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Palacios-Luna JE, López-Marrufo MV, Bautista-Bautista G, Velarde-Guerra CS, Villeda-Gabriel G, Flores-Herrera O, Osorio-Caballero M, Aguilar-Carrasco JC, Palafox-Vargas ML, García-López G, Díaz-Ruíz O, Arechavaleta-Velasco F, Flores-Herrera H. Progesterone modulates extracellular heat-shock proteins and interlukin-1β in human choriodecidual after Escherichia coli infection. Placenta 2023; 142:85-94. [PMID: 37659254 DOI: 10.1016/j.placenta.2023.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
INTRODUCTION Chorioamnionitis is an adverse condition in human pregnancy caused by many bacterial pathogens including Escherichia coli (E. coli); which has been associated with higher risk of preterm birth. We recently reported that human maternal decidua (MDec) tissue responds to E. coli infection by secreting extracellular heat-shock proteins (eHsp)-60, -70 and interlukin-1β (IL-1β). Previous studies have shown that progesterone (P4) regulates the immune response, but it is unknown whether P4 inhibits the secretion of eHsp. The aim of this investigation was to determine the role of P4 on the secretion of eHsp-27, -60, -70 and IL-1β in MDec after 3, 6, and 24 h of E. coli infection. METHODS Nine human feto-maternal interface (HFMi) tissues were included and mounted in the Transwell culture system. Only the maternal decidua (MDec) was stimulated for 3, 6 and 24 h with E. coli alone or in combination with progesterone and RU486. After each treatment, the HFMi tissue was recovered to determine histological changes and the culture medium recovered to evaluate the levels of eHsp-27, -60, -70 and IL-1β by ELISA and mRNA expression by RT-PCR. RESULTS No structural changes were observed in the HFMi tissue treated with P4 and RU486. However, stimulation with E. coli produces diffuse inflammation and ischemic necrosis. E. coli induced infection decreases, in time- and dose-dependent manner, eHsp-27 and increases eHsp-60, eHsp-70 and IL-1β levels. In contrast, incubation of HFMi tissue with E. coli + P4 reversed eHsp and IL-1β secretion levels relative to E. coli stimulation group but not relative to the control group. The same profile was observed on the expression of eHsp-27 and eHsp-60. DISCUSSION we found that progesterone modulates the anti-inflammatory (eHsp-27) and pro-inflammatory (eHsp-60 and eHsp-70) levels of eHsp induced by E. coli infection in human choriodecidual tissue. eHsp-60 and eHsp-70 levels were not completely reversed; maintaining the secretion of IL-1β, which has been associated with adverse events during pregnancy.
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Affiliation(s)
- Janelly Estefania Palacios-Luna
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Mariana Victoria López-Marrufo
- Departamento de Ginecología y Obstetricia. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Gerardo Bautista-Bautista
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Cinthia Selene Velarde-Guerra
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Graciela Villeda-Gabriel
- Departamento de Inmunología e Infectología, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Oscar Flores-Herrera
- Departamento de Bioquímica, Facultad de Medicina. Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Mauricio Osorio-Caballero
- Departamento de Salud Sexual y Reproductiva. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Jose Carlos Aguilar-Carrasco
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México. Mexico
| | - Martha Leticia Palafox-Vargas
- Departamento de Anatomía Patológica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Guadalupe García-López
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México. Mexico
| | - Oscar Díaz-Ruíz
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fabián Arechavaleta-Velasco
- Unidad de Investigación en Medicina Reproductiva. Hospital de Gineco-Obstetricia No. 4 "Luis Castelazo Ayala" Instituto Mexicano Del Seguro Social, Ciudad de México. Mexico.
| | - Hector Flores-Herrera
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico.
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Rivera-Núñez Z, Ashrap P, Barrett ES, Llanos AAM, Watkins DJ, Cathey AL, Vélez-Vega CM, Rosario Z, Cordero JF, Alshawabkeh A, Meeker JD. Personal care products: Demographic characteristics and maternal hormones in pregnant women from Puerto Rico. ENVIRONMENTAL RESEARCH 2022; 206:112376. [PMID: 34798118 PMCID: PMC8810700 DOI: 10.1016/j.envres.2021.112376] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
Personal care products (PCPs) refer to a wide variety of items commonly characterized as health or beauty products. PCPs contain a number of ingredients, often including a wide range of endocrine disrupting chemicals such as phthalates and parabens. The present study examines the association between self-reported PCP use and prenatal sex-steroids and thyroid hormones levels in women from Puerto Rico. We recruited pregnant women (n = 1070) through the Puerto Rico PROTECT Cohort and collected blood, demographic and pregnancy-related data at recruitment and subsequent visits. PCP use in the 48-h preceding the blood sample was collected through self-reported questionnaires. Nine hormones (corticotropin-releasing hormone [CRH], sex-hormone binding globulin [SHBG], estriol [E3], progesterone, testosterone, thyroid-stimulating hormone [TSH], total triiodothyronine [T3], total thyroxine [T4], and free thyroxine [fT4]) were measured in maternal serum samples at two points during pregnancy. Linear mixed models with random intercepts were used to examine associations between PCP use and serum hormone levels. Use of cosmetics significantly increased with age, household income and education level (p < 0.01). Use of hair products, such as hair dyes and bleach, relaxers, and mousse, was associated with lower levels of all sex steroid hormones compared to non-use: SHBG (%Δ = -7.1, 95%CI: -12.4,-1.8), E3 (%Δ = -23.2, 95%CI: -32.2,-13.0), progesterone (%Δ = -21.5, 95%CI: -29.4,-12.9) and testosterone (%Δ = -21.5, 95%CI: -33.1,-7.8) adjusted for maternal age, education and pre-pregnancy body mass index. Our findings suggest that household income and education level influence PCP use among pregnant women in this study. Use of certain hair products was associated with lower concentrations of sex steroid hormones. Although there are limitations to questionnaire data, characterizing PCP use is inexpensive and may represent exposure from multiple classes of chemicals, including chemicals that may not specifically appear on product labels and/or have not been tested for endocrine disrupting potential, making it a useful complement to chemical biomarker data.
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Affiliation(s)
- Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA.
| | - Pahriya Ashrap
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Amber L Cathey
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Carmen M Vélez-Vega
- Graduate Program of Public Health, University of Puerto Rico, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Zaira Rosario
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | | | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
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Rivera-Núñez Z, Ashrap P, Barrett ES, Watkins DJ, Cathey AL, Vélez-Vega CM, Rosario Z, Cordero JF, Alshawabkeh A, Meeker JD. Association of biomarkers of exposure to metals and metalloids with maternal hormones in pregnant women from Puerto Rico. ENVIRONMENT INTERNATIONAL 2021; 147:106310. [PMID: 33321388 PMCID: PMC7856269 DOI: 10.1016/j.envint.2020.106310] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/23/2020] [Accepted: 11/26/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND Metal(loid)s have been associated to adverse birth outcomes in experimental and epidemiological studies, but the underlying mechanism(s) are not well understood. Endocrine disruption may be a mechanism by which the metal(loid)s impact birth outcomes. METHODS Pregnant women were recruited through the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT). Urine, blood, demographic and pregnancy-related data were collected at recruitment and subsequent visits. Sixteen metal(loid)s were analyzed in urine and blood samples, while nine maternal hormones (corticotropin-releasing hormone (CRH), sex-hormone binding globulin (SHBG), estriol (E3), progesterone, testosterone, thyroid-stimulating hormone (TSH), total triiodothyronine (T3), total thyroxine (T4), and free thyroxine (fT4)) were measured in serum samples from 815 singleton pregnancies. Linear mixed models with random intercepts were used to examine associations between metal(loid)s in blood and urine with hormone concentrations. RESULTS Arsenic blood concentrations were significantly associated with increased levels in CRH (%Δ: 23.0, 95%CI: 8.4-39.6) and decreased levels in testosterone (%Δ: -16.3, 95%CI: -26.2--5.1). Cobalt, manganese, and lead blood concentrations were associated with small increases in SHBG (%Δ range: 3.3-4.2), E3 (%Δ range: 3.9-8.7) and progesterone (%Δ range: 4.1-6.3) levels, respectively. Nickel blood concentration was inversely associated with testosterone levels (%Δ -13.3, 95%CI: -18.7--7.6). Significant interactions were detected for the association between nickel and study visit in relation to CRH (p < 0.02) and testosterone levels (p < 0.01). CONCLUSION Our analysis suggests that metal(loid)s may act as endocrine disruptors by altering prenatal hormone levels. This disruption may depend on specific windows of exposure during pregnancy. Additionally, some essential metal(loid)s such as managense and cobalt may be contributors to adverse maternal and fetal outcomes. The study of metal(loid)s as endocrine disruptors is in the early stages of epidemiological research and future studies are needed to further investigate these associations.
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Affiliation(s)
- Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health and Rutgers Environmental and Occupational Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Pahriya Ashrap
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health and Rutgers Environmental and Occupational Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Amber L Cathey
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Carmen M Vélez-Vega
- Graduate Program of Public Health, University of Puerto Rico, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Zaira Rosario
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | | | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA.
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Cathey AL, Watkins DJ, Rosario ZY, Vega CMV, Mukherjee B, O’Neill MS, Loch-Caruso R, Alshawabkeh AN, Cordero JF, Meeker JD. Gestational Hormone Concentrations Are Associated With Timing of Delivery in a Fetal Sex-Dependent Manner. Front Endocrinol (Lausanne) 2021; 12:742145. [PMID: 34603214 PMCID: PMC8479114 DOI: 10.3389/fendo.2021.742145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/25/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Early delivery remains a significant public health problem that has long-lasting impacts on mother and child. Understanding biological mechanisms underlying timing of labor, including endocrine disruption, can inform prevention efforts. METHODS Gestational hormones were measured among 976 women in PROTECT, a longitudinal birth cohort in Puerto Rico. We evaluated associations between hormone concentrations at 18 and 26 weeks gestation and gestational age at birth, while assessing effect modification by fetal sex. Exploratory analyses assessed binary outcomes of overall preterm birth (PTB, <37 weeks gestation) and the spontaneous PTB subtype, defined as preterm premature rupture of membranes, spontaneous preterm labor, or both. Multivariable logistic and linear regressions were fit using visit-specific hormone concentrations, and fetal sex-specific effects were estimated using interaction terms. Main outcome models were adjusted for maternal age, education, marital status, alcohol consumption, environmental tobacco smoke exposure, and pre-pregnancy body mass index (BMI). Exploratory models adjusted for maternal age and education. RESULTS We observed reduced gestational age at birth with higher circulating CRH (β: -2.73 days, 95% CI: -4.97, -0.42), progesterone (β: -4.90 days, 95% CI: -7.07, -2.73), and fT4 concentrations (β: -2.73 days, 95% CI: -4.76, -0.70) at 18 weeks specifically among male fetuses. Greater odds of overall and spontaneous PTB were observed among males with higher CRH, estriol, progesterone, total triiodothyronine (T3), and free thyroxine (fT4) concentrations. Greater odds of PTB among females was observed with higher testosterone concentrations. CONCLUSIONS Various associations between hormones and timing of delivery were modified by fetal sex and timing of hormone measurement. Future studies are needed to understand differential mechanisms involved with timing of labor between fetal sexes.
