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Idowu JMV, Ojima WZ, Adetutu SB, Mayowa Mary A, Joseph Oluwakayode A, Tubosun Alex O. Women's empowerment as a determinant of neonatal mortality in Sub-Saharan Africa: a narrative review focused on Nigeria. Glob Health Action 2024; 17:2394256. [PMID: 39193753 PMCID: PMC11360643 DOI: 10.1080/16549716.2024.2394256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/15/2024] [Indexed: 08/29/2024] Open
Abstract
Neonatal mortality remains a critical public health issue, with Sub-Saharan Africa (SSA) experiencing disproportionately high rates compared to other global regions. Notably, SSA and South Asia are the regions most lagging behind the Sustainable Development Goal (SDG) 3.2, aiming for <12 neonatal deaths per 1,000 live births by 2030. Within SSA, Nigeria, the most populous country, records the highest number of neonatal deaths annually. Given the structural similarities among SSA nations, this narrative review, focusing on Nigeria, explores effective strategies to reduce the neonatal mortality gap. Information about trends, risk factors, and prevalent lapses was obtained from literature from renowned databases like PubMed, Scopus, and Google Scholar, and grey literature consisting of reports from relevant governmental and non-governmental organizations. Critical risk factors commonly identified include inadequate antenatal care (less than three visits), lack of access to skilled and clean birth practices, limited healthcare accessibility, financial barriers, substandard environmental conditions, and nutritional shortfalls. This review highlights women's empowerment as an additional critical factor, often overlooked, in the efforts to decrease neonatal mortality rates. Improving women's empowerment indices, such as the Gender Inequality Index (GII), employment, and literacy, offers a promising avenue to curtail neonatal mortality rates in Nigeria and across SSA sustainably. While this is potentially a long-term solution, short and medium-term recommendations were also proffered. By integrating women's empowerment within a broader strategy to improve maternal and newborn health, Nigeria can advance towards securing a healthier future for its youngest population.
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Affiliation(s)
- Joel-Medewase Victor Idowu
- Department of Paediatrics and Child Health, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- Department of Paediatrics and Child Health, LAUTECH Teaching Hospital, Ogbomoso, Nigeria
| | - Wada Zechariah Ojima
- Division of Sustainable Development, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
- Translational Research and Outreach Department, Global Eco-Oasis Sustainable Initiative (GESI), Ibadan, Nigeria
| | - Sayomi Bukola Adetutu
- Department of Paediatrics and Child Health, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- Department of Paediatrics and Child Health, LAUTECH Teaching Hospital, Ogbomoso, Nigeria
| | - Adetoye Mayowa Mary
- Department of Paediatrics and Child Health, LAUTECH Teaching Hospital, Ogbomoso, Nigeria
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Orav E, Kokinovic B, Teppola H, Siimon M, Lauri SE, Hartung H. Arginine vasopressin activates serotonergic neurons in the dorsal raphe nucleus during neonatal development in vitro and in vivo. Neuropharmacology 2024; 258:110068. [PMID: 38996832 DOI: 10.1016/j.neuropharm.2024.110068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/08/2024] [Accepted: 07/08/2024] [Indexed: 07/14/2024]
Abstract
Birth stress is a risk factor for psychiatric disorders and associated with exaggerated release of the stress hormone arginine vasopressin (AVP) into circulation and in the brain. In perinatal hippocampus, AVP activates GABAergic interneurons which leads to suppression of spontaneous network events and suggests a protective function of AVP on cortical networks during birth. However, the role of AVP in developing subcortical networks is not known. Here we tested the effect of AVP on the dorsal raphe nucleus (DRN) 5-hydroxytryptamine (5-HT, serotonin) system in male and female neonatal rats, since early 5-HT homeostasis is critical for the development of cortical brain regions and emotional behaviors. We show that AVP is strongly excitatory in neonatal DRN: it increases excitatory synaptic inputs of 5-HT neurons via V1A receptors in vitro and promotes their action potential firing through a combination of its effect on glutamatergic synaptic transmission and a direct effect on the excitability of these neurons. Furthermore, we identified two major firing patterns of neonatal 5-HT neurons in vivo, tonic regular firing and low frequency oscillations of regular spike trains and confirmed that these neurons are also activated by AVP in vivo. Finally, we show that the sparse vasopressinergic innervation in neonatal DRN originates exclusively from cell groups in medial amygdala and bed nucleus of stria terminalis. Hyperactivation of the neonatal 5-HT system by AVP during birth stress may impact its own functional development and affect the maturation of cortical target regions, which may increase the risk for psychiatric conditions later on.
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Affiliation(s)
- Ester Orav
- HiLIFE Neuroscience Center, University of Helsinki, Helsinki, Finland.
| | - Bojana Kokinovic
- HiLIFE Neuroscience Center, University of Helsinki, Helsinki, Finland.
| | - Heidi Teppola
- HiLIFE Neuroscience Center, University of Helsinki, Helsinki, Finland.
| | - Mari Siimon
- HiLIFE Neuroscience Center, University of Helsinki, Helsinki, Finland.
| | - Sari E Lauri
- HiLIFE Neuroscience Center, University of Helsinki, Helsinki, Finland.
| | - Henrike Hartung
- HiLIFE Neuroscience Center, University of Helsinki, Helsinki, Finland.
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Brokken T, Hütten MC, Ophelders DRMG, van Gorp C, Wolfs TGAM, Wald M. Optimized lung expansion ventilation modulates ventilation-induced lung injury in preterm lambs. Pediatr Pulmonol 2024; 59:2891-2900. [PMID: 38958257 DOI: 10.1002/ppul.27153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION Preterm infants close to viability commonly require mechanical ventilation (MV) for respiratory distress syndrome. Despite commonly used lung-sparing ventilation techniques, rapid lung expansion during MV induces lung injury, a risk factor for bronchopulmonary dysplasia. This study investigates whether ventilation with optimized lung expansion is feasible and whether it can further minimize lung injury. Therefore, optimized lung expansion ventilation (OLEV) was compared to conventional volume targeted ventilation. METHODS Twenty preterm lambs were surgically delivered after 132 days of gestation. Nine animals were randomized to receive OLEV for 24 h, and seven received standard MV. Four unventilated animals served as controls (NV). Lungs were sampled for histological analysis at the end of the experimental period. RESULTS Ventilation with OLEV was feasible, resulting in a significantly higher mean ventilation pressure (0.7-1.3 mbar). Temporary differences in oxygenation between OLEV and MV did not reach clinically relevant levels. Ventilation in general tended to result in higher lung injury scores compared to NV, without differences between OLEV and MV. While pro-inflammatory tumor necrosis factor-α messenger RNA (mRNA) levels increased in both ventilation groups compared to NV, only animals in the MV group showed a higher number of CD45-positive cells in the lung. In contrast, mean (standard deviations) surfactant protein-B mRNA levels were significantly lower in OLEV, 0.63 (0.38) compared to NV 1.03 (0.32) (p = .023, one-way analysis of variance). CONCLUSION In conclusion, a small reduction in pulmonary inflammation after 24 h of support with OLEV suggests potential to reduce preterm lung injury.
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Affiliation(s)
- Tim Brokken
- Divisions of Neonatology, MosaKids Children's Hospital, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Matthias C Hütten
- Divisions of Neonatology, MosaKids Children's Hospital, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Daan R M G Ophelders
- Divisions of Neonatology, MosaKids Children's Hospital, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Charlotte van Gorp
- Divisions of Neonatology, MosaKids Children's Hospital, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Tim G A M Wolfs
- Divisions of Neonatology, MosaKids Children's Hospital, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martin Wald
- Divisions of Neonatology, Department of Pediatrics and Adolescent Medicine, Paracelsus Medical University, Salzburg, Austria
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Manchineni SB, Meshram RJ. Revolutionizing Neonatal Care: A Comprehensive Review of Intact Cord Resuscitation in Newborns. Cureus 2024; 16:e68924. [PMID: 39381456 PMCID: PMC11459599 DOI: 10.7759/cureus.68924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Accepted: 09/07/2024] [Indexed: 10/10/2024] Open
Abstract
Neonatal resuscitation is a critical procedure aimed at ensuring the successful transition of newborns from intrauterine to extrauterine life. Traditionally, this involves immediate clamping and cutting of the umbilical cord, but recent advances have introduced intact cord resuscitation (ICR) as an alternative approach. This review aims to comprehensively analyze ICR, exploring its evolution, scientific basis, and clinical evidence. It seeks to evaluate the benefits and challenges associated with ICR and assess its impact on neonatal outcomes compared to traditional practices. A thorough review of the literature was conducted, including historical perspectives on neonatal resuscitation, the physiological rationale behind ICR, and critical clinical studies and trials. Current guidelines and recommendations were also examined, along with technological advancements and practical implementation issues. Evidence indicates that ICR offers significant benefits, including improved blood volume, better cardiovascular stability, and reduced risk of anemia in newborns. Comparative studies suggest that ICR can enhance neonatal outcomes and support a smoother transition to extrauterine life. Despite these benefits, challenges related to implementation and adherence to new practices persist. ICR represents a promising advancement in neonatal care, potentially improving newborns' health outcomes. Continued research and refinement of guidelines are necessary to fully integrate ICR into standard practice and address existing implementation challenges. This review highlights the need for ongoing evaluation and adaptation of resuscitation practices to optimize neonatal health and care.
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Affiliation(s)
- Sai Bhavani Manchineni
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Revat J Meshram
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Perrotta M, D'Adamo E, Strozzi C, D'Egidio C, Del Rosso F, Maconi A, Picone S, Giardinelli G, Cepelli L, Cicolini I, Conte M, Bellinaso M, Negri R, Gazzolo F, Cassinari M, Abella L, Abdelhameed AS, Mangifesta R, Gazzolo D. Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants. Clin Chem Lab Med 2024:cclm-2024-0821. [PMID: 39191205 DOI: 10.1515/cclm-2024-0821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVES The measurement of blood pH and gas analytes (BPGA), soon after birth, constitutes the first-line standard of care procedure in high-risk newborns. However, no data is available in capillary blood on perinatal bias such as gestational age (GA), weight at birth (BW), delivery mode, and gender. The aims of the present study were to investigate whether in a cohort of healthy preterm (PT) and term (T) infants BPGA were GA, BW, delivery mode and gender dependent, thus affecting BPGA reliability as diagnostic test. METHODS We performed a prospective case-control study in 560 healthy infants (PT: n=115, T: n=445). BPGA was measured within 24-h from birth. Perinatal characteristics, outcomes, and clinical examination were also recorded. RESULTS PT infants showed higher (p<0.001) carbon dioxide partial pressure (pCO2), fraction of fetal hemoglobin (HbF), base excess (BE), bicarbonate (HCO3), and lower lactate (Lac) levels. When corrected for delivery mode, higher (p<0.001) HbF, BE, HCO3, and lower Lac levels were found. Similarly, higher (p<0.05, for all) pCO2, HbF, BE, HCO3 and lower Lac levels were found between female and male PT and T infants. Repeated multiple logistic regression analysis showed that BPGA was GA, BW, delivery mode and gender dependent. CONCLUSIONS The present results showing that BPGA can be affected by a series of perinatal outcomes open the way to further investigations providing longitudinal BPGA reference curves in the transitional phase, thus empowering BPGA role as a reliable diagnostic and therapeutic strategies efficacy marker.
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Affiliation(s)
- Marika Perrotta
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | - Ebe D'Adamo
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | | | - Claudia D'Egidio
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | - Francesca Del Rosso
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | - Antonio Maconi
- Social Security Administration Development and Promotion of Scientific Research Unit, SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Simonetta Picone
- Neonatology and Neonatal Intensive Care Unit, Policlinico Casilino General Hospital, Rome, Italy
| | | | - Laura Cepelli
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | - Ilenia Cicolini
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | - Mariangela Conte
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
| | - Mariangela Bellinaso
- Neonatal Intensive Care Unit, SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Rossana Negri
- Neonatal Intensive Care Unit, SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | | | - Maurizio Cassinari
- Department of Clinical Biochemistry, Transfusion and Regeneration Medicine Alessandria Hospital, Alessandria, Italy
| | | | - Ali Saber Abdelhameed
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | - Diego Gazzolo
- Neonatal Intensive Care Unit G d'Annunzio University of Chieti, Chieti, Italy
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Yael A, Fishman R, Matas D, Doniger T, Vortman Y, Koren L. Fetal endocrine axes mRNA expression levels are related to sex and intrauterine position. Biol Sex Differ 2024; 15:61. [PMID: 39103957 DOI: 10.1186/s13293-024-00637-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 07/19/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND The hypothalamic-pituitary-adrenal (HPA) and -gonadal (HPG) axes are two major pathways that connect the neural and endocrine systems in vertebrates. Factors such as prenatal stress and maternal exposure to exogenous steroids have been shown to affect these pathways during fetal development. Another less studied factor is the transfer of hormones across fetuses in multifetal pregnancies. This form of transfer has been shown to influence the morphology, anatomy, physiology, and behavior of the offspring in litter-bearing mammals, an influence termed the intrauterine position (IUP) effect. In this study, we sought to delineate how the IUP effects HPA and HPG brain receptors, peptides, and enzymes (hereafter components) in utero and how these influences may differ between males and females. METHODS We utilized the unconventional model of culled free-ranging nutria (Myocastor coypus), with its large natural variation. We collected brain tissues from nutria fetuses and quantified the expression of key HPA and HPG components in three brain regions: prefrontal cortex, hypothalamus, and striatum. RESULTS We found an interaction between sex and IUP in the mineralocorticoid receptor (MR), gonadotropin-releasing hormone receptor (GNRHR), androgen receptor (AR), and estrogen receptor alpha (ESR1). IUP was significant in both gonadotropin-releasing hormone (GnRH) and its receptor GNRHR, but in different ways. In the hypothalamus, fetuses adjacent to same-sex neighbors had higher expression of GnRH than fetuses neighboring the opposite sex. Conversely, in the cortex, GNRHR exhibited the inverse pattern, and fetuses that were neighboring the opposite sex had higher expression levels than those neighboring the same sex. Regardless of IUP, in most components that showed significant sex differences, female fetuses had higher mRNA expression levels than male fetuses. We also found that HPA and HPG components were highly related in the early stages of gestation, and that there was an interaction between sex and developmental stage. In the early stages of pregnancy, female component expression levels were more correlated than males', but in the last trimester of pregnancy, male components were more related to each other than female's. CONCLUSIONS This study suggests that there are sexually different mechanisms to regulate the HPA and HPG axes during fetal development. Higher mRNA expression levels of endocrine axes components may be a mechanism to help females cope with prolonged androgen exposure over a long gestational period. Additionally, these findings suggest different coordination requirements of male and female endocrine axes during stages of fetal development.
