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Auger N, Maniraho A, Ayoub A, Arbour L. Association of maternal cancer with congenital anomalies in offspring. Paediatr Perinat Epidemiol 2024; 38:121-129. [PMID: 38112586 DOI: 10.1111/ppe.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/04/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Congenital anomalies are common, but the possibility that maternal cancer increases the chance of having a child with a birth defect is not fully understood. OBJECTIVES To examine the association between maternal cancer before or during pregnancy and the risk of birth defects in offspring. METHODS We conducted a retrospective cohort study of live births in Quebec, Canada, between 1989 and 2022 using hospital data. The main exposure measure was maternal cancer before or during pregnancy. The outcome included birth defects detected in offspring during gestation or at birth. We estimated risk ratios (RR) and 95% confidence intervals (CI) for the association of maternal cancer with birth defects using log-binomial regression models adjusted for potential confounders. RESULTS In this study of 2,568,120 newborns, birth defects were present in 6.0% and 6.7% of infants whose mothers had cancer before or during pregnancy, respectively, compared with 5.7% of infants whose mothers never had cancer. Cancer during pregnancy was associated with heart (RR 1.58, 95% CI 1.03, 2.44), nervous system (RR 4.05, 95% CI 2.20, 7.46) and urinary defects (RR 1.72, 95% CI 1.01, 2.95). Among specific types of malignancies during pregnancy, breast cancer was the most prominent risk factor for birth defects (RR 1.55, 95% CI 1.02, 2.37). Cancer before pregnancy was not associated with any type of birth defect or with defects overall (RR 1.01, 95% CI 0.92, 1.11). Moreover, no specific type of cancer before pregnancy was associated with an increased risk of birth defects. CONCLUSIONS Maternal cancer during pregnancy is associated with the risk of congenital anomalies in offspring, however, cancer before pregnancy is not associated with this outcome.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Amanda Maniraho
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
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Movva VC, Spangler B, Young AJ, Paglia MJ, Angras K. A retrospective review of the association between maternal body mass index and the risk of congenital anomalies. Congenit Anom (Kyoto) 2024; 64:17-22. [PMID: 37964631 DOI: 10.1111/cga.12544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023]
Abstract
The objective of the study was to examine the association of congenital anomalies with the specific classes of pre-pregnancy BMI. An IRB-approved retrospective cohort study was performed using the data from the Natality Public Use File from the National Center for Health Statistics (2019). We included all singleton live births and excluded pregnancies with suspected or confirmed chromosomal abnormalities and people with pre-existing diabetes mellitus and missing pertinent data. The primary outcome was the incidence of any major congenital anomalies in liveborn infants. The incidence of anomaly was analyzed across all BMI classes, using individuals with BMI between 18.5 and 24.9 kg/m2 as the comparison group. A test of trend was also performed to determine if the risk increased as the BMI class increased. A total of 3 047 382 maternal-neonatal dyads were included in the analysis. A non-significant higher incidence of any major anomaly was noted among people who had underweight and class III BMI. The risk of open neural tube defects, omphalocele, and cleft lip/palate increased and the risk of gastroschisis decreased with an increase in maternal BMI class (p < 0.05). The incidence of congenital anomalies increases as the pre-pregnancy BMI increases. Individuals should be encouraged to optimize their weight prior to conception and if feasible, they should obtain screening for fetal anatomy assessment by a Maternal-Fetal Medicine specialist.
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Affiliation(s)
- Vani C Movva
- Women's Health Service Line, Division of Maternal-Fetal Medicine, Geisinger, Danville, Pennsylvania, USA
| | - Brooke Spangler
- Women's Health Service Line, Division of Maternal-Fetal Medicine, Geisinger, Danville, Pennsylvania, USA
| | - Amanda J Young
- Biomedical and Translational Informatics Institute, Geisinger, Danville, Pennsylvania, USA
| | - Michael J Paglia
- Women's Health Service Line, Division of Maternal-Fetal Medicine, Geisinger, Danville, Pennsylvania, USA
| | - Kajal Angras
- Women's Health Service Line, Division of Maternal-Fetal Medicine, Geisinger, Danville, Pennsylvania, USA
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Bu X, Ye W, Zhou J. Paternal age, risk of congenital anomalies, and birth outcomes: a population-based cohort study. Eur J Pediatr 2023; 182:3519-3526. [PMID: 37193751 DOI: 10.1007/s00431-023-05025-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/18/2023]
Abstract
The objective of the study was to explore the impact of paternal age on the risk of congenital anomalies and birth outcomes in infants born in the USA between 2016 and 2021. This retrospective cohort study used data from the National Vital Statistics System (NVSS) database, a data set containing information on live birth in the USA between 2016 and 2021. Newborns were divided into four groups based on their paternal age (< 25, 25-34, 35-44, and > 44 years) and using the 25-34 age group as a reference. The primary outcomes were congenital anomalies involving structural anomalies and chromosome anomalies. Secondary outcomes were preterm birth, low birth weight, severe neonatal perinatal asphyxia, and admission to neonatal intensive care units (NICU). A multivariable logistic regression model was used to analyze the association between paternal age and outcomes. Overall, 17,764,695 live births were included in the final analyses. After adjusting confounding factors, advanced paternal age > 44 years was associated with increased odds of congenital anomalies (adjusted odds ratio (aOR) = 1.17, 95%CI 1.12-1.21) compared with the 25-34 age group, mainly for the chromosomal anomalies (aOR = 1.59, 95%CI 1.40-1.78) but not the structure anomalies (aOR = 1.03, 95%CI 0.97-1.09). The risk of preterm delivery, low birth weight, and NICU hospitalization in their infants was increased by advanced parental age as well. Conclusion: Advanced paternal age increases the risk of congenital anomalies, especially chromosomal anomalies in their offspring, implying prenatal genetic counseling is required. What is Known: • There's a rising trend of advanced paternal age, which is associated with an increased likelihood of premature birth and low birth weight in their offspring. However, the exploration between paternal age and congenital abnormalities in offspring was limited and contradictory. What is New: • Infants with a paternal age > 44 years were more likely to be born with congenital anomalies, especially chromosomal anomalies.
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Affiliation(s)
- Xinghe Bu
- Department of Neonatology, National Children's Medical Center (Shanghai), Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, China
| | - Wenjing Ye
- Department of Neonatology, National Children's Medical Center (Shanghai), Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, China
| | - Jianguo Zhou
- Department of Neonatology, National Children's Medical Center (Shanghai), Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, China.
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Peng T, Yin L, Xiong Y, Xie F, Ji C, Yang Z, Pan Q, Li M, Deng X, Dong J, Wu J. Maternal traditional Chinese medicine exposure and risk of congenital malformations: a multicenter prospective cohort study. Acta Obstet Gynecol Scand 2023; 102:735-743. [PMID: 37073619 PMCID: PMC10201976 DOI: 10.1111/aogs.14553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION The potential teratogenic risk of traditional Chinese medicine (TCM) is of widespread concern; however, related evidence is largely absent in humans. This study aimed to compare the prevalence of congenital malformations between pregnant women with and without TCM exposure. MATERIAL AND METHODS This was a multicenter prospective cohort study of 17 713 women who participated in a survey on periconceptional TCM exposure. Primary outcome was congenital malformations diagnosed from a survey conducted on the day 42 after delivery. RESULTS A total of 16 751 pregnant women with 273 congenital malformations were included in the analysis. Fetuses exposed to TCM had an increased risk of congenital malformations compared to those without exposure (odds ratio [OR] 2.10; 95% confidence interval [CI] 1.09-4.02) after controlling for potential confounders. There were significant associations with congenital malformations in women with early pregnant exposure (OR 2.04, 95% CI 1.00-4.20) and for those who received ≥2 TCM formulas (OR 5.84, 95% CI 1.44-23.65). Pre-pregnancy TCM exposure was significantly associated with an increased risk of congenital heart defects (OR 12.69; 95% CI 3.01-53.51). CONCLUSIONS Periconceptional TCM exposure is associated with an increased risk of congenital malformation. This effect was cumulative and sensitive to periconceptional age. Therefore, TCM deserves more attention and should be used cautiously for pregnant women and those trying to become pregnant.
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Affiliation(s)
- Ting Peng
- Department of Obstetrics, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Female Reproductive Endocrine‐Related DiseasesShanghaiChina
| | - Lin‐Liang Yin
- Center for Medical UltrasoundThe Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalSuzhouChina
| | - Yu Xiong
- Department of Obstetrics, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Female Reproductive Endocrine‐Related DiseasesShanghaiChina
| | - Feng Xie
- Medical Center of Diagnosis and Treatment for Cervical DiseaseObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Chun‐Ya Ji
- Center for Medical UltrasoundThe Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalSuzhouChina
| | - Zhong Yang
- Center for Medical UltrasoundThe Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalSuzhouChina
| | - Qi Pan
- Center for Medical UltrasoundThe Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalSuzhouChina
| | - Ming‐Qing Li
- Department of Obstetrics, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Female Reproductive Endocrine‐Related DiseasesShanghaiChina
| | - Xue‐Dong Deng
- Center for Medical UltrasoundThe Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalSuzhouChina
| | - Jing Dong
- Medical Center of Diagnosis and Treatment for Cervical DiseaseObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Jiang‐Nan Wu
- Shanghai Key Laboratory of Female Reproductive Endocrine‐Related DiseasesShanghaiChina
- Department of Clinical Epidemiology, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
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Horwitz J, Wen SW, Tan H, Zhou S, Ye C, Shen M, Retnakaran R. Analysis of Preconception Paternal Smoking and Neonatal Outcomes. JAMA Netw Open 2022; 5:e2144527. [PMID: 35061043 PMCID: PMC8783264 DOI: 10.1001/jamanetworkopen.2021.44527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cohort study evaluates the associations of preconception paternal smoking with neonatal outcomes.
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Affiliation(s)
- Jennifer Horwitz
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Shi Wu Wen
- OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Hongzhuan Tan
- School of Public Health, Central South University, Changsha, China
| | - Shujin Zhou
- Liuyang Municipal Hospital of Maternal and Child Health, Beizheng, Liuyang, China
| | - Chang Ye
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Minxue Shen
- OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Ravi Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
- Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada
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Koo EJ, Bae JG, Kim EJ, Cho YH. Correlation between Exposure to Fine Particulate Matter (PM2.5) during Pregnancy and Congenital Anomalies: Its Surgical Perspectives. J Korean Med Sci 2021; 36:e236. [PMID: 34609089 PMCID: PMC8490787 DOI: 10.3346/jkms.2021.36.e236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/08/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Fine particulate matter (PM2.5) can easily penetrate blood vessels and tissues through the human respiratory tract and cause various health problems. Some studies reported that particular matter (PM) exposure during pregnancy is associated with low birth weight or congenital cardiovascular anomalies. This study aimed to investigate the correlation between the degree of exposure to PM ≤ 2.5 μm (PM2.5) during pregnancy and congenital anomalies relevant to the field of pediatric surgery. METHODS Mother-infant dyads with registered addresses in the Metropolitan City were selected during 3 years. The electronic medical records of mothers and neonates were retrospectively analyzed, with a focus on maternal age at delivery, date of delivery, gestation week, presence of diabetes mellitus (DM) or hypertension, parity, the residence of the mother and infant, infant sex, birth weight, Apgar score, and presence of congenital anomaly. The monthly PM2.5 concentration from the first month of pregnancy to the delivery was computed based on the mothers' residences. RESULTS PM2.5 exposure concentration in the second trimester was higher in the congenital anomaly group than in the non-congenital anomaly group (24.82 ± 4.78 µg/m3, P = 0.023). PM2.5 exposure concentration did not affect the incidence of nervous, cardiovascular, and gastrointestinal anomalies. While statistically insignificant, the groups with nervous, cardiovascular, gastrointestinal, musculoskeletal, and other congenital anomalies were exposed to higher PM2.5 concentrations in the first trimester compared with their respective counterparts. The effect of PM2.5 concentration on the incidence of congenital anomalies was significant even after adjusting for the mother's age, presence of DM, hypertension, and parity. The incidence of congenital anomalies increased by 26.0% (95% confidence interval of 4.3% and 49.2%) per 7.23 µg/m3 elevation of PM2.5 interquartile range in the second trimester. CONCLUSIONS The congenital anomaly group was exposed to a higher PM2.5 concentration in the second trimester than the non-congenital anomaly group. The PM2.5 exposure concentration level in the first trimester tended to be higher in groups with anomalies than those without anomalies. This suggests that continuous exposure to a high PM2.5 concentration during pregnancy influences the incidence of neonatal anomalies in surgical respects.
