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D'Agostin M, Di Sipio Morgia C, Vento G, Nobile S. Long-term implications of fetal growth restriction. World J Clin Cases 2023; 11:2855-2863. [PMID: 37215406 PMCID: PMC10198075 DOI: 10.12998/wjcc.v11.i13.2855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/08/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
Fetal growth restriction (FGR), or intrauterine growth restriction (IUGR), is a complication of pregnancy where the fetus does not achieve its genetic growth potential. FGR is characterized by a pathological retardation of intrauterine growth velocity in the curve of intrauterine growth. However, the FGR definition is still debated, and there is a lack of a uniform definition in the literature. True IUGR, compared to constitutional smallness, is a pathological condition in which the placenta fails to deliver an adequate supply of oxygen and nutrients to the developing fetus. Infants with IUGR, compared to appropriately grown gestational age infants, have a significantly higher risk of mortality and neonatal complications with long-term consequences. Several studies have demonstrated how suboptimal fetal growth leads to long-lasting physiological alterations for the developing fetus as well as for the newborn and adult in the future. The long-term effects of fetal growth retardation may be adaptations to poor oxygen and nutrient supply that are effective in the fetal period but deleterious in the long term through structural or functional alterations. Epidemiologic studies showed that FGR could be a contributing factor for adult chronic diseases including cardiovascular disease, metabolic syndrome, diabetes, respiratory diseases and impaired lung function, and chronic kidney disease. In this review we discussed pathophysiologic mechanisms of FGR-related complications and potential preventive measures for FGR.
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Affiliation(s)
- Martina D'Agostin
- Department of Pediatrics, University of Trieste, Trieste 34100, Italy
| | - Chiara Di Sipio Morgia
- Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 000168, Italy
| | - Stefano Nobile
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 000168, Italy
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Tandra M, Walters EH, Perret J, Lowe AJ, Lodge CJ, Johns DP, Thomas PS, Bowatte G, Davis PG, Abramson MJ, Dharmage SC, Bui DS. Small for gestational age is associated with reduced lung function in middle age: A prospective study from first to fifth decade of life. Respirology 2023; 28:159-165. [PMID: 36197802 PMCID: PMC10947040 DOI: 10.1111/resp.14379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/05/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The association between birth weight, particularly relative to gestational age, and adult lung function is uncertain. We investigated the associations between birth weight relative to gestational age and measures of lung function in middle age, and mediation of these associations by adult height. METHODS Participants in the Tasmanian Longitudinal Health Study who had both known birth weight and lung function assessment at age 45 years were included (n = 849). Linear regression models were fitted to investigate the association between small for gestational age and birth weight with post-bronchodilator lung function measures (forced expiratory volume in 1 second [FEV1 ], forced vital capacity [FVC], FEV1 /FVC, diffusing capacity for carbon monoxide [DL co], residual volume [RV] and total lung capacity [TLC]), adjusting for potential confounders. The contribution of adult height as a mediator of these associations was investigated. RESULTS Compared with infants born with normal weight for gestational age, those born small for gestational age had reduced FEV1 (coefficient: -191 ml [95%CI: -296, -87]), FVC (-205 ml [-330, -81]), TLC (-292 ml [-492, -92]), RV (-126 ml [-253, 0]) and DL co (-0.42 mmol/min/kPa [-0.79, -0.041]) at age 45 years. However, they had comparable FEV1 /FVC. For every 1 kg increase in birth weight, lung function indices increased by an average of 117 ml (95%CI: 40, 196) for FEV1 , 124 ml (30, 218) for FVC, 215 ml (66, 365) for TLC and 0.36 mmol/min/kPa (0.11, 0.62) for DL co, independent of gestational age, but again not for FEV1 /FVC. These associations were significantly mediated by adult height (56%-90%). CONCLUSION Small for gestational age was associated with reduced lung function that is likely due to smaller lungs with little evidence of any specific parenchymal impairment.
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Affiliation(s)
- Melvin Tandra
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - E. Haydn Walters
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- School of Medicine and Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Jennifer Perret
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Adrian J. Lowe
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - David P. Johns
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- School of Medicine and Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Paul S. Thomas
- Inflammation and Infection Research, Faculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Gayan Bowatte
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- Department of Basic Sciences, Faculty of Allied Health SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
| | - Peter G. Davis
- Department of Obstetrics and GynaecologyUniversity of MelbourneMelbourneVictoriaAustralia
- Department of Newborn ResearchThe Royal Women's HospitalMelbourneVictoriaAustralia
| | - Michael J. Abramson
- School of Public Health & Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Dinh S. Bui
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
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Peles G, Paz-Levy D, Wainstock T, Goldbart A, Kluwgant D, Sheiner E. Pediatric respiratory hospitalizations in small for gestational age neonates born at term. Pediatr Pulmonol 2022; 57:754-760. [PMID: 34931470 DOI: 10.1002/ppul.25797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/03/2021] [Accepted: 12/13/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study investigates the risk for long-term respiratory hospitalizations of offspring born small for gestational age (SGA) at term. STUDY DESIGN A retrospective population-based cohort analysis was performed to examine the risk of long-term respiratory hospitalizations between SGA compared to appropriate for gestational age (AGA) newborns. The analysis included all term singleton deliveries occurring between 1991 and 2014 at a single tertiary medical center. Fetuses with congenital malformations, multiple gestation, cases of perinatal mortality and large for gestational age (LGA) were excluded. A Kaplan-Meier survival curve was used to compare cumulative morbidity incidence up to the age of 18 years, and a Cox hazards regression model was used to control for confounders. RESULTS During the study period 216,671 deliveries met the inclusion criteria; of them 4.8% (n = 10,450) were diagnosed as SGA neonates. During the follow-up period, the rate of hospitalization due to respiratory morbidity was significantly higher in the SGA group as compared to the AGA group (5.2% vs. 4.7%, OR = 1.13, 95% confidence interval [CI] = 1.03-1.24, p = 0.011). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of respiratory morbidity in the SGA group (log-rank p = 0.026). In the Cox hazards regression model, controlled for relevant clinical confounders, SGA was found to be an independent risk factor for long-term pediatric respiratory morbidity (adjusted hazard ratio [HR] = 1.1, 95% CI = 1.001-1.19, p = 0.049). CONCLUSION Being delivered SGA at term is an independent long-term risk factor for pediatric respiratory hospitalization.