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Affiliation(s)
- Amber L. Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Zaira Y. Rosario
- Graduate School of Public Health, University of Puerto Rico, San Juan, PR, United States
| | - Carmen M. Vélez Vega
- Graduate School of Public Health, University of Puerto Rico, San Juan, PR, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Marie S. O’Neill
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Rita Loch-Caruso
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | | | - José F. Cordero
- College of Public Health, University of Georgia, Athens, GA, United States
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
- *Correspondence: John D. Meeker,
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Cathey AL, Watkins DJ, Rosario ZY, Vélez Vega CM, Loch-Caruso R, Alshawabkeh AN, Cordero JF, Meeker JD. Polycyclic aromatic hydrocarbon exposure results in altered CRH, reproductive, and thyroid hormone concentrations during human pregnancy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:141581. [PMID: 32829279 PMCID: PMC7755823 DOI: 10.1016/j.scitotenv.2020.141581] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 05/05/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are byproducts of incomplete combustion reactions and are ubiquitous in the environment, leading to widespread human exposure via inhalation and ingestion pathways. PAHs have been implicated as endocrine disrupting compounds in previous animal and in vitro studies, but human studies are currently lacking. Pregnant women and their developing fetuses are particularly susceptible populations to environmental contaminants, in part because alterations in hormone physiology during gestation can have adverse consequences on the health of the pregnancy. We utilized data on 659 pregnant women from the PROTECT longitudinal birth cohort in Puerto Rico to assess associations between repeated measures of 8 urinary hydroxylated PAH (OH-PAH) metabolites and 9 serum hormones during gestation. Urine samples were collected at 3 study visits (median gestational ages of 18, 22, and 26 weeks at each visit, respectively) and serum samples were collected at the first and third study visits. Linear mixed effects models were used to ascertain longitudinal associations between OH-PAHs and hormones, and sensitivity analyses were employed to assess potential nonlinearity and differences in associations on the basis of fetal sex and timing of biomarker measurement. Among the multiple positive associations we observed between OH-PAHs and CRH, estriol, progesterone, T3, and the ratio of T3 to T4, and inverse associations with testosterone, the most notable are a 24.3% increase (95% CI: 13.0, 36.7) in CRH with an interquartile range (IQR) increase in 1-hydroxyphenanthrene and a 17.2% decrease (95% CI: 8.13, 25.4) in testosterone with an IQR increase in 1-hydroxynapthalene. Many associations observed were dependent on fetal sex, and some relationships showed evidence of nonlinearity. These findings demonstrate the importance of studying PAH exposures during pregnancy and highlight the potential complexity of their impacts on the physiology of human pregnancy.
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Affiliation(s)
- Amber L Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Zaira Y Rosario
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Carmen M Vélez Vega
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Rita Loch-Caruso
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - José F Cordero
- College of Public Health, Athens, University of Georgia, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Nepomnaschy PA, Rowlands A, Prescivalli Costa AP, Salvante KG. Socio-Ecological Challenges as Modulators of Women's Reproductive Trajectories. ANNUAL REVIEW OF ANTHROPOLOGY 2020. [DOI: 10.1146/annurev-anthro-102317-045930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Amenorrhea, anovulatory cycles, miscarriages, and other reproductive outcomes are often seen as pathological. Life history theory, in contrast, treats those outcomes as adaptations that helped women optimize the timing of reproductive ventures across our evolutionary history. Women's bodies adjust their reproductive strategies in response to socio-ecological conditions, a process mediated by the hypothalamic-pituitary-adrenal axis (HPAA). Here, we review the links between socio-ecological conditions, HPAA activity, and the pace of women's reproductive transitions such as puberty, age at first birth, interbirth interval, and perimenopause. We also discuss the HPAA's role as a modulator of reproductive function: It not only suppresses it but may also prime women's bodies for future reproductive ventures. We conclude by reviewing challenges and opportunities within our subfield, including the need for transdisciplinary teams to develop longitudinal studies to improve our understanding of women's reproductive trajectories and outcomes from the moment they are conceived.
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Affiliation(s)
- Pablo A. Nepomnaschy
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
| | - Amanda Rowlands
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
| | - Ana Paula Prescivalli Costa
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
| | - Katrina G. Salvante
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
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Marinić M, Lynch VJ. Relaxed constraint and functional divergence of the progesterone receptor (PGR) in the human stem-lineage. PLoS Genet 2020; 16:e1008666. [PMID: 32302297 PMCID: PMC7190170 DOI: 10.1371/journal.pgen.1008666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/29/2020] [Accepted: 02/13/2020] [Indexed: 11/18/2022] Open
Abstract
The steroid hormone progesterone, acting through the progesterone receptor (PR), a ligand-activated DNA-binding transcription factor, plays an essential role in regulating nearly every aspect of female reproductive biology. While many reproductive traits regulated by PR are conserved in mammals, Catarrhine primates evolved several derived traits including spontaneous decidualization, menstruation, and a divergent (and unknown) parturition signal, suggesting that PR may also have evolved divergent functions in Catarrhines. There is conflicting evidence, however, whether the progesterone receptor gene (PGR) was positively selected in the human lineage. Here we show that PGR evolved rapidly in the human stem-lineage (as well as other Catarrhine primates), which likely reflects an episode of relaxed selection intensity rather than positive selection. Coincident with the episode of relaxed selection intensity, ancestral sequence resurrection and functional tests indicate that the major human PR isoforms (PR-A and PR-B) evolved divergent functions in the human stem-lineage. These results suggest that the regulation of progesterone signaling by PR-A and PR-B may also have diverged in the human lineage and that non-human animal models of progesterone signaling may not faithfully recapitulate human biology.
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Affiliation(s)
- Mirna Marinić
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, United States of America
| | - Vincent J. Lynch
- Department of Biological Sciences, University at Buffalo, SUNY, Buffalo, NY, United States of America
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Aly S, El-Dib M, Lu Z, El Tatawy S, Mohamed M, Aly H. Factors affecting cerebrovascular reactivity to CO2 in premature infants. J Perinat Med 2019; 47:979-985. [PMID: 31562803 DOI: 10.1515/jpm-2019-0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 08/22/2019] [Indexed: 11/15/2022]
Abstract
Background Hypercarbia increases cerebral blood flow secondary to cerebral vasodilatation, while hypocarbia can lead to vasoconstriction with a subsequent decrease in cerebral blood flow. The aim of this study was to examine CO2 cerebral vasoreactivity in a cohort of premature infants and to identify factors which influence this reactivity. Methods We prospectively studied a cohort of hemodynamically stable premature infants [birth weight (BW) <1500 g and gestational age (GA) ≤34 weeks]. Subjects underwent two studies, one in the first 72 h and the second after 1 week of life. Infants were continuously monitored via a physiology station that included transcutaneous CO2 (tcPCO2) monitor, near-infrared spectroscopy (NIRS), arterial pulse oximetry and heart rate. The total hemoglobin (Hb-T) signal of NIRS was used as an indicator of cerebral blood volume (CBV). Correlation between tcPCO2 and Hb-T was performed in each 1-h period using Pearson's correlation. Factors affecting the CO2 cerebrovascular reactivity were examined using bivariate and linear regression analyses. Results A total of 3847 1-h epochs were obtained from 140 studies of 72 premature infants. tcPCO2 correlated positively with Hb-T in 42% of epochs. In regression analysis, factors associated with increased percentage of positive correlation epochs were male sex and younger postmenstrual age (PMA; β = 0.176, 0.169 and P-value = 0.036, 0.047 respectively). Factors associated with increased strength of positive correlation were mechanical ventilation and increased average tcPCO2 (β = 0.198, 0.220 and P-value = 0.024, 0.011 respectively). Conclusion Increased prematurity, male sex, mechanical ventilation and hypercarbia are associated with stronger PCO2 cerebrovascular reactivity in premature infants. This association may explain their role in the pathogenesis of brain injury.
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Affiliation(s)
- Safwat Aly
- The George Washington University, Washington, DC, USA.,Department of Paediatrics, The Labatt Family Heart Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Mohamed El-Dib
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard School of Medicine, 75 Francis Street, Boston, MA 02115, USA
| | - Zhigang Lu
- Brigham and Women's Hospital and Harvard School of Medicine, Boston, MA, USA
| | | | - Mohamed Mohamed
- Newborn Services, The George Washington University, Washington, DC, USA
| | - Hany Aly
- Department of Pediatrics, Cleveland Clinic, Cleveland, OH, USA
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Martin-Fairey CA, Zhao P, Wan L, Roenneberg T, Fay J, Ma X, McCarthy R, Jungheim ES, England SK, Herzog ED. Pregnancy Induces an Earlier Chronotype in Both Mice and Women. J Biol Rhythms 2019; 34:323-331. [PMID: 31018734 PMCID: PMC7408307 DOI: 10.1177/0748730419844650] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Daily rhythms generated by endogenous circadian mechanisms and synchronized to the light-dark cycle have been implicated in the timing of birth in a wide variety of species. Although chronodisruption (e.g., shift work or clock gene mutations) is associated with poor reproductive outcomes, little is known about circadian timing during pregnancy. This study tested whether daily rhythms change during full-term pregnancies in mice and women. We compared running wheel activity continuously in both nonpregnant ( n = 14) and pregnant ( n = 13) 12- to 24-week-old C57BL/6NJ mice. We also monitored wrist actigraphy in women ( N = 39) for 2 weeks before conception and then throughout pregnancy and measured daily times of sleep onset. We found that on the third day of pregnancy, mice shift their activity to an earlier time compared with nonpregnant dams. Their time of daily activity onset was maximally advanced by almost 4 h around day 7 of pregnancy and then shifted back to the nonpregnant state approximately 1 week before delivery. Mice also showed reduced levels of locomotor activity during their last week of pregnancy. Similarly, in women, the timing of sleep onset was earlier during the first and second trimesters (gestational weeks 4-13 and 14-27) than before pregnancy and returned to the prepregnant state during the third trimester (weeks 28 until delivery). Women also showed reduced levels of locomotor activity throughout pregnancy. These results indicate that pregnancy induces changes in daily rhythms, altering both time of onset and amount of activity. These changes are conserved between mice and women.
