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Hao H, Yoo SR, Strickland MJ, Darrow LA, D'Souza RR, Warren JL, Moss S, Wang H, Zhang H, Chang HH. Effects of air pollution on adverse birth outcomes and pregnancy complications in the U.S. state of Kansas (2000-2015). Sci Rep 2023; 13:21476. [PMID: 38052850 PMCID: PMC10697947 DOI: 10.1038/s41598-023-48329-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
Neonatal mortality and morbidity are often caused by preterm birth and lower birth weight. Gestational diabetes mellitus (GDM) and gestational hypertension (GH) are the most prevalent maternal medical complications during pregnancy. However, evidence on effects of air pollution on adverse birth outcomes and pregnancy complications is mixed. Singleton live births conceived between January 1st, 2000, and December 31st, 2015, and reached at least 27 weeks of pregnancy in Kansas were included in the study. Trimester-specific and total pregnancy exposures to nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5), and ozone (O3) were estimated using spatiotemporal ensemble models and assigned to maternal residential census tracts. Logistic regression, discrete-time survival, and linear models were applied to assess the associations. After adjustment for demographics and socio-economic status (SES) factors, we found increases in the second and third trimesters and total pregnancy O3 exposures were significantly linked to preterm birth. Exposure to the second and third trimesters O3 was significantly associated with lower birth weight, and exposure to NO2 during the first trimester was linked to an increased risk of GDM. O3 exposures in the first trimester were connected to an elevated risk of GH. We didn't observe consistent associations between adverse pregnancy and birth outcomes with PM2.5 exposure. Our findings indicate there is a positive link between increased O3 exposure during pregnancy and a higher risk of preterm birth, GH, and decreased birth weight. Our work supports limiting population exposure to air pollution, which may lower the likelihood of adverse birth and pregnancy outcomes.
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Affiliation(s)
- Hua Hao
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA.
| | - Sodahm R Yoo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Matthew J Strickland
- Depatment of Health Analytics and Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, NV, 89557, USA
| | - Lyndsey A Darrow
- Depatment of Health Analytics and Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, NV, 89557, USA
| | - Rohan R D'Souza
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Joshua L Warren
- Department of Biostatistics, School of Medicine, Yale University, New Haven, CT, 06510, USA
| | - Shannon Moss
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Huaqing Wang
- Department of Landscape Architecture and Environment Planning, College of Agriculture and Applied Sciences, Utah State University, Logan, UT, 84322, USA
| | - Haisu Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
| | - Howard H Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Afsar S, Turan G, Sonmez AY, Usta CS, Usta A. Fetal vascular malperfusion score is linked with developing preeclampsia in women with gestational diabetes mellitus: a retrospective cohort study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230795. [PMID: 37971131 PMCID: PMC10645183 DOI: 10.1590/1806-9282.20230795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Fetal vascular malperfusion is associated with poor perinatal outcomes in women with preeclampsia and gestational diabetes mellitus. The aim of this study was to determine the association between fetal vascular malperfusion score and syncytiotrophoblast basement membrane thickness and clinicopathological variables, such as developing preeclampsia in women with gestational diabetes mellitus. METHODS This retrospective cohort study included 65 pregnant participants (34 with gestational diabetes mellitus and 31 controls) between January 2019 and January 2022. Gestational diabetes mellitus was diagnosed as ≥2 of 4 elevated values on a 3-h, 100-g oral glucose tolerance test. The fetal vascular malperfusion score was evaluated by endothelial CD34 positivity in the villous stroma of the placenta. The association between fetal vascular malperfusion score and syncytiotrophoblast basement membrane thickness with clinicopathological variables in women with gestational diabetes mellitus was evaluated. RESULTS It was revealed that the gestational diabetes mellitus group had greater fetal vascular malperfusion scores than the control group (gestational diabetes mellitus group fetal vascular malperfusion score: 34.2±9.1 and control group fetal vascular malperfusion score: 26.5±8.7, respectively, p=0.0009). Syncytiotrophoblast basement membrane thickness was correlated with the development of preeclampsia, trophoblast proliferation, and fetal vascular malperfusions (0.3952, p=0.0129; 0.3487, p=0.0211; and 0.4331, p=0.0082, respectively). On the contrary, fetal vascular malperfusions were correlated with the development of preeclampsia, villous edema, and trophoblast proliferation (0.3154, p=0.0343; 0.2922, p=0.4123; and 0.3142, p=0.0355, respectively). CONCLUSION The gestational diabetes mellitus group displayed significantly higher fetal vascular malperfusion scores and thickening of the syncytiotrophoblast basement membrane than the control group. There is a correlation between developing preeclampsia and the fetal vascular malperfusion scores and the syncytiotrophoblast basement membrane thickness.
