The association of maternal polyunsaturated fatty acids during pregnancy with social competence and problem behaviours at 7 years of age: The MEFAB cohort

BACKGROUND

The prenatal exposure to maternal n-6 and n-3 polyunsaturated fatty acids (PUFAs) might influence the development of social competence and internalizing and externalizing behaviours of the child, because of the numerous functions of PUFAs within the nervous system.

METHODS

To analyse the association of selected maternal PUFAs (i.e., AA, EPA, DHA, total n-6, total n-3, and the n-6:n-3 ratio) measured during gestation with childhood social competence and problem behaviours, we examined 311 mother-child pairs from the Maastricht Essential Fatty Acid Birth (MEFAB) cohort. For each woman, PUFA-specific changes in relative concentrations were calculated by identifying the best-fitting curve of PUFA concentration by linear splines of gestational age. The associations of changes in maternal PUFAs in early and late pregnancy with childhood social competence, total problems, internalizing and externalizing behaviours, measured with the Child Behaviour Checklist 4/18 at age 7, were investigated with linear regression analyses adjusted for maternal and children's socio-demographic characteristics.

RESULTS

In late gestation (i.e., from gestational week 30), an increase in AA was associated with higher social competence, while a decrease in total n-6 was associated with lower externalizing behaviours. No other significant associations were found.

DISCUSSION

In this prospective study, increasing maternal AA and decreasing total n-6 were associated with improved social competence and externalizing behaviours, respectively, in 7-year old children. Nonetheless, the clinical significance of the identified associations is modest and further investigations are warranted to clarify the relationship between maternal AA and total n-6 during pregnancy and childhood social and behavioural development.

BRCA1 mutation carriers have a lower number of mature oocytes after ovarian stimulation for IVF/PGD

Purpose

The aim of this study was to determine whether BRCA1/2 mutation carriers produce fewer mature oocytes after ovarian stimulation for in vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD), in comparison to a PGD control group.

Methods

A retrospective, international, multicenter cohort study was performed on data of first PGD cycles performed between January 2006 and September 2015. Data were extracted from medical files. The study was performed in one PGD center and three affiliated IVF centers in the Netherlands and one PGD center in Belgium. Exposed couples underwent PGD because of a pathogenic BRCA1/2 mutation, controls for other monogenic conditions. Only couples treated in a long gonadotropin-releasing hormone (GnRH) agonist-suppressive protocol, stimulated with at least 150 IU follicle stimulating hormone (FSH), were included. Women suspected to have a diminished ovarian reserve status due to chemotherapy, auto-immune disorders, or genetic conditions (other than BRCA1/2 mutations) were excluded. A total of 106 BRCA1/2 mutation carriers underwent PGD in this period, of which 43 (20 BRCA1 and 23 BRCA2 mutation carriers) met the inclusion criteria. They were compared to 174 controls selected by frequency matching.

Results

Thirty-eight BRCA1/2 mutation carriers (18 BRCA1 and 20 BRCA2 mutation carriers) and 154 controls proceeded to oocyte pickup. The median number of mature oocytes was 7.0 (interquartile range (IQR) 4.0–9.0) in the BRCA group as a whole, 6.5 (IQR 4.0–8.0) in BRCA1 mutation carriers, 7.5 (IQR 5.5–9.0) in BRCA2 mutation carriers, and 8.0 (IQR 6.0–11.0) in controls. Multiple linear regression analysis with the number of mature oocytes as a dependent variable and adjustment for treatment center, female age, female body mass index (BMI), type of gonadotropin used, and the total dose of gonadotropins administered revealed a significantly lower yield of mature oocytes in the BRCA group as compared to controls (p = 0.04). This finding could be fully accounted for by the BRCA1 subgroup (BRCA1 mutation carriers versus controls p = 0.02, BRCA2 mutation carriers versus controls p = 0.50).

Conclusions

Ovarian response to stimulation, expressed as the number of mature oocytes, was reduced in BRCA1 but not in BRCA2 mutation carriers. Although oocyte yield was in correspondence to a normal response in all subgroups, this finding points to a possible negative influence of the BRCA1 gene on ovarian reserve.

