogate marker for IUGR in the assessment of foetal programming.
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Affiliation(s)
- Anja Tzschoppe
- Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Christina Riedel
- Institute of Social Paediatrics and Adolescent Medicine, University of Munich, Munich, Germany
| | - Rüdiger von Kries
- Institute of Social Paediatrics and Adolescent Medicine, University of Munich, Munich, Germany
| | - Ellen Struwe
- Regional Centre for Social Paediatrics, Klinikum Konstanz, Konstanz, Germany
| | - Wolfgang Rascher
- Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Helmuth G Dörr
- Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ralf L Schild
- Department of Obstetrics and Gynaecology, Diakonische Dienste Hannover, Hannover, Germany
| | - Tamme W Goecke
- Department of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany
| | - Allan Flyvbjerg
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jan Frystyk
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jörg Dötsch
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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Veiga-Lopez A, Kannan K, Liao C, Ye W, Domino SE, Padmanabhan V. Gender-Specific Effects on Gestational Length and Birth Weight by Early Pregnancy BPA Exposure. J Clin Endocrinol Metab 2015; 100:E1394-403. [PMID: 26406292 PMCID: PMC4702459 DOI: 10.1210/jc.2015-1724] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT AND OBJECTIVE Effects of prenatal exposure to bisphenol A (BPA) on gestational and birth outcomes are controversial. The aim of the study was to evaluate the relationship between prenatal exposure to BPA and birth and gestational outcomes. design, setting, participants, and outcome: Levels of unconjugated (uBPA) and BPA glucuronide in 80 matching samples of pregnant women during the first trimester of pregnancy and at delivery and matching term cord blood obtained from a prospective study conducted at the University of Michigan Hospitals were determined using a methodology validated in the National Institutes of Environmental Health Sciences funded Round Robin study and related to pregnancy outcomes. RESULTS Highest levels of uBPA were found in maternal term samples followed by first trimester maternal (M1) samples and cord blood. A 2-fold increase in M1 uBPA was associated with 55-g less birth weight when male and female pregnancies were combined and 183-g less birth weight with only female pregnancies. A 2-fold increase in maternal term uBPA was associated with an increased gestational length of 0.7 days for all pregnancies and 1.1 days for only female pregnancies. CONCLUSION Higher uBPA exposure levels during first trimester and term are associated with sex-specific reduction in birth weight and increase in gestational length, respectively. Race, parity, and employment have an effect on BPA exposure. Because low birth weight is associated with adverse health outcomes, effect of early pregnancy BPA levels on reducing birth weight highlights the risk posed by developmental exposure to BPA.
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Affiliation(s)
- Almudena Veiga-Lopez
- Department of Pediatrics (A.V.-L., V.P.), University of Michigan, Ann Arbor, Michigan 48109; Wadsworth Center (K.K.), New York State Department of Health, Albany, New York 12208; and Department of Biostatistics (W.Y.), and Department of Obstetrics and Gynecology (S.E.D., V.P.), University of Michigan, Ann Arbor, Michigan 48109
| | - Kurunthachalam Kannan
- Department of Pediatrics (A.V.-L., V.P.), University of Michigan, Ann Arbor, Michigan 48109; Wadsworth Center (K.K.), New York State Department of Health, Albany, New York 12208; and Department of Biostatistics (W.Y.), and Department of Obstetrics and Gynecology (S.E.D., V.P.), University of Michigan, Ann Arbor, Michigan 48109
| | - Chunyang Liao
- Department of Pediatrics (A.V.-L., V.P.), University of Michigan, Ann Arbor, Michigan 48109; Wadsworth Center (K.K.), New York State Department of Health, Albany, New York 12208; and Department of Biostatistics (W.Y.), and Department of Obstetrics and Gynecology (S.E.D., V.P.), University of Michigan, Ann Arbor, Michigan 48109
| | - Wen Ye
- Department of Pediatrics (A.V.-L., V.P.), University of Michigan, Ann Arbor, Michigan 48109; Wadsworth Center (K.K.), New York State Department of Health, Albany, New York 12208; and Department of Biostatistics (W.Y.), and Department of Obstetrics and Gynecology (S.E.D., V.P.), University of Michigan, Ann Arbor, Michigan 48109