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Affiliation(s)
- Galia Peles
- Department of Obstetrics and Gynecology, Joyce and Irving Goldman Medical School, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dorit Paz-Levy
- Department of Obstetrics and Gynecology, Joyce and Irving Goldman Medical School, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviv Goldbart
- Department of Pediatrics, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dvora Kluwgant
- Department of Obstetrics and Gynecology, Joyce and Irving Goldman Medical School, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Joyce and Irving Goldman Medical School, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Sakic A, Ekström M, Sharma S, Nilsson PM. Can birth weight predict offspring's lung function in adult age? Evidence from two Swedish birth cohorts. Respir Res 2022; 23:348. [PMID: 36522741 PMCID: PMC9753232 DOI: 10.1186/s12931-022-02269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Associations between birth weight (BW) and adult lung function have been inconsistent and limited to early adulthood. We aimed to study this association in two population-based cohorts and explore if BW, adjusted for gestational age, predicts adult lung function. We also tested adult lung function impairment according to the mis-match hypothesis-small babies growing big as adults. METHODS We included 3495 individuals (aged 46.4 ± 5.4 years) from the Malmo Preventive Project (MPP), Sweden, born between 1921 and 1949, and 1401 young to middle-aged individuals (aged 28.6 ± 6.7 years) from the Malmo Offspring Study (MOS) with complete data on BW and gestational age. Adult lung function (forced vital capacity [FVC], forced expiratory volume in one second [FEV1] and the FEV1/FVC-ratio) were analysed as level of impairment (z-score), using multiple linear and logistic regressions. RESULTS BW (z-score) did not predict adult lung function in MPP, whereas BW was a significant (p = 0.003) predictor of FEV1 following full adjustment in MOS. For every additional unit increase in BW, children were 0.77 (95% CI 0.65-0.92) times less likely to have impaired adult lung function (FEV1). Moreover, adults born with lower BW (< 3510 g) showed improved lung function (FEV1 and FEV1/FVC in MOS and MPP, respectively) if they achieved higher adult body weight. CONCLUSIONS Adults born with lower birth weight, adjusted for gestational age, are more likely to have impaired lung function, seen in a younger birth cohort. Postnatal growth pattern may, however, compensate for low birth weight and contribute to better adult lung function.
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Affiliation(s)
- Aleksandra Sakic
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden
| | - Magnus Ekström
- grid.4514.40000 0001 0930 2361Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Shantanu Sharma
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden
| | - Peter M. Nilsson
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden ,grid.4514.40000 0001 0930 2361Department of Clinical Sciences, and Department of Internal Medicine, Lund University, Skåne University Hospital, Jan Waldenströms Gata 15, 5th floor, 20502 Malmö, Sweden
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Moradi B, Ghorbani Z, Shirazi M, Gity M, Kazemi MA, Sharifian H, Rahimi Sharbaf F. Comparison of fetal lung maturation in fetuses with intrauterine growth restriction with control group, using lung volume, lung/liver and lung/muscle signal intensity and apparent diffusion coefficient ratios on different magnetic resonance imaging sequences. J Matern Fetal Neonatal Med 2021; 35:8936-8944. [PMID: 34847801 DOI: 10.1080/14767058.2021.2008349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare lung volume, lung apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) on different magnetic resonance imaging (MRI) sequences between intrauterine growth restriction (IUGR) fetuses and the control group. MATERIALS AND METHODS 49 IUGR and 58 non-IUGR fetuses were imaged using 3 Tesla MRI units. Total lung volume (TLV), lung/liver SIR (LLSIR) and lung/muscle SIR (LMSIR) in T1 and T2-weighted sequences and lung/liver ADC ratio (LLADCR) and lung/muscle ADC ratio (LMADCR) were assessed. RESULTS LLSIR and LMSIR were significantly higher in the T1-weighted sequence (p-value: .03) and LLADCR and LMADCR were significantly lower on diffusion-weighted imaging (DWI) in IUGR fetuses compared to the control group (p-value: .01). There was no significant difference in SIRs in the T2-weighted sequence between the two groups. Although TLV was increased with gestational age in both groups, it was significantly lower in the IUGR group (mean: 82 ± 22.7 ml vs. 110.8 ± 18 ml, p-value: <.001). CONCLUSION The T1-weighted sequence and DWI seem to be better than the T2-weighted sequence for assessing the faint difference of lung maturity between groups. However, SIR differences were not as meaningful as TLV differences and this could be related to the complex maturation process in IUGR fetuses as the effect of higher endogenous corticosteroids.
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Affiliation(s)
- Behnaz Moradi
- Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohre Ghorbani
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Shirazi
- Maternal, Fetal and Neonatal Research Center, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Gity
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Kazemi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.,Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rahimi Sharbaf
- Maternal, Fetal and Neonatal Research Center, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Bauer SE, Vanderpool CPB, Ren C, Cristea AI. Nutrition and growth in infants with established bronchopulmonary dysplasia. Pediatr Pulmonol 2021; 56:3557-3562. [PMID: 34415681 DOI: 10.1002/ppul.25638] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 07/06/2021] [Accepted: 08/17/2021] [Indexed: 12/23/2022]
Abstract
Bronchopulmonary dysplasia (BPD) remains the most common late morbidity of preterm birth. Ongoing clinical care and research have largely focused on the pathogenesis and prevention of BPD in preterm infants. However, preterm infants who develop BPD have significant medical needs that persist throughout their neonatal intensive care unit course and continue post-discharge, including those associated with growth and nutrition. The objective of this manuscript was to provide a review on nutrition and growth in infants with established BPD after discharge from the hospital and to identify the knowledge and research gaps to provide direction for future studies.
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Affiliation(s)
- Sarah E Bauer
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | | | - Clement Ren
- Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Aura Ioana Cristea
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
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Endothelial Progenitor Cells Dysfunctions and Cardiometabolic Disorders: From Mechanisms to Therapeutic Approaches. Int J Mol Sci 2021; 22:ijms22136667. [PMID: 34206404 PMCID: PMC8267891 DOI: 10.3390/ijms22136667] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 12/12/2022] Open
Abstract
Metabolic syndrome (MetS) is a cluster of several disorders, such as hypertension, central obesity, dyslipidemia, hyperglycemia, insulin resistance and non-alcoholic fatty liver disease. Despite health policies based on the promotion of physical exercise, the reduction of calorie intake and the consumption of healthy food, there is still a global rise in the incidence and prevalence of MetS in the world. This phenomenon can partly be explained by the fact that adverse events in the perinatal period can increase the susceptibility to develop cardiometabolic diseases in adulthood. Individuals born after intrauterine growth restriction (IUGR) are particularly at risk of developing cardiovascular diseases (CVD) and metabolic disorders later in life. It has been shown that alterations in the structural and functional integrity of the endothelium can lead to the development of cardiometabolic diseases. The endothelial progenitor cells (EPCs) are circulating components of the endothelium playing a major role in vascular homeostasis. An association has been found between the maintenance of endothelial structure and function by EPCs and their ability to differentiate and repair damaged endothelial tissue. In this narrative review, we explore the alterations of EPCs observed in individuals with cardiometabolic disorders, describe some mechanisms related to such dysfunction and propose some therapeutical approaches to reverse the EPCs dysfunction.
