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Hang C, Zu L, Luo X, Wang Y, Yan L, Zhang Z, Le K, Huang Y, Ye L, Ying Y, Chen K, Xu X, Lv Q, Du L. Ddx5 Targeted Epigenetic Modification of Pericytes in Pulmonary Hypertension After Intrauterine Growth Restriction. Am J Respir Cell Mol Biol 2024; 70:400-413. [PMID: 38301267 DOI: 10.1165/rcmb.2023-0244oc] [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: 07/04/2023] [Accepted: 02/01/2024] [Indexed: 02/03/2024] Open
Abstract
Newborns with intrauterine growth restriction (IUGR) have a higher likelihood of developing pulmonary arterial hypertension (PAH) in adulthood. Although there is increasing evidence suggesting that pericytes play a role in regulating myofibroblast transdifferentiation and angiogenesis in malignant and cardiovascular diseases, their involvement in the pathogenesis of IUGR-related pulmonary hypertension and the underlying mechanisms remain incompletely understood. To address this issue, a study was conducted using a Sprague-Dawley rat model of IUGR-related pulmonary hypertension. Our investigation revealed increased proliferation and migration of pulmonary microvascular pericytes in IUGR-related pulmonary hypertension, accompanied by weakened endothelial-pericyte interactions. Through whole-transcriptome sequencing, Ddx5 (DEAD-box protein 5) was identified as one of the hub genes in pericytes. DDX5, a member of the RNA helicase family, plays a role in the regulation of ATP-dependent RNA helicase activities and cellular function. MicroRNAs have been implicated in the pathogenesis of PAH, and microRNA-205 (miR-205) regulates cell proliferation, migration, and angiogenesis. The results of dual-luciferase reporter assays confirmed the specific binding of miR-205 to Ddx5. Mechanistically, miR-205 negatively regulates Ddx5, leading to the degradation of β-catenin by inhibiting the phosphorylation of Gsk3β at serine 9. In vitro experiments showed the addition of miR-205 effectively ameliorated pericyte dysfunction. Furthermore, in vivo experiments demonstrated that miR-205 agomir could ameliorate pulmonary hypertension. Our findings indicated that the downregulation of miR-205 expression mediates pericyte dysfunction through the activation of Ddx5. Therefore, targeting the miR-205/Ddx5/p-Gsk3β/β-catenin axis could be a promising therapeutic approach for IUGR-related pulmonary hypertension.
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Affiliation(s)
| | - Lu Zu
- Department of Neonatology and
| | - Xiaofei Luo
- Department of Pediatrics, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China; and
| | - Yu Wang
- Department of Neonatology and
| | - Lingling Yan
- Department of Pediatrics, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China; and
| | | | - Kaixing Le
- Academy of Pediatrics, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | | | | | | | | | - Xuefeng Xu
- Department of Rheumatology, Immunology, and Allergy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, People's Republic of China
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Ye L, Huang Y, Chen K, Hang C, Ying Y, Zu L, Luo X, Du L. Early postnatal moderate catch‑up growth in rats with nutritional intrauterine growth restriction preserves pulmonary vascular and cognitive function in adulthood. Exp Ther Med 2024; 27:183. [PMID: 38515647 PMCID: PMC10952380 DOI: 10.3892/etm.2024.12471] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/09/2024] [Indexed: 03/23/2024] Open
Abstract
Intrauterine growth restriction (IUGR) with rapid postnatal catch-up growth is strongly associated with pulmonary vascular dysfunction in adulthood, whereas IUGR with delayed growth in early postnatal life results in long-term brain deficits. In the present study, it was hypothesized that IUGR with early moderate catch-up growth may alleviate pulmonary vascular remodeling in adulthood without affecting memory function. An IUGR model was established by restricting maternal nutrition during pregnancy. Different growth patterns were achieved by adjusting the litter size in each group during lactation. Rats meeting the weight requirement at weaning were selected for subsequent studies at three time points (3, 9 and 13 weeks). Cognitive function was evaluated using a Y-maze. Invasive hemodynamic measurements were conducted to measure the mean pulmonary arterial pressure (mPAP). In addition, primary pulmonary artery smooth muscle cells (PASMCs) and pulmonary vascular endothelial cells (PVECs) were cultured to investigate their role in the increase in mPAP following rapid catch-up growth. The results showed that memory function deficits in the rats in the delayed growth group were associated with reduced proliferation of neural stem cells in the subgranular zone of the hippocampus. Furthermore, moderate catch-up growth at the three time points improved memory function while maintaining a normal mPAP. In adult IUGR rats experiencing rapid catch-up growth, although memory function improved, elevated mPAP and medial thickening of pulmonary arterioles were observed. Additionally, PASMCs exhibited excessive proliferation, migration and anti-apoptotic activity in the rapid catch-up group, and PVECs also displayed excessive proliferation. These results suggested that moderate catch-up growth after IUGR is a better strategy for optimal cognition and cardiovascular health in adulthood compared with rapid catch-up growth or delayed growth.
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Affiliation(s)
- Lixia Ye
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Yajie Huang
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Kewei Chen
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Chengcheng Hang
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Yuhan Ying
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Lu Zu
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Xiaofei Luo
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
| | - Lizhong Du
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, P.R. China
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Mathewlynn S, Kitmiridou D, Impey L, Ioannou C. The impact of late pregnancy dating on the detection of fetal growth restriction at term. Acta Obstet Gynecol Scand 2024; 103:938-945. [PMID: 38240293 PMCID: PMC11019509 DOI: 10.1111/aogs.14769] [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] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 04/17/2024]
Abstract
INTRODUCTION The inaccuracy of late pregnancy dating is often discussed, and the impact on diagnosis of fetal growth restriction is a concern. However, the magnitude and direction of this effect has not previously been demonstrated. In this study, we aimed to investigate the effect of late pregnancy dating by head circumference on the detection of late onset growth restriction, compared to first trimester crown-rump length dating. MATERIAL AND METHODS This was a cohort study of 14 013 pregnancies receiving obstetric care at a tertiary center over a three-year period. Universal scans were performed at 12 weeks, including crown-rump length; at 20 weeks including fetal biometry; and at 36 weeks, where biometry, umbilical artery doppler and cerebroplacental ratio were used to determine the incidence of fetal growth restriction according to the Delphi consensus. For the entire cohort, the gestational age was first calculated using T1 dating; and was then recalculated using head circumference at 20 weeks (T2 dating); and at 36 weeks (T3 dating). The incidence of fetal growth restriction following T2 and T3 dating was compared to T1 dating using four-by-four sensitivity tables. RESULTS When the cohort was redated from T1 to T2, the median gestation at delivery changed from 40 + 0 to 40 + 2 weeks (p < 0.001). When the cohort was redated from T1 to T3, the median gestation at delivery changed from 40 + 0 to 40 + 3 weeks (p < 0.001). T2 dating resulted in fetal growth restriction sensitivity of 80.2% with positive predictive value of 78.8% compared to T1 dating. T3 dating resulted in sensitivity of 8.6% and positive predictive value of 27.7%, respectively. The sensitivity of abnormal CPR remained high despite T2 and T3 redating; 98.0% and 89.4%, respectively. CONCLUSIONS Although dating at 11-14 weeks is recommended, late pregnancy dating is sometimes inevitable, and this can prolong the estimated due date by an average of two to three days. One in five pregnancies which would be classified as growth restricted if the pregnancy was dated in the first trimester, will be reclassified as nongrowth restricted following dating at 20 weeks, whereas nine out of 10 pregnancies will be reclassified as non-growth restricted with 36-week dating.
