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Tian Y, Inocencio IM, Sehgal A, Wong FY. Impact of Kangaroo mother care on autonomic cardiovascular control in foetal-growth-restricted preterm infants. Pediatr Res 2024:10.1038/s41390-024-03555-z. [PMID: 39242939 DOI: 10.1038/s41390-024-03555-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/25/2024] [Accepted: 08/27/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Kangaroo mother care (KMC) is WHO-recommended for low-birth-weight infants, yet its impact on autonomic cardiovascular control in preterm foetal growth-restricted (FGR) infants remains unclear. We hypothesised that KMC would promote autonomic cardiovascular control, benefiting preterm FGR infants with reduced baseline autonomic function compared to appropriate for gestational age (AGA) infants. METHODS Autonomic control was assessed via heart rate variability (HRV) in low frequency (LF) and high frequency (HF) bands using spectral analysis. Preterm FGR (n = 22) and AGA (n = 20) infants were assessed for 30-min before and 60-min during KMC. Comparisons were made between FGR and AGA infants; and between infants with baseline HRV below and above median. RESULTS Overall, no significant HRV changes were observed during KMC for FGR or AGA infants compared to baselines. Infants with low baseline HRV LF showed increased HRV during KMC (p = 0.02 and 0.05 for the entire group and FGR group, respectively). This effect was absent in the AGA group regardless of baseline HRV. Infants with high baseline HRV had decreased HRV during KMC. CONCLUSIONS Infants with low baseline HRV, suggesting reduced autonomic control, are more likely to benefit from KMC with increased HRV. Further, this effect is stronger in FGR than AGA infants. IMPACT Kangaroo mother care (KMC) is WHO-recommended for low-birth-weight infants, yet its impact on autonomic cardiovascular control in preterm foetal growth-restricted (FGR) infants is unclear. Preterm infants with low baseline heart rate variability (HRV) are more likely to benefit from KMC and increase their HRV suggesting improved autonomic control. This effect is stronger in preterm FGR infants than those with appropriate growth for age.
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Affiliation(s)
- Yueyang Tian
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Ishmael M Inocencio
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Arvind Sehgal
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
- Monash Newborn, Monash Children's Hospital, Melbourne, VIC, Australia
| | - Flora Y Wong
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia.
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
- Monash Newborn, Monash Children's Hospital, Melbourne, VIC, Australia.
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Barrientos G, Schuman ML, Landa MS, Robello E, Incardona C, Conrad ML, Galleano M, García SI. Therapeutic Effect of Alpha Lipoic Acid in a Rat Preclinical Model of Preeclampsia: Focus on Maternal Signs, Fetal Growth and Placental Function. Antioxidants (Basel) 2024; 13:730. [PMID: 38929169 PMCID: PMC11200649 DOI: 10.3390/antiox13060730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Chronic hypertension is a major risk factor for preeclampsia (PE), associated with significant maternal and neonatal morbidity. We previously demonstrated that pregnant stroke-prone spontaneously hypertensive rats (SHRSP) display a spontaneous PE-like phenotype with distinct placental, fetal, and maternal features. Here, we hypothesized that supplementation with alpha lipoic acid (ALA), a potent antioxidant, during early pregnancy could ameliorate the PE phenotype in this model. To test this hypothesis, timed pregnancies were established using 10 to 12-week-old SHRSP females (n = 19-16/group), which were assigned to two treatment groups: ALA (injected intraperitoneally with 25 mg/kg body weight ALA on gestation day (GD1, GD8, and GD12) or control, receiving saline following the same protocol. Our analysis of maternal signs showed that ALA prevented the pregnancy-dependent maternal blood pressure rise (GD14 blood pressure control 169.3 ± 19.4 mmHg vs. 146.1 ± 13.4 mmHg, p = 0.0001) and ameliorated renal function, as noted by the increased creatinine clearance and improved glomerular histology in treated dams. Treatment also improved the fetal growth restriction (FGR) phenotype, leading to increased fetal weights (ALA 2.19 ± 0.5 g vs. control 1.98 ± 0.3 g, p = 0.0074) and decreased cephalization indexes, indicating a more symmetric fetal growth pattern. This was associated with improved placental efficiency, decreased oxidative stress marker expression on GD14, and serum soluble fms-like tyrosine kinase 1 (sFlt1) levels on GD20. In conclusion, ALA supplementation mitigated maternal signs and improved placental function and fetal growth in SHRSP pregnancies, emerging as a promising therapy in pregnancies at high risk for PE.
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Affiliation(s)
- Gabriela Barrientos
- Laboratorio de Medicina Experimental, Hospital Alemán, Ciudad Autónoma de Buenos Aires C1118AAT, Argentina;
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires C1118AAT, Argentina
| | - Mariano L. Schuman
- Facultad de Medicina, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1053ABH, Argentina; (M.L.S.); (M.S.L.)
- Departamento de Cardiología Molecular, Instituto de Investigaciones Médicas (IDIM), UBA-CONICET, Ciudad Autónoma de Buenos Aires C1427ARN, Argentina
| | - Maria S. Landa
- Facultad de Medicina, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1053ABH, Argentina; (M.L.S.); (M.S.L.)
- Departamento de Cardiología Molecular, Instituto de Investigaciones Médicas (IDIM), UBA-CONICET, Ciudad Autónoma de Buenos Aires C1427ARN, Argentina
| | - Elizabeth Robello
- Facultad de Farmacia y Bioquímica, Cátedra de Fisicoquímica, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1053ABH, Argentina; (E.R.); (M.G.)
- Instituto de Bioquímica y Medicina Molecular-Dr. Alberto Boveris (IBIMOL), UBA-CONICET, Ciudad Autónoma de Buenos Aires C1113AAD, Argentina
| | - Claudio Incardona
- Fundación GADOR, Ciudad Autónoma de Buenos Aires C1414CUI, Argentina;
| | - Melanie L. Conrad
- Institute of Microbiology, Infectious Diseases and Immunology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 12203 Berlin, Germany;
| | - Monica Galleano
- Facultad de Farmacia y Bioquímica, Cátedra de Fisicoquímica, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1053ABH, Argentina; (E.R.); (M.G.)
- Instituto de Bioquímica y Medicina Molecular-Dr. Alberto Boveris (IBIMOL), UBA-CONICET, Ciudad Autónoma de Buenos Aires C1113AAD, Argentina
| | - Silvia I. García
- Laboratorio de Medicina Experimental, Hospital Alemán, Ciudad Autónoma de Buenos Aires C1118AAT, Argentina;
- Facultad de Medicina, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1053ABH, Argentina; (M.L.S.); (M.S.L.)
- Departamento de Cardiología Molecular, Instituto de Investigaciones Médicas (IDIM), UBA-CONICET, Ciudad Autónoma de Buenos Aires C1427ARN, Argentina
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Kim MJ, Hutcheon JA, Lee AF, Liauw J. Autopsy-Based Growth Charts May under-Detect Fetal Growth Restriction at Autopsy. Fetal Pediatr Pathol 2024; 43:198-207. [PMID: 38186330 DOI: 10.1080/15513815.2023.2299491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
Background: Accurate identification of fetal growth restriction in fetal autopsy is critical for assessing causes of death. We examined the impact of using a chart derived from ultrasound measurements of healthy fetuses (World Health Organization fetal growth chart) versus a chart commonly used by pathologists (Archie et al.) derived from fetal autopsy-based populations in diagnosing small-for-gestational-age (SGA) birth in perinatal deaths. Study Design: We examined perinatal deaths that underwent autopsy at BC Women's Hospital, 2015-2021. Weight centiles were assigned using the ultrasound-based fetal growth chart for birthweight and autopsy-based growth chart for autopsy weight. Results: Among 352 fetuses, 30% were SGA based on the ultrasound-based fetal growth chart versus 17% using the autopsy-based growth chart (p < 0.001). Weight centiles were lower when using the ultrasound-based versus autopsy-based growth chart (median difference of 9 centiles [IQR 2, 20]). Conclusions: Autopsy-based growth charts may under-classify SGA status compared to ultrasound-based fetal growth charts.
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Affiliation(s)
- Min Jung Kim
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jennifer A Hutcheon
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Anna F Lee
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Jessica Liauw
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
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Emmer R, Ajne G, Papadogiannakis N. Missed abortion in the 11-21-week period: Fetal autopsy and placental histopathological analysis of 794 cases. Eur J Obstet Gynecol Reprod Biol 2024; 296:158-162. [PMID: 38442533 DOI: 10.1016/j.ejogrb.2024.02.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Missed abortion (MA) is a type of miscarriage with multiple etiological factors that refers to fetal death with a failure of the retained intrauterine product of conception to be discharged spontaneously. Currently fetal death in missed abortion is categorized according to three main causes: Fetal, placental, and maternal factors. The aim of the current study was to contribute and increase knowledge in clinical practice of late first and second trimester MA (Gestational age: week 11 + 0 - week 20 + 6). MATERIAL AND METHODS This retrospective case series study includes 794 cases of fetuses and matching placentas sent to the Section of Perinatal Pathology, Department of Pathology, Karolinska Hospital between 2003 and 2019 from five different gynecology departments in the Stockholm region, Sweden. RESULTS The cases were divided into two groups according to gestational length; gestational week 11 + 0-14 + 6 (group A) and 15 + 0-20 + 6 (group B) respectively, and comparisons were made between groups. Fetal growth restriction and placental pathology were more common in late MA, but number of cases with malformation were higher in early MA. Cord pathology was seen in approximately 40 % of the cases and equally distributed in the gestational weeks included. DISCUSSION Fetal growth restriction and placental pathology were more common in late second trimester MA. This might demonstrate an early placental dysfunction affecting fetal growth and may be associated to maternal comorbidity such as autoimmune disease and cardiovascular disease. It is advisable to investigate maternal factors more closely after late second trimester MA before a future pregnancy. The risk for recurrent MA is believed to be low in cases of significant cord pathology. CONCLUSION Cord complications were over-represented in missed abortion suggesting a probable etiopathogenetic link to fetal demise in this condition.
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Affiliation(s)
- Rony Emmer
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Gunilla Ajne
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden; Div of Obstet and Gyn, Dep of Clinical Science and Intervention, Karolinska Institute, Stockholm, Sweden
| | - Nikos Papadogiannakis
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, Stockholm, Sweden; Department of Pathology, Karolinska University Hospital, Stockholm, Sweden.
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Chu TW, Shannon P, Parks T. Skeletal Growth Arrest Lines in Fetal Remains: Histopathology and Correlative Placental Pathology. Pediatr Dev Pathol 2024; 27:23-31. [PMID: 37818682 DOI: 10.1177/10935266231195750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Skeletal growth arrest lines (GAL) are transverse lines of metaphyseal radiodensity accompanying episodic severe physiological stress. They are poorly described in fetal remains. MATERIALS AND METHODS We searched our autopsy practice for instances of fetal GAL in post mortem radiology, and correlated them with long bone histology and placental pathology. We describe the appearance, distribution, and pathology of GAL in a cohort of fetal autopsies, and compare the placental pathology accompanying GAL to the placental pathology of asymmetrical growth restriction (AGR) in the same time period. RESULTS In 2108 consecutive fetal post mortems, we found 20 cases with GAL. About 16 were in singletons with AGR. In these 16, the distribution of placental pathologies was similar to a contemporaneous cohort of 113 cases with AGR. Of the remaining 4, two twins out of 9 sets of monochorionic twins with AGR demonstrated GAL. One case of GAL had symmetrical growth restriction with cytomegalovirus infection, and one case had no AGR and an old, unexplained retroplacental hemorrhage. On histology, GAL are characterized by a region of mineralized chondroid, which is variably incorporated into irregular trabecular bone. DISCUSSION GALs accompany a variety of placental pathologies and twin-twin transfusion, suggesting episodic disease progression.
