1
|
Geva N, Geva Y, Katz L, Binyamin Y, Rotem R, Weintraub AY, Yaniv Salem S. Correlation between total deceleration area in CTG records and cord blood pH in pregnancies with IUGR. Arch Gynecol Obstet 2024; 310:1425-1431. [PMID: 38225432 DOI: 10.1007/s00404-023-07240-0] [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: 08/09/2023] [Accepted: 09/14/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE Fetal cardiotocography is the most common method to assess fetal well-being during labor. Nevertheless, its predictive ability for acidemia is limited, both in low-risk and high-risk pregnancies (Nelson et al. in N Engl J Med 334: 613-9, 1996; Rinciples P et al. in Health and Human Development Workshop Report on Electronic Fetal Monitoring : Update on Definitions. no. 2007, 510-515, 2008), especially in high-risk pregnancies, such as those complicated by growth restriction. In this study we aim examine the association between deceleration and acceleration areas and other measure of fetal heart rate in intrapartum fetal monitoring and neonatal arterial cord blood pH in pregnancies complicated by growth restriction. MATERIALS AND METHODS A retrospective cohort study of 100 deliveries complicated by growth restriction, delivered during 2018, was conducted. Known major fetal anomalies, non-vertex presentation and elective cesarean deliveries were excluded. Total deceleration and acceleration areas were calculated as the sum of the areas within the deceleration and acceleration, respectively. RESULTS In deliveries complicated by growth restriction, cord blood pH is significantly associated with total deceleration area (p = 0.05) and correlates with cumulative duration of the decelerations (Spearman's rank -0.363, p < 0.05), and total acceleration area (-0.358, p < 0.05). By comparing the cord blood pH in deliveries with a total deceleration area that was above and below the median total deceleration area, we demonstrated a significant difference between the categories. CONCLUSIONS Cord blood pH significantly correlates with total deceleration area and other fetal monitoring characteristics in neonates with growth restriction. Future studies using real-time, machine-learning based techniques of fetal heart rate monitoring, may provide population specific threshold values that will support bedside clinical decision making and perhaps achieve better outcomes.
Collapse
Affiliation(s)
- Neta Geva
- Department of Neonatology, Ben-Gurion University of the Negev Faculty of Health Sciences, Sheril and Hain Saban Children Hospital, Soroka Medical Center, Beer-Sheva, Israel.
| | - Yael Geva
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Lior Katz
- Pediatric Division, Rambam Health Care Campus, Haifa, Israel
| | - Yair Binyamin
- Department of Anesthesiology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Reut Rotem
- Division of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel
| | - Adi Yehuda Weintraub
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shimrit Yaniv Salem
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| |
Collapse
|
2
|
Mansor E, Ahmad N, Mohd Zulkefli NA, Lim PY. Incidence and determinants of low birth weight in Peninsular Malaysia: A multicentre prospective cohort study. PLoS One 2024; 19:e0306387. [PMID: 38995940 PMCID: PMC11244833 DOI: 10.1371/journal.pone.0306387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/17/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Pregnant mothers are at risk of many adverse pregnancy outcomes, including infants with low birth weight (LBW). The World Health Organization aimed to achieve a 30% reduction in the number of LBW infants by the year 2025. In this study, we aimed to determine the incidence and determinants of LBW infants among pregnant mothers attending government health clinics in Peninsular Malaysia. MATERIAL AND METHODS A prospective cohort study "Relative Risk of Determinants of Adverse Pregnancy Outcomes Among Pregnant Mothers Attending Government Health Clinics, Peninsular Malaysia, PEN-MUM" was conducted from March 2022 until March 2023 at 20 government health clinics in Peninsular Malaysia that were randomly selected through a multistage sampling method. Malaysian pregnant mothers between 18 and 49 years old were recruited at 12-18 weeks of gestation and followed up at three time points: 1 (24-28 weeks of gestation), 2 (36-40 weeks of gestation), and 3 (post-delivery). Eight exposure factors of LBW were studied: gestational weight gain, dengue infection, urinary tract infection, COVID-19 infection, gestational hypertension, preeclampsia, maternal anemia, and gestational diabetes mellitus (GDM). RESULTS Among 507 participants enrolled in the cohort, 40 were lost to follow-up. A total of 467 were included in the final analysis, giving an attrition rate of 7.9%. The incidence of LBW infants in Peninsular Malaysia was 14.3%. After adjusting for three covariates (ethnicity, employment status, and gestational age at birth), three determinants of LBW were identified. The risk of giving birth to LBW infants was higher among those with inadequate gestational weight gain (aRR = 2.86, 95% CI: 1.12, 7.37, p = 0.03), gestational hypertension (aRR = 4.12; 95% CI: 1.66, 10.43; p = 0.002), and GDM (aRR = 2.21; 95% CI: 1.18, 4.14; p = 0.013) during the second and third trimesters. CONCLUSIONS The incidence of LBW infants in Peninsular Malaysia can be considered high. Having inadequate gestational weight gain, gestational hypertension, and GDM in the second and third trimesters increased the risk of LBW infants by threefold, fivefold, and twofold respectively. Thus, intervention strategies should target prevention, early detection, and treatment of gestational hypertension and GDM, as well as promoting adequate weight gain during antenatal care.