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Affiliation(s)
- Sam Mathewlynn
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalOxfordUK
- Nuffield Department of Women's Reproductive Health, John Radcliffe HospitalOxford UniversityOxfordUK
| | - Despoina Kitmiridou
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalOxfordUK
| | - Lawrence Impey
- Nuffield Department of Women's Reproductive Health, John Radcliffe HospitalOxford UniversityOxfordUK
- Department of Fetal Medicine, John Radcliffe HospitalOxford University Hospitals NHS TrustOxfordUK
| | - Christos Ioannou
- Nuffield Department of Women's Reproductive Health, John Radcliffe HospitalOxford UniversityOxfordUK
- Department of Fetal Medicine, John Radcliffe HospitalOxford University Hospitals NHS TrustOxfordUK
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Azmi MB, Nasir MF, Asif U, Kazi M, Uddin MN, Qureshi SA. Analyzing molecular signatures in preeclampsia and fetal growth restriction: Identifying key genes, pathways, and therapeutic targets for preterm birth. Front Mol Biosci 2024; 11:1384214. [PMID: 38712342 PMCID: PMC11070483 DOI: 10.3389/fmolb.2024.1384214] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/22/2024] [Indexed: 05/08/2024] Open
Abstract
Background Intrauterine growth restriction (IUGR) and preeclampsia (PE) are intricately linked with specific maternal health conditions, exhibit shared placental abnormalities, and play pivotal roles in precipitating preterm birth (PTB) incidences. However, the molecular mechanism underlying the association between PE and IUGR has not been determined. Therefore, we aimed to analyze the data of females with PE and those with PE + IUGR to identify the key gene(s), their molecular pathways, and potential therapeutic interactions. Methods In this study, a comprehensive relationship analysis of both PE and PE + IUGR was conducted using RNA sequence datasets. Using two datasets (GSE148241 and GSE114691), differential gene expression analysis via DESeq2 through R-programming was performed. Gene set enrichment analysis was performed using ClusterProfiler, protein‒protein interaction (PPI) networks were constructed, and cluster analyses were conducted using String and MCODE in Cytoscape. Functional enrichment analyses of the resulting subnetworks were performed using ClueGO software. The hub genes were identified under both conditions using the CytoHubba method. Finally, the most common hub protein was docked against a library of bioactive flavonoids and PTB drugs using the PyRx AutoDock tool, followed by molecular dynamic (MD) simulation analysis. Pharmacokinetic analysis was performed to determine the ADMET properties of the compounds using pkCSM. Results We identified eight hub genes highly expressed in the case of PE, namely, PTGS2, ENG, KIT, MME, CGA, GAPDH, GPX3, and P4HA1, and the network of the PE + IUGR gene set demonstrated that nine hub genes were overexpressed, namely, PTGS2, FGF7, FGF10, IL10, SPP1, MPO, THBS1, CYBB, and PF4. PTGS2 was the most common hub gene found under both conditions (PE and PEIUGR). Moreover, the greater (-9.1 kcal/mol) molecular binding of flavoxate to PTGS2 was found to have satisfactory pharmacokinetic properties compared with those of other compounds. The flavoxate-bound PTGS2 protein complex remained stable throughout the simulation; with a ligand fit to protein, i.e., a RMSD ranging from ∼2.0 to 4.0 Å and a RMSF ranging from ∼0.5 to 2.9 Å, was observed throughout the 100 ns analysis. Conclusion The findings of this study may be useful for treating PE and IUGR in the management of PTB.
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Affiliation(s)
- Muhammad Bilal Azmi
- Computational Biochemistry Research Laboratory, Department of Biochemistry, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Mushyeda Fatima Nasir
- Department of Biosciences, Faculty of Life Sciences, Mohammad Ali Jinnah University, Karachi, Pakistan
| | - Uzma Asif
- Department of Biochemistry, Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Mohsin Kazi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Lin ET, Bae Y, Birkett R, Sharma AM, Zhang R, Fisch KM, Funk W, Mestan KK. Cord Blood Adductomics Reveals Oxidative Stress Exposure Pathways of Bronchopulmonary Dysplasia. Antioxidants (Basel) 2024; 13:494. [PMID: 38671941 PMCID: PMC11047351 DOI: 10.3390/antiox13040494] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Fetal and neonatal exposures to perinatal oxidative stress (OS) are key mediators of bronchopulmonary dysplasia (BPD). To characterize these exposures, adductomics is an exposure science approach that captures electrophilic addition products (adducts) in blood protein. Adducts are bound to the nucleophilic cysteine loci of human serum albumin (HSA), which has a prolonged half-life. We conducted targeted and untargeted adductomics to test the hypothesis that adducts of OS vary with BPD. We studied 205 preterm infants (≤28 weeks) and 51 full-term infants from an ongoing birth cohort. Infant plasma was collected at birth (cord blood), 1-week, 1-month, and 36-weeks postmenstrual age. HSA was isolated from plasma, trypsin digested, and analyzed using high-performance liquid chromatography-mass spectrometry to quantify previously annotated (known) and unknown adducts. We identified 105 adducts in cord and postnatal blood. A total of 51 known adducts (small thiols, direct oxidation products, and reactive aldehydes) were increased with BPD. Postnatally, serial concentrations of several known OS adducts correlated directly with supplemental oxygen exposure. The application of large-scale adductomics elucidated OS-mediated pathways of BPD. This is the first study to investigate the "neonatal-perinatal exposome" and to identify oxidative stress-related exposure biomarkers that may inform antioxidant strategies to protect the health of future generations of infants.
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Affiliation(s)
- Erika T. Lin
- Department of Pediatrics, Division of Neonatology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Yeunook Bae
- Department of Preventive Medicine, Northwestern University, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (Y.B.)
| | - Robert Birkett
- Department of Pediatrics, Division of Neonatology, Northwestern University, Chicago, IL 60611, USA
| | - Abhineet M. Sharma
- Department of Pediatrics, Division of Neonatology, Northwestern University, Chicago, IL 60611, USA
| | - Runze Zhang
- Department of Preventive Medicine, Northwestern University, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (Y.B.)
| | - Kathleen M. Fisch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA 92093, USA;
| | - William Funk
- Department of Preventive Medicine, Northwestern University, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (Y.B.)
| | - Karen K. Mestan
- Department of Pediatrics, Division of Neonatology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
- Department of Pediatrics, Division of Neonatology, Northwestern University, Chicago, IL 60611, USA
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Aydın E, Khanmammadova N, Burns P, Lim FY, Habli MA, Peiró JL. Bias in the prenatal lung measurements in fetal congenital diaphragmatic hernia with intrauterine growth restriction. J Perinat Med 2024; 0:jpm-2023-0425. [PMID: 38634775 DOI: 10.1515/jpm-2023-0425] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/23/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES The failure of a fetus to develop to its full potential due to maternal or placental factors is known as intrauterine growth restriction (IUGR). Fetal head growth is usually preserved in that situation producing a potential discordance between head and body size. Our goal is to discover if IUGR has an impact on the prenatal ultrasound measurements taken to assess pulmonary development in congenital diaphragmatic hernia (CDH). METHODS A retrospective chart review (IRB#2017-6361) was performed on all prenatally diagnosed CDH patients from 2007 to 2016. Patient demographics, fetal and neonatal anthropometric measurements, and fetal lung parameters were the main subjects of the data that were gathered. Fetal growth was assessed by the curves based on US data by Olsen et al. and by Peleg et al. Of 147 CDH patients, 19 (12.9 %) patients were diagnosed with IUGR before the 30th gestational week while there were 20 (13.6 %) patients after the 30th gestational week. RESULTS Patients with IUGR and the observed-to-expected lung-to-head ratio (O/E LHR) less than 25 % had better survival rates both to discharge and date compared to non IUGR group (p=0.226, OR 2.25 95 % CI 0.60-1.08 and p=0.175, OR 2.40 95 % CI 0.66-1.17, respectively). Moreover, the ECMO need of the patients who had IUGR and O/E LHR less than 25 % was significantly less than the patients without IUGR (38.5 vs. 80.0 %, p=0.005). CONCLUSIONS This study confirms that the intrauterine measurements to predict pulmonary hypoplasia in CDH patients are misleading in the presence of IUGR and cause an overestimation.