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Affiliation(s)
- Selim Afsar
- Balikesir University, School of Medicine, Department of Obstetrics and Gynecology – Balikesir, Turkey
| | - Gulay Turan
- Balikesir University, School of Medicine, Department of Pathology – Balikesir, Turkey
| | - Ayse Yigit Sonmez
- Adana Yuregir State Hospital, Department of Obstetrics and Gynecology – Adana, Turkey
| | - Ceyda Sancakli Usta
- Balikesir University, School of Medicine, Department of Obstetrics and Gynecology – Balikesir, Turkey
| | - Akın Usta
- Balikesir University, School of Medicine, Department of Obstetrics and Gynecology – Balikesir, Turkey
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Busuioc CJ, Roşu GC, Zorilă GL, Mogoantă L, Istrate-Ofiţeru AM, Pirici D, Liliac IM, Iovan L, Berbecaru EIA, Comănescu MC, Cazacu SM, Iliescu DG. The influence of SARS-CoV-2 on the immune system elements and on the placental structure. Clinical, histological and immunohistochemical study. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:549-557. [PMID: 38184836 PMCID: PMC10863699 DOI: 10.47162/rjme.64.4.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND The effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy remain relatively unknown. AIM We present this original paper where we analyzed 60 parturients, at term, 30 without associated infection (C-) and 30 with associated infection (C+), present at birth. METHODS We analyzed the blood count and placental microscopic structure through classical and immunohistochemical staining and observed the placental areas affected by the presence of SARS-CoV-2. RESULTS SARS-CoV-2 infection was accompanied by a decrease in the number of lymphocytes, the number of platelets and the presence of placental structural changes, identifying extensive areas of amyloid deposits, placental infarcts, vascular thrombosis, syncytial knots, with a decrease in placental vascular density and the presence of infection in the cells located at decidual level, at syncytiotrophoblast level and at the level of the cells of the chorionic plate, still without overcoming this barrier and without causing any fetal infection in the analyzed cases. CONCLUSIONS This study shows that the invasion of SARS-CoV-2 in the placenta can produce significant structural changes, with a decrease in placental vascular density that can have significant implications on proper fetal perfusion. Also, the presence of immunoreactivity at the level of decidua, the placental villi, as well as the chorionic plate proves that the virus can overcome the maternal-fetal barrier. However, in the analyzed cases there were no fetal infections at birth, which may show that local placental factors can be a protective filter for the fetus.
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Affiliation(s)
| | | | - George-Lucian Zorilă
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania
| | - Laurenţiu Mogoantă
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania
- Romanian Academy of Medical Sciences, Craiova Subsidiary, Romania
| | | | - Daniel Pirici
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania
| | - Ilona Mihaela Liliac
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania
| | - Larisa Iovan
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania
| | | | | | - Sergiu Marian Cazacu
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, Romania
| | - Dominic-Gabriel Iliescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania
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An H, Chen H, Li Z, Zhang L, Zhang Y, Liu J, Ye R, Li N. Association of Gestational Hypertension with Anemia under 5 Years Old: Two Large Longitudinal Chinese Birth Cohorts. Nutrients 2022; 14:1621. [PMID: 35458183 PMCID: PMC9032033 DOI: 10.3390/nu14081621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Gestational hypertension may interfere with the placental iron metabolism, thus probably increasing the risk of childhood anemia. We aim to examine the association between gestational hypertension and childhood anemia at different ages in two large Chinese birth cohorts. Cohort 1 was conducted in 5 counties in northern China and was comprised of 17,264 mother-children pairs (97.3%) during 2006-2009, whereas cohort 2 was conducted in 21 counties in southern China and was comprised of 185,093 mother-children pairs (93.8%) during 1993-1996. All pregnant women were registered in a monitoring system and followed up until the termination of pregnancies. The childhood anemia was diagnosed at 6 month and 12 month in cohort 1 and at 55 month in cohort 2. The overall incidence of childhood anemia was 6.78% and 5.28% at 6 month and 12 month, respectively, in cohort 1 and 13.18% at 55 month in cohort 2. Gestational hypertension was associated with increased risk of anemia at 6 month (adjusted Odds Ratio (OR): 1.31; 95% confidence interval (CI): 1.05, 1.63) and at 12 month (adjusted OR: 1.50; 95% CI: 1.18, 1.90) in cohort 1 and at 55 month (adjusted OR: 1.06; 95% CI: 1.01, 1.12) in cohort 2. The hemoglobin values of children at different ages were lower among gestational hypertension group in the linear models, which was consistent with the results of binary regression analysis. Our study found gestational hypertension may associate with an increased risk of childhood anemia. It suggests a possible need for exploring changes in prenatal care that might prevent childhood anemia.
