Impact of asymmetric intrauterine growth restriction on organ function in newborn piglets

Effect of average litter weight in pigs on growth performance, carcass characteristics and meat quality of the offspring as depending on birth weight

Offspring born from normal litter size (10 to 15 piglets) but classified as having lower than average birth weight (average of the sow herd used: 1.46 ± 0.2 kg; mean ± s.d.) carry at birth negative phenotypic traits normally associated with intrauterine growth restriction, such as brain-sparing and impaired myofiber hyperplasia. The objective of the study was to assess long-term effects of intrauterine crowding by comparing postnatal performance, carcass characteristics and pork quality of offspring born from litters with higher (>1.7 kg) or lower (<1.3 kg) than average litter birth weight. From a population of multiparous Swiss Large White sows (parity 2 to 6), 16 litters with high (H = 1.75 kg) or low (L = 1.26 kg) average litter birth weight were selected. At farrowing, two female pigs and two castrated pigs were chosen from each litter: from the H-litters those with the intermediate (HI = 1.79 kg) and lowest (HL = 1.40 kg) birth weight, and from L-litters those with the highest (LH = 1.49 kg) and intermediate (LI = 1.26 kg) birth weight. Average birth weight of the selected HI and LI piglets differed (P < 0.05), whereas birth weight of the HL- and LH-piglets were similar (P > 0.05). These pigs were fattened in group pen and slaughtered at 165 days of age. Pre-weaning performance of the litters and growth performance, carcass and meat quality traits of the selected pigs were assessed. Number of stillborn and pig mortality were greater (P < 0.05) in L- than in H-litters. Consequently, fewer (P < 0.05) piglets were weaned and average litter weaning weight decreased by 38% (P < 0.05). The selected pigs of the L-litters displayed catch-up growth during the starter and grower-finisher periods, leading to similar (P > 0.05) slaughter weight at 165 days of age. However, HL-gilts were more feed efficient and had leaner carcasses than HI-, LH- and LI-pigs (birth weight class × gender interaction P < 0.05). Meat quality traits were mostly similar between groups. The marked between-litter birth weight variation observed in normal size litters had therefore no evident negative impact on growth potential and quality of pigs from the lower birth weight group.

Circulating mRNA for epidermal growth factor-like domain 7 (EGFL7) in maternal blood and early intrauterine growth restriction. A preliminary analysis

OBJECTIVE

To evaluate the alteration in epidermal growth factor-like domain 7 (EGFL7) mRNA expression in maternal blood from pregnancies affected by early-onset intrauterine growth restriction (IUGR) at 20-24 weeks.

METHOD

Case-control study encompassing six women with pregnancies affected by IUGR (cases) matched in a 1 : 7 ratio for gestational age and fetal gender with 42 controls. We quantified EGFL7 mRNA expression in normal and IUGR patients. Matched rank-sum analysis and multiples of median were used to evaluate differences of the marker of interest between cases and controls. Spearman regression analysis was used to correlate the estimated fetal weight at blood sampling with the EGFL7 mRNA values.

RESULTS

The mean observed rank in the IUGR group was significantly higher than that of controls (6.67 vs 4.19, p = 0.01). Pregnancies affected with IUGR exhibited 1.70-fold higher levels of maternal EGFL7 mRNA compared with matched controls (p = 0.014). EGFL7 mRNA values were inversely correlated with estimated fetal weight (Spearman's ρ = -0.429, p = 0.198).

CONCLUSION

Early IUGR at 20-24 weeks' gestation is associated with higher values of EGFL7 expression in maternal plasma.

In utero programming of later adiposity: the role of fetal growth restriction

Intrauterine growth restriction (IUGR) is strongly associated with obesity in adult life. The mechanisms contributing to the onset of IUGR-associated adult obesity have been studied in animal models and humans, where changes in fetal adipose tissue development, hormone levels and epigenome have been identified as principal areas of alteration leading to later life obesity. Following an adverse in utero development, IUGR fetuses display increased lipogenic and adipogenic capacity in adipocytes, hypoleptinemia, altered glucocorticoid signalling, and chromatin remodelling, which subsequently all contribute to an increased later life obesity risk. Data suggest that many of these changes result from an enhanced activity of the adipose master transcription factor regulator, peroxisome proliferator-activated receptor-γ (PPARγ) and its coregulators, increased lipogenic fatty acid synthase (FAS) expression and activity, and upregulation of glycolysis in fetal adipose tissue. Increased expression of fetal hypothalamic neuropeptide Y (NPY), altered hypothalamic leptin receptor expression and partitioning, reduced adipose noradrenergic sympathetic innervations, enhanced adipose glucocorticoid action, and modifications in methylation status in the promoter of hepatic and adipose adipogenic and lipogenic genes in the fetus also contribute to obesity following IUGR. Therefore, interventions that inhibit these fetal developmental changes will be beneficial for modulation of adult body fat accumulation.