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Affiliation(s)
- Emrah Aydın
- Cincinnati Fetal Center, Division of Pediatric General and Thoracic Surgery, 2518 Cincinnati Children's Hospital Medical Center (CCHMC) , Cincinnati, OH, USA
- Department of Pediatric Surgery, 472605 Tekirdag Namik Kemal University School of Medicine , Tekirdag, Türkiye
| | - Narmina Khanmammadova
- Department of Pediatric Surgery, 472605 Tekirdag Namik Kemal University School of Medicine , Tekirdag, Türkiye
| | - Patricia Burns
- Cincinnati Fetal Center, Division of Pediatric General and Thoracic Surgery, 2518 Cincinnati Children's Hospital Medical Center (CCHMC) , Cincinnati, OH, USA
| | - Foong-Yen Lim
- Cincinnati Fetal Center, Division of Pediatric General and Thoracic Surgery, 2518 Cincinnati Children's Hospital Medical Center (CCHMC) , Cincinnati, OH, USA
| | - Mounira A Habli
- Cincinnati Fetal Center, Division of Pediatric General and Thoracic Surgery, 2518 Cincinnati Children's Hospital Medical Center (CCHMC) , Cincinnati, OH, USA
| | - Jose Luis Peiró
- Cincinnati Fetal Center, Division of Pediatric General and Thoracic Surgery, 2518 Cincinnati Children's Hospital Medical Center (CCHMC) , Cincinnati, OH, USA
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Chirilă CN, Mărginean C, Ghiga DV, Voidăzan S, Chirilă PM, Gliga ML. A Second Trimester Prediction Algorithm for Early-Onset Hypertensive Disorders of Pregnancy Occurrence and Severity Based on Soluble fms-like Tyrosine Kinase 1 (sFlt-1)/Placental Growth Factor (PlGF) Ratio and Uterine Doppler Ultrasound in Women at Risk. Children (Basel) 2024; 11:468. [PMID: 38671685 PMCID: PMC11049313 DOI: 10.3390/children11040468] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Hypertensive disorders of pregnancy (HDPs) represent a significant source of severe maternal and fetal morbidity. Screening strategies relying on traditional medical history and clinical risk factors have traditionally shown relatively modest performance, mainly in the prediction of preeclampsia, displaying a sensitivity of 37% for the early-onset form and 29% for the late-onset form. The development of more accurate predictive and diagnostic models of preeclampsia in the early stages of pregnancy represents a matter of high priority. The aim of the present paper is to create an effective second trimester prediction algorithm of early-onset HDP occurrence and severity, by combining the following two biochemical markers: a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio and uterine artery Doppler ultrasound parameters, namely the pulsatility index (PI) and the resistivity index (RI), in a population of high-risk pregnant women, initially assessed through traditional risk factors. A prospective single-center observational longitudinal study was conducted, in which 100 women with singleton pregnancy and traditional clinical and medical history risk factors for preeclampsia were enrolled at 24 weeks of gestation. Shortly after study enrollment, all women had their sFlt-1 and PlGF levels and mean uterine artery PI and RI determined. All pregnancies were followed up until delivery. Receiver operating characteristic (ROC) analysis established algorithms based on cutoffs for the prediction of the later development of preeclampsia: PI 1.25 (96.15% sensitivity, 86.49% specificity), RI 0.62 (84.6% sensitivity, 89.2% specificity) and sFlt-1/PlGF ratio 59.55 (100% sensitivity, 89.2% specificity). The sFlt-1/PlGF ratio was the best predictor for preeclampsia, as it displayed the highest area under the curve (AUC) of 0.973. The prediction algorithm for the severe form of preeclampsia, complicated by fetal growth restriction leading to preterm birth, antepartum fetal demise or acute fetal distress with a cerebro-placental ratio of
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Affiliation(s)
- Cristian Nicolae Chirilă
- Department of Internal Medicine-Nephrology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (C.N.C.); (M.L.G.)
- Department of Nephrology, Mures Clinical County Hospital, 540103 Târgu Mureș, Romania
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
| | - Claudiu Mărginean
- Department of Obstetrics and Gynecology 2, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
- Department of Obstetrics and Gynecology, Mures Clinical County Hospital, 540057 Târgu Mureș, Romania
| | - Dana Valentina Ghiga
- Department of Scientific Medical Research Methodology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
| | - Septimiu Voidăzan
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
| | - Paula Maria Chirilă
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
- Department of Endocrinology, Mures Clinical County Hospital, 540142 Târgu Mureș, Romania
| | - Mirela Liana Gliga
- Department of Internal Medicine-Nephrology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (C.N.C.); (M.L.G.)
- Department of Nephrology, Mures Clinical County Hospital, 540103 Târgu Mureș, Romania
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Xie Z, Yun Y, Yu G, Zhang X, Zhang H, Wang T, Zhang L. Bacillus subtilis alleviates excessive apoptosis of intestinal epithelial cells in intrauterine growth restriction suckling piglets via the members of Bcl-2 and caspase families. J Sci Food Agric 2024. [PMID: 38597265 DOI: 10.1002/jsfa.13525] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 02/15/2024] [Accepted: 04/10/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND The intestine is a barrier resisting various stress responses. Intrauterine growth restriction (IUGR) can cause damage to the intestinal barrier via destroying the balance of intestinal epithelial cells' proliferation and apoptosis. Bacillus subtilis has been reported to regulate intestinal epithelial cells' proliferation and apoptosis. Thus, the purpose of this study was to determine if B. subtilis could regulate intestinal epithelial cells' proliferation and apoptosis in intrauterine growth restriction suckling piglets. RESULTS Compared with the normal birth weight group, the IUGR group showed greater mean optical density values of Ki-67-positive cells in the ileal crypt (P < 0.05). IUGR resulted in higher ability of proliferation and apoptosis of intestinal epithelial cells, by upregulation of the messenger RNA (mRNA) or proteins expression of leucine rich repeat containing G protein coupled receptor 5, Caspase-3, Caspase-7, β-catenin, cyclinD1, B-cell lymphoma-2 associated agonist of cell death, and BCL2 associated X (P < 0.05), and downregulation of the mRNA or protein expression of B-cell lymphoma-2 and B-cell lymphoma-2-like 1 (P < 0.05). However, B. subtilis supplementation decreased the mRNA or proteins expression of leucine rich repeat containing G protein coupled receptor 5, SPARC related modular calcium binding 2, tumor necrosis factor receptor superfamily member 19, cyclinD1, Caspase-7, β-catenin, B-cell lymphoma-2 associated agonist of cell death, and Caspase-3 (P < 0.05), and increased the mRNA expression of B-cell lymphoma-2 (P < 0.05). CONCLUSION IUGR led to excessive apoptosis of intestinal epithelial cells, which induced compensatory proliferation. However, B. subtilis treatment prevented intestinal epithelial cells of IUGR suckling piglets from excessive apoptosis. © 2024 Society of Chemical Industry.
