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Trilla Solà C, Parra Roca J, Llurba Olivé E. Reference Ranges of 2-Dimensional Placental Biometry and 3-Dimensional Placental Volume between 11 and 14 Weeks of Gestation. Diagnostics (Basel) 2024; 14:1556. [PMID: 39061694 PMCID: PMC11276113 DOI: 10.3390/diagnostics14141556] [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: 06/27/2024] [Revised: 07/13/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE The purpose of this study was to provide gestational age (GA) specific reference ranges for 2-dimensional (2D) placental biometry and 3-dimensional (3D) placental volume between 11 and 14 weeks of gestation. METHODS Placental biometry including 2D and 3D variables was calculated in 1142 first-trimester singleton pregnancies with non-complicated outcome between September 2016 and February 2020. Ultrasound datasets were obtained at the time of the first-trimester ultrasound, and 2D basal plate (BP), chorionic plate (CP), placental thickness (PT), and 3D placental volume (PV) were measured following a standardized methodology. Reference ranges for each variable were calculated according to GA and crown-rump-length (CRL). RESULTS A total of 1142 uncomplicated pregnancies were considered for analysis. All placental measurements increased significantly between 11 and 14 weeks, especially for PT (39.64%) and PV (64.4%). Reference ranges were constructed for each 2D and 3D first-trimester placental variable using the best-fit regression model for the predicted mean and SD as a function of GA and CRL. CONCLUSIONS Reference ranges of 2D placental biometry and 3D placental volume between 11 and 14 weeks of gestation were constructed, generating reference values. Placental biometry showed a progressive increase during the first trimester. This highlights the importance of using reference range charts according to GA.
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Affiliation(s)
- Cristina Trilla Solà
- Department of Obstetrics and Gynecology, Institut d’Investigació Biomèdica Sant Pau-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS, RD21/0012/0001), Instituto de Salud Carlos III, 28040 Madrid, Spain
| | - Juan Parra Roca
- Department of Obstetrics and Gynecology, Institut d’Investigació Biomèdica Sant Pau-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
| | - Elisa Llurba Olivé
- Department of Obstetrics and Gynecology, Institut d’Investigació Biomèdica Sant Pau-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS, RD21/0012/0001), Instituto de Salud Carlos III, 28040 Madrid, Spain
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Yue T, Guo Y, Qi X, Zheng W, Zhang H, Wang B, Liu K, Zhou B, Zeng X, Ouzhuluobu, He Y, Su B. Sex-biased regulatory changes in the placenta of native highlanders contribute to adaptive fetal development. eLife 2024; 12:RP89004. [PMID: 38869160 PMCID: PMC11175615 DOI: 10.7554/elife.89004] [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: 06/14/2024] Open
Abstract
Compared with lowlander migrants, native Tibetans have a higher reproductive success at high altitude though the underlying mechanism remains unclear. Here, we compared the transcriptome and histology of full-term placentas between native Tibetans and Han migrants. We found that the placental trophoblast shows the largest expression divergence between Tibetans and Han, and Tibetans show decreased immune response and endoplasmic reticulum stress. Remarkably, we detected a sex-biased expression divergence, where the male-infant placentas show a greater between-population difference than the female-infant placentas. The umbilical cord plays a key role in the sex-biased expression divergence, which is associated with the higher birth weight of the male newborns of Tibetans. We also identified adaptive histological changes in the male-infant placentas of Tibetans, including larger umbilical artery wall and umbilical artery intima and media, and fewer syncytial knots. These findings provide valuable insights into the sex-biased adaptation of human populations, with significant implications for medical and genetic studies of human reproduction.
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Affiliation(s)
- Tian Yue
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- Kunming College of Life Science, University of Chinese Academy of SciencesBeijingChina
| | - Yongbo Guo
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- Kunming College of Life Science, University of Chinese Academy of SciencesBeijingChina
| | - Xuebin Qi
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- Fukang Obstetrics, Gynecology and Children Branch Hospital, Tibetan Fukang HospitalKunmingChina
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and TechnologyKunmingChina
| | - Wangshan Zheng
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
| | - Hui Zhang
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and TechnologyKunmingChina
| | - Bin Wang
- Fukang Obstetrics, Gynecology and Children Branch Hospital, Tibetan Fukang HospitalKunmingChina
| | - Kai Liu
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
| | - Bin Zhou
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- Kunming College of Life Science, University of Chinese Academy of SciencesBeijingChina
| | - Xuerui Zeng
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- Kunming College of Life Science, University of Chinese Academy of SciencesBeijingChina
| | - Ouzhuluobu
- Fukang Obstetrics, Gynecology and Children Branch Hospital, Tibetan Fukang HospitalKunmingChina
| | - Yaoxi He
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
| | - Bing Su
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of SciencesKunmingChina
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of SciencesKunmingChina
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Reim PK, Engelbrechtsen L, Gybel-Brask D, Schnurr TM, Kelstrup L, Høgdall EV, Hansen T. The influence of insulin-related genetic variants on fetal growth, fetal blood flow, and placental weight in a prospective pregnancy cohort. Sci Rep 2023; 13:19638. [PMID: 37949941 PMCID: PMC10638310 DOI: 10.1038/s41598-023-46910-6] [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: 05/26/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023] Open
Abstract
The fetal insulin hypothesis proposes that low birthweight and type 2 diabetes (T2D) in adulthood may be two phenotypes of the same genotype. In this study we aimed to explore this theory further by testing the effects of GWAS-identified genetic variants related to insulin release and sensitivity on fetal growth and blood flow from week 20 of gestation to birth and on placental weight at birth. We calculated genetic risk scores (GRS) of first phase insulin release (FPIR), fasting insulin (FI), combined insulin resistance and dyslipidaemia (IR + DLD) and insulin sensitivity (IS) in a study population of 665 genotyped newborns. Two-dimensional ultrasound measurements with estimation of fetal weight and blood flow were carried out at week 20, 25, and 32 of gestation in all 665 pregnancies. Birthweight and placental weight were registered at birth. Associations between the GRSs and fetal growth, blood flow and placental weight were investigated using linear mixed models. The FPIR GRS was directly associated with fetal growth from week 20 to birth, and both the FI GRS, IR + DLD GRS, and IS GRS were associated with placental weight at birth. Our findings indicate that insulin-related genetic variants might primarily affect fetal growth via the placenta.
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Affiliation(s)
- Pauline K Reim
- Faculty of Health Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Maersk Tower, Blegdamsvej 3B, 8th Floor, 2200, Copenhagen, Denmark
| | - Line Engelbrechtsen
- Faculty of Health Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Maersk Tower, Blegdamsvej 3B, 8th Floor, 2200, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Dorte Gybel-Brask
- Psycotherapeutic Outpatient Clinic, Department of Psychiatry, Ballerup Hospital, Ballerup, Denmark
| | - Theresia M Schnurr
- Faculty of Health Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Maersk Tower, Blegdamsvej 3B, 8th Floor, 2200, Copenhagen, Denmark
| | - Louise Kelstrup
- Department of Gynaecology and Obstetrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Estrid V Høgdall
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Torben Hansen
- Faculty of Health Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Maersk Tower, Blegdamsvej 3B, 8th Floor, 2200, Copenhagen, Denmark.