Intrauterine crowding impairs formation and growth of secondary myofibers in pigs

There are indications that intrauterine crowding may cause intrauterine growth retardation with the possibility of an impaired myofiber hyperplasia. The aim of the study was to confirm this by generating large differences in uterine space using sows that were unilaterally hysterectomized-ovariectomized (HO; crowded) or unilaterally oviduct ligated (OL; non-crowded). In the study, seven HO and seven OL Swiss Large White third parity sows were used. At farrowing, litter size and litter birth weight were determined. Subsequently, within each litter two male and two female progenies each with the respectively lowest (L) and highest (H) birth weight were sacrificed. Internal organs and brain were weighed, and longissimus (LM) and semitendinosus muscle (SM) samples were collected. Histological analyses were performed in both muscles using mATPase staining after preincubation at pH 4.3 and 10.2. Myosin heavy chain (MyHC) polymorphism was determined in the LM by means of SDS-PAGE. The number of piglets born alive was similar in both sow groups, but litter size expressed per uterine horn was lower (P < 0.05) in OL than HO sows. Consequently, OL progeny were markedly heavier (P < 0.01). Regardless of gender, the organs, the brain and the SM were heavier (P < 0.001) in OL and H compared with HO and L offspring, respectively. Compared with HO pigs, the SM of OL offspring tended (P < 0.1) to have more myofibers, which were of larger (P < 0.05) size. However, myofiber density appeared to be lower (P < 0.1) in the SM of OL than HO pigs. The impact of birth weight on myofiber characteristics was limited to the lower (P < 0.05) myofiber density in the SM and the larger (P < 0.01) myofiber size in the light portion of the SM of H than L offspring, whereas myofiber hyperplasia did not differ between birth weight categories. The SM, but not the LM, of male offspring had a greater (P < 0.05) myofiber density. This did not affect total SM myofiber number. The relative abundance of fetal and type I MyHC in the LM was lower (P < 0.05) and that of type II MyHC was greater (P < 0.001) in OL than HO pigs. The current data suggest that regardless of birth weight and gender, in the LM and SM of individuals born from a crowded environment, not only hyperplasia but also hypertrophy of myofibers is impaired and their maturity seems delayed.

Gender-specific early postnatal catch-up growth after intrauterine growth retardation by food restriction in swine with obesity/leptin resistance

The effects of undernutrition during pregnancy on prenatal and postnatal development of the offspring were evaluated in sows with obesity/leptin resistance. Females were fed, from day 35 of pregnancy onwards, a diet fulfilling either 100% (group control,n=10) or 50% of the nutritional requirements (group underfed,n=10). In the control group, maternal body weight increased during pregnancy (P<0.05) while it decreased or remained steady in the underfed group. At days 75 and 100 of gestation, plasma triglycerides were lower but urea levels were higher in restricted than in control sows (P<0.05 for both). Assessment of the offspring indicated that the trunk diameter was always smaller in the restricted group (P<0.01 at day 50,P<0.005 at days 75 and 100 andP<0.0001 at birth) while head measurements were similar through pregnancy, although smaller in the restricted than in the control group at birth (P<0.05). Newborns from restricted sows were also lighter than offspring from control females (P<0.01) and had higher incidence of growth retardation (P<0.01). Afterwards, during lactation, early postnatal growth in restricted piglets was modulated by gender. At weaning, males from restricted sows were still lighter than their control counterparts (P<0.05), while females from control and underfed sows were similar. Thus, the current study indicates a gender-related differential effect in the growth patterns of the piglets, with females from restricted sows evidencing catch-up growth to neutralise prenatal retardation and reaching similar development than control counterparts.

Isoflurane/nitrous oxide anesthesia and stress-induced procedures enhance neuroapoptosis in intrauterine growth-restricted piglets

PURPOSE

There is compelling evidence that interference of various anesthetics with synaptic functions and stress-provoking procedures during critical periods of brain maturation results in increased neuroapoptotic cell death. The hypothesis is that adverse intrauterine environmental conditions leading to intrauterine growth restriction (IUGR) with altered brain development may result in enhanced susceptibility to developmental anesthetic neurotoxicity.