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Affiliation(s)
- Ariel Yael
- The Faculty of Life Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Ruth Fishman
- The Faculty of Life Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel
- Department of Brain Sciences, Weizmann Institute of Science, 76100, Rehovot, Israel
| | - Devorah Matas
- The Faculty of Life Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Tirza Doniger
- The Faculty of Life Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Yoni Vortman
- Department of Animal Sciences, Hula Research Center, Tel Hai Academic College, Upper Galilee, 1220800, Qiryat Shemona, Israel
| | - Lee Koren
- The Faculty of Life Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel.
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Abreu RAD, Almeida LLD, Rosa Filho RRD, Angrimani DDSR, Brito MM, Flores RB, Vannucchi CI. Canine pulmonary clearance during feto-neonatal transition according to the type of delivery. Theriogenology 2024; 224:156-162. [PMID: 38776703 DOI: 10.1016/j.theriogenology.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/01/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
The success of immediate adaptation to extrauterine life depends on appropriate lung function, however, elective cesarean section can increase the risk of respiratory distress as a result of reduced pulmonary fluid absorption. This study aimed to evaluate the influence of birth mode on pulmonary clearance and respiratory performance of canine neonates in the transition period. For this purpose, 37 neonates were selected according to the obstetric condition: Vaginal Eutocia (n = 17) and Elective C-section (n = 20). Neonates were evaluated for neonatal vitality score, as well as evaluation of heart and respiratory rates, body temperature and body weight, venous hemogasometric evaluation, blood lactate and glucose, pulse oximetry and radiographic evaluation during the first 24 h of life. Additionally, amniotic fluid electrolyte composition of each puppy was evaluated. There was no influence of the type of delivery on electrolyte composition of canine amniotic fluid and neonatal pulmonary liquid content, analyzed by thoracic X-Rays. On the other hand, elective cesarean section delayed pulmonary adaptation, resulting in hypoxemia and less efficient compensatory response to acid-base imbalance and thermoregulation. In conclusion, elective c-section does not delay pulmonary clearance, whilst alters pulmonary adaptation by less efficient gas exchange and lower oxygenation, hindering the compensatory response to acid-base imbalance during the fetal-neonatal transition in dogs.
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Affiliation(s)
- Renata Azevedo de Abreu
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil
| | - Letícia Lima de Almeida
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil
| | - Roberto Rodrigues da Rosa Filho
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil
| | - Daniel de Souza Ramos Angrimani
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil
| | - Maíra Morales Brito
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil
| | - Renato Bueno Flores
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil
| | - Camila Infantosi Vannucchi
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87 - Cidade Universitária, São Paulo, SP, 05508-270, Brazil.
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Sotiropoulos JX, Saugstad OD, Oei JL. Aspects on Oxygenation in Preterm Infants before, Immediately after Birth, and Beyond. Neonatology 2024; 121:562-569. [PMID: 39089224 PMCID: PMC11446306 DOI: 10.1159/000540481] [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: 04/30/2024] [Accepted: 06/21/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Oxygen is crucial for life but too little (hypoxia) or too much (hyperoxia) may be fatal or cause lifelong morbidity. SUMMARY In this review, we discuss the challenges of balancing oxygen control in preterm infants during fetal development, the first few minutes after birth, in the neonatal intensive care unit and after hospital discharge, where intensive care monitoring and response to dangerous oxygen levels is more often than not, out of reach with current technologies and services. KEY MESSAGES Appropriate oxygenation is critically important even from before birth, but at no time is the need to strike a balance more important than during the first few minutes after birth, when body physiology is changing at its most rapid pace. Preterm infants, in particular, have a poor control of oxygen balance. Underdeveloped organs, especially of the lungs, require supplemental oxygen to prevent hypoxia. However, they are also at risk of hyperoxia due to immature antioxidant defenses. Existing evidence demonstrate considerable challenges that need to be overcome before we can ensure safe treatment of preterm infants with one of the most commonly used drugs in newborn care, oxygen.
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Affiliation(s)
- James X Sotiropoulos
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Ola D Saugstad
- Department of Pediatric Research, University of Oslo, Oslo, Norway
- Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ju Lee Oei
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia,
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia,
- Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia,
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Ali N, Donofrio MT. Delivery room and early postnatal management of neonates with congenital heart disease. Prenat Diagn 2024; 44:915-924. [PMID: 38858803 DOI: 10.1002/pd.6617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
Advancements in prenatal detection have improved postnatal outcomes for patients with congenital heart disease (CHD). Detailed diagnosis during pregnancy allows for preparation for the delivery and immediate postnatal care for the newborns with CHD. Most CHDs do not result in hemodynamic instability at the time of birth and can be stabilized following the guidelines of the neonatal resuscitation program (NRP). Critical CHD that requires intervention immediately after birth is recommended to be delivered in facilities where immediate neonatal and cardiology care can be provided. Postnatal stabilization and resuscitation for these defects warrant deviation from the standardized NRP. For neonatal providers, knowing the diagnosis of fetal CHD allows for preparation for the anticipated instability in the delivery room. Prenatal detection fosters collaboration between fetal cardiology, cardiology specialists, obstetrics, and neonatology, improving outcomes for neonates with critical CHD.
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Affiliation(s)
- Noorjahan Ali
- Division of Neonatal-Perinatal Medicine, University of Texas Southwestern, Dallas, Texas, USA
| | - Mary T Donofrio
- The George Washington University Division of Cardiology, Washington, Washington, USA
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Masters H, Wang S, Tu C, Nguyen Q, Sha Y, Karikomi MK, Fung PSR, Tran B, Martel C, Kwang N, Neel M, Jaime OG, Espericueta V, Johnson BA, Kessenbrock K, Nie Q, Monuki ES. Sequential emergence and contraction of epithelial subtypes in the prenatal human choroid plexus revealed by a stem cell model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.12.598747. [PMID: 38948782 PMCID: PMC11212933 DOI: 10.1101/2024.06.12.598747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Despite the major roles of choroid plexus epithelial cells (CPECs) in brain homeostasis and repair, their developmental lineage and diversity remain undefined. In simplified differentiations from human pluripotent stem cells, derived CPECs (dCPECs) displayed canonical properties and dynamic multiciliated phenotypes that interacted with Aβ uptake. Single dCPEC transcriptomes over time correlated well with human organoid and fetal CPECs, while pseudotemporal and cell cycle analyses highlighted the direct CPEC origin from neuroepithelial cells. In addition, time series analyses defined metabolic (type 1) and ciliogenic dCPECs (type 2) at early timepoints, followed by type 1 diversification into anabolic-secretory (type 1a) and catabolic-absorptive subtypes (type 1b) as type 2 cells contracted. These temporal patterns were then confirmed in independent derivations and mapped to prenatal stages using human tissues. In addition to defining the prenatal lineage of human CPECs, these findings suggest new dynamic models of ChP support for the developing human brain.
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Mende S, Ahmed S, DeShea L, Szyld E, Shah BA. Electronic Heart (ECG) Monitoring at Birth and Newborn Resuscitation. CHILDREN (BASEL, SWITZERLAND) 2024; 11:685. [PMID: 38929264 PMCID: PMC11202155 DOI: 10.3390/children11060685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/27/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Approximately 10% of newborns require assistance at delivery, and heart rate (HR) is the primary vital sign providers use to guide resuscitation methods. In 2016, the American Heart Association (AHA) suggested electrocardiogram in the delivery room (DR-ECG) to measure heart rate during resuscitation. This study aimed to compare the frequency of resuscitation methods used before and after implementation of the AHA recommendations. METHODS This longitudinal retrospective cohort study compared a pre-implementation (2015) cohort with two post-implementation cohorts (2017, 2021) at our Level IV neonatal intensive care unit. RESULTS An initial increase in chest compressions at birth associated with the introduction of DR-ECG monitoring was mitigated by focused educational interventions on effective ventilation. Implementation was accompanied by no changes in neonatal mortality. CONCLUSIONS Investigation of neonatal outcomes during the ongoing incorporation of DR-ECG may help our understanding of human and system factors, identify ways to optimize resuscitation team performance, and assess the impact of targeted training initiatives on clinical outcomes.
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Affiliation(s)
- Sarah Mende
- Department of Pediatrics, College of Medicine, University of Oklahoma (OU), Oklahoma City, OK 73104, USA
| | - Syed Ahmed
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Lise DeShea
- Department of Pediatrics, College of Medicine, University of Oklahoma (OU), Oklahoma City, OK 73104, USA
| | - Edgardo Szyld
- Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Birju A. Shah
- Department of Pediatrics, College of Medicine, University of Oklahoma (OU), Oklahoma City, OK 73104, USA
- Neonatal-Perinatal Medicine, Oklahoma Children’s Hospital at OU Health, 1200 North Everett Drive, 7th Floor North Pavilion ETNP #7504, Oklahoma City, OK 73104, USA
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12
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Lucero-Orozco NB, Reyes-Lagos JJ, Ortíz-Pedroza MDR, Talavera-Peña AK, Abarca-Castro EA, Mendieta-Zerón H, Pliego-Carrillo AC, Rodríguez-Arce J, Zúñiga-Avilés LA, Santiago-Fuentes LM, Ledesma-Ramírez CI, Peña-Castillo MÁ. Analysis of fetal heart rate fluctuations in women diagnosed with preeclampsia during the latent phase of labor. Front Physiol 2024; 15:1340441. [PMID: 38846420 PMCID: PMC11154906 DOI: 10.3389/fphys.2024.1340441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/19/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Fetal heart rate variability (fHRV) is a tool used to investigate the functioning of the fetal autonomic nervous system. Despite the significance of preeclampsia, fHRV during the latent phase of labor has not been extensively studied. This study aimed to evaluate fetal cardiac autonomic activity by using linear and nonlinear indices of fHRV analysis in women diagnosed with preeclampsia without hypertensive treatment during gestation, compared to normotensive women during the latent phase of labor. Methods A cross-sectional and exploratory study was conducted among pregnant women in the latent phase of labor, forming three study groups: normotensive or control (C, 38.8 ± 1.3 weeks of pregnancy, n = 22), preeclampsia with moderate features (P, 37.6 ± 1.4 weeks of pregnancy n = 10), and preeclampsia with severe features (SP, 36.9 ± 1.2 weeks of pregnancy, n = 12). None of the participants received anti-hypertensive treatment during their pregnancy. Linear and nonlinear features of beat-to-beat fHRV, including temporal, frequency, symbolic dynamics, and entropy measures, were analyzed to compare normotensive and preeclamptic groups. Results Significantly lower values of multiscale entropy (MSE) and short-term complexity index (Ci) were observed in the preeclamptic groups compared to the C group (p < 0.05). Additionally, higher values of SDNN (standard deviation of R-R intervals) and higher values of low-frequency power (LF) were found in the P group compared to the C group. Conclusion Our findings indicate that changes in the complexity of fetal heart rate fluctuations may indicate possible disruptions in the autonomic nervous system of fetuses in groups affected by undiagnosed preeclampsia during pregnancy. Reduced complexity and shifts in fetal autonomic cardiac activity could be associated with preeclampsia's pathophysiological mechanisms during the latent phase of labor.