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Affiliation(s)
- Eun-Jung Koo
- Division of Pediatric Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Jin-Gon Bae
- Department of Obstetrics & Gynecology, Keimyung University School of Medicine, Daegu, Korea
| | - Eun Jung Kim
- Department of Urban Planning, Keimyung University, Daegu, Korea.
| | - Yong-Hoon Cho
- Division of Pediatric Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Gyeongnam, Korea.
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Sun L, Xi Y, Wen X, Zou W. Use of metoclopramide in the first trimester and risk of major congenital malformations: A systematic review and meta-analysis. PLoS One 2021; 16:e0257584. [PMID: 34543335 PMCID: PMC8452057 DOI: 10.1371/journal.pone.0257584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/03/2021] [Indexed: 01/11/2023] Open
Abstract
Background Nausea and vomiting of pregnancy affects up to 80% of pregnant women, it typically occurs during the first trimester which is the most sensitive time for environmental exposures given organogenesis. Metoclopramide is an antiemetic drug used widely during NVP, but the findings of studies evaluating its safety of use in pregnancy is inconsistent. Therefore, we conducted a systematic review and meta-analysis to assess whether metoclopramide use during first trimester of pregnancy is associated with the risk of major congenital malformations. Methods The systematic search using database included Pubmed, Embase, Web of science, and Cochrane library. Studies written in English, comprising with an exposed group and a control group, reporting major congenital malformation as an outcome were included. Results Six studies assessing a total number of 33374 metoclopramide-exposed and 373498 controls infants were included in this meta-analysis. No significant increase in the rate of major congenital malformation was detected following metoclopramide use during first trimester (OR, 1.14; 95% CI, 0.93–1.38). Conclusions Metoclopramide use during first trimester of pregnancy was not associated with the risk of major congenital malformations.
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Affiliation(s)
- Li Sun
- Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Yang Xi
- Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacy, Central South University, Changsha, Hunan, China
- * E-mail:
| | - Xiaoke Wen
- Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Wei Zou
- Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
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Abstract
IMPORTANCE In the US, approximately 12.7% of reproductive age women seek treatment for infertility each year. This review summarizes current evidence regarding diagnosis and treatment of infertility. OBSERVATIONS Infertility is defined as the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse. Approximately 85% of infertile couples have an identifiable cause. The most common causes of infertility are ovulatory dysfunction, male factor infertility, and tubal disease. The remaining 15% of infertile couples have "unexplained infertility." Lifestyle and environmental factors, such as smoking and obesity, can adversely affect fertility. Ovulatory disorders account for approximately 25% of infertility diagnoses; 70% of women with anovulation have polycystic ovary syndrome. Infertility can also be a marker of an underlying chronic disease associated with infertility. Clomiphene citrate, aromatase inhibitors such as letrozole, and gonadotropins are used to induce ovulation or for ovarian stimulation during in vitro fertilization (IVF) cycles. Adverse effects of gonadotropins include multiple pregnancy (up to 36% of cycles, depending on specific therapy) and ovarian hyperstimulation syndrome (1%-5% of cycles), consisting of ascites, electrolyte imbalance, and hypercoagulability. For individuals presenting with anovulation, ovulation induction with timed intercourse is often the appropriate initial treatment choice. For couples with unexplained infertility, endometriosis, or mild male factor infertility, an initial 3 to 4 cycles of ovarian stimulation may be pursued; IVF should be considered if these approaches do not result in pregnancy. Because female fecundity declines with age, this factor should guide decision-making. Immediate IVF may be considered as a first-line treatment strategy in women older than 38 to 40 years. IVF is also indicated in cases of severe male factor infertility or untreated bilateral tubal factor. CONCLUSIONS AND RELEVANCE Approximately 1 in 8 women aged 15 to 49 years receive infertility services. Although success rates vary by age and diagnosis, accurate diagnosis and effective therapy along with shared decision-making can facilitate achievement of fertility goals in many couples treated for infertility.
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Affiliation(s)
- Sandra Ann Carson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
| | - Amanda N Kallen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
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Albarano L, Zupo V, Caramiello D, Toscanesi M, Trifuoggi M, Guida M, Libralato G, Costantini M. Sub-Chronic Effects of Slight PAH- and PCB-Contaminated Mesocosms in Paracentrotus lividus Lmk: A Multi-Endpoint Approach and De Novo Transcriptomic. Int J Mol Sci 2021; 22:ijms22136674. [PMID: 34206685 PMCID: PMC8268688 DOI: 10.3390/ijms22136674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022] Open
Abstract
Sediment pollution is a major issue in coastal areas, potentially endangering human health and the marine environments. We investigated the short-term sublethal effects of sediments contaminated with polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) on the sea urchin Paracentrotus lividus for two months. Spiking occurred at concentrations below threshold limit values permitted by the law (TLVPAHs = 900 µg/L, TLVPCBs = 8 µg/L, Legislative Italian Decree 173/2016). A multi-endpoint approach was adopted, considering both adults (mortality, bioaccumulation and gonadal index) and embryos (embryotoxicity, genotoxicity and de novo transcriptome assembly). The slight concentrations of PAHs and PCBs added to the mesocosms were observed to readily compartmentalize in adults, resulting below the detection limits just one week after their addition. Reconstructed sediment and seawater, as negative controls, did not affect sea urchins. PAH- and PCB-spiked mesocosms were observed to impair P. lividus at various endpoints, including bioaccumulation and embryo development (mainly PAHs) and genotoxicity (PAHs and PCBs). In particular, genotoxicity tests revealed that PAHs and PCBs affected the development of P. lividus embryos deriving from exposed adults. Negative effects were also detected by generating a de novo transcriptome assembly and its annotation, as well as by real-time qPCR performed to identify genes differentially expressed in adults exposed to the two contaminants. The effects on sea urchins (both adults and embryos) at background concentrations of PAHs and PCBs below TLV suggest a need for further investigations on the impact of slight concentrations of such contaminants on marine biota.
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Affiliation(s)
- Luisa Albarano
- Stazione Zoologica Anton Dohrn, Department of Marine Biotechnology, Villa Comunale, 80121 Naples, Italy; (L.A.); (G.L.)
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant’Angelo, Via Cinthia 21, 80126 Naples, Italy;
| | - Valerio Zupo
- Stazione Zoologica Anton Dohrn, Department of Marine Biotechnology, Villa Dohrn, Punta San Pietro, 80077 Naples, Italy;
| | - Davide Caramiello
- Stazione Zoologica Anton Dohrn, Department of Research Infrastructures for Marine Biological Resources, Marine Organisms Core Facility, Villa Comunale, 80121 Naples, Italy;
| | - Maria Toscanesi
- Dipartimento di Scienze Chimiche, Università degli Studi di Napoli Federico II, Complesso Universitario di Monte S. Angelo, Via Cintia, 80126 Naples, Italy; (M.T.); (M.T.)
| | - Marco Trifuoggi
- Dipartimento di Scienze Chimiche, Università degli Studi di Napoli Federico II, Complesso Universitario di Monte S. Angelo, Via Cintia, 80126 Naples, Italy; (M.T.); (M.T.)
| | - Marco Guida
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant’Angelo, Via Cinthia 21, 80126 Naples, Italy;
| | - Giovanni Libralato
- Stazione Zoologica Anton Dohrn, Department of Marine Biotechnology, Villa Comunale, 80121 Naples, Italy; (L.A.); (G.L.)
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant’Angelo, Via Cinthia 21, 80126 Naples, Italy;
| | - Maria Costantini
- Stazione Zoologica Anton Dohrn, Department of Marine Biotechnology, Villa Comunale, 80121 Naples, Italy; (L.A.); (G.L.)
- Correspondence:
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Yoon SH, Kong Y. Severe neonatal Marfan syndrome with a novel mutation in the intron of the FBN1 gene: A case report. Medicine (Baltimore) 2021; 100:e24301. [PMID: 33578525 PMCID: PMC10545169 DOI: 10.1097/md.0000000000024301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/11/2020] [Accepted: 12/24/2020] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Marfan syndrome (MFS) has been defined as a genetic disorder that affects various systems such as the musculoskeletal, orbital, and cardiovascular systems. Neonatal MFS is considered rare and the most severe form of MFS is characterized by rapidly progressive atrioventricular valve dysfunction, often leading to death during early childhood due to congestive heart failure. PATIENT CONCERNS A newborn with neonatal MFS and severe cardiac involvement. He presented various severe clinical features such as arachnodactyly, camptodactyly, elbow and knee joint contracture, senile facial appearance, and deep settling with down-slanting palpebral fissure, hypoplastic ear cartilage, sagging mouth, brachycephaly, and ectopia lentis. DIAGNOSIS Genetic analysis revealed a novel mutation at nucleotide 3964 (c.3964 + 1 G > T) in intron 32 of the fibrillin-1 gene. This mutation is identified to be in the so-called neonatal region of fibrillin-1 exon 24 to 32, as reported previously. INTERVENTIONS The patient was managed medically for improving the low cardiac output according to severe mitral regurgitation and aortic regurgitation. Afterload reduction, full sedation, and use of diuretic were attempted to improve the oliguria and heart failure. OUTCOMES Despite the medical management, aortic regurgitation, mitral regurgitation, pulmonary hypertension, and cardiac contractility got worse. Surgical treatment is essential to prolong the patient's life, however, considerations for the grave progression of the disease make families decide to continue palliative care instead of surgical treatment. A few months after birth, he presented with rapidly progressive aortic regurgitation, mitral regurgitation, and congestive heart failure leading to death. CONCLUSIONS This review demonstrated the prominent characteristics of neonatal MFS mutations, it would be helpful for the recognition of novel neonatal MFS variants and valuable for the understanding of the genotype-phenotype correlations and using the plans for managements and counseling in neonatal MFS.
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Affiliation(s)
- Su Hyun Yoon
- Department of Pediatrics, Jeonbuk National University Hospital
| | - Younghwa Kong
- Department of Pediatrics, Jeonbuk National University Hospital
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Abebe S, Gebru G, Amenu D, Mekonnen Z, Dube L. Risk factors associated with congenital anomalies among newborns in southwestern Ethiopia: A case-control study. PLoS One 2021; 16:e0245915. [PMID: 33508017 PMCID: PMC7843017 DOI: 10.1371/journal.pone.0245915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/08/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Human embryo is well protected in the uterus by the embryonic membrane, although teratogens may cause developmental disruptions after maternal exposure to them during early pregnancy. Most of the risk factors contributing to the development of congenital anomalies are uncertain; however, genetic factors, environmental factors and multifactorial inheritance are found to be risk factors. Regardless of their clinical importance, there are little/no studies conducted directly related to predisposing risk factors in southwestern Ethiopia. OBJECTIVE The study aimed to determine the associated risk factors with congenital anomalies among newborns in southwestern Ethiopia. METHODS Case-control study was conducted on newborns and their mothers in six purposively selected hospitals in southwestern Ethiopia from May 2016 to May 2018. Data was collected after evaluation of the neonates for the presence of congenital anomalies using the standard pretested checklist. The data was analyzed using SPSS version 25.0. P <0.01 was set as statistically significant. RESULTS Risk factors such as unidentified medicinal usage in the first three months of pregnancy (AOR = 3.435; 99% CI: 2.012-5.863), exposure to pesticide (AOR = 3.926; 99% CI: 1.266-12.176), passive smoking (AOR = 4.104; 99% CI: 1.892-8.901), surface water as sources of drinking (AOR = 2.073; 99% CI: 1.221-3.519), folic acid supplementation during the early pregnancy (AOR = 0.428; 99% CI: 0.247-0.740) were significantly associated with the congenital anomalies. CONCLUSIONS In this study, risk factors such as passive smoking, exposure to pesticides, chemicals and use of surface water as a source of drinking during early pregnancy had a significant association with congenital anomalies. There is a need to continuously provide health information for the community on how to prevent and control predisposing risk factors.
