1
|
Nguyen-Hoang L, Chaemsaithong P, Ip PN, Guo J, Wang X, Chong MKC, Sahota DS, Chung JP, Poon LC. Biomarkers in the prediction of complications in pregnancy after assisted reproductive technology. Int J Gynaecol Obstet 2024. [PMID: 39016290 DOI: 10.1002/ijgo.15786] [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: 02/19/2024] [Revised: 06/08/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVES To compare the temporal changes in mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFlt-1) across gestation between assisted reproductive technology (ART) pregnancies complicated with great obstetrical syndromes (GOS) or gestational diabetes (GDM) ± large-for-gestational-age (LGA) fetus, and uncomplicated ART pregnancies. METHODS This was a prospective longitudinal study of 143 women with singleton pregnancies who conceived through ART at the Department of Obstetrics and Gynecology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR between December 2017 and January 2020. The participants were followed up at 6-6+3, 11-13+6, 20-24+6, 30-34+6, and 35-37+6 weeks for the measurement of MAP, UtA-PI, PlGF, and sFlt-1. A linear mixed-effects analysis was performed to compare the biomarkers in the GOS, GDM ± LGA, and uncomplicated groups across gestation. RESULTS Thirty-three (23.1%) and fifty-five (31.5%) women were diagnosed with GOS and GDM ± LGA, respectively. The GOS group had higher estimated marginal mean log10 MAP mulitples of the median (MoM) across gestation, compared with the uncomplicated group (0.00771 vs -0.02022; P < 0.001), when adjusting for clinical visits and days of embryo transfer. The absolute mean log10 MAP MoM in the GOS group was found to be significantly higher than that of the uncomplicated group at all clinical visits from 6 weeks onwards. Furthermore, the estimated marginal mean log10 PlGF MoM was significantly lower in the GOS group across gestation, compared with the uncomplicated group (-0.04226 vs 0.05566; P = 0.010). The significant difference in log10 PlGF MoM was observed from 11-13+6 to 30-34+6 week of gestation (P < 0.05). However, no significant differences in the estimated marginal means of log10 UtA-PI MoM and log10 sFlt-1 MoM between GOS and uncomplicated groups were observed. GDM ± LGA group had a lower estimated marginal mean log10 PlGF MoM throughout pregnancy compared with the uncomplicated group (-0.01536 vs 0.05572; P = 0.032). In the individual visit analysis, the significant difference was observed at the 20-24+6 and 35-37+6 weeks visits (P < 0.05). There were no significant differences in estimated marginal mean log10 MoM of MAP, UtA-PI, and sFlt-1 between GDM ± LGA and uncomplicated groups during pregnancy. CONCLUSION Our study has revealed that among pregnancies conceived through ART, GOS is associated with higher MAP and lower PlGF from early gestation until late third trimester, while GDM ± LGA is associated with lower PlGF during the second half of pregnancy. The same degree of differences in MAP and PlGF persists from early until late gestation in the GOS group and these findings highlight the importance of early screening during the first trimester to identify women who are at risk for developing GOS following ART procedures. Lastly, the potential of PlGF in predicting the development of GDM from the second trimester of pregnancy requires further investigation.
Collapse
Affiliation(s)
- Long Nguyen-Hoang
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Piya Chaemsaithong
- Department of Obstetrics and Gynecology, Mahidol University, Bangkok, Thailand
| | - Patricia N Ip
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jun Guo
- Department of Obstetrics and Gynecology, Beijing Tongren Hospital, The Capital Medical University, Beijing, China
| | - Xueqin Wang
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Marc K C Chong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Daljit S Sahota
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jacqueline P Chung
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Liona C Poon
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, SAR, China
| |
Collapse
|
2
|
Tasca C, Parisi F, Zambon M, Bonato S, Bombelli M, Rossi RS, Caselli E, Petrella D, Nebuloni M, Cetin I. A real-life prospective blinded evaluation of placental biometry and macroscopic morphology from 1008 unselected consecutive pregnancies. Placenta 2024; 146:9-16. [PMID: 38157652 DOI: 10.1016/j.placenta.2023.12.021] [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: 10/07/2023] [Revised: 12/10/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The study of the macroscopic appearance of the placenta may represent a useful tool to understand the pathophysiology of adverse pregnancy outcomes. The aim of this study was to evaluate biometry and morphology of placentas in relation to maternal, neonatal and pregnancy course characteristics. METHODS Clinical and placental data (biometry and macroscopic features of chorionic disk and adnexa) from unselected consecutive singleton pregnancies were recorded at the same Institution. Placental efficiency was approximated as ratio between fetal and placental weight (FPR). The total population was grouped according to the presence of any maternal comorbidity or pregnancy complication (group 1), neonatal complications diagnosed only at birth (2) and absence of any comorbidity (3). Multi-adjusted general linear and logistic regression models were performed to analyze associations between groups and placental biometry and morphology. RESULTS The study population counted 1008 pregnancies: 576 (57.2 %) classified as group 1, 76 (7.5 %) as group 2 and 356 (35.3 %) uncomplicated controls (group 3). In multivariate models adjusted for confounding factors, no significant differences in placental biometry and macroscopic features were observed among the three groups. Maternal BMI was significantly associated with higher placental and birth weight and lower FPR; moreover FPR was significantly higher in pregnancies carrying males compared to female neonates. DISCUSSION Maternal comorbidity or pregnancy disease was not associated with significant changes in placental macroscopic biometry and morphology. Conversely, maternal pregestational BMI and fetal sex impact on placental biometry and efficiency, suggesting different intrauterine adaptations in obese mothers and in male and female fetuses.
Collapse
Affiliation(s)
- Chiara Tasca
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Francesca Parisi
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Marta Zambon
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Susanna Bonato
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Martina Bombelli
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Roberta Simona Rossi
- Pathology Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Emilio Caselli
- Pathology Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Duccio Petrella
- Pathology Unit, Fatebenefratelli Hospital, University of Milan, Milan, Italy
| | - Manuela Nebuloni
- Pathology Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Irene Cetin
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.
| |
Collapse
|
3
|
Wu S, Liu K, Zhou B, Wu S. N6-methyladenosine modifications in maternal-fetal crosstalk and gestational diseases. Front Cell Dev Biol 2023; 11:1164706. [PMID: 37009476 PMCID: PMC10060529 DOI: 10.3389/fcell.2023.1164706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
As a medium among pregnant women, environment and fetus, placenta owns powerful and delicate epigenetic processes to regulate gene expression and maintain cellular homeostasis. N6-methyladenosine (m6A) is the most prevalent modification that determines the fate of RNA, and its dynamic reversibility indicates that m6A may serve as a sensitive responder to environmental stimuli. Emerging evidence suggests that m6A modifications play an essential role in placental development and maternal-fetal crosstalk, and are closely related to gestational diseases. Herein, we summarized the latest techniques for m6A sequencing and highlighted current advances of m6A modifications in maternal-fetal crosstalk and the underlying mechanisms in gestational diseases. Therefore, proper m6A modifications are important in placental development, but its disturbance mainly caused by various environmental factors can lead to abnormal placentation and function with possible consequences of gestational diseases, fetal growth and disease susceptibility in adulthood.
Collapse
Affiliation(s)
- Suqi Wu
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ketong Liu
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Bingyan Zhou
- Hubei Clinical Center of Hirschsprung’s Disease and Allied Disorders, Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Bingyan Zhou, ; Suwen Wu,
| | - Suwen Wu
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- *Correspondence: Bingyan Zhou, ; Suwen Wu,
| |
Collapse
|
4
|
Hebert JF, Myatt L. Metformin Impacts Human Syncytiotrophoblast Mitochondrial Function from Pregnancies Complicated by Obesity and Gestational Diabetes Mellitus in a Sexually Dimorphic Manner. Antioxidants (Basel) 2023; 12:719. [PMID: 36978967 PMCID: PMC10044921 DOI: 10.3390/antiox12030719] [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: 01/30/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/16/2023] Open
Abstract
Maternal obesity and gestational diabetes mellitus (GDM) are associated with placental dysfunction, small for gestational age (SGA) offspring, and programming of adult-onset disease. We examine how metformin, commonly used to treat type A2 GDM, affects placental metabolism as well as mitochondrial content and function. Syncytiotrophoblasts (STBs) were prepared from placentas of male and female fetuses collected at term cesarean section from lean (pre-pregnancy BMI < 25), obese (BMI > 30), and obese A2GDM women. Metformin treatment (0.001-10 mM) of STB caused no change in non-mitochondrial respiration but significant concentration-dependent (1 and 10 mM) decreases in basal, maximal, and ATP-linked respiration and spare capacity. Respiration linked to proton leak was significantly increased in STB of male A2GDM placentas at low metformin concentrations. Metformin concentrations ≥1 mM increased glycolysis in STB from placentas from lean women, but only improved glycolytic capacity in female STB. Whereas metformin had little effect on superoxide generation from male STB of any group, it gave a concentration-dependent decrease in superoxide generation from female STB of lean and obese women. Fewer mitochondria were observed in STB from obese women and male STB from lean women with increasing metformin concentration. Metformin affects STB mitochondrial function in a sexually dimorphic manner but at concentrations above those reported in maternal circulation (approximately 0.01 mM) in women treated with metformin for GDM.
