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Kumar N, Kamath S, Kumar G, Vaishali K, Sinha MK, Amin R, Chamallamudi MR. Prenatal Learning and Memory: Review on the Impact of Exposure. Curr Pediatr Rev 2023; 19:108-120. [PMID: 35652394 DOI: 10.2174/1573396318666220601160537] [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: 12/05/2021] [Revised: 03/28/2022] [Accepted: 04/21/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Prenatal Learning is a topic still debated for its existence, although the concept is well known since ancient times. OBJECTIVE The present review highlights the impact of various stimuli on learning and memory in prenatal and postnatal life. METHODS For review, various articles from preclinical and clinical studies providing early pieces of evidence of prenatal learning to date were included based on the relevancy of the databases, namely, Scopus, Pubmed, and Google Scholar. RESULTS Learning is the process of acquiring skills/ preferences/ habits from the experiences of the exposures of the past. These exposures are the stimuli, which help in categorizing learning into associated or nonassociated learning. The stimuli of adults related to auditory, gustatory, olfactory, visual, touch, etc. are also accessible to the prenatal life in utero either directly or indirectly through the mother. The effects of these stimuli are remarkable during prenatal life and can be seen clearly in infants. These stimuli play an important role in prenatal learning and contribute to neuronal development. The present review summarizes the pieces of evidence for each of these types of learning & their impact on the ex utero life, a futuristic view & the scope of understanding prenatal learning. The review also elucidates the factors affecting prenatal learning. CONCLUSION Studies from clinical and preclinical studies reflected the impacts of several aspects of an infant's life and the memory created during prenatal life was found to be most likely carried on to postnatal life.
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Affiliation(s)
- Nitesh Kumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India.,Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur-844102, Bihar, India
| | - Sushmitha Kamath
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India
| | - Gautam Kumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India
| | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India
| | - Mukesh Kumar Sinha
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India
| | - Revati Amin
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India
| | - Mallikarjuna Rao Chamallamudi
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka- 576104, India
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Romero R, Yoon BH, Chaemsaithong P, Cortez J, Park CW, Gonzalez R, Behnke E, Hassan SS, Chaiworapongsa T, Yeo L. Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage? J Matern Fetal Neonatal Med 2013; 27:775-88. [PMID: 24028637 DOI: 10.3109/14767058.2013.844124] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Meconium-stained amniotic fluid (MSAF) is a common occurrence among women in spontaneous labor at term, and has been associated with adverse outcomes in both mother and neonate. MSAF is a risk factor for microbial invasion of the amniotic cavity (MIAC) and preterm birth among women with preterm labor and intact membranes. We now report the frequency of MIAC and the presence of bacterial endotoxin in the amniotic fluid of patients with MSAF at term. MATERIALS AND METHODS We conducted a cross-sectional study including women in presumed preterm labor because of uncertain dates who underwent amniocentesis, and were later determined to be at term (n = 108). Patients were allocated into two groups: (1) MSAF (n = 66) and (2) clear amniotic fluid (n = 42). The presence of bacteria was determined by microbiologic techniques, and endotoxin was detected using the Limulus amebocyte lysate (LAL) gel clot assay. Statistical analyses were performed to test for normality and bivariate comparisons. RESULTS Bacteria were more frequently present in patients with MSAF compared to those with clear amniotic fluid [19.6% (13/66) versus 4.7% (2/42); p < 0.05]. The microorganisms were Gram-negative rods (n = 7), Ureaplasma urealyticum (n = 4), Gram-positive rods (n = 2) and Mycoplasma hominis (n = 1). The LAL gel clot assay was positive in 46.9% (31/66) of patients with MSAF, and in 4.7% (2/42) of those with clear amniotic fluid (p < 0.001). After heat treatment, the frequency of a positive LAL gel clot assay remained higher in the MSAF group [18.1% (12/66) versus 2.3% (1/42), p < 0.05]. Median amniotic fluid IL-6 concentration (ng/mL) was higher [1.3 (0.7-1.9) versus 0.6 (0.3-1.2), p = 0.04], and median amniotic fluid glucose concentration (mg/dL) was lower [6 (0-8.9) versus 9 (7.4-12.6), p < 0.001] in the MSAF group, than in those with clear amniotic fluid. CONCLUSION MSAF at term was associated with an increased incidence of MIAC. The index of suspicion for an infection-related process in postpartum women and their neonates should be increased in the presence of MSAF.