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Affiliation(s)
- Nancy B. Lucero-Orozco
- División de Ciencias Básicas e Ingeniería, Universidad Autónoma Metropolitana-Iztapalapa (UAM-I), Ciudad de México, Mexico
| | | | - María del Rocío Ortíz-Pedroza
- División de Ciencias Básicas e Ingeniería, Universidad Autónoma Metropolitana-Iztapalapa (UAM-I), Ciudad de México, Mexico
| | - Ana Karen Talavera-Peña
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Lerma (UAM-L), Lerma de Villada, Mexico
| | - Eric Alonso Abarca-Castro
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Lerma (UAM-L), Lerma de Villada, Mexico
| | - Hugo Mendieta-Zerón
- Facultad de Medicina, Universidad Autónoma del Estado de México (UAEMéx), Toluca, Mexico
| | | | - Jorge Rodríguez-Arce
- Facultad de Ingeniería, Universidad Autónoma del Estado de México (UAEMéx), Toluca, Mexico
| | - Luis Adrián Zúñiga-Avilés
- Facultad de Medicina, Universidad Autónoma del Estado de México (UAEMéx), Toluca, Mexico
- Facultad de Ingeniería, Universidad Autónoma del Estado de México (UAEMéx), Toluca, Mexico
| | - Laura Mercedes Santiago-Fuentes
- Facultad de Medicina, Universidad Autónoma del Estado de México (UAEMéx), Toluca, Mexico
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa (UAM-I), Iztapalapa, Mexico
| | | | - Miguel Ángel Peña-Castillo
- División de Ciencias Básicas e Ingeniería, Universidad Autónoma Metropolitana-Iztapalapa (UAM-I), Ciudad de México, Mexico
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13
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Fairchild KD, Petroni GR, Varhegyi NE, Strand ML, Josephsen JB, Niermeyer S, Barry JS, Warren JB, Rincon M, Fang JL, Thomas SP, Travers CP, Kane AF, Carlo WA, Byrne BJ, Underwood MA, Poulain FR, Law BH, Gorman TE, Leone TA, Bulas DI, Epelman M, Kline-Fath BM, Chisholm CA, Kattwinkel J. Ventilatory Assistance Before Umbilical Cord Clamping in Extremely Preterm Infants: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2411140. [PMID: 38758557 PMCID: PMC11102017 DOI: 10.1001/jamanetworkopen.2024.11140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/07/2024] [Indexed: 05/18/2024] Open
Abstract
Importance Providing assisted ventilation during delayed umbilical cord clamping may improve outcomes for extremely preterm infants. Objective To determine whether assisted ventilation in extremely preterm infants (23 0/7 to 28 6/7 weeks' gestational age [GA]) followed by cord clamping reduces intraventricular hemorrhage (IVH) or early death. Design, Setting, and Participants This phase 3, 1:1, parallel-stratified randomized clinical trial conducted at 12 perinatal centers across the US and Canada from September 2, 2016, through February 21, 2023, assessed IVH and early death outcomes of extremely preterm infants randomized to receive 120 seconds of assisted ventilation followed by cord clamping vs delayed cord clamping for 30 to 60 seconds with ventilatory assistance afterward. Two analysis cohorts, not breathing well and breathing well, were specified a priori based on assessment of breathing 30 seconds after birth. Intervention After birth, all infants received stimulation and suctioning if needed. From 30 to 120 seconds, infants randomized to the intervention received continuous positive airway pressure if breathing well or positive-pressure ventilation if not, with cord clamping at 120 seconds. Control infants received 30 to 60 seconds of delayed cord clamping followed by standard resuscitation. Main Outcomes and Measures The primary outcome was any grade IVH on head ultrasonography or death before day 7. Interpretation by site radiologists was confirmed by independent radiologists, all masked to study group. To estimate the association between study group and outcome, data were analyzed using the stratified Cochran-Mantel-Haenszel test for relative risk (RR), with associations summarized by point estimates and 95% CIs. Results Of 1110 women who consented to participate, 548 were randomized and delivered infants at GA less than 29 weeks. A total of 570 eligible infants were enrolled (median [IQR] GA, 26.6 [24.9-27.7] weeks; 297 male [52.1%]). Intraventricular hemorrhage or death occurred in 34.9% (97 of 278) of infants in the intervention group and 32.5% (95 of 292) in the control group (adjusted RR, 1.02; 95% CI, 0.81-1.27). In the prespecified not-breathing-well cohort (47.5% [271 of 570]; median [IQR] GA, 26.0 [24.7-27.4] weeks; 152 male [56.1%]), IVH or death occurred in 38.7% (58 of 150) of infants in the intervention group and 43.0% (52 of 121) in the control group (RR, 0.91; 95% CI, 0.68-1.21). There was no evidence of differences in death, severe brain injury, or major morbidities between the intervention and control groups in either breathing cohort. Conclusions and Relevance This study did not show that providing assisted ventilation before cord clamping in extremely preterm infants reduces IVH or early death. Additional study around the feasibility, safety, and efficacy of assisted ventilation before cord clamping may provide additional insight. Trial Registration ClinicalTrials.gov Identifier: NCT02742454.
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Affiliation(s)
- Karen D. Fairchild
- Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville
| | - Gina R. Petroni
- Division of Translational Research and Applied Statistics, Department of Public Health Sciences, University of Virginia, Charlottesville
| | - Nikole E. Varhegyi
- Division of Translational Research and Applied Statistics, Department of Public Health Sciences, University of Virginia, Charlottesville
| | - Marya L. Strand
- Division of Neonatology, Department of Pediatrics, St Louis University, St Louis, Missouri
| | - Justin B. Josephsen
- Division of Neonatology, Department of Pediatrics, St Louis University, St Louis, Missouri
| | - Susan Niermeyer
- Section of Neonatology, Department of Pediatrics, University of Colorado, Denver
| | - James S. Barry
- Section of Neonatology, Department of Pediatrics, University of Colorado, Denver
| | - Jamie B. Warren
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland
| | - Monica Rincon
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland
| | - Jennifer L. Fang
- Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sumesh P. Thomas
- Section of Newborn Critical Care, Department of Pediatrics, University of Calgary, Alberta, Canada
| | - Colm P. Travers
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham
| | - Andrea F. Kane
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham
| | - Waldemar A. Carlo
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham
| | - Bobbi J. Byrne
- Division of Neonatology, Department of Pediatrics, Indiana University, Indianapolis
| | - Mark A. Underwood
- Division of Neonatology, Department of Pediatrics, University of California, Davis, Sacramento
| | - Francis R. Poulain
- Division of Neonatology, Department of Pediatrics, University of California, Davis, Sacramento
| | - Brenda H. Law
- Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Terri E. Gorman
- Division of Neonatology, Department of Pediatrics, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Tina A. Leone
- Division of Neonatology, Department of Pediatrics, Columbia University, New York, New York
| | - Dorothy I. Bulas
- Department of Radiology, Children’s National Medical Center, Washington, DC
| | - Monica Epelman
- Department of Radiology, Nemours Children’s Hospital, Orlando, Florida
| | - Beth M. Kline-Fath
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Christian A. Chisholm
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville
| | - John Kattwinkel
- Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville
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14
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Mamidi RR, McEvoy CT. Oxygen in the neonatal ICU: a complicated history and where are we now? Front Pediatr 2024; 12:1371710. [PMID: 38751747 PMCID: PMC11094359 DOI: 10.3389/fped.2024.1371710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Despite major advances in neonatal care, oxygen remains the most commonly used medication in the neonatal intensive care unit (NICU). Supplemental oxygen can be life-saving for term and preterm neonates in the resuscitation period and beyond, however use of oxygen in the neonatal period must be judicious as there can be toxic effects. Newborns experience substantial hemodynamic changes at birth, rapid energy consumption, and decreased antioxidant capacity, which requires a delicate balance of sufficient oxygen while mitigating reactive oxygen species causing oxidative stress. In this review, we will discuss the physiology of neonates in relation to hypoxia and hyperoxic injury, the history of supplemental oxygen in the delivery room and beyond, supporting clinical research guiding trends for oxygen therapy in neonatal care, current practices, and future directions.
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Affiliation(s)
- Rachna R. Mamidi
- Division of Neonatology, Oregon Health & Science University, Portland, OR, United States
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15
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Abreu RAD, Almeida LLD, Brito MMD, Rosa Filho RRD, Veronesi MC, Vannucchi CI. Maternal and neonatal cortisol and catecholamines throughout vaginal eutocia and C-section in dogs. Domest Anim Endocrinol 2024; 87:106838. [PMID: 38401307 DOI: 10.1016/j.domaniend.2024.106838] [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: 11/28/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
Increased fetal cortisol is associated with catecholamine release, a primary factor for neonatal adaptive responses. However, relationship between canine peripartum cortisol and catecholamine is unknown. We aimed to compare serum adrenaline, noradrenaline and cortisol during peripartum in bitches and neonates of distinct obstetric conditions and to assess amniotic fluid cortisol concentration. Twenty females and maximum of three puppies per litter were allocated into Vaginal Eutocia (10 females; 17 neonates) and Elective C-section (10 females; 20 neonates) groups. Amniotic fluid was collected at delivery for cortisol concentration. Maternal and neonatal blood were collected prepartum, intrapartum, postpartum and 1h postpartum, and at birth, 30 and 60min, 12hs and 24hs, respectively, for cortisol, adrenaline and noradrenaline assessment. C-section determined higher noradrenaline throughout delivery and cortisol concentration from intrapartum through 1h postpartum, compared to vaginal birth. C-section maternal cortisol showed progressive increase from intrapartum onwards, while neonatal cortisol remained unchanged. No difference of maternal cortisol concentration occurred along whelping, whereas a significant decrease was verified for vaginal delivery puppies from birth until the 12hs. Puppies delivered vaginally had higher cortisol concentration at birth and 30min, compared to c-section puppies. There was a higher concentration of amniotic fluid cortisol in vaginal eutocia. In conclusion, c-section induces higher maternal stress during and after surgery, whilst vaginal delivery is a more neonatal physiologically stressful condition, contributing to better adaptation during transition.
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Affiliation(s)
- Renata Azevedo de Abreu
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Letícia Lima de Almeida
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Maíra Morales de Brito
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Roberto Rodrigues da Rosa Filho
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Maria Cristina Veronesi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Italy
| | - Camila Infantosi Vannucchi
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil.
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16
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Yaremenko AV, Pechnikova NA, Porpodis K, Damdoumis S, Aggeli A, Theodora P, Domvri K. Association of Fetal Lung Development Disorders with Adult Diseases: A Comprehensive Review. J Pers Med 2024; 14:368. [PMID: 38672994 PMCID: PMC11051200 DOI: 10.3390/jpm14040368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Fetal lung development is a crucial and complex process that lays the groundwork for postnatal respiratory health. However, disruptions in this delicate developmental journey can lead to fetal lung development disorders, impacting neonatal outcomes and potentially influencing health outcomes well into adulthood. Recent research has shed light on the intriguing association between fetal lung development disorders and the development of adult diseases. Understanding these links can provide valuable insights into the developmental origins of health and disease, paving the way for targeted preventive measures and clinical interventions. This review article aims to comprehensively explore the association of fetal lung development disorders with adult diseases. We delve into the stages of fetal lung development, examining key factors influencing fetal lung maturation. Subsequently, we investigate specific fetal lung development disorders, such as respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), congenital diaphragmatic hernia (CDH), and other abnormalities. Furthermore, we explore the potential mechanisms underlying these associations, considering the role of epigenetic modifications, transgenerational effects, and intrauterine environmental factors. Additionally, we examine the epidemiological evidence and clinical findings linking fetal lung development disorders to adult respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and other respiratory ailments. This review provides valuable insights for healthcare professionals and researchers, guiding future investigations and shaping strategies for preventive interventions and long-term care.
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Affiliation(s)
- Alexey V. Yaremenko
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
| | - Nadezhda A. Pechnikova
- Laboratory of Chemical Engineering A’, School of Chemical Engineering, Faculty of Engineering, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (N.A.P.); (A.A.)
- Saint Petersburg Pasteur Institute, Saint Petersburg 197101, Russia
| | - Konstantinos Porpodis
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
| | - Savvas Damdoumis
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
| | - Amalia Aggeli
- Laboratory of Chemical Engineering A’, School of Chemical Engineering, Faculty of Engineering, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (N.A.P.); (A.A.)
| | - Papamitsou Theodora
- Laboratory of Histology-Embryology, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Kalliopi Domvri
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
- Laboratory of Histology-Embryology, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
- Pathology Department, George Papanikolaou Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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17
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Johnson D, Hensler JG, O'Sullivan J, Blouin D, de la Garza MA, Yauger Y. Effects of Endotracheal Epinephrine on Pharmacokinetics and Survival in a Swine Pediatric Cardiac Arrest Model. Pediatr Emerg Care 2024; 40:197-202. [PMID: 38416651 DOI: 10.1097/pec.0000000000003142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
OBJECTIVES The aim of this study was to compare the endotracheal tube (ET) and intravenous (IV) administration of epinephrine relative to concentration maximum, time to maximum concentration, mean concentration over time (MC), area under the curve, odds, and time to return of spontaneous circulation (ROSC) in a normovolemic pediatric cardiac arrest model. METHODS Male swine weighing 24-37 kg were assigned to 4 groups: ET (n = 8), IV (n = 7), cardiopulmonary resuscitation (CPR) + defibrillation (CPR + Defib) (n = 5), and CPR only (n = 3). Swine were placed arrest for 2 minutes, and then CPR was initiated for 2 minutes. Epinephrine (0.1 mg/kg) for the ET group or 0.01 mg/kg for the IV was administered every 4 minutes or until ROSC. Defibrillation started at 3 minutes and continued every 2 minutes for 30 minutes or until ROSC for all groups except the CPR-only group. Blood samples were collected over a period of 5 minutes. RESULTS The MC of plasma epinephrine for the IV group was significantly higher at the 30- and 60-second time points (P = 0.001). The ET group had a significantly higher MC of epinephrine at the 180- and 240-second time points (P < 0.05). The concentration maximum of plasma epinephrine was significantly lower for the ET group (195 ± 32 ng/mL) than for the IV group (428 ± 38 ng/mL) (P = 0.01). The time to maximum concentration was significantly longer for the ET group (145 ± 26 seconds) than for the IV group (42 ± 16 seconds) (P = 0.01). No significant difference existed in area under the curve between the 2 groups (P = 0.62). The odds of ROSC were 7.7 times greater for the ET versus IV group. Time to ROSC was not significantly different among the IV, ET, and CPR + Defib groups (P = 0.31). CONCLUSIONS Based on the results of this study, the ET route of administration should be considered a first-line intervention.