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Dyhr JJ, Linderoth IR, Hansen DN, Frøkjaer JB, Peters DA, Sinding M, Sørensen A. Confined placental mosaicism: placental size and function evaluated on magnetic resonance imaging. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:130-136. [PMID: 36730148 DOI: 10.1002/uog.26174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Evidence regarding placental function in pregnancies complicated by confined placental mosaicism (CPM) is conflicting. We aimed to compare placental function between CPM and non-CPM pregnancies prenatally and at birth. A secondary objective was to evaluate the relationship between placental function and chromosomal subtype of CPM. METHODS This was a retrospective study of pregnancies with CPM and control pregnancies delivered at a tertiary hospital in Denmark between 2014 and 2017. Placental volume and placental transverse relaxation time (T2*) were estimated on magnetic resonance imaging (MRI), fetal weight and uterine artery pulsatility index (UtA-PI) were estimated on ultrasound and fetoplacental ratio was assessed on MRI and at birth. These estimates of placental function were adjusted for gestational age and compared between groups using the Wilcoxon rank-sum test. Within the group of CPM pregnancies, measures of placental function were compared between those at high risk (chromosome numbers 2, 3, 7, 13 and 16) and those at low risk (chromosome numbers 5, 18 and 45X). RESULTS A total of 90 pregnancies were included, of which 12 had CPM and 78 were controls. MRI and ultrasound examinations were performed at a median gestational age of 32.6 weeks (interquartile range, 24.7-35.3 weeks). On MRI assessment, CPM placentae were characterized by a lower placental T2* Z-score (P = 0.004), a lower fetoplacental ratio (P = 0.03) and a higher UtA-PI Z-score (P = 0.03), compared with non-CPM placentae. At birth, the fetoplacental ratio was significantly lower (P = 0.02) and placental weight Z-score was higher (P = 0.01) in CPM pregnancies compared with non-CPM pregnancies. High-risk CPM pregnancies showed a reduced placental T2* Z-score (P = 0.003), lower birth-weight Z-score (P = 0.041), earlier gestational age at delivery (P = 0.019) and higher UtA-PI Z-score (P = 0.028) compared with low-risk CPM pregnancies. Low-risk CPM pregnancies did not differ in any of these parameters from non-CPM pregnancies. CONCLUSIONS CPM pregnancies are characterized by an enlarged and dysfunctional placenta. Placental function was highly related to the chromosomal type of CPM; placental dysfunction was seen predominantly in high-risk CPM pregnancies in which chromosomes 2, 3, 7, 13 or 16 were involved. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J J Dyhr
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - I R Linderoth
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - D N Hansen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - J B Frøkjaer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - D A Peters
- Department of Clinical Engineering, Central Denmark Region, Aarhus, Denmark
| | - M Sinding
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - A Sørensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Busse M, Langwisch S, Tedford K, Fischer KD, Zenclussen AC. Maternal B cell signaling orchestrates fetal development in mice. Development 2022; 149:272200. [PMID: 34528666 DOI: 10.1242/dev.199783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/25/2021] [Indexed: 01/12/2023]
Abstract
B cell participation in early embryo/fetal development and the underlying molecular pathways have not been explored. To understand whether maternal B cell absence or impaired signaling interferes with placental and fetal growth, we paired CD19-deficient (CD19-/-) mice, females with B cell-specific MyD88 (BMyD88-/-) or IL10 (BIL10-/-) deficiency as well as wild-type and MyD88-/- controls on C57Bl/6 background with BALB/c males. Pregnancies were followed by ultrasound and Doppler measurements. Implantation number was reduced in BMyD88-/- and MyD88-/- mice. Loss of MyD88 or B cell-specific deletion of MyD88 or IL10 resulted in decreased implantation areas at gestational day (gd) 5, gd8 and gd10, accompanied by reduced placental thickness, diameter and areas at gd10. Uterine artery resistance was enhanced in BIL10-/- dams at gd10. Challenge with 0.4 mg lipopolysaccharide/kg bodyweight at gd16 revealed that BMyD88-/-, BIL10-/- and CD19-/- mothers delivered preterm, whereas controls maintained their pregnancy. B cell-specific MyD88 and IL10 expression is essential for appropriate in utero development. IL10+B cells are involved in uterine blood flow regulation during pregnancy. Finally, B cell-specific CD19, MyD88 and IL10 expression influences susceptibility towards preterm birth.
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Affiliation(s)
- Mandy Busse
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg 39108, Germany
| | - Stefanie Langwisch
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg 39108, Germany
| | - Kerry Tedford
- Institute for Biochemistry and Cell Biology, Medical Faculty, Otto-von-Guericke University, Magdeburg 39112, Germany
| | - Klaus-Dieter Fischer
- Institute for Biochemistry and Cell Biology, Medical Faculty, Otto-von-Guericke University, Magdeburg 39112, Germany
| | - Ana Claudia Zenclussen
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg 39108, Germany.,Department of Environmental Immunology, Helmholtz Centre for Environmental Research, Leipzig 04318, Germany.,Perinatal Research Group, Saxonian Incubator for Translation, Leipzig University, Leipzig 04103, Germany
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Andescavage N, Kapse K, Lu YC, Barnett SD, Jacobs M, Gimovsky AC, Ahmadzia H, Quistorff J, Lopez C, Andersen NR, Bulas D, Limperopoulos C. Normative placental structure in pregnancy using quantitative Magnetic Resonance Imaging. Placenta 2021; 112:172-179. [PMID: 34365206 DOI: 10.1016/j.placenta.2021.07.296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To characterize normative morphometric, textural and microstructural placental development by applying advanced and quantitative magnetic resonance imaging (qMRI) techniques to the in-vivo placenta. METHODS We enrolled 195 women with uncomplicated, healthy singleton pregnancies in a prospective observational study. Women underwent MRI between 16- and 40-weeks' gestation. Morphometric and textural metrics of placental growth were calculated from T2-weighted (T2W) images, while measures of microstructural development were calculated from diffusion-weighted images (DWI). Normative tables and reference curves were constructed for each measured index across gestation and according to fetal sex. RESULTS Data from 269 MRI studies from 169 pregnant women were included in the analyses. During the study period, placentas undergo significant increases in morphometric measures of volume, thickness, and elongation. Placental texture reveals increasing variability with advancing gestation as measured by grey level non uniformity, run length non uniformity and long run high grey level emphasis. Placental microstructure did not vary with gestational age. Placental elongation was the only metric that differed significantly between male and female fetuses. DISCUSSION We report quantitative metrics of placental morphometry, texture and microstructure in a large cohort of healthy controls during the second and third trimesters of pregnancy. These measures can serve as normative references of in-vivo placental development to better understand placental function in high-risk conditions and allow for the early detection of placental mal-development.
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Affiliation(s)
- Nickie Andescavage
- Division of Neonatology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA; Department of Pediatrics, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Kushal Kapse
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Yuan-Chiao Lu
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Scott D Barnett
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Marni Jacobs
- Division of Biostatistics & Study Methodology, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20037, USA
| | - Alexis C Gimovsky
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Homa Ahmadzia
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Jessica Quistorff
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Catherine Lopez
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Nicole Reinholdt Andersen
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Dorothy Bulas
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA; Department of Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Catherine Limperopoulos
- Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA; Department of Pediatrics, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA; Department of Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA.
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Influence of the placental cord insertion site on the placental mass and the birth weight in dichorionic diamniotic twins. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.001843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of the study was to determine the effect of the displacement of the umbilical cord insertion site from the centre of the placenta on the placental mass and the birth weight of dichorionic diamniotic twins and to consider the importance of the direction of the displacement, as well as to assess the influence of the umbilical cord displacement on the placental mass and the birth weight of dichorionic diamniotic twins taking into account the direction of displacement.