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Affiliation(s)
- Zechen Xie
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
| | - Yang Yun
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
| | - Ge Yu
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
| | - Xin Zhang
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
| | - Hao Zhang
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
| | - Tian Wang
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
| | - Lili Zhang
- College of Animal Science and Technology, Nanjing Agriculture University, Nanjing, China
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O'Keeffe R, Mulligan K, McParland P, McAuliffe FM, Mahony R, Corcoran S, O'Connor C, Carroll S, Walsh J. Estimating fetal weight in gastroschisis: A 10 year audit of outcomes at the National Maternity Hospital. Int J Gynaecol Obstet 2024. [PMID: 38572954 DOI: 10.1002/ijgo.15525] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/14/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To identify whether conventional methods of estimating fetal growth (Hadlock's formula), which relies heavily on abdominal circumference measurements, are accurate in fetuses with gastroschisis. METHODS A retrospective cohort study was performed between the period January 1, 2011 and December 31, 2021 in a tertiary referral maternity hospital identifying all pregnancies with a diagnosis of gastroschisis. Projected fetal weight was obtained using the formula (EFW [Hadlock's formula] + 185 g × [X/7]) where X was the number of days to delivery. RESULTS During the study period 41 cases were identified. The median maternal age was 25. The median BMI was 25 and 63% were primiparous women (n = 26). Median gestation at diagnosis was 21 weeks. Median gestation at delivery was 36 weeks. A total of 4.8% of mothers had a history of drug use (n = 2). The rate of maternal tobacco use was 21.9% (n = 9). A total of 4.8% of fetuses had additional congenital anomalies including amniotic band syndrome and myelomeningocele (n = 2). Estimated fetal weight (EFW) and birth weight data were available for 34 cases. A Wilcoxon signed-rank test showed projected EFW using Hadlock's formula did not result in a statistically significant different birth weight (Z = -1.3, P = 0.169). Median projected weight and actual birth weight were 2241.35 and 2415 g respectively. Median difference was 0.64 g (95% CI: -148 to -28.5). CONCLUSION Our data showed accuracy using standard formulae for EFW in fetuses with gastroschisis.
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Affiliation(s)
- Rachel O'Keeffe
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
| | - Karen Mulligan
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
| | - Peter McParland
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Rhona Mahony
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Siobhan Corcoran
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Clare O'Connor
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Stephen Carroll
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
| | - Jennifer Walsh
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Turyasima M, Ahmed FM, Egesa WI, Twesigemukama S, Kyoshabire J. Challenges and lessons learnt in the management of an HIV-exposed neonate with gastroschisis in a resource-limited setting: case report. Ann Med Surg (Lond) 2024; 86:2208-2213. [PMID: 38576955 PMCID: PMC10990413 DOI: 10.1097/ms9.0000000000001924] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/25/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance The incidence of congenital abdominal wall defects is increasing, but few cases have been reported in the African population. Case presentation The authors report a case of gastroschisis in a term neonate who was delivered through spontaneous vaginal delivery (SVD) in a remote health facility before transfer to a tertiary hospital in Uganda. Although there was no environmental exposure to teratogens, the major risk factor of Gastroschisis, the neonate was low birth weight, HIV-exposed, and the mother had not received folic acid supplementation during the first trimester, known risk factors of gastroschisis. Physical examination revealed intrauterine growth restriction in addition to the findings of the abdominal wall defect. Clinical discussion There were many missed opportunities in the management of this case which was marred by delayed essential care of the newborn, delayed surgical repair, and transfer to the tertiary surgical centre. At the tertiary surgical centre, a modified silo technique with delayed secondary closure was used to repair the defect, but the neonate still met its death before completing day 7 of life. Conclusion This case of gastroschisis shows how the diagnosis and management of neonates born with major congenital structural abnormalities in resource-limited settings is still desirable due to lack of sophisticated medical care services to assist in early detection during pregnancy and early surgical intervention at birth to prevent associated mortality. The authors discuss the lessons learnt and provide recommendations for improvement in the care of neonates born with abdominal wall defects and other congenital birth defects.
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Affiliation(s)
- Munanura Turyasima
- Department of Pediatrics and Child Health, Kampala International University, Faculty of Medicine and Dentistry
- Department of Standards Compliance Accreditation and Patient Protection, Ministry of Health
| | - Fadumo Mohamed Ahmed
- Department of Pediatrics and Child Health, Kampala International University, Faculty of Medicine and Dentistry
| | - Walufu Ivan Egesa
- Department of Pediatrics and Child Health, Nile International Hospital, Jinja City, Uganda
| | - Sabinah Twesigemukama
- Department of Pediatrics and Child Health, Kampala International University, Faculty of Medicine and Dentistry
| | - Joan Kyoshabire
- Department of Management Science, Uganda Management Institute, Kampala
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Martinelli S, Rolfo A, Pace C, Canu L, Nuzzo AM, Giuffrida D, Gaglioti P, Todros T. Anatomical and functional changes of the fetal adrenal gland in intrauterine growth restriction. Int J Gynaecol Obstet 2024. [PMID: 38532440 DOI: 10.1002/ijgo.15491] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/26/2024] [Accepted: 03/10/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The aim of this study was to demonstrate the establishment of adrenal sparing in intrauterine growth restricted (IUGR) human fetuses. IUGR fetuses are a subgroup of small for gestational age (SGA) fetuses that are unable to reach their own growth potential because of chronic hypoxia and undernutrition. We hypothesized that in IUGR fetuses the adrenal gland is relatively larger and secretion of noradrenaline (NA), adrenaline (A), and cortisol is increased. STUDY DESIGN This is a prospective observational study including 65 singleton pregnancies (42 IUGR and 23 controls). Using two-dimensional ultrasound, we measured fetal adrenal diameters and adrenal/abdominal circumference (AD/AC) ratio between 25 and 37 weeks. We considered only one measurement per fetus. In 21 pregnancies we also measured NA, A, and cortisol levels in arterial and venous fetal cord blood collected at the time of delivery. RESULTS The AD/AC ratio was significantly higher in IUGR fetuses than in controls. Cord NA and A levels were significantly higher in IUGR fetuses than in controls. An increase in cortisol secretion in IUGR fetuses was observed but the difference was not statistically significant. CONCLUSIONS Adrenal sparing correlates with a relative increase in adrenal measurements and function.
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Affiliation(s)
- Serena Martinelli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- European Network for the Study of Adrenal Tumors, (ENS@T) Center of Excellence, Florence, Italy
| | - Alessandro Rolfo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Carlotta Pace
- AOU Città della Salute e della Scienza, Sant' Anna Hospital, Turin, Italy
| | - Letizia Canu
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- European Network for the Study of Adrenal Tumors, (ENS@T) Center of Excellence, Florence, Italy
| | - Anna Maria Nuzzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Pietro Gaglioti
- AOU Città della Salute e della Scienza, Sant' Anna Hospital, Turin, Italy
| | - Tullia Todros
- Department of Surgical Sciences, University of Turin, Turin, Italy
- AOU Città della Salute e della Scienza, Sant' Anna Hospital, Turin, Italy
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12
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Grobeisen-Duque O, Villavicencio-Carrisoza O, Mora-Vargas CD, Arteaga-Lopez CP, Martinez-Salazar MG, Rosas-Balan A, León-Juárez M, Villegas-Mota MI, Zaga-Clavellina V, Aguilera-Arreola MG, Helguera-Repetto AC. Impact of Pre-Gestational BMI and Gestational Weight Gain on Fetal Development Outcomes in Adolescent Pregnant Women. J Clin Med 2024; 13:1839. [PMID: 38610604 PMCID: PMC11012914 DOI: 10.3390/jcm13071839] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
Background. Gestational weight gain (GWG) constitutes an essential aspect of the gestational process. Due to factors such as pregestational body mass index (BMI), nutritional intake, level of physical activity, and psychological aspects, the recommended GWG may not be achieved, leading to adverse neonatal outcomes. Adolescents, due to their physiological and mental developmental stage, are at a higher risk of inappropriate GWG. Our aim is to highlight the importance of GWG in our population and to determine the correlation with perinatal outcomes. Methods. Pregnant adolescents who attended a tertiary care institution for prenatal care were included; maternal data such as preBMI and GWG were used to determine maternal and neonatal outcomes using the chi-square test and OR determination. Results. A total of 202 adolescent pregnant patients were included, comprising those with inadequate GWG (n = 70), adequate GWG (n = 85), and excessive GWG (n = 47). A statistically significant association was found between low BMI and inadequate GWG. Patients with inadequate GWG demonstrated a correlation with IUGR and low birth weight, while patients with excessive GWG gave birth to macrosomic neonates. Conclusion. We concluded that previous habits play a significant role in determining weight gain throughout pregnancy. GWG has a direct impact on neonatal growth and development.