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Affiliation(s)
- Don Johnson
- From the US Army Graduate Program in Anesthesia Nursing, US Army Medical Center of Excellence, Fort Sam Houston, TX
| | - Julie G Hensler
- From the US Army Graduate Program in Anesthesia Nursing, US Army Medical Center of Excellence, Fort Sam Houston, TX
| | | | | | | | - Young Yauger
- TriService Nursing Research Program, Uniformed Services University, Bethesda, MD
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18
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Holmes H, Saini BS, Moir OJ, Darby JRT, Morrison JL, Sun L, Seed M. Pulmonary Vascular Regulation in the Fetal and Transitional Lung. Clin Perinatol 2024; 51:1-19. [PMID: 38325936 DOI: 10.1016/j.clp.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Fetal lungs have fewer and smaller arteries with higher pulmonary vascular resistance (PVR) than a newborn. As gestation advances, the pulmonary circulation becomes more sensitive to changes in pulmonary arterial oxygen tension, which prepares them for the dramatic drop in PVR and increase in pulmonary blood flow (PBF) that occur when the baby takes its first few breaths of air, thus driving the transition from fetal to postnatal circulation. Dynamic and intricate regulatory mechanisms control PBF throughout development and are essential in supporting gas exchange after birth. Understanding these concepts is crucial given the role the pulmonary vasculature plays in the development of complications with transition, such as in the setting of persistent pulmonary hypertension of the newborn and congenital heart disease. An improved understanding of pulmonary vascular regulation may reveal opportunities for better clinical management.
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Affiliation(s)
- Hannah Holmes
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, M5G 1X8, Canada
| | - Brahmdeep S Saini
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, M5G 1X8, Canada
| | - Olivia J Moir
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, M5G 1X8, Canada
| | - Jack R T Darby
- Early Origins of Adult Health Research Group, University of South Australia, Adelaide, South Australia, 5001, Australia
| | - Janna L Morrison
- Early Origins of Adult Health Research Group, University of South Australia, Adelaide, South Australia, 5001, Australia; Department of Physiology, Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada; Translational Medicine Program, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada
| | - Liqun Sun
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, M5G 1X8, Canada
| | - Mike Seed
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, M5G 1X8, Canada; Department of Physiology, Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada; Translational Medicine Program, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada; Research Institute, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada; Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada.
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19
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Cheng K, Zhu H, Zhou Z, Chen W, Yang A. Value of brain tissue oxygen saturation in neonatal respiratory distress syndrome: a clinical study. Eur J Transl Myol 2024; 34:11863. [PMID: 38372644 PMCID: PMC11017171 DOI: 10.4081/ejtm.2024.11863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 02/20/2024] Open
Abstract
Neonatal respiratory distress syndrome (NRDS) is one of the major causes of pre-term mortality and morbidity among very-low-birth-weight infants (VLBWI) in low- and middle-income countries (LMIC). Some of the neonates pass away despite admission and care in intensive care units (ICUs). The present clinical trial seeks the application value of elevating oxygen saturation in the brain cells of pre-term neonates born with NRDS. Near-infrared spectroscopy (NIRS) was used to monitor the neonates' microscopic cerebral oxygenation levels do determine hemoglobin concentration in brain tissues, whereas the pulse oximetry was used to measure oxygenation levels among the patients. In statistical analyses, the Analysis of Variance (ANOVA), and descriptive statistics was deployed in the Jupyter Notebook environment using Python language. High saturation of oxygen in the brain tissues result in important biological and physiological processes, including enhanced oxygen supply to cells, reduced severity of NRDS, and balancing oxygen demand and supply. The correlations of oxygen saturation with systemic saturation of oxygen, the saturation of oxygen in brain tissues, the association between brain-specific and systemic saturation, and the impact of these outcomes on clinical practices were deliberated. Also, the pH gas values, the saturation of oxygen in neonates' brain tissues, metabolic acidosis, the effect of acid-base balance and cerebral oxygen supply, and the oxygenation of brain tissues and the pH values emerged as important variables of oxygenation of brain tissues in pre-term neonates. Oxygen saturation in brain cells influence vital physiological and biological processes. Balancing acid-base saturation or levels is needed despite the challenging achievement. Oxygenation of brain tissues improve the brain's overall functioning.
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Affiliation(s)
- Keping Cheng
- Department of Neonatology, Yongkang Maternal and Child Health Hospital, Yongkang, Zhejiang.
| | - Huijie Zhu
- Department of Neonatology, Yongkang Maternal and Child Health Hospital, Yongkang, Zhejiang.
| | - Zikai Zhou
- Department of Neonatology, Yongkang Maternal and Child Health Hospital, Yongkang, Zhejiang.
| | - Weiyuan Chen
- Department of Neonatology, Yongkang Maternal and Child Health Hospital, Yongkang, Zhejiang.
| | - Aijuan Yang
- Department of Neonatology, Yongkang Maternal and Child Health Hospital, Yongkang, Zhejiang.
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20
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van Haren JS, Delbressine FLM, Schoberer M, te Pas AB, van Laar JOEH, Oei SG, van der Hout-van der Jagt MB. Transferring an extremely premature infant to an extra-uterine life support system: a prospective view on the obstetric procedure. Front Pediatr 2024; 12:1360111. [PMID: 38425664 PMCID: PMC10902175 DOI: 10.3389/fped.2024.1360111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
To improve care for extremely premature infants, the development of an extrauterine environment for newborn development is being researched, known as Artificial Placenta and Artificial Womb (APAW) technology. APAW facilitates extended development in a liquid-filled incubator with oxygen and nutrient supply through an oxygenator connected to the umbilical vessels. This setup is intended to provide the optimal environment for further development, allowing further lung maturation by delaying gas exposure to oxygen. This innovative treatment necessitates interventions in obstetric procedures to transfer an infant from the native to an artificial womb, while preventing fetal-to-neonatal transition. In this narrative review we analyze relevant fetal physiology literature, provide an overview of insights from APAW studies, and identify considerations for the obstetric procedure from the native uterus to an APAW system. Lastly, this review provides suggestions to improve sterility, fetal and maternal well-being, and the prevention of neonatal transition.
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Affiliation(s)
- Juliette S. van Haren
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | | | - Mark Schoberer
- Institute for Applied Medical Engineering and Clinic for Neonatology, University Hospital Aachen, Aachen, Germany
| | - Arjan B. te Pas
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Judith O. E. H. van Laar
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - S. Guid Oei
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - M. Beatrijs van der Hout-van der Jagt
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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21
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Dong XY, Qi JH, Zhuo QC, Ding YJ, Qiao X, Wang Y, Yang DJ, Li D, Li L, Jiang HY, Liu QY, Li ZL, Zhang X, Zhang BJ, Yu YH. Association of antenatal corticosteroids with mortality and morbidities in very preterm infants born to women with hypertensive disorders of pregnancy: a multicenter prospective cohort study. BMC Pregnancy Childbirth 2024; 24:109. [PMID: 38317068 PMCID: PMC10840159 DOI: 10.1186/s12884-023-06195-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) is the most common cause of indicated preterm delivery, but the impact of prenatal steroid exposure on the outcomes of preterm infants born to HDP mothers, who may be at risk for intrauterine hypoxia-ischemia, remains uncertain. The study objective is to evaluate the mortality and morbidities in HDP for very preterm infants (VPIs) exposed to different course of ANS. METHODS This is a prospective cohort study comprising infants with < 32 weeks gestation born to women with HDP only from 1 Jan. 2019 to 31 Dec. 2021 within 40 participating neonatal intensive care units (NICUs) in Sino-northern network. ANS courses included completed, partial, repeated, and no ANS. Univariate and multivariable analyses were performed on administration of ANS and short-term outcomes before discharge. RESULTS Among 1917 VPIs born to women with HDP only, 987(51.4%) received a complete course of ANS within 48 h to 7 days before birth, 560(29.2%) received partial ANS within 24 h before delivery, 100(5.2%) received repeat ANS and 270 (14.1%) did not receive any ANS. Compared to infants who received complete ANS, infants unexposed to ANS was associated with higher odds of death (AOR 1.85; 95%CI 1.10, 3.14), Severe Neurological Injury (SNI) or death (AOR 1.68; 95%CI 1.29,3.80) and NEC or death (AOR 1.78; 95%CI 1.55, 2.89), the repeated ANS group exhibits a significant negative correlation with the duration of oxygen therapy days (correlation coefficient - 18.3; 95%CI-39.2, -2.1). However, there were no significant differences observed between the full course and partial course groups in terms of outcomes. We can draw similar conclusions in the non-SGA group, while the differences are not significant in the SGA group. From KM curve, it showed that the repeated group had the highest survival rate, but the statistical analysis did not indicate a significant difference. CONCLUSIONS Even partial courses of ANS administered within 24 h before delivery proved to be protective against death and other morbidities. The differences mentioned above are more pronounced in the non-SGA group. Repeat courses demonstrate a trend toward protection, but this still needs to be confirmed by larger samples.
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Affiliation(s)
- Xiao-Yu Dong
- Department of Pediatrics, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Jian-Hong Qi
- Department of Neonatology, Shandong University; Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, HuaiYin District, Jinan, Shandong, 250021, China
| | - Qing-Cui Zhuo
- Department of Neonatology, Qilu Hospital of Shandong University, Jinan, China
| | - Yan-Jie Ding
- Department of Neonatology, Yantai Yuhuangding Hospital, Yantai, China
| | - Xin Qiao
- Department of Neonatology, Jinan Maternity and Child Healthcare Hospital, Jinan, China
| | - Yan Wang
- Department of Neonatology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - De-Juan Yang
- Department of Neonatology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Dan Li
- Department of Neonatology, Liaocheng People's Hospital, Liaocheng, China
| | - Li Li
- Department of Neonatology, Linyi People's Hospital, Linyi, China
| | - Hai-Yan Jiang
- Department of Pediatrics, The Third Hospital of Baogang Group, Baotou, China
| | - Qiong-Yu Liu
- Department of Neonatology, Women and Children's Healthcare Hospital of Linyi, Linyi, China
| | - Zhong-Liang Li
- Department of Neonatology, W.F. Maternal and Child Health Hospital, Weifang, China
| | - Xiang Zhang
- Department of Neonatology, Hebei Petro China Central Hospital, Langfang, China
| | - Bing-Jin Zhang
- Department of Neonatology, Shengli Olifield Central Hospital, Yantai, China
| | - Yong-Hui Yu
- Department of Neonatology, Shandong University; Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, HuaiYin District, Jinan, Shandong, 250021, China.
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22
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Rueda AD, Salvador-Martínez I, Sospedra-Arrufat I, Alcaina-Caro A, Fernández-Miñán A, Burgos-Ruiz AM, Cases I, Mohedano A, Tena JJ, Heyn H, Lopez-Rios J, Nusspaumer G. The cellular landscape of the endochondral bone during the transition to extrauterine life. Immunol Cell Biol 2024; 102:131-148. [PMID: 38184783 DOI: 10.1111/imcb.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
The cellular complexity of the endochondral bone underlies its essential and pleiotropic roles during organismal life. While the adult bone has received significant attention, we still lack a deep understanding of the perinatal bone cellulome. Here, we have profiled the full composition of the murine endochondral bone at the single-cell level during the transition from fetal to newborn life and in comparison with the adult tissue, with particular emphasis on the mesenchymal compartment. The perinatal bone contains different fibroblastic clusters with blastema-like characteristics in organizing and supporting skeletogenesis, angiogenesis and hematopoiesis. Our data also suggest dynamic inter- and intra-compartment interactions, as well as a bone marrow milieu that seems prone to anti-inflammation, which we hypothesize is necessary to ensure the proper program of lymphopoiesis and the establishment of central and peripheral tolerance in early life. Our study provides an integrative roadmap for the future design of genetic and cellular functional assays to validate cellular interactions and lineage relationships within the perinatal bone.
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Affiliation(s)
- Alejandro Díaz Rueda
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Irepan Salvador-Martínez
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Ismael Sospedra-Arrufat
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Ana Alcaina-Caro
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Ana Fernández-Miñán
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Ana M Burgos-Ruiz
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Ildefonso Cases
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Alberto Mohedano
- Intensive Care Unit, Severo Ochoa University Hospital Leganés, Madrid, Spain
| | - Juan J Tena
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
| | - Holger Heyn
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Javier Lopez-Rios
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
- Universidad Loyola Andalucía, School of Health Sciences, Dos Hermanas, Seville, Spain
| | - Gretel Nusspaumer
- Centro Andaluz de Biología del Desarrollo (CABD), CSIC-Universidad Pablo de Olavide-Junta de Andalucía, Seville, Spain
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23
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Caldas JPDS, Junqueira EDAO, de Camargo JF, Marba STM. Association of hypermagnesemia at birth and admission hypothermia in pre-term infants: A secondary analysis of a prospective cohort study. J Neonatal Perinatal Med 2024; 17:191-198. [PMID: 38607766 DOI: 10.3233/npm-230130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Hypothermia on admission is associated with increased mortality in preterm infants. Drugs administered to pregnant women is implicated in its occurrence. Since magnesium sulfate has a myorelaxant effect, we aimed evaluating the association of hypermagnesemia at birth and admission hypothermia (axillary temperature <36.5°C) in preterm infants. METHODS We performed a secondary analysis of a prospective cohort study database including inborn infants <34 weeks, without congenital malformations. Hypermagnesemia was considered if the umbilical magnesium level > 2.5 mEq/L. Maternal and neonatal variables were used to adjust the model, submitted to the multivariate hierarchical modelling process. RESULTS We evaluated 249 newborns with median birth weight and gestational age of 1375 (IQR 1020-1375) g and 31 (IQR 28-32) weeks, respectively. Hypermagnesemia occurred in 28.5% and admission hypothermia occurred in 28.9%. In the univariate analysis, the following variables were identified as being associated with admission hypothermia: hypermagnesemia (OR 3.71; CI 2.06-6.68), resuscitation (OR 2.39; CI 1.37-4.19), small to gestational age (OR 1.91; CI1.03-3.53), general anesthesia (OR 3.34; CI 1.37-8.13), birth weight (OR 0.998; CI 0.998-0.999) and gestational age (OR 0.806; CI 0.725-0.895). In the hierarchical regression model, hypermagnesemia remained independent associated with admission hypothermia (OR 3.20; CI 1.66-6.15), as well as birth weight (OR 0.999; CI 0.998-0.999) and tracheal intubation (3.83; CI 1.88-7.80). CONCLUSION Hypermagnesemia was associated with an increased risk of admission hypothermia, as did tracheal intubation and lower birth weight.