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Affiliation(s)
- Soressa Abebe
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmai Gebru
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Demisew Amenu
- Department of Gynecology and Obstetrics, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Lemessa Dube
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
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12
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Long R, Wang M, Yang QY, Hu SQ, Zhu LX, Jin L. Risk of birth defects in children conceived by artificial oocyte activation and intracytoplasmic sperm injection: a meta-analysis. Reprod Biol Endocrinol 2020; 18:123. [PMID: 33308238 PMCID: PMC7731535 DOI: 10.1186/s12958-020-00680-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/06/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Whether artificial oocyte activation (ICSI-AOA) will increase the risk of birth defects remains controversial. Thus, we performed this study to evaluate the risk of birth defects and further compare the incidence of different birth defects types (chromosomal aberrations and non-chromosomal aberrations) in children conceived by ICSI-AOA and conventional intracytoplasmic sperm injection (ICSI) in an enlarged sample size. METHOD A comprehensive review of the literatures comparing birth defects in children conceived by ICSI-AOA and conventional ICSI by October 2020 was performed in PubMed, Embase, Cochrane Libraries, Web of Science, and Chinese databases including China National Knowledge Infrastructure, China Biology Medicine disc and Wan Fang. Risk ratios (RR) and 95% confidence intervals (CI) were calculated. RESULTS Five studies were included in the final analysis. Compared with conventional ICSI, ICSI-AOA did not increase the birth defects rate (RR = 1.27, 95%CI 0.70-2.28) of children. Furthermore, in a subgroup analysis, birth defects were classified into two types (chromosomal aberrations and non-chromosomal aberrations) in four studies and no statistical difference were revealed. CONCLUSION Our analysis indicates that ICSI-AOA represents no significant difference in the prevalence of major birth defects or types of birth defects (chromosomal aberrations and non-chromosomal aberrations) comparing with conventional ICSI. This conclusion may provide clinicians evidence-based support in patient counseling and instruction of the application and safety concern about ICSI-AOA.
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Affiliation(s)
- Rui Long
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
| | - Meng Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
| | - Qi Yu Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
| | - Shi Qiao Hu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
| | - Li Xia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
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13
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Chen C, Huang S, Sun L, Li S, Huang L, Wang Z, Luo X, Ding X. Analysis of Etiologic Factors in Pediatric Rhegmatogenous Retinal Detachment With Genetic Testing. Am J Ophthalmol 2020; 218:330-336. [PMID: 32112773 DOI: 10.1016/j.ajo.2020.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/08/2020] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to investigate the etiology and clinical features of nontraumatic rhegmatogenous retinal detachment (RRD) in children. DESIGN Consecutive, cross-sectional study. METHODS In this study, 112 operative eyes of 102 patients ≤18 years of age with nontraumatic RRD were included. Comprehensive ophthalmic examinations were performed in all patients. Genetic testing was performed in 34 patients with hereditary congenital/developmental diseases. The etiology of RRD was analyzed. RESULTS The average age was 12.2 ± 4.5 years (range, 1-18 years). The percentages of male and female patients were 74.5% (76/102) and 25.5% (26/102), respectively. The most common etiologic factors were congenital/developmental anomalies (51/102, 50%), followed by simple myopia (34/102, 33.3%) and previous intraocular surgery (6/102, 5.9%). More than half (31/51, 60.8%) of the patients with congenital/developmental anomalies had familial exudative vitreoretinopathy. Further analysis of the underlying etiologic factors based on age revealed that the most common etiology of RRD in patients ≤12 years of age was congenital/developmental anomalies (28/48, 58.3%); however, simple myopia was the major etiologic factor in patients >12 years of age (27/54, 50%). CONCLUSIONS Congenital/developmental diseases were the most common etiologies of pediatric nontraumatic RRD in China. Familial exudative vitreoretinopathy accounted for most of the congenital/developmental anomalies.
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Affiliation(s)
- Chonglin Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Sijian Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Limei Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Songshan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Li Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhirong Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoling Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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14
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Badeghiesh A, Ismail S, Baghlaf H, Suarthana E, Dahan MH. Pregnancy, delivery and neonatal outcomes among women with congenital adrenal hyperplasia: a study of a large US database. Reprod Biomed Online 2020; 41:1093-1099. [PMID: 33008769 DOI: 10.1016/j.rbmo.2020.08.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/16/2020] [Accepted: 08/26/2020] [Indexed: 01/27/2023]
Abstract
RESEARCH QUESTION What is the association between congenital adrenal hyperplasia (CAH) and pregnancy, delivery and neonatal outcomes, using a population database cohort. DESIGN Retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database from 2004-2014. ICD-9 code 255.2 was used to extract the cases of CAH. Pregnancies complicated with CAH were compared with the other pregnancies. All confounding variables were adjusted using multivariate logistic regression, based on any significant differences between the two groups. RESULTS A total of 9,096,788 deliveries occurred during the study period. Two hundred and ninety-nine pregnant women had CAH. Chorioamnionitis was higher in CAH compared with controls after controlling for risk factors (adjusted OR 2.67, 95% CI 1.17 to 6.06). The rates of caesarean section and maternal infection were also higher in CAH than controls (adjusted OR 2.10, 95% CI 1.44 to 3.07 and adjusted OR 2.63, 95% CI 1.22 to 5.63, respectively). Risk of gestational diabetes and pregnancy-induced hypertension rates were not significantly different in CAH (adjusted OR 1.53, 95% CI 0.91 to 2.58 and adjusted OR 0.87, 95% CI 0.49 to 1.56, respectively). At birth, 8% and 2.2% of the neonates were found to be small for gestational age in the CAH and the control groups, respectively (adjusted OR 3.37, 95% CI 1.86 to 6.11). Congenital anomalies were encountered in 2.7% and 0.4% in the CAH and control groups, respectively (adjusted OR 5.24, 95% CI 2.31 to 11.90). CONCLUSIONS Women with CAH were at risk of complications and fetal anomalies. Expected increases in rates of hypertension and gestational diabetes were not encountered. These patients will benefit from surveillance to decrease morbidity.
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MESH Headings
- Adrenal Hyperplasia, Congenital/complications
- Adrenal Hyperplasia, Congenital/epidemiology
- Adrenal Hyperplasia, Congenital/therapy
- Adult
- Case-Control Studies
- Cohort Studies
- Congenital Abnormalities/epidemiology
- Congenital Abnormalities/etiology
- Databases, Factual
- Delivery, Obstetric/methods
- Delivery, Obstetric/statistics & numerical data
- Female
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/etiology
- Male
- Pregnancy
- Pregnancy Complications/epidemiology
- Pregnancy Complications/therapy
- Pregnancy Outcome/epidemiology
- Prenatal Care/statistics & numerical data
- Retrospective Studies
- United States/epidemiology
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Affiliation(s)
- Ahmad Badeghiesh
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montréal Quebec H3A 0G4, Canada; McGill University Health Center, 1001 Decarie Boulevard, Room D05.2519, Montreal QC H4A 3J1.
| | - Sara Ismail
- Faculty of Medicine, McGill University, Montréal Quebec H3G 2M1, Canada
| | - Haitham Baghlaf
- Division of Maternal-Fetal Medicine, Obstetrics & Gynecology Department, University of Toronto, McGill University, Montreal, QC, Canada
| | - Eva Suarthana
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montréal Quebec H3A 0G4, Canada
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montréal Quebec H3A 0G4, Canada; MUHC Reproductive Centre, McGill University, Montréal Quebec H2L 4S8, Canada
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15
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Abstract
Experts cautiously optimistic that virus doesn’t target fetus during first trimester.
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16
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Ménézo Y, Elder K. Epigenetic remodeling of chromatin in human ART: addressing deficiencies in culture media. J Assist Reprod Genet 2020; 37:1781-1788. [PMID: 32676929 DOI: 10.1007/s10815-020-01884-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 02/02/2023] Open
Affiliation(s)
- Yves Ménézo
- Laboratoire Clément, 17 Avenue d'Eylau, 75016, Paris, France.
| | - Kay Elder
- Bourn Hall Clinic, Bourn, Cambridge, CB232TN, UK
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17
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Birth Defects Associated with Higher Risk of Childhood Cancers: Forty specific birth defect-childhood cancer associations were identified as statistically significant. Am J Med Genet A 2019; 179:1908-9. [PMID: 31503403 DOI: 10.1002/ajmg.a.40462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Madej A, Mazanowska N, Cyganek A, Pazik J, Pietrzak B. Neonatal and Maternal Outcomes among Women with Glomerulonephritis. Am J Nephrol 2020; 51:534-541. [PMID: 32610308 DOI: 10.1159/000508600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/12/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The outcomes of pregnancy in women with renal diseases remain controversial. The purpose of the study was to report fetal and maternal outcomes among women with glomerular disease in comparison with healthy pregnant women and a review of the current literature on this issue. METHODS Retrospective analysis included 72 pregnancies in 62 women with biopsy-proven glomerulonephritis (GN) (in 65.3% of cases, immunoglobulin A nephropathy was found). The control group consisted of 315 healthy pregnant women. We assessed fetal (prematurity, low birth weight, hypotrophy, fetal malformation, or intrauterine death) and maternal (gestational hypertension, preeclampsia, deterioration in kidney function, and maternal death) outcomes. Descriptive data analysis, Fisher's exact test, unpaired Student's t test, and ANOVA were performed. RESULTS Hypertension prevalence among the GN group and controls was 76.4 and 10.2%, respectively. Preeclampsia complicated 29.2% of pregnancies among women with GN and 2.9% of controls. In 8.3% of patients, at least a 50% decrease in GFR during pregnancy was observed. Preterm delivery prevalence in the GN group and controls was 74.7 and 12.7%, respectively. Hypotrophy was diagnosed in 12.5% of cases from the GN group and 5.4% of controls. The analysis showed that low estimated glomerular filtration rate, hypertension, and proteinuria were risk factors of adverse neonatal outcomes. CONCLUSION Women with GN are a risk factor of adverse pregnancy outcomes. As pregnancy complications are more prevalent across all the CKD stages, even in patients with near-normal kidney function, they require specialized care. It might be advisable to screen pregnant women for the presence of CKD, as especially in the early stage, it is often asymptomatic. Both hypertension and proteinuria are risk factors for neonatal and maternal complications.
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Affiliation(s)
- Anna Madej
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Mazanowska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland,
| | - Anna Cyganek
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Pazik
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Bronisława Pietrzak
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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19
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Abstract
Overweight and obesity in pregnancy confer a wide range of risks on mother, fetus, and offspring throughout their lives. In addition to compounding many common pregnancy complications, including both iatrogenic preterm delivery and cesarean delivery, obesity is associated with multiple fetal anomalies, metabolic sequelae including diabetes and obesity, allergy and asthma, attention-deficit disorder, and likely many other challenges for the offspring. As targeted interventions are being developed, encouraging solid nutrition and exercise in women of childbearing age may stave off risks and mitigate obesity in the next generation.
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Affiliation(s)
- Margaret L Dow
- Mayo Clinic, 200 First Street Southwest, Rochester, MN 59505, USA.
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20
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Zhu Y, Bateman BT, Gray KJ, Hernandez-Diaz S, Mogun H, Straub L, Huybrechts KF. Oral fluconazole use in the first trimester and risk of congenital malformations: population based cohort study. BMJ 2020; 369:m1494. [PMID: 32434758 PMCID: PMC7237981 DOI: 10.1136/bmj.m1494] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine the risk of congenital malformations associated with exposure to oral fluconazole at commonly used doses in the first trimester of pregnancy for the treatment of vulvovaginal candidiasis. DESIGN Population based cohort study. SETTING A cohort of pregnancies publicly insured in the United States, with data from the nationwide Medicaid Analytic eXtract 2000-14. PARTICIPANTS Pregnancies of women enrolled in Medicaid from three or more months before the last menstrual period to one month after delivery, and infants enrolled for three or more months after birth. INTERVENTIONS Use of fluconazole and topical azoles was established by requiring one or more prescriptions during the first trimester of pregnancy. MAIN OUTCOME MEASURES Risk of musculoskeletal malformations, conotruncal malformations, and oral clefts (primary outcomes), associated with exposure to oral fluconazole, diagnosed during the first 90 days after delivery, were examined. RESULTS The study cohort of 1 969 954 pregnancies included 37 650 (1.9%) pregnancies exposed to oral fluconazole and 82 090 (4.2%) pregnancies exposed to topical azoles during the first trimester. The risk of musculoskeletal malformations was 52.1 (95% confidence interval 44.8 to 59.3) per 10 000 pregnancies exposed to fluconazole versus 37.3 (33.1 to 41.4) per 10 000 pregnancies exposed to topical azoles. The risks of conotruncal malformations were 9.6 (6.4 to 12.7) versus 8.3 (6.3 to 10.3) per 10 000 pregnancies exposed to fluconazole and topical azoles, respectively; risks of oral clefts were 9.3 (6.2 to 12.4) versus 10.6 (8.4 to 12.8) per 10 000 pregnancies, respectively. The adjusted relative risk after fine stratification of the propensity score was 1.30 (1.09 to 1.56) for musculoskeletal malformations, 1.04 (0.70 to 1.55) for conotruncal malformations, and 0.91 (0.61 to 1.35) for oral clefts overall. Based on cumulative doses of fluconazole, the adjusted relative risks for musculoskeletal malformations, conotruncal malformations, and oral clefts overall were 1.29 (1.05 to 1.58), 1.12 (0.71 to 1.77), and 0.88 (0.55 to 1.40) for 150 mg of fluconazole; 1.24 (0.93 to 1.66), 0.61 (0.26 to 1.39), and 1.08 (0.58 to 2.04) for more than 150 mg up to 450 mg of fluconazole; and 1.98 (1.23 to 3.17), 2.30 (0.93 to 5.65), and 0.94 (0.23 to 3.82) for more than 450 mg of fluconazole, respectively. CONCLUSIONS Oral fluconazole use in the first trimester was not associated with oral clefts or conotruncal malformations, but an association with musculoskeletal malformations was found, corresponding to a small adjusted risk difference of about 12 incidents per 10 000 exposed pregnancies overall.