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Affiliation(s)
- Tsz Wing Chu
- Mount Sinai Hospital, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Patrick Shannon
- Mount Sinai Hospital, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Tony Parks
- Mount Sinai Hospital, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
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Ho SY, Yuliana ME, Chou HC, Chen CM. Intrauterine growth restriction alters kidney metabolism at the end of nephrogenesis. Nutr Metab (Lond) 2023; 20:50. [PMID: 37990266 PMCID: PMC10664663 DOI: 10.1186/s12986-023-00769-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND This study investigated the effect of uteroplacental insufficiency (UPI) on renal development by detecting metabolic alterations in the kidneys of rats with intrauterine growth restriction (IUGR). METHODS On gestational day 17, pregnant Sprague Dawley rats were selected and allocated randomly to either the IUGR group or the control group. The IUGR group received a protocol involving the closure of bilateral uterine vessels, while the control group underwent a sham surgery. The rat pups were delivered on gestational day 22 by natural means. Pups were randomly recruited from both the control and IUGR groups on the seventh day after birth. The kidneys were surgically removed to conduct Western blot and metabolomic analyses. RESULTS IUGR was produced by UPI, as evidenced by the significantly lower body weights of the pups with IUGR compared to the control pups on postnatal day 7. UPI significantly increased the levels of cleaved caspase-3 (p < 0.05) and BAX/Bcl-2 (p < 0.01) in the pups with IUGR. Ten metabolites exhibited statistically significant differences between the groups (q < 0.05). Metabolic pathway enrichment analysis demonstrated statistically significant variations between the groups in the metabolism related to fructose and mannose, amino and nucleotide sugars, and inositol phosphate. CONCLUSIONS UPI alters kidney metabolism in growth-restricted newborn rats and induces renal apoptosis. The results of our study have the potential to provide new insights into biomarkers and metabolic pathways that are involved in the kidney changes generated by IUGR.
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Affiliation(s)
- Sheng-Yuan Ho
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Merryl Esther Yuliana
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia
| | - Hsiu-Chu Chou
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chung-Ming Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.
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Xu P, Guo J, Jin Y, Lee SC, Li Z, Kong L, Liu M, Niu X, Liu Y, Bai G, Ren L, Ren B, Fan L, Zhao M, Wang L. Toxic effects of maternal cadmium exposure on the metabolism and transport system of amino acids in the maternal livers. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 254:114726. [PMID: 36898312 DOI: 10.1016/j.ecoenv.2023.114726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/26/2022] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Fetal growth restriction (FGR) is one of the most common obstetric diseases, and affects approximately 10 % of all pregnancies worldwide. Maternal cadmium (Cd) exposure is one of the factors that may increase the risk of the development of FGR. However, its underlying mechanisms remain largely unknown. In this study, using Cd-treated mice as an experimental model, we analyzed the levels of some nutrients in the circulation and the fetal livers by biochemical assays; the expression patterns of several key genes involved in the nutrient uptake and transport, and the metabolic changes in the maternal livers were also examined by quantitative real-time PCR and gas chromatography-time of flight-mass spectrometry method. Our results showed that, the Cd treatment specifically reduced the levels of total amino acids in the peripheral circulation and the fetal livers. Concomitantly, Cd upregulated the expressions of three amino acid transport genes (SNAT4, SNAT7 and ASCT1) in the maternal livers. The metabolic profiling of maternal livers also revealed that, several amino acids and their derivatives were also increased in response to the Cd treatment. Further bioinformatics analysis indicated that the experimental treatment activated the metabolic pathways, including the alanine, aspartate and glutamate metabolism, valine, leucine and isoleucine biosynthesis, arginine and proline metabolism. These findings suggest that maternal Cd exposure activate the amino acid metabolism and increase the amino acid uptake in the maternal liver, which reduces the supply of amino acids to the fetus via the circulation. We suspect that this underlies the Cd-evoked FGR.
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Affiliation(s)
- Peng Xu
- School of Life Science, Shanxi University, Taiyuan 030006, China; Lvliang Comprehensive Test Center, Lvliang 033000, China.
| | - Jing Guo
- School of Life Science, Shanxi University, Taiyuan 030006, China
| | - Yaling Jin
- School of Life Science, Shanxi University, Taiyuan 030006, China
| | - Shao Chin Lee
- School of Life Sciences, Jiangsu Normal University, Xuzhou 221116, China
| | - Zhilang Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lingyu Kong
- School of Life Science, Shanxi University, Taiyuan 030006, China
| | - Ming Liu
- University of Chinese Academy of Sciences, Beijing 100049, China; State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Xiaomin Niu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yun Liu
- Department of Oncology, Fudan University Pudong Medical Center, Shanghai 201300, China
| | - Guoqiang Bai
- Lvliang Comprehensive Test Center, Lvliang 033000, China
| | - Lu Ren
- The Eleventh Clinical College of Shanxi Medical University, Lvliang People's Hospital, Lvliang 033000, China
| | - Bei Ren
- Institute of Drug Testing Technology, Shanxi Provincial Inspection and Testing Center, Taiyuan 030001, China
| | - Linxiao Fan
- Shanxi Provincial People's Hospital, Taiyuan 030012, China
| | - Meirong Zhao
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou 310014, China
| | - Lan Wang
- School of Life Science, Shanxi University, Taiyuan 030006, China.
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Takeno MA, Nomura RMY. Fetal thymus in growth-restricted fetuses due to placental insufficiency. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:136-141. [PMID: 36629653 PMCID: PMC9937593 DOI: 10.1590/1806-9282.20220975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to assess fetal thymus size by ultrasound in growth-restricted fetuses due to placental insufficiency and compare to high-risk and low-risk pregnancy fetuses with normal placental function. METHODS This is a nested case-control study of pregnant women followed up at a university hospital (July 2012 to July 2013). In all, 30 pregnant women presenting small fetuses for gestational age (estimated fetal weight <p10) due to placental insufficiency (umbilical artery Doppler >p95) were compared to 30 high-risk and 30 low-risk pregnancies presenting normal Doppler indices. The thymus transverse diameter and perimeter were converted into zeta score according to the normal values for gestational age. Head circumference and femur length were used to calculate ratios. RESULTS Fetal thymus were significantly lower in pregnancies with placental insufficiency when compared to high-risk and low-risk pregnancies presenting, respectively, transverse diameter zeta score (-0.69±0.83 vs. 0.49±1.13 vs. 0.83±0.85, p<0.001) and P zeta score (-0.73±0.68 vs. 0.45±0.96 vs. 0.26±0.89, p<0.001). There was also a significant difference (p<0.05) in the ratios among the groups: pregnancies with placental insufficiency (TD/HC=0.10, P/FL=1.32, and P/HC=0.26), high-risk pregnancies (TD/HC=0.11, P/FL=1.40, and P/HC=0.30), and control group (DT/HC=0.11, P/FL=1.45, and P/HC=0.31). CONCLUSION Fetal thymus size is reduced in growth-restricted fetuses due to placental insufficiency, suggesting fetal response as a consequence of the adverse environment.
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Affiliation(s)
- Marisa Akemi Takeno
- Universidade de São Paulo, Faculty of Medicine, Department of Obstetrics and Gynecology – São Paulo (SP), Brazil
| | - Roseli Mieko Yamamoto Nomura
- Universidade de São Paulo, Faculty of Medicine, Department of Obstetrics and Gynecology – São Paulo (SP), Brazil.,Corresponding author:
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Cobham AE, Neumann B, Mirth CK. Maintaining robust size across environmental conditions through plastic brain growth dynamics. Open Biol 2022; 12:220037. [PMID: 36102061 PMCID: PMC9471992 DOI: 10.1098/rsob.220037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Organ growth is tightly regulated across environmental conditions to generate an appropriate final size. While the size of some organs is free to vary, others need to maintain constant size to function properly. This poses a unique problem: how is robust final size achieved when environmental conditions alter key processes that regulate organ size throughout the body, such as growth rate and growth duration? While we know that brain growth is ‘spared’ from the effects of the environment from humans to fruit flies, we do not understand how this process alters growth dynamics across brain compartments. Here, we explore how this robustness in brain size is achieved by examining differences in growth patterns between the larval body, the brain and a brain compartment—the mushroom bodies—in Drosophila melanogaster across both thermal and nutritional conditions. We identify key differences in patterns of growth between the whole brain and mushroom bodies that are likely to underlie robustness of final organ shape. Further, we show that these differences produce distinct brain shapes across environments.
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Affiliation(s)
- Ansa E Cobham
- School of Biological Sciences, Monash University, Melbourne, Australia
| | - Brent Neumann
- Neuroscience Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Christen K Mirth
- School of Biological Sciences, Monash University, Melbourne, Australia
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Soltanghoraee H, Moradi-Lakeh M, Khalili N, Soltani A. A retrospective autopsy study of 42 cases of stillbirth in Avicenna Research Institute. BMC Pregnancy Childbirth 2022; 22:507. [PMID: 35739463 PMCID: PMC9229882 DOI: 10.1186/s12884-022-04822-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND According to the World Health Organization about 2.6 million deaths were reported worldwide in 2015. More than 98% of stillbirths occur in developing countries. At present, the causes of many cases of stillbirth are unknown due to the lack of necessary data and autopsies in Iran. The aim of this study was to investigate the most plausible cause of stillbirth by evaluating clinical records and autopsies. METHODS A cross-sectional study of 42 stillbirth autopsies in Avicenna Research Institute from 2012 to 2019, was conducted. Data were extracted from a checklist prepared by the project researchers. The checklist contains maternal demographic information, medical history and maternal illness, pregnancy risk factors, placenta and stillbirth information. Collected data were reviewed and classified according to the ReCoDe (Relevant Condition at Death) system. RESULTS In the present study, based on ReCoDe classification, related causes of 95.2% of stillbirths were identified and 4.8% were in the unclassified group. The most common causes were: Fetal causes (64.3%), umbilical cord (14.3%), placenta (7.1%), amniotic fluid (4.8%), maternal medical conditions (2.4%). The causes of about 70% of stillbirth in Iran are unexplained, but in this study, using autopsy results and ReCoDe classification, only 4.8% of stillbirth causes remained unexplained. CONCLUSIONS In our study, unknown cases were rare after autopsy. But considering the limitations and costs of autopsy, we need to design the guideline to specify cases who need an autopsy. Fetal autopsy, placental examination and clinical information could reduce the proportion of stillbirths that remain unexplained.
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Affiliation(s)
- Haleh Soltanghoraee
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research InstituteDepartment of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Khalili
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research InstituteDepartment of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Azadeh Soltani
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
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Turgut E, Özdemir H, Turan G, Bayram M, Karcaaltincaba D. Comparison of cardiac morphology and function in small for gestational age fetuses and fetuses with late-onset fetal growth retardation. J Perinat Med 2022; 50:391-397. [PMID: 34905668 DOI: 10.1515/jpm-2021-0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To compare cardiac structural and functional findings of fetuses with fetal growth restriction (FGR) and small for gestational age (SGA). METHODS In this prospective cohort study, patients were classified into three groups using Delphi procedure according to fetal weight, umbilical, uterine artery Doppler and cerebroplacental ratio. Fetal cardiac ultrasonographic morphology and Doppler examination was performed to all pregnant women at 36 weeks of gestation. RESULTS Seventy three patients were included in the study. There were one (6.7%) patient in the control group, 2 (13.3%) in the SGA group and 12 (80%) in the FGR group who needed neonatal intensive care unit (NICU) and NICU requirement was significantly higher in FGR fetuses (p<0.001). Left spherical index was found to be lower only among FGR fetuses (p=0.046). Left ventricular wall thickness was decreased and the right/left ventricular wall ratio was increased in FGR fetuses (p=0.006, p<0.001). Tricuspid/mitral valve ratio and mitral annular plane systolic excursion value was lower in FGR fetuses (p=0.034, p=0.024 respectively). Also, myocardial performance index was remarkably higher in FGR group (p=0.002). CONCLUSIONS We detected cardiac morphological changes in cases of both SGA and FGR-more pronounced in the FGR cases. Findings related to morphological changes on the left side in FGR cases were considered secondary to volume increase in FGR cases as an indicator of a brain-protective effect. In the FGR group, both systolic and diastolic dysfunctions were detected in the left heart.
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Affiliation(s)
- Ezgi Turgut
- Department of Obstetrics and Gynecology, Division of Perinatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Halis Özdemir
- Department of Obstetrics and Gynecology, Division of Perinatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Gökçe Turan
- Department of Obstetrics and Gynecology, Division of Perinatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Merih Bayram
- Department of Obstetrics and Gynecology, Division of Perinatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Deniz Karcaaltincaba
- Department of Obstetrics and Gynecology, Division of Perinatology, Gazi University Medical Faculty, Ankara, Turkey
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12
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Vautier AN, Cadaret CN. Long-Term Consequences of Adaptive Fetal Programming in Ruminant Livestock. FRONTIERS IN ANIMAL SCIENCE 2022. [DOI: 10.3389/fanim.2022.778440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Environmental perturbations during gestation can alter fetal development and postnatal animal performance. In humans, intrauterine growth restriction (IUGR) resulting from adaptive fetal programming is known as a leading cause of perinatal morbidity and mortality and predisposes offspring to metabolic disease, however, the prevalence and impact in livestock is not characterized as well. Multiple animal models have been developed as a proxy to determine mechanistic changes that underlie the postnatal phenotype resulting from these programming events in humans but have not been utilized as robustly in livestock. While the overall consequences are similar between models, the severity of the conditions appear to be dependent on type, timing, and duration of insult, indicating that some environmental insults are of more relevance to livestock production than others. Thus far, maternofetal stress during gestation has been shown to cause increased death loss, low birth weight, inefficient growth, and aberrant metabolism. A breadth of this data comes from the fetal ruminant collected near term or shortly thereafter, with fewer studies following these animals past weaning. Consequently, even less is known about how adaptive fetal programming impacts subsequent progeny. In this review, we summarize the current knowledge of the postnatal phenotype of livestock resulting from different models of fetal programming, with a focus on growth, metabolism, and reproductive efficiency. We further describe what is currently known about generational impacts of fetal programming in production systems, along with gaps and future directions to consider.
