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Sahni D, Sanil Y, Thomas R, Ross RD. Nucleated Red Blood Cell Counts Differentiate Cardiac from Respiratory Causes of Cyanosis at Birth. Pediatr Cardiol 2024; 45:513-519. [PMID: 38308060 DOI: 10.1007/s00246-024-03409-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/04/2024] [Indexed: 02/04/2024]
Abstract
Tissue hypoxia increases erythropoietin production and release of immature erythrocytes that can be measured using nucleated red blood cell counts (nRBC). We hypothesized that hypoxia due to congenital heart disease (CHD) is chronic and is better tolerated than hypoxia due to respiratory disease (RD), which is an acute stress in newborns leading to higher nRBC. This study assesses the utility of nRBC as a marker to differentiate hypoxia due to CHD vs RD in term neonates. This was a single-center, retrospective study of term neonates with cyanosis from 2015 to 2022. Neonates < 37 weeks of gestation, with hypoxic-ischemic encephalopathy, and those with other causes of cyanosis were excluded. The patients were divided into 2 groups: cyanotic CHD and cyanotic RD. Clinical and laboratory data done within 12 h and 24-36 h after birth were collected. Data are represented as median and Interquartile range. Of 189 patients with cyanosis, 80 had CHD and 109 had RD. The absolute nRBC count at ≤ 12 h of age was lower in the CHD (360 cells/mm3) compared to RD group (2340 cells/mm3) despite the CHD group having significantly lower baseline saturations. A value of 1070 cells/mm3 was highly sensitive and specific for differentiating CHD from RD. The positive predictive value for this cut-off value of 1070 cells/mm3 was 0.94 and the negative predictive value was 0.89. The absolute nRBC is a simple screening test and is available worldwide. A nRBC < 1070 cells/mm3 in cyanotic newborns should hasten the search for CHD etiology with the possible need for prostaglandin therapy.
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Affiliation(s)
- Deepank Sahni
- Division of Cardiology, Central Michigan University College of Medicine, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI, 48201, USA
| | - Yamuna Sanil
- Division of Cardiology, Central Michigan University College of Medicine, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI, 48201, USA.
| | - Ronald Thomas
- Carman and Ann Adams Department of Pediatrics, Central Michigan University College of Medicine, Children's Hospital of Michigan, Detroit, USA
| | - Robert D Ross
- Division of Cardiology, Central Michigan University College of Medicine, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI, 48201, USA
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2
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Bahr TM, Ohls RK, Baserga MC, Lawrence SM, Winter SL, Christensen RD. Implications of an Elevated Nucleated Red Blood Cell Count in Neonates with Moderate to Severe Hypoxic-Ischemic Encephalopathy. J Pediatr 2022; 246:12-18.e2. [PMID: 35430249 DOI: 10.1016/j.jpeds.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/21/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate associations between nucleated red blood cell (NRBC) count in neonates with hypoxic-ischemic encephalopathy (HIE), acute perinatal sentinel events, and neurodevelopmental outcomes and to examine the mechanism(s) causing elevated counts. STUDY DESIGN We included newborn infants with HIE treated with therapeutic hypothermia with ≥3 NRBC counts during their neonatal intensive care unit hospitalization and neurodevelopmental evaluations at a mean of 24 ± 6 months. RESULTS Ninety-five of 152 infants who met our study criteria (63%) had a normal NRBC count after birth, defined as ≤95th percentile of the upper reference interval, and the other 57 (37%) had an elevated count. Documented sentinel events during labor resulting in emergency delivery (eg, acute abruption) (n = 79) were associated with a normal NRBC count (OR, 257; 95% CI, 33-1988). Of the 152 infants evaluated, 134 (88%) survived to discharge. The odds of surviving were 3-fold greater (OR, 3.0; 95% CI, 1.1-8.3) when the first NRBC count was normal than when it was elevated. Normal counts were moderately predictive of infants without neurodevelopmental impairment at a 2-year evaluation (P < .001). NRBC half-life was longer in infants with an elevated NRBC count compared with those with a normal count (60 hours vs 39 hours; P < .01). CONCLUSIONS In infants with HIE, a normal NRBC count after birth was associated with acute intrapartum events necessitating emergent delivery. Normal counts were modestly predictive of a better prognosis. We speculate that the elevated NRBC counts at birth resulted from hypoxia that occurred earlier or chronically. Impaired clearance of NRBCs from the blood might be one mechanistic explanation for the high counts.