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Affiliation(s)
- Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS , Bethesda, MD and Detroit, MI , USA
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Czernik C, Schmalisch G, Bührer C, Proquitté H. Fetal and neonatal samples of a precursor surfactant protein B inversely related to gestational age. BMC Pediatr 2013; 13:164. [PMID: 24112641 PMCID: PMC3852371 DOI: 10.1186/1471-2431-13-164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 10/08/2013] [Indexed: 11/12/2022] Open
Abstract
Background Alveolar–capillary membrane leaks can increase the amount of surfactant protein B (SP-B) in the bloodstream. The purpose of this study was to measure the concentration of C-proSP-B, a SP-B precursor that includes C-terminal domains, in various body fluids of newborn infants and determine its dependence on gestational age. Methods C-pro-SPB was measured in amniotic fluid and umbilical cord blood at birth, and in peripheral blood and urine on postnatal day 3 in 137 newborn infants with a median birth weight of 2015 g (range, 550–4475 g) and gestational age of 34 weeks (range, 23–42 weeks). Results C-proSP-B levels differed more than 100-fold among samples. The levels (median; interquartile range) were highest in peripheral blood (655.6 ng/mL; 419.0-1467.0 ng/mL) and lowest in urine (3.08 ng/mL; 2.96-3.35 ng/mL). C-proSP-B levels in amniotic fluid (314.9 ng/mL; 192.7–603.6 ng/mL) were approximately half of those in peripheral blood. In cord blood C-proSP-B was slightly lower (589.1 ng/mL; 181.2-1129.0 ng/mL) compared with peripheral blood. C-proSP-B levels significantly increased in all the fluids sampled except urine with decreasing gestational age (p < 0.001). Conclusions This novel assay allows for the quantitative measurement of C-proSP-B in blood and amniotic fluid. The dependence of C-proSP-B on gestational age may hamper its use for the detection of alveolar leaks in preterm newborns.
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Affiliation(s)
- Christoph Czernik
- Department of Neonatology, Charité University Medical Center, Berlin, Germany.
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Aubry E, Fayoux P, Jani J, Deprest J, Deruelle P, Houfflin-Debarge V, Storme L. Tracheal occlusion alters pulmonary circulation in the fetal lamb with normally developing lungs. J Pediatr Surg 2013; 48:481-7. [PMID: 23480900 DOI: 10.1016/j.jpedsurg.2012.08.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 07/17/2012] [Accepted: 08/14/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tracheal occlusion (TO) promotes fetal lung growth through an increase in intraluminal pressure. Although evidence suggests that fetal TO (FETO) decreases the occurrence of pulmonary hypertension in severe congenital diaphragmatic hernia, controversies on its effect on the pulmonary circulation remain. Therefore, we investigated the effects of FETO on the lung hemodynamics in a chronically catheterized fetal lamb model. METHODS Fifteen pregnant ewes were operated on between 125 and 128 days of gestation (term: 145 days). Catheters and ultrasonic flow transducer were placed through a left thoracotomy in the lamb fetus to determine aortic, pulmonary and left atrial pressures, and left pulmonary artery blood flow. A balloon was positioned between the carina and vocal cords under fetoscopic control. The animals were assigned to either control (n=6) or FETO (n=9) groups. TO was performed by inflating the balloon. We studied the acute effects of temporary (2-h) and prolonged (4-day) TO on basal pulmonary vascular tone and on the pulmonary vascular reactivity to acetylcholine and to increased fetal oxygen tension. RESULTS We found that left pulmonary blood flow (LPA) increased and pulmonary vascular resistance (PVR) decreased by 20% during brief TO (p<0.05). After balloon deflation, LPA blood flow further increased by 40%, and PVR decreased by 50% compared to baseline values (p<0.05). In contrast, no change in LPA blood flow or PVR was observed during prolonged TO. Moreover, the vasodilator responses to acetylcholine and to increased fetal PaO2 were blunted during TO. CONCLUSIONS These data indicate that antenatal tracheal occlusion promotes active pulmonary vasodilation, which is partly blunted by the mechanical effects of elevation of the intraluminal pressure.
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Affiliation(s)
- Estelle Aubry
- EA4489, Environnement Périnatal et Croissance, Faculté de Médecine, IFR 114, Université de Lille 2, France
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Grangé G, Bernabé-Dupont C, Cabrol D. Study of fetal tracheal fluid velocities using Doppler ultrasound. Eur J Obstet Gynecol Reprod Biol 2009; 148:141-3. [PMID: 19926202 DOI: 10.1016/j.ejogrb.2009.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 07/05/2009] [Accepted: 10/19/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To characterize tracheal fluid flow during fetal breathing movements by Doppler ultrasound. STUDY DESIGN To use pulsed Doppler to measure flow velocity during inspiration and expiration in a cross-sectional study of 15 normal fetuses and determine the correlation, if any, between flow velocity and gestational age. RESULTS Cyclic respiratory profiles - both regular and irregular - were observed. Intratracheal flow velocity was very elevated during inspiration, ranging from 10 to 80 cm/s and from 5 to 20 cm/s during expiration. CONCLUSION This technique enables the noninvasive semiquantitative evaluation of fetal breathing movements. This Doppler application opens the field for future studies to characterize the extent of pulmonary hypoplasia.