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Affiliation(s)
- Orly Grobeisen-Duque
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
| | - Oscar Villavicencio-Carrisoza
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
| | - Carlos Daniel Mora-Vargas
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
- Escuela Nacional de Ciencias Biologicas del Instituto Politecnico Nacional, Ciudad de Mexico 11350, Mexico;
| | - Carolina Penelope Arteaga-Lopez
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca 42000, Mexico
| | - Maria Guadalupe Martinez-Salazar
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
| | - Alejandro Rosas-Balan
- Coordinación de Medicina de la Adolescente, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico;
| | - Moises León-Juárez
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
| | - Maria Isabel Villegas-Mota
- Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico;
| | - Veronica Zaga-Clavellina
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
| | | | - Addy Cecilia Helguera-Repetto
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico; (O.G.-D.); (O.V.-C.); (C.D.M.-V.); (C.P.A.-L.); (M.G.M.-S.); (M.L.-J.); (V.Z.-C.)
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13
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Ye X, Ghosh S, Shin BC, Ganguly A, Maggiotto L, Jacobs JP, Devaskar SU. Brain serotonin and serotonin transporter expression in male and female postnatal rat offspring in response to perturbed early life dietary exposures. Front Neurosci 2024; 18:1363094. [PMID: 38576870 PMCID: PMC10991790 DOI: 10.3389/fnins.2024.1363094] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Serotonin (5-HT) is critical for neurodevelopment and the serotonin transporter (SERT) modulates serotonin levels. Perturbed prenatal and postnatal dietary exposures affect the developing offspring predisposing to neurobehavioral disorders in the adult. We hypothesized that the postnatal brain 5-HT-SERT imbalance associated with gut dysbiosis forms the contributing gut-brain axis dependent mechanism responsible for such ultimate phenotypes. Methods Employing maternal diet restricted (IUGR, n=8) and high fat+high fructose (HFhf, n=6) dietary modifications, rodent brain serotonin was assessed temporally by ELISA and SERT by quantitative Western blot analysis. Simultaneously, colonic microbiome studies were performed. Results At early postnatal (P) day 2 no changes in the IUGR, but a ~24% reduction in serotonin (p = 0.00005) in the HFhf group occurred, particularly in the males (p = 0.000007) revealing a male versus female difference (p = 0.006). No such changes in SERT concentrations emerged. At late P21 the IUGR group reared on HFhf (IUGR/HFhf, (n = 4) diet revealed increased serotonin by ~53% in males (p = 0.0001) and 36% in females (p = 0.023). While only females demonstrated a ~40% decrease in serotonin (p = 0.010), the males only trended lower without a significant change within the HFhf group (p = 0.146). SERT on the other hand was no different in HFhf or IUGR/RC, with only the female IUGR/HFhf revealing a 28% decrease (p = 0.036). In colonic microbiome studies, serotonin-producing Bacteriodes increased with decreased Lactobacillus at P2, while the serotonin-producing Streptococcus species increased in IUGR/HFhf at P21. Sex-specific changes emerged in association with brain serotonin or SERT in the case of Alistipase, Anaeroplasma, Blautia, Doria, Lactococcus, Proteus, and Roseburia genera. Discussion We conclude that an imbalanced 5-HT-SERT axis during postnatal brain development is sex-specific and induced by maternal dietary modifications related to postnatal gut dysbiosis. We speculate that these early changes albeit transient may permanently alter critical neural maturational processes affecting circuitry formation, thereby perturbing the neuropsychiatric equipoise.
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Affiliation(s)
- Xin Ye
- Department of Pediatrics, Division of Neonatology & Developmental Biology and The Neonatal Research Center of the Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Shubhamoy Ghosh
- Department of Pediatrics, Division of Neonatology & Developmental Biology and The Neonatal Research Center of the Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Bo-Chul Shin
- Department of Pediatrics, Division of Neonatology & Developmental Biology and The Neonatal Research Center of the Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Amit Ganguly
- Department of Pediatrics, Division of Neonatology & Developmental Biology and The Neonatal Research Center of the Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Liesbeth Maggiotto
- Department of Pediatrics, Division of Neonatology & Developmental Biology and The Neonatal Research Center of the Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Jonathan P. Jacobs
- The Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
- Division of Gastroenterology, Hepatology and Parenteral Nutrition, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Sherin U. Devaskar
- Department of Pediatrics, Division of Neonatology & Developmental Biology and The Neonatal Research Center of the Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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14
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Nüsken E, Appel S, Saschin L, Kuiper-Makris C, Oberholz L, Schömig C, Tauscher A, Dötsch J, Kribs A, Alejandre Alcazar MA, Nüsken KD. Intrauterine Growth Restriction: Need to Improve Diagnostic Accuracy and Evidence for a Key Role of Oxidative Stress in Neonatal and Long-Term Sequelae. Cells 2024; 13:501. [PMID: 38534344 PMCID: PMC10969486 DOI: 10.3390/cells13060501] [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: 12/29/2023] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
Intrauterine growth restriction (IUGR) and being small for gestational age (SGA) are two distinct conditions with different implications for short- and long-term child development. SGA is present if the estimated fetal or birth weight is below the tenth percentile. IUGR can be identified by additional abnormalities (pathological Doppler sonography, oligohydramnion, lack of growth in the interval, estimated weight below the third percentile) and can also be present in fetuses and neonates with weights above the tenth percentile. There is a need to differentiate between IUGR and SGA whenever possible, as IUGR in particular is associated with greater perinatal morbidity, prematurity and mortality, as well as an increased risk for diseases in later life. Recognizing fetuses and newborns being "at risk" in order to monitor them accordingly and deliver them in good time, as well as to provide adequate follow up care to ameliorate adverse sequelae is still challenging. This review article discusses approaches to differentiate IUGR from SGA and further increase diagnostic accuracy. Since adverse prenatal influences increase but individually optimized further child development decreases the risk of later diseases, we also discuss the need for interdisciplinary follow-up strategies during childhood. Moreover, we present current concepts of pathophysiology, with a focus on oxidative stress and consecutive inflammatory and metabolic changes as key molecular mechanisms of adverse sequelae, and look at future scientific opportunities and challenges. Most importantly, awareness needs to be raised that pre- and postnatal care of IUGR neonates should be regarded as a continuum.
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Affiliation(s)
- Eva Nüsken
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Sarah Appel
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Leon Saschin
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Celien Kuiper-Makris
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Laura Oberholz
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Charlotte Schömig
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Anne Tauscher
- Department of Obstetrics and Gynecology, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Jörg Dötsch
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Angela Kribs
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
| | - Miguel A. Alejandre Alcazar
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
- Institute for Lung Health (ILH), University of Giessen and Marburg Lung Center (UGMLC) and Cardiopulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
| | - Kai-Dietrich Nüsken
- Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; (E.N.)