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Affiliation(s)
- Yanmin Zhu
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
| | - Brian T Bateman
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kathryn J Gray
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA
| | - Sonia Hernandez-Diaz
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Helen Mogun
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
| | - Loreen Straub
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
| | - Krista F Huybrechts
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
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21
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Abstract
Over the past 40 years access and effectiveness of assisted reproductive technologies (ART) have increased, and to date more than 8 million children have been conceived after ART globally. Most pregnancies resulting from ART are uncomplicated and result in the birth of healthy children. Yet, it is well known that pregnancies following ART are more likely to be affected by obstetric complications such as hypertensive disorders in pregnancy, preterm birth, and low birth weight compared with spontaneously conceived pregnancies. ART children are also at increased risk of birth defects. The majority of the problems arise as a result of multiple pregnancies and can be reduced by transferring a single embryo, thereby avoiding multiple pregnancies. New ART technologies are constantly introduced, and monitoring of the health of ART children is crucial.
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Affiliation(s)
- Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, Gothenburg, Sweden
- CONTACT Ulla-Britt Wennerholm Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, GothenburgSE 416 85, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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22
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Putri ND, Dhenni R, Handryastuti S, Johar E, Ma’roef CN, Fadhilah A, Perma Iskandar AT, Prayitno A, Karyanti MR, Satari HI, Jumiyanti N, Aprilia YY, Sriyani IY, Dewi YP, Yudhaputri FA, Safari D, Hadinegoro SR, Rosenberg R, Powers AM, Aye Myint KS. Absence of Evidence of Zika Virus Infection in Cord Blood and Urine from Newborns with Congenital Abnormalities, Indonesia. Am J Trop Med Hyg 2020; 102:876-879. [PMID: 32043460 PMCID: PMC7124925 DOI: 10.4269/ajtmh.19-0593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 11/20/2019] [Indexed: 11/07/2022] Open
Abstract
Zika virus (ZIKV) has recently been confirmed as endemic in Indonesia, but no congenital anomalies (CA) related to ZIKV infection have been reported. We performed molecular and serological testing for ZIKV and other flaviviruses on cord serum and urine samples collected in October 2016 to April 2017 during a prospective, cross-sectional study of neonates in Jakarta, Indonesia. Of a total of 429 neonates, 53 had CA, including 14 with microcephaly. These 53, and 113 neonate controls without evidence of CA, were tested by ZIKV-specific real-time reverse transcription polymerase chain reaction (RT-PCR), pan-flavivirus RT-PCR, anti-ZIKV and anti-DENV IgM ELISA, and plaque reduction neutralization test. There was no evidence of ZIKV infection among neonates in either the CA or non-CA cohorts, except in three cases with low titers of anti-ZIKV neutralizing antibodies. Further routine evaluation throughout Indonesia of pregnant women and their newborns for exposure to ZIKV should be a high priority for determining risk.
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Affiliation(s)
- Nina Dwi Putri
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rama Dhenni
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Setyo Handryastuti
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Edison Johar
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Chairin Nisa Ma’roef
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Araniy Fadhilah
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Adhi Teguh Perma Iskandar
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ari Prayitno
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mulya Rahma Karyanti
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hindra Irawan Satari
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Niphidiah Jumiyanti
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yuni Yudha Aprilia
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ida Yus Sriyani
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Yora Permata Dewi
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | | | - Dodi Safari
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Sri Rezeki Hadinegoro
- Department of Paediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ronald Rosenberg
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Ann M. Powers
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Khin Saw Aye Myint
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
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Ebbing C, Kessler J, Moster D, Rasmussen S. Single umbilical artery and risk of congenital malformation: population-based study in Norway. Ultrasound Obstet Gynecol 2020; 55:510-515. [PMID: 31132166 DOI: 10.1002/uog.20359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/06/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Single umbilical artery (SUA) is associated with congenital malformations in most organ systems, but reported findings have not been consistent. While it has been suggested that genetic and persisting environmental factors influence the development of SUA, it is not known whether there is an increased risk of recurrence in a subsequent pregnancy of the same woman. The aims of this study were to investigate the occurrence of, and risk factors for, SUA in Norway, to assess its association with congenital malformations and trisomies 13, 18 and 21 and to study the risk of recurrence of SUA in subsequent pregnancies. METHODS This was a population-based study of all (n = 918 933) singleton pregnancies of > 16 weeks' gestation recorded in the Medical Birth Registry of Norway from 1999 to 2014. To identify risk factors and congenital malformations associated with SUA, generalized estimating equations and logistic regression were used to calculate odds ratios (OR) with 95% CIs. ORs were also calculated for the recurrence of SUA in subsequent pregnancy. RESULTS The occurrence of SUA in our population was 0.46% (4241/918 933). Parity ≥ 4, smoking, maternal pregestational diabetes, epilepsy, chronic hypertension, previous Cesarean delivery and conception by assisted reproductive technology increased the odds of having SUA. There was a particularly strong association between SUA and gastrointestinal atresia or stenosis in the neonate, with ORs of 25.8 (95% CI, 17.0-39.1) and 20.3 (95% CI, 13.4-30.9) for esophageal and anorectal atresia or stenosis, respectively, followed by an OR of 5.9 (95% CI, 1.9-18.5) for renal agenesis. SUA was associated with an up to 7-8 times increased risk of congenital heart defects. There was an association with microcephaly, congenital hydrocephalus and other congenital malformations of the brain and spinal cord. Diaphragmatic hernia, limb reductions and cleft lip or palate had a weaker association with SUA, with ORs ranging from 4.8 to 2.8. The associations with trisomy 18 and 13 were equally strong (OR 14.4 (95% CI, 9.3-22.4) and OR 13.6 (95% CI, 6.7-27.8), respectively), and the risk of trisomy 21 was doubled (OR 2.1 (95% CI, 1.2-3.6)). Pregnancies with SUA, with or without an associated malformation, had a 2-fold increased risk for SUA in a subsequent pregnancy. CONCLUSIONS SUA is associated strongly with gastrointestinal atresia or stenosis, suggesting common developmental mechanisms. The increased risk of recurrence of SUA suggests that genetic and/or persisting environmental factors influence the risk. We found that SUA had equally strong associations with trisomies 13 and 18. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- C Ebbing
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - J Kessler
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - D Moster
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - S Rasmussen
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Li Z, Ma J, Li X, Chan MTV, Wu WKK, Wu Z, Shen J. Aberrantly expressed long non-coding RNAs in air pollution-induced congenital defects. J Cell Mol Med 2019; 23:7717-7725. [PMID: 31557384 PMCID: PMC6815773 DOI: 10.1111/jcmm.14645] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/07/2019] [Accepted: 08/18/2019] [Indexed: 12/20/2022] Open
Abstract
Air pollution has been a serious public health issue over the past few decades particularly in developing countries. Air pollution exposure during pregnancy poses potential threat to offspring as the deleterious substances might pass through placenta to alter foetal development. A growing number of studies have demonstrated that long non-coding RNAs (lncRNAs) participate in the development of many diseases, including congenital defects. Here, we used RNA sequencing to identify differentially expressed lncRNAs in air pollution-exposed rat embryos compared with control group. Our data suggested that 554 lncRNAs (216 up-regulated and 338 down-regulated) were significantly differentially expressed in the air pollution-exposed embryos. Moreover, potential cellular functions of these deregulated lncRNAs were predicted via KEGG signal pathway/GO enrichment analyses, which suggested the possible involvements of neurological process, sensory perception of smell and the G-protein signalling pathway. Furthermore, potential functional network of deregulated lncRNAs and their correlated mRNAs in the development of congenital spinal abnormality was established. Our data suggested that lncRNAs may play a vital role in the pathophysiology of air pollution-exposed congenital spinal malformation.
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Affiliation(s)
- Zheng Li
- Department of Orthopaedic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jianqing Ma
- Department of Orthopedic SurgeryThe General Hospital of Xingtai Mining Industry Bloc.Orthopaedic Hospital of XingtaiXingtaiChina
| | - Xingye Li
- Department of Orthopedic SurgeryBeijing Jishuitan HospitalFourth Clinical College of Peking UniversityJishuitan Orthopaedic College of Tsinghua UniversityBeijingChina
| | - Matthew T. V. Chan
- Department of Anaesthesia and Intensive CareThe Chinese University of Hong KongHong KongChina
| | - William K. K. Wu
- Department of Anaesthesia and Intensive CareThe Chinese University of Hong KongHong KongChina
- State Key Laboratory of Digestive DiseasesLi Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong KongChina
| | - Zhanyong Wu
- Department of Orthopedic SurgeryThe General Hospital of Xingtai Mining Industry Bloc.Orthopaedic Hospital of XingtaiXingtaiChina
| | - Jianxiong Shen
- Department of Orthopaedic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Abstract
This cohort study uses Swedish Medical Birth Register data to investigate risk of birth defects in infants born to women who had Roux-en-Y bariatric surgery between 2007 and 2014.
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Affiliation(s)
- Martin Neovius
- Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Björn Pasternak
- Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Ingmar Näslund
- Department of Surgery, Örebro University, Örebro, Sweden
| | - Jonas Söderling
- Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Kari Johansson
- Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Olof Stephansson
- Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
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Abstract
While research has demonstrated the effects of tobacco control policies on birth outcomes, there is little known about their impact on birth defects. Using 2005-2015 natality data on 26,334,854 singletons from 47 US states and District of Columbia linked to state-level cigarette taxes and smoke-free restaurant legislation, we examined the impact of tobacco control policies on birth defects by maternal race/ethnicity and education. We found that among white women with less than a high school degree, every $1.00 increase in cigarette taxes reduced prenatal smoking by 3.48 percentage points and reduced the risk of their infant having any birth defect by 0.0023 percentage points. Tax increases also reduced the risk of cyanotic heart defects, cleft palate, gastroschisis, and limb reduction. We found no evidence for associations between the enactment of smoke-free legislation, prenatal smoking and birth defects. Our findings suggest that state cigarette taxes are a population-level intervention that can help reduce prenatal smoking and the risk of birth defects.
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Affiliation(s)
- Summer Sherburne Hawkins
- Boston College, School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - Christopher F Baum
- Boston College, School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Boston College, Department of Economics, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; German Institute for Economic Research (DIW Berlin), Department of Macroeconomics, Mohrenstraße 58, 10117 Berlin, Germany
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Abstract
Hyperglycemia is common during pregnancy, involving multisystem adaptations. Pregnancy-induced metabolic changes increase insulin resistance. Pregnancy-induced insulin resistance adds to preexisting insulin resistance. Preexisting pancreatic β-cell defect compromises the ability to enhance insulin secretion, leading to hyperglycemia. Women with type 2 DM have similar rates of major congenital malformations, stillbirth, and neonatal mortality, but an even higher risk of perinatal mortality. In utero type 2 DM exposure confers greater risk and reduces time to development of type 2 DM in offspring. Preconception care to improve metabolic control in women with type 2 diabetes is critical.