Collapse
Affiliation(s)
- Elliza Mansor
- Ministry of Health, Putrajaya, Malaysia
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| |
Collapse
|
3
|
Wang L, Zhang C, Di J, Wang Q, Ren M, Huang A, Chen S, Zhao W, Hu H, Wang A, Di Q, Ji JS, Liang W, Huang C. Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 931:172730. [PMID: 38663596 DOI: 10.1016/j.scitotenv.2024.172730] [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: 12/22/2023] [Revised: 04/07/2024] [Accepted: 04/22/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Heat exposure during pregnancy can increase the risk of preterm birth (PTB) through a range of potential mechanisms including pregnancy complications, hormone secretion and infections. However, current research mainly focuses on the effect of heat exposure on pathophysiological pathways of pregnant women, but ignore that maternal heat exposure can also cause physiological changes to the fetus, which will affect the risk of PTB. OBJECTIVE In this study, we aimed to explore the mediating role of fetal heart rate (FHR) in the relationship between maternal heat exposure and PTB incidence. METHODS We assigned heat exposure to a multi-center birth cohort in China during 2015-2018, which included all 162,407 singleton live births with several times FHR measurements during the second and third trimesters. We examined the associations between heat exposure, FHR and PTB in the entire pregnancy, each trimester and the last gestational month. The inverse odds ratio-weighted approach applied to the Cox regression was used to identify the mediation effect of heat exposure on PTB and its clinical subtypes via FHR. FINDINGS Exposure to heat significantly increased the risk of PTB during the third trimester and the entire pregnancy, hazard ratios and 95 % CIs were 1.266 (1.161, 1.379) and 1.328 (1.218, 1.447). Heat exposure during the third trimester and entire pregnancy increased FHR in the third trimester by 0.24 bpm and 0.14 bpm. The proportion of heat exposure mediated by FHR elevation on PTB and its subtype ranged from 3.68 % to 24.06 %, with the significant mediation effect found for both medically indicated PTB and spontaneous PTB. CONCLUSIONS This study suggests that heat exposure during pregnancy has an important impact on fetal health, and FHR, as a surrogate marker of fetal physiology, may mediate the increased risk of PTB caused by extreme heat. Monitoring and managing physiological changes in the fetus would constitute a promising avenue to reduce adverse birth outcomes associated with maternal heat exposure.