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Affiliation(s)
- Gilles Grangé
- Maternité Port-Royal, Groupe Hospitalier Cochin Saint Vincent De Paul, APHP, Université Paris Descartes, Fondation PremUp, Paris, France.
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Abstract
Impaired lung development afflicts a range of newborns cared for by paediatric surgeons. As a result the speciality has led in the development of surgical models that illustrate the biomechanical regulation of lung growth. Using transgenic mutants, biologists have similarly discovered much about the biochemical regulation of prenatal lung growth. Airway smooth muscle (ASM) and its prenatal contractility airway peristalsis (AP) represent a novel link between these areas: ASM progenitors produce an essential biochemical factor for lung morphogenesis, whilst calcium-driven biomechanical ASM activity appears to regulate the same. In this invited paper, I take the opportunity both to review our recent findings on lung growth and prenatal ASM, and also to discuss mechanisms by which ASM contractility can regulate growth. Finally, I will introduce some novel ideas for exploration: ASM contractility could help to schedule parturition (pulmonary parturition clock) and could even be a generic model for smooth muscle regulation of morphogenesis in similar organs.
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Affiliation(s)
- Edwin C Jesudason
- Academy of Medical Sciences Clinician Scientist/Consultant Paediatric Surgeon, Alder Hey Children's Hospital, The Division of Child Health, University of Liverpool, Liverpool L12 2AP, UK. .
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Stockx EM, Pfister RE, Kyriakides MA, Brodecky V, Berger PJ. Expulsion of liquid from the fetal lung during labour in sheep. Respir Physiol Neurobiol 2007; 157:403-10. [PMID: 17368117 DOI: 10.1016/j.resp.2007.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 01/25/2007] [Accepted: 02/08/2007] [Indexed: 11/16/2022]
Abstract
Effective gas exchange after birth requires clearance of most of the liquid filling the lung during gestation. To date the focus has been on active Na(+) transport from lung lumen to interstitium, but Na(+) transport begins only close to delivery, making it an unlikely mechanism for clearing the bulk of fetal lung liquid. We hypothesised that fetal trunk muscle contractions, known to occur in labour, are involved in lung liquid clearance. We measured maternal uterine contractions, fetal tracheal flow directly and fetal electromyograms in thoracic and abdominal muscles. During labour in five fetal sheep, brief flow pulses were observed in the trachea, most of which expelled a small volume of lung liquid. Tracheal flow pulses were associated with fetal muscle contractions 89% of the time, which were associated on 91% of occasions with uterine contractions. Our results suggest that liquid contained in the fetal lung is cleared before and during labour as a result of fetal muscular effort, perhaps stimulated by uterine contractions.
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Affiliation(s)
- Elaine M Stockx
- Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, 246 Clayton Road, Clayton, Victoria 3168, Australia
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Dahl M, Holmskov U, Husby S, Juvonen PO. Surfactant protein D levels in umbilical cord blood and capillary blood of premature infants. The influence of perinatal factors. Pediatr Res 2006; 59:806-10. [PMID: 16641214 DOI: 10.1203/01.pdr.0000219122.81734.03] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Surfactant protein D (SP-D) is a collectin that plays an important role in the innate immune system and takes part in the surfactant homeostasis by regulating the surfactant pool size. The aims of this study were to investigate the values of SP-D in umbilical cord blood and capillary blood of premature infants and to relate the levels to perinatal conditions. A total of 254 premature infants were enrolled in the present study. Umbilical cord blood was drawn at the time of birth and capillary blood at regular intervals throughout the admission. The concentration of SP-D in umbilical cord blood and capillary blood was measured using ELISA technique. The median concentration of SP-D in umbilical cord blood was twice as high as in mature infants, 769 ng/mL (range 140-2,551), with lowest values in infants with intrauterine growth retardation (IUGR) and rupture of membranes (ROM). The median concentration of SP-D in capillary blood day 1 was 1,466 ng/mL (range 410-5,051 ng/mL), with lowest values in infants born with ROM and delivered vaginally. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be more likely in infants in need for respiratory support or surfactant treatment and susceptibility to infections. We conclude that SP-D concentrations in umbilical cord blood and capillary blood in premature infants are twice as high as in mature infants and depend on several perinatal conditions. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be related to increased risk of RDS and infections.
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Affiliation(s)
- Marianne Dahl
- Department of Pediatrics, Odense University Hospital, DK-5000 Odense C, Denmark.