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Affiliation(s)
- Anil Kapur
- World Diabetes Foundation, 30 A, Krogshoejvej, Bagsverd 2880, Denmark; FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel.
| | - Harold David McIntyre
- FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel; UQ Mater Clinical Unit, Faculty of Medicine, Mater Health Services, University of Queensland, Raymond Terrace, South Brisbane, Brisbane, Qld 4101, Australia
| | - Moshe Hod
- FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel; Department of Obstetrics and Gynecology, Clalit Health Services, Mor Women's Health Center, Rabin Medical Center, Tel Aviv University, 18 Aba Ahimeir St., Tel Aviv 6949204, Israel
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Subissi L, Dub T, Besnard M, Mariteragi-Helle T, Nhan T, Lutringer-Magnin D, Barboza P, Gurry C, Brindel P, Nilles EJ, Baud D, Merianos A, Musso D, Glynn JR, Dupuis G, Cao-Lormeau VM, Giard M, Mallet HP. Zika Virus Infection during Pregnancy and Effects on Early Childhood Development, French Polynesia, 2013-2016. Emerg Infect Dis 2019; 24:1850-1858. [PMID: 30226164 PMCID: PMC6154169 DOI: 10.3201/eid2410.172079] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Congenital Zika virus syndrome consists of a large spectrum of neurologic abnormalities seen in infants infected with Zika virus in utero. However, little is known about the effects of Zika virus intrauterine infection on the neurocognitive development of children born without birth defects. Using a case-control study design, we investigated the temporal association of a cluster of congenital defects with Zika virus infection. In a nested study, we also assessed the early childhood development of children recruited in the initial study as controls who were born without known birth defects,. We found evidence for an association of congenital defects with both maternal Zika virus seropositivity (time of infection unknown) and symptomatic Zika virus infection during pregnancy. Although the early childhood development assessment found no excess burden of developmental delay associated with maternal Zika virus infection, larger, longer-term studies are needed.
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Oosterhof N, Chang IJ, Karimiani EG, Kuil LE, Jensen DM, Daza R, Young E, Astle L, van der Linde HC, Shivaram GM, Demmers J, Latimer CS, Keene CD, Loter E, Maroofian R, van Ham TJ, Hevner RF, Bennett JT. Homozygous Mutations in CSF1R Cause a Pediatric-Onset Leukoencephalopathy and Can Result in Congenital Absence of Microglia. Am J Hum Genet 2019; 104:936-947. [PMID: 30982608 DOI: 10.1016/j.ajhg.2019.03.010] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/08/2019] [Indexed: 01/30/2023] Open
Abstract
Microglia are CNS-resident macrophages that scavenge debris and regulate immune responses. Proliferation and development of macrophages, including microglia, requires Colony Stimulating Factor 1 Receptor (CSF1R), a gene previously associated with a dominant adult-onset neurological condition (adult-onset leukoencephalopathy with axonal spheroids and pigmented glia). Here, we report two unrelated individuals with homozygous CSF1R mutations whose presentation was distinct from ALSP. Post-mortem examination of an individual with a homozygous splice mutation (c.1754-1G>C) demonstrated several structural brain anomalies, including agenesis of corpus callosum. Immunostaining demonstrated almost complete absence of microglia within this brain, suggesting that it developed in the absence of microglia. The second individual had a homozygous missense mutation (c.1929C>A [p.His643Gln]) and presented with developmental delay and epilepsy in childhood. We analyzed a zebrafish model (csf1rDM) lacking Csf1r function and found that their brains also lacked microglia and had reduced levels of CUX1, a neuronal transcription factor. CUX1+ neurons were also reduced in sections of homozygous CSF1R mutant human brain, identifying an evolutionarily conserved role for CSF1R signaling in production or maintenance of CUX1+ neurons. Since a large fraction of CUX1+ neurons project callosal axons, we speculate that microglia deficiency may contribute to agenesis of the corpus callosum via reduction in CUX1+ neurons. Our results suggest that CSF1R is required for human brain development and establish the csf1rDM fish as a model for microgliopathies. In addition, our results exemplify an under-recognized form of phenotypic expansion, in which genes associated with well-recognized, dominant conditions produce different phenotypes when biallelically mutated.
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Affiliation(s)
- Nynke Oosterhof
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Irene J Chang
- Department of Pediatrics, Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Ehsan Ghayoor Karimiani
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Laura E Kuil
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Dana M Jensen
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Ray Daza
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Erica Young
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Lee Astle
- Department of Laboratory and Pathology, Alaska Native Medical Center, Anchorage, AK 99508, USA
| | - Herma C van der Linde
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | | | - Jeroen Demmers
- Proteomics Center, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Caitlin S Latimer
- Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Emily Loter
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Reza Maroofian
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; Department of Neuromuscular Disorders and Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Tjakko J van Ham
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands.
| | - Robert F Hevner
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA; Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - James T Bennett
- Department of Pediatrics, Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA; Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98101, USA.
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30
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Araujo GS, Pavlaki MD, Soares AMVM, Abessa DMS, Loureiro S. Bioaccumulation and morphological traits in a multi-generation test with two Daphnia species exposed to lead. Chemosphere 2019; 219:636-644. [PMID: 30554050 DOI: 10.1016/j.chemosphere.2018.12.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 06/09/2023]
Abstract
Anthropic pressure negatively affects natural environments. Lead (Pb) is a non-essential highly toxic metal that is present in aquatic ecosystems. Two daphnid species from two different latitudes, the temperate Daphnia magna and the tropical Daphnia similis were used as test-organisms to evaluate a long-term Pb exposure. Both species were exposed for nine generations to a chronic concentration of Pb (50 μg/L) and the effects were explored, considering some endpoints not commonly used in toxicity tests: body burden of Pb and presence of granules in the dorsal region of neonates, hemoglobin contents, carapace deformation and morphology, production of males and ephippia (or dormant haploid egg), changes in the eggs' colour and eggs abortion. This multi-generation test was conducted under two food regimes, the usual (3 × 105 cells/mL) and the restricted (1.5 × 105 cells/mL) regime. On generation F6, Pb acclimated neonates were changed to a clean media for three generations, to evaluate exposure retrieval (recovery period). Negative and adverse effects occurred through generations, but no disparity was shown between D. magna and D. similis. The D. magna Pb accumulation showed different patterns regarding food regime. Bioaccumulation was faster under usual food, rapidly reaching a saturation point, whereas a gradual increase occurred under food restriction. A successful retrieval happened regarding Pb in D. magna, since no difference between control and recovering organisms was evidenced regarding their Pb body burdens. Generational Pb exposure led to carapace malformations, Pb aggregation in neonates' dorsal region, reddish extremities, production of males, ephippia (or dormant haploid egg), and aborted eggs, and changes in the eggs' colour (green and white). Food restriction also induced the production of males. Reddish extremities disappeared in recovering organisms and ephippia (or dormant haploid egg) did not occurred during the recovery period. Existent males revealed a shorter lifespan than females (under stress). D. magna and D. similis presented similar responses, for the endpoints analysed; however, it does not mean that this lack of sensitivity difference will be observed when other endpoints (e.g. survival, reproduction) are considered. Bioaccumulation of Pb and adverse effects occurred at the tested concentration of 50μg/L, although higher Pb levels are allowed in the environment as safe concentrations, as reported by the Brazilian legislation and the literature where effects are evidences above 400 μg/L of Pb. Pb effects on reproduction, respiration, malformation, and other adverse effects suggest that a chronic generational exposure can be harmful to both D. magna and D. similis, and that such chronic contaminated environments should not be disregarded when it comes to environmental monitoring.
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Affiliation(s)
- G S Araujo
- Department of Biology & CESAM, University of Aveiro, 3810-193, Portugal.
| | - M D Pavlaki
- Department of Biology & CESAM, University of Aveiro, 3810-193, Portugal
| | - A M V M Soares
- Department of Biology & CESAM, University of Aveiro, 3810-193, Portugal
| | - D M S Abessa
- NEPEA, Campus do Litoral Paulista, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Praça Infante Dom Henrique, s/n, CP 11330-900, São Vicente, SP, Brazil
| | - S Loureiro
- Department of Biology & CESAM, University of Aveiro, 3810-193, Portugal
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Kocylowski R, Grzesiak M, Gaj Z, Lorenc W, Bakinowska E, Barałkiewicz D, von Kaisenberg CS, Lamers Y, Suliburska J. Associations between the Level of Trace Elements and Minerals and Folate in Maternal Serum and Amniotic Fluid and Congenital Abnormalities. Nutrients 2019; 11:E328. [PMID: 30717440 PMCID: PMC6413094 DOI: 10.3390/nu11020328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 12/27/2022] Open
Abstract
Congenital birth defects may result in a critical condition affecting the baby, including severe fetal/neonatal handicap and mortality. Several studies have shown that genetic, nutritional, and environmental factors may have an impact on fetal development and neonatal health. The relevance of essential and toxic elements on fetal development has not yet been fully investigated, and the results of recent research indicate that these elements may be crucial in the assessment of the risk of malformations in neonates. We determined the association between essential and toxic elements and the level of folate in maternal serum (MS) and amniotic fluid (AF), along with neonatal abnormalities. A total of 258 pregnant Polish women in the age group of 17⁻42 years participated in this study. AF and MS were collected during vaginal delivery or during cesarean section. An inductively coupled plasma mass spectrometry technique was used to determine the levels of various elements in AF and MS. The results of this exploratory study indicate that the levels of essential and toxic elements are associated with fetal and newborn anatomical abnormalities and growth disorders.
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Affiliation(s)
- Rafal Kocylowski
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
- PreMediCare New Med Medical Center, ul. Drużbickiego 13, 61-693 Poznan, Poland.
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
| | - Zuzanna Gaj
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
- Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
| | - Wiktor Lorenc
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznan, ul. Umultowska 89b, 61-614 Poznan, Poland.
| | - Ewa Bakinowska
- Institute of Mathematics, Poznan University of Technology, ul. Piotrowo 3A, 60-965 Poznan, Poland.
| | - Danuta Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznan, ul. Umultowska 89b, 61-614 Poznan, Poland.
| | - Constantin S von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
| | - Yvonne Lamers
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- British Columbia Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada.
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland, ul. Wojska Polskiego 31, 60-624 Poznan, Poland.
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Samii L, Kallas-Koeman M, Donovan LE, Lodha A, Crawford S, Butalia S. The association between vascular complications during pregnancy in women with Type 1 diabetes and congenital malformations. Diabet Med 2019; 36:237-242. [PMID: 30499197 DOI: 10.1111/dme.13872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2018] [Indexed: 11/30/2022]
Abstract
AIMS To assess the association between vascular complications of diabetes and the risk of congenital malformations in pregnant women with Type 1 diabetes. METHODS We conducted an observational retrospective cohort study in women with Type 1 diabetes who received care consecutively from three tertiary care diabetes-in-pregnancy clinics in Calgary, Alberta, Canada. Multivariable logistic regression was used to assess the association between vascular complications (retinopathy, nephropathy and pre-existing hypertension) and congenital malformations in offspring of women with Type 1 diabetes. RESULTS Of 232 women with Type 1 diabetes, 49 (21%) had at least one vascular complication and there were 52 babies with congenital malformations. Maternal age (31.8 ± 5.0 vs. 29.4 ± 4.7 years, P < 0.01), diabetes duration (20.9 ± 6.7 vs. 11.2 ± 7.4 years, P < 0.01) and pre-eclampsia rate (12.5% vs. 1.3%, P < 0.01) were higher in mothers with vascular complications than in those without. Multivariable analyses showed that vascular complications were not associated with an increased risk of congenital malformations (odds ratio 1.16, 95% confidence interval 0.46 to 2.88). CONCLUSIONS Vascular complications are common, occurring in one-fifth of pregnant women with Type 1 diabetes, and in this study do not appear to be associated with an increased risk of congenital malformations in children.