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Affiliation(s)
- Hang An
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Huiting Chen
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Le Zhang
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yali Zhang
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Rongwei Ye
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Nan Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing 100191, China; (H.A.); (H.C.); (Z.L.); (L.Z.); (Y.Z.); (J.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
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Camen IV, Istrate-Ofiţeru AM, Novac LV, Manolea MM, Dijmărescu AL, Neamţu SD, Radu L, Şerbănescu MS, Stoica M, Motoc AGM, Novac MB, Bujorescu DL, Novac MB, Bujorescu DL. Analysis of the relationship between placental histopathological aspects of preterm and term birth. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:357-367. [PMID: 36374141 PMCID: PMC9801675 DOI: 10.47162/rjme.63.2.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study aims to establish a correlation between placental histopathological and immunohistochemical (IHC) changes and preterm birth with fetal growth restriction (FGR, formerly called intrauterine growth restriction - IUGR). PATIENTS, MATERIALS, AND METHODS This prospective study was performed on a group of 30 parturients, with singleton gestation, of which 15 patients gave birth at term, and the other 15 patients gave birth prematurely. After the statistical correlation of the clinical and demographic data with premature birth (PB) and term birth (TB), we performed histological and IHC research on the respective placentae. To observe normal and pathological microscopic placental structures, we used the Hematoxylin-Eosin (HE) and Periodic Acid Schiff-Hematoxylin (PAS-H) classical stainings, but also special immunostaining with anti-cluster of differentiation 34 (CD34) and anti-vascular endothelial growth factor (VEGF) antibodies. RESULTS We found a statistically significant difference between the TB∕PB categories and the age of the patients, their antepartum weight, the weight of the newborns, and the placenta according to the sex of the newborn. Histological analysis revealed in the case of TB, small areas of perivillous amyloid deposition, with the significant extension of these areas both intravillous and perivillous in the case of PB. Massive intravillous calcifications, syncytial knots, and intravillous vascular thrombosis were also frequently present in PB. With PAS-H staining were highlighted the intra∕extravillous vascular basement membranes, but especially the massive fibrin deposits rich in glycosaminoglycans. By the IHC technique with the anti-CD34 antibody, we noticed the numerical vascular density, higher in the case of TB, but in the case of PB, there were large areas of placental infarction, with a lack of immunostaining in these areas. Through the anti-VEGF antibody, we observed the presence of signal proteins that determined and stimulated the formation of neoformation vessels in the areas affected by the lack of post-infarction placental vascularization. We observed a highly significant difference between placental vascular density between TB∕PB and newborn weight, sex, or placental weight. CONCLUSIONS Any direct proportional link between the clinical maternal-fetal and histological elements yet studied must be considered. Thus, establishing an antepartum risk group can prevent a poor pregnancy outcome.
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Affiliation(s)
- Ioana Victoria Camen
- Department of Histology, Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, Romania; ;
| | - Anca-Maria Istrate-Ofiţeru
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania,Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania,Department of Obstetrics and Gynecology, Emergency County Hospital, Craiova, Romania
| | - Liliana Victoria Novac
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania
| | - Maria Magdalena Manolea
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania
| | - Anda Lorena Dijmărescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania
| | - Simona Daniela Neamţu
- Department of Hematology and Immunology, University of Medicine and Pharmacy of Craiova, Romania
| | - Lucreţiu Radu
- Department of Hygiene, University of Medicine and Pharmacy of Craiova, Romania
| | - Mircea-Sebastian Şerbănescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, Romania
| | - Maria Stoica
- Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Marius Bogdan Novac
- Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, Romania
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