Collapse
Affiliation(s)
- Liyun Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chunying Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Aiqun Huang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sidi Chen
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanqing Hu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
| |
Collapse
|
4
|
Wu P, Wang J, Ji X, Chai J, Chen L, Zhang T, Long X, Tu Z, Chen S, Zhang L, Wang K, Zhang L, Guo Z, Wang J. Maternal Hypermethylated Genes Contribute to Intrauterine Growth Retardation of Piglets in Rongchang Pigs. Int J Mol Sci 2024; 25:6462. [PMID: 38928167 PMCID: PMC11203632 DOI: 10.3390/ijms25126462] [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: 04/16/2024] [Revised: 06/04/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
The placenta is a crucial determinant of fetal survival, growth, and development. Deficiency in placental development directly causes intrauterine growth retardation (IUGR). IUGR can lead to fetal growth restriction and an increase in the mortality rate. The genetic mechanisms underlying IUGR development, however, remain unclear. In the present study, we integrated whole-genome DNA methylation and transcriptomic analyses to determine distinct gene expression patterns in various placental tissues to identify pivotal genes that are implicated with IUGR development. By performing RNA-sequencing analysis, 1487 differentially expressed genes (DEGs), with 737 upregulated and 750 downregulated genes, were identified in IUGR pigs (H_IUGR) compared with that in normal birth weight pigs (N_IUGR) (p < 0.05); furthermore, 77 miRNAs, 1331 lncRNAs, and 61 circRNAs were differentially expressed. The protein-protein interaction network analysis revealed that among these DEGs, the genes GNGT1, ANXA1, and CDC20 related to cellular developmental processes and blood vessel development were the key genes associated with the development of IUGR. A total of 495,870 differentially methylated regions were identified between the N_IUGR and H_IUGR groups, which included 25,053 differentially methylated genes (DMEs); moreover, the overall methylation level was higher in the H_IUGR group than in the N_IUGR group. Combined analysis showed an inverse correlation between methylation levels and gene expression. A total of 1375 genes involved in developmental processes, tissue development, and immune system regulation exhibited methylation differences in gene expression levels in the promoter regions and gene ontology regions. Five genes, namely, ANXA1, ADM, NRP2, SHH, and SMAD1, with high methylation levels were identified as potential contributors to IUGR development. These findings provide valuable insights that DNA methylation plays a crucial role in the epigenetic regulation of gene expression and mammalian development and that DNA-hypermethylated genes contribute to IUGR development in Rongchang pigs.
Collapse
Affiliation(s)
- Pingxian Wu
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| | - Junge Wang
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Xiang Ji
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Jie Chai
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| | - Li Chen
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| | - Tinghuan Zhang
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
| | - Xi Long
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| | - Zhi Tu
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| | - Siqing Chen
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
| | - Lijuan Zhang
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
| | - Ketian Wang
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
| | - Liang Zhang
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
| | - Zongyi Guo
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| | - Jinyong Wang
- Chongqing Academy of Animal Sciences, Rongchang, Chongqing 402460, China (S.C.)
- National Center of Technology Innovation for Pigs, Rongchang, Chongqing 402460, China
- Chongqing Modern Agricultural Industry Technology System, Chongqing 401120, China
| |
Collapse
|
5
|
Tang M, Xin Y, Zhao Y, Zhang X, Zhang M, Sun D, Zhu X, Yao Y, Fei W, Zheng C. Placenta-anchored tadalafil liposomes rescues intrauterine growth restriction through continuous placental blood perfusion improvement. J Control Release 2024; 368:466-480. [PMID: 38452820 DOI: 10.1016/j.jconrel.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
Physiological or pathological hypoperfusion of the placenta is one of the main causes of intrauterine growth restriction (IUGR) which poses a significant risk to the health of the fetus and newborn. Tadalafil, a 5-type phosphodiesterase inhibitor, has previously been found to improve the symptoms of IUGR in various clinical studies. Unfortunately, its clinical utility is hindered by its limited water solubility, rapid metabolism, and lack of specific distribution in target tissues rendering tadalafil unable to maintain long-term placental perfusion. In this study, iRGD-modified tadalafil-loaded liposomes (iRGD-lipo@Tad) featuring a size of approximately 480 nm were designed to rectify the shortcomings of tadalafil. The prepared iRGD-lipo@Tad exhibited superior stability, sustained drug release capacity, and low cytotoxicity. The fluorescence study, tissue slice study, and drug biodistribution study together demonstrated the placenta-anchored ability of iRGD-modified liposomes. This was achieved by a dual approach consisting of the iRGD-mediated placenta-targeting effect and special particle size-mediated placenta resident effect. The pharmacokinetic study revealed a significant improvement in the in vivo process of tadalafil encapsulated by the iRGD-modified liposomes. In comparison to the tadalafil solution, the peak plasma concentration of iRGD-lipo@Tad was significantly increased, and the area under the curve was increased by about 7.88 times. In the pharmacodynamic study, iRGD-lipo@Tad achieved a continuous and efficient improvement of placental blood perfusion. This was achieved by decreasing the ratio of plasma soluble fms-like tyrosine kinase to placental growth factor and increasing the levels of cyclic guanosine monophosphate and nitric oxide. Consequently, iRGD-lipo@Tad resulted in a significant increase in embryo weight and a reduction in the miscarriage rate of N-Nitro-L-arginine methyl ester-induced IUGR pregnant mice without detectable toxicity. In summary, the nanotechnology-assisted therapy strategy presented here not only overcomes the limitations of tadalafil in the clinical treatment of IUGR but also offers new avenues to address the treatment of other placenta-originated diseases.