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Affiliation(s)
- J P de Siqueira Caldas
- Department of Pediatrics, School of Medical Sciences, State University of Campinas, Sao Paulo, Brazil
| | | | | | - S T M Marba
- Department of Pediatrics, School of Medical Sciences, State University of Campinas, Sao Paulo, Brazil
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24
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Smith B. Thermoregulation of the Extremely Low Birth Weight Neonate. Neonatal Netw 2024; 43:12-18. [PMID: 38267092 DOI: 10.1891/nn-2023-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The birth of an extremely low birth weight (ELBW) neonate is complex because of their immaturity. Respiratory and hemodynamic stabilization often takes precedence in the immediate delivery period. While establishing effective breathing and circulation is vital to the survival of the neonate, it is crucial to understand that other adverse outcomes can occur during the resuscitation and transport of the ELBW neonate. Impaired thermoregulation is one of the most detrimental adverse outcomes during the golden hour period and later in the neonatal intensive care unit. Hypothermia is an independent risk factor for increased morbidity and mortality and can impact multiple body systems, making management even more challenging. This article discusses the physiology of thermoregulation while exploring interventions to maintain normothermia in the ELBW neonate, ultimately improving long-term outcomes.
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25
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Abstract
Pulmonary surfactant is a critical component of lung function in healthy individuals. It functions in part by lowering surface tension in the alveoli, thereby allowing for breathing with minimal effort. The prevailing thinking is that low surface tension is attained by a compression-driven squeeze-out of unsaturated phospholipids during exhalation, forming a film enriched in saturated phospholipids that achieves surface tensions close to zero. A thorough review of past and recent literature suggests that the compression-driven squeeze-out mechanism may be erroneous. Here, we posit that a surfactant film enriched in saturated lipids is formed shortly after birth by an adsorption-driven sorting process and that its composition does not change during normal breathing. We provide biophysical evidence for the rapid formation of an enriched film at high surfactant concentrations, facilitated by adsorption structures containing hydrophobic surfactant proteins. We examine biophysical evidence for and against the compression-driven squeeze-out mechanism and propose a new model for surfactant function. The proposed model is tested against existing physiological and pathophysiological evidence in neonatal and adult lungs, leading to ideas for biophysical research, that should be addressed to establish the physiological relevance of this new perspective on the function of the mighty thin film that surfactant provides.
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Affiliation(s)
- Fred Possmayer
- Department of Biochemistry, Western University, London, Ontario N6A 3K7, Canada
- Department of Obstetrics/Gynaecology, Western University, London, Ontario N6A 3K7, Canada
| | - Yi Y Zuo
- Department of Mechanical Engineering, University of Hawaii at Manon, Honolulu, Hawaii 96822, United States
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96826, United States
| | - Ruud A W Veldhuizen
- Department of Physiology & Pharmacology, Western University, London, Ontario N6A 5C1, Canada
- Department of Medicine, Western University, London, Ontario N6A 3K7, Canada
- Lawson Health Research Institute, London, Ontario N6A 4V2, Canada
| | - Nils O Petersen
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
- Department of Chemistry, Western University, London, Ontario N6A 5B7, Canada
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26
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Wickramasinghe LC, Tsantikos E, Kindt A, Raftery AL, Gottschalk TA, Borger JG, Malhotra A, Anderson GP, van Wijngaarden P, Hilgendorff A, Hibbs ML. Granulocyte Colony-Stimulating Factor is a Determinant of Severe Bronchopulmonary Dysplasia and Coincident Retinopathy. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:2001-2016. [PMID: 37673326 DOI: 10.1016/j.ajpath.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/05/2023] [Accepted: 07/25/2023] [Indexed: 09/08/2023]
Abstract
Bronchopulmonary dysplasia (BPD), also called chronic lung disease of immaturity, afflicts approximately one third of all extremely premature infants, causing lifelong lung damage. There is no effective treatment other than supportive care. Retinopathy of prematurity (ROP), which impairs vision irreversibly, is common in BPD, suggesting a related pathogenesis. However, specific mechanisms of BPD and ROP are not known. Herein, a neonatal mouse hyperoxic model of coincident BPD and retinopathy was used to screen for candidate mediators, which revealed that granulocyte colony-stimulating factor (G-CSF), also known as colony-stimulating factor 3, was up-regulated significantly in mouse lung lavage fluid and plasma at postnatal day 14 in response to hyperoxia. Preterm infants with more severe BPD had increased plasma G-CSF. G-CSF-deficient neonatal pups showed significantly reduced alveolar simplification, normalized alveolar and airway resistance, and normalized weight gain compared with wild-type pups after hyperoxic lung injury. This was associated with a marked reduction in the intensity, and activation state, of neutrophilic and monocytic inflammation and its attendant oxidative stress response, and protection of lung endothelial cells. G-CSF deficiency also provided partial protection against ROP. The findings in this study implicate G-CSF as a pathogenic mediator of BPD and ROP, and suggest the therapeutic utility of targeting G-CSF biology to treat these conditions.
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Affiliation(s)
- Lakshanie C Wickramasinghe
- Leukocyte Signalling Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Evelyn Tsantikos
- Leukocyte Signalling Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Alida Kindt
- Metabolomics and Analytics Centre, Leiden University, Leiden, the Netherlands
| | - April L Raftery
- Leukocyte Signalling Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Timothy A Gottschalk
- Leukocyte Signalling Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jessica G Borger
- Leukocyte Signalling Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Atul Malhotra
- Early Neurodevelopment Clinic, Monash Children's Hospital, Clayton, Victoria, Australia; Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Gary P Anderson
- Lung Health Research Centre, Department of Biochemistry and Pharmacology, University of Melbourne, Victoria, Australia
| | - Peter van Wijngaarden
- Division of Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Anne Hilgendorff
- Institute for Lung Health and Immunity, Helmholtz Zentrum Muenchen, Munich, Germany; Center for Comprehensive Developmental Care, Ludwig-Maximilian Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Margaret L Hibbs
- Leukocyte Signalling Laboratory, Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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27
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Demirtas MS, Kilicbay F, Erdal H, Tunc G. Oxidative Stress Levels and Dynamic Thiol-Disulfide Balance in Preterm Newborns with Bronchopulmonary Dysplasia. Lab Med 2023; 54:587-592. [PMID: 36896684 DOI: 10.1093/labmed/lmad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess the oxidative stress (OS) levels and dynamic thiol-disulfide balance in preterm newborns with bronchopulmonary dysplasia (BPD). METHODS This prospective study included newborns separated into 2 groups, those with BPD (case) or without BPD (control). The 2 groups were compared by clinical and laboratory findings. The OS parameters total oxidant status (TOS), total antioxidant status (TAS), OS index (OSI), native thiol (NT), and total thiol were measured within the first day after birth. Oxygen requirements were measured using the fraction of inspired oxygen (FIO2) recorded in the first hour after birth/admission and the average FIO2 within 28 days of the birth. RESULTS Infants diagnosed with BPD had a significantly lower gestational age and birth weight and a lower 5-min Apgar score (P < .05). Infants with BPD also had a higher rate of respiratory distress syndrome, rate of use of surfactant therapy, duration of ventilation therapy, and duration of hospital stay compared with control (P = .001, P = .001, P = .001, and P = .001, respectively). Plasma TAS and NT levels of newborns with BPD were significantly lower than newborns without BPD (P < .05). In the BPD group, plasma TOS and OSI levels were significantly higher than in the control group. CONCLUSION We found that OS was increased in newborns with BPD. The clinical significance of this study will provide the clinician with a different perspective on BPD by determining the dynamic thiol disulfide balance.
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Affiliation(s)
| | - Fatih Kilicbay
- Division of Neonatology, Department of Pediatrics, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Huseyin Erdal
- Department of Medical Genetics, Aksaray University Faculty of Medicine, Aksaray, Turkey
| | - Gaffari Tunc
- Division of Neonatology, Department of Pediatrics, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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28
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Dey R, Sardar SK, Kumar Saha A, Mukherjee S. Nonsynchronized nasal intermittent positive pressure ventilation versus continuous positive airway pressure as a primary mode of respiratory support in neonates (26-40 weeks) admitted in a tertiary care center: A randomized controlled trial. Pediatr Pulmonol 2023; 58:3063-3070. [PMID: 37530509 DOI: 10.1002/ppul.26624] [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: 04/03/2023] [Revised: 07/08/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION Continuous positive airway pressure (CPAP) is a standard respiratory care for neonates for last few decades but it too has a high failure rate. Nasal intermittent positive pressure ventilation (NIPPV) is proven to be superior to CPAP in maintaining higher mean airway pressure in neonates with Respiratory Distress Syndrome. The main objective of this study was to compare failure within 72 h of initiation of primary respiratory support between nonsynchronized NIPPV and CPAP in all causes of respiratory distress in newborn infants. Secondarily feed intolerance, Necrotizing enterocolitis (NEC > stage II), hemodynamically significant patent ductus arteriosus, intraventricular hemorrhage (IVH > gradeIII), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), duration of support and mortality were also compared. METHODS This was a single center randomized controlled trial. Stratified randomization was done for 216 neonates, based on the gestational age in two subgroups 26-33 weeks and 34-40 weeks whopresented with respiratory distress within 5 days of birth, to receive either NIPPV or CPAP. Primary and secondary outcomes were documented. RESULTS Statisticalsignificant difference was noted for primary outcome (RR 0.48 [confidence interval = 0.301-0.786], p = 0.003) but not for other secondary outcomes. NIPPV appeared superior in respect to noninvasiveventilation days, BPD occurrence and hospitalization duration. CONCLUSION As a primary mode, nonsynchronized NIPPV was more efficacious than CPAP in preventing intubation within 72 h of initiation of respiratory support. Further multicenter studies are warranted to explore the benefits of this respiratory support.
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Affiliation(s)
- Rakesh Dey
- Department of Neonatology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
| | - Syamal Kumar Sardar
- Department of Neonatology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
| | - Anindya Kumar Saha
- Department of Neonatology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
| | - Suchandra Mukherjee
- Department of Neonatology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
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29
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Abstract
Metabolic switches are a crucial hallmark of cellular development and regeneration. In response to changes in their environment or physiological state, cells undergo coordinated metabolic switching that is necessary to execute biosynthetic demands of growth and repair. In this Review, we discuss how metabolic switches represent an evolutionarily conserved mechanism that orchestrates tissue development and regeneration, allowing cells to adapt rapidly to changing conditions during development and postnatally. We further explore the dynamic interplay between metabolism and how it is not only an output, but also a driver of cellular functions, such as cell proliferation and maturation. Finally, we underscore the epigenetic and cellular mechanisms by which metabolic switches mediate biosynthetic needs during development and regeneration, and how understanding these mechanisms is important for advancing our knowledge of tissue development and devising new strategies to promote tissue regeneration.
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Affiliation(s)
- Ahmed I. Mahmoud
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
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30
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Wu XC, Ye FL, Zheng XZ. Fetal pulmonary artery stiffness is a strong predictor of persistent pulmonary hypertension of the newborn - An echocardiographic study. Eur J Obstet Gynecol Reprod Biol 2023; 289:60-64. [PMID: 37639816 DOI: 10.1016/j.ejogrb.2023.08.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/23/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Pulmonary artery stiffness (PAS) is a strong and independent predictor of mortality in adult patients with pulmonary hypertension (PH). But the change in PAS during perinatal period remains unknown. Here, we aimed to explore the feasibility and performance of PAS on predicting persistent pulmonary hypertension of the newborn (PPHN). METHODS 1325 fetuses underwent a dedicated echocardiography screening for fetal heart defects during second trimester, third-trimester and neonatal period with the measurement of acceleration time (PAAT) and maximal frequency shift (MFS) of pulmonary artery flow. PAS (MFS/PAAT ratio) was calculated. RESULTS Six fetuses were diagnosed as PPHN. Compared with the normal fetuses, those with PH had greater values of PAS during each period of time (second trimester, 52.6(46.2-54.5) vs. 32.4(28.0-39.4) kHz/s, p = 0.0003; third trimester, 52.9(46.1-55.3) vs. 29.7(27.3-33.3) kHz/s, p = 0.0002; neonatal period, 127.4(85.2-150.8) vs. 26.6(22.7-35.0) kHz/s, p < 0.0001). There was a statistically significant correlation between PAS and mean pulmonary artery pressure (p < 0.05) but no correlation between PAS and gestational age (p > 0.05) whether in normal fetuses or not. The area under receiver operating characteristic curve (AUC) of 0.97 for PAS during third trimester was superior to that for PAS during second trimester (AUC, 0.94) in predicting PPHN. The optimal cutoff value of PAS during third trimester was 37.40 KHz/s, with a sensitivity of 100%, a specificity of 91%, and an accuracy of 92%. CONCLUSION There was a significant difference in PAS between normal fetuses and those with PH. PAS has a power performance on predicting PPHN.
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Affiliation(s)
- Xu-Chu Wu
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai 200090, People's Republic of China
| | - Fang-Li Ye
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai 200090, People's Republic of China
| | - Xiao-Zhi Zheng
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai 200090, People's Republic of China.