| | - Steven E Domino
- Department of Pediatrics (A.V.-L., V.P.), University of Michigan, Ann Arbor, Michigan 48109; Wadsworth Center (K.K.), New York State Department of Health, Albany, New York 12208; and Department of Biostatistics (W.Y.), and Department of Obstetrics and Gynecology (S.E.D., V.P.), University of Michigan, Ann Arbor, Michigan 48109
| | - Vasantha Padmanabhan
- Department of Pediatrics (A.V.-L., V.P.), University of Michigan, Ann Arbor, Michigan 48109; Wadsworth Center (K.K.), New York State Department of Health, Albany, New York 12208; and Department of Biostatistics (W.Y.), and Department of Obstetrics and Gynecology (S.E.D., V.P.), University of Michigan, Ann Arbor, Michigan 48109
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Bakalis S, Peeva G, Gonzalez R, Poon LC, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 30-34 weeks. Ultrasound Obstet Gynecol 2015; 46:446-451. [PMID: 25826154 DOI: 10.1002/uog.14863] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 03/25/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of combined screening by maternal characteristics and medical history (maternal factors), estimated fetal weight (EFW), uterine artery pulsatility index (UtA-PI), mean arterial pressure (MAP) and serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) at 30-34 weeks' gestation in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE). METHODS This was a screening study in 9472 singleton pregnancies at 30-34 weeks' gestation, comprising 469 that delivered SGA neonates and 9003 cases unaffected by SGA, PE or gestational hypertension. Multivariable logistic regression analysis was used to determine if UtA-PI, MAP and serum PlGF or sFlt-1, individually or in combination, improved the prediction of SGA neonates provided from screening by maternal factors and EFW. RESULTS Compared to the normal group, mean log10 multiples of the median (MoM) values of UtA-PI, MAP and serum sFlt-1 were significantly higher and log10 MoM PlGF was lower in the SGA group. Multivariable logistic regression analysis demonstrated that in the prediction of SGA neonates with a birth weight < 5(th) percentile, delivering < 5 weeks and ≥ 5 weeks after assessment, there were significant independent contributions from maternal factors, EFW, UtA-PI, MAP, and serum PlGF and sFlt-1, but the best performance was provided by a combination of maternal factors, EFW, UtA-PI, MAP and serum PlGF, excluding sFlt-1. Combined screening predicted, at a 10% false-positive rate, 89%, 94%, 96% of SGA neonates delivering at 32-36 weeks' gestation with birth weight < 10(th) , < 5(th) and < 3(rd) percentiles, respectively; the respective detection rates of combined screening for SGA neonates delivering ≥ 37 weeks were 57%, 65% and 72%. CONCLUSION Combined screening by maternal factors and biophysical and biochemical markers at 30-34 weeks' gestation could identify a high proportion of pregnancies that will deliver SGA neonates.
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Affiliation(s)
- S Bakalis
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Peeva
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Gonzalez
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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87
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Manokhina I, Wilson SL, Robinson WP. Noninvasive nucleic acid-based approaches to monitor placental health and predict pregnancy-related complications. Am J Obstet Gynecol 2015; 213:S197-206. [PMID: 26428499 DOI: 10.1016/j.ajog.2015.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/11/2015] [Accepted: 07/13/2015] [Indexed: 12/18/2022]
Abstract
During pregnancy, the placenta releases a variety of nucleic acids (including deoxyribonucleic acid, messenger ribonucleic acid, or microribonucleic acids) either as a result of cell turnover or as an active messaging system between the placenta and cells in the maternal body. The profile of released nucleic acids changes with the gestational age and has been associated with maternal and fetal parameters. It also can directly reflect pathological changes in the placenta. Nucleic acids may therefore provide a rich source of novel biomarkers for the prediction of pregnancy complications. However, their utility in the clinical setting depends, first, on overcoming some technical considerations in their quantification, and, second, on developing a better understanding of the factors that influence their function and abundance.