Collapse
Affiliation(s)
| | - Leslie Myatt
- Department of Obstetrics and Gynecology, Oregon Health & Science University; Portland, OR 97239, USA
| |
Collapse
|
5
|
Roberts DJ, Baergen RN, Boyd TK, Carreon CK, Duncan VE, Ernst LM, Faye-Petersen OM, Folkins AK, Hecht JL, Heerema-McKenney A, Heller DS, Linn RL, Polizzano C, Ravishankar S, Redline RW, Salafia CM, Torous VF, Castro EC. Criteria for placental examination for obstetrical and neonatal providers. Am J Obstet Gynecol 2022; 228:497-508.e4. [PMID: 36549567 DOI: 10.1016/j.ajog.2022.12.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/28/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Pathologic examination of the placenta can provide insight into likely (and unlikely) causes of antepartum and intrapartum events, diagnoses with urgent clinical relevance, prognostic information for mother and infant, support for practice evaluation and improvement, and insight into advancing the sciences of obstetrics and neonatology. Although it is true that not all placentas require pathologic examination (although alternative opinions have been expressed), prioritization of placentas for pathologic examination should be based on vetted indications such as maternal comorbidities or pregnancy complications in which placental pathology is thought to be useful for maternal or infant care, understanding pathophysiology, or practice modifications. Herein we provide placental triage criteria for the obstetrical and neonatal provider based on publications and expert opinion of 16 placental pathologists and a pathologists' assistant, formulated using a modified Delphi approach. These criteria include indications in which placental pathology has clinical relevance, such as pregnancy loss, maternal infection, suspected abruption, fetal growth restriction, preterm birth, nonreassuring fetal heart testing requiring urgent delivery, preeclampsia with severe features, or neonates with early evidence of multiorgan system failure including neurologic compromise. We encourage a focused gross examination by the provider or an attendant at delivery for all placentas and provide guidance for this examination. We recommend that any placenta that is abnormal on gross examination undergo a complete pathology examination. In addition, we suggest practice criteria for placental pathology services, including a list of critical values to be used by the relevant provider. We hope that these sets of triage indications, criteria, and practice suggestions will facilitate appropriate submission of placentas for pathologic examination and improve its relevance to clinical care.
Collapse
Affiliation(s)
- Drucilla J Roberts
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX.
| | - Rebecca N Baergen
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Theonia K Boyd
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Chrystalle Katte Carreon
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Virginia E Duncan
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Linda M Ernst
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Ona M Faye-Petersen
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Ann K Folkins
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Jonathon L Hecht
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Amy Heerema-McKenney
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Debra S Heller
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Rebecca L Linn
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Carolyn Polizzano
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Sanjita Ravishankar
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Raymond W Redline
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Carolyn M Salafia
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Vanda F Torous
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Eumenia C Castro
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| |
Collapse
|
6
|
Li T, Li Z, Fu J, Tang C, Liu L, Xu J, Zhao J, Li Z. Nickel nanoparticles exert cytotoxic effects on trophoblast HTR-8/SVneo cells possibly via Nrf2/MAPK/caspase 3 pathway. ENVIRONMENTAL RESEARCH 2022; 215:114336. [PMID: 36103928 DOI: 10.1016/j.envres.2022.114336] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/20/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
Nickel nanoparticles are widely used in the industry and may affect the reproductive system. The potential molecular mechanism of exposing the first-trimester trophoblast cell line (HTR-8/SVneo) to nickel nanoparticles remains unclear. Hence, the aim of this study was to investigate the in vitro cytotoxicity of Ni NPs on HTR-8/SVneo cells. HTR-8/SVneo cells were subjected to various concentrations (0, 2.5, 5, 7.5, 10, and 12.5 μg/cm2) of Ni NPs. The toxicity of the Ni NPs was evaluated in HTR-8/SVneo cells by measuring cell viability. The underlying mechanism of nickel nanoparticles toxicity to HTR-8/SVneo cells was determined by measuring the content of intracellular reactive oxygen species, mitochondrial membrane potential, and the rate of cell apoptosis and cell cycle, by measuring adenosine triphosphate levels, intracellular lipid peroxidation malondialdehyde, total superoxide dismutase, and CuZn/Mn-SOD activities, and by determining proteins related to Nrf2, MAPK, and Cytochrome c. Our results showed that the nickel nanoparticles treatment reduced the viability of HTR-8/SVneo cells, while it increased their oxidative stress and lowered their mitochondrial respiratory capacity. Additionally, the nickel nanoparticles treatment induced cell S-phase arrest and apoptosis. These molecular events may be linked to the oxidative stress-Nrf2 pathway/MAPK/Caspase 3 cascade. Thus, nickel nanoparticles exert cytotoxic effects on HTR-8/SVneo cells, which could affect the function of the placenta in human.
Collapse
Affiliation(s)
- Ting Li
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, PR China
| | - Zhou Li
- Xiang Yang Center for Disease Control and Prevention, 172 Tanxi Road, Xiangyang, Hubei province 441022, PR China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, Zhejiang Province 315010, PR China
| | - Chunlan Tang
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, PR China
| | - Liya Liu
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, PR China
| | - Jin Xu
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, PR China
| | - Jinshun Zhao
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, PR China
| | - Zhen Li
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, PR China.
| |
Collapse
|
7
|
Deeba F, Hu R, Lessoway V, Terry J, Pugash D, Hutcheon J, Mayer C, Salcudean S, Rohling R. SWAVE 2.0 Imaging of Placental Elasticity and Viscosity: Potential Biomarkers for Placenta-Mediated Disease Detection. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2486-2501. [PMID: 36180312 DOI: 10.1016/j.ultrasmedbio.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
Pregnancy complications such as pre-eclampsia (PE) and intrauterine growth restriction (IUGR) are associated with structural and functional changes in the placenta. Different elastography techniques with an ability to assess the mechanical properties of tissue can identify and monitor the pathological state of the placenta. Currently available elastography techniques have been used with promising results to detect placenta abnormalities; however, limitations include inadequate measurement depth and safety concerns from high negative pressure pulses. Previously, we described a shear wave absolute vibro-elastography (SWAVE) method by applying external low-frequency mechanical vibrations to generate shear waves and studied 61 post-delivery clinically normal placentas to explore the feasibility of SWAVE for placental assessment and establish a measurement baseline. This next phase of the study, namely, SWAVE 2.0, improves the previous system and elasticity reconstruction by incorporating a multi-frequency acquisition system and using a 3-D local frequency estimation (LFE) method. Compared with its 2-D counterpart, the proposed system using 3-D LFE was found to reduce the bias and variance in elasticity measurements in tissue-mimicking phantoms. In the aim of investigating the potential of improved SWAVE 2.0 measurements to identify placental abnormalities, we studied 46 post-delivery placentas, including 26 diseased (16 IUGR and 10 PE) and 20 normal control placentas. By use of a 3.33-MHz motorized curved-array transducer, multi-frequency (80,100 and 120 Hz) elasticity measures were obtained with 3-D LFE, and both IUGR (15.30 ± 2.96 kPa, p = 3.35e-5) and PE (12.33 ± 4.88 kPa, p = 0.017) placentas were found to be significantly stiffer compared with the control placentas (8.32 ± 3.67 kPa). A linear discriminant analysis (LDA) classifier was able to classify between healthy and diseased placentas with a sensitivity, specificity and accuracy of 87%, 78% and 83% and an area under the receiver operating curve of 0.90 (95% confidence interval: 0.8-0.99). Further, the pregnancy outcome in terms of neonatal intensive care unit admission was predicted with a sensitivity, specificity and accuracy of 70%, 71%, 71%, respectively, and area under the receiver operating curve of 0.78 (confidence interval: 0.62-0.93). A viscoelastic characterization of placentas using a fractional rheological model revealed that the viscosity measures in terms of viscosity parameter n were significantly higher in IUGR (2.3 ± 0.21) and PE (2.11 ± 0.52) placentas than in normal placentas (1.45 ± 0.65). This work illustrates the potential relevance of elasticity and viscosity imaging using SWAVE 2.0 as a non-invasive technology for detection of placental abnormalities and the prediction of pregnancy outcomes.
Collapse
Affiliation(s)
- Farah Deeba
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Ricky Hu
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria Lessoway
- Department of Ultrasound, BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Jefferson Terry
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Denise Pugash
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Hutcheon
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantal Mayer
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Septimiu Salcudean
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Rohling
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada; Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
8
|
Novel Biomolecules in the Pathogenesis of Gestational Diabetes Mellitus 2.0. Int J Mol Sci 2022; 23:ijms23084364. [PMID: 35457182 PMCID: PMC9031541 DOI: 10.3390/ijms23084364] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 12/04/2022] Open
Abstract
Gestational diabetes mellitus (GDM) has become a major public health problem and one of the most discussed issues in modern obstetrics. GDM is associated with serious adverse perinatal outcomes and long-term health consequences for both the mother and child. Currently, the importance and purposefulness of finding a biopredictor that will enable the identification of women with an increased risk of developing GDM as early as the beginning of pregnancy are highly emphasized. Both “older” molecules, such as adiponectin and leptin, and “newer” adipokines, including fatty acid-binding protein 4 (FABP4), have proven to be of pathophysiological importance in GDM. Therefore, in our previous review, we presented 13 novel biomolecules, i.e., galectins, growth differentiation factor-15, chemerin, omentin-1, osteocalcin, resistin, visfatin, vaspin, irisin, apelin, FABP4, fibroblast growth factor 21, and lipocalin-2. The purpose of this review is to present the potential and importance of another nine lesser known molecules in the pathogenesis of GDM, i.e., 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF), angiopoietin-like protein-8 (ANGPTL-8), nesfatin-1, afamin, adropin, fetuin-A, zonulin, secreted frizzled-related proteins (SFRPs), and amylin. It seems that two of them, fetuin-A and zonulin in high serum levels, may be applied as biopredictors of GDM.
Collapse
|
9
|
The influence of the dietary exposome on oxidative stress in pregnancy complications. Mol Aspects Med 2022; 87:101098. [DOI: 10.1016/j.mam.2022.101098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/16/2022]
|
10
|
Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention. REPRODUCTIVE MEDICINE 2021. [DOI: 10.3390/reprodmed3010001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Gestational diabetes mellitus (GDM) complicates between 5 and 12% of pregnancies, with associated maternal, fetal, and neonatal complications. The ideal screening and diagnostic criteria to diagnose and treat GDM have not been established and, currently, diagnostic use with an oral glucose tolerance test occurs late in pregnancy and produces poor reproducibility. Therefore, in recent years, significant research has been undertaken to identify a first-trimester biomarker that can predict GDM later in pregnancy, enable early intervention, and reduce GDM-related adverse pregnancy outcomes. Possible biomarkers include glycemic markers (fasting glucose and hemoglobin A1c), adipocyte-derived markers (adiponectin and leptin), pregnancy-related markers (pregnancy-associated plasma protein-A and the placental growth factor), inflammatory markers (C-reactive protein and tumor necrosis factor-α), insulin resistance markers (sex hormone-binding globulin), and others. This review summarizes current data on first-trimester biomarkers, the advantages, and the limitations. Large multi-ethnic clinical trials and cost-effectiveness analyses are needed not only to build effective prediction models but also to validate their clinical use.