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31
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Muro-Valdez JC, Meza-Rios A, Aguilar-Uscanga BR, Lopez-Roa RI, Medina-Díaz E, Franco-Torres EM, Zepeda-Morales ASM. Breastfeeding-Related Health Benefits in Children and Mothers: Vital Organs Perspective. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1535. [PMID: 37763654 PMCID: PMC10536202 DOI: 10.3390/medicina59091535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023]
Abstract
Breast milk (BM) is a constantly changing fluid that represents the primary source of nutrition for newborns. It is widely recognized that breastfeeding provides benefits for both the child and the mother, including a lower risk of ovarian and breast cancer, type 2 diabetes mellitus, decreased blood pressure, and more. In infants, breastfeeding has been correlated with a lower risk of infectious diseases, obesity, lower blood pressure, and decreased incidence of respiratory infections, diabetes, and asthma. Various factors, such as the baby's sex, the health status of the mother and child, the mother's diet, and the mode of delivery, can affect the composition of breast milk. This review focuses on the biological impact of the nutrients in BM on the development and functionality of vital organs to promote the benefit of health.
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Affiliation(s)
- Julio César Muro-Valdez
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
| | - Alejandra Meza-Rios
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
| | - Blanca Rosa Aguilar-Uscanga
- Laboratorio de Microbiología Industrial, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Rocio Ivette Lopez-Roa
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Eunice Medina-Díaz
- Instituto Transdisciplinar de Investigación y Servicios, CUCEI, Universidad de Guadalajara, Av. José Parres Arias 5, Rinconada de la Azalea, Industrial Belenes, Zapopan 45150, Mexico
| | - Esmeralda Marisol Franco-Torres
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Adelaida Sara Minia Zepeda-Morales
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
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Sinclair-Wilson A, Lawrence A, Ferezou I, Cartonnet H, Mailhes C, Garel S, Lokmane L. Plasticity of thalamocortical axons is regulated by serotonin levels modulated by preterm birth. Proc Natl Acad Sci U S A 2023; 120:e2301644120. [PMID: 37549297 PMCID: PMC10438379 DOI: 10.1073/pnas.2301644120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/09/2023] [Indexed: 08/09/2023] Open
Abstract
Sensory inputs are conveyed to distinct primary areas of the neocortex through specific thalamocortical axons (TCA). While TCA have the ability to reorient postnatally to rescue embryonic mistargeting and target proper modality-specific areas, how this remarkable adaptive process is regulated remains largely unknown. Here, using a mutant mouse model with a shifted TCA trajectory during embryogenesis, we demonstrated that TCA rewiring occurs during a short postnatal time window, preceded by a prenatal apoptosis of thalamic neurons-two processes that together lead to the formation of properly innervated albeit reduced primary sensory areas. We furthermore showed that preterm birth, through serotonin modulation, impairs early postnatal TCA plasticity, as well as the subsequent delineation of cortical area boundary. Our study defines a birth and serotonin-sensitive period that enables concerted adaptations of TCA to primary cortical areas with major implications for our understanding of brain wiring in physiological and preterm conditions.
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Affiliation(s)
- Alexander Sinclair-Wilson
- Team Brain Development and Plasticity, Institut de Biologie de l’ENS, École Normale Supérieure, CNRS, INSERM, PSL Research University, 75005Paris, France
| | - Akindé Lawrence
- Team Brain Development and Plasticity, Institut de Biologie de l’ENS, École Normale Supérieure, CNRS, INSERM, PSL Research University, 75005Paris, France
| | - Isabelle Ferezou
- Université Paris-Saclay, CNRS, Institut des Neurosciences Paris-Saclay, 91400Saclay, France
| | - Hugues Cartonnet
- Team Brain Development and Plasticity, Institut de Biologie de l’ENS, École Normale Supérieure, CNRS, INSERM, PSL Research University, 75005Paris, France
| | - Caroline Mailhes
- Acute Transgenesis Facility, Institut de Biologie de l’ENS, École Normale Supérieure, CNRS, INSERM, PSL Research University, 75005Paris, France
| | - Sonia Garel
- Team Brain Development and Plasticity, Institut de Biologie de l’ENS, École Normale Supérieure, CNRS, INSERM, PSL Research University, 75005Paris, France
- Collège de France, PSL Research University, 75005Paris, France
| | - Ludmilla Lokmane
- Team Brain Development and Plasticity, Institut de Biologie de l’ENS, École Normale Supérieure, CNRS, INSERM, PSL Research University, 75005Paris, France
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Christifano DN, Chollet-Hinton L, Hoyer D, Schmidt A, Gustafson KM. Intake of eggs, choline, lutein, zeaxanthin, and DHA during pregnancy and their relationship to fetal neurodevelopment. Nutr Neurosci 2023; 26:749-755. [PMID: 35715980 PMCID: PMC9758270 DOI: 10.1080/1028415x.2022.2088944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Maternal intake of eggs and nutrients contained within eggs during pregnancy have the potential to impact fetal neurodevelopment; however, this area is understudied. The purpose of this study was to determine whether maternal egg and choline intake and nutrient interactions between choline, lutein and zeaxanthin (L/Z), and DHA predict fetal neurodevelopment in a large cohort of pregnant women (n = 202). NCT02709239. METHODS Food frequency questionnaires were used to assess egg and nutrient intake during pregnancy. Fetal neurodevelopment was measured using fetal biomagnetometry at 32 and 36wks gestation, and fetal autonomic indices (SDNN, RMSSD) and brain maturation indices (fABAS) were calculated. Generalized linear models tested the relationships between choline intake, egg intake, and nutrient interactions with fetal neurodevelopment. RESULTS Maternal egg intake predicted RMSSD at 32wks and fABAS at 36wks. The interaction between choline and L/Z intake predicted fABAS at 32wks and 36wks and the interaction between choline intake, L/Z intake, and DHA predicted fABAS at 36wks. At 36wks, SDNN was predicted by L/Z intake and interactions between choline and L/Z, L/Z and DHA, and choline, L/Z, and DHA. CONCLUSION Eggs and the nutrients contained within eggs showed synergistic associations with fetal neurodevelopment, and consumption should be encouraged among pregnant women.
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Affiliation(s)
- Danielle N Christifano
- Department of Nutrition and Dietetics, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lynn Chollet-Hinton
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Dirk Hoyer
- Biomagnetic Center, Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - Alexander Schmidt
- Biomagnetic Center, Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Kathleen M Gustafson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
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Bienboire-Frosini C, Wang D, Marcet-Rius M, Villanueva-García D, Gazzano A, Domínguez-Oliva A, Olmos-Hernández A, Hernández-Ávalos I, Lezama-García K, Verduzco-Mendoza A, Gómez-Prado J, Mota-Rojas D. The Role of Brown Adipose Tissue and Energy Metabolism in Mammalian Thermoregulation during the Perinatal Period. Animals (Basel) 2023; 13:2173. [PMID: 37443971 DOI: 10.3390/ani13132173] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Hypothermia is one of the most common causes of mortality in neonates, and it could be developed after birth because the uterus temperature is more elevated than the extrauterine temperature. Neonates use diverse mechanisms to thermoregulate, such as shivering and non-shivering thermogenesis. These strategies can be more efficient in some species, but not in others, i.e., altricials, which have the greatest difficulty with achieving thermoneutrality. In addition, there are anatomical and neurological differences in mammals, which may present different distributions and amounts of brown fat. This article aims to discuss the neuromodulation mechanisms of thermoregulation and the importance of brown fat in the thermogenesis of newborn mammals, emphasizing the analysis of the biochemical, physiological, and genetic factors that determine the distribution, amount, and efficiency of this energy resource in newborns of different species. It has been concluded that is vital to understand and minimize hypothermia causes in newborns, which is one of the main causes of mortality in neonates. This would be beneficial for both animals and producers.
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Affiliation(s)
- Cécile Bienboire-Frosini
- Department of Molecular Biology and Chemical Communication, Research Institute in Semiochemistry and Applied Ethology (IRSEA), 84400 Apt, France
| | - Dehua Wang
- School of Life Sciences, Shandong University, Qingdao 266237, China
| | - Míriam Marcet-Rius
- Animal Behaviour and Welfare Department, Research Institute in Semiochemistry and Applied Ethology (IRSEA), 84400 Apt, France
| | - Dina Villanueva-García
- Division of Neonatology, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico
| | - Angelo Gazzano
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Adriana Olmos-Hernández
- Division of Biotechnology-Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City 14389, Mexico
| | - Ismael Hernández-Ávalos
- Clinical Pharmacology and Veterinary Anesthesia, Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán Izcalli 54714, Mexico
| | - Karina Lezama-García
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Antonio Verduzco-Mendoza
- Division of Biotechnology-Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City 14389, Mexico
| | - Jocelyn Gómez-Prado
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
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Takeuchi Y, Nomura A, Yamoto M, Ohfuji S, Fujii S, Yoshimoto S, Funakoshi T, Shinkai M, Urushihara N, Yokoi A. The Association between the First Cry and Clinical Outcomes in CDH Neonates: A Retrospective Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1145. [PMID: 37508642 PMCID: PMC10377899 DOI: 10.3390/children10071145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023]
Abstract
Congenital diaphragmatic hernia (CDH) is a life-threatening condition characterized by the herniation of abdominal organs into the thorax, resulting in hypoplastic lungs and pulmonary hypertension. The impact of the first cry, a crucial event for lung transition during birth, on CDH patients remains unclear. This study investigated the impact of the first cry during birth on CDH patient survival, along with other prognosis factors. A multi-institutional retrospective study assessed CDH patient characteristics and survival rates by analyzing factors including the first cry, disease severity, birth weight, Apgar scores, oxygenation index (OI) and surgical closure. Among the CDH patients in the study, a positive first cry was linked to 100% survival, regardless of disease severity (p < 0.001). Notably, the presence of a positive first cry did not significantly affect survival rates in patients with worse prognostic factors, such as low birth weight (<2500 g), high CDH severity, low Apgar scores (1 min ≤ 4), high best OI within 24 h after birth (≥8), or those who underwent patch closure. Furthermore, no significant association was found between the first cry and the use of inhaled nitric oxide (iNO) or extracorporeal membrane oxygenation (ECMO). In conclusion, this study suggests that the first cry may not have a negative impact on the prognosis of CDH patients and could potentially have a positive effect.
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Affiliation(s)
- Yuki Takeuchi
- Department of Pediatric Surgery, Kobe Children's Hospital, Kobe 650-0047, Japan
| | - Akiyoshi Nomura
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka 420-0953, Japan
| | - Masaya Yamoto
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka 420-0953, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Shunsuke Fujii
- Department of Pediatric Surgery, Kanagawa Children's Medical Center, Yokohama 232-0066, Japan
| | - Seiji Yoshimoto
- Department of Neonatology, Kobe Children's Hospital, Kobe 650-0047, Japan
| | - Toru Funakoshi
- Department of Obstetrics, Kobe Children's Hospital, Kobe 650-0047, Japan
| | - Masato Shinkai
- Department of Pediatric Surgery, Kanagawa Children's Medical Center, Yokohama 232-0066, Japan
| | - Naoto Urushihara
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka 420-0953, Japan
| | - Akiko Yokoi
- Department of Pediatric Surgery, Kobe Children's Hospital, Kobe 650-0047, Japan
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Rabe H, Mercer J. Knowledge gaps in optimal umbilical cord management at birth. Semin Perinatol 2023:151791. [PMID: 37357042 DOI: 10.1016/j.semperi.2023.151791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
In 2014 the World Health Organisation recommended providing placental blood to all newborn infants by waiting for at least one minute before clamping the umbilical cord. Mounting evidence supports providing a placental transfusion at the time of birth for all infants. The optimal time before clamping and cutting the umbilical cord is still not yet known, and debate exists around other cord management issues. The newborn's transition phase from intra- to extra-uterine life and the effects of blood volume on the many necessary adaptations are understudied. How best to support these adaptations guides our suggested research questions. Parents' perceptions of enrolling their unborn infant into a study play important parts in the conduct of such trials. This article aims to address these topics and suggest research questions for further studies.
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Affiliation(s)
- Heike Rabe
- Academic Department of Paediatrics, Brighton and Sussex Medical School, University of Sussex, UK.
| | - Judith Mercer
- Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego CA, USA; College of Nursing, University of Rhode Island, Kingston RI, USA
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Vøgg ROB, Sillesen AS, Wohlfahrt J, Pihl C, Raja AA, Vejlstrup N, Norsk JB, Elia E, Sleeper LA, Colan SD, Iversen KK, Boyd HA, Bundgaard H. Normative Echocardiographic Left Ventricular Parameters and Reference Intervals in Infants. J Am Coll Cardiol 2023; 81:2175-2185. [PMID: 37257953 DOI: 10.1016/j.jacc.2023.03.423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND In pediatric echocardiography, reference intervals are required to distinguish normal variation from pathology. Left ventricular (LV) parameters are particularly important predictors of clinical outcome. However, data from healthy newborns are limited, and current reference intervals provide an inadequate approximation of normal reference ranges. OBJECTIVES Normative reference intervals and z-scores for 2-dimensional echocardiographic measurements of LV structure and function based on a large group of healthy newborns were developed. METHODS The study population included 13,454 healthy newborns from the Copenhagen Baby Heart Study who were born at term to healthy mothers, had an echocardiogram performed within 30 days of birth, and did not have congenital heart disease. To develop normative reference intervals, this study modeled 10 LV parameters as a function of body surface area through joint modeling of 4 statistical components. RESULTS Infants in the study population (48.5% were female) had a median body surface area of 0.23 m2 (IQR: 0.22-0.25 m2) and median age of 12.0 days (IQR: 8.0-15.0 days) at examination. All normative reference intervals performed well in both sexes without stratification on infant sex. In contrast, creation of separate reference models for infants examined at <7 days of age and those examined at 7-30 days of age was necessary to optimize the performance of the reference intervals. CONCLUSIONS This study provides normative reference intervals and z-scores for 10 clinical, widely used echocardiographic measures of LV structure and function based on a large cohort of newborns. These results provide highly needed reference material for clinical application by pediatric cardiologists.