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Affiliation(s)
- Carmel A Martin-Fairey
- Department of Biology, Washington University, St. Louis, MO, USA
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Leping Wan
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Till Roenneberg
- Institute for Medical Psychology, Department of Human Chronobiology, Ludwig-Maximilians-University, Munich, Germany
| | - Justin Fay
- Department of Biology, University of Rochester, Rochester, NY, USA
| | - Xiaofeng Ma
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Ronald McCarthy
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Emily S Jungheim
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Erik D Herzog
- Department of Biology, Washington University, St. Louis, MO, USA
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10
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Cathey AL, Watkins D, Rosario ZY, Vélez C, Alshawabkeh AN, Cordero JF, Meeker JD. Associations of Phthalates and Phthalate Replacements With CRH and Other Hormones Among Pregnant Women in Puerto Rico. J Endocr Soc 2019; 3:1127-1149. [PMID: 31093596 PMCID: PMC6510018 DOI: 10.1210/js.2019-00010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/05/2019] [Indexed: 11/25/2022] Open
Abstract
CONTEXT Phthalates are endocrine-disrupting chemicals that may be associated with adverse birth outcomes. Dysregulation of maternal endocrine homeostasis could be a possible biological pathway between phthalates and birth outcomes. OBJECTIVE Examine associations between 19 maternal urinary phthalate or phthalate replacement metabolites and 9 serum hormones measured over two time points during pregnancy. DESIGN Longitudinal study conducted in the PROTECT pregnancy cohort. SETTING Puerto Rico. PATIENTS Six hundred seventy-seven women in the first trimester of pregnancy. MAIN OUTCOME MEASURES SERUM CRH, estriol, SHBG, progesterone, TSH, total T3, free T4, total T4, and testosterone. RESULTS T3 was significantly associated with most metabolites. CRH was inversely associated with mono carboxyisononyl phthalate [MCNP; percent change (%Δ), -4.08; 95% CI, -7.24, -0.804], mono-3-carboxypropyl phthalate (MCPP; %Δ, -5.25; 95% CI, -8.26, -2.14), mono-2-ethyl-5-carboxypentyl phthalate (MECPP; %Δ, -18.4; 95% CI, -30.4, -4.37), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP; %Δ, -13.4; 95% CI, -22.7, -2.92), and mono-2-ethyl-5-oxohexyl phthalate (MEOHP; %Δ, -12.7; 95% CI, -22.2, -2.20). Positive associations were found between numerous phthalate metabolites and free T4, T4, and the T3/T4 ratio. Testosterone was positively associated with mono hydroxybutyl phthalate (MHBP; %Δ, 4.71; 95% CI, 0.27, 9.35) and inversely associated with monoethyl phthalate (MEP; %Δ, -14.5; 95% CI, -24.3, -3.42), and relationships with MCNP and mono carboxyisooctyl phthalate (MCOP) were significantly modified by study visit. Finally, an inverse association was found between mono-2-ethyl-5-hydrohexyl terephthalate (MEHHTP), a terephthalate metabolite, and progesterone at visit 3 only (%Δ, -13.1; 95% CI, -22.3, -2.75). CONCLUSIONS These results indicate that exposure to phthalates may differentially impact the maternal endocrine system at different points during pregnancy, and that exposures to phthalate replacement chemicals may be particularly important to consider in future human health studies.
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Affiliation(s)
- Amber L Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Deborah Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Zaira Y Rosario
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Carmen Vélez
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | | | - José F Cordero
- College of Public Health, Athens, University of Georgia, Athens, Georgia
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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11
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Aker AM, Ferguson KK, Rosario ZY, Mukherjee B, Alshawabkeh AN, Calafat AM, Cordero JF, Meeker JD. A repeated measures study of phenol, paraben and Triclocarban urinary biomarkers and circulating maternal hormones during gestation in the Puerto Rico PROTECT cohort. Environ Health 2019; 18:28. [PMID: 30940137 PMCID: PMC6444601 DOI: 10.1186/s12940-019-0459-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 02/28/2019] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Prenatal exposure to some phenols and parabens has been associated with adverse birth outcomes. Hormones may play an intermediate role between phenols and adverse outcomes. We examined the associations of phenol and paraben exposures with maternal reproductive and thyroid hormones in 602 pregnant women in Puerto Rico. Urinary triclocarban, phenol and paraben biomarkers, and serum hormones (estriol, progesterone, testosterone, sex-hormone-binding globulin (SHBG), corticotropin-releasing hormone (CRH), total triiodothyronine (T3), total thyroxine (T4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH)) were measured at two visits during pregnancy. METHODS Linear mixed models with a random intercept were constructed to examine the associations between hormones and urinary biomarkers. Results were additionally stratified by study visit. Results were transformed to hormone percent changes for an inter-quartile-range difference in exposure biomarker concentrations (%Δ). RESULTS Bisphenol-S was associated with a decrease in CRH [(%Δ -11.35; 95% CI: -18.71, - 3.33), and bisphenol-F was associated with an increase in FT4 (%Δ: 2.76; 95% CI: 0.29, 5.22). Butyl-, methyl- and propylparaben were associated with decreases in SHBG [(%Δ: -5.27; 95% CI: -9.4, - 1.14); (%Δ: -3.53; 95% CI: -7.37, 0.31); (%Δ: -3.74; 95% CI: -7.76, 0.27)]. Triclocarban was positively associated with T3 (%Δ: 4.08; 95% CI: 1.18, 6.98) and T3/T4 ratio (%Δ: 4.67; 95% CI: -1.37, 6.65), and suggestively negatively associated with TSH (%Δ: -10.12; 95% CI: -19.47, 0.32). There was evidence of susceptible windows of vulnerability for some associations. At 24-28 weeks gestation, there was a positive association between 2,4-dichlorophenol and CRH (%Δ: 9.66; 95% CI: 0.67, 19.45) and between triclosan and estriol (%Δ: 13.17; 95% CI: 2.34, 25.2); and a negative association between triclocarban and SHBG (%Δ: -9.71; 95% CI:-19.1, - 0.27) and between bisphenol A and testosterone (%Δ: -17.37; 95% CI: -26.7, - 6.87). CONCLUSION Phenols and parabens are associated with hormone levels during pregnancy. Further studies are required to substantiate these findings.
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Affiliation(s)
- Amira M. Aker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Room 1835 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
| | - Kelly K. Ferguson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Room 1835 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
- Epidemiology Branch, Intramural Research Program, National Institute of Environmental Health Sciences, Durham, USA
| | - Zaira Y. Rosario
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI USA
| | | | | | - José F. Cordero
- College of Public Health, University of Georgia, Athens, GA USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Room 1835 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
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12
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Johnsson VL, Pedersen NG, Worda K, Krampl-Bettelheim E, Skibsted L, Hinterberger S, Strobl I, Bowman ME, Smith R, Tabor A, Rode L. Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery. Acta Obstet Gynecol Scand 2018; 98:86-94. [PMID: 30218572 DOI: 10.1111/aogs.13464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 09/09/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The aim of this study was to examine the association between plasma hormone concentrations, cervical length, and preterm delivery in twin pregnancies, including the effect of progesterone treatment. MATERIAL AND METHODS This study included 191 women pregnant with twins from a randomized placebo-controlled trial. A baseline blood sample was collected at 18-24 weeks before treatment with vaginal progesterone (n = 95) or placebo pessaries (n = 96), and 167 (87.4%) women had a second sample collected after 4-8 weeks of treatment. At baseline, 155 (81.2%) women had their cervical length measured. Progesterone, estradiol, and unconjugated estriol concentration was measured, and the association between hormone concentrations, cervical length, and gestational age at delivery was examined. Hormone concentrations were compared in the placebo and progesterone group. Statistical analysis included Spearman's rho, Mann-Whitney U test, Cuzick's test for trends, and linear regression analyses. RESULTS A short cervical length was associated with preterm delivery. Cervical length and hormone concentrations were not associated (Spearman's rho; progesterone -.05, estradiol .04, estriol .08). Decreasing gestational age at delivery was associated with higher progesterone and estradiol concentrations at baseline (P trend; progesterone 0.04, estradiol 0.02) but not in the second sample or in the weekly change between samples. Progesterone treatment did not increase the progesterone concentration. CONCLUSIONS Plasma concentrations of progesterone, estradiol, and unconjugated estriol at 18-24 weeks are not associated with cervical length or preterm delivery in twin pregnancies. Vaginal progesterone treatment does not increase the circulating progesterone concentration in twin pregnancies. Cervical length, but not hormone concentration, is predictive of preterm delivery in twin gestations.
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Affiliation(s)
- Vilma L Johnsson
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, , Copenhagen, Denmark
| | - Nina G Pedersen
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, , Copenhagen, Denmark
| | - Katharina Worda
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | | | - Lillian Skibsted
- Department of Obstetrics and Gynecology, University Hospital Roskilde, Roskilde, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stefan Hinterberger
- Department of Obstetrics and Gynecology, General Hospital of Klagenfurt, Klagenfurt, Austria
| | - Isolde Strobl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Maria E Bowman
- Mothers and Babies Research Center/Hunter Medical Research Institute, John Hunter Hospital, Faculty of Health/School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Roger Smith
- Mothers and Babies Research Center/Hunter Medical Research Institute, John Hunter Hospital, Faculty of Health/School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Ann Tabor
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, , Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Line Rode
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, , Copenhagen, Denmark.,Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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13
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Romero R, Conde-Agudelo A, Da Fonseca E, O'Brien JM, Cetingoz E, Creasy GW, Hassan SS, Nicolaides KH. Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data. Am J Obstet Gynecol 2018; 218:161-180. [PMID: 29157866 PMCID: PMC5987201 DOI: 10.1016/j.ajog.2017.11.576] [Citation(s) in RCA: 285] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/13/2017] [Accepted: 11/13/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. OBJECTIVE To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. STUDY DESIGN We searched MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017); Cochrane databases; bibliographies; and conference proceedings for randomized controlled trials comparing vaginal progesterone vs placebo/no treatment in women with a singleton gestation and a midtrimester sonographic cervical length ≤25 mm. This was a systematic review and meta-analysis of individual patient data. The primary outcome was preterm birth <33 weeks of gestation. Secondary outcomes included adverse perinatal outcomes and neurodevelopmental and health outcomes at 2 years of age. Individual patient data were analyzed using a 2-stage approach. Pooled relative risks with 95% confidence intervals were calculated. Quality of evidence was assessed using the GRADE methodology. RESULTS Data were available from 974 women (498 allocated to vaginal progesterone, 476 allocated to placebo) with a cervical length ≤25 mm participating in 5 high-quality trials. Vaginal progesterone was associated with a significant reduction in the risk of preterm birth <33 weeks of gestation (relative risk, 0.62; 95% confidence interval, 0.47-0.81; P = .0006; high-quality evidence). Moreover, vaginal progesterone significantly decreased the risk of preterm birth <36, <35, <34, <32, <30, and <28 weeks of gestation; spontaneous preterm birth <33 and <34 weeks of gestation; respiratory distress syndrome; composite neonatal morbidity and mortality; birthweight <1500 and <2500 g; and admission to the neonatal intensive care unit (relative risks from 0.47-0.82; high-quality evidence for all). There were 7 (1.4%) neonatal deaths in the vaginal progesterone group and 15 (3.2%) in the placebo group (relative risk, 0.44; 95% confidence interval, 0.18-1.07; P = .07; low-quality evidence). Maternal adverse events, congenital anomalies, and adverse neurodevelopmental and health outcomes at 2 years of age did not differ between groups. CONCLUSION Vaginal progesterone decreases the risk of preterm birth and improves perinatal outcomes in singleton gestations with a midtrimester sonographic short cervix, without any demonstrable deleterious effects on childhood neurodevelopment.