Collapse
|
11
|
Ganer Herman H, Marom O, Koren L, Horowitz E, Schreiber L, Okmian O, Raziel A, Kovo M. Gestational diabetes mellitus in in-vitro fertilization pregnancies - Clinical and placental histological characteristics. Placenta 2021; 117:156-160. [PMID: 34902728 DOI: 10.1016/j.placenta.2021.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/11/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION We aimed to investigate obstetric and neonatal outcomes and placental histological findings in in vitro fertilization (IVF) pregnancies complicated by gestational diabetes mellitus (GDM) as compared to unassisted pregnancies. METHODS This was a retrospective cohort of deliveries at a single university affiliated center between 12/2008 and 01/2020. Included were singleton pregnancies complicated by GDM, for which placental histopathological examination was performed. Obstetric, neonatal and placental outcomes were compared between pregnancies following IVF and unassisted pregnancies. Placental lesions were categorized according to the "Amsterdam" criteria. RESULTS Included were 688 deliveries with a diagnosis of GDM with placental examination - 69 IVF pregnancies (IVF group) and 619 unassisted pregnancies (control group). The IVF group was characterized by a significantly higher maternal age and higher rate of nulliparous women - 60.8% vs. 32.9%, p < 0.001. There were no differences in GDM type between the study groups - about two thirds of cases were GDMA1 and on third GDMA2. A higher incidence of preeclampsia was noted in the IVF group - 17.3% vs. 9.3%, p = 0.03, with no difference in cesarean deliveries and birthweight. IVF deliveries were characterized by a significantly higher rate of adverse neonatal outcomes - 18.8% vs. 8.8%, p = 0.008, although this did not attain significance after adjustment to gestational age. No differences were noted in placental histology between the groups. DISCUSSION GDM in IVF is associated with a significantly higher rate of adverse neonatal outcomes, as compared with non-assisted pregnancies complicated by GDM. Placental histology does not shed light on these clinical associations.
Collapse
Affiliation(s)
- Hadas Ganer Herman
- In-Vitro Fertilizationt, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Or Marom
- Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liron Koren
- Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Horowitz
- In-Vitro Fertilizationt, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Letizia Schreiber
- Pathology Department, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Okmian
- Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arieh Raziel
- In-Vitro Fertilizationt, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Kovo
- Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
12
|
Analysis of Maternal and Neonatal Complications in a Group of Patients with Gestational Diabetes Mellitus. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111170. [PMID: 34833388 PMCID: PMC8619358 DOI: 10.3390/medicina57111170] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/14/2021] [Accepted: 10/25/2021] [Indexed: 12/22/2022]
Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) represents one of the most common complications during pregnancy, being associated with numerous maternal and neonatal complications. The study aimed to analyze maternal and neonatal complications associated with GDM. The risk factors of GDM and of the maternal and neonatal complications were studied in order to prevent their occurrence. Materials and Methods: The study included 97 women in the study, who underwent an oral glucose tolerance test (OGTT) between weeks 24–28 of pregnancy, consequently being divided into two groups: pregnant women with and without GDM. Statistical analysis was performed using the SPSS 26.0 software and MATLAB fitglm, the results being considered statistically significant if p < 0.05. Results: We observed statistically significant differences between the group of women with and without GDM, regarding gestational hypertension (17.6% vs. 0%), preeclampsia (13.72% vs. 0%), and cesarean delivery (96.1% vs. 78,3%). Data on the newborn and neonatal complications: statistically significant differences were recorded between the two groups (GDM vs. no GDM) regarding the average weight at birth (3339.41 ± 658.12 g vs. 3122.83 ± 173.67 g), presence of large for gestational age (21.6% vs. 0%), macrosomia (13.7% vs. 0%), excessive fetal growth (35.3% vs. 0%), respiratory distress (31.4% vs. 0%), hospitalization for at least 24 h in the Neonatal Intensive Care Unit (9.80% vs. 0%), and APGAR score <7 both 1 and 5 min following birth (7.8% vs. 0%). Additionally, the frequency of neonatal hypoglycemia and hyperbilirubinemia was higher among newborns from mothers with GDM. Conclusions: The screening and diagnosis of GDM is vital, and appropriate management is required for the prevention of maternal and neonatal complications associated with GDM. It is also important to know the risk factors for GDM and attempt to prevent their appearance.
Collapse
|
13
|
Maternal Melatonin Deficiency Leads to Endocrine Pathologies in Children in Early Ontogenesis. Int J Mol Sci 2021; 22:ijms22042058. [PMID: 33669686 PMCID: PMC7922827 DOI: 10.3390/ijms22042058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 12/17/2022] Open
Abstract
The review summarizes the results of experimental and clinical studies aimed at elucidating the causes and pathophysiological mechanisms of the development of endocrine pathology in children. The modern data on the role of epigenetic influences in the early ontogenesis of unfavorable factors that violate the patterns of the formation of regulatory mechanisms during periods of critical development of fetal organs and systems and contribute to the delayed development of pathological conditions are considered. The mechanisms of the participation of melatonin in the regulation of metabolic processes and the key role of maternal melatonin in the formation of the circadian system of regulation in the fetus and in the protection of the genetic program of its morphofunctional development during pregnancy complications are presented. Melatonin, by controlling DNA methylation and histone modification, prevents changes in gene expression that are directly related to the programming of endocrine pathology in offspring. Deficiency and absence of the circadian rhythm of maternal melatonin underlies violations of the genetic program for the development of hormonal and metabolic regulatory mechanisms of the functional systems of the child, which determines the programming and implementation of endocrine pathology in early ontogenesis, contributing to its development in later life. The significance of this factor in the pathophysiological mechanisms of endocrine disorders determines a new approach to risk assessment and timely prevention of offspring diseases even at the stage of family planning.
Collapse
|
14
|
Yang Y, Guo F, Peng Y, Chen R, Zhou W, Wang H, OuYang J, Yu B, Xu Z. Transcriptomic Profiling of Human Placenta in Gestational Diabetes Mellitus at the Single-Cell Level. Front Endocrinol (Lausanne) 2021; 12:679582. [PMID: 34025588 PMCID: PMC8139321 DOI: 10.3389/fendo.2021.679582] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/14/2021] [Indexed: 12/13/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is associated with an increased risk of adverse pregnancy outcomes. Increasing evidence shows that placentation defects may play important roles in GDM. However, our understanding of the human placenta remains limited. In this study, we generated a comprehensive transcriptomic profile of cellular signatures and transcriptomes in the human placenta in GDM using single-cell RNA sequencing (scRNA-seq), constructed a comprehensive cell atlas, and identified cell subtypes and subtype-specific marker genes. In addition, we investigated the placental cellular function and intercellular interactions in GDM. These findings help to elucidate the molecular mechanisms of GDM, and may facilitate the development of new approaches to GDM treatment and prevention.
Collapse
Affiliation(s)
- Yuqi Yang
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Fang Guo
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Yue Peng
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Rong Chen
- International Genome Center, Jiangsu University, Zhenjiang, China
| | - Wenbo Zhou
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Huihui Wang
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Jun OuYang
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Bin Yu
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
- *Correspondence: Bin Yu, ; Zhengfeng Xu,
| | - Zhengfeng Xu
- Womens Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Bin Yu, ; Zhengfeng Xu,
| |
Collapse
|
15
|
Hebert JF, Myatt L. Placental mitochondrial dysfunction with metabolic diseases: Therapeutic approaches. Biochim Biophys Acta Mol Basis Dis 2021; 1867:165967. [PMID: 32920120 PMCID: PMC8043619 DOI: 10.1016/j.bbadis.2020.165967] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/25/2022]
Abstract
Both obesity and gestational diabetes mellitus (GDM) lead to poor maternal and fetal outcomes, including pregnancy complications, fetal growth issues, stillbirth, and developmental programming of adult-onset disease in the offspring. Increased placental oxidative/nitrative stress and reduced placental (trophoblast) mitochondrial respiration occur in association with the altered maternal metabolic milieu of obesity and GDM. The effect is particularly evident when the fetus is male, suggesting a sexually dimorphic influence on the placenta. In addition, obesity and GDM are associated with inflexibility in trophoblast, limiting the ability to switch between usage of glucose, fatty acids, and glutamine as substrates for oxidative phosphorylation, again in a sexually dimorphic manner. Here we review mechanisms underlying placental mitochondrial dysfunction: its relationship to maternal and fetal outcomes and the influence of fetal sex. Prevention of placental oxidative stress and mitochondrial dysfunction may improve pregnancy outcomes. We outline pathways to ameliorate deficient mitochondrial respiration, particularly the benefits and pitfalls of mitochondria-targeted antioxidants.
Collapse
Affiliation(s)
- Jessica F Hebert
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, United States of America
| | - Leslie Myatt
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, United States of America.
| |
Collapse
|
16
|
Li Y, Zhuang J. miR-345-3p serves a protective role during gestational diabetes mellitus by targeting BAK1. Exp Ther Med 2020; 21:2. [PMID: 33235611 PMCID: PMC7678625 DOI: 10.3892/etm.2020.9434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/18/2020] [Indexed: 02/07/2023] Open
Abstract
Recent studies have demonstrated that microRNAs (miRs) serve a crucial role during the development of gestational diabetes mellitus (GDM). However, the mechanisms underlying miR-345-3p and its protective role during GDM have not been previously reported. The present study investigated miR-345-3p expression and function in vitro, and the possible molecular mechanisms underlying GDM. Compared with healthy pregnant women, miR-345-3p was downregulated in the placental tissue and peripheral blood of patients with GDM. Further investigation revealed that BCL2-antagonist/killer 1 (BAK1) was a predicted target gene of miR-345-3p, and the expression of BAK1 was significantly increased in patients with GDM compared with healthy pregnant women. In vitro analysis revealed that miR-345-3p mimic significantly increased cell viability, migration and invasion, inhibited apoptosis, upregulated Bcl-2 and matrix metallopeptidase 9 expression, and decreased Bax expression compared with the control group. Furthermore, miR-245-3p mimic-induced alterations were reversed by BAK1 overexpression. The results suggested that miR-345-3p overexpression exhibited a protective role in patients with GDM by inhibiting HTR8-/SVneo cell apoptosis, and promoting cell proliferation and migration via targeting BAK1. The use of miR-345-3p for the diagnosis of GDM requires further investigation.