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Affiliation(s)
- R Ottilia B Vøgg
- Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
| | - Anne-Sophie Sillesen
- Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Jan Wohlfahrt
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Christian Pihl
- Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Anna Axelsson Raja
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Niels Vejlstrup
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jakob B Norsk
- Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Eleni Elia
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lynn A Sleeper
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Steven D Colan
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kasper K Iversen
- Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Heather A Boyd
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Wilkinson CL, Pierce LJ, Sideridis G, Wade M, Nelson CA. Associations between EEG trajectories, family income, and cognitive abilities over the first two years of life. Dev Cogn Neurosci 2023; 61:101260. [PMID: 37262938 PMCID: PMC10245106 DOI: 10.1016/j.dcn.2023.101260] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/23/2023] [Accepted: 05/26/2023] [Indexed: 06/03/2023] Open
Abstract
We sought to characterize developmental trajectories of EEG spectral power over the first 2 years after birth and examine whether family income or maternal education alter those trajectories. We analyzed EEGs (n = 161 infants, 534 EEGs) collected longitudinally between 2 and 24 months of age, and calculated frontal absolute power across 7 canonical frequency bands. For each frequency band, a piecewise growth curve model was fit, resulting in an estimated intercept and two slope parameters from 2 to 9 months and 9-24 months of age. Across 6/7 frequency bands, absolute power significantly increased over age, with steeper slopes in the 2-9 month period compared to 9-24 months. Increased family income, but not maternal education, was associated with higher intercept (2-3 month power) across delta-gamma bands (p range = 0.002-0.04), and reduced change in power between 2 and 9 months of age in lower frequency bands (delta-alpha, p range = 0.01-0.02). There was no significant effect of income on slope between 9 and 24 months. EEG intercept and slope measures did not mediate relationships between income and 24-month verbal and nonverbal development. These results add to growing literature concerning the role of socioeconomic factors in shaping brain trajectories.
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Affiliation(s)
- Carol L Wilkinson
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Lara J Pierce
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Psychology, York University, Toronto, Ontario, Canada
| | - Georgios Sideridis
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Mark Wade
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada
| | - Charles A Nelson
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Harvard Graduate School of Education, Cambridge, MA 02138, USA
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Bienboire-Frosini C, Muns R, Marcet-Rius M, Gazzano A, Villanueva-García D, Martínez-Burnes J, Domínguez-Oliva A, Lezama-García K, Casas-Alvarado A, Mota-Rojas D. Vitality in Newborn Farm Animals: Adverse Factors, Physiological Responses, Pharmacological Therapies, and Physical Methods to Increase Neonate Vigor. Animals (Basel) 2023; 13:ani13091542. [PMID: 37174579 PMCID: PMC10177313 DOI: 10.3390/ani13091542] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/18/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Vitality is the vigor newborn animals exhibit during the first hours of life. It can be assessed by a numerical score, in which variables, such as heart rate, respiratory rate, mucous membranes' coloration, time the offspring took to stand up, and meconium staining, are monitored. Vitality can be affected by several factors, and therapies are used to increase it. This manuscript aims to review and analyze pharmacological and physical therapies used to increase vitality in newborn farm animals, as well as to understand the factors affecting this vitality, such as hypoxia, depletion of glycogen, birth weight, dystocia, neurodevelopment, hypothermia, and finally, the physiological mechanism to achieve thermostability. It has been concluded that assessing vitality immediately after birth is essential to determine the newborn's health and identify those that need medical intervention to minimize the deleterious effect of intrapartum asphyxia. Vitality assessment should be conducted by trained personnel and adequate equipment. Evaluating vitality could reduce long-term neonatal morbidity and mortality in domestic animals, even if it is sometimes difficult with the current organization of some farms. This review highlights the importance of increasing the number of stock people during the expected days of parturitions to reduce long-term neonatal morbidity and mortality, and thus, improve the farm's performance.
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Affiliation(s)
- Cécile Bienboire-Frosini
- Department of Molecular Biology and Chemical Communication, Research Institute in Semiochemistry and Applied Ethology (IRSEA), 84400 Apt, France
| | - Ramon Muns
- Agri-Food and Biosciences Institute, Hillsborough BT 26 6DR, Northern Ireland, UK
| | - Míriam Marcet-Rius
- Animal Behaviour and Welfare Department, Research Institute in Semiochemistry and Applied Ethology (IRSEA), 84400 Apt, France
| | - Angelo Gazzano
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy
| | - Dina Villanueva-García
- Division of Neonatology, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico
| | - Julio Martínez-Burnes
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Mexico
| | - Adriana Domínguez-Oliva
- Agri-Food and Biosciences Institute, Hillsborough BT 26 6DR, Northern Ireland, UK
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Karina Lezama-García
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Alejandro Casas-Alvarado
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
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Pergialiotis V, Rodolaki K, Nikolakea M, Antsaklis P, Stavros S, Panagopoulos P, Vrachnis N, Daskalakis G. Neonatal hypoglycemia following antenatal corticosteroid treatment prior to elective cesarean delivery during the early term period: a meta-analysis. AJOG GLOBAL REPORTS 2023; 3:100179. [PMID: 36923687 PMCID: PMC10009722 DOI: 10.1016/j.xagr.2023.100179] [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: 02/17/2023] Open
Abstract
OBJECTIVE The necessity of administering antenatal corticosteroids in early-term neonates delivered by planned cesarean delivery remains arbitrary as their observed benefit addresses a few cases that may need pulmonary resuscitation. However, to date, whether the use of antenatal corticosteroids in the preterm period is associated with neonatal hypoglycemia, which is the most prominent neonatal side effect during this period, remains unknown. This study aimed to determine the effect of antenatal corticosteroids administered during the early term period on neonatal hypoglycemia rates. DATA SOURCES The databases of Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar were used. STUDY ELIGIBILITY CRITERIA Published clinical trials and observational studies were considered eligible. METHODS A modified data form that was based on the Cochrane data collection form for intervention reviews for randomized controlled trials and nonrandomized controlled trials was used. Meta-analysis was performed using RStudio (RStudio, Inc, Boston, MA). The quality of included studies was assessed with the Risk Of Bias In Non-randomized Studies of Interventions tool. Trial sequential analysis was performed to evaluate the sample size. RESULTS A total of 6 studies of moderate risk of bias were included in this systematic review consisting of 1273 parturients, of whom 537 received corticosteroids. The risk of neonatal hypoglycemia did not increase with the use of antenatal corticosteroids before early-term elective cesarean delivery (odds ratio, 1.80; 95% confidence interval, 0.45-7.25). Similarly, the risk of admission to the neonatal intensive care unit for respiratory distress syndrome or transient tachypnoea of the newborn was not affected by the use of corticosteroids (odds ratio, 0.61; 95% confidence interval, 0.19-1.99). CONCLUSION The use of antenatal corticosteroids did not seem to increase the risk of neonatal hypoglycemia. Given the quality and sample size of included studies, the effect size cannot be accounted for as definitive and cannot be directly applied in clinical practice. However, the provided information can be used as a guide for women participating in future trials.
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Affiliation(s)
- Vasilios Pergialiotis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece (Drs Pergialiotis, Antsaklis, and Daskalakis).,Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Athens, Greece (Drs Pergialiotis, Rodolaki, and Nikolakea)
| | - Kalliopi Rodolaki
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Athens, Greece (Drs Pergialiotis, Rodolaki, and Nikolakea).,1st Department of Pediatrics, "Aghia Sophia" Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dr Rodolaki)
| | - Melina Nikolakea
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Athens, Greece (Drs Pergialiotis, Rodolaki, and Nikolakea)
| | - Panagiotis Antsaklis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece (Drs Pergialiotis, Antsaklis, and Daskalakis)
| | - Sofoklis Stavros
- 3rd Department of Obstetrics and Gynecology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece (Drs Stavros, Panagopoulos, and Vrachnis)
| | - Periklis Panagopoulos
- 3rd Department of Obstetrics and Gynecology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece (Drs Stavros, Panagopoulos, and Vrachnis)
| | - Nikolaos Vrachnis
- 3rd Department of Obstetrics and Gynecology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece (Drs Stavros, Panagopoulos, and Vrachnis)
| | - Georgios Daskalakis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece (Drs Pergialiotis, Antsaklis, and Daskalakis)
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41
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Dimasi CG, Darby JRT, Morrison JL. A change of heart: understanding the mechanisms regulating cardiac proliferation and metabolism before and after birth. J Physiol 2023; 601:1319-1341. [PMID: 36872609 PMCID: PMC10952280 DOI: 10.1113/jp284137] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/17/2023] [Indexed: 03/07/2023] Open
Abstract
Mammalian cardiomyocytes undergo major maturational changes in preparation for birth and postnatal life. Immature cardiomyocytes contribute to cardiac growth via proliferation and thus the heart has the capacity to regenerate. To prepare for postnatal life, structural and metabolic changes associated with increased cardiac output and function must occur. This includes exit from the cell cycle, hypertrophic growth, mitochondrial maturation and sarcomeric protein isoform switching. However, these changes come at a price: the loss of cardiac regenerative capacity such that damage to the heart in postnatal life is permanent. This is a significant barrier to the development of new treatments for cardiac repair and contributes to heart failure. The transitional period of cardiomyocyte growth is a complex and multifaceted event. In this review, we focus on studies that have investigated this critical transition period as well as novel factors that may regulate and drive this process. We also discuss the potential use of new biomarkers for the detection of myocardial infarction and, in the broader sense, cardiovascular disease.
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Affiliation(s)
- Catherine G. Dimasi
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health SciencesUniversity of South AustraliaAdelaideSAAustralia
| | - Jack R. T. Darby
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health SciencesUniversity of South AustraliaAdelaideSAAustralia
| | - Janna L. Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health SciencesUniversity of South AustraliaAdelaideSAAustralia
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42
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Mann S, Gandy J, Curone G, Abuelo A. The effect of heat treatment on colostral and newborn calf redox status and oxylipid biomarkers. J Dairy Sci 2023; 106:3537-3547. [PMID: 36907758 DOI: 10.3168/jds.2022-22679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/15/2022] [Indexed: 03/12/2023]
Abstract
Newborn calves experience altered redox balance upon transition to extrauterine life. In addition to its nutritional value, colostrum is rich in bioactive factors, including pro- and antioxidants. The objective was to investigate differences in pro- and antioxidants as well as oxidative markers in raw and heat-treated (HT) colostrum and in the blood of calves fed either raw or HT colostrum. Eleven colostrum samples (≥8 L) of Holstein cows were each divided into a raw or HT (60°C, 60 min) portion. Both treatments were stored for <24 h at 4°C and tube-fed in a randomized-paired design at 8.5% of body weight to 22 newborn female Holstein calves within 1 h after birth. Colostrum samples were obtained before feeding, and calf blood samples were taken immediately before feeding (0 h) and at 4, 8, and 24 h after feeding. All samples were analyzed for reactive oxygen and nitrogen species (RONS) and antioxidant potential (AOP), from which the oxidant status index (OSi) was calculated. In 0-, 4-, and 8-h plasma samples, targeted fatty acids (FA) were analyzed using liquid chromatography-mass spectrometry, and oxylipids and isoprostanes (IsoP) using liquid chromatography-tandem mass spectrometry. Results for RONS, AOP, and OSi were analyzed by mixed-effects ANOVA or mixed-effects repeated-measures ANOVA, for colostrum and calf blood samples, respectively, whereas FA, oxylipid, and IsoP were analyzed using false discovery rate-adjusted analysis of paired data. Compared with control, HT colostrum showed lower RONS [least squares means (LSM) 189, 95% confidence interval (95% CI): 159-219 vs. 262, 95% CI: 232-292) relative fluorescence units] and OSi (7.2, 95% CI: 6.0-8.3 vs. 10.0, 95% CI: 8.9-11.1), but AOP remained unchanged (26.7, 95% CI: 24.4-29.0 vs. 26.4, 95% CI: 24.1-28.7 Trolox equivalents/µL). Changes in colostrum oxidative markers due to heat treatment were minor. No changes in RONS, AOP, OSi, or oxidative markers were detected in calf plasma. In both groups of calves, plasma RONS activity declined considerably at all postfeeding time points compared with precolostral values, and AOP reached its maximum 8 to 24 h after feeding. Generally, oxylipid and IsoP plasma abundance reached nadirs at 8 h post-colostrum in both groups. Overall, effects due to heat treatment on redox balance of colostrum and newborn calves and on oxidative biomarkers were minimal. In this study, heat treatment of colostrum reduced RONS activity but did not lead to detectable changes in calf oxidative status overall. This indicates that there were only minor changes in colostral bioactive components that could alter newborn redox balance and markers of oxidative damage.
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Affiliation(s)
- Sabine Mann
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
| | - Jeff Gandy
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824
| | - Giulio Curone
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy
| | - Angel Abuelo
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824
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43
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Cannavò L, Perrone S, Gitto E. Brain-Oriented Strategies for Neuroprotection of Asphyxiated Newborns in the First Hours of Life. Pediatr Neurol 2023; 143:44-49. [PMID: 36996760 DOI: 10.1016/j.pediatrneurol.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 01/31/2023] [Accepted: 02/24/2023] [Indexed: 04/01/2023]
Abstract
Perinatal asphyxia represents the first cause of severe neurological disabilities and the second cause of neonatal death in term-born babies. Currently, no treatment can prevent immediate cell death from necrosis, but some therapeutic interventions, such as therapeutic hypothermia (TH), can reduce delayed cell death from apoptosis. TH significantly improves the combined outcome of mortality or major neurodevelopmental disability, but the number of patients to be treated is 7 to get 1 child with no adverse neurological outcome. The aim of this educational review is to analyze the other care strategies to be implemented to improve the neurological outcome of children with hypoxic ischemic encephalopathy (HIE). Hypocapnia, hypoglycemia, pain control, and functional brain monitoring are recognized as appropriate approaches to improve outcome in critically ill infants with HIE. Pharmacologic neuroprotective adjuncts are currently under investigation. New drugs such as allopurinol and melatonin seem to provide positive effects although more randomized controlled trials are required to establish the effective therapeutic scheme. In the meantime, sustaining the respiratory, metabolic, and cardiovascular system during TH can be a valuable aid in managing and treating the patient with HIE in an optimal way.