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13
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Ghosh S, Leng W, Wilsch-Bräuninger M, Barrera-Velázquez M, Léopold P, Eaton S. A local insulin reservoir in Drosophila alpha cell homologs ensures developmental progression under nutrient shortage. Curr Biol 2022; 32:1788-1797.e5. [PMID: 35316653 DOI: 10.1016/j.cub.2022.02.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/21/2021] [Accepted: 02/23/2022] [Indexed: 12/19/2022]
Abstract
Insulin/insulin-like growth factor (IGF) signaling (IIS) controls many aspects of development and physiology. In Drosophila, a conserved family of insulin-like peptides called Dilps is produced by brain neurosecretory cells, and it regulates organismal growth and developmental timing. To accomplish these systemic functions, the Dilps are secreted into the general circulation, and they signal to peripheral tissues in an endocrine fashion. Here, we describe the local uptake and storage of Dilps in the corpora cardiaca (CC), an endocrine organ composed of alpha cell homologs known to produce the glucagon-like adipokinetic hormone (AKH). We show that Dilp uptake by the CC relies on the expression of an IGF-binding protein called ImpL2. Following their uptake, immunogold staining demonstrates that Dilps are co-packaged with AKH in dense-core vesicles for secretion. In response to nutrient shortage, this specific Dilp reservoir is released and activates IIS in a paracrine manner in the prothoracic gland. This stimulates the production of the steroid hormone ecdysone and initiates entry into pupal development. We therefore uncover a sparing mechanism whereby insulin stores in CC serve to locally activate IIS and the production of ecdysone in the PG, accelerating developmental progression in adverse food conditions.
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Affiliation(s)
- Suhrid Ghosh
- Max Planck Institute of Molecular Cell Biology and Genetics, Pfotenhauerstraße 108, 01307 Dresden, Germany; Biotechnologisches Zentrum, Technische Universität Dresden, Tatzberg 47/49, 01307 Dresden, Germany.
| | - Weihua Leng
- Max Planck Institute of Molecular Cell Biology and Genetics, Pfotenhauerstraße 108, 01307 Dresden, Germany
| | - Michaela Wilsch-Bräuninger
- Max Planck Institute of Molecular Cell Biology and Genetics, Pfotenhauerstraße 108, 01307 Dresden, Germany
| | - Mariana Barrera-Velázquez
- Max Planck Institute of Molecular Cell Biology and Genetics, Pfotenhauerstraße 108, 01307 Dresden, Germany; Undergraduate Program on Genomic Sciences, Centro de Ciencias Genómicas, UNAM, Cuernavaca, Morelos 62210, Mexico
| | - Pierre Léopold
- Institut Curie, PSL Research University, CNRS UMR3215, Inserm U934, 26 Rue d'Ulm, 75005 Paris, France.
| | - Suzanne Eaton
- Max Planck Institute of Molecular Cell Biology and Genetics, Pfotenhauerstraße 108, 01307 Dresden, Germany; Biotechnologisches Zentrum, Technische Universität Dresden, Tatzberg 47/49, 01307 Dresden, Germany
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14
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Stremming J, Chang EI, Knaub LA, Armstrong ML, Baker PR, Wesolowski SR, Reisdorph N, Reusch JEB, Brown LD. Lower citrate synthase activity, mitochondrial complex expression, and fewer oxidative myofibers characterize skeletal muscle from growth-restricted fetal sheep. Am J Physiol Regul Integr Comp Physiol 2022; 322:R228-R240. [PMID: 34907787 PMCID: PMC8858669 DOI: 10.1152/ajpregu.00222.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/19/2021] [Accepted: 12/06/2021] [Indexed: 12/12/2022]
Abstract
Skeletal muscle from the late gestation sheep fetus with intrauterine growth restriction (IUGR) has evidence of reduced oxidative metabolism. Using a sheep model of placental insufficiency and IUGR, we tested the hypothesis that by late gestation, IUGR fetal skeletal muscle has reduced capacity for oxidative phosphorylation because of intrinsic deficits in mitochondrial respiration. We measured mitochondrial respiration in permeabilized muscle fibers from biceps femoris (BF) and soleus (SOL) from control and IUGR fetal sheep. Using muscles including BF, SOL, tibialis anterior (TA), and flexor digitorum superficialis (FDS), we measured citrate synthase (CS) activity, mitochondrial complex subunit abundance, fiber type distribution, and gene expression of regulators of mitochondrial biosynthesis. Ex vivo mitochondrial respiration was similar in control and IUGR muscle. However, CS activity was lower in IUGR BF and TA, indicating lower mitochondrial content, and protein expression of individual mitochondrial complex subunits was lower in IUGR TA and BF in a muscle-specific pattern. IUGR TA, BF, and FDS also had lower expression of type I oxidative fibers. Fiber-type shifts that support glycolytic instead of oxidative metabolism may be advantageous for the IUGR fetus in a hypoxic and nutrient-deficient environment, whereas these adaptions may be maladaptive in postnatal life.
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Affiliation(s)
- Jane Stremming
- Department of Pediatrics, University of Colorado, Aurora, Colorado
| | - Eileen I Chang
- Department of Pediatrics, University of Colorado, Aurora, Colorado
| | - Leslie A Knaub
- Division of Endocrinology, University of Colorado, Aurora, Colorado
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado
| | | | - Peter R Baker
- Department of Pediatrics, University of Colorado, Aurora, Colorado
| | | | | | - Jane E B Reusch
- Division of Endocrinology, University of Colorado, Aurora, Colorado
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado
| | - Laura D Brown
- Department of Pediatrics, University of Colorado, Aurora, Colorado
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15
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Mutamba AK, He X, Wang T. Therapeutic advances in overcoming intrauterine growth restriction induced metabolic syndrome. Front Pediatr 2022; 10:1040742. [PMID: 36714657 PMCID: PMC9875160 DOI: 10.3389/fped.2022.1040742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Intrauterine growth restriction (IUGR) remains a great public health challenge as it affects neonatal survival and influences their normal biological development and metabolism. Several clinical researches have revealed the occurrence of metabolic syndrome, such as insulin resistance, obesity, type 2 diabetes mellitus, oxidative stress, dyslipidemia, as direct results of IUGR. Therefore, it is essential to understand its underlying mechanism, impact and develop effective therapies. The purpose of this work is to review the current knowledge on IUGR induced metabolic syndrome and relevant therapies. Here in, we elaborate on the characteristics and causes of IUGR by pointing out recent research findings. Furthermore, we discuss the impact of IUGR on different organs of the body, followed by preclinical studies on IUGR using suitable animal models. Additionally, various metabolic disorders with their genetic implications, such as insulin resistance, type 2 diabetes mellitus, dyslipidemia, obesity are detailed. Finally, the current therapeutic options used in the treatment of IUGR are summarized with some prospective therapies highlighted.
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Affiliation(s)
- Alpha Kalonda Mutamba
- Department of Pediatrics, Neonatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaori He
- Department of Pediatrics, Neonatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tao Wang
- Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, China
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16
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Neurovascular Unit Alterations in the Growth-Restricted Newborn Are Improved Following Ibuprofen Treatment. Mol Neurobiol 2021; 59:1018-1040. [PMID: 34825315 DOI: 10.1007/s12035-021-02654-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
The developing brain is particularly vulnerable to foetal growth restriction (FGR) and abnormal neurodevelopment is common in the FGR infant ranging from behavioural and learning disorders to cerebral palsy. No treatment exists to protect the FGR newborn brain. Recent evidence suggests inflammation may play a key role in the mechanism responsible for the progression of brain impairment in the FGR newborn, including disruption to the neurovascular unit (NVU). We explored whether ibuprofen, an anti-inflammatory drug, could reduce NVU disruption and brain impairment in the FGR newborn. Using a preclinical FGR piglet model, ibuprofen was orally administered for 3 days from birth. FGR brains demonstrated a proinflammatory state, with changes to glial morphology (astrocytes and microglia), and blood-brain barrier disruption, assessed by IgG and albumin leakage into the brain parenchyma and a decrease in blood vessel density. Loss of interaction between astrocytic end-feet and blood vessels was evident where plasma protein leakage was present, suggestive of structural deficits to the NVU. T-cell infiltration was also evident in the parenchyma of FGR piglet brains. Ibuprofen treatment reduced the pro-inflammatory response in FGR piglets, reducing the number of activated microglia and enhancing astrocyte interaction with blood vessels. Ibuprofen also attenuated plasma protein leakage, regained astrocytic end-feet interaction around vessels, and decreased T-cell infiltration into the FGR brain. These findings suggest postnatal administration of ibuprofen modulates the inflammatory state, allowing for stronger interaction between vasculature and astrocytic end-feet to restore NVU integrity. Modulation of the NVU improves the FGR brain microenvironment and may be key to neuroprotection.
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17
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Combination of human endothelial colony-forming cells and mesenchymal stromal cells exert neuroprotective effects in the growth-restricted newborn. NPJ Regen Med 2021; 6:75. [PMID: 34795316 PMCID: PMC8602245 DOI: 10.1038/s41536-021-00185-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/19/2021] [Indexed: 11/09/2022] Open
Abstract
The foetal brain is particularly vulnerable to the detrimental effects of foetal growth restriction (FGR) with subsequent abnormal neurodevelopment being common. There are no current treatments to protect the FGR newborn from lifelong neurological disorders. This study examines whether pure foetal mesenchymal stromal cells (MSC) and endothelial colony-forming cells (ECFC) from the human term placenta are neuroprotective through modulating neuroinflammation and supporting the brain vasculature. We determined that one dose of combined MSC-ECFCs (cECFC; 106 ECFC 106 MSC) on the first day of life to the newborn FGR piglet improved damaged vasculature, restored the neurovascular unit, reduced brain inflammation and improved adverse neuronal and white matter changes present in the FGR newborn piglet brain. These findings could not be reproduced using MSCs alone. These results demonstrate cECFC treatment exerts beneficial effects on multiple cellular components in the FGR brain and may act as a neuroprotectant.
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18
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Lee K, Hardy DB. Metabolic Consequences of Gestational Cannabinoid Exposure. Int J Mol Sci 2021; 22:9528. [PMID: 34502436 PMCID: PMC8430813 DOI: 10.3390/ijms22179528] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Up to 20% of pregnant women ages 18-24 consume cannabis during pregnancy. Moreover, clinical studies indicate that cannabis consumption during pregnancy leads to fetal growth restriction (FGR), which is associated with an increased risk of obesity, type II diabetes (T2D), and cardiovascular disease in the offspring. This is of great concern considering that the concentration of Δ9- tetrahydrocannabinol (Δ9-THC), a major psychoactive component of cannabis, has doubled over the last decade and can readily cross the placenta and enter fetal circulation, with the potential to negatively impact fetal development via the endocannabinoid (eCB) system. Cannabis exposure in utero could also lead to FGR via placental insufficiency. In this review, we aim to examine current pre-clinical and clinical findings on the direct effects of exposure to cannabis and its constituents on fetal development as well as indirect effects, namely placental insufficiency, on postnatal metabolic diseases.