Collapse
Affiliation(s)
- Yuxia Li
- Department of Gynecology and Obstetrics, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430010, P.R. China
| | - Jun Zhuang
- Department of Obstetrics, Lianshui County People's Hospital, Huai'an, Jiangsu 223400, P.R. China
| |
Collapse
|
17
|
Fetal and Placental Weight in Pre-Gestational Maternal Obesity (PGMO) vs. Excessive Gestational Weight Gain (EGWG)-A Preliminary Approach to the Perinatal Outcomes in Diet-Controlled Gestational Diabetes Mellitus. J Clin Med 2020; 9:jcm9113530. [PMID: 33142800 PMCID: PMC7693942 DOI: 10.3390/jcm9113530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/24/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
Both pre-gestational maternal obesity (PGMO) and excessive gestational weight gain (EGWG) increase the risk of gestational diabetes mellitus (GDM). Here, we conducted a retrospective study to comparatively examine the relation between fetal birth weight (FW) and placental weight (PW) in PGMO (n = 100) compared to EGWG (n = 100) with respect to perinatal outcomes in diet-controlled GDM. The control group was made up of 100 healthy pregnancies. The mean FW and the mean PW in EGWG were correlated with lowered fetal weight/placental weight ratio (FW/PW ratio). The percentage of births completed by cesarean section accounted for 47%, 32%, and 18% of all deliveries (EGWG, PGMO, and controls, respectively), with the predominance of FW-related indications for cesarean section. Extended postpartum hospital stays due to neonate were more frequent in EGWG, especially due to neonatal jaundice (p < 0.05). The results indicate the higher perinatal risk in mothers with EGWG compared to PGMO during GDM-complicated pregnancy. Further in-depth comparative studies involving larger patient pools are needed to validate these findings, the intent of which is to formulate guidelines for GDM patients in respect to management of PGMO and EGWG.
Collapse
|
18
|
Eliesen GAM, van Hove H, Meijer MH, van den Broek PHH, Pertijs J, Roeleveld N, van Drongelen J, Russel FGM, Greupink R. Toxicity of anticancer drugs in human placental tissue explants and trophoblast cell lines. Arch Toxicol 2020; 95:557-571. [PMID: 33083868 PMCID: PMC7870638 DOI: 10.1007/s00204-020-02925-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/05/2020] [Indexed: 12/28/2022]
Abstract
The application of anticancer drugs during pregnancy is associated with placenta-related adverse pregnancy outcomes. Therefore, it is important to study placental toxicity of anticancer drugs. The aim of this study was to compare effects on viability and steroidogenesis in placental tissue explants and trophoblast cell lines. Third trimester placental tissue explants were exposed for 72 h (culture day 4–7) to a concentration range of doxorubicin, paclitaxel, cisplatin, carboplatin, crizotinib, gefitinib, imatinib, or sunitinib. JEG-3, undifferentiated BeWo, and syncytialised BeWo cells were exposed for 48 h to the same drugs and concentrations. After exposure, tissue and cell viability were assessed and progesterone and estrone levels were quantified in culture medium. Apart from paclitaxel, all compounds affected both cell and tissue viability at clinically relevant concentrations. Paclitaxel affected explant viability moderately, while it reduced cell viability by 50% or more in all cell lines, at 3–10 nM. Doxorubicin (1 µM) reduced viability in explants to 83 ± 7% of control values, whereas it fully inhibited viability in all cell types. Interference with steroid release in explants was difficult to study due to large variability in measurements, but syncytialised BeWo cells proved suitable for this purpose. We found that 1 µM sunitinib reduced progesterone release to 76 ± 6% of control values, without affecting cell viability. While we observed differences between the models for paclitaxel and doxorubicin, most anticancer drugs affected viability significantly in both placental explants and trophoblast cell lines. Taken together, the placenta should be recognized as a potential target organ for toxicity of anticancer drugs.
Collapse
Affiliation(s)
- Gaby A M Eliesen
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Hedwig van Hove
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Maartje H Meijer
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Petra H H van den Broek
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jeanne Pertijs
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Joris van Drongelen
- Department of Obstetrics and Gynecology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frans G M Russel
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Rick Greupink
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, (Route 137), PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Dong J, Shin N, Lee JY, Jia B, Chudnovets A, McLane MW, Li S, Na Q, Lei J, Burd I. Maternal inflammation leads to different mTORC1 activity varied by anatomic locations in mouse placenta†. Biol Reprod 2020; 101:1046-1055. [PMID: 31403169 DOI: 10.1093/biolre/ioz151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/21/2019] [Accepted: 07/29/2019] [Indexed: 02/06/2023] Open
Abstract
Maternal inflammation (MI) is associated with many adverse perinatal outcomes. The placenta plays a vital role in mediating maternal-fetal resource allocation. Studies have shown that MI contributes to placental dysfunction, which then leads to adverse birth outcomes and high health risks throughout childhood. Placental mammalian target of rapamycin complex 1 (mTORC1) signaling pathway links maternal nutrient availability to fetal growth; however, the impact of MI on mTORC1 signaling in the placenta remains unclear. In this study, we sought to explore the changes of mTORC1 signaling in the mouse placenta at late gestation by using two models of MI employing lipopolysaccharide (LPS) and interleukin-1β (IL-1β) to mimic acute (aMI) and sub-chronic (cMI) inflammatory states, respectively. We determined placental mTORC1 activity by measuring the activity of mTORC1 downstream molecules, including S6k, 4Ebp1, and rpS6. In the aMI model, we found that mTORC1 activity was significantly decreased in the placental decidual and junctional zone at 2 and 6 h after LPS surgery, respectively; however, mTORC1 activity was significantly increased in the placental labyrinth zone at 2, 6, and 24 h after LPS treatment, respectively. In the cMI model, we observed that mTORC1 activity was increased only in the placental labyrinth zone after consecutive IL-1β exposure. Our study reveals that different parts of the mouse placenta react differently to MI, leading to variable mTORC1 activity throughout the placenta. This suggests that different downstream molecules of mTORC1 from different parts of the mouse placenta may be used in clinical research to monitor the fetal well-being during MI.
Collapse
Affiliation(s)
- Jie Dong
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Reproductive Medical Center, Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Na Shin
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ji Yeon Lee
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bei Jia
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anna Chudnovets
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael W McLane
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Su Li
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Quan Na
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jun Lei
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Irina Burd
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
20
|
Gundacker C, Ellinger I. The unique applicability of the human placenta to the Adverse Outcome Pathway (AOP) concept: the placenta provides fundamental insights into human organ functions at multiple levels of biological organization. Reprod Toxicol 2020; 96:273-281. [PMID: 32768559 DOI: 10.1016/j.reprotox.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 12/17/2022]
Abstract
Despite the short lifespan of the human placenta, the proper formation and function of the organ is of crucial importance for fetal development. Placental dysfunction increases the risk of complications for mother and child during pregnancy and childbirth and beyond as it predisposes to fetal programming. The placenta is an upstream organ of the fetus. It performs the functions of fetal lungs, liver, intestines, kidneys and glands as long as these organs are not fully functional. Furthermore, it is the only human organ that is non-invasively available either after elective abortion or after birth. This is a crucial point given that the conceptual framework of Adverse Outcome Pathway (AOP) requires data on organ function. In vitro and ex vivo placental studies, combined with epidemiological and clinical data on pregnant women, newborns, and infants can uniquely cover all levels of information needed to develop new AOPs and complement existing AOPs related to reproductive toxicity and beyond. To stimulate further research in this area and to support researchers in future studies dealing with the development of AOPs related to the placenta, this review first gives a brief description of placental structure, placental development and relevant pregnancy diseases. The state of knowledge about the available placental models, their particularities and limitations are briefly discussed. Finally, the use of placental research for the development of AOPs is presented with an illustrative example.
Collapse
Affiliation(s)
- Claudia Gundacker
- Institute of Medical Genetics, Medical University Vienna, Vienna, Austria.
| | - Isabella Ellinger
- Institute for Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria
| |
Collapse
|
21
|
Bayoglu Tekin Y, Baki Erin K, Yilmaz A. Evaluation of SCUBE-1 levels as a placental dysfunction marker at gestational diabetes mellitus. Gynecol Endocrinol 2020; 36:417-420. [PMID: 31668102 DOI: 10.1080/09513590.2019.1683537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objective: To evaluate the alteration of plasma levels of signal peptide-CUB-EGF domain-containing protein (SCUBE)-1 as a marker of endothelial dysfunction and vascular injury in gestational diabetes mellitus (GDM) in comparison to healthy pregnant controls.Methods: A prospective study conducted at an antenatal outpatient clinic of a University hospital. Fifty pregnancies with GDM and thirty healthy pregnancies as controls were enrolled in the study.Results: There was no statistically significant difference between the groups in terms of age, gravidity, weight and BMI from pre-pregnancy until delivery, total weight gain, fetal weight and other hematological and biochemical parameters. SCUBE-1 levels were significantly higher in GDM patients (p = .007).Conclusions: Hyperglycemia predisposes to endothelial injury and vascular remodeling at GDM, and therefore, SCUBE-1 could be a predictor of vascular injury during pregnancy. Our study is the first to illustrate increased SCUBE-1 levels in GDM as a marker of placental endothelial dysfunction.