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Affiliation(s)
- Irina Manokhina
- Child and Family Research Institute, Vancouver, BC, Canada; Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Samantha L Wilson
- Child and Family Research Institute, Vancouver, BC, Canada; Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Wendy P Robinson
- Child and Family Research Institute, Vancouver, BC, Canada; Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Poon LC, Lesmes C, Gallo DM, Akolekar R, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 19-24 weeks. Ultrasound Obstet Gynecol 2015; 46:437-445. [PMID: 25988293 DOI: 10.1002/uog.14904] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/08/2015] [Accepted: 05/12/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the value of combined screening by maternal characteristics and medical history, fetal biometry and biophysical and biochemical markers at 19-24 weeks' gestation, for prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE), and examine the potential value of such assessment in deciding whether the third-trimester scan should be at 32 and/or 36 weeks' gestation. METHODS This was a screening study in 7816 singleton pregnancies, including 389 (5.0%) that delivered SGA neonates with birth weight < 5(th) percentile (SGA < 5(th) ), in the absence of PE. Multivariable logistic regression analysis was used to determine if screening by a combination of maternal factors, fetal biometry, uterine artery pulsatility index (UtA-PI) and maternal serum concentrations of placental growth factor (PlGF) and α-fetoprotein (AFP) had significant contribution in predicting SGA neonates. A model was developed for selecting the gestational age for third-trimester assessment, at 32 and/or 36 weeks, based on the results of screening at 19-24 weeks. RESULTS Significant independent contributions to the prediction of SGA < 5(th) were provided by maternal factors, fetal biometry, UtA-PI and serum PlGF and AFP. The detection rate (DR) of such combined screening at 19-24 weeks was 100%, 78% and 42% for SGA < 5(th) delivering < 32, at 32-36 and ≥ 37 weeks' gestation, respectively, at a false-positive rate (FPR) of 10%. In a hypothetical model, it was estimated that if the desired objective of prenatal screening is to predict about 80% of the cases of SGA < 5(th) , it would be necessary to select 11% of the population at the 19-24-week assessment to be reassessed at 32 weeks and 44% to be reassessed at 36 weeks; 57% would not require a third-trimester scan. CONCLUSION Prenatal prediction of a high proportion of SGA neonates necessitates the undertaking of screening in the third trimester of pregnancy, in addition to assessment in the second trimester, and the timing of such screening, at 32 and/or 36 weeks, should be contingent on the results of the assessment at 19-24 weeks.
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Affiliation(s)
- L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - C Lesmes
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham, Kent, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Lesmes C, Gallo DM, Gonzalez R, Poon LC, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by maternal serum biochemical markers at 19-24 weeks. Ultrasound Obstet Gynecol 2015; 46:341-349. [PMID: 25969963 DOI: 10.1002/uog.14899] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/05/2015] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the value of maternal serum concentrations of placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin (β-hCG) and α-fetoprotein (AFP) at 19-24 weeks' gestation, in combination with maternal factors and fetal biometry, in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE) and examine the potential value of such assessment in deciding whether the third-trimester scan should be performed at 32 and/or 36 weeks' gestation. METHODS This was a screening study in 9715 singleton pregnancies, including 481 (5.0%) that delivered SGA neonates with birth weight < 5(th) percentile (SGA < 5(th) ), in the absence of PE. Multivariable logistic regression analysis was used to determine if screening by a combination of maternal factors, Z-scores of fetal head circumference, abdominal circumference and femur length, and log10 multiples of the median (MoM) values of PlGF, sFlt-1, PAPP-A, free β-hCG or AFP had a significant contribution to the prediction of SGA neonates. A model was developed in selecting the gestational age for third-trimester assessment, at 32 and/or 36 weeks, based on the results of screening at 19-24 weeks. RESULTS Compared to the normal group, the mean log10 MoM value of PlGF was lower, AFP was higher and sFlt-1, PAPP-A and free β-hCG were not significantly different in the SGA < 5(th) group that delivered < 37 weeks. The detection rate (DR) of combined screening by maternal factors, fetal biometry and serum PlGF and AFP at 19-24 weeks was 100%, 76% and 38% for SGA < 5(th) delivering < 32, 32-36 and ≥ 37 weeks' gestation, respectively, at a false-positive rate (FPR) of 10%. In a hypothetical model, it was estimated that, if the desired objective of prenatal screening is to predict about 80% of the cases of SGA < 5(th) , it would be necessary to select 11% of the population at the 19-24-week assessment to be reassessed at 32 weeks and 46% to be reassessed at 36 weeks; 54% would not require a third-trimester scan. CONCLUSION Prenatal prediction of a high proportion of SGA neonates necessitates the undertaking of screening in the third trimester of pregnancy, in addition to assessment in the second trimester, and the timing of such screening, at 32 and/or 36 weeks, should be contingent on the results of the assessment at 19-24 weeks.