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Affiliation(s)
- Kendrick Lee
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada;
- The Children’s Health Research Institute, The Lawson Health Research Institute, London, ON N6A 5C1, Canada
| | - Daniel B. Hardy
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada;
- The Children’s Health Research Institute, The Lawson Health Research Institute, London, ON N6A 5C1, Canada
- Department of Obstetrics and Gynaecology, Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
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[Impact of the healthcare pathway on the rate of obstetrical interventions in small for gestational age fetuses (IATROPAG Study)]. ACTA ACUST UNITED AC 2021; 49:665-671. [PMID: 33677122 DOI: 10.1016/j.gofs.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND While previous studies have demonstrated an improvement in implementation of clinical practices and an improved neonatal prognosis when growth restricted fetuses were followed within a standardized healthcare pathway, the objective of this study was to assess the prevalence of obstetric interventions in small-for-gestational-age (SGA) fetuses followed within a standardized care pathway compared to a traditional care pathway. METHODS We conducted a retrospective study between 2015 and 2017, in a type III maternity hospital in Lyon, in a population of SGA fetuses, considered as such in case of antenatal diagnosis of fetal weight<10th percentile but>3rd centile without umbilical Doppler abnormality during antenatal surveillance and without ultrasound argument suggesting intrauterine growth retardation (IUGR). We collected the gestational age at diagnosis, obstetrical events and prevention of preterm delivery (antenatal corticosteroids), gestation age at birth, the method of delivery (spontaneous or induced), indication of induction, the method of birth (spontaneous, instrumental extraction or caesarean section), and the immediate neonatal outcome including cord pH, Apgar score at 5minutes, birth weight and fetal sex. After diagnosis, the choice of the pathway was left to the practitioner depending on their habit, their ability to manage the follow-up and their organizational constraints. RESULTS Over the study period, and after exclusion of IUGR, 96 SGA were followed up in the traditional pathway and 106 SGA were followed up in the standardized pathway P=0.75. The traditional pathway showed in multivariate analysis a higher prevalence of antenatal corticosteroid therapy for SGA (16,6%) between 2015 and 2017 with OR 7.3 95% CI [1.41-38.43] when compared to the standardized pathway (3,7%). Similarly, the traditional pathway proposes a higher prevalence of induction of labor (54,1%) than the standardized pathway (33,9%) between 2015 and 2017 with OR 3.19 95% CI [1.70-7.80]. The "a posteriori" post-hoc power of the study is 82.9%. CONCLUSION This study confirms the absence of excessive obstetrical intervention in the SGA population when followed in a standardized healthcare pathway. The latter would reduce unnecessary obstetrical interventions while respecting the intrinsic neonatal prognosis of small for gestational age fetuses.
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Betts KS, Kisely S, Alati R. Proposing a new approach to measuring birth size asymmetry. Paediatr Perinat Epidemiol 2021; 35:65-74. [PMID: 32741001 DOI: 10.1111/ppe.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/30/2020] [Accepted: 04/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Existing methods of measuring birth size asymmetry based on ratios of growth parameters are clinically useful but simplistic, and as such may have limited usefulness in studies of aetiology. OBJECTIVES We aimed to develop a novel method of measuring asymmetric fetal growth at birth and demonstrate its utility in characterising the perturbed growth associated with a number of prenatal exposures and neonatal outcomes. METHODS Data were drawn from the Queensland (QLD) Perinatal Data Collection, which included all livebirths in the Australian state of QLD between July 2010 and December 2015, with analyses restricted to babies born between 32 and 42 weeks of gestation (n = 280 084). Novel measures of asymmetric birthweight, length, and head circumference were developed using a weighted average, representing "how far" an individual's given birth size measure deviated from the sample average and their other birth size measures. Associations among prenatal exposures and neonatal outcomes with the new asymmetry measures and traditional ratio measures (ie ponderal index, brain-to-body weight ratio, and birth length divided by head circumference) were then compared using log-binomial and multinomial regressions. RESULTS The new asymmetry measures clearly indicated that prenatal smoking was linked to a disproportionate decrease in all birth size measures and that low birthweight asymmetry and low birth head circumference asymmetry were specifically associated with neonatal respiratory distress and chromosomal abnormalities, respectively. When these same associations were tested using the traditional ratios, the estimates were weak, imprecise, and non-specific. CONCLUSIONS We developed a new approach to measuring fetal growth asymmetry which provides complimentary insights against the existing ratios approach. Associations with the new asymmetry measures were more precise and easier to interpret than the associations obtained using the ratios, and may better reflect the underlying pathological processes, providing an advantage when investigating the aetiologies of perturbed fetal growth.
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Affiliation(s)
- Kim S Betts
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Steve Kisely
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Rosa Alati
- School of Public Health, Curtin University, Perth, WA, Australia
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21
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A comparison of placental pathology between small for gestational age infants at < 5 % versus 5-9. Eur J Obstet Gynecol Reprod Biol 2020; 252:483-489. [PMID: 32758859 DOI: 10.1016/j.ejogrb.2020.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Among SGA newborns, those < 5th % for GA are more likely to have adverse outcomes than those at 5-9th %. The differential morbidity and mortality may be due to abnormal placental pathology between groups. Our purpose was to compare placental pathology characteristics and composite placental pathology among SGA infants with birth weights <5th % vs. 5-9th %. METHODS This study is a secondary analysis of a multicenter, retrospective cohort study. Placental pathological variables and composite placental pathology (CPP) among SGA infants <5th % and 5-9th % were compared. Multivariable logistic regression was used to model the probability of an infant's birth weight being classified as <5th % based on pathology characteristics. RESULTS Of 11,487 live singleton births, 925 SGA infants met inclusion criteria. Placental pathology was available for review in 407 (44 %) SGA infants: 210 (51.6 %) <5th % and 197 (48.4 %) 5-9th %. A decreased placental weight for GA, was more common in the <5th % group compared to the 5-9th % group (p = 0.0019). No significant differences in the distribution of pathological variables or in CPP (p = 0.3) was observed between the two centile groups. A decreased placental weight was the only reliable predictor of an infant's birth weight centile group (p = 0.0018). CONCLUSIONS Placental hypoplasia, reflected by a decreased placental weight for GA, was significantly more common among SGA infants < 5th % compared to the 5-9th %. There was no difference in placental pathological features or CPP between the two centile groups of SGA infants.
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Aski SK, Akbari R, Hantoushzadeh S, Ghotbizadeh F. A bibliometric analysis of Intrauterine Growth Restriction research. Placenta 2020; 95:106-120. [PMID: 32452397 DOI: 10.1016/j.placenta.2020.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/24/2020] [Indexed: 12/15/2022]
Abstract
Intrauterine growth restriction (IUGR) is not a new subject in pregnancy. Nevertheless, this concept has newly begun to be integrated into pregnancy studies. We recognized articles that were published in English from 1977 to 2019 through electronic searches of the Web of Science™ database. The WoS database was searched for all published articles that compared preeclampsia from 1977 to January 2020. About 1469 documents in obstetrics and gynecology areas were analyzed in WoS database. VOSviewer software was employed to visualize the networks. The survey resulted in a 1469 published documents from 1977 to 2020. 'Gratacos' from Spain and 'Cetin' from Italy contributed the most publications. The greatest contribution came from the 'USA' (n = 498), 'Italy' (n = 155), and 'England' (n = 147). Furthermore, our results found that among these journals, the 'AJOG' (n = 318) and the 'Reproductive Sciences' (n = 209) published the largest number of papers. The top 100 most cited papers showed that 30% were reported in the 'AJOG'. About half the articles were published in the last decade and the most common studies were research paper (77%). The co-occurrence and co-citation analysis showed that the study formed four clusters. Finally, the strategic map was designed. We found that there existed an increasing trend in the large amount of publication on IUGR from 1977 to 2020. The number of studies in IUGR has substantially improved in the last decade. Authors from the 'USA' appeared the most proactive in addressing the IUGR area. By studying these articles, we propose important to support not only for grinding the IUGR challenges field but also for designing a new trend in this area.
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Affiliation(s)
- Soudabeh Kazemi Aski
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Rasht, Iran.
| | - Razieh Akbari
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fahimeh Ghotbizadeh
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Asghar A, Asad MR, Naaz S, Rani M. Screening of the growth of thymus of human fetuses. Anat Cell Biol 2019; 52:478-485. [PMID: 31949988 PMCID: PMC6952689 DOI: 10.5115/acb.19.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/09/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022] Open
Abstract
The thymus is a lymphoepithelial organ, and its morphometry is commonly utilized for surveillance of the immunological status of fetus and neonates. Many studies showed that fetal thymus size is used as a prognostic indicator for pregnancy-related disorders such as eclampsia, preterm labor, and gestational diabetes. The study aims to establish reference ranges of the normal fetal thymus size between 12 and 40 weeks of gestational age (GA). The study was conducted on 89 fetuses. They were dissected to capture the morphometry of thymus: transverse diameter, perimeter, and weight. Considering these parameters were dependent variables of GA and gestational weight (GW). Their relationship was studied by a multiple regression model. The best fit models in predicting thymic dimensions as a function of GA and GW were determined using regression analysis. Mean transverse diameter, perimeter, and thymus weight was 33.45±2.91 mm, 125.72±55.4 mm, and 3.078±3.06 g, respectively. They were increased throughout pregnancy as GA and GW advanced. The regression equation for a transverse diameter of the thymus as a function of GA was (0.303×GA-4.885, R2=0.8196) and for the perimeter of the thymus was (1.0212×GA-15.24, R2=0.8666). Reference ranges and baseline data of the normal fetal thymic dimensions between 12 and 40 weeks of GA have been established.
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Affiliation(s)
- Adil Asghar
- Department of Anatomy, All India Institute of Medical Sciences Patna, Patna, India
| | - Mohammad Rehan Asad
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al-Majma'ah, Saudi Arabia
| | - Shagufta Naaz
- Department of Anaesthesiology, All India Institute of Medical Sciences Patna, Patna, India
| | - Mamta Rani
- Department of Anatomy, Uttar Pradesh University of Medical Sciences, Etawah, India
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Cadaret CN, Merrick EM, Barnes TL, Beede KA, Posont RJ, Petersen JL, Yates DT. Sustained maternal inflammation during the early third-trimester yields intrauterine growth restriction, impaired skeletal muscle glucose metabolism, and diminished β-cell function in fetal sheep1,2. J Anim Sci 2019; 97:4822-4833. [PMID: 31616931 PMCID: PMC6915216 DOI: 10.1093/jas/skz321] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/08/2019] [Indexed: 12/15/2022] Open
Abstract
Maternal inflammation causes fetal intrauterine growth restriction (IUGR), but its impact on fetal metabolism is not known. Thus, our objective was to determine the impact of sustained maternal inflammation in late gestation on fetal inflammation, skeletal muscle glucose metabolism, and insulin secretion. Pregnant ewes were injected every third day from the 100th to 112th day of gestation (term = 150 d) with saline (controls) or lipopolysaccharide (LPS) to induce maternal inflammation and IUGR (MI-IUGR). Fetal femoral blood vessels were catheterized on day 118 to assess β-cell function on day 123, hindlimb glucose metabolic rates on day 124, and daily blood parameters from days 120 to 125. Fetal muscle was isolated on day 125 to assess ex vivo glucose metabolism. Injection of LPS increased (P < 0.05) rectal temperatures, circulating white blood cells, and plasma tumor necrosis factor α (TNFα) concentrations in MI-IUGR ewes. Maternal leukocytes remained elevated (P < 0.05) and TNFα tended to remain elevated (P < 0.10) compared with controls almost 2 wk after the final LPS injection. Total white blood cells, monocytes, granulocytes, and TNFα were also greater (P < 0.05) in MI-IUGR fetuses than controls over this period. MI-IUGR fetuses had reduced (P < 0.05) blood O2 partial pressures and greater (P < 0.05) maternofetal O2 gradients, but blood glucose and maternofetal glucose gradients did not differ from controls. Basal and glucose-stimulated insulin secretion were reduced (P < 0.05) by 32% and 42%, respectively, in MI-IUGR fetuses. In vivo hindlimb glucose oxidation did not differ between groups under resting conditions but was 47% less (P < 0.05) in MI-IUGR fetuses than controls during hyperinsulinemia. Hindlimb glucose utilization did not differ between fetal groups. At day 125, MI-IUGR fetuses were 22% lighter (P < 0.05) than controls and tended to have greater (P < 0.10) brain/BW ratios. Ex vivo skeletal muscle glucose oxidation did not differ between groups in basal media but was less (P < 0.05) for MI-IUGR fetuses in insulin-spiked media. Glucose uptake rates and phosphorylated-to-total Akt ratios were less (P < 0.05) in muscle from MI-IUGR fetuses than controls regardless of media. We conclude that maternal inflammation leads to fetal inflammation, reduced β-cell function, and impaired skeletal muscle glucose metabolism that persists after maternal inflammation ceases. Moreover, fetal inflammation may represent a target for improving metabolic dysfunction in IUGR fetuses.