METHODS

This was a prospective, randomized, blinded animal study performed in a university laboratory involving 20 normal-weight (NW) and 19 IUGR newborn piglets. General inhalation anesthesia with isoflurane and nitrous oxide at clinically comparable dosages were administered for about 10 h. Surgical and monitoring procedures were accompanied by appropriate stage of general anesthesia. Resulting effects on developmental anesthetic and stress-induced neurotoxicity were assessed by estimation of apoptotic rates in untreated piglets and piglets after 10-h general anesthesia with MAC 1.0 isoflurane in 70 % nitrous oxide and 30 % oxygen.

RESULTS

IUGR piglets exposed to different levels of isoflurane inhalation exhibited a significant increased apoptosis rate (TUNEL-positive neuronal cells) compared to NW animals of similar condition (P < 0.05). Cardiovascular and metabolic monitorings revealed similar effects of general anesthesia together with similar effects on brain electrical activity and broadly a similar dose-dependent gradual restriction in brain oxidative metabolism in NW and IUGR piglets.

CONCLUSIONS

There is no indication that the increased rate in neuroapoptosis in IUGR piglets is confounded by additional adverse systemic or organ-specific impairments resulting from administered mixed inhalation anesthesia. Developmental anesthetic and stress-induced neuroapoptosis presumably originated in response to fetal adaptations to adverse conditions during prenatal life and should be considered in clinical interventions on infants having suffered from fetal growth restriction.

Long term respiratory consequences of intrauterine growth restriction

Epidemiological studies demonstrate that in-utero growth restriction and low birth weight are associated with impaired lung function and increased respiratory morbidity from infancy, throughout childhood and into adulthood. Chronic restriction of nutrients and/or oxygen during late pregnancy causes abnormalities in the airways and lungs of offspring, including smaller numbers of enlarged alveoli with thicker septal walls and basement membranes. The structural abnormalities and impaired lung function seen soon after birth persist or even progress with age. These changes are likely to cause lung symptomology through life and hasten lung aging.

Accelerated growth rate induced by neonatal high-protein milk formula is not supported by increased tissue protein synthesis in low-birth-weight piglets

Low-birth-weight neonates are routinely fed a high-protein formula to promote catch-up growth and antibiotics are usually associated to prevent infection. Yet the effects of such practices on tissue protein metabolism are unknown. Baby pigs were fed from age 2 to 7 or 28 d with high protein formula with or without amoxicillin supplementation, in parallel with normal protein formula, to determine tissue protein metabolism modifications. Feeding high protein formula increased growth rate between 2 and 28 days of age when antibiotic was administered early in the first week of life. This could be explained by the occurrence of diarrhea when piglets were fed the high protein formula alone. Higher growth rate was associated with higher feed conversion and reduced protein synthesis rate in the small intestine, muscle and carcass, whereas proteolytic enzyme activities measured in these tissues were unchanged. In conclusion, accelerated growth rate caused by high protein formula and antibiotics was not supported by increased protein synthesis in muscle and carcass.

Low birth weight is associated with reduced nephron number and increased blood pressure in adulthood in a novel spontaneous intrauterine growth-restricted model in Yucatan miniature Swine

BACKGROUND

Impaired fetal growth and rapid postnatal growth are associated with programming of hypertension and metabolic syndrome in adulthood.

OBJECTIVES

This study evaluated this phenomenon in a novel spontaneous intrauterine growth-restricted (IUGR) model in Yucatan miniature pigs.

METHODS

IUGR piglets (n = 6, 3 days old, 0.73 ± 0.11 kg) were paired with a normal weight (NW) same-sex littermate (n = 6, 1.11 ± 0.13 kg), fed milk replacer for 4 weeks followed by a standard diet ad libitum for 5 h/day. At 9 months of age, arterial blood pressure (BP) telemeters were implanted to assess BP before (0.5% NaCl) and after (4.5% NaCl) a 7-day salt-loading period. At 10 months of age, nephron numbers were determined.

RESULTS

Prior to sexual maturity, IUGR pigs showed greater (p < 0.05) relative feed intake and experienced significant catch-up growth. Adult IUGR pigs also had higher BP (diastolic BP: 93.8 ± 5.5 vs. 90.0 ± 8.7 mm Hg, p < 0.05) and 43% fewer nephrons per kidney (p < 0.05). Nephron number was positively associated with birth weight and negatively correlated with BP (p < 0.05). Acute salt loading increased BP in both groups (p < 0.05); however, the degree of salt sensitivity was similar between groups (p > 0.05).