Collapse
Affiliation(s)
- Yesim Bayoglu Tekin
- Department of Gynecology and Obstetrics, Sağlık Bilimleri University, School of Medicine, İstanbul, Turkey
| | - Kübra Baki Erin
- Department of Gynecology and Obstetrics, Sağlık Bilimleri University, School of Medicine, İstanbul, Turkey
| | - Adnan Yilmaz
- Department of Biochemistry, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey
| |
Collapse
|
22
|
Shen Y, Jia Y, Zhou J, Cheng XY, Huang HY, Sun CQ, Fan LL, Chen J, Jiang LY. Association of gestational diabetes mellitus with adverse pregnancy outcomes: our experience and meta-analysis. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00802-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
23
|
Kelley AS, Smith YR, Padmanabhan V. A Narrative Review of Placental Contribution to Adverse Pregnancy Outcomes in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2019; 104:5299-5315. [PMID: 31393571 PMCID: PMC6767873 DOI: 10.1210/jc.2019-00383] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/01/2019] [Indexed: 12/29/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of reproductive-aged women. In pregnancy, women with PCOS experience increased risk of miscarriage, gestational diabetes, preeclampsia, and extremes of fetal birth weight, and their offspring are predisposed to reproductive and cardiometabolic dysfunction in adulthood. Pregnancy complications, adverse fetal outcomes, and developmental programming of long-term health risks are known to have placental origins. These findings highlight the plausibility of placental compromise in pregnancies of women with PCOS. EVIDENCE SYNTHESIS A comprehensive PubMed search was performed using terms "polycystic ovary syndrome," "placenta," "developmental programming," "hyperandrogenism," "androgen excess," "insulin resistance," "hyperinsulinemia," "pregnancy," and "pregnancy complications" in both human and animal experimental models. CONCLUSIONS There is limited human placental research specific to pregnancy of women with PCOS. Gestational androgen excess and insulin resistance are two clinical hallmarks of PCOS that may contribute to placental dysfunction and underlie the higher rates of maternal-fetal complications observed in pregnancies of women with PCOS. Additional research is needed to prevent adverse maternal and developmental outcomes in women with PCOS and their offspring.
Collapse
Affiliation(s)
- Angela S Kelley
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Yolanda R Smith
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Vasantha Padmanabhan
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
- Correspondence and Reprint Requests: Vasantha Padmanabhan, PhD, Department of Pediatrics, University of Michigan, 7510 MSRB 1, 1500 West Medical Center Drive, Ann Arbor, Michigan 48109. E-mail:
| |
Collapse
|
24
|
Ozler S, Oztas E, Gumus Guler B, Erel O, Turhan Caglar A, Ergin M, Uygur D, Danisman N. Are serum levels of ADAMTS5, TAS and TOS at 24-28 gestational weeks associated with adverse perinatal outcomes in gestational diabetic women? J OBSTET GYNAECOL 2019; 40:619-625. [PMID: 31526197 DOI: 10.1080/01443615.2019.1634025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We aimed to determine the role of placental A Disintegrin and Metalloproteinase with thrombospondin motifs 5 (ADAMTS5), and maternal serum ADAMTS5, total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) levels at 24-28th gestational weeks in GDM. This study included 57 patients, who had been diagnosed as having GDM at their 24-28th gestational week, and 29 controls. The maternal blood samples were collected at the 24-28th gestational week and ADAMTS5 was studied with the enzyme-linked immunosorbent assay (ELISA) method, whereas an automated colorimetric method was used to study TAS, TOS, and OSI. The level of ADAMTS5 in maternal serum of patients with GDM were significantly lower than the controls (p = .017); whereas TOS and OSI levels were significantly higher (p = .003 and p = .008). Multivariable logistic regression analysis revealed ADAMTS5 and TOS levels were independently associated with adverse perinatal outcomes (p = .004 and p = .018). We found that serum ADAMTS5 levels decreased and TOS level increased in GDM pregnant at 24-28th gestational weeks. In addition, we found that increased levels of serum ADAMTS5 and decreased TOS levels at 24-28th weeks were associated with adverse perinatal outcomes independent of the mode of treatment in GDM.Impact statementWhat is already known on this subject? Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. The insulin resistance, which starts at the 24-28th gestational weeks, increases during gestation. GDM increases maternal complications like preeclampsia, cesarean rate, cardiovascular disease, obesity, and diabetes after pregnancy; and neonatal complications like macrosomia, hypoglycemia, hyperbilirubinemia, delivery trauma, shoulder dystocia, and adult-onset obesity, and diabetes.What the results of this study add? A significant relationship between ADAMTS5, TOS levels and adverse perinatal outcome. insulin resistance and was observed.What the implications are of these findings for clinical practice and/or further research? Based on this finding, we concluded that increased levels of oxidative stress and decreased ADAMTS5 levels are associated with GDM and predictive for adverse perinatal outcomes. The results of the present study were consistent with the previous reports and indicated that increased oxidative stress in GDM patients are related to adverse perinatal outcomes.
Collapse
Affiliation(s)
- Sibel Ozler
- Department of Perinatology, Selcuk University Medical School, Konya, Turkey
| | - Efser Oztas
- Department of Perinatology, Eskisehir City Hospital, Eskisehir, Turkey
| | | | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ali Turhan Caglar
- Department of Clinical Biochemistry, Aralik State Hospital, Gaziantep, Turkey
| | - Merve Ergin
- Department of Pathology, Etlik Zübeyde Haním Women's Health Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Clinical Biochemistry, Aralik State Hospital, Gaziantep, Turkey
| | - Nuri Danisman
- Department of Perinatology, Acıbadem Acıbadem University Medical School, Istanbul, Turkey
| |
Collapse
|
25
|
Yang GR, Dye TD, Li D. Effects of pre-gestational diabetes mellitus and gestational diabetes mellitus on macrosomia and birth defects in Upstate New York. Diabetes Res Clin Pract 2019; 155:107811. [PMID: 31401151 PMCID: PMC8783133 DOI: 10.1016/j.diabres.2019.107811] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023]
Abstract
AIMS To evaluate the effects of pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) on macrosomia and birth defects. METHODS Existing birth registry data from the Perinatal Data System in Upstate New York was analysed. 650,914 women with a singleton term pregnancy (≥37 weeks) aged 18-55 years from 2004 to 2016 were included. RESULTS The prevalence of macrosomia in infants born to women with PGDM and GDM were 26.0% and 16.4%, respectively, higher than that in the controls (11.2%). Compared with the controls (0.8%), the PGDM and GDM groups had higher prevalence of any birth defect (1.8% and 1.0%). The PGDM group had the highest prevalence of cyanotic heart disease (0.6%). Moreover, the PGDM group had higher prevalence of cleft lip and palate, cleft palate alone, hypospadias and limb reduction defect compared to the GDM and control groups (p < 0.05). However, these birth defects in the GDM group were similar to those in the controls. Both the PGDM and GDM groups had significantly elevated odds of macrosomia, cyanotic heart disease and any birth defect than controls. The PGDM group had higher odds of cleft lip and palate, cleft palate alone, hypospadias and limb reduction defect. CONCLUSIONS Using the Perinatal Data System database, PGDM and GDM, especially PGDM, was associated with higher prevalence of macrosomia, cyanotic heart disease and any birth defect in singleton term pregnancy in Upstate New York. PGDM, not GDM had higher prevalence of cleft lip and palate, cleft palate alone, hypospadias and limb reduction defect.
Collapse
Affiliation(s)
- Guang-Ran Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14620, United States.
| | - Timothy D Dye
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14620, United States
| | - Dongmei Li
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14620, United States.
| |
Collapse
|
26
|
Abstract
Hyperglycemia is common during pregnancy, involving multisystem adaptations. Pregnancy-induced metabolic changes increase insulin resistance. Pregnancy-induced insulin resistance adds to preexisting insulin resistance. Preexisting pancreatic β-cell defect compromises the ability to enhance insulin secretion, leading to hyperglycemia. Women with type 2 DM have similar rates of major congenital malformations, stillbirth, and neonatal mortality, but an even higher risk of perinatal mortality. In utero type 2 DM exposure confers greater risk and reduces time to development of type 2 DM in offspring. Preconception care to improve metabolic control in women with type 2 diabetes is critical.
Collapse
Affiliation(s)
- Anil Kapur
- World Diabetes Foundation, 30 A, Krogshoejvej, Bagsverd 2880, Denmark; FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel.
| | - Harold David McIntyre
- FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel; UQ Mater Clinical Unit, Faculty of Medicine, Mater Health Services, University of Queensland, Raymond Terrace, South Brisbane, Brisbane, Qld 4101, Australia
| | - Moshe Hod
- FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel; Department of Obstetrics and Gynecology, Clalit Health Services, Mor Women's Health Center, Rabin Medical Center, Tel Aviv University, 18 Aba Ahimeir St., Tel Aviv 6949204, Israel
| |
Collapse
|
27
|
Heidari Z, Mahmoudzadeh-Sagheb H, Narouei M, Sheibak N. Effects of gestational diabetes mellitus on stereological parameters and extravillous trophoblast cells of placenta compared to the control group. J OBSTET GYNAECOL 2019; 39:928-933. [PMID: 31064235 DOI: 10.1080/01443615.2019.1578948] [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] [Indexed: 12/14/2022]
Abstract
The quantitative changes of extravillous trophoblast cells (EVTs) in placenta of gestational diabetes mellitus (GDM) patients were investigated compared to healthy controls using stereological methods. The volumetric parameters of the placenta and EVTs were estimated using Cavalieri's principle and Physical Disector stereological methods. The placental volume and weight in the GDM group increased compared to the control group (p < .05). The difference in the total volume of intervillous space and blood vessels of the placenta between GDM and control groups was statistically significant (p < .05). In addition, there was a significant difference in the volume density of blood vessels and syncytiotrophoblast between the GDM group and the control group (p < .05). The total volume of the EVTs, nucleus and cytoplasm diameter, volume of the nucleus and cytoplasm, nucleus to cytoplasm ratio (N/C) of EVTs and the total number of EVTs per unit volume of the placenta in the GDM group showed a significant increase compared to the controls (p < .05). Impact statement What is already known on this subject? It is reported that extravillous trophoblast cells (EVTs) played an important role in pregnancy complications. There are limited studies on the quantitative changes of EVTs in the placental bed of GDM patients. What do the results of this study add? The results showed that volumetric parameters and number of EVTs were significantly altered in GDM placentas. These changes can be associated with disturbances in trophoblastic invasion in GDM pregnancies and may affect the development and survival of the embryo. What are the implications of these findings for clinical practice and/or further research? In the present study, there is a new insight to placenta structure that probably could be useful to understanding possible mechanisms of pregnancy complications and the achievement of new therapeutic strategies. Further investigation on the molecular biology of these cells in pregnancy complications will be needed to clarify this hypothesis.