Material and methods. The study was performed on 135 dichorionic diamniotic pairs: 68 opposite-sex, 35 same-sex males, and 32 same-sex females. The impact of an absolute cord displacement from the centroid of the placental disc and the direction of its shifting were compared with the birth weight and the placental mass.
Results. In the investigated group, a central insertion was revealed in 6 (2.2 %), eccentric – in 224 (83.0 %), marginal – in 31 (11.5 %), and velamentous – in 9 (3.3 %) cases. The first two types of cord insertion are considered to be normal, the third and the fourth are seen as abnormal. The placental mass was in a strong positive correlation with the birth weight (r=0.71, p<0.0001). The placentas with an eccentric cord insertion had a smaller surface area. A negative correlation was established between the displacement of the cord insertion site and the placental mass (r=-0.4284, p<0.0001) as well as the birth weight (r=-0.6115, p<0.0001). The shift along the long axis was of greater importance than in relation to the shorter one. The placental mass and the birth weight were higher in the new-borns with a normal cord insertion site. In the abnormal cord insertion group, 32.5 % of the infants were under the 10th birth weight percentile, in the normal cord insertion group – only 8.3 %.
Conclusions. The birth weight of dichorionic diamniotic twins and their placental mass are negatively correlated with the distance of the umbilical cord insertion site from the placental centre. The insertion site displacement along the long axis has a stronger negative effect on the birth weight and the placental mass in comparison with the shifting along the short axis. The placentas with an eccentric cord insertion have a smaller surface area.
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Chen Y, Zhang Z, Wu C, Davaasuren D, Goldstein JA, Gernand AD, Wang JZ. AI-PLAX: AI-based placental assessment and examination using photos. Comput Med Imaging Graph 2020; 84:101744. [PMID: 32634729 PMCID: PMC7533514 DOI: 10.1016/j.compmedimag.2020.101744] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 11/24/2022]
Abstract
Post-delivery analysis of the placenta is useful for evaluating health risks of both the mother and baby. In the U.S., however, only about 20% of placentas are assessed by pathology exams, and placental data is often missed in pregnancy research because of the additional time, cost, and expertise needed. A computer-based tool that can be used in any delivery setting at the time of birth to provide an immediate and comprehensive placental assessment would have the potential to not only to improve health care, but also to radically improve medical knowledge. In this paper, we tackle the problem of automatic placental assessment and examination using photos. More concretely, we first address morphological characterization, which includes the tasks of placental image segmentation, umbilical cord insertion point localization, and maternal/fetal side classification. We also tackle clinically meaningful feature analysis of placentas, which comprises detection of retained placenta (i.e., incomplete placenta), umbilical cord knot, meconium, abruption, chorioamnionitis, and hypercoiled cord, and categorization of umbilical cord insertion type. We curated a dataset consisting of approximately 1300 placenta images taken at Northwestern Memorial Hospital, with hand-labeled pixel-level segmentation map, cord insertion point and other information extracted from the associated pathology reports. We developed the AI-based Placental Assessment and Examination system (AI-PLAX), which is a novel two-stage photograph-based pipeline for fully automated analysis. In the first stage, we use three encoder-decoder convolutional neural networks with a shared encoder to address morphological characterization tasks by employing a transfer-learning training strategy. In the second stage, we employ distinct sub-models to solve different feature analysis tasks by using both the photograph and the output of the first stage. We evaluated the effectiveness of our pipeline by using the curated dataset as well as the pathology reports in the medical record. Through extensive experiments, we demonstrate our system is able to produce accurate morphological characterization and very promising performance on aforementioned feature analysis tasks, all of which may possess clinical impact and contribute to future pregnancy research. This work is the first for comprehensive, automated, computer-based placental analysis and will serve as a launchpad for potentially multiple future innovations.
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Affiliation(s)
- Yukun Chen
- The Pennsylvania State University, University Park, PN, USA.
| | - Zhuomin Zhang
- The Pennsylvania State University, University Park, PN, USA
| | - Chenyan Wu
- The Pennsylvania State University, University Park, PN, USA
| | | | | | | | - James Z Wang
- The Pennsylvania State University, University Park, PN, USA.
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Link D, Many A, Ben Sira L, Tarrasch R, Bak S, Kidron D, Gordon Z, Yagel S, Harel S, Ben Bashat D. Placental vascular tree characterization based on ex-vivo MRI with a potential application for placental insufficiency assessment. Placenta 2020; 101:252-260. [PMID: 32933767 DOI: 10.1016/j.placenta.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Understanding regarding the whole placental vascular network structure is limited. Our aim was to quantitatively characterize the human placental vascular tree ex-vivo using high-resolution MRI. METHODS 34 normal placentas were rinsed and injected with a solution of gelatin and contrast agent through the umbilical vessels. A sample of six placentas taken from pregnancies with intrauterine-growth-restriction (IUGR) was used to demonstrate the potential application to cases with placental insufficiency. Structural ex-vivo MR scans of the placenta were performed using high resolution T1 weighted images. A semi-automatic method was developed to segment and characterize the placental vascular architecture: placental volume and cord insertion location; number of bifurcations, generations and vessels diameters. RESULTS Different vascular patterns were found in placentas with central versus marginal cord-insertion. Based on the placental volume and number of bifurcations we were able to predict birth weight. Furthermore, preliminary results on IUGR sample demonstrated the potential of this method to differentiate between small newborns with suspected IUGR from small normal newborns who reached their full growth potential. Results obtained using the automatic method were validated against manual values demonstrating no significant differences or bias. Histopathology supported the imaging findings. DISCUSSION This is the first study to quantitatively characterize the human placental vascular architecture using high resolution ex-vivo MRI. Different patterns of vascular architecture may be related to different functioning of the placenta and affect fetal development. This method is simple, relatively fast, provides detailed information of the placental vascular architecture, and may have important clinical applications.
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Affiliation(s)
- Daphna Link
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariel Many
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liat Ben Sira
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Pediatric Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ricardo Tarrasch
- Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Stella Bak
- Division of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Debora Kidron
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pathology, Meir Medical Center, Kfar Saba, Israel
| | - Zoya Gordon
- Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Medical Engineering Afeka, Tel Aviv Academic College of Engineering, Tel Aviv, Israel
| | - Simcha Yagel
- Obstretrics and Gynecology Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Shaul Harel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dafna Ben Bashat
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Wang C, Gao R, Huang L, Hu P, Zhu L, Chen WQ. Effect of prenatal nutritional intervention on foetal growth restriction: a real-world study in Shenzhen, China. J Matern Fetal Neonatal Med 2020; 35:2435-2444. [PMID: 32627652 DOI: 10.1080/14767058.2020.1786512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: Fetal growth restriction (FGR) is the primary cause of infant morbidity and mortality. Although nutritional intervention is generally used to cure FGR, its effects on early- and late-onset FGR have not been reported. This study aimed to resolve this issue in a real-world setting.Study design: We collected the data of pregnant women whose fetuses were diagnosed with FGR and subsequently born at Nanshan Women and Children's Care Hospital in Shenzhen, China. We conducted a MANOVA and series of Cox regression analyses to evaluate the effects of a prenatal nutritional intervention on early and late FGR after adjusting for potential confounders.Results: Our results demonstrated that the average birth weights in the four sub-intervention groups were 50.36-160.05 g higher than those in the nonintervention group. These differences were insignificant with respect to early-onset FGR. In late-onset FGR, however, the interventions led to birth weight increases of 164.95-244.45 g greater than those in the nonintervention group, and these differences were significant. During early-onset FGR, four different nutritional interventions reduced the incidence of small-for-gestational age by 8.00-13.76% relative to the incidence in the nonintervention group, while in late-onset FGR, the incidence decreased by 11.37-17.39%.Conclusions: Our results based on a real-world setting reaffirmed that a prenatal nutritional intervention could improve the birth outcomes in cases of FGR and further suggested a better effectiveness on late-onset FGR.