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Dahl M, Juvonen PO, Holmskov U, Husby S. Surfactant protein D in newborn infants: factors influencing surfactant protein D levels in umbilical cord blood and capillary blood. Pediatr Res 2005; 58:908-12. [PMID: 16183822 DOI: 10.1203/01.pdr.0000181379.72900.ec] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Surfactant protein D (SP-D) is a collectin that plays an important role in the innate immune system. The role of SP-D in the metabolism of surfactant is as yet quite unclear. The aims of this study were to establish normal values of SP-D in the umbilical cord blood and capillary blood of mature newborn infants and to assess the influence of perinatal conditions on these levels. A total of 458 infants were enrolled in the present study. Umbilical cord blood was drawn at the time of birth and capillary blood at age 4 to 10 d. The concentration of SP-D in umbilical cord blood and capillary blood was measured by enzyme-linked immunosorbent assay. The median concentration of SP-D in umbilical cord blood was 392.1 ng/mL and was found to be influenced by maternal smoking and labor. The median concentration of SP-D in capillary blood was 777.5 ng/mL and was found to be influenced by the mode of delivery, the highest levels being observed in infants born by cesarean section. It was concluded that SP-D concentrations in umbilical cord blood and capillary blood are highly variable and depend on several perinatal conditions. Further studies are needed to elucidate the effect of respiratory distress and infection on SP-D concentrations.
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Affiliation(s)
- Marianne Dahl
- Department of Paediatrics, Odense University Hospital, University of Southern Denmark, SK-5000 Odense, Denmark.
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Heerema AE, Rabban JT, Sydorak RM, Harrison MR, Jones KD. Lung pathology in patients with congenital diaphragmatic hernia treated with fetal surgical intervention, including tracheal occlusion. Pediatr Dev Pathol 2003; 6:536-46. [PMID: 15018453 DOI: 10.1007/s10024-003-5054-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fetal intervention for congenital diaphragmatic hernia was developed to lessen the high morbidity and mortality of pulmonary hypoplasia. Lung pathology and morphometry in patients treated with fetal intervention have not been described. We report clinical and autopsy findings, as well as basic lung morphometry in 16 cases of congenital diaphragmatic hernia with fetal intervention (12 cases tracheal occlusion; 4 cases hernia repair), and 19 cases of congenital diaphragmatic hernia without fetal intervention. All patients who underwent fetal intervention were born premature. Lung enlargement with increased lung-to-body weight ratio was observed with fetal tracheal occlusion, accompanied by lower than normal radial alveolar counts and increased alveolar size. Patients treated with tracheal occlusion also had early alveolar development (at 29.8, 30.6, and 30.9 wk postconceptual age) as well as mucous fluid pooling in airways and alveoli. All cases showed severe alveolar septal widening, more extensive in patients without fetal intervention. When grouped by postconceptual age, no statistically significant difference was found between patients with and without fetal intervention with respect to lung-to-body weight ratio, radial alveolar count, mean alveolar length, and relative arteriolar media thickness. Lung enlargement has been observed with fetal tracheal occlusion sonographically; our studies suggest that this is due in part to emphysema and mucous fluid pooling. The lung remains abnormal with low radial alveolar counts and increased alveolar size. Tracheal occlusion did not prevent development of lung pathology associated with pulmonary hypoplasia.
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Affiliation(s)
- Amy E Heerema
- Department of Pathology, University of California, San Francisco, 300 Parnassus Avenue, Box 0506, San Francisco, CA 94143-0506, USA.
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Moes MJ, Filly RA. The neonatal diaphragmatic crura are hypertrophied: a necessary preparation for the first breath? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2003; 22:715-718. [PMID: 12862271 DOI: 10.7863/jum.2003.22.7.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To sonographically show that the neonatal crura are markedly hypertrophied. METHODS Fifty patients in each of 2 groups, ages 0 to 2 months and 18 to 40 years, were randomly chosen from patients who recently underwent abdominal sonography. A single longitudinal plane of a section was used to measure both the anteroposterior diameter of the aorta and the diaphragmatic crus. The ratios of these were compared in the 2 groups. RESULTS A significant difference was shown between the sizes of the diaphragmatic crura of the neonate and the adult when the aorta was used as an internal standard of size variability. The mean ratio of the aorta to the right crus in neonates was 2.95, and in young adults it was 1.04 (P < .0001). CONCLUSIONS The neonatal crura are hypertrophied at birth, likely to allow the markedly atelectatic and fluid-filled lungs to fully expand in relatively few breaths.
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Affiliation(s)
- Maria J Moes
- Department of Radiology, University of California, San Francisco, San Francisco, California 94143-0628, USA.
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