CONCLUSIONS

In conclusion, IUGR piglets have reduced nephron endowment associated with a modest BP increase in early adulthood. This new model can be used to conduct longitudinal mechanistic studies on the early programming phenomenon.

Aetiology and pathogenesis of IUGR

Intrauterine growth restriction (IUGR) is a major cause of perinatal mortality and morbidity. A complex and dynamic interaction of maternal, placental and fetal environment is involved in ensuring normal fetal growth. An imbalance or lack of coordination in this complex system may lead to IUGR. Animal studies have given us an insight into some aspects of the basic pathophysiology of IUGR, and recent technologies such as Doppler studies of maternal and fetal vessels have added further information. The aetiologies of IUGR are diverse, involving multiple complex mechanisms, which make understanding of the pathophysiology difficult. However, particular focus is placed on the mechanisms involved in uteroplacental insufficiency as a cause of IUGR, as (1) it is common, (2) outcome can be good if timing of delivery is optimal and (3) it may be amenable to therapy in the future. While the research into the pathophysiology of IUGR continues, there have been interesting discoveries related to the genetic contribution to IUGR and the intrauterine programming of adult-onset diseases attributed to IUGR.

Gestational programming of offspring obesity/hypertension

The intrauterine milieu impacts fetal growth directly during gestation. It is now clear, however, that postnatal phenotype is also influenced by prenatal conditions. A variety of disorders in the adult have been linked to fetal size at birth; these include glucose intolerance, cardiovascular disease, and the subjects of this review, obesity and hypertension. We will review recent data regarding these associations and the pathophysiologic mechanisms underlying them in humans as well as in animal models.

Perfil de natimortalidade de acordo com ordem de nascimento, peso e sexo de leitões

Foram acompanhados 575 partos para avaliar a influência da ordem de nascimento, do sexo e do peso dos leitões na ocorrência de natimortos. Dos 7061 leitões, 90,2%, 6,0% e 3,8% nasceram vivos, natimortos ou mumificados, respectivamente. O percentual de partos com natimortos foi 44,5%. Partos com dois ou mais natimortos foram responsáveis por 63,1% das perdas por natimortalidade, embora tenham sido responsáveis por 17,2% das leitegadas. O percentual de natimortos aumentou com a ordem de nascimento; a maior taxa de natimortos, 21,7%, ocorreu a partir da 14ª ordem. A taxa de natimortalidade foi de 3,6% e 10,1% nos leitões de primeira a nona e de 10ª a 13ª ordem, respectivamente. Em leitões com até 500g a taxa de natimortos foi de 52,1%, mais alta que a de leitões mais pesados. Em leitões com 501 a 1200g foi de 10,1%, maior que entre os com mais de 1200g (4,0%). Não houve efeito de sexo dos leitões na ocorrência de natimortos, que foi de 6,2% e 5,8% para machos e fêmeas, respectivamente. A natimortalidade é maior entre os leitões com baixo peso ou com ordem de nascimento elevada.

Briana D, Baka S, Vraila VM, Kontara L, Hassiakos D, Malamitsi-Puchner A. Perinatal changes of cardiac troponin-I in normal and intrauterine growth-restricted pregnancies

Intrauterine growth restriction (IUGR) implies fetal hypoxia, resulting in blood flow redistribution and sparing of vital organs (brain, heart). Serum cardiac Troponin-I (cTnI), a well-established marker of myocardial ischaemia, was measured in 40 mothers prior to delivery, the doubly clamped umbilical cords (representing fetal state), and their 20 IUGR and 20 appropriate-forgestational-age (AGA) neonates on day 1 and 4 postpartum. At all time points, no differences in cTnI levels were observed between the AGA and IUGR groups. Strong positive correlations were documented between maternal and fetal/neonatal values (r ≥ .498, P ≤ .025 in all cases in the AGA and r ≥ .615, P ≤ .009 in all cases in the IUGR group). These results may indicate (a) normal heart function, due to heart sparing, in the IUGR group (b) potential crossing of the placental barrier by cTnI in both groups.

Cord blood ischemia-modified albumin levels in normal and intrauterine growth restricted pregnancies

Ischemia-modified albumin (IMA) is a sensitive biomarker of cardiac ischemia. Intrauterine growth restriction (IUGR) may imply fetal hypoxia, resulting in blood flow centralization in favour of vital organs (brain, heart, adrenals—“brain sparing effect”). Based on the latter, we hypothesized that cord blood IMA levels should not differ between IUGR and appropriate-for-gestational-age (AGA) full-term pregnancies. IMA was measured in blood samples from doubly-clamped umbilical cords of 110 AGA and 57 asymmetric IUGR pregnancies. No significant differences in IMA levels were documented between AGA and IUGR groups. IMA levels were elevated in cases of elective cesarean section (P = .035), and offspring of multigravidas (P = .021). In conclusion, “brain sparing effect” is possibly responsible for the lack of differences in cord blood IMA levels at term, between IUGR and AGA groups. Furthermore, higher oxidative stress could account for the elevated IMA levels in cases of elective cesarean section, and offspring of multigravidas.