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Affiliation(s)
- Chanmin Wang
- Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Rui Gao
- Nanshan Women and Child Healthcare Hospital of Shenzhen, China
| | - Lihua Huang
- Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pian Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liqing Zhu
- Nanshan Women and Child Healthcare Hospital of Shenzhen, China
| | - Wei-Qing Chen
- Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Health Management, Xinhua College of Sun Yat-sen University, Guangzhou, China
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11
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Eroğlu H, Tolunay HE, Tonyalı NV, Orgul G, Şahin D, Yücel A. Comparison of placental elasticity in normal and intrauterine growth retardation pregnancies by ex vivo strain elastography. Arch Gynecol Obstet 2020; 302:109-115. [PMID: 32430754 DOI: 10.1007/s00404-020-05596-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/06/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare the placental elasticity in fetuses with or without intrauterine growth restriction (IUGR). MATERIALS AND METHODS One hundred pregnant women (50 IUGR and 50 healthy) with anteriorly located placenta were evaluated during the third trimester of pregnancy. Measurements were carried out by a machine that has a real-time elastographic ultrasonography feature. After obtaining the optimum image, three areas (subcutaneous tissue, center, and the edge of the placenta) were provided to identify the placental strain values. Then, the placental strain ratio (PSR) value was calculated automatically. Two groups compared in terms of their PSR values. RESULTS There was a significant difference in placental elasticity between the groups (P < 0.001). PSR value was 2.8 ± 1.2 in the IUGR group and 1.3 ± 0.6 in the control group. A PSR value of 1.78 had an 86% sensitivity (OR 4.3) and 80% specificity (OR 0.17) in IUGR cases. The positive predictive value was 81.1% and the negative predictive value was 85.1% for this cut-off value. CONCLUSIONS We have shown that placental strain ratio is increased during the third trimester of pregnancy in fetuses with IUGR. Increased stiffness and elasticity may be responsible for the onset of IUGR in some cases.
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Affiliation(s)
- Hasan Eroğlu
- Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey.
| | - Harun Egemen Tolunay
- Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey
| | - Nazan Vanlı Tonyalı
- Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey
| | - Gokcen Orgul
- Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey
| | - Dilek Şahin
- Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey
| | - Aykan Yücel
- Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey
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12
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Placental vascular tree characterization based on ex-vivo MRI with a potential application for placental insufficiency assessment. Placenta 2020; 96:34-43. [PMID: 32560856 DOI: 10.1016/j.placenta.2020.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/13/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Understanding regarding the whole placental vascular network structure is limited. Our aim was to quantitatively characterize the human placental vascular tree ex-vivo using high-resolution MRI. METHODS 34 normal placentas were rinsed and injected with a solution of gelatin and contrast agent through the umbilical vessels. A sample of six placentas taken from pregnancies with intrauterine-growth-restriction (IUGR) was used to demonstrate the potential application to cases with placental insufficiency. Structural ex-vivo MR scans of the placenta were performed using high resolution T1 weighted images. A semi-automatic method was developed to segment and characterize the placental vascular architecture: placental volume and cord insertion location, number of bifurcations, generations and vessels diameters. RESULTS Different vascular patterns were found in placentas with central versus marginal cord-insertion. Based on the placental volume and number of bifurcations we were able to predict birth weight. Furthermore, preliminary results on IUGR sample demonstrated the potential of this method to differentiate between small newborns with suspected IUGR from small normal newborns who reached their full growth potential. Results obtained using the automatic method were validated against manual values demonstrating no significant differences or bias. Histopathology supported the imaging findings. DISCUSSION This is the first study to quantitatively characterize the human placental vascular architecture using high resolution ex-vivo MRI. Different patterns of vascular architecture may be related to different functioning of the placenta and affect fetal development. This method is simple, relatively fast, provides detailed information of the placental vascular architecture, and may have important clinical applications.
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13
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Markovic S, Zigic Z, Cerovac A, Kunosic S, Lelic M, Dzafic F. Stereological Analysis of Adolescent Placentas and Anthropometric Characteristics of Newborns. Med Arch 2020; 73:234-239. [PMID: 31762556 PMCID: PMC6853742 DOI: 10.5455/medarh.2019.73.234-239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. Aim: The aim of our study, was to determine the stereological structural parameters of the parenchymal part of placenta, ratio of birth weight and placental weight, and to determine their correlation with the body length and head circumference of the newborns of adolescent pregnant women. Methods: The study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. The experimental group consisted of 30 placenta of pregnant women aged 13-19. The control group consisted of 30 placenta of pregnant women aged 20-35. Computer assisted morphological analysis of images of histological preparations using stereological methods was performed. Results: Surface density of terminal villi of adolescent placentas is significant higher than the control group (t = 14,179, df = 29, p <0,0001). The T-test (t = -5,868, df = 29, p <0,0001) showed statistically significant difference in the surface density of fibrinoid in two compared groups. T-test (t = 6.438, df = 29, p <0.0001) found that total surface of terminal villi was significantly higher in adolescent placentas. The T-test (t = -6,747, df = 29, p <0,0001) found that total surface of fibrinoid was significantly lower in adolescent group. The T-test (t = 4.203, df = 29, p <0.0001) found that the ratio of birth weight of newborn and adolescent placental weight was significantly higher in relation to the control group. Conclusion: Adolescent placentas was more efficient in increasing the weight of newborns, compared to the control group placentas.
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Affiliation(s)
- Sergije Markovic
- Department of Histology and Embryology, Faculty of Medicine; University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zlata Zigic
- Department of Histology and Embryology, Faculty of Medicine; University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Anis Cerovac
- Department of Gynaecology and Obstetrics, General Hospital Tešanj, Tešanj; Bosnia and Herzegovina.,Department of Anatomy, Faculty of Medicine; University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Suad Kunosic
- Department of Physics, Faculty of Natural Sciences and Mathematics, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Melisa Lelic
- Department of Histology and Embryology, Faculty of Medicine; University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Fejzo Dzafic
- Polyclinic for laboratory diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
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14
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Nascente LMDP, Grandi C, Aragon DC, Cardoso VC. Placental measurements and their association with birth weight in a Brazilian cohort. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200004. [PMID: 32130393 DOI: 10.1590/1980-549720200004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/13/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Epidemiological studies have shown associations between placental measurements and perinatal and later life outcomes. OBJECTIVES To report placental measurements and evaluate their association with birth weight in a Brazilian birth cohort. METHODS Retrospective cohort study with 958 mothers, placentas, and newborns delivered at the Ribeirão Preto Medical School Hospital, Universidade de São Paulo, Brazil, in 2010 and 2011. The information was collected from interviews, medical records, and pathology reports. The placental measurements were: weight, largest and smallest diameters, eccentricity, thickness, shape, area, and birth weight/placental weight and placental weight/birth weight ratios. We analyzed the associations between birth weight and placental measurements using multiple linear regression. RESULTS Placental weight alone accounted for 48% of birth weight variability (p < 0.001), whereas placental measurements combined (placental weight, largest and smallest diameters, and thickness) were responsible for 50% (p < 0.001). When adjusted for maternal and neonatal characteristics, placental measurements explained 74% of birth weight variability (p < 0.001). CONCLUSION Placental measurements are powerful independent predictors of birth weight. Placental weight is the most predictive of them, followed by the smallest diameter.