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Affiliation(s)
- C Lesmes
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Gonzalez
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Griffin M, Seed PT, Webster L, Myers J, MacKillop L, Simpson N, Anumba D, Khalil A, Denbow M, Sau A, Hinshaw K, von Dadelszen P, Benton S, Girling J, Redman CWG, Chappell LC, Shennan AH. Diagnostic accuracy of placental growth factor and ultrasound parameters to predict the small-for-gestational-age infant in women presenting with reduced symphysis-fundus height. Ultrasound Obstet Gynecol 2015; 46:182-190. [PMID: 25826778 PMCID: PMC4744762 DOI: 10.1002/uog.14860] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/25/2015] [Accepted: 03/25/2015] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To assess the diagnostic accuracy of placental growth factor (PlGF) and ultrasound parameters to predict delivery of a small-for-gestational-age (SGA) infant in women presenting with reduced symphysis-fundus height (SFH). METHODS This was a multicenter prospective observational study recruiting 601 women with a singleton pregnancy and reduced SFH between 24 and 37 weeks' gestation across 11 sites in the UK and Canada. Plasma PlGF concentration < 5(th) centile, estimated fetal weight (EFW) < 10(th) centile, umbilical artery Doppler pulsatility index > 95(th) centile and oligohydramnios (amniotic fluid index < 5 cm) were compared as predictors for a SGA infant < 3(rd) customized birth-weight centile and adverse perinatal outcome. Test performance statistics were calculated for all parameters in isolation and in combination. RESULTS Of the 601 women recruited, 592 were analyzed. For predicting delivery of SGA < 3(rd) centile (n = 78), EFW < 10(th) centile had 58% sensitivity (95% CI, 46-69%) and 93% negative predictive value (NPV) (95% CI, 90-95%), PlGF had 37% sensitivity (95% CI, 27-49%) and 90% NPV (95% CI, 87-93%); in combination, PlGF and EFW < 10(th) centile had 69% sensitivity (95% CI, 55-81%) and 93% NPV (95% CI, 89-96%). The equivalent receiver-operating characteristics (ROC) curve areas were 0.79 (95% CI, 0.74-0.84) for EFW < 10(th) centile, 0.70 (95% CI, 0.63-0.77) for low PlGF and 0.82 (95% CI, 0.77-0.86) in combination. CONCLUSIONS For women presenting with reduced SFH, ultrasound parameters had modest test performance for predicting delivery of SGA < 3(rd) centile. PlGF performed no better than EFW < 10(th) centile in determining delivery of a SGA infant.
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Affiliation(s)
- M. Griffin
- Women's Health Academic CentreKing's College LondonLondonUK
| | - P. T. Seed
- Women's Health Academic CentreKing's College LondonLondonUK
| | - L. Webster
- Women's Health Academic CentreKing's College LondonLondonUK
| | - J. Myers
- Maternal and Fetal Health Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | | | - N. Simpson
- Section of Obstetrics & Gynaecology, Institute of Biochemical & Clinical SciencesUniversity of LeedsLeedsUK
| | - D. Anumba
- Academic Unit of Reproductive and Developmental MedicineUniversity of SheffieldSheffieldUK
| | - A. Khalil
- St George's Hospital Medical SchoolUniversity of LondonLondonUK
| | | | - A. Sau
- University HospitalLewishamLondonUK
| | | | - P. von Dadelszen
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverCanada
| | - S. Benton
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverCanada
| | - J. Girling
- West Middlesex University HospitalIsleworthMiddlesexUK
| | - C. W. G. Redman
- Nuffield Department of Obstetrics and GynaecologyUniversity of OxfordOxfordUK
| | - L. C. Chappell
- Women's Health Academic CentreKing's College LondonLondonUK
| | - A. H. Shennan
- Women's Health Academic CentreKing's College LondonLondonUK
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91
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Rojekar MV, Mogarekar MR. Study of serum paraoxonase and phospholipase activities in pregnant women in relation to birth weight. Minerva Ginecol 2015; 67:327-333. [PMID: 26149812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Low birth weight is an important issue due to its dreadful consequences in future. Well prevailing over the world, this is important in view of developing countries. Low birth weight is associated with high neonatal and infant mortality, lower trajectory of growth during childhood and adolescence, increases risk of non-communicable diseases during adult life. Oxidative stress is a major player among the various etiologies. Paraoxonase1 is an important antioxidant defense. Phospholipase is required to release free fatty acids from phosphoglycerides utilized for fetal growth. We conducted the study to look for the predictive value of serum paraoxonase and phospholipase. METHODS With binding to Helsinki declaration and approval from Institutional Ethical Committee, we have selected 100 pregnant ladies. Serum PON1 arylesterase (ARE), lactonase (LACT) and serum phospholipase (PL) activities are measured. We used SPSS 20.0 for linear and logistic regression models to assess the predictability of the ARE, LACT and PL for predicting the IUGR. RESULTS R value increases in the order of maternal age, maternal weight, phospholipase, arylesterase, lactonase. Logistic regression analysis with different models and with birth weight as dependent factor, maternal age is flagged out as not significant. PL, LACT, ARE emerge out to be good predictors of IUGR. CONCLUSION From this study we have concluded that PON1 LACT, ARE and serum PL, could be the newer markers IUGR in maternal serum. IUGR can be predicted beforehand by using PON1 LACT, PON1 ARE and serum phospholipase. This surely will help in timely diagnosis and treatment accordingly of possible adverse pregnancy outcome.