Collapse
Affiliation(s)
- Miao Tang
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310014, China
| | - Yu Xin
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; Research Center for Clinical Pharmacy, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yunchun Zhao
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Xiao Zhang
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Meng Zhang
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Dongli Sun
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Xiaojun Zhu
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Yao Yao
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Weidong Fei
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
| | - Caihong Zheng
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; Research Center for Clinical Pharmacy, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China.
| |
Collapse
|
6
|
Zhou HL, Jiang XZ, Ventikos Y. Role of blood flow in endothelial functionality: a review. Front Cell Dev Biol 2023; 11:1259280. [PMID: 37905167 PMCID: PMC10613523 DOI: 10.3389/fcell.2023.1259280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
Endothelial cells, located on the surface of blood vessel walls, are constantly stimulated by mechanical forces from the blood flow. The mechanical forces, i.e., fluid shear stress, induced by the blood flow play a pivotal role in controlling multiple physiological processes at the endothelium and in regulating various pathways that maintain homeostasis and vascular function. In this review, research looking at different blood fluid patterns and fluid shear stress in the circulation system is summarized, together with the interactions between the blood flow and the endothelial cells. This review also highlights the flow profile as a response to the configurational changes of the endothelial glycocalyx, which is less revisited in previous reviews. The role of endothelial glycocalyx in maintaining endothelium health and the strategies for the restoration of damaged endothelial glycocalyx are discussed from the perspective of the fluid shear stress. This review provides a new perspective regarding our understanding of the role that blood flow plays in regulating endothelial functionality.
Collapse
Affiliation(s)
- Hui Lin Zhou
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
| | - Xi Zhuo Jiang
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
| | - Yiannis Ventikos
- Department of Mechanical Engineering, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
7
|
Meier K, Glavind J, Milidou I, Sørensen JCH, Sandager P. Burst Spinal Cord Stimulation in Pregnancy: First Clinical Experiences. Neuromodulation 2023; 26:224-232. [PMID: 35697598 DOI: 10.1016/j.neurom.2022.03.008] [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: 11/23/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Spinal cord stimulation (SCS) is a treatment for chronic neuropathic pain. It is based on the delivery of electric impulses to the spinal cord, traditionally in a regular square-wave pattern ("tonic" stimulation) and, more recently, in a rhythmic train-of-five "BurstDR" pattern. The safety of active SCS therapy in pregnancy is not established, and recommendations are based on limited casuistic evidence. We present in this study clinical data on a case series of six women treated with burst SCS during pregnancy. In addition, we present the ultrasonographic flow measurements of fetal and uteroplacental blood flow in a pregnant patient. MATERIALS AND METHODS Patients were included if they had been implanted with a full SCS system at Aarhus University Hospital, Denmark, between 2006 and 2020 and received active burst SCS stimulation during a pregnancy. Telephone interviews were conducted, including details on SCS therapy, medication, pregnancy course and outcome, and health status of the offspring. In one patient, the uteroplacental and fetal blood flow was assessed in gestational week 29 by Doppler flow measurements performed during both ON and OFF phases of the SCS system. RESULTS Six patients were included with a total of 11 pregnancies. Three pregnancies ended in miscarriages, all in the same patient who had preexisting significant risk factors for miscarriage. Eight resulted in a live-born child with normal birth weight for gestational age; seven were born at term, and one was born late preterm, in gestational week 36. Ultrasonographic Doppler flow, measured in one patient, was normal and did not reveal any immediate changes between burst SCS ON and OFF. Seven children were reported healthy with normal neurodevelopment and one physically healthy but with developmental delays. CONCLUSIONS The data presented in this study add to the accumulating evidence of the safety of SCS in pregnancy.