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Affiliation(s)
| | - Carlos Grandi
- Department of Pediatrics, Sardá Maternity Hospital, Universidad de Buenos Aires - Buenos Aires, Argentina
| | - Davi Casale Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil
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15
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Kelley AS, Smith YR, Padmanabhan V. A Narrative Review of Placental Contribution to Adverse Pregnancy Outcomes in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2019; 104:5299-5315. [PMID: 31393571 PMCID: PMC6767873 DOI: 10.1210/jc.2019-00383] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/01/2019] [Indexed: 12/29/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of reproductive-aged women. In pregnancy, women with PCOS experience increased risk of miscarriage, gestational diabetes, preeclampsia, and extremes of fetal birth weight, and their offspring are predisposed to reproductive and cardiometabolic dysfunction in adulthood. Pregnancy complications, adverse fetal outcomes, and developmental programming of long-term health risks are known to have placental origins. These findings highlight the plausibility of placental compromise in pregnancies of women with PCOS. EVIDENCE SYNTHESIS A comprehensive PubMed search was performed using terms "polycystic ovary syndrome," "placenta," "developmental programming," "hyperandrogenism," "androgen excess," "insulin resistance," "hyperinsulinemia," "pregnancy," and "pregnancy complications" in both human and animal experimental models. CONCLUSIONS There is limited human placental research specific to pregnancy of women with PCOS. Gestational androgen excess and insulin resistance are two clinical hallmarks of PCOS that may contribute to placental dysfunction and underlie the higher rates of maternal-fetal complications observed in pregnancies of women with PCOS. Additional research is needed to prevent adverse maternal and developmental outcomes in women with PCOS and their offspring.
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Affiliation(s)
- Angela S Kelley
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Yolanda R Smith
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Vasantha Padmanabhan
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
- Correspondence and Reprint Requests: Vasantha Padmanabhan, PhD, Department of Pediatrics, University of Michigan, 7510 MSRB 1, 1500 West Medical Center Drive, Ann Arbor, Michigan 48109. E-mail:
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16
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Liu HJ, Liu PC, Hua J, Zhao Y, Cao J. Placental weight and size in relation to fetal growth restriction: a case-control study. J Matern Fetal Neonatal Med 2019; 34:1356-1360. [PMID: 31234675 DOI: 10.1080/14767058.2019.1636371] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Reductions in placental weight and size have been associated with reduced fetal growth. However, few studies have examined the association of placental weight and size with the risk of fetal growth restriction (FGR). METHODS We enrolled 121 mother-newborn pairs, including 54 FGR cases and 67 healthy controls, from our previous case-control study. The weight, surface area, and thickness of the placenta were measured by medical professionals. RESULTS Reduced placental weight and surface area were found to be associated with decreased birth weight. A 10-unit decrement in placental weight (g) and surface area (cm2) was associated with 33.9 (β = 33.9, 95% CI, 22.1-45.7) and 24.3 (β = 24.3, 95% CI, 11.2-37.5) g decrease in birth weight, respectively. Those associations varied by infant gender and the magnitudes of effect were larger among male fetuses. Moreover, reduced placental weight and surface area were associated with increased odds of FGR. A 10-unit decrease in placental weight and surface area were associated with 21% (OR = 1.21, 95% CI, 1.08-1.44) and 19% (OR = 1.19, 95% CI, 1.06-1.41) increase in the odds of FGR. CONCLUSIONS Our results suggest that fetuses with lower placental weight and smaller surface area are at higher risk of developing FGR.
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Affiliation(s)
- Hong-Jiao Liu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Peng-Cheng Liu
- Health Science Center, Peking University, Beijing, China
| | - Jing Hua
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Zhao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia Cao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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17
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Freedman AA, Hogue CJ, Marsit CJ, Rajakumar A, Smith AK, Goldenberg RL, Dudley DJ, Saade GR, Silver RM, Gibbins KJ, Stoll BJ, Bukowski R, Drews-Botsch C. Associations Between the Features of Gross Placental Morphology and Birthweight. Pediatr Dev Pathol 2019; 22:194-204. [PMID: 30012074 PMCID: PMC6335186 DOI: 10.1177/1093526618789310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The placenta plays a critical role in regulating fetal growth. Recent studies suggest that there may be sex-specific differences in placental development. The purpose of our study was to evaluate the associations between birthweight and placental morphology in models adjusted for covariates and to assess sex-specific differences in these associations. We analyzed data from the Stillbirth Collaborative Research Network's population-based case-control study conducted between 2006 and 2008, which recruited cases of stillbirth and population-based controls in 5 states. Our analysis was restricted to singleton live births with a placental examination (n = 1229). Characteristics of placental morphology evaluated include thickness, surface area, difference in diameters, shape, and umbilical cord insertion site. We used linear regression to model birthweight as a function of placental morphology and covariates. Surface area had the greatest association with birthweight; a reduction in surface area of 83 cm2, which reflects the interquartile range, is associated with a 260.2-g reduction in birthweight (95% confidence interval, -299.9 to -220.6), after adjustment for other features of placental morphology and covariates. Reduced placental thickness was also associated with lower birthweight. These associations did not differ between males and females. Our results suggest that reduced placental thickness and surface area are independently associated with lower birthweight and that these relationships are not related to sex.
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Affiliation(s)
- Alexa A Freedman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carol J Hogue
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carmen J Marsit
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Augustine Rajakumar
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Robert L Goldenberg
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York
| | - Donald J Dudley
- Department of Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - George R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Robert M Silver
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Karen J Gibbins
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Barbara J Stoll
- McGovern Medical School, University of Texas Health Science Center, Houston, Texas
| | - Radek Bukowski
- Department of Women’s Health, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Carolyn Drews-Botsch
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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18
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Ismail KI, Hannigan A, Kelehan P, Fitzgerald B, O'Donoghue K, Cotter A. Small for gestational age infants and the association with placental and umbilical cord morphometry: a digital imaging study. J Matern Fetal Neonatal Med 2019; 33:3632-3639. [PMID: 30760075 DOI: 10.1080/14767058.2019.1582628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction: Individual placental and umbilical cord morphometry have been previously identified to have an association with fetal growth. This study aims to identify which of the morphometric measurements in combination are associated with pregnancies with small for gestational age (SGA) infants using digital imaging of the delivered placenta.Material and methods: This study examined 1005 placentas from consecutively delivered singleton pregnancies in a tertiary center. Standardized images of each placenta were taken. Placental weight and thickness; umbilical cord length and diameter were measured on gross examination. Distance from the placental cord insertion site to placental margin, length and breadth of the placenta and placental chorionic surface area were measured digitally using ImageJ software. Logistic regression models and area under the curve (AUC) were used to identify the best subset of morphometric measurements to classify infants as SGA (<10th centile).Results: Overall, 141 (14%) infants were SGA. The morphometric measurements at delivery most strongly associated with the classification of infants as SGA were placental weight (AUC = 0.806) and placental surface area (AUC = 0.749). Of the potential antenatal morphometric measurements, umbilical cord diameters, both placental (AUC = 0.644) and fetal end (AUC = 0.629) were most strongly associated with SGA. A logistic regression model with maternal age, smoking status, current history of preeclampsia, umbilical cord length, placental weight, birthweight-to-placental weight ratio and umbilical cord diameter (placental end) had a sensitivity of 53% and a false-positive rate of 2% (AUC = 0.945) for the classification of infants as SGA.Conclusion: Placental and umbilical cord morphometry measured at delivery are different between SGA and non-SGA infants. Further studies are warranted to investigate the feasibility and accuracy of ultrasound to measure placental and umbilical cord morphometry during pregnancy.