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Affiliation(s)
- M V Rojekar
- Department of Biochemistry, Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra, India -
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92
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Seferovic MD, Goodspeed DM, Chu DM, Krannich LA, Gonzalez-Rodriguez PJ, Cox JE, Aagaard KM. Heritable IUGR and adult metabolic syndrome are reversible and associated with alterations in the metabolome following dietary supplementation of 1-carbon intermediates. FASEB J 2015; 29:2640-52. [PMID: 25757570 PMCID: PMC4447228 DOI: 10.1096/fj.14-266387] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/19/2015] [Indexed: 12/16/2022]
Abstract
Metabolic syndrome (MetS), following intrauterine growth restriction (IUGR), is epigenetically heritable. Recently, we abrogated the F2 adult phenotype with essential nutrient supplementation (ENS) of intermediates along the 1-carbon pathway. With the use of the same grandparental uterine artery ligation model, we profiled the F2 serum metabolome at weaning [postnatal day (d)21; n = 76] and adulthood (d160; n = 12) to test if MetS is preceded by alterations in the metabolome. Indicative of developmentally programmed MetS, adult F2, formerly IUGR rats, were obese (621 vs. 461 g; P < 0.0001), dyslipidemic (133 vs. 67 mg/dl; P < 0.001), and glucose intolerant (26 vs. 15 mg/kg/min; P < 0.01). Unbiased gas chromatography-mass spectrometry (GC-MS) profiling revealed 34 peaks corresponding to 12 nonredundant metabolites and 9 unknowns to be changing at weaning [false discovery rate (FDR) < 0.05]. Markers of later-in-life MetS included citric acid, glucosamine, myoinositol, and proline (P < 0.03). Hierarchical clustering revealed grouping by IUGR lineage and supplementation at d21 and d160. Weanlings grouped distinctly for ENS and IUGR by partial least-squares discriminate analysis (PLS-DA; P < 0.01), whereas paternal and maternal IUGR (IUGR(pat)/IUGR(mat), respectively) control-fed rats, destined for MetS, had a distinct metabolome at weaning (randomForest analysis; class error < 0.1) and adulthood (PLS-DA; P < 0.05). In sum, we have found that alterations in the metabolome accompany heritable IUGR, precede adult-onset MetS, and are partially amenable to dietary intervention.
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Affiliation(s)
- Maxim D Seferovic
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
| | - Danielle M Goodspeed
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
| | - Derrick M Chu
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
| | - Laura A Krannich
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
| | - Pablo J Gonzalez-Rodriguez
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
| | - James E Cox
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
| | - Kjersti M Aagaard
- Departments of *Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Molecular and Cell Biology, Molecular and Human Genetics, and Molecular Physiology and Biophysics, and Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA; and Department of Biochemistry and Metabolomics Core, University of Utah, Salt Lake City, Utah, USA
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Boutsikou T, Giotaki M, Boutsikou M, Briana DD, Baka S, Piatopoulou D, Hassiakos D, Gourgiotis D, Malamitsi-Puchner A. Cord blood galectin-1 and -3 concentrations in term pregnancies with normal restricted and increased fetal growth. J Perinat Med 2015; 43:305-9. [PMID: 24717333 DOI: 10.1515/jpm-2013-0220] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 03/17/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine levels of galectins (gal)-1 and -3 (implicated in angiogenesis/immunologic mechanisms) in intrauterine growth restricted (IUGR), large (LGA) and appropriate for gestational age (AGA) pregnancies, as these groups differ in fat mass, angiogenic patterns and immune responses. METHODS Cord-blood (UC) gal-1 and -3 concentrations were measured in 30 IUGR, 30 LGA and 20 AGA singleton full-term infants and their mothers (MS). RESULTS IUGR, LGA and AGA groups did not differ in gal-1 and -3 concentrations. UC gal-1 levels were lower when mothers were older [b=-0.651, CI 95% -1.186 (-0.116), P=0.018] and UC gal-3 levels were increased when mothers presented gestational diabetes [b=9.836, CI 95% 3.833- (15.839), P=0.002]. In IUGRs MS gal-3 and in LGAs UC gal-1 were decreased in multiparas [b=-5.372, CI 95% -9.584- (-1.161), P=0.014], and [b=-7.540, CI 95% -14.606- (-0.473), P=0.037], respectively. No correlations were found between MS or UC gal-1 and gal-3 concentrations. CONCLUSIONS Lower UC gal-1 levels, when mothers were older, and increased UC gal-3 levels in cases of gestational diabetes, possibly reflect angiogenic activity. In multiparas, decreased MS gal-3 and UC gal-1 levels in IUGR/LGA, respectively, might imply inflammatory response against immunosuppression expected in subsequent pregnancies, as compared to the first one.