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Affiliation(s)
- L Samii
- Department of Medicine, University of Calgary, Calgary Alberta, Canada
| | - M Kallas-Koeman
- Department of Medicine, University of Calgary, Calgary Alberta, Canada
| | - L E Donovan
- Department of Medicine, University of Calgary, Calgary Alberta, Canada
- Department of Obstetrics and Gynecology, University of Calgary, Calgary Alberta, Canada
| | - A Lodha
- Department of Community Health Sciences, University of Calgary, Calgary Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - S Crawford
- Alberta Perinatal Health Program, Alberta Health Services, Calgary Alberta, Canada
| | - S Butalia
- Department of Medicine, University of Calgary, Calgary Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary Alberta, Canada
- Libin Cardiovascular Institute, Calgary Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Offor I, Awodele O, Oshikoya KA. Drug-related teratogenic and pathologic causes of birth defects in a tertiary hospital in Southwestern Nigeria. Pharmacol Res Perspect 2019; 7:e00452. [PMID: 30766684 PMCID: PMC6364330 DOI: 10.1002/prp2.452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 12/19/2022] Open
Abstract
Birth defects are important causes of neonatal morbidity and mortality. A good understanding of the etiology is a vital step toward developing improved treatment and preventive strategies. We conducted an audit of medical records of newborns with birth abnormalities in a tertiary hospital over a 10-year period, using a Pro forma designed to collect information on obstetric history, antenatal history, sociodemographics of parents, and the type of birth abnormality. Of the 180 medical records reviewed, female babies were 92 (51.1%) and male babies were 86 (47.8%). The mean age of the fathers was 38.2 + 6.2, and mothers 31.8 + 4.9. Majority 115 (63.9%) of the mothers had records of acute illnesses, and 23 (12.8%) chronic illnesses during pregnancy. Unspecified febrile illness 44 (38.3%), malaria 40 (34.8%), typhoid 8 (6.9%), hypertension 13 (56.5%), pregestational diabetes 4 (17.4%), and HIV 3 (13.0%) were the commonest maternal pathologies. Most of the documented birth abnormalities were Down's syndrome 34 (15.2%); congenital hydrocephalus 32 (14.3%); acyanotic congenital heart defect 30 (13.4%); deformity of the digits 26 (11.6%); and ventricular septal defect 20 (8.9%). The prevalence of maternal pathologies calls for concern, as these may be implicated in birth defects, therefore should be further investigated in future studies.
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Affiliation(s)
- Ifeanyichukwu Offor
- Department of Pharmacology, Therapeutics & ToxicologyCollege of MedicineUniversity of LagosLagosNigeria
| | - Olufunsho Awodele
- Department of Pharmacology, Therapeutics & ToxicologyCollege of MedicineUniversity of LagosLagosNigeria
| | - Kazeem A. Oshikoya
- Department of PharmacologyCollege of MedicineLagos State UniversityLagosNigeria
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Zhao B, Wang M, Lü C, Meng H, Fan Q, Guo J, Wang W, Wang H, Zhou H, He J. Increasing risk of congenital anomalies associated with seasonal pattern of air pollution: Differences by maternal comorbidities. Ecotoxicol Environ Saf 2019; 167:317-323. [PMID: 30343146 DOI: 10.1016/j.ecoenv.2018.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/12/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Abstract
To interpret the relationship of the seasonal pattern of air pollution exposure associated with increased risk of congenital anomalies (CA) and the trimester-specific effects. In this work, 55,428 hospital records with 847 doctor-diagnosed CA from July 2013 to December 2016 were collected in Hohhot, China. Maternal exposure to critical air pollutants (SO2, CO, PM10, O3, NO2 and PM2.5) were estimated using an inverse distance weighted (IDW) method on the basis of the ambient air quality monitoring stations. Logistic regression analysis was employed to determine the association of CA (in terms of odds ratio (OR) and 95% confidence interval (CI)) in three trimesters with heating/none heating season exposure. The results showed that CO exposure was found a significant association with ORs (95% CI) 1.58 (1.09, 2.27) changing from IQR2-3 and 1.40 (1.01, 1.93) changing from IQR3-IQR4 in 1st trimester and 1.51 (1.12, 2.04) changing from IQR2-3 in 2nd trimester, respectively. PM10 also presented significant association with ORs (95% CI) 1.42(1.08, 1.86) changing from IQR3-4 in 2nd trimester. Exposure effects were found more obvious in heating season, i.e. CO exposure levels were associated with the risks of CA with IQR changing ORs (95% CI) of 5.21(2.02, 7.44), 2.24 (1.21, 4.15) and 1.84 (1.10, 3.11) in 1st trimester, respectively; PM2.5 exposure levels were associated with the risks of CA with IQR changing ORs (95% CI) of 3.76 (1.48, 6.55), 2.45 (1.10, 5.44) and 3.30 (1.63, 6.67) in 2nd trimester, respectively. Our findings suggested some positive associations of pregnancy and CA with maternal exposure to ambient CO and PM2.5 during the 1st and 2nd trimester after controlling for maternal comorbidities general covariates and other pollutants. PM10 was also found significantly associated with increased risk of CA in 2nd trimester besides seasons. There was no association found in 3rd trimester.
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Affiliation(s)
- Boyi Zhao
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Min Wang
- The Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, China
| | - Changwei Lü
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot 010021, China.
| | - Haixia Meng
- The Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, China
| | - Qingyun Fan
- Environmental Monitoring Center of Inner Mongolia, 010011 Hohhot, China
| | - Jing Guo
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Wenqing Wang
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Haoji Wang
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Haijun Zhou
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Environmental Monitoring Center of Inner Mongolia, 010011 Hohhot, China
| | - Jiang He
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot 010021, China.
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Janitz AE, Dao HD, Campbell JE, Stoner JA, Peck JD. The association between natural gas well activity and specific congenital anomalies in Oklahoma, 1997-2009. Environ Int 2019; 122:381-388. [PMID: 30551805 PMCID: PMC6328052 DOI: 10.1016/j.envint.2018.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/11/2018] [Accepted: 12/04/2018] [Indexed: 05/17/2023]
Abstract
BACKGROUND Natural gas drilling may pose multiple health risks, including congenital anomalies, through air pollutant emissions and contaminated water. Two recent studies have evaluated the relationship between natural gas activity and congenital anomalies, with both observing a positive relationship. OBJECTIVES We aimed to evaluate whether residence near natural gas wells is associated with critical congenital heart defects (CCHD), neural tube defects (NTD), and oral clefts in Oklahoma, the third highest natural gas producing state in the US. METHODS We conducted a retrospective cohort study among singleton births in Oklahoma (n = 476,600) to evaluate natural gas activity and congenital anomalies. We calculated an inverse distance-squared weighted (IDW) score based on the number of actively producing wells within a two-mile radius of the maternal residence during the month of delivery. We used modified Poisson regression with robust error variance to estimate prevalence proportion ratios (PPR) and 95% confidence intervals (CI) for the association between tertiles of natural gas activity (compared to no wells) and CCHD, NTD, and oral clefts adjusted for maternal education. RESULTS We observed an increased, though imprecise, prevalence of NTDs among children with natural gas activity compared to children with no wells (2nd tertile PPR: 1.34, 95% CI: 0.93, 1.93; 3rd tertile PPR: 1.20, 95% CI: 0.82, 1.75). We observed no association with CCHD or oral clefts overall. Specific CCHDs of common truncus, transposition of the great arteries, pulmonary valve atresia and stenosis, tricuspid valve atresia and stenosis, interrupted aortic arch, and total anomalous pulmonary venous connection were increased among those living in areas with natural gas activity compared to those living in areas without activity, though not statistically significant. DISCUSSION Our results were similar to previous studies for NTDs and specific CCHDs. Future directions include evaluating the association between specific phases of the drilling process and congenital anomalies to better refine the relevant exposure period.
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Affiliation(s)
- Amanda E Janitz
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Hanh Dung Dao
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie A Stoner
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jennifer D Peck
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Sokal A, Elefant E, Leturcq T, Beghin D, Mariette X, Seror R. Pregnancy and newborn outcomes after exposure to bisphosphonates: a case-control study. Osteoporos Int 2019; 30:221-229. [PMID: 30171300 DOI: 10.1007/s00198-018-4672-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/13/2018] [Indexed: 01/13/2023]
Abstract
UNLABELLED We analyzed women and newborn outcome after maternal exposure to BPs. BPs have no teratogenic effect on the 36 analyzed pregnancies compared to unexposed controls matched on women underlying diseases (either systemic disease, either "bone" disease) but some outcome differed: neonatal complications rate in systemic diseases and live birth rate in bone diseases). INTRODUCTION The effect of bisphosphonates (BPs) during pregnancy remains unclear. We aimed to study pregnancy outcomes in women exposed to BPs during pregnancy. METHODS Data for cases and controls were from the French Reference Centre of Teratogenic Agents. Cases were women who received BPs in the 6 weeks before or during a pregnancy and had systemic or bone diseases. We included two respectively matched control groups: women with systemic diseases not exposed to BPs and healthy women not exposed to BPs or any teratogenic agent. Four controls were assigned to each case. RESULTS Thirty-six women were exposed to BPs including 5 just before pregnancy and 30 during the first trimester; 23 had systemic diseases (systemic lupus erythematosus, n = 5; rheumatoid arthritis, n = 5; other, n = 13) and 13 had bone diseases. Rate of observed congenital malformations did not differ in women with a systemic or a bone disease compared to their respective controls (respectively 2/23 [8.7%] vs 2/92 [2.2%], p = 0.178 and 0/13 [0%] vs 0/52 [0%], p = 1.00). Among women with systemic diseases, non-specific neonatal complications were more frequent for cases (4/16 [25.0%] vs 4/64 [6.3%], p = 0.027). Among women with bone disorders, the live birth rate was lower for cases than healthy controls (8/10 [80%] vs 50/50 [100%], p = 0.025). CONCLUSION We found no major teratogenic effects of BPs, but rates of neonatal complications were increased for women with systemic diseases, as were spontaneous abortions for women with bone diseases likely linked to the severity of the underlying diseases and concomitant medications.
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Affiliation(s)
- A Sokal
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Department of Rheumatology, Hôpital Bicêtre Université Paris-Sud, INSERM U1184, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
| | - E Elefant
- Centre de Référence sur les Agents Tératogènes (CRAT), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Est Parisien - Pôle Périnatalité - Hôpital Armand Trousseau, 26, av Dr Netter, 75571, Paris cedex 12, France
| | - T Leturcq
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Department of Rheumatology, Hôpital Bicêtre Université Paris-Sud, INSERM U1184, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
| | - D Beghin
- Centre de Référence sur les Agents Tératogènes (CRAT), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Est Parisien - Pôle Périnatalité - Hôpital Armand Trousseau, 26, av Dr Netter, 75571, Paris cedex 12, France
| | - X Mariette
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Department of Rheumatology, Hôpital Bicêtre Université Paris-Sud, INSERM U1184, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
| | - R Seror
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Department of Rheumatology, Hôpital Bicêtre Université Paris-Sud, INSERM U1184, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
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Xiong L, Xu Z, Wang H, Liu Z, Xie D, Wang A, Kong F. The association between ambient air pollution and birth defects in four cities in Hunan province, China, from 2014 to 2016. Medicine (Baltimore) 2019; 98:e14253. [PMID: 30681619 PMCID: PMC6358400 DOI: 10.1097/md.0000000000014253] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/28/2018] [Accepted: 01/02/2019] [Indexed: 12/04/2022] Open
Abstract
This study was performed to assess whether air pollution was positively associated with birth defects and if a specific pregnancy stage played a role. This was a population-based case-control study comprising 153,822 perinatal births in four cities located in Hunan province, China, during the period 2014 to 2016. Exposure to SO2, NO2, and PM10 in each pregnant woman in the first 3 months before pregnancy, and in the first and third trimester was assessed. The risk of birth defects related to SO2 in the first 3 months before pregnancy was between 1.191 and 1.566. In the first trimester stage the risk was between 1.104 and 1.348. The risk of birth defects related to NO2 before pregnancy was 1.285 (95%CI: 1.180-1.399), in the first trimester stage the risk was between 1.280 (95%CI: 1.197-1.368) and 1.380 (95%CI: 1.293-1.473). In the third month before delivery the risk was 1.484 (95%CI: 1.366-1.613). The risk of birth defects related to PM10 in the first month of pregnancy was 1.098 (95%CI: 1.057-1.140), and in the third month before delivery the risk was 1.296 (95%CI: 1.222-1.375). SO2 had a greater effect on the prophase of pregnancy, while NO2 and PM10 had an effect in the late third trimester.
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Affiliation(s)
- Lili Xiong
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Zenghui Xu
- Changsha Environment Protection College, Changsha, China
| | - Hua Wang
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Zhiyu Liu
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Donghua Xie
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Aihua Wang
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Fanjuan Kong
- Hunan Province Maternal and Children Care Hospital, Changsha, China
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Abstract
Despite concerns of the scientific community regarding the adverse effects of human exposure to exogenous man-made chemical substances or mixtures that interfere with normal hormonal balance, the so called "endocrine disruptors (EDs)", their production has been increased during the last few decades. EDs' extensive use has been implicated in the increasing incidence of male reproductive disorders including poor semen quality, testicular malignancies and congenital developmental defects such as hypospadias and cryptorchidism. Several animal studies have demonstrated that exposure to EDs during fetal, neonatal and adult life has deleterious consequences on male reproductive system; however, the evidence on humans remains ambiguous. The complexity of their mode of action, the differential effect according to the developmental stage that exposure occurs, the latency from exposure and the influence of the genetic background in the manifestation of their toxic effects are all responsible factors for the contradictory outcomes. Furthermore, the heterogeneity in the published human studies has hampered agreement in the field. Interventional studies to establish causality would be desirable, but unfortunately the nature of the field excludes this possibility. Therefore, future studies based on standardized guidelines are necessary, in order to estimate human health risks and implement policies to limit public exposure.