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Affiliation(s)
- Caitlin N Cadaret
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Elena M Merrick
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Taylor L Barnes
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Kristin A Beede
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Robert J Posont
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Jessica L Petersen
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Dustin T Yates
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
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Cadaret CN, Posont RJ, Swanson RM, Beard JK, Barnes TL, Beede KA, Petersen JL, Yates DT. Intermittent maternofetal O 2 supplementation during late gestation rescues placental insufficiency-induced intrauterine growth restriction and metabolic pathologies in the neonatal lamb. Transl Anim Sci 2019; 3:1696-1700. [PMID: 33336152 PMCID: PMC6999172 DOI: 10.1093/tas/txz060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/29/2019] [Indexed: 12/28/2022] Open
Affiliation(s)
- Caitlin N Cadaret
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Robert J Posont
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Rebecca M Swanson
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Joslyn K Beard
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Taylor L Barnes
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Kristin A Beede
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Jessica L Petersen
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
| | - Dustin T Yates
- Department of Animal Science, University of Nebraska–Lincoln, Lincoln, NE
- Corresponding author:
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Akbas M, Koyuncu FM, Artunç-Ulkumen B. Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction. J Perinat Med 2019; 47:841-846. [PMID: 31494639 DOI: 10.1515/jpm-2019-0238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/06/2019] [Indexed: 12/26/2022]
Abstract
Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.
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Affiliation(s)
- Murat Akbas
- Manisa Celal Bayar University, Department of Obstetrics and Gynecology, Perinatology Division, Manisa, Turkey
| | - Faik M Koyuncu
- Manisa Celal Bayar University, Department of Obstetrics and Gynecology, Perinatology Division, Manisa, Turkey
| | - Burcu Artunç-Ulkumen
- Manisa Celal Bayar University, Department of Obstetrics and Gynecology, Perinatology Division, Manisa, Turkey
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28
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Zaidi H, Lamalmi N, Malihi A, Barkat A, Alhamany Z. [Histopathological lesions of the placenta associated with severe intrauterine growth retardation: about a clinical case]. Pan Afr Med J 2019; 34:56. [PMID: 31762922 PMCID: PMC6859036 DOI: 10.11604/pamj.2019.34.56.15160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/28/2019] [Indexed: 11/21/2022] Open
Abstract
L'examen du placenta est indispensable dans le diagnostic du retard de croissance intra-utérin (RCIU). Son intérêt réside dans la recherche étiologique de cette pathologie, et les conséquences materno-fœtal qui peuvent en découler, ainsi dans la mise en place des stratégies préventive lors des grossesses ultérieures dans le cas des pathologies récidivantes. Nous rapportons les lésions anatomopathologiques possibles retrouvées au niveau du placenta de cette pathologie à travers une observation de RCIU sévère suivi au sein du Service de Néonatologie du CHU Ibn Sina de Rabat.
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Affiliation(s)
- Hanaa Zaidi
- Université Mohammed V, Faculté de Médecine et de Pharmacie, 10170, Rabat, Maroc.,Laboratoire d'Anatomie et de Cytologie Pathologique du Complexe Hôpital d'Enfant Maternité Souissi CHU Ibn Sina, 10170, Rabat, Maroc
| | - Najat Lamalmi
- Université Mohammed V, Faculté de Médecine et de Pharmacie, 10170, Rabat, Maroc.,Laboratoire d'Anatomie et de Cytologie Pathologique du Complexe Hôpital d'Enfant Maternité Souissi CHU Ibn Sina, 10170, Rabat, Maroc
| | - Abderahmane Malihi
- Laboratoire d'Anatomie et de Cytologie Pathologique du Complexe Hôpital d'Enfant Maternité Souissi CHU Ibn Sina, 10170, Rabat, Maroc
| | - Amina Barkat
- Université Mohammed V, Faculté de Médecine et de Pharmacie, 10170, Rabat, Maroc.,Service de Néonatologie P5, Hôpital d'Enfant CHU Ibn Sina, 10170, Rabat, Maroc
| | - Zaytouna Alhamany
- Université Mohammed V, Faculté de Médecine et de Pharmacie, 10170, Rabat, Maroc.,Laboratoire d'Anatomie et de Cytologie Pathologique du Complexe Hôpital d'Enfant Maternité Souissi CHU Ibn Sina, 10170, Rabat, Maroc
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29
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Barbeito-Andrés J, Castro-Fonseca E, Qiu LR, Bernal V, Lent R, Henkelman M, Lukowiak K, Gleiser PM, Hallgrimsson B, Gonzalez PN. Region-specific changes in Mus musculus brain size and cell composition under chronic nutrient restriction. ACTA ACUST UNITED AC 2019; 222:jeb.204651. [PMID: 31395680 DOI: 10.1242/jeb.204651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/01/2019] [Indexed: 11/20/2022]
Abstract
Nutrition is one of the most influential environmental factors affecting the development of different tissues and organs. It is suggested that under nutrient restriction the growth of the brain is spared as a result of the differential allocation of resources from other organs. However, it is not clear whether this sparing occurs brain-wide. Here, we analyzed morphological changes and cell composition in different regions of the offspring mouse brain after maternal exposure to nutrient restriction during pregnancy and lactation. Using high-resolution magnetic resonance imaging, we found that brain regions were differentially sensitive to maternal protein restriction and exhibited particular patterns of volume reduction. The cerebellum was reduced in absolute and relative volume, while cortex volume was relatively preserved. Alterations in cell composition (examined by the isotropic fractionator method) and organization of white matter (measured by diffusor tensor images) were also region specific. These changes were not related to the metabolic rate of the regions and were only partially explained by their specific growth trajectories. This study is a first step towards understanding the mechanisms of regional brain sparing at microstructural and macrostructural levels resulting from undernutrition.
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Affiliation(s)
- Jimena Barbeito-Andrés
- Institute for Studies in Neuroscience and Complex Systems Studies, ENyS, CONICET, CP 1888 Buenos Aires, Argentina
| | - Emily Castro-Fonseca
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21941-590, Brazil
| | - Lily R Qiu
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, ON M5T 3H7, Canada
| | - Valeria Bernal
- Anthropology Department, School of Natural Sciences, National University of La Plata, CP 1900 Buenos Aires, Argentina
| | - Roberto Lent
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21941-590, Brazil
| | - Mark Henkelman
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, ON M5T 3H7, Canada
| | - Kenneth Lukowiak
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Pablo M Gleiser
- Medical Physics Department, Bariloche Atomic Centre, Bariloche CP 8400, Río Negro, Argentina
| | - Benedikt Hallgrimsson
- Department of Cell Biology and Anatomy, McCaig Institute for Bone and Joint Health, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Paula N Gonzalez
- Institute for Studies in Neuroscience and Complex Systems Studies, ENyS, CONICET, CP 1888 Buenos Aires, Argentina
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30
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Blythe C, Vazquez REZ, Cabrera MS, Zekic Tomas S, Oc Anumba D, Cohen MC. Results of full postmortem examination in a cohort of clinically unexplained stillbirths: undetected fetal growth restriction and placental insufficiency are prevalent findings. J Perinatol 2019; 39:1196-1203. [PMID: 31266993 DOI: 10.1038/s41372-019-0412-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/27/2019] [Accepted: 05/10/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To analyze a cohort of clinically unexplained stillbirths (CUS) referred for postmortem. STUDY DESIGN In total, 258 CUS were referred for full postmortem between 2009 and 2015. Relevant Condition at Death (ReCoDe) classification was applied. Statistical analysis included chi-square test and multiple logistic regression. RESULTS In all, 386 ReCoDe categories identified corresponded to: fetus (99); umbilical cord (48); placenta (165); amniotic fluid (55), and mother (1). No condition was identified in 18 cases. Prevalent conditions were placental insufficiency (101 cases, 39%) and fetal growth restriction (96 cases, 37%), frequently presenting together (41 cases, 15.9%). Significant associations were found between fetal growth restriction and gestational age, asymmetrical fetal growth and placental insufficiency. CONCLUSIONS In total, 60.5% of CUS were diagnosed at postmortem to have fetal growth restriction and/or placental insufficiency. The mean gestational age of death in which these conditions presented was 32.7 weeks and 35.5 weeks, respectively, suggesting a critical time-frame to monitor to potentially reduce stillbirth occurrence.
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Affiliation(s)
- Claire Blythe
- Department of Paediatrics, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK
| | | | - Maria S Cabrera
- Department of Obstetrics and Gynaecology Department, Hospital Ramos Mejia, Buenos Aires, Argentina.,Histopathology Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, S10 2TH, UK
| | - Sandra Zekic Tomas
- Histopathology Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, S10 2TH, UK.,Pathology Department, University Hospital Split, Split, Croatia
| | - Dilly Oc Anumba
- Department of Obstetrics and Gynaecology, Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK
| | - Marta C Cohen
- Histopathology Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, S10 2TH, UK. .,Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
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Cohen E, Baerts W, Caicedo Dorado A, Naulaers G, van Bel F, Lemmers PMA. Cerebrovascular autoregulation in preterm fetal growth restricted neonates. Arch Dis Child Fetal Neonatal Ed 2019; 104:F467-F472. [PMID: 30355781 DOI: 10.1136/archdischild-2017-313712] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/12/2018] [Accepted: 09/22/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation in preterm neonates during the first 3 days of life. DESIGN Case-control study. SETTING Neonatal intensive care unit of the Wilhelmina Children's Hospital, The Netherlands. PATIENTS 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th-80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. METHODS The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. RESULTS FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016). CONCLUSION FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.
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Affiliation(s)
- Emily Cohen
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands.,The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Willem Baerts
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Alexander Caicedo Dorado
- Department of Applied Mathematics and Computer Science, Faculty of Natural Sciences and Mathematics, Universidad del Rosario, Bogota, Colombia
| | - Gunnar Naulaers
- Department of Neonatology, University Hospital Leuven, Leuven, Belgium
| | - Frank van Bel
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Petra M A Lemmers
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands
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Zhang G, Zhou J, Huang W, Fang M, Yu L, Wang H, Zhang Y. Prenatal ethanol exposure-induced a low level of foetal blood cholesterol and its mechanism of IGF1-related placental cholesterol transport dysfunction. Toxicology 2019; 424:152237. [PMID: 31226463 DOI: 10.1016/j.tox.2019.152237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/29/2019] [Accepted: 06/17/2019] [Indexed: 02/04/2023]
Abstract
Clinical researches showed that intrauterine growth retardation (IUGR) foetus had decreased blood cholesterol levels. The present study aimed to confirm that prenatal ethanol exposure (PEE) caused decreased blood cholesterol levels in IUGR foetal rats and elucidate its placental mechanism. Pregnant Wistar rats were intragastrically administrated with ethanol (4 g/kg.d) on gestational days 9-20 (GD9-20). in vivo, PEE increased the levels of total cholesterol (TCH), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) in maternal serum, whereas decreased them in both female and male foetal serum. Moreover, the expression of cholesterol transport genes, scavenger receptor class B type 1 (SCARB1), low-density lipoprotein receptor (LDLR), ATP binding cassette subfamily A member 1 (ABCA1) and ATP binding cassette subfamily G member 1 (ABCG1) was reduced in female and male placentas in the PEE group. Meanwhile, the proliferation decreased and the apoptosis increased in female and male placentas, and the insulin like growth factor 1 (IGF1) signal pathway was inhibited. in vitro, after being treated with ethanol (15, 30, 60, 120 mM) for 72 h, the expression of cholesterol transport genes was decreased, the apoptosis was increased, the proliferation was decreased and the IGF1 signal pathway was inhibited in BeWo cells, whereas exogenous IGF1 reversed these changes. In conclusion, by inhibiting the IGF1 signal pathway in placentas, PEE induced apoptosis and inhibited proliferation, thus decreased the cholesterol transport in placentas, and eventually leading to low blood cholesterol levels in foetal rats.
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Affiliation(s)
- Guohui Zhang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Jin Zhou
- Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Wen Huang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Man Fang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Luting Yu
- Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Hui Wang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China; Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China.
| | - Yuanzhen Zhang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China.
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Wixey JA, Sukumar KR, Pretorius R, Lee KM, Colditz PB, Bjorkman ST, Chand KK. Ibuprofen Treatment Reduces the Neuroinflammatory Response and Associated Neuronal and White Matter Impairment in the Growth Restricted Newborn. Front Physiol 2019; 10:541. [PMID: 31133875 PMCID: PMC6523042 DOI: 10.3389/fphys.2019.00541] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/17/2019] [Indexed: 12/31/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is a condition where the fetus does not achieve optimal growth, commonly caused by placental insufficiency. The chronic decrease in blood flow restricts oxygen and nutrient supply to the fetus, which can damage numerous organ systems, with the fetal brain being particularly vulnerable. Although white matter and neuronal injury are evident in IUGR infants, the specific mechanisms underlying these changes are poorly understood. Inflammation is considered to be a main driver in exacerbating brain injury. Using a spontaneous piglet model of IUGR, we aim to determine whether administration of the anti-inflammatory drug ibuprofen will decrease inflammation at postnatal day 4 (P4). The treatment group received ibuprofen (20 mg/kg/day on day 1 and 10 mg/kg/day on days 2 and 3) in piglet formula during the morning feed each day and brains examined on P4. Markers of inflammation, apoptosis, cell proliferation, neuronal injury, and white matter injury were examined. Ibuprofen treatment ameliorated the increase in numbers of microglia and astrocytes in the parietal cortex and white matter tracts of the IUGR piglet brain on P4 as well as decreasing proinflammatory cytokines. Ibuprofen treatment prevented the reduction in apoptosis, neuronal cell counts, and myelin index in the IUGR piglets. Our findings demonstrate ibuprofen reduces the inflammatory response in the IUGR neonatal brain and concurrently reduces neuronal and white matter impairment.