Perinatal changes of circulating N-terminal pro B-type natriuretic peptide (NT-proBNP) in normal and intrauterine-growth-restricted pregnancies

OBJECTIVE

To investigate changes in NT-proBNP in intrauterine-growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) pregnancies.

METHODS

NT-proBNP levels were measured in 40 mothers (MS), umbilical cords (UC), and their 20 IUGR/ 20 AGA neonates on day 1 (N1) and day 4 (N4).

RESULTS

UC, N1, and N4 NT-proBNP was lower in IUGR pregnancies (p <or= 0.049). In both groups, NT-proBNP levels were similar in MS and higher in N1 (p <or= 0.001). In AGA, MS NT-proBNP correlated positively with UC.

CONCLUSIONS

Fetal and neonatal NT-proBNP levels are lower in IUGR compared with AGA, probably due to blood flow redistribution in IUGR and NT-proBNP placental transport in AGA. NT-proBNP levels peak on N1.

Renal Angiotensin receptor type 1 and 2 upregulation in intrauterine growth restriction of newborn piglets

Epidemiological and experimental studies suggest that intrauterine growth restriction (IUGR) is associated with abnormalities in kidney development which is thought to be linked with alterations causing adult cardiovascular diseases. The renin-angiotensin system (RAS) plays an important role in the development of renal vascular and tubular structures, and is known to be altered by experimentally induced IUGR. These experimental models of IGUR have been criticized because they may have a more severe impact on intrauterine development than that which is normally encountered in humans. Therefore, we asked whether naturally occurring small-for-gestational-age newborn piglets exhibit features of altered RAS activity. We investigated the regional renal expression of angiotensin II type 1 (AT1) and AT2 receptors in normal-weight and IUGR piglets. The AT1 receptor mRNA expression was markedly enhanced in IUGR piglets, in the renal cortex by 64% and in the renal medulla by 52% (p < 0.05, compared with normal littermates). In contrast, mRNA expression for the AT2 receptor was similar in both the normal-weight and IUGR piglets. A significantly higher AT1 receptor protein expression was found in the IUGR piglets (p < 0.05) in the glomeruli, in the proximal and distal tubules, as well as in the collecting ducts by immunohistochemistry. Furthermore, AT2 receptor protein expression was significantly higher in the IUGR piglets (p < 0.05) in the subcapsular nephrogenic zone and in the distal tubules and collecting ducts. Thus, IUGR is accompanied by an upregulation of angiotensin II receptor expression in the kidneys of newborn piglets. This may indicate an alteration of the RAS in newborns suffering from naturally occurring IUGR.

Growth patterns of the heart and kidney suggest inter-organ collaboration in facultative fetal growth

Maternal smoking during pregnancy has been associated with a number of negative sequelae among offspring, including elevated postnatal blood pressure. While animal studies have described organ level alterations with smoke exposure, human data have been more limited. Thirty-four healthy maternal/fetal pairs (24 nonsmokers, 10 smokers) participated in a longitudinal growth study from the thirteenth week of pregnancy to document fetal kidney and heart growth trajectories and morphology. Curve fitting followed by a mixed model for repeated measures identified significantly different growth patterns in kidney width, thickness, length, and volume growth with exposure: the smoke-exposed fetal kidney was wide and thick compared to the unexposed kidney during the second and early third trimester, declining to proportionately thin kidneys for length and width subsequently. Cardiac growth in width and volume followed a reverse pattern: a surge in cardiac volume occurred after 30 weeks with acceleration in cardiac width, resulting in a heart that was wide for length and for fetal weight. Smoke exposure altered fetal growth in size and timing of the heart and kidneys during midgestation, with changes in organ morphology suggesting compensatory growth. These are the first data providing anatomical evidence of altered renal/cardiac volume relationships that may provide a mechanism to previously reported sequelae of in utero smoke exposure. They suggest that cell-level adaptive responses to hypoxia and/or chemical insults are operative and illustrate the importance of longitudinal ultrasound to directly assess the organ-level growth response of the human fetus to a prenatal stress, in lieu of relying on birth outcome measures.