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Affiliation(s)
- Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI.
| | - Agustin Conde-Agudelo
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Eduardo Da Fonseca
- Departamento de Obstetrícia e Ginecologia, Hospital do Servidor Publico Estadual "Francisco Morato de Oliveira" and School of Medicine, University of São Paulo, São Paulo, Brazil
| | - John M O'Brien
- Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY
| | - Elcin Cetingoz
- Department of Obstetrics and Gynecology, Turkish Red Crescent Altintepe Medical Center, Maltepe, Istanbul, Turkey
| | - George W Creasy
- Center for Biomedical Research, Population Council, New York, NY
| | - Sonia S Hassan
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Kypros H Nicolaides
- Harris Birthright Research Center for Fetal Medicine, King's College Hospital, London, United Kingdom
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14
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Wagner GP, Nnamani MC, Chavan AR, Maziarz J, Protopapas S, Condon J, Romero R. Evolution of Gene Expression in the Uterine Cervix related to Steroid Signaling: Conserved features in the regulation of cervical ripening. Sci Rep 2017; 7:4439. [PMID: 28667298 PMCID: PMC5493687 DOI: 10.1038/s41598-017-04759-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/19/2017] [Indexed: 01/01/2023] Open
Abstract
The uterine cervix is the boundary structure between the uterus and the vagina and is key for the maintenance of pregnancy and timing of parturition. Here we report on a comparative transcriptomic study of the cervix of four placental mammals, mouse, guinea pig, rabbit and armadillo, and one marsupial, opossum. Our aim is to investigate the evolution of cervical gene expression as related to putative mechanisms for functional progesterone withdrawal. Our findings are: 1) The patterns of gene expression in eutherian (placental) mammals are consistent with the notion that an increase in the E/P4 signaling ratio is critical for cervical ripening. How the increased E/P4 ratio is achieved, however, is variable between species. 2) None of the genes related to steroid signaling, that are modulated in eutherian species, change expression during opossum gestation. 3) A tendency for decreased expression of progesterone receptor co-activators (NCOA1, -2 and -3, and CREBBP) towards term is a shared derived feature of eutherians. This suggests that parturition is associated with broad scale histone de-acetylation. Western-blotting on mouse cervix confirmed large scale histone de-acetylation in labor. This finding may have important implications for the control of premature cervical ripening and prevention of preterm birth in humans.
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Affiliation(s)
- Günter P Wagner
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, 06520, USA. .,Department of Obstetrics, Gynecology and Reproductive Science, Yale University, New Haven, CT, 06520, USA. .,Yale Systems Biology Institute, West Haven, CT, 06516, USA. .,Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, 48202, USA.
| | - Mauris C Nnamani
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, 06520, USA.,Yale Systems Biology Institute, West Haven, CT, 06516, USA
| | - Arun Rajendra Chavan
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, 06520, USA.,Yale Systems Biology Institute, West Haven, CT, 06516, USA
| | - Jamie Maziarz
- Yale Systems Biology Institute, West Haven, CT, 06516, USA
| | | | - Jennifer Condon
- Perinatology Research Branch, NICHD, NIH, Detroit, MI, 48201, USA.,Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, 48202, USA
| | - Roberto Romero
- Perinatology Research Branch, NICHD, NIH, Detroit, MI, 48201, USA.,Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, 48202, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Epidemiology, Michigan State University, East Lansing, MI, 48824, USA
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15
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Pan X, Hu J, Xia W, Zhang B, Liu W, Zhang C, Yang J, Hu C, Zhou A, Chen Z, Cao J, Zhang Y, Wang Y, Huang Z, Lv B, Song R, Zhang J, Xu S, Li Y. Prenatal chromium exposure and risk of preterm birth: a cohort study in Hubei, China. Sci Rep 2017; 7:3048. [PMID: 28596517 PMCID: PMC5465100 DOI: 10.1038/s41598-017-03106-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/25/2017] [Indexed: 12/27/2022] Open
Abstract
Few studies have investigated the association of environmental chromium exposure and preterm birth in general population. This study was designed to investigate whether maternal chromium exposure during pregnancy is associated with reduced gestational age or risk of preterm birth using the data from Healthy Baby Cohort study conducted in Hubei, China between 2012 and 2014 (n = 7290). Chromium concentrations in maternal urine samples collected at delivery were measured with inductively coupled plasma mass spectrometry. Tertiles of chromium concentrations was negatively associated with gestational age in multivariable linear regression analyses [β (95% CI): low = reference; middle = -0.67 days (-1.14, -0.20); high = -2.30 days (-2.93, -1.67); p trend <0.01]. Logistic regression analyses also indicated that higher maternal chromium [adjusted odds ratio (OR) (95% CI): 1.55(0.99, 2.42) for the medium tertile; 1.89(1.13, 3.18) for the highest tertile; p trend <0.01] was associated with increased risk of preterm birth. The associations appeared to be more pronounced in male infants (adjusted OR (95% CI): 2.54 (1.29, 4.95) for the medium tertile; 2.92 (1.37, 6.19) for the highest tertile; p trend <0.01). Our findings suggest maternal exposure to higher chromium levels during pregnancy may potentially increase the risk of delivering preterm infants, particularly for male infants.
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Affiliation(s)
- Xinyun Pan
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jie Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Bin Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China
| | - Wenyu Liu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Chuncao Zhang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jie Yang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Chen Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Aifen Zhou
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China
| | - Zhong Chen
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China
| | - Jiangxia Cao
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China
| | - Yiming Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China
| | - Youjie Wang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Zheng Huang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Bin Lv
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Ranran Song
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jianduan Zhang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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Hajagos-Toth J, Bota J, Ducza E, Csanyi A, Tiszai Z, Borsodi A, Samavati R, Benyhe S, Gaspar R. The effects of estrogen on the α2-adrenergic receptor subtypes in rat uterine function in late pregnancy in vitro. Croat Med J 2017; 57:100-9. [PMID: 27106352 PMCID: PMC4856191 DOI: 10.3325/cmj.2016.57.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM To assess the effect of 17β-estradiol pretreatment on the function and expression of α2- adrenergic receptors (ARs) subtypes in late pregnancy in rats. METHODS Sprague-Dawley rats (n=37) were treated with 17β-estradiol for 4 days starting from the 18th day of pregnancy. The myometrial expression of the α2-AR subtypes was determined by real time polymerase chain reaction and Western blot analysis. In vitro contractions were stimulated with (-)-noradrenaline, and its effect was modified with the selective antagonists BRL 44408 (α2A), ARC 239 (α2B/C), and spiroxatrine (α2A). The cyclic adenosine monophosphate (cAMP) accumulation was also measured. The activated G-protein level was investigated by guanosine 5'-O-[gamma-thio]triphosphate (GTPγS) binding assay. RESULTS 17β-estradiol pretreatment decreased the contractile effect of (-)-noradrenaline via the α2-ARs, and abolished the contractile effect via the α2B-ARs. All the α2-AR subtypes' mRNA was significantly decreased. 17β-estradiol pretreatment significantly increased the myometrial cAMP level in the presence of BRL 44408 (P=0.001), ARC 239 (P=0.007), and spiroxatrine (P=0.045), but did not modify it in the presence of spiroxatrine + BRL 44408 combination (P=0.073). It also inhibited the G-protein-activating effect of (-)-noradrenaline by 25% in the presence of BRL 44408 + spiroxatrine combination. CONCLUSIONS The expression of the α2-AR subtypes is sensitive to 17β-estradiol, which decreases the contractile response of (-)-noradrenaline via the α2B-AR subtype, and might cause changes in G-protein signaling pathway. Estrogen dysregulation may be responsible for preterm labor or uterine inertia via the α2-ARs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Robert Gaspar
- Robert Gaspar, Szeged, H-6701, P.O. Box 121, Hungary,
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Li H, Zhou J, Wei X, Chen R, Geng J, Zheng R, Chai J, Li F, Jiang S. miR-144 and targets, c-fos and cyclooxygenase-2 (COX2), modulate synthesis of PGE2 in the amnion during pregnancy and labor. Sci Rep 2016; 6:27914. [PMID: 27297132 PMCID: PMC4906292 DOI: 10.1038/srep27914] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/26/2016] [Indexed: 12/30/2022] Open
Abstract
Labor is initiated as a result of hormonal changes that are induced by the activation of the inflammatory response and a series of biochemical events. The amnion, which is the primary source of prostaglandin E2 (PGE2), plays an important role in the process of labor. In the present study, we uncovered a pathway in which c-fos, cyclooxygenase-2 (COX2) and miR-144 function as hormonal modulators in the amnions of pregnant mice and humans. miR-144 down-regulated the synthesis of PGE2 during pregnancy by directly and indirectly inhibiting COX2 expression and by directly inhibiting the expression of c-fos, a transcriptional activator of COX2 and miR-144. Estrogen (E2) activated c-fos, thus promoting the expression of miR-144 and COX2 during labor. However, the increase in COX2 resulted in the partial inhibition of COX2 expression by miR-144, thereby slightly reducing the secretion of PGE2. These observations suggest that miR-144 inhibits PGE2 secretion by section to prevent the initiation of premature labor. Up-regulated expression of miR-144, c-fos and COX2 was also observed both in preterm mice and in mice undergoing normal labor. In summary, miR-144, c-fos and COX2 play important roles in regulating PGE2 secretion in the amnion during pregnancy and labor.
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Affiliation(s)
- Huanan Li
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Jiawei Zhou
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Xiajie Wei
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Ran Chen
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Junnan Geng
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Rong Zheng
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Jin Chai
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Fenge Li
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Siwen Jiang
- Key Laboratory of Swine Genetics and Breeding of Agricultural Ministry and Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, People's Republic of China.,The Cooperative Innovation Center for Sustainable Pig Production, Wuhan 430070, China People's Republic of China
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Vannuccini S, Bocchi C, Severi FM, Challis JR, Petraglia F. Endocrinology of human parturition. ANNALES D'ENDOCRINOLOGIE 2016; 77:105-13. [DOI: 10.1016/j.ando.2016.04.025] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
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Weinberger B, Vetrano AM, Archer FE, Marcella SW, Buckley B, Wartenberg D, Robson MG, Klim J, Azhar S, Cavin S, Wang L, Rich DQ. Effects of maternal exposure to phthalates and bisphenol A during pregnancy on gestational age. J Matern Fetal Neonatal Med 2013; 27:323-7. [PMID: 23795657 DOI: 10.3109/14767058.2013.815718] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Phthalates and bisphenol A (BPA) are ubiquitous environmental toxicants, present in high concentrations in numerous consumer products. We hypothesized that maternal exposure to phthalates and BPA in pregnancy is associated with shortened gestation. METHODS Urinary phthalate and BPA metabolites from 72 pregnant women were measured at the last obstetric clinic visit prior to delivery. Using linear regression models, we estimated the change in gestational age associated with each interquartile range (IQR) increase in phthalate and BPA metabolite concentration. RESULTS IQR increases in urinary mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and BPA concentrations were associated with 4.2 and 1.1 d decreases in gestation, respectively. When stratified by gender, these alterations were found only in male infants. CONCLUSIONS We conclude that MEHHP and BPA (free + glucuronide) are associated with reductions in gestation, with effects observed only in males. Our findings are consistent with the idea that these agents induce gender-specific alterations in signaling via PPAR-γ transcription factor, androgen precursors and/or inflammatory mediators during the initiation of labor.