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Affiliation(s)
- Julie A Wixey
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Kishen R Sukumar
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Rinaldi Pretorius
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Kah Meng Lee
- Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Paul B Colditz
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Perinatal Research Centre, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - S Tracey Bjorkman
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Kirat K Chand
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Roelofs S, Alferink FAC, Ipema AF, van de Pas T, van der Staay FJ, Nordquist RE. Discrimination learning and judgment bias in low birth weight pigs. Anim Cogn 2019; 22:657-671. [PMID: 31049725 PMCID: PMC6687882 DOI: 10.1007/s10071-019-01262-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 03/29/2019] [Accepted: 04/06/2019] [Indexed: 12/22/2022]
Abstract
Low birth weight (LBW) is a risk factor for cognitive and emotional impairments in humans. In pigs, LBW is a common occurrence, but its effects on cognition and emotion have received only limited scientific attention. To assess whether LBW pigs suffer from impaired cognitive and emotional development, we trained and tested 21 LBW and 21 normal birth weight (NBW) pigs in a judgment bias task. Judgment bias is a measure of emotional state which reflects the influence of emotion on an animal’s interpretation of ambiguous stimuli. Pigs were trained to perform a specific behavioral response to two auditory stimuli, predicting either a positive or negative outcome. Once pigs successfully discriminated between these stimuli, they were presented with intermediate, ambiguous stimuli. The pigs’ responses to ambiguous stimuli were scored as optimistic (performance of ‘positive’ response) or pessimistic (performance of ‘negative’ response). Optimistic or pessimistic interpretation of an ambiguous stimulus is indicative of a positive or negative emotional state, respectively. We found LBW pigs to require more discrimination training sessions than NBW pigs to reach criterion performance, suggesting that LBW causes a mild cognitive impairment in pigs. No effects of LBW on judgment bias were found, suggesting a similar emotional state for LBW and NBW pigs. This was supported by comparable salivary and hair cortisol concentrations for both groups. It is possible the enriched housing conditions and social grouping applied during our study influenced these results.
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Affiliation(s)
- Sanne Roelofs
- Behaviour and Welfare Group, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, Utrecht University, Stratenum Building, Room STR5.203, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.,Department of Clinical Studies, Swine Teaching and Research Center, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Road, Kennett Square, PA, 19348, USA
| | - Floor A C Alferink
- Behaviour and Welfare Group, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL, Utrecht, The Netherlands.,Study Programme Applied Biology, HAS University of Applied Sciences, Onderwijsboulevard 221, 5223 DE, 's Hertogenbosch, The Netherlands
| | - Allyson F Ipema
- Behaviour and Welfare Group, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL, Utrecht, The Netherlands.,Adaptation Physiology Group, Wageningen University, De Elst 1, 6708 WD, Wageningen, The Netherlands
| | - Tessa van de Pas
- Behaviour and Welfare Group, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL, Utrecht, The Netherlands.,Department of Clinical Studies, Swine Teaching and Research Center, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Road, Kennett Square, PA, 19348, USA
| | - Franz Josef van der Staay
- Behaviour and Welfare Group, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, Utrecht University, Stratenum Building, Room STR5.203, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Rebecca E Nordquist
- Behaviour and Welfare Group, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL, Utrecht, The Netherlands. .,Brain Center Rudolf Magnus, Utrecht University, Stratenum Building, Room STR5.203, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.
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Shukrun N, Shabtai Y, Pillemer G, Fainsod A. Retinoic acid signaling reduction recapitulates the effects of alcohol on embryo size. Genesis 2019; 57:e23284. [PMID: 30672660 DOI: 10.1002/dvg.23284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/13/2019] [Accepted: 01/21/2019] [Indexed: 12/16/2022]
Abstract
Intrauterine growth restriction (IUGR) is commonly observed in human pregnancies and can result in severe clinical outcomes. IUGR is observed in Fetal Alcohol Syndrome (FAS) fetuses as a result of alcohol (ethanol) exposure during pregnancy. To further understand FAS, the severe form of Fetal Alcohol Spectrum Disorder, we performed an extensive quantitative analysis of the effects of ethanol on embryo size utilizing our Xenopus model. Ethanol-treated embryos exhibited size reduction along the anterior-posterior axis. This effect was evident primarily from the hindbrain caudally, while rostral regions appeared refractive to ethanol-induced size changes, also known as asymmetric IUGR. Interestingly, some embryo batches in addition to shortening from the hindbrain caudally also exhibited an alcohol-dependent reduction of the anterior head domain, known as symmetric IUGR. To study the connection between ethanol exposure and reduced retinoic acid levels we treated embryos with the retinaldehyde dehydrogenase inhibitors, DEAB and citral. Inhibition of retinoic acid biosynthesis recapitulated the growth defects induced by ethanol affecting mainly axial elongation from the hindbrain caudally. To study the competition between ethanol clearance and retinoic acid biosynthesis we demonstrated that, co-exposure to alcohol reduces the teratogenic effects of treatment with retinol (vitamin A), the retinoic acid precursor. These results further support the role of retinoic acid in the regulation of axial elongation.
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Affiliation(s)
- Natalie Shukrun
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Shabtai
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Graciela Pillemer
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Fainsod
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Wixey JA, Lee KM, Miller SM, Goasdoue K, Colditz PB, Tracey Bjorkman S, Chand KK. Neuropathology in intrauterine growth restricted newborn piglets is associated with glial activation and proinflammatory status in the brain. J Neuroinflammation 2019; 16:5. [PMID: 30621715 PMCID: PMC6323795 DOI: 10.1186/s12974-018-1392-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/17/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The fetal brain is particularly vulnerable to intrauterine growth restriction (IUGR) conditions evidenced by neuronal and white matter abnormalities and altered neurodevelopment in the IUGR infant. To further our understanding of neurodevelopment in the newborn IUGR brain, clinically relevant models of IUGR are required. This information is critical for the design and implementation of successful therapeutic interventions to reduce aberrant brain development in the IUGR newborn. We utilise the piglet as a model of IUGR as growth restriction occurs spontaneously in the pig as a result of placental insufficiency, making it a highly relevant model of human IUGR. The purpose of this study was to characterise neuropathology and neuroinflammation in the neonatal IUGR piglet brain. METHODS Newborn IUGR (< 5th centile) and normally grown (NG) piglets were euthanased on postnatal day 1 (P1; < 18 h) or P4. Immunohistochemistry was utilised to examine neuronal, white matter and inflammatory responses, and PCR for cytokine analysis in parietal cortex of IUGR and NG piglets. RESULTS The IUGR piglet brain displayed less NeuN-positive cells and reduced myelination at both P1 and P4 in the parietal cortex, indicating neuronal and white matter disruption. A concurrent decrease in Ki67-positive proliferative cells and increase in cell death (caspase-3) in the IUGR piglet brain was also apparent on P4. We observed significant increases in the number of both Iba-1-positive microglia and GFAP-positive astrocytes in the white matter in IUGR piglet brain on both P1 and P4 compared with NG piglets. These increases were associated with a change in activation state, as noted by altered glial morphology. This inflammatory state was further evident with increased expression levels of proinflammatory cytokines (interleukin-1β, tumour necrosis factor-α) and decreased levels of anti-inflammatory cytokines (interleukin-4 and -10) observed in the IUGR piglet brains. CONCLUSIONS These findings suggest that the piglet model of IUGR displays the characteristic neuropathological outcomes of neuronal and white matter impairment similar to those reported in the IUGR human brain. The activated glial morphology and elevated proinflammatory cytokines is indicative of an inflammatory response that may be associated with neuronal damage and white matter disruption. These findings support the use of the piglet as a pre-clinical model for studying mechanisms of altered neurodevelopment in the IUGR newborn.
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Affiliation(s)
- Julie A Wixey
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia.
| | - Kah Meng Lee
- Institute of Health Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| | - Stephanie M Miller
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
| | - Kate Goasdoue
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
| | - Paul B Colditz
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia.,Perinatal Research Centre, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia
| | - S Tracey Bjorkman
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
| | - Kirat K Chand
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
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Yates DT, Petersen JL, Schmidt TB, Cadaret CN, Barnes TL, Posont RJ, Beede KA. ASAS-SSR Triennnial Reproduction Symposium: Looking Back and Moving Forward-How Reproductive Physiology has Evolved: Fetal origins of impaired muscle growth and metabolic dysfunction: Lessons from the heat-stressed pregnant ewe. J Anim Sci 2018; 96:2987-3002. [PMID: 29701769 PMCID: PMC6095381 DOI: 10.1093/jas/sky164] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/24/2018] [Indexed: 12/11/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is the second leading cause of perinatal mortality and predisposes offspring to metabolic disorders at all stages of life. Muscle-centric fetal adaptations reduce growth and yield metabolic parsimony, beneficial for IUGR fetal survival but detrimental to metabolic health after birth. Epidemiological studies have reported that IUGR-born children experience greater prevalence of insulin resistance and obesity, which progresses to diabetes, hypertension, and other metabolic disorders in adulthood that reduce quality of life. Similar adaptive programming in livestock results in decreased birth weights, reduced and inefficient growth, decreased carcass merit, and substantially greater mortality rates prior to maturation. High rates of glucose consumption and metabolic plasticity make skeletal muscle a primary target for nutrient-sparing adaptations in the IUGR fetus, but at the cost of its contribution to proper glucose homeostasis after birth. Identifying the mechanisms underlying IUGR pathophysiology is a fundamental step in developing treatments and interventions to improve outcomes in IUGR-born humans and livestock. In this review, we outline the current knowledge regarding the adaptive restriction of muscle growth and alteration of glucose metabolism that develops in response to progressively exacerbating intrauterine conditions. In addition, we discuss the evidence implicating developmental changes in β adrenergic and inflammatory systems as key mechanisms for dysregulation of these processes. Lastly, we highlight the utility and importance of sheep models in developing this knowledge.