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94
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Volpato GT, Damasceno DC, Sinzato YK, Ribeiro VM, Rudge MVC, Calderon IMP. Oxidative stress status and placental implications in diabetic rats undergoing swimming exercise after embryonic implantation. Reprod Sci 2015; 22:602-8. [PMID: 25361551 PMCID: PMC4519768 DOI: 10.1177/1933719114556485] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The potential benefits and risks of physical exercise on fetal development during pregnancy remain unclear. The aim was to analyze maternal oxidative stress status and the placental morphometry to relate to intrauterine growth restriction (IUGR) from diabetic female rats submitted to swimming program after embryonic implantation. Pregnant Wistar rats were distributed into 4 groups (11 animals/group): control-nondiabetic sedentary rats, control exercised-nondiabetic exercised rats, diabetic-diabetic sedentary rats, and diabetic exercised-diabetic exercised rats. A swimming program was used as an exercise model. At the end of pregnancy, the maternal oxidative stress status, placental morphology, and fetal weight were analyzed. The swimming program was not efficient to reduce the hyperglycemia-induced oxidative stress. This fact impaired placental development, resulting in altered blood flow and energy reserves, which contributed to a deficient exchange of nutrients and oxygen for the fetal development, leading to IUGR.
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Affiliation(s)
- Gustavo Tadeu Volpato
- Laboratory of Experimental Research on Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, Botucatu, São Paulo, Brazil Laboratory of General Physiology and Reproductive Toxicology, Institute of Biological and Health Sciences, University Center of Araguaia, Federal University of Mato Grosso, Barra do Garças, Mato Grosso, Brazil
| | - Débora Cristina Damasceno
- Laboratory of Experimental Research on Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, Botucatu, São Paulo, Brazil
| | - Yuri Karen Sinzato
- Laboratory of Experimental Research on Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, Botucatu, São Paulo, Brazil
| | - Viviane Maria Ribeiro
- Laboratory of Experimental Research on Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, Botucatu, São Paulo, Brazil
| | - Marilza Vieira Cunha Rudge
- Laboratory of Experimental Research on Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, Botucatu, São Paulo, Brazil
| | - Iracema Mattos Paranhos Calderon
- Laboratory of Experimental Research on Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, Botucatu, São Paulo, Brazil
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Tsiakkas A, Duvdevani N, Wright A, Wright D, Nicolaides KH. Serum placental growth factor in the three trimesters of pregnancy: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol 2015; 45:591-598. [PMID: 25653039 DOI: 10.1002/uog.14811] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To define the contribution of maternal variables which influence the measured level of maternal serum placental growth factor (PlGF) in screening for pregnancy complications. METHODS Maternal characteristics and medical history were recorded and serum levels of PlGF were measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 or 35 + 0 to 37 + 6 weeks' gestation. For women delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history important in the prediction of PlGF were determined from a linear mixed-effects multiple regression. RESULTS Serum levels of PlGF were measured in 38,002 cases in the first trimester, 10,281 in the second trimester and 12,392 in the third trimester. Significant independent contributions to serum PlGF were provided by gestational age, maternal age, weight and racial origin, cigarette smoking, diabetes mellitus, and gestational age at delivery and birth-weight Z-score of the neonate in the previous pregnancy. The machine used to measure serum PlGF was also found to have a significant effect. Allowing for other factors, the effect of maternal age on PlGF changed over the three trimesters, whereas other variables had constant effects over the three trimesters. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured serum PlGF and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this complication. CONCLUSIONS A model was fitted to express the measured level of maternal serum PlGF across the three trimesters of pregnancy as MoMs, after adjusting for variables of maternal characteristics and medical history that affect this measurement.