Collapse
Affiliation(s)
- Zahra Heidari
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences , Zahedan , Iran.,Department of Histology, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran
| | - Hamidreza Mahmoudzadeh-Sagheb
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences , Zahedan , Iran.,Department of Histology, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran
| | - Mahdieh Narouei
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran
| | - Nadia Sheibak
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran
| |
Collapse
|
28
|
Severe Uncontrolled Maternal Hyperglycemia Induces Microsomia and Neurodevelopment Delay Accompanied by Apoptosis, Cellular Survival, and Neuroinflammatory Deregulation in Rat Offspring Hippocampus. Cell Mol Neurobiol 2019; 39:401-414. [DOI: 10.1007/s10571-019-00658-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/30/2019] [Indexed: 12/14/2022]
|
29
|
Xiong F, Li G, Sun Q, Chen P, Wang Z, Wan C, Yao Z, Zhong H, Zeng Y. Obstetric and perinatal outcomes of pregnancies according to initial maternal serum HCG concentrations after vitrified-warmed single blastocyst transfer. Reprod Biomed Online 2019; 38:455-464. [PMID: 30660603 DOI: 10.1016/j.rbmo.2018.12.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION Do pregnancy, obstetric and perinatal outcomes differ according to initial maternal serum human chorionic gonadotrophin (HCG) level measured on day 11 after single blastocyst transfer? DESIGN Vitrified-warmed single blastocyst transfer cycles (n = 640) were collected between 1 January 2013 and 30 April 2017 with positive HCG values and retrospectively analysed by receiver operating characteristic curves to predict clinical pregnancy, ongoing pregnancy and delivery. Cycles were divided into a low HCG group (n = 155) and high HCG group (n = 485) based on cut-off value of live birth prediction. Cycles in the HCG group were subdivided into a low-high subgroup (n = 162), medium-high subgroup (n = 162) and high-high subgroup (n = 161) based on tertile points. Pregnancy rates and obstetric and perinatal outcomes were compared. RESULTS The area under curves for clinical pregnancy, ongoing pregnancy and live birth prediction were 0.95, 0.81 and 0.79, respectively; corresponding cut-off values were 152.2 IU/l, 211.9 IU/l and 211.9 IU/l; HCG less than 211.9 IU/l indicated an extremely low clinical pregnancy rate (34.84%), a high early miscarriage rate (61.11%) and a low live birth rate (12.26%). Rates of gestational diabetes mellitus (GDM) (P = 0.007) and female neonates (P = 0.001) were significantly higher in the LHG group compared with the HHG group; no significant differences were observed in the low versus high HCG group overall. CONCLUSIONS Lower initial maternal serum HCG levels indicated poorer clinical outcomes. Within the high HCG group, a lower initial maternal HCG level was found to be associated with GDM occurrence and proportion of female neonates.
Collapse
Affiliation(s)
- Feng Xiong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Guangui Li
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Qing Sun
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Peilin Chen
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Zhuran Wang
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Caiyun Wan
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Zhihong Yao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Huixian Zhong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China
| | - Yong Zeng
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, People's Republic of China.
| |
Collapse
|
30
|
Langmia IM, Kräker K, Weiss SE, Haase N, Schütte T, Herse F, Dechend R. Cardiovascular Programming During and After Diabetic Pregnancy: Role of Placental Dysfunction and IUGR. Front Endocrinol (Lausanne) 2019; 10:215. [PMID: 31024453 PMCID: PMC6466995 DOI: 10.3389/fendo.2019.00215] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/18/2019] [Indexed: 12/31/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is a condition whereby a fetus is unable to achieve its genetically determined potential size. IUGR is a global health challenge due to high mortality and morbidity amongst affected neonates. It is a multifactorial condition caused by maternal, fetal, placental, and genetic confounders. Babies born of diabetic pregnancies are usually large for gestational age but under certain conditions whereby prolonged uncontrolled hyperglycemia leads to placental dysfunction, the outcome of the pregnancy is an intrauterine growth restricted fetus with clinical features of malnutrition. Placental dysfunction leads to undernutrition and hypoxia, which triggers gene modification in the developing fetus due to fetal adaptation to adverse utero environmental conditions. Thus, in utero gene modification results in future cardiovascular programming in postnatal and adult life. Ongoing research aims to broaden our understanding of the molecular mechanisms and pathological pathways involved in fetal programming due to IUGR. There is a need for the development of effective preventive and therapeutic strategies for the management of growth-restricted infants. Information on the mechanisms involved with in utero epigenetic modification leading to development of cardiovascular disease in adult life will increase our understanding and allow the identification of susceptible individuals as well as the design of targeted prevention strategies. This article aims to systematically review the latest molecular mechanisms involved in the pathogenesis of IUGR in cardiovascular programming. Animal models of IUGR that used nutrient restriction and hypoxia to mimic the clinical conditions in humans of reduced flow of nutrients and oxygen to the fetus will be discussed in terms of cardiac remodeling and epigenetic programming of cardiovascular disease. Experimental evidence of long-term fetal programming due to IUGR will also be included.
Collapse
Affiliation(s)
- Immaculate M. Langmia
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Alexander von Humboldt Foundation, Bonn, Germany
| | - Kristin Kräker
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Sara E. Weiss
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nadine Haase
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Till Schütte
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Center for Cardiovascular Research, Institute of Pharmacology, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Herse
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- HELIOS-Klinikum, Berlin, Germany
- *Correspondence: Ralf Dechend
| |
Collapse
|
31
|
Wong CH, Chen CP, Sun FJ, Chen CY. Comparison of placental three-dimensional power Doppler indices and volume in the first and the second trimesters of pregnancy complicated by gestational diabetes mellitus. J Matern Fetal Neonatal Med 2018; 32:3784-3791. [PMID: 29716432 DOI: 10.1080/14767058.2018.1472226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objective: To compare the changes of placental three-dimensional power Doppler indices and volume in the first and the second trimesters of pregnancy with gestational diabetes mellitus (GDM). Methods: This was a prospective case-control study of singleton pregnancies with risk factors for GDM. Data on placental vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI), as well as placental volume were obtained and analyzed during the first and the second trimesters between pregnant women with and without GDM. Results: Of the 155 pregnant women enrolled, 31 developed GDM and 124 did not. VI and VFI were significantly lower in the GDM group during the first and second trimesters (VI: p = .023, and VFI: p = .014 in the first trimester; VI: p = .049, and VFI: p = .031 in the second trimester). However, the placental volume was similar in both the groups during the first trimester, while it was significantly increased in the GDM group during the second trimester (p = .022). There were no significant differences in FI and uterine artery pulsatility index between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in the first trimester VFI (adjusted odds ratio (OR) 0.76, 95% confidence interval (CI) 0.61-0.93), second trimester VFI (adjusted or 0.83, 95%CI 0.71-0.96), and second trimester placental volume (adjusted or 1.03, 95%CI 1.01-1.05). Conclusions: Placental vascular indices can provide an insight into placental vascularization in GDM during early pregnancy. VFI rather than placental volume may be a sensitive sonographic marker in the first trimester of GDM placentas.
Collapse
Affiliation(s)
- Chian-Huey Wong
- a Department of Medicine , Mackay Medical College , New Taipei City , Taiwan.,b Department of Obstetrics and Gynecology , Mackay Memorial Hospital , Taipei , Taiwan
| | - Chie-Pein Chen
- a Department of Medicine , Mackay Medical College , New Taipei City , Taiwan.,b Department of Obstetrics and Gynecology , Mackay Memorial Hospital , Taipei , Taiwan
| | - Fang-Ju Sun
- c Department of Medical Research , Mackay Memorial Hospital , Taipei , Taiwan
| | - Chen-Yu Chen
- a Department of Medicine , Mackay Medical College , New Taipei City , Taiwan.,b Department of Obstetrics and Gynecology , Mackay Memorial Hospital , Taipei , Taiwan
| |
Collapse
|
32
|
Sklempe Kokic I, Ivanisevic M, Biolo G, Simunic B, Kokic T, Pisot R. Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial. Women Birth 2018; 31:e232-e238. [DOI: 10.1016/j.wombi.2017.10.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 10/04/2017] [Indexed: 11/15/2022]
|
33
|
Reed LC, Estrada SM, Walton RB, Napolitano PG, Ieronimakis N. Evaluating maternal hyperglycemic exposure and fetal placental arterial dysfunction in a dual cotyledon, dual perfusion model. Placenta 2018; 69:109-116. [PMID: 30213479 DOI: 10.1016/j.placenta.2018.07.015] [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: 12/06/2017] [Revised: 07/11/2018] [Accepted: 07/27/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Gestational diabetes affects almost 1 in 10 pregnancies and is associated with adverse outcomes including fetal demise. Pregnancy complications related to diabetes are attributed to placental vascular dysfunction. With diabetes, maternal hyperglycemia is thought to promote placental vasoconstriction. However, it remains poorly understood if and how hyperglycemia leads to placental vascular dysfunction or if humoral factors related to maternal diabetes are responsible. METHODS AND RESULTS Utilizing a human placenta dual cotyledon, dual perfusion assay we examined the arterial pressure response to the thromboxane mimetic U44619, in cotyledons exposed to normal vs. a hyperglycemic infusion into the intervillous space. Tissues were then analyzed for the activity of key signaling molecules related to vascular tone; eNOS, Akt, PKA and VEGFR2. Results indicate a significant increase in fetal vascular resistance with maternal exposure to hyperglycemia. This response corresponded with a reduction in the phosphorylation of eNOS at Ser1177 and Akt at Thr308. In contrast, VEGFR2 at Tyr1175 and PKA at Thr197 were not different with hyperglycemia. CONCLUSION Reductions of eNOS and Akt phosphorylation at key residues implicated in nitric oxide production suggest that hyperglycemia alters the vasodilatory signaling of placental vessels. In contrast, acute hyperglycemic exposure may not alter vasoconstriction via VEGF and PKA signaling. Altogether our results link hyperglycemic exposure in human placentas to nitric oxide signaling; a mechanisms that may account for the elevations in vascular resistance commonly observed in diabetic pregnancies.