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Affiliation(s)
- Dustin T Yates
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Jessica L Petersen
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Ty B Schmidt
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Caitlin N Cadaret
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Taylor L Barnes
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Robert J Posont
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Kristin A Beede
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
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Barrientos G, Pussetto M, Rose M, Staff AC, Blois SM, Toblli JE. Defective trophoblast invasion underlies fetal growth restriction and preeclampsia-like symptoms in the stroke-prone spontaneously hypertensive rat. Mol Hum Reprod 2018; 23:509-519. [PMID: 28402512 DOI: 10.1093/molehr/gax024] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 04/07/2017] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the impact of chronic hypertension on placental development, fetal growth and maternal outcome in the stroke-prone spontaneously hypertensive rat (SHRSP)? SUMMARY ANSWER SHRSP showed an impaired remodeling of the spiral arteries and abnormal pattern of trophoblast invasion during placentation, which were associated with subsequent maternal glomerular injury and increased baseline hypertension as well as placental insufficiency and asymmetric fetal growth restriction (FGR). WHAT IS KNOWN ALREADY A hallmark in the pathogenesis of preeclampsia (PE) is abnormal placentation with defective remodeling of the spiral arteries preceding the onset of the maternal syndrome. Pregnancies affected by chronic hypertension display an increased risk for PE, often associated with poor maternal and fetal outcomes. However, the impact of chronic hypertension on the placentation process as well as the nature of the factors promoting the development of PE in pregnant hypertensive women remain elusive. STUDY DESIGN, SIZE, DURATION Timed pregnancies [n = 5] were established by mating 10-12-week-old SHRSP and Wistar Kyoto (WKY, normotensive controls) females with congenic males. Maternal systolic blood pressures (SBPs) were recorded pre-mating, throughout pregnancy (GD1-19) and post-partum by the tail-cuff method. On selected dates, 24 h urine- and blood samples were collected, and animals were euthanized for isolation of implantation sites and kidneys for morphometrical analyses. PARTICIPANTS/MATERIALS, SETTING, METHODS The 24 h proteinuria and the albumin:creatinine ratio were used for evaluation of maternal renal function. Renal injury was assessed on periodic acid Schiff, Masson's trichrome and Sirius red stainings. Placental and fetal weights were recorded on gestation day (GD)18 and GD20, followed by determination of fetal cephalization indexes and developmental stage, according to the Witschi scale. Morphometric analyses of placental development were conducted on hematoxylin-eosin stained tissue sections collected on GD14 and GD18, and complemented with immunohistochemical evaluation of isolectin B4 binding for assessment of placental vascularization. Analyses of vascular wall alpha actin content, perforin-positive natural killer (NK) cells and cytokeratin expression by immunohistochemistry were used for evaluation of spiral artery remodeling and trophoblast invasion. MAIN RESULTS AND THE ROLE OF CHANCE SHRSP females presented significantly increased SBP records from GD13 to GD17 (SBPGD13 = 183.9 ± 3.9 mmHg, P < 0.005 versus baseline) and increased proteinuria at GD18 (P < 0.01 versus WKY). Histological examination of GD18 kidneys revealed glomerular enlargement and mesangial matrix expansion, which were not evident in pregnant WKY or age-matched virgin SHRSP. At GD20, SHRSP displayed a significant reduction of placental mass (P < 0.01 versus WKY) and signs of placental insufficiency (i.e. hypertrophy and reduced branching morphogenesis of the labyrinth layer), associated with decreased offspring weights and increased cephalization index (both P < 0.001 versus WKY) indicating asymmetric FGR. Notably, SHRSP placentas displayed an incomplete remodeling of spiral arteries starting as early as GD14, with luminal narrowing and reduced densities of perivascular NK cells followed by decreased infiltration of endovascular trophoblasts at GD18. LARGE SCALE DATA n/a. LIMITATIONS, REASONS FOR CAUTION A pitfall of the present study is the differences in the blood pressure profiles between rats and humans (i.e. unlike pregnancies affected by PE, blood pressure in SHRSP and other hypertensive rat models decreases pre-delivery), which limits extrapolation of the results. WIDER IMPLICATIONS OF THE FINDINGS Our findings provide new insights on the role of chronic hypertension as a risk factor for PE by interfering with early events during the placentation process. The SHRSP strain represents an attractive model for further studies aimed at addressing the relative contribution of intrinsic (i.e. placental) and extrinsic (i.e. decidual/vascular) factors to defective spiral artery remodeling in pregnancies affected by PE. STUDY FUNDING AND COMPETING INTEREST(S) This work was supported by research grants from Fundación Florencio Fiorini to G.B., from Charité Stiftung to S.M.B. and University of Buenos Aires (UBACyt) to J.T. The authors have no competing interests to declare.
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Affiliation(s)
- G Barrientos
- Laboratory of Experimental Medicine, Hospital Alemán, School of Medicine, University of Buenos Aires, CONICET. Av. Pueyrredon 1640 (C1118AAT), Buenos Aires, Argentina.,Charité-Center for Internal Medicine and Dermatology, Division of General Internal and Psychosomatic Medicine, Reproductive Medicine Research Group, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Pussetto
- Laboratory of Experimental Medicine, Hospital Alemán, School of Medicine, University of Buenos Aires, CONICET. Av. Pueyrredon 1640 (C1118AAT), Buenos Aires, Argentina
| | - M Rose
- Charité-Center for Internal Medicine and Dermatology, Division of General Internal and Psychosomatic Medicine, Reproductive Medicine Research Group, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - A C Staff
- Department of Obstetrics and Department of Gynaecology, Women's Division, Oslo University Hospital, Ullevål and University of Oslo, Oslo, Norway
| | - S M Blois
- Charité-Center for Internal Medicine and Dermatology, Division of General Internal and Psychosomatic Medicine, Reproductive Medicine Research Group, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J E Toblli
- Laboratory of Experimental Medicine, Hospital Alemán, School of Medicine, University of Buenos Aires, CONICET. Av. Pueyrredon 1640 (C1118AAT), Buenos Aires, Argentina
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Cohen E, Whatley C, Wong FY, Wallace EM, Mockler JC, Odoi A, Hollis S, Horne RSC, Yiallourou SR. Effects of foetal growth restriction and preterm birth on cardiac morphology and function during infancy. Acta Paediatr 2018; 107:450-455. [PMID: 29115693 DOI: 10.1111/apa.14144] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/21/2017] [Accepted: 11/01/2017] [Indexed: 01/25/2023]
Abstract
AIM To investigate the effects of foetal growth restriction (FGR) and prematurity on cardiac morphology and function in infancy. We hypothesised that FGR and prematurity would both alter cardiac development. METHODS Cardiac morphology and function were evaluated in 24 preterm FGR infants (p-FGR) and 23 preterm and 19 term appropriately grown for gestational age infants (p-AGA and t-AGA, respectively) by conventional echocardiography and Tissue Doppler Imaging. p-FGR and p-AGA infants were studied on postnatal day 1 and all groups were studied at one-and six-months post-term age. RESULTS p-FGR infants demonstrated increased cardiac sphericity compared to AGA peers on postnatal day 1 (p = 0.004) and at one-month post-term age (p = 0.004). Posterior and relative wall thickness increased overtime in the p-FGR group only (p < 0.05). Systolic function was not different between groups. E/e' ratio was higher in both preterm groups compared to the term group at one-month post-term age (p = 0.01). No statistically significant group differences were found at six-months post-term age. CONCLUSION Foetal growth restriction was associated with subtle cardiac morphological changes, whereas both prematurity and FGR were associated with subclinical alterations in diastolic function.
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Affiliation(s)
- Emily Cohen
- The Ritchie Centre; Hudson Institute of Medical Research and Department of Paediatrics; Monash University; Melbourne Vic. Australia
- Department of Neonatology; Wilhelmina Children's Hospital; Utrecht The Netherlands
| | | | - Flora Y. Wong
- The Ritchie Centre; Hudson Institute of Medical Research and Department of Paediatrics; Monash University; Melbourne Vic. Australia
- Monash Newborn; Monash Children's Hospital; Melbourne Vic. Australia
| | - Euan M. Wallace
- The Ritchie Centre; Department of Obstetrics and Gynaecology; Monash University; Melbourne Vic. Australia
| | - Joanne C. Mockler
- Department of Obstetrics and Gynaecology; Monash Health; Monash University and Monash Women's; Melbourne Vic. Australia
| | - Alexsandria Odoi
- The Ritchie Centre; Hudson Institute of Medical Research and Department of Paediatrics; Monash University; Melbourne Vic. Australia
| | - Samantha Hollis
- The Ritchie Centre; Hudson Institute of Medical Research and Department of Paediatrics; Monash University; Melbourne Vic. Australia
| | - Rosemary S. C. Horne
- The Ritchie Centre; Hudson Institute of Medical Research and Department of Paediatrics; Monash University; Melbourne Vic. Australia
| | - Stephanie R. Yiallourou
- The Ritchie Centre; Hudson Institute of Medical Research and Department of Paediatrics; Monash University; Melbourne Vic. Australia
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40
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Espiritu MM, Bailey S, Wachtel EV, Mally PV. Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review. J Perinat Med 2018; 46:81-86. [PMID: 28803228 DOI: 10.1515/jpm-2016-0287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 07/17/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Due to the extremely low incidence of TORCH (toxoplasmosis, rubella, CMV, herpes simplex virus) infections, diagnostic testing of all small for gestational age (SGA) infants aimed at TORCH etiologies may incur unnecessary tests and cost. OBJECTIVE To determine the frequency of urine CMV PCR and total IgM testing among infants with birth weight <10% and the rate of test positivity. To evaluate the frequency of alternative etiologies of SGA in tested infants. METHODS Retrospective chart review of SGA infants admitted to the neonatal intensive care unit (NICU) at NYU Langone Medical Center between 2007 and 2012. Subjects were classified as being SGA with or without intrauterine growth restriction (IUGR). The IUGR subjects were then further categorized as having either symmetric or asymmetric IUGR utilizing the Fenton growth chart at birth. Initial testing for TORCH infections, which included serum total IgM, CMV PCR and head ultrasound, were reviewed and analyzed. RESULTS Three hundred and eighty-six (13%) infants from a total of 2953 NICU admissions had a birth weight ≤10th percentile. Of these, 44% were IUGR; 34% being symmetric IUGR and 10% asymmetric. A total of 32% of SGA infants had urine CMV PCR and total IgM tested with no positive results. As expected, significantly higher percentage of symmetric IUGR infants were tested compared to asymmetric IUGR and non-IUGR SGA infants, (64% vs. 47% vs. 19%) P≤0.01. However, 63% of infants with a known cause for IUGR had same testing done aimed at TORCH infections. We calculated additional charges of $64,065 that were incurred by such testing. CONCLUSIONS The majority of infants in our study who received testing for urine CMV PCR and total IgM aimed at TORCH infections had one or more other known non-infectious etiologies for IUGR. Because the overall yield of such testing is extremely low, we suggest tests for possible TORCH infections may be limited to symmetric IUGR infants without other known etiologies. Improved guidelines testing for TORCH infections can result in reducing hospital charges and unnecessary studies.
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Affiliation(s)
- Michael M Espiritu
- Department of Pediatrics, Division of Neonatology, New York University School of Medicine, 317 E 34th Street, Suite 902, New York, NY 10016, USA
| | - Sean Bailey
- Department of Pediatrics, Division of Neonatology, New York University School of Medicine, New York, NY 10016, USA
| | - Elena V Wachtel
- Department of Pediatrics, Division of Neonatology, New York University School of Medicine, New York, NY 10016, USA
| | - Pradeep V Mally
- Department of Pediatrics, Division of Neonatology, New York University School of Medicine, New York, NY 10016, USA
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Arioz Habibi H, Alici Davutoglu E, Kandemirli SG, Aslan M, Ozel A, Kalyoncu Ucar A, Zeytun P, Madazli R, Adaletli I. In vivo assessment of placental elasticity in intrauterine growth restriction by shear-wave elastography. Eur J Radiol 2017; 97:16-20. [DOI: 10.1016/j.ejrad.2017.10.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 08/31/2017] [Accepted: 10/03/2017] [Indexed: 11/24/2022]
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Kadji C, Camus MF, Bevilacqua E, Cannie MM, Sanchez TC, Jani JC. Repeatability of estimated fetal weight: Comparison between MR imaging versus 2D ultrasound in at- and near-term patients. Eur J Radiol 2017. [DOI: 10.1016/j.ejrad.2017.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Yingjun X, Zhiyang H, Linhua L, Fangming S, Linhuan H, Jinfeng T, Qianying P, Xiaofang S. Chromosomal uniparental disomy 16 and fetal intrauterine growth restriction. Eur J Obstet Gynecol Reprod Biol 2017; 211:1-7. [DOI: 10.1016/j.ejogrb.2016.12.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/18/2016] [Indexed: 11/28/2022]
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Rahman A, Zhou YQ, Yee Y, Dazai J, Cahill LS, Kingdom J, Macgowan CK, Sled JG. Ultrasound detection of altered placental vascular morphology based on hemodynamic pulse wave reflection. Am J Physiol Heart Circ Physiol 2017; 312:H1021-H1029. [PMID: 28364018 DOI: 10.1152/ajpheart.00791.2016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/16/2017] [Accepted: 03/28/2017] [Indexed: 11/22/2022]
Abstract
Abnormally pulsatile umbilical artery (UA) Doppler ultrasound velocity waveforms are a hallmark of severe or early onset placental-mediated intrauterine growth restriction (IUGR), whereas milder late onset IUGR pregnancies typically have normal UA pulsatility. The diagnostic utility of these waveforms to detect placental pathology is thus limited and hampered by factors outside of the placental circulation, including fetal cardiac output. In view of these limitations, we hypothesized that these Doppler waveforms could be more clearly understood as a reflection phenomenon and that a reflected pulse pressure wave is present in the UA that originates from the placenta and propagates backward along the UA. To investigate this, we developed a new ultrasound approach to isolate that portion of the UA Doppler waveform that arises from a pulse pressure wave propagating backward along the UA. Ultrasound measurements of UA lumen diameter and flow waveforms were used to decompose the observed flow waveform into its forward and reflected components. Evaluation of CD1 and C57BL/6 mice at embryonic day (E)15.5 and E17.5 demonstrated that the reflected waveforms diverged between the strains at E17.5, mirroring known changes in the fractal geometry of fetoplacental arteries at these ages. These experiments demonstrate the feasibility of noninvasively measuring wave reflections that originate from the fetoplacental circulation. The observed reflections were consistent with theoretical predictions based on the area ratio of parent to daughters at bifurcations in fetoplacental arteries suggesting that this approach could be used in the diagnosis of fetoplacental vascular pathology that is prevalent in human IUGR. Given that the proposed measurements represent a subset of those currently used in human fetal surveillance, the adaptation of this technology could extend the diagnostic utility of Doppler ultrasound in the detection of placental vascular pathologies that cause IUGR.NEW & NOTEWORTHY Here, we describe a novel approach to noninvasively detect microvascular changes in the fetoplacental circulation using ultrasound. The technique is based on detecting reflection pulse pressure waves that travel along the umbilical artery. Using a proof-of-principle study, we demonstrate the feasibility of the technique in two strains of experimental mice.