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Comparison of maternal and neonatal outcomes between acute fatty liver of pregnancy and hemolysis, elevated liver enzymes and low platelets syndrome: a retrospective cohort study. BMC Pregnancy Childbirth 2021; 21:293. [PMID: 33845770 PMCID: PMC8042922 DOI: 10.1186/s12884-021-03761-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/30/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are two uncommon disorders that mimic each other clinically, but are distinct pathophysiologically. This study aimed to compare maternal and neonatal outcomes between AFLP and HELLP syndrome. METHODS This retrospective cohort study was performed at a tertiary referral center in Taiwan between June 2004 and April 2020. We used the Swansea Criteria to diagnose AFLP, and the Tennessee Classification System to diagnose HELLP syndrome. Maternal characteristics, laboratory data, complications, and neonatal outcomes were compared. We analyzed the categorical variables with Chi-square test or Fisher's exact test and continuous variables with Student's t test or Mann-Whitney U test. Subsequent logistic regression analyses adjusting by potential confounding factors with significant difference were analyzed. RESULTS During the study period, 21 women had AFLP and 80 women had HELLP syndrome. There was a higher rate of preeclampsia (95.0 % versus 23.8 %) in the HELLP syndrome group compared to the AFLP group. However, the AFLP group had more other maternal complications including jaundice (85.7 % versus 13.8 %), acute kidney injury (61.9 % versus 15.0 %), disseminated intravascular coagulopathy (66.7 % versus 8.8 %), and sepsis (47.6 % versus 10.0 %) compared to the HELLP syndrome group. Nevertheless, higher rates of small for gestational age neonates (57.1 % versus 33.3 %), neonatal respiratory distress syndrome (39.2 % versus 8.3 %) and neonatal sepsis (34.2 % versus 12.5 %) were noted in the HELLP syndrome group. CONCLUSIONS AFLP is associated with a higher rate of multiple organ dysfunction in mothers, whereas HELLP syndrome is associated with a higher rate of neonatal morbidity.
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Yang L, Sato M, Saito-Abe M, Irahara M, Nishizato M, Sasaki H, Konishi M, Ishitsuka K, Mezawa H, Yamamoto-Hanada K, Matsumoto K, Ohya Y. Association of Hemoglobin and Hematocrit Levels during Pregnancy and Maternal Dietary Iron Intake with Allergic Diseases in Children: The Japan Environment and Children's Study (JECS). Nutrients 2021; 13:nu13030810. [PMID: 33804474 PMCID: PMC7999127 DOI: 10.3390/nu13030810] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/20/2021] [Accepted: 02/24/2021] [Indexed: 12/21/2022] Open
Abstract
Few epidemiologic studies have examined the role of maternal iron status in allergic diseases in offspring and findings have been inconsistent. We used a large birth cohort in Japan to explore the association of the markers for maternal iron status (maternal hemoglobin, hematocrit and dietary iron intake during pregnancy) with allergy development in offspring during early childhood. We analyzed information on children age 0–3 years from the Japan Environment and Children’s Study (JECS). We used logistic models and generalized estimating equation models to evaluate the effect of maternal hemoglobin and hematocrit levels and dietary iron intake on allergies in children. Models were also fitted with propensity score-matched datasets. Data were collected for a total of 91,247 mother–child pairs. The prevalence (95% confidence interval) of low hemoglobin and hematocrit was 14.0% (13.7–14.2%) and 12.5% (12.3–12.8%), respectively. After adjusting confounders, low hemoglobin and hematocrit during pregnancy were not associated with childhood allergic outcomes. Findings from models with propensity score-matched datasets also indicated that children born to mothers with low hemoglobin or hematocrit levels during pregnancy did not have a higher risk of developing allergic conditions at 3 years old. We found no meaningful associations between low energy adjusted maternal dietary iron intake and allergies in children. In conclusion, using birth cohort data, we found no evidence supporting an association of low maternal hemoglobin, hematocrit and low dietary iron intake with allergy symptoms during early childhood. Further studies with more suitable proxy markers for blood iron status are needed.
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Affiliation(s)
- Limin Yang
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
- Correspondence: ; Tel.: +81-3-3416-0181; Fax: +81-3-3416-2222
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Makoto Irahara
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Minaho Nishizato
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Hatoko Sasaki
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Mizuho Konishi
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Kazue Ishitsuka
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Hidetoshi Mezawa
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Kiwako Yamamoto-Hanada
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Kenji Matsumoto
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan; (M.S.); (M.S.-A.); (M.I.); (M.N.); (H.S.); (M.K.); (K.I.); (H.M.); (K.Y.-H.); (K.M.); (Y.O.)
- Medical Support Center for the Japan Environment and Children’s Study, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
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Johansson CJ, Nilsson PM, Ignell C. Early life exposures and risk of adult respiratory disease during 50 years of follow-up. Eur J Epidemiol 2020; 35:1157-1166. [PMID: 32270394 PMCID: PMC7762746 DOI: 10.1007/s10654-020-00626-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/27/2020] [Indexed: 11/24/2022]
Abstract
Adult health is influenced by factors during fetal life affecting organ development and birth weight. We aimed to study such factors in relation to adult respiratory disease (ARD) risk. The Helsingborg Birth Cohort, Sweden, contributed baseline data collected by medical staff through clinical examination and questionnaires on maternal and birth characteristics 1964-1967. Register linkages were performed with completions of data on ARD by ICD 8-10 classifications (1969-2016), and/or ARD-related drug usage (2005-2016) enabling a 50-year follow-up time. Cox proportional hazard regression analyses were made to adjust for potential confounders, adjusted hazard ratio (aHR). A total of 3675 mothers and their offspring were included. Female offspring showed higher frequency of ARD than males, aHR 1.5 (95% CI 1.3-1.8). Maternal use of sedatives during second trimester, aHR 2.2 (95% CI 1.4-3.4), and maternal smoking during most of pregnancy, aHR 1.2 (95% CI 1.0-1.4), were associated with offspring ARD. Stratified by sex, large-for-gestational-age, aHR 1.4 (95% CI 1.0-1.9), was significantly associated with ARD in female offspring along with maternal sedative use during second trimester and maternal smoking during most of pregnancy. Maternal sedative use during second trimester or all trimesters were the only significant risk factors for male offspring. In conclusion, maternal sedative use in second trimester was independently associated with subsequent respiratory disease in adult offspring irrespective of sex.