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Sethi S, Friesen-Waldner LJ, Regnault TRH, McKenzie CA. Quantifying Brain Myelin Water Fraction in a Guinea Pig Model of Spontaneous Intrauterine Growth Restriction. J Magn Reson Imaging 2024. [PMID: 38445838 DOI: 10.1002/jmri.29332] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Intrauterine growth restriction (IUGR) is an obstetrical condition where a fetus has not achieved its genetic potential. A consequence of IUGR is a decrease in brain myelin content. Myelin water imaging (MWI) has been used to assess fetal myelin water fraction (MWF) and might potentially assess myelination changes associated with IUGR. PURPOSE To quantify and compare the MWF of non-IUGR and IUGR fetal guinea pigs (GPs) in late gestation. STUDY TYPE Prospective animal model. ANIMAL MODEL Dunkin-Hartley GP model of spontaneous IUGR (mean ± SD: 60 ± 1.2 days gestation; 19 IUGR, 52 control). FIELD STRENGTH/SEQUENCE Eight spoiled gradient-recalled (SPGR) gradient echo volumes (flip angles [α]: 2°-16°), and two sets of eight balanced steady-state free precession (bSSFP) gradient echo volumes (α: 8° - 64°), at 0° and 180° phase increments, at 3.0 T. ASSESSMENT MWF maps were generated for each fetal GP brain using multicomponent driven equilibrium single pulse observation of T1 /T2 (mcDESPOT). MWF was quantified in the fetal corpus callosum (CC), fornix (FOR), parasagittal white matter (PSW), and whole fetal brain. STATISTICAL TESTS Linear regression was performed between five fetal IUGR markers (body volume, body-to-pregnancy volume ratio, brain-to-liver volume ratio, brain-to-placenta volume ratio, and brain-to-body volume ratio) and MWF (coefficient of determination, R2 ). A t-test with a linear mixed model compared the MWF of non-IUGR and IUGR fetal GPs (significance was determined at α < 0.05). RESULTS The MWF of the control fetuses are (mean ± SD): 0.23 ± 0.02 (CC), 0.31 ± 0.02 (FOR), 0.28 ± 0.02 (PSW), and 0.20 ± 0.01 (whole brain). The MWF of the IUGR fetuses are (mean ± SD): 0.19 ± 0.02 (CC), 0.27 ± 0.01 (FOR), 0.24 ± 0.03 (PSW), and 0.16 ± 0.01 (whole brain). Significant differences in MWF were found between the non-IUGR and IUGR fetuses in every comparison. DATA CONCLUSION The mean MWF of IUGR fetal GPs is significantly lower than non-IUGR fetal GPs. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Simran Sethi
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | | | - Timothy R H Regnault
- Department of Obstetrics & Gynaecology, Western University, London, Ontario, Canada
- Department of Physiology & Pharmacology, Western University, London, Ontario, Canada
- Division of Maternal, Fetal and Newborn Health, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Charles A McKenzie
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- Division of Maternal, Fetal and Newborn Health, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
- Robarts Research Institute, Western University, London, Ontario, Canada
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Yang Y, Hou G, Ji F, Zhou H, Lv R, Hu C. Maternal Supplementation with Ornithine Promotes Placental Angiogenesis and Improves Intestinal Development of Suckling Piglets. Animals (Basel) 2024; 14:689. [PMID: 38473074 DOI: 10.3390/ani14050689] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
The blood vessels of the placenta are crucial for fetal growth. Here, lower vessel density and ornithine (Orn) content were observed in placentae for low-birth-weight fetuses versus normal-birth-weight fetuses at day 75 of gestation. Furthermore, the Orn content in placentae decreased from day 75 to 110 of gestation. To investigate the role of Orn in placental angiogenesis, 48 gilts (Bama pig) were allocated into four groups. The gilts in the control group were fed a basal diet (CON group), while those in the experimental groups were fed a basal diet supplemented with 0.05% Orn (0.05% Orn group), 0.10% Orn (0.10% Orn group), and 0.15% Orn (0.15% Orn group), respectively. The results showed that 0.15% Orn and 0.10% Orn groups exhibited increased birth weight of piglets compared with the CON group. Moreover, the 0.15% Orn group was higher than the CON group in the blood vessel densities of placenta. Mechanistically, Orn facilitated placental angiogenesis by regulating vascular endothelial growth factor-A (VEGF-A). Furthermore, maternal supplementation with 0.15% Orn during gestation increased the jejunal and ileal villi height and the concentrations of colonic propionate and butyrate in suckling piglets. Collectively, these results showed that maternal supplementation with Orn promotes placental angiogenesis and improves intestinal development of suckling piglets.
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Affiliation(s)
- Yun Yang
- Tropical Crop Genetic Resource Research Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, China
- College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Guanyu Hou
- Tropical Crop Genetic Resource Research Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, China
| | - Fengjie Ji
- Tropical Crop Genetic Resource Research Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, China
| | - Hanlin Zhou
- Tropical Crop Genetic Resource Research Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, China
| | - Renlong Lv
- Tropical Crop Genetic Resource Research Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, China
| | - Chengjun Hu
- Tropical Crop Genetic Resource Research Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, China
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Vasilache IA, Scripcariu IS, Doroftei B, Bernad RL, Cărăuleanu A, Socolov D, Melinte-Popescu AS, Vicoveanu P, Harabor V, Mihalceanu E, Melinte-Popescu M, Harabor A, Bernad E, Nemescu D. Prediction of Intrauterine Growth Restriction and Preeclampsia Using Machine Learning-Based Algorithms: A Prospective Study. Diagnostics (Basel) 2024; 14:453. [PMID: 38396491 PMCID: PMC10887724 DOI: 10.3390/diagnostics14040453] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/10/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Prenatal care providers face a continuous challenge in screening for intrauterine growth restriction (IUGR) and preeclampsia (PE). In this study, we aimed to assess and compare the predictive accuracy of four machine learning algorithms in predicting the occurrence of PE, IUGR, and their associations in a group of singleton pregnancies; (2) Methods: This observational prospective study included 210 singleton pregnancies that underwent first trimester screenings at our institution. We computed the predictive performance of four machine learning-based methods, namely decision tree (DT), naïve Bayes (NB), support vector machine (SVM), and random forest (RF), by incorporating clinical and paraclinical data; (3) Results: The RF algorithm showed superior performance for the prediction of PE (accuracy: 96.3%), IUGR (accuracy: 95.9%), and its subtypes (early onset IUGR, accuracy: 96.2%, and late-onset IUGR, accuracy: 95.2%), as well as their association (accuracy: 95.1%). Both SVM and NB similarly predicted IUGR (accuracy: 95.3%), while SVM outperformed NB (accuracy: 95.8 vs. 94.7%) in predicting PE; (4) Conclusions: The integration of machine learning-based algorithms in the first-trimester screening of PE and IUGR could improve the overall detection rate of these disorders, but this hypothesis should be confirmed in larger cohorts of pregnant patients from various geographical areas.
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Affiliation(s)
- Ingrid-Andrada Vasilache
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Ioana-Sadyie Scripcariu
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Bogdan Doroftei
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Robert Leonard Bernad
- Faculty of Computer Science, Politechnica University of Timisoara, 300006 Timisoara, Romania;
| | - Alexandru Cărăuleanu
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Demetra Socolov
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Alina-Sînziana Melinte-Popescu
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania; (A.-S.M.-P.); (V.H.)
| | - Petronela Vicoveanu
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Valeriu Harabor
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania; (A.-S.M.-P.); (V.H.)
| | - Elena Mihalceanu
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
| | - Marian Melinte-Popescu
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania;
- Department of Internal Medicine, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania
| | - Anamaria Harabor
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania; (A.-S.M.-P.); (V.H.)
| | - Elena Bernad
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania; (A.-S.M.-P.); (V.H.)