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Romero R, Yeo L, Miranda J, Hassan S, Conde-Agudelo A, Chaiworapongsa T. A blueprint for the prevention of preterm birth: vaginal progesterone in women with a short cervix. J Perinat Med 2013; 41:27-44. [PMID: 23314512 PMCID: PMC4151573 DOI: 10.1515/jpm-2012-0272] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 12/07/2012] [Indexed: 12/11/2022]
Abstract
Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and is the most important challenge to modern obstetrics. A major obstacle has been that preterm birth is treated (implicitly or explicitly) as a single condition. Two thirds of preterm births occur after the spontaneous onset of labor, and the remaining one third after "indicated" preterm birth; however, the causes of spontaneous preterm labor and "indicated" preterm birth are different. Spontaneous preterm birth is a syndrome caused by multiple etiologies, one of which is a decline in progesterone action, which induces cervical ripening. A sonographic short cervix (identified in the midtrimester) is a powerful predictor of spontaneous preterm delivery. Randomized clinical trials and individual patient meta-analyses have shown that vaginal progesterone reduces the rate of preterm delivery at <33 weeks of gestation by 44%, along with the rate of admission to the neonatal intensive care unit, respiratory distress syndrome, requirement for mechanical ventilation, and composite neonatal morbidity/mortality score. There is no evidence that 17-α-hydroxyprogesterone caproate can reduce the rate of preterm delivery in women with a short cervix, and therefore, the compound of choice is natural progesterone (not the synthetic progestin). Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and the implementation of such a policy is urgently needed. Vaginal progesterone is as effective as cervical cerclage in reducing the rate of preterm delivery in women with a singleton gestation, history of preterm birth, and a short cervix (<25 mm).
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Affiliation(s)
- Roberto Romero
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, MD, USA.
| | - Lami Yeo
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, and Detroit, Michigan, USA,Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Jezid Miranda
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, and Detroit, Michigan, USA
| | - Sonia Hassan
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, and Detroit, Michigan, USA,Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Agustin Conde-Agudelo
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, and Detroit, Michigan, USA
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, and Detroit, Michigan, USA,Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
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Meis PJ. The role of 17 alpha-hydroxyprogesterone caproate in the prevention of preterm birth. ACTA ACUST UNITED AC 2012; 2:819-24. [PMID: 19803999 DOI: 10.2217/17455057.2.6.819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Preterm birth is a major public-health problem in the USA, which has higher rates of preterm birth than most other developed countries. Attempts at the prevention of preterm birth have been largely unsuccessful. The recent publication of a large, multicenter, randomized trial of 17 alpha-hydroxyprogesterone caproate, which showed efficacy in preventing recurrent preterm delivery, has sparked renewed interest in progestational drugs in general and this compound in particular for use in preventing preterm delivery. Although this drug is not currently commercially available, an application has been made to the US FDA to produce 17 alpha-hydroxyprogesterone caproate, as Gestiva() for the prevention of preterm delivery.
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Affiliation(s)
- Paul J Meis
- Department of Obstetrics & Gynecology, Section of Maternal Fetal Medicine, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27157, USA.
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Gao L, Tao Y, Hu T, Liu W, Xu C, Liu J, You X, Gu H, Ni X. Regulation of estradiol and progesterone production by CRH-R1 and -R2 is through divergent signaling pathways in cultured human placental trophoblasts. Endocrinology 2012; 153:4918-28. [PMID: 22865371 DOI: 10.1210/en.2012-1453] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CRH and its related peptides urocortins (UCN) have been identified in placenta and implicated to play pivotal roles in the regulation of pregnancy and parturition in humans. The objectives of present study were to investigate the effects of endogenous CRH and its related peptides in the regulation of steroid production in placenta. Placental trophoblasts were isolated from term placenta tissues and cultured for 72 h. Estradiol (E(2)) and progesterone (P(4)) contents in culture media were determined by radioimmunoassay. Treatment of cultured trophoblasts with CRH or UCNI antibody showed decreased E(2), whereas increased P(4) production. Treatment of cells with CRH receptor type 1 antagonist antalarmin or CRH receptor type 2 (CRH-R2) antagonist astressin-2b also decreased E(2) but increased P(4) production. Knockdown of CRH receptor type 1 or CRH-R2 cells showed a decrease in E(2) production and an increase in P(4) production. In CRH-R2 knockdown cells, CRH stimulated GTP-bound Gαs protein and phosphorylated phospholipase C-β3. Adenylyl cyclase and protein kinase A inhibitors blocked CRH-induced increased E(2) production but not decreased P(4) production. PLC inhibitor U73122 and protein kinase C inhibitor chelerythrine blocked the effects of CRH on E(2) and P(4) production in CRH-R2 knockdown cells. UCNIII, the specific CRH-R2 agonist, stimulated GTP-bound Gαi protein and phosphorylated phospholipase C-β3 expression. Both U73122 and chelerythrine blocked UCNIII-induced increased E(2) production and decreased P(4) production. We suggest that CRH and its related peptides might be involved in changes in the progesterone to estrogen ratio during human pregnancy.
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Affiliation(s)
- Lu Gao
- Department of Physiology, Second Military Medical University, Shanghai 200433, China
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Wagner GP, Tong Y, Emera D, Romero R. An evolutionary test of the isoform switching hypothesis of functional progesterone withdrawal for parturition: humans have a weaker repressive effect of PR-A than mice. J Perinat Med 2012; 40:345-51. [PMID: 22752763 PMCID: PMC4151568 DOI: 10.1515/jpm-2011-0256] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 02/09/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND A decrease in maternal serum progesterone (P4) concentrations precedes the onset of labor in most placental mammals. Humans differ by maintaining high levels of P4 throughout birth. Parturition in humans probably includes mechanisms that undercut the pregnancy sustaining function of P4. One attractive hypothesis is the isoform switching hypothesis (ISH). ISH is supported by in vitro evidence that progesterone receptor isoform A (PR-A) inhibits PR-B and that the PR-A/PR-B ratio increases towards term. MATERIALS AND METHODS Here, we test the hypothesis that isoform switching is an adaptation to high levels of P4 at term, predicting that, in humans, PR-A mediated repression of PR-B is stronger than in mouse. We use reporter assays with human and mouse PRs to detect species differences in the repressive effects of PR-A. RESULTS We found that human PR-B is less sensitive to repression by human PR-A than mouse PR-B, contrary to our prediction. The difference between human and mouse PR-B sensitivity is most pronounced at PR-A/PR-B ratios typical for the preterm myometrium. CONCLUSIONS Our results are inconsistent with the ISH. We speculate that, instead, the lower sensitivity of human PR-B to PR-A may be relevant for the maintenance of pregnancy at high progesterone levels and increasing PR-A concentrations towards term.
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Affiliation(s)
- GP Wagner
- Yale Systems Biology Institute and Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA,Corresponding Author: Yale Systems Biology Institute Department of Ecology and Evolutionary Biology Yale University 165 Prospect Street New Haven, CT 06410 USA Phone: 203-432-9998 (main) 203-737-3091 (west campus) Fax: 203-737-3109
| | - Y Tong
- Yale Systems Biology Institute and Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
| | - D Emera
- Yale Systems Biology Institute and Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
| | - R Romero
- Perinatology Research Branch, NICHD, Detroit, MI, USA
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Romero R, Nicolaides K, Conde-Agudelo A, Tabor A, O'Brien JM, Cetingoz E, Da Fonseca E, Creasy GW, Klein K, Rode L, Soma-Pillay P, Fusey S, Cam C, Alfirevic Z, Hassan SS. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data. Am J Obstet Gynecol 2012; 206:124.e1-19. [PMID: 22284156 PMCID: PMC3437773 DOI: 10.1016/j.ajog.2011.12.003] [Citation(s) in RCA: 337] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To determine whether the use of vaginal progesterone in asymptomatic women with a sonographic short cervix (≤ 25 mm) in the midtrimester reduces the risk of preterm birth and improves neonatal morbidity and mortality. STUDY DESIGN Individual patient data metaanalysis of randomized controlled trials. RESULTS Five trials of high quality were included with a total of 775 women and 827 infants. Treatment with vaginal progesterone was associated with a significant reduction in the rate of preterm birth <33 weeks (relative risk [RR], 0.58; 95% confidence interval [CI], 0.42-0.80), <35 weeks (RR, 0.69; 95% CI, 0.55-0.88), and <28 weeks (RR, 0.50; 95% CI, 0.30-0.81); respiratory distress syndrome (RR, 0.48; 95% CI, 0.30-0.76); composite neonatal morbidity and mortality (RR, 0.57; 95% CI, 0.40-0.81); birthweight <1500 g (RR, 0.55; 95% CI, 0.38-0.80); admission to neonatal intensive care unit (RR, 0.75; 95% CI, 0.59-0.94); and requirement for mechanical ventilation (RR, 0.66; 95% CI, 0.44-0.98). There were no significant differences between the vaginal progesterone and placebo groups in the rate of adverse maternal events or congenital anomalies. CONCLUSION Vaginal progesterone administration to asymptomatic women with a sonographic short cervix reduces the risk of preterm birth and neonatal morbidity and mortality.
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Affiliation(s)
- Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
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Baroutis G, Mousiolis A, Hoffman D, Antsaklis A. Preterm birth seasonality in Greece: an epidemiological study. J Matern Fetal Neonatal Med 2011; 25:1406-12. [PMID: 22070139 DOI: 10.3109/14767058.2011.636103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Seasonality of preterm birth has been noted, although not conclusively studied. Weather is also thought to play a role. We sought preterm birth seasonality and additionally studied the effect of weather parameters in the preterm birth pattern. METHODS Vital statistics from the Hellenic Statistical Authority were retrieved, covering the years from 1980 to 2008. Additionally, weather data were retrieved for the years of the study. Time series analysis was used to create various statistical models that would be compared to each other for their accuracy to predict preterm birth. Factors used in the modeling included month of birth, gender and weather factors. RESULTS Preterm birth seasonality was exhibited. Two peaks of higher risk of preterm birth were noted: One during summer and one during winter. Males were more influenced by seasonality and exhibited slightly different seasonal patterns than females, although no higher risk for preterm birth was noted. The best model that described seasonal pattern of preterm birth was the one that included meteorological factors. Notably, extreme (hotter or colder) weather was accompanied by an increase in preterm birth. CONCLUSIONS Evidence for seasonality of preterm birth was shown and extreme weather was associated with a higher incidence of it.
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Cetingoz E, Cam C, Sakallı M, Karateke A, Celik C, Sancak A. Progesterone effects on preterm birth in high-risk pregnancies: a randomized placebo-controlled trial. Arch Gynecol Obstet 2011; 283:423-9. [PMID: 20091317 DOI: 10.1007/s00404-009-1351-2] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 12/29/2009] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate whether the prophylactic administration of vaginal progesterone would reduce the preterm birth rate in high-risk population including singleton and twin pregnancies. METHODS This was a randomized, double blind, placebo-controlled study that included 150 high-risk pregnancies. Risk groups included prior spontaneous preterm birth, twin pregnancy, and uterine malformation. Micronized progesterone or placebo (100 mg) was administered daily by vaginal suppository between 24 and 34 weeks of gestation. We compared progesterone and placebo groups for incidence of preterm labor and preterm delivery. Data were compared by χ² analysis and Fisher exact test. RESULTS There was a statistically significant difference in the rate of preterm labor between placebo and progesterone groups (45.7 vs. 25%, respectively; p < 0.05). More women delivered before 37 weeks in placebo group (57.2%) than in progesterone group (40%; p < 0.05). Administering progesterone also reduced the preterm birth before 34 weeks of gestation. The difference between placebo and progesterone group was statistically significant (24.3 vs. 8.8%; p < 0.05). However, there was no significant difference in neonatal death between placebo and progesterone groups. CONCLUSION Prophylactic vaginal progesterone reduced the rate of preterm labor and preterm delivery in high-risk pregnancies.