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Affiliation(s)
- Carl J Johansson
- Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences, Internal Medicine, Skane University Hospital, Lund University, Malmö, Sweden.
| | - Claes Ignell
- Department of Clinical Sciences, Internal Medicine, Skane University Hospital, Lund University, Malmö, Sweden
- Department of Obstetrics and Gynaecology, Helsingborg Hospital, Helsingborg, Sweden
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11
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Briana DD, Malamitsi‐Puchner A. Perinatal biomarkers implying 'Developmental Origins of Health and Disease' consequences in intrauterine growth restriction. Acta Paediatr 2020; 109:1317-1322. [PMID: 31577039 DOI: 10.1111/apa.15022] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/16/2019] [Indexed: 12/11/2022]
Abstract
The intrauterine-growth-restricted (IUGR) state, particularly the asymmetric one, has been associated with 'Developmental Origins of Health and Disease' (DOHaD) consequences later in life. Several environmental factors, acting during the phase of foetal developmental plasticity interact with genotypic variation, 'programme' tissue function and change the capacity of the organism to cope with its environment. They may be responsible for chronic illness risk in adulthood. Detection of possible future DOHaD consequences at a very early age, by applying relevant biomarkers, is of utmost importance. This review focuses on biomarkers possibly predicting consequences from bone, psychoneural system and lung. Although no concrete biomarker has been identified for bone disorders in adulthood, reduced brain-derived neurotrophic factor (BDNF) concentrations in cord blood and BDNF DNA methylation might predict schizophrenia and possibly depression, bipolar disorder and autism. High surfactant protein D (SP-D) concentrations in cord blood of IUGR foetuses/neonates could point to structural lung immaturity, resulting to asthma and chronic obstructive pulmonary disease in adult life.
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Affiliation(s)
- Despina D. Briana
- Medical School National and Kapodistrian University of Athens Athens Greece
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12
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Kim YH, Kim KW, Eun HS, Shin JE, Sol IS, Kim SY, Kim YS, Sohn MH, Namgung R. Small for gestational age birth may increase airflow limitation in bronchopulmonary dysplasia. Pediatr Pulmonol 2020; 55:346-353. [PMID: 31794162 DOI: 10.1002/ppul.24580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 11/10/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To determine significant indices for assessing the pulmonary function of infants according to bronchopulmonary dysplasia (BPD) severity and to evaluate whether small for gestational age (SGA) could affect pulmonary function in BPD. METHODS We evaluated 117 preterm infants who had undergone tidal breathing flow-volume loop and multiple-breath washout analyses within 7 months after birth. We categorized preterm infants according to BPD severity into mild/moderate BPD (n = 86), severe BPD (n = 21), and without BPD (n = 10) and the presence of SGA or appropriate gestational age (AGA) using the Fenton growth chart. We evaluated nine healthy term infants as controls. RESULTS The tidal breathing ratio (time to peak expiratory flow/expiratory time [tPEF /tE ]) was significantly lower in infants with severe BPD than in those with mild/moderate BPD. Lung clearance index (LCI) was not different based on BPD severity. In the correlation analysis after adjusting for gestational age and sex, tPEF /tE was correlated with the duration of mechanical ventilation (r = -0.347, P < .001) and the duration of oxygen supply (r = -0.248, P = .013) in infants with BPD. The proportion of "lower tPEF /tE ," defined as below the cut-off value, was greater in SGA infants (P = .017), while no significant difference was seen in the percentage of "higher LCI," defined as above the cut-off value between SGA and AGA infants. CONCLUSIONS In infants with BPD, tPEF /tE could be a useful pulmonary index which shows lower values in severe BPD. The finding of SGA in infants with BPD could be associated with poor pulmonary function related to the tPEF /tE values.
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Affiliation(s)
- Yoon Hee Kim
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Sun Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Division of Neonatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Division of Neonatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - In Suk Sol
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Yeon Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Suh Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Hyun Sohn
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ran Namgung
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.,Division of Neonatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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13
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Birth weight and prematurity with lung function at ~17.5 years: "Children of 1997" birth cohort. Sci Rep 2020; 10:341. [PMID: 31941940 PMCID: PMC6962201 DOI: 10.1038/s41598-019-56086-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 12/04/2019] [Indexed: 01/18/2023] Open
Abstract
We aimed to determine if prematurity and lower birth weight are associated with poorer lung function in a non-western developed setting with less marked confounding by socioeconomic position. Using multivariable linear regression in Hong Kong’s “Children of 1997” birth cohort, adjusted associations of prematurity and birth weight with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25–75% of the pulmonary volume (FEF25–75%) at ~17.5 years were assessed. Associations for birth weight were stronger in boys for FEV1 (boys: 0.31 L, 95% confidence interval (CI) 0.24 to 0.38, girls: 0.18 L, 95% CI 0.12 to 0.25), FVC (boys: 0.36 L, 95% CI 0.27 to 0.44, girls: 0.22 L, 95% CI 0.15 to 0.28) and FEF25–75% (boys: 0.35 L, 95% CI 0.21 to 0.49, girls: 0.22 L, 95% CI 0.09 to 0.34) adjusted for age, socioeconomic position and infant and maternal characteristics. Similarly adjusted, preterm birth (compared to full-term birth) was associated with lower FEV1/FVC and FEF25–75%. Thus, associations of lower birth weight, especially in boys, and prematurity with poorer lung function at 17.5 years were found. Identifying underlying mechanism might contribute to the improvement of pulmonary health and the prevention of adult respiratory illness.
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14
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Fandiño J, Toba L, González-Matías LC, Diz-Chaves Y, Mallo F. Perinatal Undernutrition, Metabolic Hormones, and Lung Development. Nutrients 2019; 11:nu11122870. [PMID: 31771174 PMCID: PMC6950278 DOI: 10.3390/nu11122870] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 02/06/2023] Open
Abstract
Maternal and perinatal undernutrition affects the lung development of litters and it may produce long-lasting alterations in respiratory health. This can be demonstrated using animal models and epidemiological studies. During pregnancy, maternal diet controls lung development by direct and indirect mechanisms. For sure, food intake and caloric restriction directly influence the whole body maturation and the lung. In addition, the maternal food intake during pregnancy controls mother, placenta, and fetal endocrine systems that regulate nutrient uptake and distribution to the fetus and pulmonary tissue development. There are several hormones involved in metabolic regulations, which may play an essential role in lung development during pregnancy. This review focuses on the effect of metabolic hormones in lung development and in how undernutrition alters the hormonal environment during pregnancy to disrupt normal lung maturation. We explore the role of GLP-1, ghrelin, and leptin, and also retinoids and cholecalciferol as hormones synthetized from diet precursors. Finally, we also address how metabolic hormones altered during pregnancy may affect lung pathophysiology in the adulthood.