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Affiliation(s)
- Khadijah I Ismail
- Obstetrics and Gynecology Department, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Ailish Hannigan
- Biostatistics Department, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Peter Kelehan
- Pathology Department, National Maternity Hospital, Dublin, Ireland
| | | | - Keelin O'Donoghue
- Obstetrics and Gynecology Department, University College Cork, Cork, Ireland
| | - Amanda Cotter
- Obstetrics and Gynecology Department, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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19
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Salavati N, Smies M, Ganzevoort W, Charles AK, Erwich JJ, Plösch T, Gordijn SJ. The Possible Role of Placental Morphometry in the Detection of Fetal Growth Restriction. Front Physiol 2019; 9:1884. [PMID: 30670983 PMCID: PMC6331677 DOI: 10.3389/fphys.2018.01884] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/12/2018] [Indexed: 01/08/2023] Open
Abstract
Fetal growth restriction (FGR) is often the result of placental insufficiency and is characterized by insufficient transplacental transport of nutrients and oxygen. The main underlying entities of placental insufficiency, the pathophysiologic mechanism, can broadly be divided into impairments in blood flow and exchange capacity over the syncytiovascular membranes of the fetal placenta villi. Fetal growth restriction is not synonymous with small for gestational age and techniques to distinguish between both are needed. Placental insufficiency has significant associations with adverse pregnancy outcomes (perinatal mortality and morbidity). Even in apparently healthy survivors, altered fetal programming may lead to long-term neurodevelopmental and metabolic effects. Although the concept of fetal growth restriction is well appreciated in contemporary obstetrics, the appropriate detection of FGR remains an issue in clinical practice. Several approaches have aimed to improve detection, e.g., uniform definition of FGR, use of Doppler ultrasound profiles and use of growth trajectories by ultrasound fetal biometry. However, the role of placental morphometry (placental dimensions/shape and weight) deserves further exploration. This review article covers the clinical relevance of placental morphometry during pregnancy and at birth to help recognize fetuses who are growth restricted. The assessment has wide intra- and interindividual variability with various consequences. Previous studies have shown that a small placental surface area and low placental weight are associated with a slower growth of the fetus. Parameters such as placental surface area, placental volume and placental weight in relation to birth weight can help to identify FGR. In the future, a model including sophisticated antenatal placental morphometry may prove to be a clinically useful method for screening or diagnosing growth restricted fetuses, in order to provide optimal monitoring.
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Affiliation(s)
- Nastaran Salavati
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Maddy Smies
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Wessel Ganzevoort
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | | | - Jan Jaap Erwich
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Torsten Plösch
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sanne J. Gordijn
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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20
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Niu Z, Xie C, Wen X, Tian F, Ding P, He Y, Fan L, Yuan S, Jia D, Chen WQ. Mediating role of maternal serum interleukin-1beta and tumor necrosis factor-alpha in the association between environmental tobacco smoke exposure in pregnancy and low birth weight at term. J Matern Fetal Neonatal Med 2017; 31:1251-1258. [PMID: 28347163 DOI: 10.1080/14767058.2017.1312332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To explore the mediation effects of maternal serum interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) on the association between environmental tobacco smoke (ETS) exposure during pregnancy and low birth weight (LBW) at term. METHODS ETS exposure, birth weight, blood sample and covariates were collected from 195 pregnant women delivered term LBW infants and 195 controls delivered normal birth weight infants in two Maternity and Child Hospitals in Guangdong, China. Maternal serum IL-1β and TNF-α were measured by flow cytometry. Logistic regression models and path analyses explored the mediation effects of maternal IL-1β and TNF-α on the association between ETS exposure and LBW. RESULTS LBW was significantly associated with maternal ETS exposure (OR = 2.14 (95% CI =1.06-4.32)). TNF-α and IL-1β were significantly associated with both LBW (OR = 1.87 (1.41-2.47) and OR = 1.53 (1.14-2.05)) and ETS (β = 0.32 (0.04-0.60) and β = 0.27 (0.05-0.49)). Traditional mediation analyses indicated the separate mediation effect of TNF-α and IL-1β was 32.2% and 24.6%, respectively. Path analysis revealed the combined mediation effects of TNF-α and IL-1β as 29.4% in the pathway from ETS exposure to LBW. CONCLUSIONS Maternal serum IL-1β and TNF-α may play a mediating role in the association between maternal ETS exposure during pregnancy and term LBW.
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Affiliation(s)
- Zhongzheng Niu
- a Department of Biostatistics and Epidemiology, School of Public Health , Sun Yat-sen University , Guangzhou , PR China
| | - Chuanbo Xie
- b Department of Cancer Prevention Research, State Key Laboratory of Oncology in South China , Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - Xiaozhong Wen
- c Department of Pediatrics, Division of Behavioral Medicine, School of Medicine and Biomedical Sciences , State University of New York at Buffalo , Buffalo , NY , USA
| | - Fuying Tian
- a Department of Biostatistics and Epidemiology, School of Public Health , Sun Yat-sen University , Guangzhou , PR China
| | - Peng Ding
- a Department of Biostatistics and Epidemiology, School of Public Health , Sun Yat-sen University , Guangzhou , PR China
| | - Yanhui He
- a Department of Biostatistics and Epidemiology, School of Public Health , Sun Yat-sen University , Guangzhou , PR China
| | - Lijun Fan
- a Department of Biostatistics and Epidemiology, School of Public Health , Sun Yat-sen University , Guangzhou , PR China
| | - Shixin Yuan
- d Shenzhen Women and Children's Hospital , Shenzhen , PR China
| | - Deqin Jia
- e Foshan Women and Children's Hospital , Foshan , PR China
| | - Wei-Qing Chen
- a Department of Biostatistics and Epidemiology, School of Public Health , Sun Yat-sen University , Guangzhou , PR China
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Che L, Yang Z, Xu M, Xu S, Che L, Lin Y, Fang Z, Feng B, Li J, Chen D, Wu D. Maternal nutrition modulates fetal development by inducing placental efficiency changes in gilts. BMC Genomics 2017; 18:213. [PMID: 28245787 PMCID: PMC5331709 DOI: 10.1186/s12864-017-3601-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 02/22/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Intra-uterine growth restriction (IUGR) and fetal overgrowth increase risks to postnatal health. Maternal nutrition is the major intrauterine environmental factor that alters fetal weight. However, the mechanisms underlying the effects of maternal nutrition on fetal development are not entirely clear. We developed a pig model, and using isobaric tags for relative and absolute quantification (iTRAQ), we investigated alterations in the placental proteome of gilts on a normal-energy-intake (Con) and high-energy-intake (HE) diet. RESULTS In the Con group, heavy and light fetuses were found at the tubal and cervical ends of the uterus respectively at 90 d of gestation. Moreover, the heavy fetuses had a higher glucose concentration than the light fetuses. However, a higher uniformity was noted in the HE group. Placental promoters between these two positions indicated that 78 and 50 differentially expressed proteins were detected in the Con and HE groups respectively. In the Con group, these proteins were involved in lipid metabolism (HADHA, AACS, CAD), nutrient transport (GLUT, SLC27A1), and energy metabolism (NDUFV1, NDUFV2, ATP5C1). However, in the HE group they mainly participated in transcriptional and translational regulation, and intracellular vesicular transport. CONCLUSIONS Our findings revealed that maternal nutrition may alter birth weight mainly through the modulation of placental lipid and energy metabolism, which also provides a possible mechanism to explain the higher uniformity of fetal weight in gilts fed a HE diet.