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Affiliation(s)
- Timothy M Bahr
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Murray, UT; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT.
| | - Robin K Ohls
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT
| | - Mariana C Baserga
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT
| | - Shelley M Lawrence
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT
| | - Sarah L Winter
- Division of General Pediatrics, Department of Pediatrics, University of Utah Health, Salt Lake City, UT; Division of Neurology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT
| | - Robert D Christensen
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Murray, UT; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT
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3
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Helfrich KK, Saini N, Kwan STC, Rivera OC, Hodges R, Smith SM. Gestational Iron Supplementation Improves Fetal Outcomes in a Rat Model of Prenatal Alcohol Exposure. Nutrients 2022; 14:nu14081653. [PMID: 35458215 PMCID: PMC9025692 DOI: 10.3390/nu14081653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/16/2022] [Accepted: 04/13/2022] [Indexed: 12/19/2022] Open
Abstract
Prenatal alcohol exposure causes neurodevelopmental disability and is associated with a functional iron deficiency in the fetus and neonate, even when the mother consumes an apparently iron-adequate diet. Here, we test whether gestational administration of the clinically relevant iron supplement Fer-In-Sol mitigates alcohol’s adverse impacts upon the fetus. Pregnant Long-Evans rats consumed an iron-adequate diet and received 5 g/kg alcohol by gavage for 7 days in late pregnancy. Concurrently, some mothers received 6 mg/kg oral iron. We measured maternal and fetal weights, hematology, tissue iron content, and oxidative damage on gestational day 20.5. Alcohol caused fetal anemia, decreased fetal body and brain weight, increased hepatic iron content, and modestly elevated hepatic malondialdehyde (p’s < 0.05). Supplemental iron normalized this brain weight reduction in alcohol-exposed males (p = 0.154) but not female littermates (p = 0.031). Iron also reversed the alcohol-induced fetal anemia and normalized both red blood cell numbers and hematocrit (p’s < 0.05). Iron had minimal adverse effects on the mother or fetus. These data show that gestational iron supplementation improves select fetal outcomes in prenatal alcohol exposure (PAE) including brain weight and hematology, suggesting that this may be a clinically feasible approach to improve prenatal iron status and fetal outcomes in alcohol-exposed pregnancies.
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Affiliation(s)
- Kaylee K. Helfrich
- UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA; (K.K.H.); (S.T.C.K.); (O.C.R.); (R.H.)
- Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA
| | - Nipun Saini
- UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA; (K.K.H.); (S.T.C.K.); (O.C.R.); (R.H.)
- Correspondence: (N.S.); (S.M.S.)
| | - Sze Ting Cecilia Kwan
- UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA; (K.K.H.); (S.T.C.K.); (O.C.R.); (R.H.)
| | - Olivia C. Rivera
- UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA; (K.K.H.); (S.T.C.K.); (O.C.R.); (R.H.)
| | - Rachel Hodges
- UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA; (K.K.H.); (S.T.C.K.); (O.C.R.); (R.H.)
| | - Susan M. Smith
- UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA; (K.K.H.); (S.T.C.K.); (O.C.R.); (R.H.)
- Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA
- Correspondence: (N.S.); (S.M.S.)
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Prenatal Hypoxia Affects Foetal Cardiovascular Regulatory Mechanisms in a Sex- and Circadian-Dependent Manner: A Review. Int J Mol Sci 2022; 23:ijms23052885. [PMID: 35270026 PMCID: PMC8910900 DOI: 10.3390/ijms23052885] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/17/2022] Open
Abstract
Prenatal hypoxia during the prenatal period can interfere with the developmental trajectory and lead to developing hypertension in adulthood. Prenatal hypoxia is often associated with intrauterine growth restriction that interferes with metabolism and can lead to multilevel changes. Therefore, we analysed the effects of prenatal hypoxia predominantly not associated with intrauterine growth restriction using publications up to September 2021. We focused on: (1) The response of cardiovascular regulatory mechanisms, such as the chemoreflex, adenosine, nitric oxide, and angiotensin II on prenatal hypoxia. (2) The role of the placenta in causing and attenuating the effects of hypoxia. (3) Environmental conditions and the mother's health contribution to the development of prenatal hypoxia. (4) The sex-dependent effects of prenatal hypoxia on cardiovascular regulatory mechanisms and the connection between hypoxia-inducible factors and circadian variability. We identified that the possible relationship between the effects of prenatal hypoxia on the cardiovascular regulatory mechanism may vary depending on circadian variability and phase of the days. In summary, even short-term prenatal hypoxia significantly affects cardiovascular regulatory mechanisms and programs hypertension in adulthood, while prenatal programming effects are not only dependent on the critical period, and sensitivity can change within circadian oscillations.