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15
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Fishel Bartal M, Chen HY, Blackwell SC, Chauhan SP, Sibai BM. Neonatal morbidity in late preterm small for gestational age neonates. J Matern Fetal Neonatal Med 2019; 34:3208-3213. [PMID: 31645162 DOI: 10.1080/14767058.2019.1680630] [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: 10/25/2022]
Abstract
INTRODUCTION To compare neonatal respiratory morbidity among small for gestational age (SGA; birth weight less than 10th percentile for gestational age) versus appropriate for gestational age (AGA; BW at 10-90th percentile) neonates born in the late preterm period. METHODS A secondary analysis of a multicenter randomized trial of antenatal corticosteroids for women at risk for late preterm birth. Singleton, nonanomalous, AGA or SGA births that delivered at 34-36 weeks were included. Women were excluded if they delivered after 37 weeks or had a large for gestational age baby (LGA; weight over 90th for gestational age). The primary outcome was a composite of any of the following: respiratory support by 72 h (continuous positive airway pressure or high flow nasal cannula ≥2 h, oxygen with a fraction of inspired oxygen of ≥30% for ≥4 h, extra corporeal membrane oxygenation or mechanical ventilation) or neonatal death. The secondary outcomes included several neonatal and maternal morbidities. Multivariable Poisson regression models were used to examine the association between neonatal weight and outcomes (using adjusted relative risk [aRR] and 95% confidence intervals [CI]). RESULTS Of the 2831 women in the parent trial, 2315 (82%) women met inclusion criteria; among them, 426 (18%) of the neonates were SGA. There was no significant difference in the risk of the primary outcome between SGA and AGA (13.1 versus 15.1%, aRR 0.85, 95% CI 0.66-1.10). SGA, however, was associated with an increased risk for neonatal intensive care unit admission (68 versus 45%, aRR 1.60, 95% CI 1.47-1.74), hypothermia (12.2 versus 8.8%, aRR 1.36, 95% CI 1.01-1.83), feeding problems (47.2 versus 36.9%, aRR 1.24, 95% CI 1.07-1.45) and a decreased risk of neonatal hyperbilirubinemia (7.5 versus 12.7%, aRR 0.59, 95% CI 0.41-0.84), when compared to AGA. CONCLUSION In this cohort of late preterm birth, there was no significant difference in the rate of composite respiratory morbidity between SGA and AGA newborns.
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Affiliation(s)
- Michal Fishel Bartal
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Han-Yang Chen
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sean C Blackwell
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Suneet P Chauhan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Baha M Sibai
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA
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16
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Maternal Metformin Treatment Improves Developmental and Metabolic Traits of IUGR Fetuses. Biomolecules 2019; 9:biom9050166. [PMID: 31035702 PMCID: PMC6572102 DOI: 10.3390/biom9050166] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/20/2019] [Accepted: 04/23/2019] [Indexed: 12/16/2022] Open
Abstract
Metformin is an anti-hyperglycemic drug widely used for the treatment of insulin resistance and glucose intolerance and is currently considered for preventing large-for-gestational-age (LGA) offspring in pregnant women affected by obesity or diabetes. Our hypothesis was the opposite—metformin may be used for improving the development of offspring affected by intrauterine growth restriction (IUGR) and preventing the appearance of small-for-gestational-age (SGA) neonates in non-obese and non-diabetic but malnourished pregnancies. The current study, performed in a swine preclinical model of IUGR by undernutrition, showed that fetuses in the treated group showed no significant increases in body-weight, but showed a significantly higher weight of the brain, the total thoracic and abdominal viscera, the liver, the kidneys, the spleen, and the adrenal glands. Maternal metformin treatment was also related to significant increases in the fetal plasma concentration of parameters indicative of glycemic (glucose and fructosamine) and lipid profiles (triglycerides). Overall, these results suggest a protective effect of the treatment on the developmental competence of the fetuses. These findings may be of high value for human medicine in case of maternal malnutrition, since metformin is a cheap drug easily available, but also in case of placental deficiency, since metformin seems to improve placental development and function.
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17
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Mone F, Thompson A, Stewart MC, Segurado R, Curry J, Dornan JC, McAuliffe FM, Shields MD. The impact of fetal umbilical artery Doppler pulsatility index on childhood respiratory function and atopy: a prospective case-control study. J Matern Fetal Neonatal Med 2018; 33:707-711. [PMID: 29996681 DOI: 10.1080/14767058.2018.1499720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: To determine if an elevated fetal umbilical artery Doppler pulsatility index is associated with abnormal respiratory function and atopy in children aged 12 years.Methods: This prospective case-control study compared children that had an elevated fetal umbilical artery Doppler pulsatility index (>90th centile) to those with a normal pulsatility index (<90th centile). All subjects were delivered at full-term and with appropriate growth for gestational age. Outcome measures included; (i) presence of asthma and/or atopy; (ii) spirometry measurements and (iii) serum C-reactive protein and leptin. Multiple regression was used to account for parental smoking, childhood age, gender and socioeconomic status.Results: 174 children with an average age of 12.1 (±0.6 SD), 48% of who were male were included in the analysis. Of the 174, 99 (57%) were in the normal umbilical artery Doppler pulsatility index group and 75 (43%) elevated umbilical artery Doppler pulsatility index groups. The overall proportion of subjects with asthma was 28% (48/174) and atopy 56% (98/174). No association was found between elevated fetal umbilical artery Doppler pulsatility index and asthma (p = .47) or atopy (p = .75) at age 12 years. Similarly there was no association between FEV1(%) (p = .96), forced vital capacity (FVC)(%) (p = .98), elevated serum C-reactive protein (p = .69) or leptin (p = .20) and an elevated fetal umbilical artery Doppler pulsatility index.Conclusions: An elevated umbilical artery Doppler at 28-weeks gestation in the absence of prematurity or fetal growth restriction is not associated with altered respiratory function or the presence of atopy in children aged 12 years. These findings support the theory that such disease has a multifactorial pathophysiology.
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Affiliation(s)
- Fionnuala Mone
- Obstetrics and Gynaecology, UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Andrew Thompson
- Royal Belfast Hospital for Sick Children, Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - Moira C Stewart
- Royal Belfast Hospital for Sick Children, Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - Ricardo Segurado
- CSTAR, School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Jennifer Curry
- Royal Belfast Hospital for Sick Children, Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - James C Dornan
- Department of Fetal Medicine, Royal Jubilee Maternity Hospital, Belfast, United Kingdom
| | - Fionnuala M McAuliffe
- Obstetrics and Gynaecology, UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Michael D Shields
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
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18
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Arigliani M, Spinelli AM, Liguoro I, Cogo P. Nutrition and Lung Growth. Nutrients 2018; 10:E919. [PMID: 30021997 PMCID: PMC6073340 DOI: 10.3390/nu10070919] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 12/21/2022] Open
Abstract
Experimental evidence from animal models and epidemiology studies has demonstrated that nutrition affects lung development and may have a lifelong impact on respiratory health. Chronic restriction of nutrients and/or oxygen during pregnancy causes structural changes in the airways and parenchyma that may result in abnormal lung function, which is tracked throughout life. Inadequate nutritional management in very premature infants hampers lung growth and may be a contributing factor in the pathogenesis of bronchopulmonary dysplasia. Recent evidence seems to indicate that infant and childhood malnutrition does not determine lung function impairment even in the presence of reduced lung size due to delayed body growth. This review will focus on the effects of malnutrition occurring at critical time periods such as pregnancy, early life, and childhood, on lung growth and long-term lung function.