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Affiliation(s)
- Elcin Cetingoz
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Education and Research Hospital, Uskudar, Istanbul, Turkey.
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Pepels P, Spaanderman M, Hermus A, Lotgering F, Sweep C. Placental urocortin-2 and -3: Endocrine or Paracrine Functioning During Healthy Pregnancy? Placenta 2010; 31:475-81. [DOI: 10.1016/j.placenta.2010.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2010] [Revised: 03/14/2010] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
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Mitchell BF, Taggart MJ. Are animal models relevant to key aspects of human parturition? Am J Physiol Regul Integr Comp Physiol 2009; 297:R525-45. [PMID: 19515978 DOI: 10.1152/ajpregu.00153.2009] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Preterm birth remains the most serious complication of pregnancy and is associated with increased rates of infant death or permanent neurodevelopmental disability. Our understanding of the regulation of parturition remains inadequate. The scientific literature, largely derived from rodent animal models, suggests two major mechanisms regulating the timing of parturition: the withdrawal of the steroid hormone progesterone and a proinflammatory response by the immune system. However, available evidence strongly suggests that parturition in the human has significantly different regulators and mediators from those in most of the animal models. Our objectives are to critically review the data and concepts that have arisen from use of animal models for parturition and to rationalize the use of a new model. Many animal models have contributed to advances in our understanding of the regulation of parturition. However, we suggest that those animals dependent on progesterone withdrawal to initiate parturition clearly have a limitation to their translation to the human. In such models, a linear sequence of events (e.g., luteolysis, progesterone withdrawal, uterine activation, parturition) gives rise to the concept of a "trigger" mechanism. Conversely, we propose that human parturition may arise from the concomitant maturation of several systems in parallel. We have termed this novel concept "modular accumulation of physiological systems" (MAPS). We also emphasize the urgency to determine the precise role of the immune system in the process of parturition in situations other than intrauterine infection. Finally, we accentuate the need to develop a nonprimate animal model whose physiology is more relevant to human parturition. We suggest that the guinea pig displays several key physiological characteristics of gestation that more closely resemble human pregnancy than do currently favored animal models. We conclude that the application of novel concepts and new models are required to advance translational research in parturition.
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Affiliation(s)
- Bryan F Mitchell
- Department of Obstetrics & Gynecology, Heritage Medical Research Centre, University of Alberta, Edmonton, Alberta, Canada.
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Smith R, Smith JI, Shen X, Engel PJ, Bowman ME, McGrath SA, Bisits AM, McElduff P, Giles WB, Smith DW. Patterns of plasma corticotropin-releasing hormone, progesterone, estradiol, and estriol change and the onset of human labor. J Clin Endocrinol Metab 2009; 94:2066-74. [PMID: 19258402 DOI: 10.1210/jc.2008-2257] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Clinical prediction of preterm delivery is largely ineffective, and the mechanism mediating progesterone (P) withdrawal and estrogen activation at the onset of human labor is unclear. OBJECTIVES Our objectives were to determine associations of rates of change of circulating maternal CRH in midpregnancy with preterm delivery, CRH with estriol (E3) concentrations in late pregnancy, and predelivery changes in the ratios of E3, estradiol (E2), and P. DESIGN AND SETTING A cohort of 500 pregnant women was followed from first antenatal visits to delivery during the period 2000-2004 at John Hunter Hospital, New South Wales, Australia, a tertiary care obstetric hospital. PATIENTS Unselected subjects were recruited (including women with multiple gestations) and serial blood samples obtained. MAIN OUTCOME MEASURES CRH daily percentage change in term and preterm singletons at 26 wk, ratios E3/E2, P/E3, and P/E2 and the association between E3 and CRH concentrations in the last month of pregnancy (with spontaneous labor onset) were assessed. RESULTS CRH percentage daily change was significantly higher in preterm than term singletons at 26 wk (medians 3.09 and 2.73; P = 0.003). In late pregnancy, CRH and E3 concentrations were significantly positively associated (P = 0.003). E3/E2 increased, P/E3 decreased, and P/E2 was unchanged in the month before delivery (medians: E3/E2, 7.04 and 10.59, P < 0.001; P/E3, 1.55 and 0.98, P < 0.001; P/E2, 11.78 and 10.79, P = 0.07). CONCLUSIONS The very rapid rise of CRH in late pregnancy is associated with an E3 surge and critically altered P/E3 and E3/E2 ratios that create an estrogenic environment at the onset of labor. Our evidence provides a rationale for the use of CRH in predicting preterm birth and informs approaches to delaying labor using P supplementation.
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Affiliation(s)
- Roger Smith
- Mothers and Babies Research Centre, University of Newcastle, Endocrine Unit, John Hunter Hospital, Newcastle, NSW 2305, Australia.
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Haddad R, Romero R, Gould BR, Tromp G, Gotsch F, Edwin SS, Zingg HH. Angiogenesis gene expression in mouse uterus during the common pathway of parturition. Am J Obstet Gynecol 2008; 198:539.e1-8. [PMID: 18455529 DOI: 10.1016/j.ajog.2007.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Revised: 08/14/2007] [Accepted: 11/08/2007] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The objective of the study was to investigate changes in the expression of angiogenesis-related genes during the common terminal pathway of parturition including spontaneous labor at term, as well as preterm labor (PTL), induced by either bacteria or ovariectomy. STUDY DESIGN Preterm pregnant mice (14.5 days of gestation) were treated with the following: (1) intrauterine injection of media; (2) intrauterine injection of heat-inactivated Escherichia coli; (3) ovariectomy; and (4) sham operation. Tissues from mice at term (19.5 days of gestation) were collected at term not in labor, term in labor, and 12 hours postpartum. Angiogenesis-related gene expression levels were quantitated by the measurement of specific mRNAs in uterine tissue by RT-qPCR and analyzed by repeated-measures analysis of variance. RESULTS The following results were found: (1) microarray analysis of the uterine transcriptome indicated an enrichment for the gene ontology category of angiogenesis in bacteria-induced PTL samples (P < or = .093); (2) several genes related to angiogenesis demonstrated significantly increased expression in samples in either term spontaneous labor or preterm labor; and (3) qRT-PCR measurements demonstrated that spontaneous term labor and preterm labor induced by either bacteria or ovariectomy all substantially increased the expression of multiple angiogenesis-related genes (P < or = .0003; Angpt2, Ctgf, Cyr61, Dscr1, Pgf, Serpine1, Thbs1, and Wisp 1). CONCLUSION Spontaneous labor at term, as well as pathologically induced preterm labor, all result in greatly increased expression of angiogenesis-related genes in the uterus.
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Guoyang Luo, Morgan T, Bahtiyar MO, Snegovskikh VV, Schatz F, Kuczynski E, Funai EF, Dulay AT, Huang STJ, Buhimschi CS, Buhimschi IA, Fortunato SJ, Menon R, Lockwood CJ, Norwitz ER. Single Nucleotide Polymorphisms in the Human Progesterone Receptor Gene and Spontaneous Preterm Birth. Reprod Sci 2008; 15:147-55. [DOI: 10.1177/1933719107310990] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Guoyang Luo
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Thomas Morgan
- Department of Pediatrics, Washington University, St Louis, Missouri
| | - Mert O. Bahtiyar
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Victoria V. Snegovskikh
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Frederick Schatz
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Edward Kuczynski
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Edmund F. Funai
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Antonette T. Dulay
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Se-Te Joseph Huang
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Catalin S. Buhimschi
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Irina A. Buhimschi
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | | | | | - Charles J. Lockwood
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
| | - Errol R. Norwitz
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut,
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Romero R. Prevention of spontaneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2007; 30:675-86. [PMID: 17899585 DOI: 10.1002/uog.5174] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Gidlöf S, Wedell A, Nordenström A. Gestational age correlates to genotype in girls with CYP21 deficiency. J Clin Endocrinol Metab 2007; 92:246-9. [PMID: 17047018 DOI: 10.1210/jc.2006-1369] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The mechanisms behind onset of labor and prolongation of pregnancy are not fully understood, but steroid hormones are thought to contribute. 17-Hydroxyprogesterone has been shown to prolong pregnancy in humans. Male fetuses have been reported to have longer gestation than females. OBJECTIVE The objective of the study was to investigate whether severity of 21-hydroxylase gene (CYP21) deficiency in fetuses with congenital adrenal hyperplasia (CAH) correlates with length of pregnancy. DESIGN AND SUBJECTS The gestational age (GA) of a cohort of CAH patients born between 1978 and 2004 was studied retrospectively. The GA was correlated to the severity of disease indicated by CYP21 genotype in 114 patients. The results were compared with respect to sex and the normal Swedish population data. RESULTS In female fetuses with CAH, we found a correlation between GA and CYP21 genotype. Females with the most severe form of the disease, null mutation, had the longest GA and differed significantly from the normal population. No difference between the sexes was detected for fetuses with CAH as a group. There were no significant differences between CYP21 genotype groups for males. CONCLUSIONS Female patients with severe CYP21 deficiency had longer GA than patients with the milder form of the disease, indicating that androgen excess, increased 17-hydroxyprogesterone levels, or cortisol deficiency or a combination of these factors is of importance for prolongation of pregnancy. The same correlation was not observed for male patients. The results of this study support the notion that steroid hormones affect the prolongation of pregnancy or onset of labor or both.
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Affiliation(s)
- Sebastian Gidlöf
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Centre for Inherited Metabolic Diseases, Karolinska University Hospital Huddinge, SE-141 86 Huddinge, Sweden.
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Vance CJ, Esplin MS, Hamblin S, Graves SW. Alterations in uterine sodium pump abundance may contribute to the onset and progression of term and preterm labor in mice. Am J Obstet Gynecol 2006; 195:1407-14. [PMID: 16875653 DOI: 10.1016/j.ajog.2006.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2006] [Revised: 04/28/2006] [Accepted: 05/04/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Other investigators have shown that reductions in active sodium pump units increase uterine contractility. Therefore, our goal was to determine whether uterine sodium pump abundance is decreased in mouse models of term and preterm labor. STUDY DESIGN Mice were studied during the final one-third of pregnancy. Other pregnant mice had preterm labor induced with lipopolysaccharide and were studied at timed intervals thereafter. Uterine sodium pump alpha3-isoform messenger RNA and protein were measured. Data were analyzed by analysis of variance. RESULTS Uterine sodium pump alpha3-isoform messenger RNA fell significantly from day 14 to day 18 and remained low on the day of birth. Uterine sodium pump alpha3-isoform protein levels decreased significantly also. In lipopolysaccharide-induced preterm labor, uterine sodium pump alpha3-isoform protein, but not messenger RNA, decreased significantly. CONCLUSION Sodium pump alpha3-isoform protein levels decreased in uterus before term labor and lipopolysaccharide-induced preterm labor. These findings are similar to those in humans, which suggests that this mouse model may be useful in the study of the sodium pump in human pregnancy. Reductions in sodium pump number can increase uterine contractile force and may contribute to labor.