- Department of Obstetrics-Gynecology II, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dragos Nemescu
- Department of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.V.); (A.C.); (D.S.); (P.V.); (E.M.)
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Jensen A, Rochow N, Voigt M, Neuhäuser G. Differential effects of growth restriction and immaturity on predicted psychomotor development at 4 years of age in preterm infants. AJOG Glob Rep 2024; 4:100305. [PMID: 38327671 PMCID: PMC10847025 DOI: 10.1016/j.xagr.2023.100305] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Fetal growth restriction and immaturity are associated with poor neurocognitive development and child psychopathology affecting educational success at school and beyond. However, the differential effects of either obstetrical risk factor on predicted psychomotor development have not yet been deciphered. OBJECTIVE This study aimed to separately study the impact of growth restriction and that of immaturity on predicted psychomotor development at the preschool age of 4.3 (standard deviation, 0.8) years using birthweight percentiles in a prospective cohort of preterm infants born at ≤37+6/7 weeks of gestation. Differences between small for gestational age newborns with intrauterine growth restriction and those without were described. We examined predicted total psychomotor development score, predicted developmental disability index, calculated morphometric vitality index, and predicted intelligence quotient, Porteus Maze test score, and neurologic examination optimality score in 854 preterm infants from a large prospective screening cohort (cranial ultrasound screening, n=5,301). STUDY DESIGN This was a prospective cranial ultrasound screening study with a single-center cohort observational design (data collection done from 1984-1988, analysis done in 2022). The study included 5,301 live-born infants, of whom 854 (16.1%) were preterm infants (≤37+6/7 weeks' gestation), and was conducted on the day of discharge of the mother at 5 to 8 days postpartum from a level 3 perinatal center. Predicted psychomotor development, as assessed by the predicted total psychomotor development score, predicted developmental disability index, calculated morphometric vitality index, predicted intelligence quotient, Porteus Maze test score, and neurologic examination optimality score were calculated. We related psychomotor development indices and measures to gestational age in 3 groups of birthweight percentiles (ie, 10%, 50%, and 90% for small, appropriate, and large for gestational age newborns, respectively) using linear regression analysis, analysis of variance, multivariate analysis of variance, and t test procedures. RESULTS The key result of our study is the observation that in preterm infants born at ≤37+6/7 weeks of gestation, growth restriction as compared with immaturity is the prime risk factor for impairment of overall predicted psychomotor development, intelligence quotient, Porteus Maze test results, and neurologic examination optimality score at the preschool age of 4.3 (standard deviation, 0.8) years (P<.001). This is particularly true for intrauterine growth restriction. These detrimental effects of growth restriction become more prominent with decreasing gestational age (P<.001). As expected, growth restriction in preterm infants born at ≤37+6/7 weeks of gestation was associated with a number of obstetrical risk factors, including hypertension in pregnancy (P<.001), multiple pregnancy (P<.001), pathologic cardiotocography (P=.001), and low pH (P=.007), increased pCO2 (P=.009), and poor pO2 (P<.001) in umbilical arterial blood. Of note, there were no differences in cerebral hemorrhage or white matter damage among small, appropriate, and large for gestational age birthweight percentile groups, suggesting an independent mechanism of brain injury caused by preterm growth restriction resulting in poor psychomotor development. CONCLUSION Compared with immaturity, growth restriction in preterm infants has more intense detrimental effects on psychomotor development, necessitating improved risk stratification. This finding has implications for clinical management, parental consultation, and early intervention strategies to improve school performance, educational success, and mental health in children. The mechanisms of brain injury specific to growth restriction in preterm infants require further elucidation.
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Affiliation(s)
- Arne Jensen
- Campus Clinic Gynecology, Ruhr-University Bochum, Germany (Dr Jensen)
| | - Niels Rochow
- Department of Pediatrics, Paracelsus Medical University, Nuremberg, Germany (Dr Rochow)
- Department of Pediatrics, University Medicine Rostock, Rostock, Germany (Dr Rochow)
- DEUZWEG German Center for Growth, Development and Health Promotion in Childhood and Adolescence, Berlin, Germany (Drs Rochow and Voigt)
| | - Manfred Voigt
- DEUZWEG German Center for Growth, Development and Health Promotion in Childhood and Adolescence, Berlin, Germany (Drs Rochow and Voigt)
- Institute for Perinatal Growth Research, Sievershagen, Germany (Dr Voigt)
| | - Gerhard Neuhäuser
- Department of Paediatric Neurology, University of Giessen, Germany (Dr Neuhäuser)
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Mucellini AB, Laureano DP, Alves MB, Dalle Molle R, Borges MB, Salvador APDA, Pokhvisneva I, Manfro GG, Silveira PP. The impact of poor fetal growth and chronic hyperpalatable diet exposure in adulthood on hippocampal function and feeding patterns in male rats. Dev Psychobiol 2024; 66:e22459. [PMID: 38372503 DOI: 10.1002/dev.22459] [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: 08/01/2023] [Revised: 12/05/2023] [Accepted: 01/02/2024] [Indexed: 02/20/2024]
Abstract
Poor fetal growth affects eating behavior and the mesocorticolimbic system; however, its influence on the hippocampus has been less explored. Brain insulin sensitivity has been linked to developmental plasticity in response to fetal adversity and to cognitive performance following high-fat diet intake. We investigated whether poor fetal growth and exposure to chronic hyperpalatable food in adulthood could influence the recognition of environmental and food cues, eating behavior patterns, and hippocampal insulin signaling. At 60 days of life, we assigned male offspring from a prenatal animal model of 50% food restriction (FR) to receive either a high-fat and -sugar (HFS) diet or standard chow (CON) diet. Behavioral tests were conducted at 140 days, then tissues were collected. HFS groups showed a diminished hippocampal pAkt/Akt ratio. FR-CON and FR-HFS groups had higher levels of suppressor of cytokine signaling 3, compared to control groups. FR groups showed increased exploration of a novel hyperpalatable food, independent of their diet, and HFS groups exhibited overall lower entropy (less random, more predictable eating behavior) when the environment changed. Poor fetal growth and chronic HFS diet in adulthood altered hippocampal insulin signaling and eating patterns, diminishing the flexibility associated with eating behavior in response to extrinsic changes in food availability in the environment.