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Affiliation(s)
- Anum Rahman
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Yu-Qing Zhou
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yohan Yee
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Jun Dazai
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lindsay S Cahill
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
| | - John Kingdom
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.,Mount Sinai Hospital, Toronto, Ontario, Canada; and
| | - Christopher K Macgowan
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - John G Sled
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada; .,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.,Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
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Gayatri R, Crasta J, Thomas T, Pratibha D, Thomas A, Sridhar TS, Kurpad AV. Structural Analysis of the Umbilical Cord and Its Vessels in Intrauterine Growth Restriction and Pre-eclampsia. JOURNAL OF FETAL MEDICINE 2017. [DOI: 10.1007/s40556-017-0118-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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46
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GABA A receptor expression and white matter disruption in intrauterine growth restricted piglets. Int J Dev Neurosci 2017; 59:1-9. [PMID: 28219764 DOI: 10.1016/j.ijdevneu.2017.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 12/25/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is one of the most common causes of perinatal mortality and morbidity. White matter and neuronal injury are major pathophysiological features of the IUGR neonatal brain. GABAA (γ-aminobutyric acid type A) receptors have been shown to play a role in oligodendrocyte differentiation and proliferation in the neonatal brain and may be a key factor in white matter injury and myelination in IUGR neonates. Whether there are impairments to the GABAergic system and neuronal cytoskeleton in IUGR brain has yet to be elucidated. This study aims to examine GABAA receptor α1 and α3 subunit protein expression and distribution in parietal cortex and hippocampus of the IUGR piglet at four different ages (term=115d - days gestational age), 100d, 104d, birth (postnatal day 0-P0) and P7 and to examine neuronal and myelination patterns. Significant alterations to GABAA receptor α1 and α3 protein expression levels were observed in the IUGR piglet brain of P7 IUGR piglets with significantly greater α3 expression compared to α1 expression in the hippocampus while there was virtually no difference between the two subunits in the parietal cortex. However a significantly lower α1/α3 ratio was evident in P7 IUGR cortex when compared with P7 NG cortex. Neuronal somatodendrites studied using MAP2 immunohistochemistry showed reduced and disrupted somatodendrites while MBP immunolabelling showed loss of axonal fibres from gestational day 104d through to P7. These findings provide insights into the effects of IUGR on the development of the GABA system, altered developmental maturation of GABAA receptor subunit expression in the IUGR brain may influence myelination and may partly explain the cognitive disabilities observed in IUGR. Understanding the mechanisms behind grey and white matter injury in the IUGR infant is essential to identifying targets for treatments to improve long-term outcomes for IUGR infants.
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Cox P, Marton T, Hargitai B, Coetzee A, Bowen C, Penman D, Evans M, Gannon C, French P, Cohen M, Holden S, Allotey J, Evans C, Murphy A, Turner K, Cullinane C, Stahlschmidt J, Kokai G, Al Adnani M, Marnerides A, Vadgama B, McPartland J. Re: Stillbirth collection by Man et al. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:281-282. [PMID: 28169497 DOI: 10.1002/uog.17380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Affiliation(s)
- P Cox
- Perinatal Pathology, Birmingham Women's Hospital, Mindelsohn Way, Birmingham, B15 2TG, UK
| | - T Marton
- Perinatal Pathology, Birmingham Women's Hospital, Mindelsohn Way, Birmingham, B15 2TG, UK
| | - B Hargitai
- Perinatal Pathology, Birmingham Women's Hospital, Mindelsohn Way, Birmingham, B15 2TG, UK
| | - A Coetzee
- Perinatal Pathology, Birmingham Women's Hospital, Mindelsohn Way, Birmingham, B15 2TG, UK
| | - C Bowen
- Paediatric Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - D Penman
- Paediatric Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - M Evans
- Perinatal Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - C Gannon
- Perinatal Pathologist, Bangor, Northern, Ireland
| | - P French
- Paediatric Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - M Cohen
- Pathology, Sheffield Children's Hospital NHS Trust, Sheffield, UK
| | - S Holden
- Paediatric & Perinatal Pathology, Southampton General Hospital, Southampton, UK
| | - J Allotey
- Paediatric Pathology, Queen's Medical Centre, Nottingham, UK
| | - C Evans
- Paediatric Pathology, Queen's Medical Centre, Nottingham, UK
| | - A Murphy
- Paediatric Pathology, Queen's Medical Centre, Nottingham, UK
| | - K Turner
- Paediatric & Perinatal Pathology, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - C Cullinane
- Paediatric & Perinatal Pathology, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Stahlschmidt
- Paediatric & Perinatal Pathology, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G Kokai
- Paediatric Pathology, Alder Hey Children's Hospital, Liverpool, UK
| | - M Al Adnani
- Paediatric & Perinatal Pathology, St Thomas' Hospital, London, UK
| | - A Marnerides
- Paediatric & Perinatal Pathology, St Thomas' Hospital, London, UK
| | - B Vadgama
- Paediatric & Perinatal Pathology, Southampton General Hospital, Southampton, UK
| | - J McPartland
- Paediatric Pathology, Alder Hey Children's Hospital, Liverpool, UK
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48
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Lopez-Tello J, Arias-Alvarez M, Jimenez-Martinez MA, Garcia-Garcia RM, Rodriguez M, Lorenzo Gonzalez PL, Bermejo-Poza R, Gonzalez-Bulnes A, Garcia Rebollar P. Competition for Materno-Fetal Resource Partitioning in a Rabbit Model of Undernourished Pregnancy. PLoS One 2017; 12:e0169194. [PMID: 28046002 PMCID: PMC5207739 DOI: 10.1371/journal.pone.0169194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 12/13/2016] [Indexed: 02/07/2023] Open
Abstract
The major goal of animal production is to obtain abundant and healthy meat for consumers. Maternal food restriction (MFR) is often applied in farms to reduce production costs. However, the suitability of MFR in livestock animals is questionable, as this management may compromise maternal fitness due to a severe negative energetic balance and can induce Intrauterine Growth Restriction (IUGR) and prenatal programming in the offspring. Here, we sought to determine, using pregnant rabbits, the consequences of MFR on maternal endocrine and metabolic status and conceptus development. Pregnant dams were distributed into three groups: CONTROL (ad libitum feeding throughout the entire pregnancy; mean pregnancy length being around 31 days), UNDERFED (50% MFR during the entire pregnancy) and EARLY-UNDERFED (50% MFR only during the preimplantation period, Days 0–7). Maternal leptin concentrations and glycemic and lipid profiles were determined throughout pregnancy, whilst conceptus development was assessed ex-vivo at Day 28. Placental parameters were determined by macroscopic and histological evaluations and apoptotic assessments (TUNEL and Caspase-3). The main results of the study showed that, despite MFR altered maternal plasma lipid concentration (P<0.05), there were no effects on maternal bodyweight, plasma leptin concentration or glycemic profile. Fetal crown-rump lengths were reduced in both undernourished groups (P<0.001), but a significant reduction in fetal weight was only observed in the UNDERFED group (P<0.001). Growth in both undernourished groups was asymmetrical, with reduced liver weight (P<0.001) and significantly increased brain: fetal weight-ratio (P<0.001) and brain: liver weight-ratio (P<0.001) when compared to the CONTROL group. A significant reduction in placental weight was only observed in the UNDERFED group (P<0.001), despite both undernourished groups showing higher apoptotic rates at decidua and labyrinth zone (P<0.05) than the CONTROL group. Thus, these groups evidenced signs of placental degeneration, necrosis and stromal collapse. In summary, MFR may encourage the mother to make strategic decisions to safeguard her metabolic status and fitness at the expense of growth reduction in the litter, resulting in enhanced apoptotic and pathological processes at placental level and IUGR.
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Affiliation(s)
- Jorge Lopez-Tello
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
- * E-mail:
| | - Maria Arias-Alvarez
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
| | - Maria Angeles Jimenez-Martinez
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
| | - Rosa Maria Garcia-Garcia
- Department of Physiology (Animal Physiology), Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
| | - Maria Rodriguez
- Department of Agrarian Production, E.T.S.I.A.A.B. Polytechnic University of Madrid, Ciudad Universitaria, Madrid, Spain
| | - Pedro Luis Lorenzo Gonzalez
- Department of Physiology (Animal Physiology), Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
| | - Ruben Bermejo-Poza
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
| | | | - Pilar Garcia Rebollar
- Department of Agrarian Production, E.T.S.I.A.A.B. Polytechnic University of Madrid, Ciudad Universitaria, Madrid, Spain
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49
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Gerger RPC, Zago FC, Ribeiro ES, Gaudencio Neto S, Martins LT, Aguiar LH, Rodrigues VHV, Furlan FH, Ortigari I, Sainz RD, Ferrell CL, Miglino MA, Ambrósio CE, Rodrigues JL, Rossetto R, Forell F, Bertolini LR, Bertolini M. Morphometric developmental pattern of bovine handmade cloned concepti in late pregnancy. Reprod Fertil Dev 2017; 29:950-967. [DOI: 10.1071/rd15215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 01/15/2016] [Indexed: 11/23/2022] Open
Abstract
Cloning procedures often interfere with conceptus growth and life ex utero, in a set of symptoms known as abnormal offspring syndrome (AOS). The aim of the present study was to compare the developmental pattern of in vivo-derived (IVD), IVF-derived and handmade cloning-derived (NT-HMC) Day 225 bovine concepti using established procedures. Pregnancy diagnosis was performed on Day 30 following blastocyst transfer on Day 7. Conceptus morphometry was assessed by ultrasonography on Day 51, and on Day 225 pregnant cows were killed for morphological examination of concepti. Pregnancy outcome was similar between groups, with greater pregnancy losses in the first trimester (70.6%) and smaller fetuses on Day 51 in the NT-HMC group than in the IVD (14.3%) and IVF (20.0%) groups. However, NT-HMC-derived concepti were twofold larger on Day 225 of gestation than controls. A higher frequency (63.5%) of placentomes larger than the largest in the IVD group was observed in the NT-HMC group, which may be relevant to placental function. Conceptus traits in the IVF group were similar to the IVD controls, with only slight changes in placentome types. Morphological changes in cloned concepti likely affected placental function and metabolism, disrupting the placental constraining mechanism on fetal growth in mid- to late pregnancy.
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50
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Durhan G, Ünverdi H, Deveci C, Büyükşireci M, Karakaya J, Değirmenci T, Bayrak A, Koşar P, Hücümenoğlu S, Ergün Y. Placental Elasticity and Histopathological Findings in Normal and Intra-Uterine Growth Restriction Pregnancies Assessed with Strain Elastography in Ex Vivo Placenta. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:111-118. [PMID: 27742142 DOI: 10.1016/j.ultrasmedbio.2016.08.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 07/17/2016] [Accepted: 08/29/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to investigate the differences of placental elasticity between intra-uterine growth restriction (IUGR) and normal pregnancies to show whether or not there is any association between histopathological changes and placental elasticity. Fifty-five human placentas were collected at delivery, including 25 with IUGR and 30 controls. Strain elastography (SE) was performed ex vivo and all placentas were examined histopathologically. Elasticity index (EI) and histopathological findings were compared between groups. The placental stiffness and presence of histopathological changes were higher in the IUGR group than in controls (p < 0.05). Also, histopathological findings were associated with decreased EI values, but no specific patterns of histologic abnormalities were identified except villitis and delayed villous maturity. Distinct reduced placental elasticity could be the result of the cumulative effects of all the histologic findings in IUGR.
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Affiliation(s)
- Gamze Durhan
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
| | - Hatice Ünverdi
- Department of Pathology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Canan Deveci
- Department of Obstetrics and Gynecology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Mehmet Büyükşireci
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Tülin Değirmenci
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Ahmet Bayrak
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Pınar Koşar
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Sema Hücümenoğlu
- Department of Pathology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Yusuf Ergün
- Department of Obstetrics and Gynecology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
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