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Affiliation(s)
- Long Che
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - ZhenGuo Yang
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - MengMeng Xu
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - ShengYu Xu
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - LianQiang Che
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - Yan Lin
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - ZhengFeng Fang
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - Bin Feng
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - Jian Li
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - DaiWen Chen
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
| | - De Wu
- Key Laboratory of Animal Disease-Resistance Nutrition and Feed Science, Ministry of Agriculture, P. R. China, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130 China
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22
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Dynamic modeling of uteroplacental blood flow in IUGR indicates vortices and elevated pressure in the intervillous space - a pilot study. Sci Rep 2017; 7:40771. [PMID: 28102332 PMCID: PMC5244422 DOI: 10.1038/srep40771] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/12/2016] [Indexed: 01/14/2023] Open
Abstract
Ischemic placental disease is a concept that links intrauterine growth retardation (IUGR) and preeclampsia (PE) back to insufficient remodeling of uterine spiral arteries. The rheological consequences of insufficient remodeling of uterine spiral arteries were hypothesized to mediate the considerably later manifestation of obstetric disease. However, the micro-rheology in the intervillous space (IVS) cannot be examined clinically and rheological animal models of the human IVS do not exist. Thus, an in silico approach was implemented to provide in vivo inaccessible data. The morphology of a spiral artery and the inflow region of the IVS were three-dimensionally reconstructed to provide a morphological stage for the simulations. Advanced high-end supercomputing resources were used to provide blood flow simulations at high spatial resolution. Our simulations revealed turbulent blood flow (high-velocity jets and vortices) combined with elevated blood pressure in the IVS and increased wall shear stress at the villous surface in conjunction with insufficient spiral artery remodeling only. Post-hoc histological analysis of uterine veins showed evidence of increased trophoblast shedding in an IUGR placenta. Our data support that rheological alteration in the IVS is a relevant mechanism linking ischemic placental disease to altered structural integrity and function of the placenta.
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González-Domínguez MI, Lazo-de-la-Vega-Monroy ML, Zaina S, Sabanero M, Daza-Benítez L, Malacara JM, Barbosa-Sabanero G. Association of cord blood des-acyl ghrelin with birth weight, and placental GHS-R1 receptor expression in SGA, AGA, and LGA newborns. Endocrine 2016; 53:182-91. [PMID: 26754660 DOI: 10.1007/s12020-015-0833-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 12/14/2015] [Indexed: 11/29/2022]
Abstract
Although ghrelin in cord blood has been associated to birth weight, its role in fetal and postnatal growth has not been elucidated. The aim of this study was to analyze total ghrelin, acyl ghrelin (AG), and des-acyl ghrelin (DAG) in cord blood of newborns with idiopathic birth weight alterations, and to evaluate protein expression of placental GHS-R1, in order to investigate their correlation with birth weight and placental weight. We performed a cross-sectional comparative study in umbilical cord blood and placentas from healthy mothers of SGA, AGA, and LGA (small, adequate and large for gestational age) term newborns (n = 20 per group). Cord blood total ghrelin, AG, and DAG were measured by ELISA, and placental GHS-R1 expression was evaluated by Western blot. Cord blood DAG was higher in SGA compared to AGA newborns (902.1 ± 109.1 and 597.4 ± 58.2 pg/ml, respectively, p = 0.01) while LGA and AGA showed similar values (627.2 ± 76.4 pg/ml for LGA, p = 0.80). DAG negatively correlated with birthweight (r = -0.31, p = 0.02) and placental weight (r = -0.33, p = 0.02). No differences in AG or total ghrelin were found. GHS-R1 protein in placenta was not differentially expressed among SGA, AGA, and LGA. Our results suggest a role of DAG in intrauterine growth. Further studies are needed in order to elucidate the mechanisms by which DAG participates in fetal growth.
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Affiliation(s)
- Martha I González-Domínguez
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Maria-Luisa Lazo-de-la-Vega-Monroy
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Silvio Zaina
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Myrna Sabanero
- Biology Department, Natural and Exact Sciences Division, University of Guanajuato, Guanajuato Campus, Guanajuato, Mexico
| | | | - Juan Manuel Malacara
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Gloria Barbosa-Sabanero
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico.
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24
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Haeussner E, Schmitz C, Frank HG, Edler von Koch F. Novel 3D light microscopic analysis of IUGR placentas points to a morphological correlate of compensated ischemic placental disease in humans. Sci Rep 2016; 6:24004. [PMID: 27045698 PMCID: PMC4820778 DOI: 10.1038/srep24004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 03/18/2016] [Indexed: 11/30/2022] Open
Abstract
The villous tree of the human placenta is a complex three-dimensional (3D) structure with branches and nodes at the feto-maternal border in the key area of gas and nutrient exchange. Recently we introduced a novel, computer-assisted 3D light microscopic method that enables 3D topological analysis of branching patterns of the human placental villous tree. In the present study we applied this novel method to the 3D architecture of peripheral villous trees of placentas from patients with intrauterine growth retardation (IUGR placentas), a severe obstetric syndrome. We found that the mean branching angle of branches in terminal positions of the villous trees was significantly different statistically between IUGR placentas and clinically normal placentas. Furthermore, the mean tortuosity of branches of villous trees in directly preterminal positions was significantly different statistically between IUGR placentas and clinically normal placentas. We show that these differences can be interpreted as consequences of morphological adaptation of villous trees between IUGR placentas and clinically normal placentas, and may have important consequences for the understanding of the morphological correlates of the efficiency of the placental villous tree and their influence on fetal development.
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Affiliation(s)
- Eva Haeussner
- Department of Anatomy II, LMU Munich, Pettenkoferstr. 11, 80336 Munich, Germany
| | - Christoph Schmitz
- Department of Anatomy II, LMU Munich, Pettenkoferstr. 11, 80336 Munich, Germany
| | - Hans-Georg Frank
- Department of Anatomy II, LMU Munich, Pettenkoferstr. 11, 80336 Munich, Germany
| | - Franz Edler von Koch
- Clinic for Obstetrics and Gynecology Dritter Orden, Menzinger Str. 44, 80638 Munich, Germany
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Niu Z, Xie C, Wen X, Tian F, Ding P, He Y, Lin J, Yuan S, Guo X, Jia D, Chen WQ. Placenta mediates the association between maternal second-hand smoke exposure during pregnancy and small for gestational age. Placenta 2015; 36:876-80. [DOI: 10.1016/j.placenta.2015.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/22/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
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26
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Yamazaki I, Kimura F, Nakagawa K, Nakai K, Arima T, Kawabata T, Kagawa Y, Saitoh S, Mizuno S, Yaegashi N, Miyazawa T. Heterogeneity of the Fatty Acid Composition of Japanese Placentae for Determining the Perinatal Fatty Acid Status: a Methodological Study. J Oleo Sci 2015; 64:905-14. [PMID: 26179007 DOI: 10.5650/jos.ess15071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Analysis of the placenta can be a useful way to determine the fatty acid (FA) status of pregnant women and neonates since this large organ can be obtained easily and non-invasively. Although several studies have been conducted on using placental tissue for FA analysis, the sampling methods have not been thoroughly examined. The aim of the present study was to determine a suitable method of sampling human placentae by focusing on their heterogeneity. Twenty-four placentae were collected from healthy pregnant Japanese women in the Miyagi Prefecture of Japan. Five of them were used to compare the FA composition between the peripheral area and the central area of the placentae. The other 19 were examined to determine differences in the FA composition between the fetal and maternal side. Placental tissue crude lipid was saponified, and methyl was esterified with 14% sodium boron trifluoride methanol for gas chromatography with flame ionization detector analysis. Fifty-six peaks were detected from the methyl esters of the placental total lipid, and 33 of those were identified as FA methyl esters. There were considerable variations in the FA composition, as the variation was low in the central parts and high in the peripheral parts of the placentae. The 18:1n-9 and 18:2n-6 levels were higher in the fetal side, whereas the 20:3n-6, 20:4n-6, and 22:6n-3 levels were higher in the maternal side. These findings indicate the presence of heterogeneity in the FA composition of human placenta, and they suggest the necessity for standardizing the sampling method so that the placental tissue can be used to determine the FA status.