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Bahr TM, Henry E, O'Brien EA, Christensen RD. Nucleated Red Blood Cell Counts of Neonates Born Emergently 1-4 h after a Maternal Cardiac Arrest. Neonatology 2022; 119:663-664. [PMID: 35700702 DOI: 10.1159/000525198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Timothy M Bahr
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA.,Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
| | - Erick Henry
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Elizabeth A O'Brien
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA.,Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
| | - Robert D Christensen
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA.,Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
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6
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Bahr TM, Henry E, O'Brien EA, Christensen RD. Nucleated Red Blood Cell Counts of Neonates Born Emergently 1-4 h after a Maternal Cardiac Arrest. Neonatology 2022; 119:255-259. [PMID: 35045419 DOI: 10.1159/000521043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022]
Abstract
A high nucleated red blood cell (NRBC) count in a newborn infant at birth is sometimes used to imply that fetal hypoxia occurred. However, it is debated whether many hours are required between fetal hypoxia and the appearance of high NRBC or alternatively, whether this can occur very quickly, with fetal hypoxia within minutes to a few hours before birth. We sought relevant information from four unfortunate cases, where during a previously healthy pregnancy, the mother had a sudden cardiac arrest, with cardiopulmonary resuscitation begun at the incident scene and continued through emergent cesarean section delivery.
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Affiliation(s)
- Timothy M Bahr
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA.,Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
| | - Erick Henry
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Elizabeth A O'Brien
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA.,Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
| | - Robert D Christensen
- Obstetric and Neonatal Operations, Department of Neonatology, Intermountain Healthcare, Salt Lake City, Utah, USA.,Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
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Carr NR, Henry E, Bahr TM, Ohls RK, Page JM, Ilstrup SJ, Christensen RD. Fetomaternal hemorrhage: Evidence from a multihospital healthcare system that up to 40% of severe cases are missed. Transfusion 2021; 62:60-70. [PMID: 34674275 DOI: 10.1111/trf.16710] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND We previously reported fetomaternal hemorrhage (FMH) in 1/9160 births, and only one neonatal death from FMH among 219,853 births. Recent reports indicate FMH is not uncommon among stillbirths. Consequently, we speculated we were missing cases among early neonatal deaths. We began a new FMH initiative to determine the current incidence. METHODS We analyzed births from 2011 to 2020 where FMH was diagnosed. We also evaluated potential cases among neonates receiving an emergent transfusion just after birth, whose mothers were not tested for FMH. RESULTS Among 297,403 births, 1375 mothers were tested for FMH (1/216 births). Fourteen percent tested positive (1/1599 births). Of those, we found 25 with clinical and laboratory evidence of FMH adversely affecting the neonate. Twenty-one received one or more emergency transfusions on the day of birth; all but two lived. We found 17 others who received an emergency transfusion on the day of birth where FMH was not tested for, but was likely; eight of those died. The 42 severe (proven + probable) cases equate to 1/7081 births. We judged that 10 of the 42 had an acute FMH, and in the others it likely had more than a day before birth. CONCLUSIONS We estimate that we fail to diagnose >40% of our severe FMH cases. Needed improvements include (1) education to request maternal FMH testing when neonates are born anemic, (2) education on false-negative FMH tests, and (3) improved FMH communications between neonatology, obstetrics, and blood bank.