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Affiliation(s)
- Laura Cannavò
- Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Serafina Perrone
- Neonatal Unit, University of Parma, Azienda Ospedaliero Universitaria di Parma, Parma, Italy.
| | - Eloisa Gitto
- Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
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44
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Bressan AF, Maia VO, de Souza Rodrigues B, Bertozi G, Batah SS, Fabro AT, Pelizzo G, Pierucci UM, Tostes RC, Sbragia L, Carneiro FS. CONGENITAL DIAPHRAGMATIC HERNIA INCREASES THE SENSITIVITY OF PULMONARY ARTERIES TO NITRIC OXIDE. Pharmacol Res 2023; 191:106749. [PMID: 37004830 DOI: 10.1016/j.phrs.2023.106749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/13/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
Left congenital diaphragmatic hernia (CDH) can lead to pulmonary arteries abnormalities in the contralateral and ipsilateral sides of the diaphragm. Nitric oxide (NO) is the main therapy used to attenuate the vascular effects of CDH, but it is not always effective. We hypothesized that the left and right pulmonary arteries do not respond similarly to NO donors during CDH. Therefore, vasorelaxant responses of the left and right pulmonary arteries to sodium nitroprusside (SNP, a NO donor) were determined in a rabbit experimental model of left CDH. CDH was surgically induced in the fetuses of rabbits on the 25th day of pregnancy. On the 30th day of pregnancy, a midline laparotomy was performed to access the fetuses. The fetuses' left and right pulmonary arteries were isolated and mounted in myograph chambers. Vasodilation was evaluated by cumulative concentration-effect curves to SNP. Protein expression of guanylate cyclase isoforms (GCα, GCβ) and the α isoform of cGMP-dependent protein kinase 1 (PKG1α), and the concentration of NO and cGMP were determined in the pulmonary arteries. The left and right pulmonary arteries of newborns with CDH exhibited increased vasorelaxant responses to SNP (i.e. the potency of SNP was increased) compared to the control group. GCα, GCβ, and PKG1α expression were decreased, while NO and cGMP concentrations were increased in the pulmonary arteries of newborns with CDH compared to the control group. The increased cGMP mobilization may be responsible for the increased vasorelaxant responses to the SNP in the pulmonary arteries during left CDH.
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45
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Zhu J, Li S, Zhao Y, Xiong Y. The role of antenatal corticosteroids in twin pregnancy. Front Pharmacol 2023; 14:1072578. [PMID: 36817154 PMCID: PMC9933922 DOI: 10.3389/fphar.2023.1072578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Twin pregnancy was associated with significantly higher rates of adverse neonatal and perinatal outcomes. One of the underlying causes is that twins are prone to preterm birth. Antenatal corticosteroids are widely used for reducing the incidence of neonatal respiratory distress syndrome initially and other neonatal mortality and morbidities subsequently. As it is widely used as a prophylactic treatment for potential premature births, there remain controversies of issues relating to twin gestations, including window for opportunity, timing of use, repeat course, optimal administration-to-delivery intervals, dosage, and type of corticosteroid. Thus, we present a thorough review of antenatal corticosteroids usage in twin gestation, emphasizing the aforementioned issues and attempting to offer direction for future investigation and clinical practice.
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Affiliation(s)
- Jie Zhu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China,The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Shuyue Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China,The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Ying Zhao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China,The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Yu Xiong
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China,The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China,*Correspondence: Yu Xiong,
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46
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Clifton-Bligh RJ. The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy. Rev Endocr Metab Disord 2023; 24:49-56. [PMID: 36637675 PMCID: PMC9884650 DOI: 10.1007/s11154-022-09773-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 01/14/2023]
Abstract
Diagnosis of pheochromocytoma or paraganglioma (PPGL) in pregnancy has been associated historically with high rates of materno-fetal morbidity and mortality. Recent evidence suggests outcomes are improved by recognition of PPGL before or during pregnancy and appropriate medical management with alpha-blockade. Whether antepartum surgery (before the third trimester) is required remains controversial and open to case-based merits. Women with PPGL in pregnancy are more commonly delivered by Caesarean section, although vaginal delivery appears to be safe in selected cases. At least some PPGLs express the luteinizing hormone/chorionic gonadotropin receptor (LHCGR) which may explain their dramatic manifestation in pregnancy. PPGLs in pregnancy are often associated with heritable syndromes, and genetic counselling and testing should be offered routinely in this setting. Since optimal outcomes are only achieved by early recognition of PPGL in (or ideally before) pregnancy, it is incumbent for clinicians to be aware of this diagnosis in a pregnant woman with hypertension occurring before 20 weeks' gestation, and acute and/or refractory hypertension particularly if paroxysmal and accompanied by sweating, palpitations and/or headaches. All women with a past history of PPGL and/or heritable PPGL syndrome should be carefully assessed for the presence of residual or recurrent disease before considering pregnancy.
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Affiliation(s)
- Roderick J Clifton-Bligh
- University of Sydney, Sydney, NSW, Australia.
- Department of Endocrinology, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
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47
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Vijayashankar SS, Sanatani G, Franciosi S, Moodley S, Ting JY. Left ventricular dysfunction in the immediate post-natal period. Transl Pediatr 2023; 12:13-19. [PMID: 36798933 PMCID: PMC9926136 DOI: 10.21037/tp-22-301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Our objective was to examine the clinical presentation, echocardiographic findings, and outcomes of newborns presenting with left ventricle (LV) dysfunction in the first 48 hours of life without perinatal asphyxia or structural heart disease. We hypothesize that LV dysfunction may occur due to maladaptation to extrauterine life. METHODS This is a retrospective cohort analysis including infants born in a quaternary perinatal centre. Late preterm and term neonates who were diagnosed with left ventricular dysfunction at less than 48 hours of life were identified using an echocardiography clinical laboratory's database and extracorporeal life support database. LV dysfunction was defined as m-mode fractional shortening (FS) <28% or ejection fraction (EF) <50% on echocardiography or reduced function reported by a cardiologist. Data extracted included patient & maternal demographics, echocardiogram parameters, clinical status, and medications. The primary outcome measure was time to recovery of LV function based on echocardiography. RESULTS Of the 69 patients identified, 19 patients were included in the final analysis. The mean gestational age was 38 weeks. Thirteen (68%) infants did not have an underlying cause identified despite extensive work-up. Four (21%) infants had exposure to maternal illicit drug use during pregnancy. Three infants died, and all infants without identifiable etiologies had recovery of LV function within 14 days of life. CONCLUSIONS LV dysfunction can occur during the abrupt transition from fetal to neonatal circulation and can be associated with maternal illicit drug use.
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Affiliation(s)
- Sakethram S Vijayashankar
- Division of Cardiology, Department of Pediatrics, University of British Columbia, BC Children's Hospital Heart Centre, Vancouver, British Columbia, Canada.,Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
| | | | - Sonia Franciosi
- Division of Cardiology, Department of Pediatrics, University of British Columbia, BC Children's Hospital Heart Centre, Vancouver, British Columbia, Canada
| | - Shreya Moodley
- Division of Cardiology, Department of Pediatrics, University of British Columbia, BC Children's Hospital Heart Centre, Vancouver, British Columbia, Canada
| | - Joseph Y Ting
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada
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48
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Ferber SG, Geva R, Weller A. When the Mind Comes to Live Inside the Body: The Ontogeny of the Perceptual Control Clock. Curr Neuropharmacol 2023; 21:13-21. [PMID: 35410607 PMCID: PMC10193756 DOI: 10.2174/1570159x20666220411095508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/18/2022] [Accepted: 04/09/2022] [Indexed: 02/04/2023] Open
Abstract
In this editorial, we discuss the neurobiological processes underlying the early emergence of awareness that we term the "when" and "how" the mind comes to live inside the body. We describe an accumulative developmental process starting during embryonic life and continuing to fetal and postnatal development, of coupling of heart rate, body movements, and sleep states on the behavioral level with underlying mechanisms on the structural, functional, cellular, and molecular levels. A developmental perspective is proposed based on Perceptual Control Theory (PCT). This includes a developing sequence of modules starting from early sensing of neural intensities to early manifestation of human mindful capacities. We also address pharmacological treatments administered to preterm infants, which may interfere with this development, and highlight the need to consider this potential "side effect" of current pharmaceuticals when developing novel pharmacogenomic treatments.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and the Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Ronny Geva
- Department of Psychology and the Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Aron Weller
- Department of Psychology and the Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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49
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Schwaberger B, Pichler G, Baik-Schneditz N, Kurath-Koller S, Sallmon H, Singh Y. Editorial: Cardio-circulatory support of neonatal transition. Front Pediatr 2023; 11:1146395. [PMID: 36861075 PMCID: PMC9969124 DOI: 10.3389/fped.2023.1146395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Affiliation(s)
- Bernhard Schwaberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Gerhard Pichler
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Nariae Baik-Schneditz
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Stefan Kurath-Koller
- Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Hannes Sallmon
- Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.,Department of Pediatric Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Yogen Singh
- Department of Pediatrics - Neonatology and Pediatric Cardiology, Cambridge University Hospitals NHS Foundation Trust and University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.,Department of Pediatrics - Division of Neonatology, Loma Linda University Children's Hospital and Loma Linda University School of Medicine, Loma Linda, CA, United States
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50
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Lezama-García K, Martínez-Burnes J, Marcet-Rius M, Gazzano A, Olmos-Hernández A, Mora-Medina P, Domínguez-Oliva A, Pereira AMF, Hernández-Ávalos I, Baqueiro-Espinosa U, Geraldo ADM, Casas-Alvarado A, Mota-Rojas D. Is the Weight of the Newborn Puppy Related to Its Thermal Balance? Animals (Basel) 2022; 12:3536. [PMID: 36552457 PMCID: PMC9774692 DOI: 10.3390/ani12243536] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Hypothermia, a factor associated with neonatal mortality, can occur immediately after birth as a protective mechanism to prevent hypoxic damage in neonates, or to reduce the metabolic rate to improve the chances of survival in the first hours of life. The heat interchange through the superficial temperature of animals can be evaluated with infrared thermography (IRT). However, to date, there is no information on thermal windows in puppies. This study aimed to evaluate, with the use of IRT, the microcirculatory alterations in 8 different thermal windows identified at 7 different times in 289 newborn puppies assigned to different groups. Three thermograms were taken from four zones of each puppy: the facial, frontal, right lateral, and left lateral regions. Newborn puppies were grouped in 4 quartiles according to their weight: Q1 (126−226 g) n = 73, Q2 (227−330 g) n = 72, Q3 (331−387 g) n = 74, and Q4 (388−452 g) n = 70. A total of 8 thermal windows were considered at 7 evaluation times from Wet at birth until 24 h after birth (AB). Two-way mixed ANOVA within and between subjects’ design for each thermal window (eight models) was performed. Results revealed a positive correlation between the puppy’s weight and its ability to achieve thermostability in all the evaluated thermal windows. Statistically significant differences (p < 0.0001) between the 4 quartiles (Q1, Q2, Q3, and Q4) were found. The lowest temperatures were recorded when the pups were still wet and the highest at 24 h AB. Thermal windows with the highest temperatures were abdominal (34.234 ± 0.056 °C), thoracic (33.705 ± 0.049 °C), nasal (30.671 ± 0.110 °C), and upper left palpebral (34.066 ± 0.052 °C), while the lowest were thoracic limb brachial biceps (27.534 ± 0.051 °C), thoracic limb elbow (27.141 ± 0.049 °C), thoracic limb metacarpal (27.024 ± 0.062 °C), and femoral pelvic limb (27.654 ± 0.055 °C). Assessing the thermal response in newborn puppies can help identify drastic temperature reductions or deficient thermoregulatory compensation during the first hours of life, preventing the consequences of hypothermia.
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Affiliation(s)
- Karina Lezama-García
- PhD Program in Biological and Health Sciences, [Doctorado en Ciencias Biológicas y de la Salud], Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - Julio Martínez-Burnes
- Animal Health Group, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Mexico
| | - Míriam Marcet-Rius
- Animal Behaviour and Welfare Department, IRSEA (Research Institute in Semiochemistry and Applied Ethology), Quartier Salignan, 84400 Apt, France
| | - Angelo Gazzano
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy
| | - Adriana Olmos-Hernández
- Division of Biotechnology—Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City 14389, Mexico
| | - Patricia Mora-Medina
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán Izcalli 54714, Mexico
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Calzada del Hueso 1100, Coapa, Col Villa Quietud, Coyoacán, Mexico City 04960, Mexico
| | - Alfredo M. F. Pereira
- Mediterranean Institute for Agriculture, Environment and Development (MED), Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - Ismael Hernández-Ávalos
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán Izcalli 54714, Mexico
| | | | - Ana de Mira Geraldo
- Mediterranean Institute for Agriculture, Environment and Development (MED), Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - Alejandro Casas-Alvarado
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Calzada del Hueso 1100, Coapa, Col Villa Quietud, Coyoacán, Mexico City 04960, Mexico
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Calzada del Hueso 1100, Coapa, Col Villa Quietud, Coyoacán, Mexico City 04960, Mexico
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