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Affiliation(s)
- Carlos J Vance
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602, USA
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Schmitz T, Levine BA, Nathanielsz PW. Localization and steroid regulation of prostaglandin E2 receptor protein expression in ovine cervix. Reproduction 2006; 131:743-50. [PMID: 16595725 DOI: 10.1530/rep.1.00767] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although prostaglandin E2 (PGE2) has been identified as a central mediator of the cervical ripening process, the mechanisms responsible for PGE2 ripening are still poorly understood, partly because of the lack of information concerning the precise cellular localization and regulation of PGE2 (EP) receptors in the cervix. To provide new insights into the mechanisms of cervical ripening, we used indirect immunofluorescence to localize cervical EP receptor protein expression in ovariectomized ewes and examined the effect of administration of progesterone or estradiol. EP receptors were widely distributed in cervical blood vessels, epithelium of the cervical canal, circular and longitudinal muscles, and stroma. Estradiol replacement decreased EP1 and EP3 receptor protein in blood vessel media (by 23 and 31% respectively, P < 0.05) and decreased EP1 receptor protein expression in the longitudinal muscle layer (by 27%, P < 0.05). Stromal EP1 and EP3 receptor protein expression was also reduced by estradiol (by 29 and 20% respectively, P < 0.05). Progesterone replacement had no significant effect on EP receptor protein expression. The arterial changes would favor PGE2-induced vasodilatation, subsequent edema and leukocyte infiltration during the cervical ripening process whereas the muscular alterations would facilitate smooth muscle relaxation and cervical dilatation. Furthermore, estradiol provoked perinuclear localization of EP3 receptor protein in the longitudinal muscle layer. This latter result suggests that cellular EP receptor localization is regulated by estradiol and that PGE2 may also control smooth muscle contraction and regulate ovine cervical dilatation in an intracrine manner via EP3 receptors.
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Affiliation(s)
- Thomas Schmitz
- Maternité Port-Royal, Hopital Cochin, AP-HP, Université René Descartes Paris V, Boulevard de Port-Royal, 75014 Paris, France.
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Abstract
BACKGROUND Neonatal mortality and morbidity are sex biased in low birth weight infants. The "Y chromosome effect" has been suggested to be responsible for these maturational differences. OBJECTIVE To examine the association of sex and neonatal outcomes. DESIGN AND METHODS A retrospective observational study. Data on all low birth weight infants who survived for >48 hrs were analyzed. Neonatal outcomes were compared between male and female infants. A regression model was used to detect the influence of sex on outcomes after controlling for confounders. Analysis was repeated after stratification of infants into three groups: group A (<1000 g), group B (1000-1499 g), and group C (1500-2499 g). RESULTS A total of 833 infants were included in this study; 419 female infants and 414 male infants. Male infants had an increased rate of overall intraventricular hemorrhage (IVH) (12.2% vs. 7.2%, p = .02) and IVH grades 3-4 (4.8% vs. 2.3%, p = .04). In addition, male infants had higher bilirubin levels (10.19 +/- 3.1 mg/dL vs. 9.32 +/- 2.94 mg/dL, p = .001). In a regression model, male sex continued to have significant influence on IVH, IVH grades 3-4, death, and bilirubin. In group A, male infants had a significantly increased prevalence of death (regression coefficient, 1.82 +/- 0.65; p = .005) that could not be explained by the increased prevalence of IVH (p = .18) in regression analysis. In group B, male sex was significantly associated with a higher bilirubin level (regression coefficient, 0.94 + 0.3; p = .002). In bivariate analyses, IVH and IVH grades 3-4 were significantly higher in male compared with female infants (19.8% vs. 3.9%, p < .0001) and (8.5% vs. 0.97%, p = .02), respectively, but these differences lost significance in multiple-regression analysis. In group C, male sex positively influenced the prevalence of IVH (regression coefficient, 1.7 +/- 0.57; p = .003). Bilirubin measured higher in male infants (11.38 +/- 2.87 mg/dL vs. 10.19 +/- 3.22 mg/dL, p = .0004), but the difference lost significance in regression analysis (regression coefficient, 0.21 +/- 0.31; p = .5). CONCLUSIONS Bilirubin, IVH, and death were significantly higher in male infants. In subgroup analysis, significance was retained in group A (<1000 g). Whether a single biological factor is responsible for these differences or perhaps a multi-causal process involving a complex interaction of physiologic, environmental, and pathologic responses needs to be further addressed in future research.
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Affiliation(s)
- Jennifer A Tioseco
- Department of Neonatology, The Children's National Medical Center, Washington, DC, USA
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Esplin MS, Fausett MB, Peltier MR, Hamblin S, Silver RM, Branch DW, Adashi EY, Whiting D. The use of cDNA microarray to identify differentially expressed labor-associated genes within the human myometrium during labor. Am J Obstet Gynecol 2005; 193:404-13. [PMID: 16098862 DOI: 10.1016/j.ajog.2004.12.021] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Revised: 11/12/2004] [Accepted: 12/10/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Microarray technology was used to comprehensively analyze gene expression during human labor in the myometrium. STUDY DESIGN cDNA micro-array was used to compare the transcriptomes of myometrium obtained from patients in spontaneous labor and those not in labor. Expression of four labor-specific genes was confirmed in the myometrium obtained from patients in spontaneous labor using RT-PCR, Northern blot analysis, and in-situ hybridization. RESULTS Of the >6000 cDNAs evaluated, 56 were found to be differentially expressed during labor. The labor-specific expression of 4 genes was confirmed using RT-PCR and Northern blot analysis. The relative increased expression of thrombospondin-1 in myometrium obtained from patients in spontaneous labor was also confirmed using in-situ hybridization. CONCLUSION cDNA microarray was used to identify 56 differentially expressed genes in myometrium obtained from patients in spontaneous labor. The up-regulation of four genes was confirmed by multiple methods. Elucidation of the role(s) of the genes identified by microarray should improve our understanding of normal labor physiology and may ultimately lead to more effective treatments for abnormal labor.
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Affiliation(s)
- M Sean Esplin
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Utah Health Science Center, Salt Lake City, UT 84108, USA.
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Abstract
The recent publication of 2 large randomized trials of 17 alpha hydroxyprogesterone caproate (17P) and progesterone suppositories, respectively, for the prevention of premature labor have renewed interest in the use of progesterone to prevent preterm birth. The results of these trials have reinforced the positive results of earlier smaller trials of 17P to prevent preterm delivery. A large body of evidence attests to the lack of teratogenic effects of 17P in pregnancy. Although progesterone is known to have many actions beneficial to the maintenance of pregnancy, the exact mode of action of 17P therapy in preventing preterm labor and delivery is not known. Current evidence supports the use of 17P treatment, begun early in the second trimester of gestation and continued weekly until 36 weeks, for women with a history of a previous spontaneous preterm delivery. At present no evidence exists for the use of 17P to prevent preterm delivery in women with multiple gestation, a short uterine cervix, or other high-risk conditions. The use of 17P or other progestins should not be encouraged for these indications outside of randomized trials. At present no evidence exists for the efficacy of any oral progesterone compound in preventing preterm labor. Four trials reporting the use of a progestational drug in patients with symptoms of preterm labor found no efficacy in prolonging pregnancy, and the use of 17P or other progestational drugs as tocolytic therapy should not be encouraged.
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Affiliation(s)
- Paul J Meis
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, Winston-Salem, North Carolina, USA.
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Abstract
The publication in 2003 of two large randomised trials of progesterone therapy to prevent preterm delivery has generated renewed interest in this treatment and has added substantial numbers of subjects to previously published small trials. The randomised trials of progestogens have generally shown efficacy in reducing the rate of recurrent preterm delivery in women with singleton pregnancies who were at high risk for preterm labour and delivery. Most of the successful trials have employed 17alpha-hydroxyprogesterone caproate, and one trial has reported positive results using progesterone vaginal suppositories. The administration of 17alpha-hydroxyprogesterone caproate or progesterone suppositories to women with these high-risk pregnancies showed a significant protective effect for preterm birth in six of the seven published trials. No successful trials of progestogens have been reported for women at risk for preterm delivery because of multiple gestations. Trials of progestogens after the occurrence of symptoms of labour have shown them to be ineffective in prolonging pregnancy.
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Affiliation(s)
- Paul J Meis
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
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Affiliation(s)
- Paul J Meis
- Section of Maternal Fetal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
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Mastorakos G, Ilias I. Maternal and fetal hypothalamic-pituitary-adrenal axes during pregnancy and postpartum. Ann N Y Acad Sci 2004; 997:136-49. [PMID: 14644820 DOI: 10.1196/annals.1290.016] [Citation(s) in RCA: 368] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The principal modulators of the hypothalamic-pituitary-adrenal (HPA) axis are corticotropin-releasing hormone (CRH) and arginine-vasopressin (AVP). Corticotropin-releasing hormone is not exclusively produced in the hypothalamus. Its presence has been demonstrated at peripheral inflammatory sites. Ovulation and luteolysis bear characteristics of an aseptic inflammation. CRH was found in the theca and stromal cells as well as in cells of the corpora lutea of human and rat ovaries. The cytoplasm of the glandular epithelial cells of the endometrium has been shown to contain CRH and the myometrium contains specific CRH receptors. It has been suggested that CRH of fetal and maternal origin regulates FasL production, thus affecting the invasion (implantation) process through a local auto-paracrine regulatory loop involving the cytotrophoblast cells. Thus, the latter may regulate their own apoptosis. During pregnancy, the plasma level of circulating maternal immunoreactive CRH increases exponentially from the first trimester of gestation due to the CRH production in the placenta, decidua, and fetal membranes. The presence in plasma and amniotic fluid of a CRH-binding protein (CRHbp) that reduces the bioactivity of circulating CRH by binding is unique to humans. Maternal pituitary ACTH secretion and plasma ACTH levels rise during pregnancy-though remaining within normal limits-paralleling the rise of plasma cortisol levels. The maternal adrenal glands during pregnancy gradually become hypertrophic. Pregnancy is a transient, but physiologic, period of hypercortisolism. The diurnal variation of plasma cortisol levels is maintained in pregnancy, probably due to the secretion of AVP from the parvicellular paraventricular nuclei. CRH is detected in the fetal hypothalamus as early as the 12th week of gestation. CRH levels in fetal plasma are 50% less than in maternal plasma. The circulating fetal CRH is almost exclusively of placental origin. The placenta secretes CRH at a slower rate in the fetal compartment. AVP is detected in some neurons of the fetal hypothalamus together with CRH. AVP is usually detectable in the human fetal neurohypophysis at 11 to 12 weeks gestation and increases over 1000-fold over the next 12 to 16 weeks. The role of fetal AVP is unclear. Labor appears to be a stimulus for AVP release by the fetus. The processing of POMC differs in the anterior and intermediate lobes of the fetal pituitary gland. Corticotropin (ACTH) is detectable by radioimmunoassay in fetal plasma at 12 weeks gestation. Concentrations are higher before 34 weeks gestation, with a significant fall in late gestation. The human fetal adrenal is enormous relative to that of the adult organ. Adrenal steroid synthesis is increased in the fetus. The major steroid produced by the fetal adrenal zone is sulfoconjugated dehydroepiandrosterone (DHEAS). The majority of cortisol present in the fetal circulation appears to be of maternal origin, at least in the nonhuman primate. The fetal adrenal uses the large amounts of progesterone supplied by the placenta to make cortisol. Another source of cortisol for the fetus is the amniotic fluid where cortisol converted from cortisone by the choriodecidua, is found. In humans, maternal plasma CRH, ACTH, and cortisol levels increase during normal labor and drop at about four days postpartum; however, maternal ACTH and cortisol levels at this stage are not correlated. In sheep, placental CRH stimulates the fetal production of ACTH, which in turn leads to a surge of fetal cortisol secretion that precipitates parturition. The 10-day-long intravenous administration of antalarmin, a CRH receptor antagonist, significantly prolonged gestation compared to the control group of animals. Thus, CRH receptor antagonism in the fetus can also delay parturition. The HPA axis during the postpartum period gradually recovers from its activated state during pregnancy. The adrenals are mildly suppressed in a way analogous to postcure Cushing's syndrome. Provocation testing has shown that hypothalamic CRH secretion is transiently suppriently suppressed at three and six weeks postpartum, normalizing at 12 weeks.