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Affiliation(s)
- Nicholas R Carr
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, United States
| | - Erick Henry
- Women and Newborn Research, Intermountain Healthcare, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, USA
| | - Timothy M Bahr
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, United States.,Center for Iron and Heme Disorders, University of Utah, Salt Lake City, Utah, USA
| | - Robin K Ohls
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, United States
| | - Jessica M Page
- Women and Newborn Research, Intermountain Healthcare, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, USA.,Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, USA
| | - Sarah J Ilstrup
- Intermountain Healthcare Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, Utah, USA
| | - Robert D Christensen
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, United States.,Women and Newborn Research, Intermountain Healthcare, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, USA.,Center for Iron and Heme Disorders, University of Utah, Salt Lake City, Utah, USA.,Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA
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8
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Liu SQ, Hou XY, Zhao F, Zhao XG. Nucleated red blood cells participate in myocardial regeneration in the toad Bufo Gargarizan Gargarizan. Exp Biol Med (Maywood) 2021; 246:1760-1775. [PMID: 34024142 DOI: 10.1177/15353702211013297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Heart regeneration is negligible in humans and mammals but remarkable in some ectotherms. Humans and mammals lack nucleated red blood cells (NRBCs), while ectotherms have sufficient NRBCs. This study used Bufo gargarizan gargarizan, a Chinese toad subspecies, as a model animal to verify our hypothesis that NRBCs participate in myocardial regeneration. NRBC infiltration into myocardium was seen in the healthy toad hearts. Heart needle-injury was used as an enlarged model of physiological cardiomyocyte loss. It recovered quickly and scarlessly. NRBC infiltration increased during the recovery. Transwell assay was done to in vitro explore effects of myocardial injury on NRBCs. In the transwell system, NRBCs could infiltrate into cardiac pieces and could transdifferentiate toward cardiomyocytes. Heart apex cautery caused approximately 5% of the ventricle to be injured to varying degrees. In the mildly to moderately injured regions, NRBC infiltration increased and myocardial regeneration started soon after the inflammatory response; the severely damaged region underwent inflammation, scarring, and vascularity before NRBC infiltration and myocardial regeneration, and recovered scarlessly in four months. NRBCs were seen in the newly formed myocardium. Enzyme-linked immunosorbent assay and Western blotting showed that the levels of tumor necrosis factor-α, interleukin- 1β, 6, and11, cardiotrophin-1, vascular endothelial growth factor, erythropoietin, matrix metalloproteinase- 2 and 9 in the serum and/or cardiac tissues fluctuated in different patterns during the cardiac injury-regeneration. Cardiotrophin-1 could induce toad NRBC transdifferentiation toward cardiomyocytes in vitro. Taken together, the results suggest that the NRBC is a cell source for cardiomyocyte renewal/regeneration in the toad; cardiomyocyte loss triggers a series of biological processes, facilitating NRBC infiltration and transition to cardiomyocytes. This finding may guide a new direction for improving human myocardial regeneration.
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Affiliation(s)
- Shu-Qin Liu
- Department of Pharmacology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Xiao-Ye Hou
- Department of Pharmacology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Feng Zhao
- The Basic Medical Central Laboratory, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Xiao-Ge Zhao
- The Central Laboratory For Biomedical Research, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
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9
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Reibel NJ, Dame C, Bührer C, Muehlbacher T. Aberrant Hematopoiesis and Morbidity in Extremely Preterm Infants With Intrauterine Growth Restriction. Front Pediatr 2021; 9:728607. [PMID: 34869097 PMCID: PMC8633541 DOI: 10.3389/fped.2021.728607] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/06/2021] [Indexed: 12/16/2022] Open
Abstract
Background and Objective: Intrauterine growth restriction (IUGR) poses additional challenges in extremely low gestational age newborns (ELGANs). We assessed disturbed hematopoiesis and morbidities associated with this disorder. Methods: This single-center retrospective case-control study compared perinatal hematological profiles, major morbidities, and mortality of 49 infants (gestational age <28 weeks, birth weight ≤ 3rd percentile, and compromised placental function) and 98 infants (birth weight >10th percentile) matched for gestational age, year, and sex. Results: IUGR-ELGANs had significantly elevated nucleated red blood cells and lower neutrophil and platelet counts at birth and on the third day of life. During the first week of life, IUGR-ELGANs received more red blood cell, platelet, and plasma transfusions and were more intensively treated with antibiotics. Rates of infections acquired during the first week (59.2 vs. 17.3%, p < 0.001), severe bronchopulmonary dysplasia or death (42.9 vs. 17.3%, p < 0.01), and mortality (36.7 vs. 7.1%, p < 0.001) were markedly elevated in IUGR-ELGANs, but not of hemorrhages or other morbidities. Conclusions: IUGR-ELGANs have high rates of acquired infections during the first week of life and display severe pulmonary morbidity leading to bronchopulmonary dysplasia or death. The high rate of transfusions observed in these infants warrants further scrutiny.