Collapse
Affiliation(s)
- Luckey C Reed
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, USA
| | - Sarah M Estrada
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, USA
| | - Robert B Walton
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, USA
| | - Peter G Napolitano
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, USA
| | - Nicholas Ieronimakis
- Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, WA, USA.
| |
Collapse
|
34
|
Zambon M, Mandò C, Lissoni A, Anelli GM, Novielli C, Cardellicchio M, Leone R, Monari MN, Massari M, Cetin I, Abati S. Inflammatory and Oxidative Responses in Pregnancies With Obesity and Periodontal Disease. Reprod Sci 2018; 25:1474-1484. [PMID: 29343164 DOI: 10.1177/1933719117749758] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Maternal obesity is related to immunologic and inflammatory systemic modifications that may worsen the pregnancy inflammatory status. Hormonal changes during pregnancy can adversely affect oral biofilms and oral health initiating or worsening periodontal diseases, with enhanced local and systemic oxidative stress and inflammation. OBJECTIVE The aim of this study was to examine the relationship between local salivary and systemic parameters of oxidative stress and inflammation in relation to obesity and periodontal diseases. STUDY DESIGN Sixty-two women with singleton pregnancies were enrolled. Twenty-seven women were normal weight (NW; 18.5< body mass index [BMI] <25 kg/m2) and 35 obese (BMI ≥30 kg/m2). Seventeen of the obese had gestational diabetes mellitus (GDM). During third trimester, periodontal status was evaluated, saliva (s) was collected to assess total antioxidant capacity (s-TAC) and C-reactive protein (s-CRP) levels, and venous plasma (p) was used to measure CRP levels (p-CRP). Maternal, fetal, and placental data were registered at delivery. RESULTS Levels of s-TAC, s-CRP, and p-CRP were significantly higher in obese, particularly in the presence of GDM, compared to NW and related to each other ( P = .000; r > 0.59), to maternal BMI ( P = .000; r > 0.52), and fasting glycemia ( P < .002; r > 0.47). Periodontal disease was more frequent in obese groups (80%) versus NW (52%; P = .04), particularly when GDM was diagnosed ( P = .009). A significant interaction effect between maternal BMI and oral condition was found for s-TAC levels. Obese with periodontitis showed significant increase in local and systemic parameters versus NW. CONCLUSION Obesity and periodontal disease could synergistically amplify the inflammatory and oxidative status, resulting in increased local and systemic biomarkers particularly when GDM is diagnosed.
Collapse
Affiliation(s)
- Marta Zambon
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Chiara Mandò
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Alessandra Lissoni
- 2 Unit of Oral Pathology, Department of Dentistry, University Vita-Salute San Raffaele and IRCCS San Raffaele University Hospital, Milan, Italy
| | - Gaia Maria Anelli
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Chiara Novielli
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Manuela Cardellicchio
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Roberto Leone
- 3 Humanitas Clinical and Research Center, Rozzano, Italy
| | - Marta Noemi Monari
- 4 Laboratory of Analysis, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Maddalena Massari
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Irene Cetin
- 1 Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Silvio Abati
- 2 Unit of Oral Pathology, Department of Dentistry, University Vita-Salute San Raffaele and IRCCS San Raffaele University Hospital, Milan, Italy
| |
Collapse
|
35
|
Kapur A, Mahmood T, Hod M. FIGO's response to the global challenge of hyperglycemia in pregnancy - toward a global consensus. Gynecol Endocrinol 2018; 34:1-3. [PMID: 28980832 DOI: 10.1080/09513590.2017.1381682] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Anil Kapur
- a FIGO Working Group on Hyperglycemia in Pregnancy, International Federation of Gynecology and Obstetrics (FIGO), Waterloo Court , London , UK
| | - Tahir Mahmood
- a FIGO Working Group on Hyperglycemia in Pregnancy, International Federation of Gynecology and Obstetrics (FIGO), Waterloo Court , London , UK
| | - Moshe Hod
- a FIGO Working Group on Hyperglycemia in Pregnancy, International Federation of Gynecology and Obstetrics (FIGO), Waterloo Court , London , UK
| |
Collapse
|
36
|
Dörnemann R, Koch R, Möllmann U, Falkenberg MK, Möllers M, Klockenbusch W, Schmitz R. Fetal thymus size in pregnant women with diabetic diseases. J Perinat Med 2017; 45:595-601. [PMID: 28195554 DOI: 10.1515/jpm-2016-0400] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/10/2017] [Indexed: 11/15/2022]
Abstract
AIM The aim of our study was to assess fetal thymus size in diabetic pregnancies compared with normal pregnancies. METHODS Sonographic fetal thymus size was retrospectively assessed in 161 pregnancies with maternal diabetes and in 161 uncomplicated pregnancies matched by gestational age. The anteroposterior thymic and the intrathoracic mediastinal diameter were measured and the quotient was calculated [thymic-thoracic ratio (TT-ratio)]. In addition, we defined the quotient of the anteroposterior thymic diameter and the head circumference as thymus-head ratio (TH-ratio). The maternal diabetes cases were subdivided into three groups: (1) diet-controlled gestational diabetes, (2) insulin-dependent gestational diabetes and (3) preexisting maternal diabetes. RESULTS TT-ratio and TH-ratio were smaller in pregnancies with maternal diabetes (P<0.001 and P<0.001, respectively). In all three maternal diabetes subgroups, the TT-ratio and the TH-ratio were lower compared with the control group (P<0.001 for each group). CONCLUSIONS Reduced fetal thymus size seems to be associated with diabetic pregnancy. We introduce fetal thymus size as a new potential prognostic parameter for maternal diabetes.
Collapse
|
37
|
Avagliano L, Massa V, Terraneo L, Samaja M, Doi P, Bulfamante GP, Marconi AM. Gestational diabetes affects fetal autophagy. Placenta 2017. [DOI: 10.1016/j.placenta.2017.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
38
|
Poirier C, Desgagné V, Guérin R, Bouchard L. MicroRNAs in Pregnancy and Gestational Diabetes Mellitus: Emerging Role in Maternal Metabolic Regulation. Curr Diab Rep 2017; 17:35. [PMID: 28378294 DOI: 10.1007/s11892-017-0856-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF THE REVIEW This review focuses on the recent emergence of microRNAs (miRNAs) as metabolic and developmental regulators in pregnancy and their role in the development of gestational diabetes mellitus (GDM). MiRNAs are short and stable RNA sequences that repress protein synthesis through interference with messenger RNA translation. RECENT FINDINGS The placenta produces numerous miRNAs with some of them being released in the maternal circulation. These miRNA genes are encoded into specific clusters and expressed preferentially by placental cells, in a time-dependent manner. They were shown to be dysregulated in plasma and placenta from women suffering from GDM and associated with pregnancy and birth-related outcomes. The discovery of pregnancy-related miRNAs and their respective characterization will provide us with important information as to their function in maternal and placental metabolic regulation. More studies are needed to determine whether they will be useful for early screening of GDM.
Collapse
Affiliation(s)
- Cédrik Poirier
- Department of Biochemistry, Universite de Sherbrooke, Sherbrooke, QC, Canada.
- ECOGENE-21 Biocluster, Chicoutimi, QC, Canada.
| | - Véronique Desgagné
- Department of Biochemistry, Universite de Sherbrooke, Sherbrooke, QC, Canada
- ECOGENE-21 Biocluster, Chicoutimi, QC, Canada
| | - Renée Guérin
- Department of Biochemistry, Universite de Sherbrooke, Sherbrooke, QC, Canada
- Department of Medical Biology, CIUSSS du Saguenay-Lac-St-Jean, Hopital de Chicoutimi, Saguenay, QC, Canada
| | - Luigi Bouchard
- Department of Biochemistry, Universite de Sherbrooke, Sherbrooke, QC, Canada
- ECOGENE-21 Biocluster, Chicoutimi, QC, Canada
- Department of Medical Biology, CIUSSS du Saguenay-Lac-St-Jean, Hopital de Chicoutimi, Saguenay, QC, Canada
| |
Collapse
|
39
|
Stanek J. Decidual arteriolopathy with or without associated hypertension modifies the underlying histomorphology in placentas from diabetic mothers. J Obstet Gynaecol Res 2017; 43:839-847. [PMID: 28127876 DOI: 10.1111/jog.13276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/29/2016] [Accepted: 12/03/2016] [Indexed: 12/13/2022]
Abstract
AIM The aim of this study was to retrospectively document the impact of hypertensive conditions in pregnancy and decidual arteriolopathy on the patterns of placental injury in maternal diabetes mellitus (MDM). METHODS Among all 5248 > 20 weeks' placentas, the frequencies of 19 selected clinical and 24 placental phenotypes were compared between 287 MDM placentas and 4961 remaining placentas (control group [CG]) before and after further exclusion of 85 and 611 patients with hypertensive conditions (gestational hypertension, pre-eclampsia, chronic hypertension). RESULTS Cesarean section rate, heavy placentas, decidual arteriolopathy, microscopic chorionic pseudocysts, and chorangiosis were more common in MDM than in the CG both before and after exclusion of hypertensive conditions. The frequencies of preuterine patterns of chronic hypoxic placental injury and plasma cell deciduitis became statistically significant only after exclusion of hypertensive conditions. CONCLUSION Hypertensive conditions of pregnancy may obscure the underlying preuterine placental hypoxic pattern in MDM placentas. Even in normotensive patients, decidual arteriolopathy, and shallow placental implantation significantly impact placental histomorphology in MDM.
Collapse
Affiliation(s)
- Jerzy Stanek
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| |
Collapse
|
40
|
Shupletsova JS, Bashmakova NV, Putilova NV, Deryabina EG, Tretyakova TB, Pestryaeva LA, Tsyvian PB. Risk factors of cerebral ischemia in infants born to mothers with gestational diabetes. Gynecol Endocrinol 2017; 33:12-14. [PMID: 29264982 DOI: 10.1080/09513590.2017.1399698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Gestational diabetes mellitus (GDM) is carbohydrate intolerance that occurs during pregnancy. The present study was arranged to determine the risk of cerebral ischemia (CI) in infants born to mothers with gestational diabetes mellitus and MTHFR gene polymorphism. MATERIAL AND METHODS The study includes 70 pregnant women with GDM, divided into two groups depending on existence of cerebral ischemia (CI) in newborn infants. All patients were tested for coagulation cascade components, polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene and assessed by thromboelastography (TEG). RESULTS We observed that there was an increased frequency (74.2%) of 1298С MTHFR genotype carriers among women with CI newborns. The state of hypercoagulation according to both coagulation cascade tests and TEG data was diagnosed in women of this group. CONCLUSIONS The results of this study suggest that hyperglycemia may program the development of cerebral ischemia in infants born to women with 1298С MTHFR gene polymorphism.