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Affiliation(s)
- Stefania Lymperi
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Goldsmith S, Garcia Jalon G, Badawi N, Blair E, Garne E, Gibson C, McIntyre S, Scott H, Smithers-Sheedy H, Andersen GL. Comprehensive investigation of congenital anomalies in cerebral palsy: protocol for a European-Australian population-based data linkage study (The Comprehensive CA-CP Study). BMJ Open 2018; 8:e022190. [PMID: 30037879 PMCID: PMC6059266 DOI: 10.1136/bmjopen-2018-022190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/17/2018] [Accepted: 06/07/2018] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Cerebral palsy (CP), an umbrella term for non-progressive conditions of cerebral origin resulting in motor impairments, is collectively the most common cause of physical disability in childhood. Cerebral and/or non-cerebral congenital anomalies are present in 15%-40% of children with CP. In order to identify effective prevention strategies for this substantial proportion of CP, a comprehensive understanding of the epidemiology of these congenital anomalies is required. International collaboration is needed, as previous attempts have fallen short due to a lack of power, since the anomalies are individually rare and CP comprises many clinical descriptions. The aim of this study is to generate new knowledge about the aetiologies of CP through a focused investigation into the role of congenital anomalies. METHODS AND ANALYSIS This collaborative, population-based data linkage study includes nine geographic regions (six in Europe, three in Australia) served by both congenital anomaly and CP registers. Register data for children with CP (both with and without congenital anomalies) and children with specific congenital anomalies (without CP) born between 1991 and 2009 will be linked and de-identified within each region. The resulting linked data sets will be quality assured, recoded, harmonised and then pooled into one data set. Analysis of the combined data set will include: frequencies/proportions of congenital anomalies and outcomes (type of CP, severity, impairments); descriptive analyses comparing timing of congenital anomaly development and brain injury/abnormality responsible for CP; ORs to calculate the odds of CP following a specific congenital anomaly; and identification of anomalies on causal pathways to CP. ETHICS AND DISSEMINATION Ethics approval for this collaborative study, The Comprehensive CA-CP Study, has been obtained from the Cerebral Palsy Alliance Human Research Ethics Committee (EC00402). Study findings will be disseminated at conferences and published in peer-reviewed journals, and recommendations will be made regarding the collection and classification of congenital anomaly data by CP registers.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Guiomar Garcia Jalon
- Northern Ireland Cerebral Palsy Register, School of Nursing and Midwifery, Queen’s University Belfast, Royal Group of Hospitals, Belfast, UK
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- Grace Centre for Newborn Care, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
| | - Catherine Gibson
- South Australian Birth Defects Register, Women’s and Children’s Hospital, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Heather Scott
- South Australian Birth Defects Register, Women’s and Children’s Hospital, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Guro L Andersen
- The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
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João EC, Ferreira ODC, Gouvêa MI, Teixeira MDLB, Tanuri A, Higa LM, Costa DA, Mohana-Borges R, Arruda MB, Matos HJ, Cruz ML, Mendes-Silva W, Read JS. Pregnant women co-infected with HIV and Zika: Outcomes and birth defects in infants according to maternal symptomatology. PLoS One 2018; 13:e0200168. [PMID: 29979796 PMCID: PMC6034846 DOI: 10.1371/journal.pone.0200168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/20/2018] [Indexed: 01/03/2023] Open
Abstract
Background Zika virus (ZIKV) was first isolated in Uganda in 1947. In Brazil, the first reported case of ZIKV infection was in May 2015. Additionally, dengue (DENV) is endemic and there has been a recent outbreak of chikungunya (CHIKV). Since the clinical manifestations of different arboviral infections (AI) can be similar, definitive diagnosis requires laboratory testing. Objectives To determine the prevalence of ZIKV, DENV, and CHIKV infections in a Brazilian cohort of HIV-infected pregnant women, to assess clinical/immunological characteristics and pregnancy outcomes of women with evidence of recent AI. Study design Laboratory diagnosis of ZIKV, DENV and CHIKV infections utilized serological assays, RT-PCR and PRNT. The tests were performed at the first visit, 34–36 weeks of gestation and at any time if a woman had symptoms suggestive of AI. Mann-Whitney tests were used for comparison of medians, Chi-square or Fisher’s to compare proportions; p< 0.05 was considered statistically significant. Poisson regression was used to analyze risk factors for central nervous system (CNS) malformations in the infant according to maternal symptomatology. Results Of 219 HIV-infected pregnant women enrolled, 92% were DENV IgG+; 47(22%) had laboratory evidence of recent AI. Of these, 34 (72%) were ZIKV+, nine (19%) CHIKV+, and two (4%) DENV+. Symptoms consistent with AI were observed in 23 (10%) women, of whom 10 (43%) were ZIKV+, eight (35%) CHIKV+. No CNS abnormalities were observed among infants of DENV+ or CHIKV+ women; four infants with CNS abnormalities were born to ZIKV+ women (three symptomatic). Infants born to ZIKV+ women had a higher risk of CNS malformations if the mother was symptomatic (RR = 7.20), albeit not statistically significant (p = 0.066). Conclusions Among HIV-infected pregnant women with laboratory evidence of a recent AI, 72% were ZIKV-infected. In this cohort, CNS malformations occurred among infants born to both symptomatic and asymptomatic pregnant women with Zika infection.
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Affiliation(s)
- Esaú C. João
- Rio de Janeiro, RJ, Brazil—Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | - Orlando da C. Ferreira
- Laboratório de Biologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro—Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Isabel Gouvêa
- Rio de Janeiro, RJ, Brazil—Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Infectologia Evandro Chagas—Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Maria de Lourdes B. Teixeira
- Rio de Janeiro, RJ, Brazil—Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Infectologia Evandro Chagas—Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Amilcar Tanuri
- Laboratório de Biologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro—Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiza M. Higa
- Laboratório de Biologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro—Rio de Janeiro, Rio de Janeiro, Brazil
| | - Deise A. Costa
- Laboratório de Genômica Estrutural, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronaldo Mohana-Borges
- Laboratório de Genômica Estrutural, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica B. Arruda
- Laboratório de Biologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro—Rio de Janeiro, Rio de Janeiro, Brazil
| | - Haroldo J. Matos
- Departamento de Epidemiologia, Instituto Evandro Chagas, Belém, Pará, Brazil
| | - Maria Leticia Cruz
- Rio de Janeiro, RJ, Brazil—Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wallace Mendes-Silva
- Maternal-Fetal Unit, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jennifer S. Read
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California, United States of America
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Borsari L, Malagoli C, Werler MM, Rothman KJ, Malavolti M, Rodolfi R, De Girolamo G, Nicolini F, Vinceti M. Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy. J Diabetes Res 2018; 2018:2782741. [PMID: 30050951 PMCID: PMC6046136 DOI: 10.1155/2018/2782741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/04/2018] [Accepted: 06/11/2018] [Indexed: 12/21/2022] Open
Abstract
Smoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007-2010 matched 1 : 5 with parturients without diabetes. Our study endpoints were preterm births and congenital anomalies. We measured interaction between PGD and maternal smoking, by calculating excess prevalence and prevalence ratio due to interaction, relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (S). Analyses were performed in the overall study population and in the subgroup whose PGD was validated through diabetes registers. The study included 992 women with PGD (10.5% smokers) and 4788 comparison women (11.9% smokers). The effects of PGD and maternal tobacco smoking were greater than additive for both preterm birth (excess prevalence due to interaction = 11.7%, excess ratio due to interaction = 1.5, RERI = 2.39, AP = 0.51, S = 2.82) and congenital anomalies (excess prevalence due to interaction = 2.2%, excess ratio due to interaction = 1.3, RERI = 1.33, AP = 0.49, S = 5.03). Joint effect on both endpoints was confirmed in the subgroup whose PGD status was validated. In conclusion, we found that maternal tobacco smoking and PGD intensify each other's effect on preterm birth and congenital anomalies.
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Affiliation(s)
- Lucia Borsari
- Department of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, Italy
| | - Carlotta Malagoli
- Department of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, Italy
| | - Martha M. Werler
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Kenneth J. Rothman
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Research Triangle Institute, Research Triangle Park, NC 27709, USA
| | - Marcella Malavolti
- Department of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, Italy
| | - Rossella Rodolfi
- Local Health Authority of Reggio Emilia, Reggio Emilia 42122, Italy
| | - Gianfranco De Girolamo
- Department of Public Health, Unit of Epidemiology and Risk Communication, Local Health Authority of Modena, Modena 41126, Italy
| | - Fausto Nicolini
- Local Health Authority of Reggio Emilia, Reggio Emilia 42122, Italy
| | - Marco Vinceti
- Department of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
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He F, Zhang CY, Wang LS, Li SL, Hu LN. Assisted Hatching in Couples with Advanced Maternal Age: A Systematic Review and Meta-analysis. Curr Med Sci 2018; 38:552-557. [PMID: 30074225 DOI: 10.1007/s11596-018-1913-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/25/2018] [Indexed: 11/28/2022]
Abstract
This systematic review aimed to evaluate the efficacy and safety of assisted hatching (AH) performed in couples with advanced maternal age. We searched for randomized controlled trials (RCTs) in electronic databases, including MEDLINE, EMBASE and CENTRAL (from inception to January 2018); in addition, we hand-searched the reference lists of included studies and similar reviews. We included RCTs comparing AH versus no treatment (control). The meta-analysis was performed by RevMan 5.3 software. The search retrieved 943 records and 8 RCTs were included, comprising 870 cycles (n=440 for AH, and n=430 for control). There was no significant difference in the rates of live birth (RR 0.88, 95% CI 0.65 to 1.18, 3 RCTs, n=427, I2=0%), clinical pregnancy (RR 1.00, 95% CI 0.83 to 1.19, 8 RCTs, n=870, I2=22%), implantation (RR 1.07, 95% CI 0.83 to 1.39, 4 RCTs, n=1359, I2=0%), miscarriage (RR 1.13, 95% CI 0.66 to 1.94, 2 RCTs, n=116, I2=0%) and multiple pregnancy (RR 0.89, 95% CI 0.31 to 2.52, 1 RCT, n=97, I2=not applicable) between the treatment group and control group. No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses. Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.
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Affiliation(s)
- Fan He
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Chan-Yu Zhang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Li-Si Wang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Sang-Lin Li
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Li-Na Hu
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
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Fishman EL, Jo K, Nguyen QPH, Kong D, Royfman R, Cekic AR, Khanal S, Miller AL, Simerly C, Schatten G, Loncarek J, Mennella V, Avidor-Reiss T. A novel atypical sperm centriole is functional during human fertilization. Nat Commun 2018; 9:2210. [PMID: 29880810 PMCID: PMC5992222 DOI: 10.1038/s41467-018-04678-8] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/15/2018] [Indexed: 11/18/2022] Open
Abstract
The inheritance of the centrosome during human fertilization remains mysterious. Here we show that the sperm centrosome contains, in addition to the known typical barrel-shaped centriole (the proximal centriole, PC), a surrounding matrix (pericentriolar material, PCM), and an atypical centriole (distal centriole, DC) composed of splayed microtubules surrounding previously undescribed rods of centriole luminal proteins. The sperm centrosome is remodeled by both reduction and enrichment of specific proteins and the formation of these rods during spermatogenesis. In vivo and in vitro investigations show that the flagellum-attached, atypical DC is capable of recruiting PCM, forming a daughter centriole, and localizing to the spindle pole during mitosis. Altogether, we show that the DC is compositionally and structurally remodeled into an atypical centriole, which functions as the zygote's second centriole. These findings now provide novel avenues for diagnostics and therapeutic strategies for male infertility, and insights into early embryo developmental defects.