Collapse
Affiliation(s)
- Kaare Meier
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark; Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark; Center for Experimental Neuroscience, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Julie Glavind
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Ioanna Milidou
- Department of Pediatrics and Adolescent Medicine, Regional Hospital West Jutland, Herning, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Christian Hedemann Sørensen
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark; Center for Experimental Neuroscience, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Puk Sandager
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark; Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
8
|
Wang YN, Ye Y, Zhou D, Guo ZW, Xiong Z, Gong XX, Jiang SW, Chen H. The Role of Syncytin in Placental Angiogenesis and Fetal Growth. Front Cell Dev Biol 2022; 10:852561. [PMID: 35493107 PMCID: PMC9039138 DOI: 10.3389/fcell.2022.852561] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/10/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Syncytin, a retroviral envelope protein, is specifically expressed on trophoblast cells and mediates formation of the syncytiotrophoblast through fusogenic activity. Decreased expression of Syncytin was found in fetal growth restriction placentas. Results: By generating an inducible knockout of the syncytin-a gene in mice, we show a specific disruption of placental angiogenesis with abnormal formation of two syncytiotrophoblast layers. Consistent with the defects observed in vivo, conditioned medium collected from trophoblast cells, following Syncytin-1 knockdown, contains lower expression of vascular endothelial growth factor and placental growth factor, and higher levels of soluble fms-like protein kinase-1 in BeWo and HTR-8/SVneo cells which related with suppressed PI3K/Akt/mTOR pathway, and is reduced in ability to induce tube formation by HUVECs. Conclusion: Syncytin participates in angiogenesis during placental development was first identified both in vivo and in vitro. Here, we give a new sight on understanding syncytin and pathophysiology of placenta related disease such as fetal growth restriction.
Collapse
Affiliation(s)
- Ya-Nan Wang
- Department of Histology and Embryology, Shantou University Medical College, Shantou, China
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yixin Ye
- Department of Histology and Embryology, Shantou University Medical College, Shantou, China
| | - Da Zhou
- Department of Histology and Embryology, Shantou University Medical College, Shantou, China
| | - Ze-Wen Guo
- Department of Obstetrics and Gynecology, Shantou Central Hospital, Shantou, China
| | - Zhelei Xiong
- Department of Histology and Embryology, Shantou University Medical College, Shantou, China
| | - Xing-Xing Gong
- Department of Histology and Embryology, Shantou University Medical College, Shantou, China
| | - Shi-Wen Jiang
- Center of Reproductive Medicine, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, China
| | - Haibin Chen
- Department of Histology and Embryology, Shantou University Medical College, Shantou, China
| |
Collapse
|
9
|
Sutovska H, Babarikova K, Zeman M, Molcan L. Prenatal Hypoxia Affects Foetal Cardiovascular Regulatory Mechanisms in a Sex- and Circadian-Dependent Manner: A Review. Int J Mol Sci 2022; 23:2885. [PMID: 35270026 PMCID: PMC8910900 DOI: 10.3390/ijms23052885] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/17/2022] Open
Abstract
Prenatal hypoxia during the prenatal period can interfere with the developmental trajectory and lead to developing hypertension in adulthood. Prenatal hypoxia is often associated with intrauterine growth restriction that interferes with metabolism and can lead to multilevel changes. Therefore, we analysed the effects of prenatal hypoxia predominantly not associated with intrauterine growth restriction using publications up to September 2021. We focused on: (1) The response of cardiovascular regulatory mechanisms, such as the chemoreflex, adenosine, nitric oxide, and angiotensin II on prenatal hypoxia. (2) The role of the placenta in causing and attenuating the effects of hypoxia. (3) Environmental conditions and the mother's health contribution to the development of prenatal hypoxia. (4) The sex-dependent effects of prenatal hypoxia on cardiovascular regulatory mechanisms and the connection between hypoxia-inducible factors and circadian variability. We identified that the possible relationship between the effects of prenatal hypoxia on the cardiovascular regulatory mechanism may vary depending on circadian variability and phase of the days. In summary, even short-term prenatal hypoxia significantly affects cardiovascular regulatory mechanisms and programs hypertension in adulthood, while prenatal programming effects are not only dependent on the critical period, and sensitivity can change within circadian oscillations.