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Affiliation(s)
- Michele Arigliani
- Department of Medicine, University Hospital of Udine, Piazzale S. Maria Misericordia 1, 33100 Udine, Italy.
| | - Alessandro Mauro Spinelli
- Department of Medicine, University Hospital of Udine, Piazzale S. Maria Misericordia 1, 33100 Udine, Italy.
| | - Ilaria Liguoro
- Department of Medicine, University Hospital of Udine, Piazzale S. Maria Misericordia 1, 33100 Udine, Italy.
| | - Paola Cogo
- Department of Medicine, University Hospital of Udine, Piazzale S. Maria Misericordia 1, 33100 Udine, Italy.
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19
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Sehgal A, Gwini SM, Menahem S, Allison BJ, Miller SL, Polglase GR. Preterm growth restriction and bronchopulmonary dysplasia: the vascular hypothesis and related physiology. J Physiol 2018; 597:1209-1220. [PMID: 29746007 DOI: 10.1113/jp276040] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 04/27/2018] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS Approximately 5-10% pregnancies are affected by fetal growth restriction. Preterm infants affected by fetal growth restriction have a higher incidence of bronchopulmonary dysplasia. The present study is the first to measure pulmonary artery thickness and stiffness. The findings show that impaired vasculogenesis may be a contributory factor in the higher incidence of bronchopulmonary dysplasia in preterm growth restricted infants. The study addresses the mechanistic link between fetal programming and vascular architecture and mechanics. ABSTRACT Bronchopulmonary dysplasia is the most common respiratory sequelae of prematurity and histopathologically features fewer, dysmorphic pulmonary arteries. The present study aimed to characterize pulmonary artery mechanics and cardiac function in preterm infants with fetal growth restriction (FGR) compared to those appropriate for gestational age (AGA) in the early neonatal period. This prospective study reviewed 40 preterm infants between 28 to 32 weeks gestational age (GA). Twenty infants had a birthweight <10th centile and were compared with 20 preterm AGA infants. A single high resolution echocardiogram was performed to measure right pulmonary arterial and right ventricular (RV) indices. The GA and birthweight of FGR and AGA infants were 29.8 ± 1.3 vs. 30 ± 0.9 weeks (P = 0.78) and 923.4 g ± 168 vs. 1403 g ± 237 (P < 0.001), respectively. Assessments were made at 10.5 ± 1.3 days after birth. The FGR infants had significantly thicker right pulmonary artery inferior wall (843.5 ± 68 vs. 761 ± 40 μm, P < 0.001) with reduced pulsatility (51.6 ± 7.6 μm vs. 59.7 ± 7.5 μm, P = 0.001). The RV contractility [fractional area change (28.7 ± 3.8% vs 32.5 ± 3.1%, P = 0.001), tricuspid annular peak systolic excursion (TAPSE) (5.2 ± 0.3% vs. 5.9 ± 0.7%, P = 0.0002) and myocardial performance index (0.35 ± 0.03 vs. 0.28 ± 0.02, P < 0.001)] was significantly impaired in FGR infants. Significant correlation between RV longitudinal contractility (TAPSE) and time to peak velocity/RV ejection time (measure of RV afterload) was noted (r2 = 0.5, P < 0.001). Altered pulmonary vascular mechanics and cardiac performance reflect maladaptive changes in response to utero-placental insufficiency. Whether managing pulmonary vascular disease will alter clinical outcomes remains to be studied prospectively.
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Affiliation(s)
- Arvind Sehgal
- Monash Newborn, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Pediatrics, Monash University, Melbourne, VIC, Australia
| | - Stella M Gwini
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Samuel Menahem
- Emeritus Head, Paediatric and Foetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
| | - Beth J Allison
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Suzanne L Miller
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Graeme R Polglase
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
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20
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Cho HY, Cho Y, Shin YJ, Park J, Shim S, Jung Y, Shim S, Cha D. Functional analysis of cell-free RNA using mid-trimester amniotic fluid supernatant in pregnancy with the fetal growth restriction. Medicine (Baltimore) 2018; 97:e9572. [PMID: 29480850 PMCID: PMC5943846 DOI: 10.1097/md.0000000000009572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The prediction and monitoring of fetal growth restriction (FGR) fetuses has become with the use of ultrasound. However, these tools lack the fundamental evidence for the growth of fetus with FGR excluding pathogenic factors.Amniotic fluid samples were obtained from pregnant women for fetal karyotyping and genetic diagnosis at 16 to 19 weeks of gestation. For this study, 15 FGR and 9 control samples were selected, and cell-free fetal RNA was isolated from each supernatant of the amniotic fluid for microarray analysis.In this study, 411 genes were differentially expressed between the FGR and control group. Of these genes, 316 genes were up-regulated, while 95 genes were down-regulated. In terms of gene ontology, the up-regulated genes were highly related to metabolic process as well as protein synthesis, while the down-regulated genes were related to receptor activity and biological adhesion. In terms of tissue-specific expression, the up-regulated genes were involved in various organs while down-regulated genes were involved only in the brain. In terms of organ-specific expression, many genes were enriched for B-cell lymphoma, pancreas, eye, placenta, epithelium, skin, and muscle. In the functional significance of gene, low-density lipoprotein receptor-related protein 10 (LRP10) was significantly increased (6-fold) and insulin-like growth factor (IGF-2) was dramatically increased (17-fold) in the FGR cases.The results show that the important brain-related genes are predominantly down-regulated in the intrauterine growth restriction fetuses during the second trimester of pregnancy. This study also suggested possible genes related to fetal development such as B-cell lymphoma, LRP10, and IGF-2. To monitor the fetal development, further study may be needed to elucidate the role of the genes identified.