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Affiliation(s)
- Isao Yamazaki
- Food and Biodynamic Chemistry Laboratory, Graduate School of Agricultural Sciences, Tohoku University
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Li B, Ma Y, Huang J, Xiao X, Li L, Liu C, Shi Y, Wang D, Wang X. Probing the effect of human normal sperm morphology rate on cycle outcomes and assisted reproductive methods selection. PLoS One 2014; 9:e113392. [PMID: 25411962 PMCID: PMC4239063 DOI: 10.1371/journal.pone.0113392] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/22/2014] [Indexed: 01/08/2023] Open
Abstract
Sperm morphology is the best predictor of fertilization potential, and the critical predictive information for supporting assisted reproductive methods selection. Given its important predictive value and the declining reality of semen quality in recent years, the threshold of normal sperm morphology rate (NSMR) is being constantly corrected and controversial, from the 4th edition (14%) to the 5th version (4%). We retrospectively analyzed 4756 cases of infertility patients treated with conventional-IVF(c-IVF) or ICSI, which were divided into three groups according to NSMR: ≥14%, 4%–14% and <4%. Here, we demonstrate that, with decrease in NSMR(≥14%, 4%–14%, <4%), in the c-IVF group, the rate of fertilization, normal fertilization, high-quality embryo, multi-pregnancy and birth weight of twins gradually decreased significantly (P<0.05), while the miscarriage rate was significantly increased (p<0.01) and implantation rate, clinical pregnancy rate, ectopic pregnancy rate, preterm birth rate, live birth rate, sex ratio, and birth weight(Singleton) showed no significant change. In the ICSI group, with decrease in NSMR (≥14%, 4%–14%, <4%), high-quality embryo rate, multi-pregnancy rate and birth weight of twins were gradually decreased significantly (p<0.05), while other parameters had no significant difference. Considering the clinical assisted methods selection, in the NFMR ≥14% group, normal fertilization rate of c-IVF was significantly higher than the ICSI group (P<0.05), in the 4%–14% group, birth weight (twins) of c-IVF were significantly higher than the ICSI group, in the <4% group, miscarriage of IVF was significantly higher than the ICSI group. Therefore, we conclude that NSMR is positively related to embryo reproductive potential, and when NSMR<4% (5th edition), ICSI should be considered first, while the NSMR≥4%, c-IVF assisted reproduction might be preferred.
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Affiliation(s)
- Bo Li
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
- * E-mail: (BL); (XHW)
| | - Yefei Ma
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Jianlei Huang
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Xifeng Xiao
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Li Li
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Chuang Liu
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Yongqian Shi
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Dong Wang
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
| | - Xiaohong Wang
- Department of Obstetrics and Gynecology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, 710038, China
- * E-mail: (BL); (XHW)
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Haeussner E, Buehlmeyer A, Schmitz C, von Koch FE, Frank HG. Novel 3D microscopic analysis of human placental villous trees reveals unexpected significance of branching angles. Sci Rep 2014; 4:6192. [PMID: 25155961 PMCID: PMC4143784 DOI: 10.1038/srep06192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/08/2014] [Indexed: 02/01/2023] Open
Abstract
The villous trees of human placentas delineate the fetomaternal border and are complex three-dimensional (3D) structures. Thus far, they have primarily been analyzed as thin, two-dimensional (2D) histological sections. However, 2D sections cannot provide access to key aspects such as branching nodes and branch order. Using samples taken from 50 normal human placentas at birth, in the present study we show that analysis procedures for 3D reconstruction of neuronal dendritic trees can also be used for analyzing trees of human placentas. Nodes and their branches (e.g., branching hierarchy, branching angles, diameters, and lengths of branches) can be efficiently measured in whole-mount preparations of isolated villous trees using high-end light microscopy. Such data differ qualitatively from the data obtainable from histological sections and go substantially beyond the morphological horizon of such histological data. Unexpectedly, branching angles of terminal branches of villous trees varied inversely with the fetoplacental weight ratio, a widely used clinical parameter. Since branching angles have never before been determined in the human placenta, this result requires further detailed studies in order to fully understand its impact.
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Affiliation(s)
- Eva Haeussner
- Ludwig-Maximilians-University, Anatomische Anstalt, Pettenkoferstrasse 11, 80336 Munich, Germany
| | - Antonia Buehlmeyer
- Ludwig-Maximilians-University, Anatomische Anstalt, Pettenkoferstrasse 11, 80336 Munich, Germany
| | - Christoph Schmitz
- Ludwig-Maximilians-University, Anatomische Anstalt, Pettenkoferstrasse 11, 80336 Munich, Germany
| | - Franz Edler von Koch
- 1] Clinic for Obstetrics and Gynaecology Dritter Orden, Menzinger Str. 44, 80638 Munich, Germany [2]
| | - Hans-Georg Frank
- 1] Ludwig-Maximilians-University, Anatomische Anstalt, Pettenkoferstrasse 11, 80336 Munich, Germany [2]
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Chiapella G, Genti-Raimondi S, Magnarelli G. Placental oxidative status in rural residents environmentally exposed to organophosphates. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 38:220-229. [PMID: 24959959 DOI: 10.1016/j.etap.2014.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 06/03/2014] [Indexed: 06/03/2023]
Abstract
The impact of environmental organophosphate pesticide exposure on the placenta oxidative status was assessed. Placental samples were collected from women residing in an agricultural area during pesticide pulverization period, non-pulverization period and from control group. Carboxylesterase activity was significantly decreased in pulverization period group. Enzymatic and non-enzymatic defense system, the oxidative stress biomarkers and the nuclear factor erythroid 2-related factor levels showed no differences among groups. However, in the pulverization period group, an inverse association between catalase activity and placental index, a useful metric for estimating placental inefficiency, was found. This result suggests that catalase may serve as a potential placental biomarker of susceptibility to pesticides. Further studies designed from a gene-environment perspective are needed.
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Affiliation(s)
- Graciela Chiapella
- Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Cipolletti, Río Negro, Argentina; LIBIQUIMA, Instituto Multidisciplinario de Investigación y Desarrollo de la Patagonia Norte (IDEPA), CONICET - Universidad Nacional del Comahue, Neuquén, Argentina.
| | - Susana Genti-Raimondi
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Gladis Magnarelli
- Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Cipolletti, Río Negro, Argentina; LIBIQUIMA, Instituto Multidisciplinario de Investigación y Desarrollo de la Patagonia Norte (IDEPA), CONICET - Universidad Nacional del Comahue, Neuquén, Argentina.
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30
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Farina A. Biophysical markers for abnormal placentation: first and/or second trimester. Prenat Diagn 2014; 34:628-34. [DOI: 10.1002/pd.4377] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 03/27/2014] [Accepted: 04/02/2014] [Indexed: 11/10/2022]
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