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Affiliation(s)
- Nora J Reibel
- Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christof Dame
- Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Bührer
- Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Muehlbacher
- Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
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Gluhcheva Y, Pavlova E, Petrova E, Tinkov AA, Ajsuvakova OP, Skalnaya MG, Vladov I, Skalny AV. The Impact of Perinatal Cobalt Chloride Exposure on Extramedullary Erythropoiesis, Tissue Iron Levels, and Transferrin Receptor Expression in Mice. Biol Trace Elem Res 2020; 194:423-431. [PMID: 31273683 DOI: 10.1007/s12011-019-01790-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/19/2019] [Indexed: 02/08/2023]
Abstract
The objective of the present study was to elucidate the effect of perinatal cobalt chloride (CoCl2) exposure on extramedullary erythropoiesis in suckling mice in relation to iron (Fe) content and transferrin receptor (TfR) expression. Pregnant ICR mice were subjected to a daily dose of 75 mg CoCl2/kg body weight 2-3 days prior and 18 days after delivery. Co exposure significantly increased erythrocyte count (RBC), and reduced the erythrocytic parameters mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) in the offspring. Total iron-binding capacity (TIBC) was decreased while bilirubin values were ~ 1.2-fold higher in the metal-exposed mice. Perinatal CoCl2 treatment also induced pathohistological changes in target organs (spleen, liver, and kidneys) as altered organ weight indices, leukocyte infiltration, abundant Kupffer cells in the liver, increased mesangial cellularity, and reduced capsular space in the kidney. CoCl2 administration induced significant 68-, 3.8-, 41.3-, and 162-fold increase of Co content in the kidney, spleen, liver, and RBC, respectively. Fe content in the target organs of CoCl2-treated mice was also significantly elevated. Immunohistochemical analysis demonstrated that TfR1 was well expressed in the renal tubules, hepatocytes, the red pulp, and marginal zone of white pulp in the spleen. TfR2 showed similar expression pattern, but its expression was stronger in the spleen and liver samples of Co-treated mice compared with that of the untreated controls. The results demonstrate that exposure to CoCl2 during late pregnancy and early postnatal period affects body and organ weights and alters hematological and biochemical parameters, iron content, and TfR expression in target organs.
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Affiliation(s)
- Yordanka Gluhcheva
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. Georgi Bonchev, Str., Bl. 25, 1113, Sofia, Bulgaria.
| | - Ekaterina Pavlova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. Georgi Bonchev, Str., Bl. 25, 1113, Sofia, Bulgaria
| | - Emilia Petrova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. Georgi Bonchev, Str., Bl. 25, 1113, Sofia, Bulgaria
| | - Alexey A Tinkov
- Yaroslavl State University, Sovetskaya Str., 14, Yaroslavl, Russia, 150000
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya Str. 6, Moscow, Russia, 117198
- IM Sechenov First Moscow State Medical University, Moscow, Russia, 119146
| | - Olga P Ajsuvakova
- Yaroslavl State University, Sovetskaya Str., 14, Yaroslavl, Russia, 150000
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya Str. 6, Moscow, Russia, 117198
- IM Sechenov First Moscow State Medical University, Moscow, Russia, 119146
| | - Margarita G Skalnaya
- Yaroslavl State University, Sovetskaya Str., 14, Yaroslavl, Russia, 150000
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya Str. 6, Moscow, Russia, 117198
- IM Sechenov First Moscow State Medical University, Moscow, Russia, 119146
| | - Ivelin Vladov
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. Georgi Bonchev, Str., Bl. 25, 1113, Sofia, Bulgaria
| | - Anatoly V Skalny
- Yaroslavl State University, Sovetskaya Str., 14, Yaroslavl, Russia, 150000
- IM Sechenov First Moscow State Medical University, Moscow, Russia, 119146
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia, 460000
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11
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Jia Z, Chen Z, Xu H, Armah MA, Teng P, Li W, Jian D, Ma L, Ni Y. Pressure Overload-induced Cardiac Hypertrophy Varies According to Different Ligation Needle Sizes and Body Weights in Mice. Arq Bras Cardiol 2018; 110:568-576. [PMID: 30226916 PMCID: PMC6023638 DOI: 10.5935/abc.20180088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 11/24/2017] [Indexed: 01/16/2023] Open
Abstract
Background The cardiac hypertrophy (CH) model for mice has been widely used, thereby
providing an effective research foundation for CH exploration. Objective To research the effects of CH modeling under abdominal aortic constriction
(AAC) using different needles and weights in mice. Methods Four needles with different external diameters (0.35, 0.40, 0.45, and 0.50
mm) were used for AAC. 150 male C57BL/6 mice were selected according to body
weight (BW) and divided into 3 weight levels: 18 g, 22 g, and 26 g (n = 50
in each group). All weight levels were divided into 5 groups: a sham group
(n = 10) and 4 AAC groups using 4 ligation intensities (n = 10 per group).