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Affiliation(s)
- Hee Young Cho
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam
| | - Yeonkyung Cho
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University
| | - Yun-Jeong Shin
- Genetic Laboratory, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Jieun Park
- Genetic Laboratory, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Sunghan Shim
- Genetic Laboratory, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Yongwook Jung
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University
| | - Sungshin Shim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University
| | - Donghyun Cha
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University
- Genetic Laboratory, CHA Gangnam Medical Center, CHA University, Seoul, Korea
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21
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McGillick EV, Orgeig S, Allison BJ, Brain KL, Niu Y, Itani N, Skeffington KL, Kane AD, Herrera EA, Giussani DA, Morrison JL. Maternal chronic hypoxia increases expression of genes regulating lung liquid movement and surfactant maturation in male fetuses in late gestation. J Physiol 2017; 595:4329-4350. [PMID: 28318025 PMCID: PMC5491863 DOI: 10.1113/jp273842] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/14/2017] [Indexed: 12/16/2022] Open
Abstract
KEY POINTS Chronic fetal hypoxaemia is a common pregnancy complication associated with intrauterine growth restriction that may influence respiratory outcome at birth. We investigated the effect of maternal chronic hypoxia for a month in late gestation on signalling pathways regulating fetal lung maturation and the transition to air-breathing at birth using isobaric hypoxic chambers without alterations to maternal food intake. Maternal chronic hypoxia in late gestation increases fetal lung expression of genes regulating hypoxia signalling, lung liquid reabsorption and surfactant maturation, which may be an adaptive response in preparation for the successful transition to air-breathing at birth. In contrast to other models of chronic fetal hypoxaemia, late gestation onset fetal hypoxaemia promotes molecular regulation of fetal lung maturation. This suggests a differential effect of timing and duration of fetal chronic hypoxaemia on fetal lung maturation, which supports the heterogeneity observed in respiratory outcomes in newborns following exposure to chronic hypoxaemia in utero. ABSTRACT Chronic fetal hypoxaemia is a common pregnancy complication that may arise from maternal, placental and/or fetal factors. Respiratory outcome of the infant at birth likely depends on the duration, timing and severity of the hypoxaemic insult. We have isolated the effect of maternal chronic hypoxia (MCH) for a month in late gestation on fetal lung development. Pregnant ewes were exposed to normoxia (21% O2 ) or hypoxia (10% O2 ) from 105 to 138 days of gestation (term ∼145 days). At 138 days, gene expression in fetal lung tissue was determined by quantitative RT-PCR. Cortisol concentrations were determined in fetal plasma and lung tissue. Numerical density of surfactant protein positive cells was determined by immunohistochemistry. MCH reduced maternal PaO2 (106 ± 2.9 vs. 47 ± 2.8 mmHg) and fetal body weight (4.0 ± 0.4 vs. 3.2 ± 0.9 kg). MCH increased fetal lung expression of the anti-oxidant marker CAT and decreased expression of the pro-oxidant marker NOX-4. MCH increased expression of genes regulating hypoxia signalling and feedback (HIF-3α, KDM3A, SLC2A1, EGLN-3). There was no effect of MCH on fetal plasma/lung tissue cortisol concentrations, nor genes regulating glucocorticoid signalling (HSD11B-1, HSD11B-2, NR3C1, NR3C2). MCH increased expression of genes regulating sodium (SCNN1-B, ATP1-A1, ATP1-B1) and water (AQP-4) movement in the fetal lung. MCH promoted surfactant maturation (SFTP-B, SFTP-D, ABCA3) at the molecular level, but did not alter the numerical density of surfactant positive cells in lung tissue. MCH in late gestation promotes molecular maturation of the fetal lung, which may be an adaptive response in preparation for the successful transition to air-breathing at birth.
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Affiliation(s)
- Erin V. McGillick
- Early Origins of Adult Health Research GroupSchool of Pharmacy & Medical Sciences, Sansom Institute for Health ResearchUniversity of South AustraliaAdelaideAustralia
- Molecular and Evolutionary Physiology of the Lung Laboratory, School of Pharmacy & Medical Sciences, Sansom Institute for Health ResearchUniversity of South AustraliaAdelaideAustralia
| | - Sandra Orgeig
- Molecular and Evolutionary Physiology of the Lung Laboratory, School of Pharmacy & Medical Sciences, Sansom Institute for Health ResearchUniversity of South AustraliaAdelaideAustralia
| | - Beth J. Allison
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Kirsty L. Brain
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Youguo Niu
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Nozomi Itani
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Katie L. Skeffington
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Andrew D. Kane
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Emilio A. Herrera
- Programa de Fisiopatología, Instituto de Ciencias BiomédicasFacultad de MedicinaUniversidad de ChileAv. Salvador 486Providencia7500922SantiagoChile
| | - Dino A. Giussani
- Department of PhysiologyDevelopment & NeuroscienceUniversity of CambridgeCambridgeshireUK
| | - Janna L. Morrison
- Early Origins of Adult Health Research GroupSchool of Pharmacy & Medical Sciences, Sansom Institute for Health ResearchUniversity of South AustraliaAdelaideAustralia
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McGillick EV, Orgeig S, Williams MT, Morrison JL. Risk of Respiratory Distress Syndrome and Efficacy of Glucocorticoids. Reprod Sci 2016; 23:1459-1472. [DOI: 10.1177/1933719116660842] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Erin V. McGillick
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
- Molecular and Evolutionary Physiology of the Lung Laboratory, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Sandra Orgeig
- Molecular and Evolutionary Physiology of the Lung Laboratory, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Marie T. Williams
- Health and Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Janna L. Morrison
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
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Pinzón-Rondón ÁM, Aguilera-Otalvaro P, Zárate-Ardila C, Hoyos-Martínez A. Acute respiratory infection in children from developing nations: a multi-level study. Paediatr Int Child Health 2016; 36:84-90. [PMID: 25936959 DOI: 10.1179/2046905515y.0000000021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Worldwide, acute respiratory infections (ARI) are the leading cause of death of children under 5 years of age. AIM To assess the accomplishment of the Millennium Development Goal on under-5 mortality particularly related to ARI in developing countries, and to explore the associations between country characteristics and ARI in children under 5 taking into account child, mother and household attributes. METHODS The study included a representative sample of 354,633 children under 5 years from 40 developing nations. A multilevel analysis of data from the Demographic and Health Surveys and the World Bank was conducted. RESULTS The prevalence of ARI was 13%. Country inequalities were associated with the disease - GINI index (95% CI 1.01-1.04). The country's per capita gross domestic product (GDP) (95% CI 1.00-1.01) and health expenditure (95% CI 1.01-1.01) affected the relationship between immunization and ARI, while inequalities influenced the relationship between household wealth (95% CI 0.99-0.99) and the disease. Other factors positively associated with ARI were male gender, low birthweight, working mothers and a high-risk indoor environment. Factors associated with ARI reduction were older children, immunization, breastfeeding for more than 6 months, older maternal age, maternal education and planned pregnancy. CONCLUSIONS In developing countries, public health campaigns to target ARI should consider the country's macro characteristics. At country level, inequalities but not health expenditure or GDP were associated with the disease and were independent of child, family and household characteristics. The effect of immunization on reducing ARI is greater in countries with a higher GDP and health expenditure. The effect of household wealth on ARI is less in countries with fewer inequalities. Reduction of inequalities is an important measure to decrease ARI in developing countries.