Electronic supplementary material

The online version of this article (doi:10.1007/s10815-017-1014-3) contains supplementary material, which is available to authorized users.

The proper delivery pressure for cardioplegic solution in neonatal cardiac surgery - an investigation of biomechanical and structural properties of neonatal and adult coronary arteries

When cardioplegic solution is injected into coronary arteries with a pump in order to ensure myocardial protection, it is necessary to determine the correct delivery pressure to avoid damage of the heart. Biomechanical and structural properties of the neonatal coronary artery wall should be taken into account when determining the delivery pressure. We investigated twelve coronary artery specimens without cardiac pathology retrieved from autopsies of neonates 9.3 ± 9.7 days old and compared them to adult specimens with no detected atherosclerosis. There was a rapid increase in the strain until the inner pressure reached 80 - 100 mmHg, whilst the increase of stress in the wall of the neonatal coronary arteries was less rapid. When the pressure exceeded 100 mmHg, the increase in the strain slowed down, whilst the wall stress and modulus of elasticity began to increase rapidly. Morphologic examination of tensile properties revealed prominent affection of the vascular wall of the neonates, with accentuated redistribution (loosening) of medial myocytes and the adventitial vasa vasorum. Collectively, a raised inner pressure applied to cardioplegic solution injected into the coronary artery of a neonate may increase the risk of structural damage to the vascular wall.

PP053. Development and validation of a model for prepregnant prediction of recurrence of early-onset preeclampsia

INTRODUCTION

Women with a history of early-onset preeclampsia, requiring delivery before 34 weeks of gestation, often receive intensive surveillance with far more visits than routine antenatal care, additional testing such as the serial measurement of various fetal arterial Doppler blood flow velocity profiles, repetitive assessment of the fetal biometry, the amount of amniotic fluid, the fetal biophysical profile, and repetitive blood testing. Yet, recurrence risk is generally low.

OBJECTIVES

To develop and validate a prepregnant prediction model to identify women at very low risk of recurrence of early-onset preeclampsia. These women may be reassured and offered routine antenatal care.

METHODS

For the derivation of the model, we enrolled 407 pregnant women from 5 Dutch hospitals who had experienced early-onset preeclampsia in their previous pregnancy. Based on previous published evidence, we selected five predictor variables (gestational age at the time of previous birth, prior small-for-gestational-age (SGA) newborn, fasting blood glucose, body mass index (BMI) and the presence or absence of chronic hypertension) to be entered in a logistic regression model. Discrimination and calibration measures were evaluated after an internal validation step using standard bootstrapping techniques. After the model was built, we enrolled another 200 women to externally validate the model. For the external validation study, 6 more hospitals provided patients.

RESULTS

The individual risk of recurrence of early-onset preeclampsia using our formula can be calculated as follows: P(recurrence)=1/(1+e(-(linear predictor))), with linear predictor=0.29-0.42*fasting blood glucose (mmol/L) + 0.59* hypertension (yes/no) - 0.01*gestational age at the time of previous birth (days) - 0.41*prior SGA (yes/no)+0.01*BMI (kg/m(2)). After internal validation, the area under the receiver operating characteristic (ROC) curve of the model was 0.65 (95% CI: 0.56-0.74) in the development sample, and was higher in the external validation sample (AUC=0.76, 95% CI=0.58-0.96), indicating that the model discriminates well between women who will develop a recurrence and those who will not. Using a predicted risk threshold of, for example, 4.6%, about one-fourth of the population would be regarded low-risk with a negative predictive value of 100%. Calibration was satisfactory in both samples.

CONCLUSION

Our model is helpful in the identification of women at very low risk of recurrent early-onset preeclampsia, and may be used to stratify women into normal care and intensified care groups. At present, we are conducting the PreCare study, in which we assess the effects and costs of introducing our prediction model into routine clinical practice.

The PDE4 inhibitor rolipram reverses object memory impairment induced by acute tryptophan depletion in the rat

RATIONALE

The selective type IV phosphodiesterase inhibitor, rolipram, has been shown to improve long-term memory and can reverse the cholinergic deficit caused by scopolamine. However, the underlying mechanisms of action of rolipram remain obscure.