Collapse
Affiliation(s)
- J S Shupletsova
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
| | - N V Bashmakova
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
| | - N V Putilova
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
| | - E G Deryabina
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
| | - T B Tretyakova
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
| | - L A Pestryaeva
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
| | - P B Tsyvian
- a Ural Scientific Research Institute of Maternity and Child Care , Yekaterinburg , Russia
- b Department of Physiology , Ural State Medical University , Yekaterinburg , Russia
| |
Collapse
|
41
|
Han Y, Zheng YL, Wu AM, Liu HB, Su JB, Lu XY, Han YW, Ji JL, Ji JH, Shi Y. Effects of management in gestational diabetes mellitus with normal prepregnancy body mass index on pregnancy outcomes and placental ultrastructures: a prospective cohort study. Endocrine 2016; 54:691-699. [PMID: 27481362 DOI: 10.1007/s12020-016-1064-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/12/2016] [Indexed: 02/02/2023]
Abstract
A great quantity of gestational diabetes mellitus with normal prepregnancy body mass index have emerged with the new criteria of gestational diabetes mellitus in China based on the International Diabetes in Pregnancy Consensus group criteria, and understanding placental changes and how they affect outcomes are necessary in order to develop effective management approach. The aim of this study was to prospectively explore the effect of active management starting from the late second trimester in gestational diabetes mellitus women with normal prepregnancy body mass index on pregnancy outcomes and placental ultrastructures, and to provide scientific evidences for optimizing the management of gestational diabetes mellitus in China. Gestational diabetes mellitus women with normal prepregnancy body mass index in the same period of this prospective cohort study were divided into intervention group (n = 51) and control group (n = 55). The intervention group was managed rigorously, while the control group received conventional prenatal cares. The glucose profile, gestational weight gain and pregnancy outcomes were followed up and placental ultrastructures were observed and recorded by transmission electron microscopy. The blood glucose level and gestational weight gain in intervention group were significantly better controlled than those in control group (P < 0.01). The incidences of fetal distress, cesarean section and large for gestational age were significantly lower in intervention group than in control group (P < 0.05). There was a significant reduction in the incidence of abnormal placental ultrastructure in the intervention group (P < 0.01). After adjustment for confounding factors, the undesirable glycemic control and conventional management were related to abnormal placental ultrastructure (P < 0.05). Meanwhile, the undesirable glycemic control, abnormal placental ultrastructure and conventional management made sense in the incidence of fetal distress (P < 0.05), and the target glycemic control, recommend weight gain and active management were associated with reductions in the prevalence of cesarean delivery and large for gestational age (P < 0.05). The active management of gestational diabetes mellitus women with normal prepregnancy body mass index can improve pregnancy outcomes and placental ultrastructures, and the abnormal placental ultrastructure might be closely associated with the undesirable glycemic control and adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Yun Han
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Yan-Li Zheng
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China.
| | - Ai-Min Wu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Hong-Bin Liu
- Department of Pathology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Jian-Bin Su
- Department of Endocrinology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Xiao-Yan Lu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Yu-Wen Han
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Jin-Long Ji
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Ju-Hua Ji
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, NO. 6 North Hai-er-xiang Road, Nantong, 226001, China
| | - Yue Shi
- Johns Hopkins Medicine, 1013 N Wolfe Street, Baltimore, MD, 21205, USA
| |
Collapse
|
42
|
Deryabina EG, Yakornova GV, Pestryaeva LA, Sandyreva ND. Perinatal outcome in pregnancies complicated with gestational diabetes mellitus and very preterm birth: case-control study. Gynecol Endocrinol 2016; 32:52-55. [PMID: 27759454 DOI: 10.1080/09513590.2016.1232215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Preterm birth is defined as all births before 37 completed weeks of gestation. Preterm birth can be further sub-divided based on gestational age: extremely preterm (<28 weeks), very preterm (28 to <32 weeks) and moderate preterm (32 to <37 weeks). Retrospective observational case-control study review (1 year i.e., 2015) is to assess pregnancy outcome among women with gestational diabetes mellitus (GDM) delivering very preterm (28 + 0/7 to 31 + 6/7 weeks of gestation). The study group included all women diagnosed with GDM and were compared to a control group of women delivering at the same gestational age period but without GDM. In all, 30 women were included in the study, of whom 15 were diagnosed with GDM and 15 were not. All women had a cesarean delivery. Neonates of mothers with GDM had higher ponderal index. Birth weight had the positive associations with blood glucose of newborn (r = 0.37, p = 0.047) and term of births (r = 0.52, p = 0.003). Birth weight had the negative associations with maternal systolic pressure (r = -0.7, p < 0.05), pre-eclampsia (r = -0.6, p < 0.05) and maternal pre-pregnancy body mass index (r = -0.5, p < 0.05). There were no differences in mortality or other parameters for neonatal morbidity, including bronchopulmonary dysplasia, prematurity retinopathy, neonatal anemia. According to our data, very preterm delivery occurring in women with GDM does not confer an increased risk for neonatal complications.
Collapse
Affiliation(s)
| | - G V Yakornova
- b Department of Physiology and Pathology of Newborns and Young Children
| | | | - N D Sandyreva
- d Department of Obstetrics and Gynecology , Federal State Institution "Ural Scientific Research Institute of Maternity and Child" , Ekaterinburg , Russia
| |
Collapse
|
43
|
Reichetzeder C, Dwi Putra SE, Pfab T, Slowinski T, Neuber C, Kleuser B, Hocher B. Increased global placental DNA methylation levels are associated with gestational diabetes. Clin Epigenetics 2016; 8:82. [PMID: 27462376 PMCID: PMC4960714 DOI: 10.1186/s13148-016-0247-9] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/11/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes. It is known that GDM is associated with an altered placental function and changes in placental gene regulation. More recent studies demonstrated an involvement of epigenetic mechanisms. So far, the focus regarding placental epigenetic changes in GDM was set on gene-specific DNA methylation analyses. Studies that robustly investigated placental global DNA methylation are lacking. However, several studies showed that tissue-specific alterations in global DNA methylation are independently associated with type 2 diabetes. Thus, the aim of this study was to characterize global placental DNA methylation by robustly measuring placental DNA 5-methylcytosine (5mC) content and to examine whether differences in placental global DNA methylation are associated with GDM. METHODS Global DNA methylation was quantified by the current gold standard method, LC-MS/MS. In total, 1030 placental samples were analyzed in this single-center birth cohort study. RESULTS Mothers with GDM displayed a significantly increased global placental DNA methylation (3.22 ± 0.63 vs. 3.00 ± 0.46 %; p = 0.013; ±SD). Bivariate logistic regression showed a highly significant positive correlation between global placental DNA methylation and the presence of GDM (p = 0.0009). Quintile stratification according to placental DNA 5mC levels revealed that the frequency of GDM was evenly distributed in quintiles 1-4 (2.9-5.3 %), whereas the frequency in the fifth quintile was significantly higher (10.7 %; p = 0.003). Bivariate logistic models adjusted for maternal age, BMI, ethnicity, recurrent miscarriages, and familiar diabetes predisposition clearly demonstrated an independent association between global placental DNA hypermethylation and GDM. Furthermore, an ANCOVA model considering known predictors of DNA methylation substantiated an independent association between GDM and placental DNA methylation. CONCLUSIONS This is the first study that employed a robust quantitative assessment of placental global DNA methylation in over a thousand placental samples. The study provides large scale evidence that placental global DNA hypermethylation is associated with GDM, independent of established risk factors.
Collapse
Affiliation(s)
- C. Reichetzeder
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
- Center for Cardiovascular Research (CCR), Campus Charité Mitte, University Hospital Charité, Berlin, Germany
| | - S. E. Dwi Putra
- Department of Experimental Nutritional Medicine, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal, Potsdam 14558 Germany
- Faculty of Biotechnology, University of Surabaya, Surabaya, Indonesia
| | - T. Pfab
- Center for Cardiovascular Research (CCR), Campus Charité Mitte, University Hospital Charité, Berlin, Germany
- Diaverum Deutschland, Potsdam, Germany
| | - T. Slowinski
- Department of Nephrology, Campus Charité Mitte, University Hospital Charité, Berlin, Germany
| | - C. Neuber
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - B. Kleuser
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - B. Hocher
- Department of Experimental Nutritional Medicine, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal, Potsdam 14558 Germany
- Institut für Laboratoriumsmedizin, Berlin, Germany
- Department of Basic Medicine, Medical College of Hunan Normal University, Changsha, China
| |
Collapse
|
44
|
Gogeneni H, Buduneli N, Ceyhan-Öztürk B, Gümüş P, Akcali A, Zeller I, Renaud DE, Scott DA, Özçaka Ö. Increased infection with key periodontal pathogens during gestational diabetes mellitus. J Clin Periodontol 2015; 42:506-12. [PMID: 25959628 PMCID: PMC4699310 DOI: 10.1111/jcpe.12418] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 12/13/2022]
Abstract
AIM Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. MATERIALS AND METHODS Four case-control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. RESULTS Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p < 0.01). GDM was also associated with increased infection with individual and multiple oral pathogens (all p < 0.05). Gingivitis during pregnancy led to a 325% increase in systemic CRP (mean, 2495 versus 8116 ng/ml, p < 0.01). CONCLUSIONS Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome.
Collapse
Affiliation(s)
- Himabindu Gogeneni
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Nurcan Buduneli
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Banu Ceyhan-Öztürk
- Department of Endocrine and Metabolic Diseases, Aydın State Hospital, Aydın, Turkey
| | - Pınar Gümüş
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Aliye Akcali
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Iris Zeller
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Diane E. Renaud
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - David A. Scott
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Özgün Özçaka
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| |
Collapse
|