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Affiliation(s)
- George Mastorakos
- 2nd Department of Obstetrics and Gynecology, Medical School, University of Athens, Aretaieion Hospital, Athens, Greece.
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Fiorini S, Ferretti ME, Biondi C, Pavan B, Lunghi L, Paganetto G, Abelli L. 17Beta-eEstradiol stimulates arachidonate release from human amnion-like WISH cells through a rapid mechanism involving a membrane receptor. Endocrinology 2003; 144:3359-67. [PMID: 12865314 DOI: 10.1210/en.2002-221106] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
17beta-Estradiol (17beta-E(2)) greatly and dose-dependently stimulates [(3)H]arachidonic acid (AA) release from the human amnion-like Wistar Institute Susan Hayflick (WISH) cells. This action is abolished by the phospholipase A(2) inhibitor AACOCF(3), significantly reduced by the estrogen receptor (ER) antagonist ICI 182,780, and uninfluenced by cycloheximide. The estradiol-BSA conjugate E(2)coBSA, which binds putative membrane ERs and is unable to enter the cell, also highly stimulates [(3)H]AA release from WISH cells, although to a lesser extent compared with 17beta-E(2). The fluorescent conjugate E(2)coBSA-FITC specifically binds to the surface of a subset of intact WISH cells, and labeling intensity appears dose and time dependent. Cell permeabilization results in a dense intracellular staining, mainly in the peripheral cytoplasm. H-150, an antibody against the N terminus of human ERbeta, also labels the plasma membrane of intact WISH cells and the cytoplasm of permeabilized cells. Almost no labeling is observed using ER-21, an antibody against the N terminus of human ERalpha. RT-PCR evidences the presence of mRNA for ERbeta, not for ERalpha. Our data suggest that 17beta-E(2) stimulates [(3)H]AA release from WISH cells through an apparently nongenomic pathway and interaction with membrane binding sites. These last are, at least in part, similar if not identical to ERbeta.
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Affiliation(s)
- Sara Fiorini
- Department of Biology, University of Ferrara, 44100-I Ferrara, Italy
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Shinkai N, Sasaki H, Okumura Y, Saito H, Takasuna K, Takayama S. Tocolytic effects of formoterol are associated with local change in the progesterone/estradiol ratio. Eur J Obstet Gynecol Reprod Biol 2003; 107:163-7. [PMID: 12648862 DOI: 10.1016/s0301-2115(02)00347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to determine whether a beta(2)-adrenoceptor agonist, formoterol, inhibits premature delivery in connection with change in estradiol and progesterone concentrations in the amniotic fluid in ovariectomized rats. STUDY DESIGN Pregnant rats at the 15th day of gestation were bilaterally ovariectomized and given injection of 17beta-estradiol immediately after the operation and every 24 h. An osmotic pump filled with a solution of formoterol or saline was also implanted subcutaneously into the back of each. The animals were killed by decapitation under light ether anesthesia 18, 36, 54 or 72 h after ovariectomy, and the numbers of undelivered fetuses and newborn were counted. Amniotic fluid was collected 16, 36, and 54 h after ovariectomy. RESULTS Formoterol (0.15 mg/(kg h)) reversed the decline in premature delivered fetuses due to 17beta-estradiol 54 and 72 h after ovariectomy. Although no influence was evident regarding the progesterone and estradiol concentrations in amniotic fluid in ovariectomized rats supplemented with 17beta-estradiol, formoterol significantly inhibited the increment in the estradiol/progesterone ratio as well as the elevation in prostaglandin F2alpha concentration. CONCLUSION These findings indicate that tocolytic effects of formoterol may be associated with suppression of uterine activity due to modulation of hormone secretion.
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Affiliation(s)
- Norihiro Shinkai
- Daiichi Pharmaceutical Co Ltd, 8-1 Minamisakae-cho, Kasukabe, Saitama 344-0067, Japan.
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Abstract
We have examined factors concerned with the maintenance of uterine quiescence during pregnancy and the onset of uterine activity at term in an animal model, the sheep, and in primate species. We suggest that in both species the fetus exerts a critical role in the processes leading to birth, and that activation of the fetal hypothalamic-pituitary-adrenal axis is a central mechanism by which the fetal influence on gestation length is exerted. Increased cortisol output from the fetal adrenal gland is a common characteristic across animal species. In primates, there is, in addition, increased output of estrogen precursor from the adrenal in late gestation. The end result, however, in primates and in sheep is similar: an increase in estrogen production from the placenta and intrauterine tissues. We have revised the pathway by which endocrine events associated with parturition in the sheep come about and suggest that fetal cortisol directly affects placental PGHS expression. In human pregnancy we suggest that cortisol increases PGHS expression, activity, and PG output in human fetal membranes in a similar manner. Simultaneously, cortisol contributes to decreases in PG metabolism and to a feed-forward loop involving elevation of CRH production from intrauterine tissues. In human pregnancy, there is no systemic withdrawal of progesterone in late gestation. We have argued that high circulating progesterone concentrations are required to effect regionalization of uterine activity, with predominantly relaxation in the lower uterine segment, allowing contractions in the fundal region to precipitate delivery. This new information, arising from basic and clinical studies, should further the development of new methods of diagnosing the patient at risk of preterm labor, and the use of scientifically based strategies specifically for the management of this condition, which will improve the health of the newborn.
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Malinowska K, Antosik A, Balcerczak M. The uterine capacity measured by the total twin birth weight and duration of twin pregnancy. ACTA GENETICAE MEDICAE ET GEMELLOLOGIAE 2000; 47:183-90. [PMID: 10916561 DOI: 10.1017/s0001566000000088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objective of this study was to answer the question whether there is the relation between the uterine capacity, estimated by the total birth weight of fetuses, and the duration of twin gestation. The material for researches contains data received from the books of births and case records concerning the pregnant who gave births to twins in the Institute of Obstetrics and Gynecology of the Medical University in Lódź between 1970-1998. The final analysis concerned only gestations lasting more than 29 weeks, without any complications (excluding prematurity and the growth-discordant twins), and when gestational age was exactly known. The selected group was finally composed of 188 pairs of twins. The analyses considered relations between total birth weight of twins, the sex of newborn babies, parity, and the duration of gestation. The duration of the analyzed twin pregnancies was 35.6 weeks, including primiparous with 35.8 weeks, and multiparous--35.1 weeks. In the group of male-male twin pairs the average duration of pregnancy was 35.7 weeks, in unlike-sexed pairs--35.6 weeks, and in female-female pairs--35.5. In the group of the primiparous having male-male twin pairs the average duration of pregnancy was 35.1 weeks, unlike-sexed pairs--36.4 weeks and female female pairs--36.6 weeks, while in the group of multiparous relatively: 36.4, 35.4, 35.0 weeks. The total birth weight of the specific pairs of twins was from 2270 g to 6900 g (average 4794 g), while in 92% < 5500 g. In the primiparous group it was 4908.1 g. and in the multiparous group--4663.1 g. Analyzing the total twins' weight according to the fetal gender and parity it was found that in primiparous with male-male twins--4715.3, unlike-sexed--5271.6 and female-female--4967.5, whereas in multiparous relatively: 4961.5, 4692.6, 4414.0. The shortening of twin pregnancies was caused by the following factors: total body mass achieved by fetuses was > 5500 g, presence of male sex in twin pregnancies (only in primiparous), and also the multiparity.
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Affiliation(s)
- K Malinowska
- Institute of Gynecology and Obstetric, Medical University, Lódź
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Abstract
Although estriol has been studied as an indicator of fetal well-being in the past, its broader biologic role has not been elucidated. Estriol in the maternal compartment closely reflects fetal adrenal activity, and increased fetal adrenal activity prior to the onset of labor is a common link in mammalian parturition. In humans, estriol increases before spontaneous labor and may be a clinically useful marker for some cases of preterm labor.
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Affiliation(s)
- T M Goodwin
- Division of Maternal-Fetal Medicine, University of Southern California, Women's and Children's Hospital, Los Angeles 90033, USA
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50
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Cooperstock MS, Bakewell J, Herman A, Schramm WF. Effects of fetal sex and race on risk of very preterm birth in twins. Am J Obstet Gynecol 1998; 179:762-5. [PMID: 9757986 DOI: 10.1016/s0002-9378(98)70079-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Our purpose was to determine whether the risk of twin preterm birth correlates with the number of male fetuses. STUDY DESIGN Among 8109 white and 1884 black twin pregnancies in the Missouri Successive Pregnancy Birth/Death Data Set, 1978 through 1990, risk for preterm birth at various gestational ages was determined with 0, 1, or 2 male infants. RESULTS Studied as individuals, white preterm twins <35 weeks' gestation demonstrated a 9.2% excess of male fetuses (P < .001). Adjusted for monozygosity, risk for preterm birth <35 weeks' gestation was 15.7% in white female-female pairs, 17.9% in unlike-sex white fetuses, and 20.2% in white male-male pairs (r = .999, P = .01). The effect was absent in black pregnancies and was unrelated to birth order, cesarean delivery, parity, twins' weight differential, year, or season. CONCLUSIONS In white twin gestations the observed linear relationship between the number of male fetuses and the likelihood of preterm birth <35 weeks' gestation suggests a fetal mechanism for preterm birth <35 weeks' gestation linked to fetal sex. Studies of mechanisms for preterm birth must stratify by fetal sex and race.
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Affiliation(s)
- M S Cooperstock
- Department of Child Health, University of Missouri School of Medicine, Columbia, USA
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