OBJECTIVES

The present study investigates the effect of rolipram in a serotonergic-deficit model of acute tryptophan depletion (ATD). In addition, the levels of plasma tryptophan (TRP) were compared to object recognition performance.

MATERIALS AND METHODS

The experiments were conducted using male Wistar rats. The time-dependent effect of ATD treatment (a gelatin-based protein mixture) on plasma TRP levels (0, 1, 3, and 6 h after injection) and object recognition task (ORT) performance (0.5, 1, 3, and 6 h after ATD treatment) was examined. The effect of rolipram (0, 0.01, 0.03, and 0.1 mg/kg, i.p.) was tested in the condition in which ATD induced a clear memory deficit.

RESULTS

ATD significantly lowered the plasma TRP ratio (TRP/Sigmalarge neutral amino acid) with a maximum of 48%, approximately 1 h after administration. Furthermore, ATD impairs ORT performance when administered 3 h before testing. Rolipram (0.1 mg/kg) reversed the memory deficit induced by ATD in a dose-dependent manner.

CONCLUSIONS

On the basis of previous studies and the ability to reverse a serotonergic deficit, we suggest that rolipram may act through elevation of cyclic adenosine monophosphate levels and subsequent increase in neurotransmitter release.

The association of birth interval, maternal age and season of birth with the fertility of daughters: a retrospective cohort study based on family reconstitutions from nineteenth and early twentieth century Quebec

In a historical follow-up study, we evaluated the association of the fertility of daughters with five perinatal factors: short (< 15 months) or long (> or = 45 months) preceding birth interval, low (< or = 20 years) or advanced (> or = 40 years) maternal age and season of birth. We used data concerning 2062 women married before the age of 31 and born in the Saguenay region of Quebec, Canada, between 1850 and 1899. Time between the wedding and first birth was used for the estimation of differences in fertility. Using logistic regression and controlling for several potential confounders, we found a slightly increased risk of monthly failure of conception for daughters born after a short but not for those born after a long birth interval (odds ratios [ORs] 1.09 [0.89, 1.33] and 0.87 [0.65, 1.16], respectively, with intervals between 21 and 32 months as the reference category). A slightly increased risk of conceptive failure was also seen for daughters of younger and older mothers (ORs 1.08 [0.89, 1.30] and 1.11 [0.91, 1.35], respectively, compared with maternal age between 24 and 30 years as the reference category). Fertility varied by season of birth (P = 0.02), with summer-born daughters having lowest and winter-born daughters having highest fertility. These results are consistent with the idea that maternal factors before or around birth play a role in the aetiology of reduced fertility. The data, however, do not unequivocally support the hypothesis that gave rise to the present study, namely that ovarian development may be disturbed after conception in conditions with an increased risk of maternal menstrual cycle irregularities.

Towards a more standardized assessment of diagnostic tumor-markers

The estimation of sensitivity and specificity are mainly used as summary measures of diagnostic power of new diagnostic tests. Unfortunately, the positive assessment outcome is often recanted, frequently because only a preliminary assessment is done in a highly selected population of already diagnosed patients and healthy individuals. Furthermore, diagnostic marker outcomes are dichotomised for the calculation of sensitivity and specificity, with loss of information as a consequence. We plead for the presentation of all relevant diagnostic information, which includes extensive description of the composition of the study group, distributions of test results for different patient groups and the use of the ROC curve and the area under it as the statistical summary measure.

In vivo import of plastocyanin and a fusion protein into developmentally different plastids of transgenic plants

Transgenic tomato plants that constitutively express a foreign plastocyanin gene were used to study protein transport in different tissues. Normally expression of endogenous plastocyanin genes in plants is restricted to photosynthetic tissues only, whereas this foreign plastocyanin protein is found to be present in all tissues examined. The protein is transported into the local plastids in these tissues and it is processed to the mature size. We conclude that plastids of developmentally different tissues are capable of importing precursor proteins that are normally not found in these tissues. Most likely such plastids, though functionally and morphologically differentiated, have similar or identical protein import mechanisms when compared to the chloroplasts in green tissue.