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Affiliation(s)
- A Tsiakkas
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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96
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Rathore DK, Nair D, Raza S, Saini S, Singh R, Kumar A, Tripathi R, Ramji S, Batra A, Aggarwal KC, Chellani HK, Arya S, Bhatla N, Paul VK, Aggarwal R, Agarwal N, Mehta U, Sopory S, Natchu UCM, Bhatnagar S, Bal V, Rath S, Wadhwa N. Underweight full-term Indian neonates show differences in umbilical cord blood leukocyte phenotype: a cross-sectional study. PLoS One 2015; 10:e0123589. [PMID: 25898362 PMCID: PMC4405369 DOI: 10.1371/journal.pone.0123589] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/19/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND While infections are a major cause of neonatal mortality in India even in full-term neonates, this is an especial problem in the large proportion (~20%) of neonates born underweight (or small-for-gestational-age; SGA). One potential contributory factor for this susceptibility is the possibility that immune system maturation may be affected along with intrauterine growth retardation. METHODS In order to examine the possibility that differences in immune status may underlie the susceptibility of SGA neonates to infections, we enumerated the frequencies and concentrations of 22 leukocyte subset populations as well as IgM and IgA levels in umbilical cord blood from full-term SGA neonates and compared them with values from normal-weight (or appropriate-for-gestational-age; AGA) full-term neonates. We eliminated most SGA-associated risk factors in the exclusion criteria so as to ensure that AGA-SGA differences, if any, would be more likely to be associated with the underweight status itself. RESULTS An analysis of 502 such samples, including 50 from SGA neonates, showed that SGA neonates have significantly fewer plasmacytoid dendritic cells (pDCs), a higher myeloid DC (mDC) to pDC ratio, more natural killer (NK) cells, and higher IgM levels in cord blood in comparison with AGA neonates. Other differences were also observed such as tendencies to lower CD4:CD8 ratios and greater prominence of inflammatory monocytes, mDCs and neutrophils, but while some of them had substantial differences, they did not quite reach the standard level of statistical significance. CONCLUSIONS These differences in cellular lineages of the immune system possibly reflect stress responses in utero associated with growth restriction. Increased susceptibility to infections may thus be linked to complex immune system dysregulation rather than simply retarded immune system maturation.
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Affiliation(s)
- Deepak K. Rathore
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Deepa Nair
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Saimah Raza
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Savita Saini
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Reeta Singh
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Amit Kumar
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Reva Tripathi
- Department of Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi, India
| | - Siddarth Ramji
- Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - Aruna Batra
- Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Kailash C. Aggarwal
- Department of Pediatrics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Harish K. Chellani
- Department of Pediatrics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Sugandha Arya
- Department of Pediatrics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod K. Paul
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh Aggarwal
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Nidhi Agarwal
- Department of Obstetrics & Gynecology, General Hospital, Gurgaon, Haryana, India
| | - Umesh Mehta
- Department of Pediatrics, General Hospital, Gurgaon, Haryana, India
| | - Shailaja Sopory
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Uma Chandra Mouli Natchu
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Shinjini Bhatnagar
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
| | - Vineeta Bal
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
- National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi, India
| | - Satyajit Rath
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
- National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi, India
| | - Nitya Wadhwa
- Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India
- * E-mail:
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97
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El-Baz MAH, El-Deeb TS, El-Noweihi AM, Mohany KM, Shaaban OM, Abbas AM. Environmental factors and apoptotic indices in patients with intrauterine growth retardation: a nested case-control study. Environ Toxicol Pharmacol 2015; 39:589-596. [PMID: 25682005 DOI: 10.1016/j.etap.2015.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 01/10/2015] [Accepted: 01/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Egypt has one of the highest incidences of IUGR. The current study investigates the effect of heavy metals toxicity as risk factors of IUGR and determines the possible role of increased apoptosis in their pathogenesis. METHODS This study was conducted in Assiut, Egypt, included 60 women diagnosed to have IUGR. We measured lead and cadmium levels in blood besides arsenic and cadmium levels in urine. Neonatal scalp hair sample were analyzed for arsenic content. Quantitative determination of human placental Bcl-2 and caspase-3 were performed. RESULTS There are significantly higher levels of heavy metals and caspase-3 and lower levels of placental Bcl-2 in the IUGR group. The levels of heavy metals were positively correlated with caspase-3 while negatively correlated (except cadmium) with Bcl-2 levels. CONCLUSIONS There is an alarming high level of heavy metals toxicity in Egypt that was positively correlated to IUGR. Increased placental apoptosis may be one of the possible mechanisms behind the effect.