After surgery, survival rates were recorded, echocardiography was performed,
hearts were dissected and used for histological detection, and data were
statistically analyzed, P < 0.05 was considered statistically
significant. Results All mice died in the following AAC groups: 18g/0.35 mm, 22 g/0.35 mm, 26
g/0.35 mm, 22 g/0.40 mm, and 26 g/0.40 mm. All mice with AAC, those ligated
with a 0.50-mm needle, and those that underwent sham operation survived.
Different death rates occurred in the following AAC groups: 18 g/0.40 mm, 18
g/0.45 mm, 18 g/0.50 mm, 22 g/45 mm, 22 g/0.50 mm, 26 g/0.45 mm, and 26
g/0.50 mm. The heart weight/body weight ratios (5.39 ± 0.85, 6.41
± 0.68, 4.67 ± 0.37, 5.22 ± 0.42, 4.23 ± 0.28,
5.41 ± 0.14, and 4.02 ± 0.13) were significantly increased
compared with those of the sham groups for mice with the same weight
levels. Conclusion A 0.45-mm needle led to more obvious CH than did 0.40-mm and 0.50-mm needles
and caused extraordinary CH in 18-g mice.
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Affiliation(s)
- Zhen Jia
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
| | - Zhijun Chen
- Department of Cardio-Thoracic Surgery, Zhoushan Hospital, Zhejiang - China
| | - Hongfei Xu
- Department of Cardio-Thoracic Surgery, Zhoushan Hospital, Zhejiang - China
| | - Malik Akuffu Armah
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
| | - Peng Teng
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
| | - Weidong Li
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
| | - Dongdong Jian
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
| | - Liang Ma
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
| | - Yiming Ni
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang - China
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12
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Schoots MH, Gordijn SJ, Scherjon SA, van Goor H, Hillebrands JL. Oxidative stress in placental pathology. Placenta 2018; 69:153-161. [PMID: 29622278 DOI: 10.1016/j.placenta.2018.03.003] [Citation(s) in RCA: 224] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 02/08/2023]
Abstract
The most important function of the placenta is the exchange of nutrients and oxygen between a mother and her fetus. To establish a healthy functioning placenta, placentation needs to occur with adequate remodelling of spiral arteries by extravillous trophoblasts. When this process is impaired, the resulting suboptimal and inadequate placenta function results in the manifestation of pregnancy complications. Impaired placenta function can cause preeclampsia and leads to fetal growth restriction due to hypoxia. Presence of hypoxia leads to oxidative stress due to an imbalance between reactive oxygen species and antioxidants, thereby causing damage to proteins, lipids and DNA. In the placenta, signs of morphological adaptation in response to hypoxia can be found. Different placental lesions like maternal or fetal vascular malperfusion or chronic villitis lead to a decreased exchange of oxygen between the mother and the fetus. Clinically, several biomarkers indicative for oxidative stress, e.g. malondialdehyde and reduced levels of free thiols are found. This review aims to give an overview of the causes and (potential) role of placental oxidative stress in the development of placental parenchymal pathology and its clinical consequences. Also, therapeutic options aiming at prevention or treatment of hypoxia of the placenta and fetus are described.
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Affiliation(s)
- Mirthe H Schoots
- Department of Pathology and Medical Biology, Pathology Section, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - Sanne J Gordijn
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sicco A Scherjon
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, Pathology Section, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Jan-Luuk Hillebrands
- Department of Pathology and Medical Biology, Pathology Section, University of Groningen, University Medical Center Groningen, The Netherlands
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