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Affiliation(s)
| | | | - Carol Zárate-Ardila
- a Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá , Colombia
| | - Alfonso Hoyos-Martínez
- a Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá , Colombia
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Abstract
In this review, we discuss the impact of environmental tobacco smoke and particulate and gaseous air pollutants derived from fossil fuel combustion on a particularly vulnerable population, infants and children. Indoor and outdoor air pollutants exacerbate chronic respiratory diseases and lower respiratory tract infections. However, there is an even more alarming impact of antenatal air pollution exposures. There are several reports in rodents and monkeys that maternal exposure to tobacco smoke or fossil fuel-generated air pollutants causes in utero growth retardation, lung remodeling, and immune cell activation which increase the risk for asthma or the risk of morbidity with respiratory infections. Importantly, epidemiologic studies confirm that maternal exposure to air pollutants decreases lung function in infants and children which may persist to young adulthood. Thus, environmental air pollutants contribute to childhood origins of chronic obstructive lung disease by changing the capacity for normal lung development and repair, by promoting early lung inflammation which increases the susceptibility to pollution-triggered symptomatic lung disease in adulthood, and by limiting the capacity for later adaptive/repair responses to environmental and infectious insults.
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25
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Deng FT, Ouyang WX, Ge LF, Zhang L, Chai XQ. Expression of lung surfactant proteins SP-B and SP-C and their modulating factors in fetal lung of FGR rats. ACTA ACUST UNITED AC 2015; 35:122-128. [PMID: 25673205 DOI: 10.1007/s11596-015-1400-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 11/28/2014] [Indexed: 01/20/2023]
Abstract
This study investigated the expression of lung surfactant proteins SP-B and SP-C, and their modulating factors TTF-1 and PLAGL2 in the fetal lung of rats with fetal growth restriction (FGR). The rat FGR model was established by prenatal hypoxia in the first stage of pregnancy, 180 rats for experiment served as hypoxia group, and 197 healthy rats served as normal control group. The FGR incidence in hypoxia was compared with that in normal control group. The histological changes in the fetal lung were observed under the light microscope and electronic microscope in two groups. The SP-B, SP-C, TTF-1 and PLAGL2 proteins were determined in the fetal lung of two groups immunohistochemically. The expression levels of SP-B, SP-C, TTF-1 and PLAGL2 protein and mRNA in the fetal lung of two groups were detected by using Western blotting and RT-PCR respectively. The FGR rat model was successfully established by using hypoxia. Pathologically the fetal lung developed slowly, and the expression levels of SP-B, SP-C, TTF-1 and PLAGL2 protein and mRNA in the fetal lung were significantly reduced in hypoxia group as compared with those in normal control group. It was suggested that maternal hypoxia in the first stage of pregnancy could induce FGR, and reduce the expression of SP-B and SP-C, resulting in the disorder of fetal lung development and maturation.
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Affiliation(s)
- Fei-Tao Deng
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wei-Xiang Ouyang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Liang-Fang Ge
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xin-Qun Chai
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
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Zana-Taieb E, Butruille L, Franco-Montoya ML, Lopez E, Vernier F, Grandvuillemin I, Evain-Brion D, Deruelle P, Baud O, Delacourt C, Jarreau PH. Effect of two models of intrauterine growth restriction on alveolarization in rat lungs: morphometric and gene expression analysis. PLoS One 2013; 8:e78326. [PMID: 24278109 PMCID: PMC3836790 DOI: 10.1371/journal.pone.0078326] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/11/2013] [Indexed: 01/21/2023] Open
Abstract
Intrauterine growth restriction (IUGR) in preterm infants increases the risk of bronchopulmonary dysplasia, characterized by arrested alveolarization. We evaluated the impact of two different rat models (nitric oxide synthase inhibition or protein deprivation) of IUGR on alveolarization, before, during, and at the end of this postnatal process. We studied IUGR rat pups of dams fed either a low protein (LPD) or a normal diet throughout gestation and pups of dams treated by continuous infusion of Nω-nitro-L-arginine methyl ester (L-NAME) or its diluent on the last four days of gestation. Morphometric parameters, alveolar surface (Svap), mean linear intercept (MLI) and radial alveolar count (RAC) and transcriptomic analysis were determined with special focus on genes involved in alveolarization. IUGR pups regained normal weight at day 21 in the two treated groups. In the LPD group, Svap, MLI and RAC were not different from those of controls at day 4, but were significantly decreased at day 21, indicating alveolarization arrest. In the L-NAME group, Svap and RAC were significantly decreased and MLI was increased at day 4 with complete correction at day 21. In the L-NAME model, several factors involved in alveolarization, VEGF, VEGF-R1 and –R2, MMP14, MMP16, FGFR3 and 4, FGF18 and 7, were significantly decreased at day 4 and/or day 10, while the various factors studied were not modified in the LPD group. These results demonstrate that only maternal protein deprivation leads to sustained impairment of alveolarization in rat pups, whereas L-NAME impairs lung development before alveolarization. Known growth factors involved in lung development do not seem to be involved in LPD-induced alveolarization disorders, raising the question of a possible programming of altered alveolarization.
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Affiliation(s)
- Elodie Zana-Taieb
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U767, Paris, France
- PremUp, Paris, France
- Service de Médecine et Réanimation néonatales de Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique – Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
- * E-mail:
| | - Laura Butruille
- Unité environnement périnatal et croissance, EA4489, Faculté de Médecine, Pôle recherche, IFR 114,Université Lille Nord de France, Lille, France
| | | | - Emmanuel Lopez
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U767, Paris, France
- PremUp, Paris, France
- Service de Médecine et Réanimation néonatales de Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Flore Vernier
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U767, Paris, France
- PremUp, Paris, France
| | - Isabelle Grandvuillemin
- Institut National de la Santé Et de la Recherche Médicale (INSERM) UMR 1076, Faculté de Pharmacie, Université de la Méditerranée. Marseille, France
| | - Danièle Evain-Brion
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U767, Paris, France
- PremUp, Paris, France
- Université Paris Descartes, Paris, France
| | - Philippe Deruelle
- Unité environnement périnatal et croissance, EA4489, Faculté de Médecine, Pôle recherche, IFR 114,Université Lille Nord de France, Lille, France
| | - Olivier Baud
- PremUp, Paris, France
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U676, Paris, France
- Service de Réanimation et Pédiatrie néonatales, Hôpital Robert Debré, Assistance Publique – Hôpitaux de Paris, Paris, France
- Université Paris Diderot, Paris, France
| | - Christophe Delacourt
- PremUp, Paris, France
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U955 IMRB Equipe 04, Créteil, France
- Service de Pneumologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique – Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
| | - Pierre-Henri Jarreau
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U767, Paris, France
- PremUp, Paris, France
- Service de Médecine et Réanimation néonatales de Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique – Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
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