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Affiliation(s)
- Emily L Fishman
- Department of Biological Sciences, University of Toledo, 2801W. Bancroft, Toledo, OH, 43607, USA
| | - Kyoung Jo
- Department of Biological Sciences, University of Toledo, 2801W. Bancroft, Toledo, OH, 43607, USA
| | - Quynh P H Nguyen
- Cell Biology Program, The Hospital for Sick Children, Department of Biochemistry, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Dong Kong
- Laboratory of Protein Dynamics and Signaling, Center for Cancer Research, National Cancer Institute, 1050 Boyles Street, Frederick, MD, 21702, USA
| | - Rachel Royfman
- Department of Biological Sciences, University of Toledo, 2801W. Bancroft, Toledo, OH, 43607, USA
| | - Anthony R Cekic
- Department of Biological Sciences, University of Toledo, 2801W. Bancroft, Toledo, OH, 43607, USA
| | - Sushil Khanal
- Department of Biological Sciences, University of Toledo, 2801W. Bancroft, Toledo, OH, 43607, USA
| | - Ann L Miller
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, 830 North University Ave, Ann Arbor, MI, 48109, USA
| | - Calvin Simerly
- Departments of Cell Biology; Obstetrics, Gynecology and Reproductive Sciences; and Bioengineering, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - Gerald Schatten
- Departments of Cell Biology; Obstetrics, Gynecology and Reproductive Sciences; and Bioengineering, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - Jadranka Loncarek
- Laboratory of Protein Dynamics and Signaling, Center for Cancer Research, National Cancer Institute, 1050 Boyles Street, Frederick, MD, 21702, USA
| | - Vito Mennella
- Cell Biology Program, The Hospital for Sick Children, Department of Biochemistry, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Tomer Avidor-Reiss
- Department of Biological Sciences, University of Toledo, 2801W. Bancroft, Toledo, OH, 43607, USA.
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Burger-Calderon R, Gonzalez K, Ojeda S, Zambrana JV, Sanchez N, Cerpas Cruz C, Suazo Laguna H, Bustos F, Plazaola M, Lopez Mercado B, Elizondo D, Arguello S, Carey Monterrey J, Nuñez A, Coloma J, Waggoner JJ, Gordon A, Kuan G, Balmaseda A, Harris E. Zika virus infection in Nicaraguan households. PLoS Negl Trop Dis 2018; 12:e0006518. [PMID: 29851968 PMCID: PMC6014677 DOI: 10.1371/journal.pntd.0006518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 06/22/2018] [Accepted: 05/10/2018] [Indexed: 12/29/2022] Open
Abstract
Zika virus (ZIKV) infection recently caused major epidemics in the Americas and is linked to congenital birth defects and Guillain-Barré Syndrome. A pilot study of ZIKV infection in Nicaraguan households was conducted from August 31 to October 21, 2016, in Managua, Nicaragua. We enrolled 33 laboratory-confirmed Zika index cases and their household members (109 contacts) and followed them on days 3–4, 6–7, 9–10, and 21, collecting serum/plasma, urine, and saliva specimens along with clinical, demographic, and socio-economic status information. Collected samples were processed by rRT-PCR to determine viral load (VL) and duration of detectable ZIKV RNA in human bodily fluids. At enrollment, 11 (10%) contacts were ZIKV rRT-PCR-positive and 23 (21%) were positive by IgM antibodies; 3 incident cases were detected during the study period. Twenty of 33 (61%) index households had contacts with ZIKV infection, with an average of 1.9 (range 1–6) positive contacts per household, and in 60% of these households, ≥50% of the members were positive for ZIKV infection. Analysis of clinical information allowed us to estimate the symptomatic to asymptomatic (S:A) ratio of 14:23 (1:1.6) among the contacts, finding 62% of the infections to be asymptomatic. The maximum number of days during which ZIKV RNA was detected was 7 days post-symptom onset in saliva and serum/plasma and 22 days in urine. Overall, VL levels in serum/plasma, saliva, and urine specimens were comparable, with means of 5.6, 5.3 and 4.5 log10 copies/ml respectively, with serum attaining the highest VL peak at 8.1 log10 copies/ml. Detecting ZIKV RNA in saliva over a similar time-period and level as in serum/plasma indicates that saliva could potentially serve as a more accessible diagnostic sample. Finding the majority of infections to be asymptomatic emphasizes the importance of silent ZIKV transmission and helps inform public health interventions in the region and globally. Zika virus (ZIKV) infection has become a major concern due to its association with congenital birth defects and Guillain-Barré Syndrome. We enrolled 33 laboratory-confirmed Zika cases (index cases) and their household members (109 contacts) in Managua, Nicaragua, and followed them for three weeks, collecting serum/plasma, urine and saliva specimens along with clinical, demographic, and socio-economic status information. We found that 61% of the index households had contacts with ZIKV infection, with an average of 1.9 (range 1–6) positive contacts per household, and in 60% of these households, ≥50% of the members were ZIKV-positive. Analysis of clinical information allowed estimating the symptomatic to asymptomatic (S:A) ratio of 14:23 (1:1.6) among the contacts. Finding 62% of the infections to be asymptomatic emphasizes the importance of silent transmission. Evaluating the maximum number of days during which ZIKV RNA was detectable showed that ZIKV was found up to 7 days post-symptom onset in serum/plasma and saliva and 22 days post-symptom onset in urine. Finding ZIKV RNA in saliva over a similar time period and concentration as serum/plasma indicates that saliva could potentially serve as a more accessible diagnostic sample. Overall, these data increase our understanding of ZIKV transmission and help inform public health interventions in the region and globally.
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Affiliation(s)
- Raquel Burger-Calderon
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Karla Gonzalez
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Cristhiam Cerpas Cruz
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | | | - Fausto Bustos
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | | | | | | | | | | | - Andrea Nuñez
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Jesse J. Waggoner
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Michigan, United States of America
| | - Guillermina Kuan
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail:
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Kalliora C, Mamoulakis C, Vasilopoulos E, Stamatiades GA, Kalafati L, Barouni R, Karakousi T, Abdollahi M, Tsatsakis A. Association of pesticide exposure with human congenital abnormalities. Toxicol Appl Pharmacol 2018; 346:58-75. [PMID: 29596925 PMCID: PMC6029725 DOI: 10.1016/j.taap.2018.03.025] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/04/2018] [Accepted: 03/22/2018] [Indexed: 01/10/2023]
Abstract
Human pesticide exposure can occur both occupationally and environmentally during manufacture and after the application of indoor and outdoor pesticides, as well as through consumption via residues in food and water. There is evidence from experimental studies that numerous pesticides, either in isolation or in combination, act as endocrine disruptors, neurodevelopmental toxicants, immunotoxicants, and carcinogens. We reviewed the international literature on this subject for the years between 1990 and 2017. The studies were considered in this review through MEDLINE and WHO resources. Out of the n = 1817 studies identified, n = 94 were reviewed because they fulfilled criteria of validity and addressed associations of interest. Epidemiological studies have provided limited evidence linking pre- and post-natal exposure to pesticides with cancers in childhood, neurological deficits, fetal death, intrauterine growth restriction, preterm birth, and congenital abnormalities (CAs). In this review, the potential association between pesticide exposure and the appearance of some human CAs (including among others musculoskeletal abnormalities; neural tube defects; urogenital and cardiovascular abnormalities) was investigated. A trend towards a positive association between environmental or occupational exposure to some pesticides and some CAs was detected, but this association remains to be substantiated. Main limitations of the review include inadequate exposure assessment and limited sample size. Adequately powered studies with precise exposure assessments such as biomonitoring, are warranted to clarify with certainty the potential association between pesticide exposure and human CAs.
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Affiliation(s)
- Charikleia Kalliora
- Medical School, University of Crete, Heraklion, Crete, Greece; Department of Pharmacology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece.
| | | | - George A Stamatiades
- Division of Endocrinology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Roza Barouni
- Department of Biology, University of Athens, Greece
| | | | - Mohammad Abdollahi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran, Iran
| | - Aristidis Tsatsakis
- Department of Toxicology & Forensic Science, Medical School, University of Crete, Voutes Campus, Heraklion 71003, Greece
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Paton C, Cookson J, Ferrier IN, Bhatti S, Fagan E, Barnes TRE. A UK clinical audit addressing the quality of prescribing of sodium valproate for bipolar disorder in women of childbearing age. BMJ Open 2018; 8:e020450. [PMID: 29654033 PMCID: PMC5898356 DOI: 10.1136/bmjopen-2017-020450] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To review prescribing practice concerning valproate, an established human teratogen, for the management of bipolar disorder in women of childbearing age. DESIGN The Prescribing Observatory for Mental Health conducted a baseline clinical audit in the UK, as part of a quality improvement programme. PARTICIPANTS Six hundred and forty-eight clinical teams from 55 mental health Trusts submitted retrospective treatment data relating to patients with a diagnosis of bipolar disorder. RESULTS Of the audit sample of 6705 patients, 3854 were 50 years of age or younger. Valproate was prescribed for 24% of women and 43% men in this age group, and the mean dose of valproate was lower in women (1196 mg) than in men (1391 mg). For only half of such women was there documented evidence that information had been provided on the risks for the unborn child and the need for adequate contraception. Valproate was more often used in men to treat mania and aggression, while the most common treatment targets in women were hypomania and relapse prevention. CONCLUSIONS Despite explicit recommendations in national treatment guidelines and published safety alerts and warnings regarding the use of valproate in women of childbearing age, current prescribing of this medication to such women in the context of the treatment of bipolar disorder falls short of best practice, particularly with regard to provision of information regarding the risks associated with exposure to valproate during pregnancy. While women younger than 50 years of age were less likely to be prescribed valproate than men in the same age group, and at a lower dosage, it is unclear to what extent this reflects clinicians' concerns about teratogenicity or is driven by perceptions of the indication for valproate, and the dosage required, for the treatment of different phases of the disorder in men and women.
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Affiliation(s)
- Carol Paton
- Prescribing Observatory for Mental Health (POMH-UK), Royal College of Psychiatrists, London, UK
- The Centre for Psychiatry, Imperial College London, London, UK
| | - John Cookson
- Tower Hamlets Centre for Mental Health, Royal London Hospital, London, UK
| | - I Nicol Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Sumera Bhatti
- Prescribing Observatory for Mental Health (POMH-UK), Royal College of Psychiatrists, London, UK
| | - Elizabeth Fagan
- Prescribing Observatory for Mental Health (POMH-UK), Royal College of Psychiatrists, London, UK
| | - Thomas R E Barnes
- Prescribing Observatory for Mental Health (POMH-UK), Royal College of Psychiatrists, London, UK
- The Centre for Psychiatry, Imperial College London, London, UK
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Webb E, Moon J, Dyrszka L, Rodriguez B, Cox C, Patisaul H, Bushkin S, London E. Neurodevelopmental and neurological effects of chemicals associated with unconventional oil and natural gas operations and their potential effects on infants and children. Rev Environ Health 2018; 33:3-29. [PMID: 29068792 DOI: 10.1515/reveh-2017-0008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/28/2017] [Indexed: 05/05/2023]
Abstract
Heavy metals (arsenic and manganese), particulate matter (PM), benzene, toluene, ethylbenzene, xylenes (BTEX), polycyclic aromatic hydrocarbons (PAHs) and endocrine disrupting chemicals (EDCs) have been linked to significant neurodevelopmental health problems in infants, children and young adults. These substances are widely used in, or become byproducts of unconventional oil and natural gas (UOG) development and operations. Every stage of the UOG lifecycle, from well construction to extraction, operations, transportation and distribution can lead to air and water contamination. Residents near UOG operations can suffer from increased exposure to elevated concentrations of air and water pollutants. Here we focus on five air and water pollutants that have been associated with potentially permanent learning and neuropsychological deficits, neurodevelopmental disorders and neurological birth defects. Given the profound sensitivity of the developing brain and central nervous system, it is reasonable to conclude that young children who experience frequent exposure to these pollutants are at particularly high risk for chronic neurological diseases. More research is needed to understand the extent of these concerns in the context of UOG, but since UOG development has expanded rapidly in recent years, the need for public health prevention techniques, well-designed studies and stronger state and national regulatory standards is becoming increasingly apparent.
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Affiliation(s)
- Ellen Webb
- Center for Environmental Health, 2201 Broadway, Suite 302, Oakland, CA 94612, USA
| | | | - Larysa Dyrszka
- Physicians for Social Responsibility, Glen Spey, NY, USA
| | | | - Caroline Cox
- Center for Environmental Health, Oakland, CA, USA
| | - Heather Patisaul
- North Carolina State University College of Sciences, Raleigh, NC, USA
| | - Sheila Bushkin
- Institute for Health and the Environment, Albany, NY, USA
| | - Eric London
- Institute for Basic Research, New York, NY, USA
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