Collapse
Affiliation(s)
| | | | - Michal Zeman
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University, 842 15 Bratislava, Slovakia; (H.S.); (K.B.); (L.M.)
| | | |
Collapse
|
10
|
Nociceptin Increases Antioxidant Expression in the Kidney, Liver and Brain of Diabetic Rats. BIOLOGY 2021; 10:biology10070621. [PMID: 34356475 PMCID: PMC8301093 DOI: 10.3390/biology10070621] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/30/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023]
Abstract
Simple Summary Nociceptin (NC) is a small peptide implicated in the physiology of pain, learning and memory. Here we investigated the role of NC in the induction of antioxidants in the kidney, liver, and the brain of diabetic rats using morphological and biochemical methods. Normal and diabetic animals were treated with NC for 5 days. Catalase (CAT) was expressed in the kidney, liver, and the neurons of the brain. Although CAT was markedly (p < 0.05) lower in the tubules of the kidney of normal and diabetic animals after NC treatment, NC significantly (p < 0.001) increased the presence of CAT in the liver and brain of diabetic rats. Superoxide dismutase (SOD) was observed in kidney tubules, hepatocytes, and neurons of the brain. Treatment with NC markedly (p < 0.001) increased the level of SOD in hepatocytes and neurons of the brain. Glutathione reductase (GRED) was seen in the convoluted tubules of the kidney, hepatocytes and neurons of the brain. Treatment with NC markedly increased (p < 0.001) the expression of GRED in kidney tubules, hepatocytes and neurons of the brain. In conclusion, NC can help diabetic patients mitigate the effects of oxidative stress by its ability to induce endogenous antioxidants. Abstract Nociceptin (NC) consists of 17 amino acids (aa) and takes part in the processing of learning and memory. The role of NC in the induction of endogenous antioxidants in still unclear. We examined the effect of NC on the expression of endogenous antioxidants in kidney, liver, cerebral cortex (CC), and hippocampus after the onset of diabetes mellitus, using enzyme-linked immunosorbent assay and immunohistochemistry. Exogenous NC (aa chain 1–17; 10 µg/kg body weight) was given intraperitoneally to normal and diabetic rats for 5 days. Our results showed that catalase (CAT) is present in the proximal (PCT) and distal (DCT) convoluted tubules of kidney, hepatocytes, and neurons of CC and hippocampus. The expression of CAT was significantly (p < 0.05) reduced in the kidney of normal and diabetic rats after treatment with NC. However, NC markedly (p < 0.001) increased the expression CAT in the liver and neurons of CC of diabetic rats. Superoxide dismutase (SOD) is widely distributed in the PCT and DCT of kidney, hepatocytes, and neurons of CC and hippocampus. NC significantly (p < 0.001) increased the expression of SOD in hepatocytes and neurons of CC and the hippocampus but not in the kidney. Glutathione reductase (GRED) was observed in kidney tubules, hepatocytes and neurons of the brain. NC markedly increased (p < 0.001) the expression of GRED in PCT and DCT cells of the kidney and hepatocytes of liver and neurons of CC. In conclusion, NC is a strong inducer of CAT, SOD, and GRED expression in the kidney, liver and brain of diabetic rats.
Collapse
|