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Affiliation(s)
- Mona A H El-Baz
- Department of Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Thorya S El-Deeb
- Department of Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Amira M El-Noweihi
- Department of Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Khalid M Mohany
- Department of Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Omar M Shaaban
- Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
| | - Ahmed M Abbas
- Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
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98
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Monen L, Kuppens SM, Hasaart TH, Oosterbaan HP, Oei SG, Wijnen H, Hutton EK, Vader HL, Pop VJ. Maternal thyrotropin is independently related to small for gestational age neonates at term. Clin Endocrinol (Oxf) 2015; 82:254-9. [PMID: 25103873 DOI: 10.1111/cen.12578] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/15/2014] [Accepted: 07/31/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Small for gestational age (SGA) newborns constitute still a major cause of perinatal morbidity and mortality. Overt thyroid disease is a known cause of preterm birth and low birthweight but in its untreated condition it is rare today. In this study, we investigated the possible relation between maternal thyroid function assessed in euthyroid women at each trimester and the incidence of term born SGA neonates. DESIGN A prospective cohort study was performed. PATIENTS Thyroid function was assessed at 12, 24 and 36 weeks gestation in 1051 healthy Caucasian women who delivered at ≥ 37 weeks gestation. MEASUREMENTS One-way anova was used to compare mean TSH and FT4 levels between women with SGA neonates and controls. Multiple logistic regression analysis was performed to adjust for known risk factors of SGA. RESULTS Seventy (6·7%) SGA neonates were identified and they were significantly more often born to women with a TSH ≥ 97·5th at first and third trimester. Multiple logistic regression analysis showed that smoking (OR: 4·4, 95% CI: 2·49-7·64), pre-eclampsia (OR: 2·8, 95% CI: 1·19-6·78) and TSH ≥ 97·5th percentile (OR 3·3, 95% CI 1·39-7·53) were significantly related to SGA. Maternal FT4 levels and TPO-Ab status were not associated with SGA offspring. CONCLUSIONS Our data show that TSH levels in the upper range of the reference interval at different trimesters (3·0-3·29 mIU/l) are independently related to an increased risk of delivering SGA neonates at term.
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Affiliation(s)
- L Monen
- Department of Obstetrics and Gynaecology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Medical Health Psychology, Tilburg University, Tilburg, The Netherlands
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99
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Davis MA, Macko AR, Steyn LV, Anderson MJ, Limesand SW. Fetal adrenal demedullation lowers circulating norepinephrine and attenuates growth restriction but not reduction of endocrine cell mass in an ovine model of intrauterine growth restriction. Nutrients 2015; 7:500-16. [PMID: 25584967 PMCID: PMC4303851 DOI: 10.3390/nu7010500] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/25/2014] [Indexed: 12/26/2022] Open
Abstract
Placental insufficiency is associated with fetal hypoglycemia, hypoxemia, and elevated plasma norepinephrine (NE) that become increasingly pronounced throughout the third trimester and contribute to intrauterine growth restriction (IUGR). This study evaluated the effect of fetal adrenal demedullation (AD) on growth and pancreatic endocrine cell mass. Placental insufficiency-induced IUGR was created by exposing pregnant ewes to elevated ambient temperatures during mid-gestation. Treatment groups consisted of control and IUGR fetuses with either surgical sham or AD at 98 days gestational age (dGA; term = 147 dGA), a time-point that precedes IUGR. Samples were collected at 134 dGA. IUGR-sham fetuses were hypoxemic, hypoglycemic, and hypoinsulinemic, and values were similar in IUGR-AD fetuses. Plasma NE concentrations were ~5-fold greater in IUGR-sham compared to control-sham, control-AD, and IUGR-AD fetuses. IUGR-sham and IUGR-AD fetuses weighed less than controls. Compared to IUGR-sham fetuses, IUGR-AD fetuses weighed more and asymmetrical organ growth was absent. Pancreatic β-cell mass and α-cell mass were lower in both IUGR-sham and IUGR-AD fetuses compared to controls, however, pancreatic endocrine cell mass relative to fetal mass was lower in IUGR-AD fetuses. These findings indicate that NE, independently of hypoxemia, hypoglycemia and hypoinsulinemia, influence growth and asymmetry of growth but not pancreatic endocrine cell mass in IUGR fetuses.
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Affiliation(s)
- Melissa A Davis
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, AZ 85721, USA.
| | - Antoni R Macko
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, AZ 85721, USA.
| | - Leah V Steyn
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, AZ 85721, USA.
| | - Miranda J Anderson
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, AZ 85721, USA.
| | - Sean W Limesand
- School of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, AZ 85721, USA.
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100
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Makris V, Daniilidis A, Koiou A, Balaouras D, Fotinakis I, Spathopoulou S, Tantanasis T, Dinas K, Loufopoulos A. Microparticles hyperactivity in a case of intrauterine growth restriction. CLIN EXP OBSTET GYN 2015; 42:231-233. [PMID: 26054126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A case of a residual intrauterine fetal growth is described in a primiparous woman, aged 33 years, undergoing the 37th week of pregnancy. The patient was admitted to the outpatient department of the present clinic complaining of decreased fetal movement in the past few days. The cardiotocography (CTG) was non reactive, with reduced variability for a period of more than 30 minutes. The evaluation of the activity of microparticles (MPs) showed a value of 48.90 nM, which was 21.26 times higher than the mean of normal women of comparable pregnancy age (2.31 ± 1.95 nM) and 18.11 times higher than that of the average women who had intrauterine growth retardation (2.70 ± 2.63 nM). The reasons for this increase in the activity of the MPs are discussed in this case report.
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