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Affiliation(s)
- Amanda Brondani Mucellini
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniela Pereira Laureano
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Child and Adolescent Health, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Márcio Bonesso Alves
- Graduate Program in Biochemistry, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Roberta Dalle Molle
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Mariana Balbinot Borges
- Faculty of Biomedicine, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Gisele Gus Manfro
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
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Czeiger S, Weissbach T, Zloto K, Wiener A, Nir O, Massarwa A, Weisz B, Bartal MF, Ulman RY, Bart Y, Achiron R, Kivilevitch Z, Mazaki-Tovi S, Kassif E. Umbilical-portal-systemic venous shunt and intrauterine growth restriction: an inquiry from a prospective study. Am J Obstet Gynecol 2024:S0002-9378(24)00011-5. [PMID: 38218510 DOI: 10.1016/j.ajog.2024.01.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The investigation of the fetal umbilical-portal venous system is based on the premise that congenital anomalies of this system may be related to adverse perinatal outcomes. Several small retrospective studies have reported an association between umbilical-portal-systemic venous shunts and intrauterine growth restriction. However, the prevalence of portosystemic shunts in the fetal growth restricted population is yet to be determined. OBJECTIVE The aims of this study were (1) to determine the prevalence of fetal umbilical-portal-systemic venous shunts in pregnancies complicated by intrauterine growth restriction and (2) to compare the perinatal and neonatal outcomes of pregnancies with intrauterine growth restriction with and without umbilical-portal-systemic venous shunts. STUDY DESIGN This was a prospective, cross-sectional study of pregnancies diagnosed with intrauterine growth restriction, as defined by the Society for Maternal-Fetal Medicine intrauterine growth restriction guidelines. All participants underwent a detailed anomaly scan, supplemented with a targeted scan of the fetal portal system. Venous shunts were diagnosed using color Doppler mode. The perinatal outcomes of pregnancies with intrauterine growth restriction with and without umbilical-portal-systemic venous shunts were compared. RESULTS A total of 150 cases with intrauterine growth restriction were recruited. The prevalence of umbilical-portal-systemic venous shunts in our cohort was 9.3% (n=14). When compared with the control group (intrauterine growth restriction without umbilical-portal-systemic venous shunts, n=136), the study group had a significantly lower mean gestational age at the time of intrauterine growth restriction diagnosis (29.7±5.6 vs 32.47±4.6 weeks of gestation; P=.036) and an earlier gestational age at delivery (33.50±6.0 vs 36.13±2.8; P=.005). The study group had a higher rate of fetal death (21.4% vs 0.7%; P<.001) and, accordingly, a lower rate of live births (71.4% vs 95.6%; P=.001). Additional associated fetal vascular anomalies were significantly more prevalent in the study group than in the control group (35.7% vs 4.4%; P≤.001). The rate of other associated anomalies was similar. The study group had a significantly lower rate of abnormal uterine artery Doppler indices (0% vs 40.4%; P=.011) and a higher rate of abnormal ductus venosus Doppler indices (64.3% vs 23%; P=.001). There were no cases of hypertensive disorders of pregnancy in the study group, whereas the control group had an incidence of 12.5% (P=.16). Other perinatal and neonatal outcomes were comparable. CONCLUSION Umbilical-portal-systemic venous shunt is a relatively common finding among fetuses with growth restriction. When compared with pregnancies with intrauterine growth restriction with a normal portal system, these pregnancies complicated by intrauterine growth restriction and an umbilical-portal-systemic venous shunt are associated with a different Doppler flow pattern, an increased risk for fetal death, earlier presentation of intrauterine growth restriction, a lower gestational age at delivery, additional congenital vascular anomalies, and a lower rate of pregnancy-induced hypertensive disorders. Meticulous sonographic evaluation of the portal system should be considered in the prenatal workup of intrauterine growth restriction, as umbilical-portal-systemic venous shunts may affect perinatal outcomes.
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Affiliation(s)
- Shelly Czeiger
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Department of Obstetrics and Gynecology, Mayanei HaYeshuha Medical Center, Bnei-Brak, Israel.
| | - Tal Weissbach
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Keren Zloto
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariella Wiener
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Nir
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abeer Massarwa
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Boaz Weisz
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Fishel Bartal
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rakefet Yoeli Ulman
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Bart
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reuven Achiron
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Zvi Kivilevitch
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Shali Mazaki-Tovi
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Kassif
- Obstetrics and Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bischoff AR, Dalle Molle R, Mucellini AB, Pokhvisneva I, Levitan RD, Meaney MJ, Silveira PP. Accumbal μ-opioid receptors and salt taste-elicited hedonic responses in a rodent model of prenatal adversity, and their correlates using human functional genomics. Stress 2024; 27:2294954. [PMID: 38140734 DOI: 10.1080/10253890.2023.2294954] [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: 07/03/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Prenatal adversity is associated with behavioral obesogenic features such as preference for palatable foods. Salt appetite may play a role in the development of adiposity and its consequences in individuals exposed to prenatal adversity, and sodium consumption involves individual differences in accumbal µ-opioid receptors function. We investigated the hedonic responses to salt and the levels of µ-opioid receptors and tyrosine hydroxylase in the nucleus accumbens (Nacc) of pups from an animal model of prenatal dietary restriction. In children, we evaluated the interaction between fetal growth and the genetic background associated with the accumbal µ-opioid receptor gene (OPRM1) expression on sodium consumption during a snack test. Sprague-Dawley dams were randomly allocated from pregnancy day 10 to receive an ad libitum (Adlib) or a 50% restricted (FR) diet. The pups' hedonic responses to a salt solution (NaCl 2%) or water were evaluated on the first day of life. FR and Adlib pups differ in their hedonic responses to salt, and there were decreased levels of accumbal µ-opioid and p-µ-opioid receptors in FR pups. In humans, a test meal and genotyping from buccal epithelial cells were performed in 270 children (38 intrauterine growth restricted-IUGR) at 4 years old from a Canadian prospective cohort (MAVAN). The OPRM1 genetic score predicted the sodium intake in IUGR children, but not in controls. The identification of mechanisms involved in the brain response to prenatal adversity and its consequences in behavioral phenotypes and risk for chronic diseases later in life is important for preventive and therapeutic purposes.
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Affiliation(s)
- Adrianne Rahde Bischoff
- Neonatal Hemodynamics, Stead Family Department of Pediatrics, Division of Neonatology, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Roberta Dalle Molle
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Amanda Brondani Mucellini
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Robert D Levitan
- Centre for Addition and Mental Health (CAMH) and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Michael J Meaney
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences and Brain - Body Initiative, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Patrícia P Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
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Santiago LTC, Freitas NAD, Meira Junior JDD, Corrente JE, Paula VG, Damasceno DC, de Souza Rugolo LMS. Oxidative status in colostrum and mature breast milk related to gestational age and fetal growth. J Matern Fetal Neonatal Med 2023; 36:2183763. [PMID: 36852433 DOI: 10.1080/14767058.2023.2183763] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION The effect of gestational age and fetal growth on the oxidant/antioxidant status of breast milk is poorly understood. OBJECTIVE To evaluate the oxidative stress biomarkers in colostrum and mature milk according to gestational age and fetal growth. METHOD A longitudinal study with mothers of premature and term infants, born in a tertiary referral hospital between 2014-2018. Inclusion criteria: postpartum women with a singleton pregnancy, who intended to exclusively breastfeed. Exclusion criteria: maternal diabetes, use of medication, drug addiction, congenital infection or malformation, mastitis, and failure to collect colostrum. Four groups were formed according to gestational age and birth weight (appropriate and small): Preterm small (n = 37), Preterm appropriate (n = 99), Full-term small (n = 65), and Full-term appropriate (control, n = 69). The colostrum samples were collected between 24-72 h and the mature milk was sampled in the 4th week of lactation for malondialdehyde (biomarker for lipid peroxidation) and Glutathione peroxidase, Catalase, and Superoxide dismutase measurements. The data were compared among groups using the Chi-square test or Fisher's exact test, one-way analysis of variance followed by Wald's Distribution test and repeated measures analysis of variance. RESULTS We found a lower malondialdehyde level in colostrum in preterm groups and term small for gestational age, and the antioxidant enzymes Superoxide dismutase and Catalase activities were higher for preterm compared to term groups. The malondialdehyde levels differed in mature milk samples (Full-term small > Full-term appropriate > Preterm small > Preterm appropriate). The malondialdehyde levels increased during lactation in all groups except Preterm appropriate, and the levels of Catalase decreased in preterm groups. CONCLUSION The oxidative status in breast milk is influenced by gestational age and fetal growth, which increased antioxidant defense for preterm infants and decreased oxidative stimuli for small for gestational age infants. These findings contribute to encouraging breastfeeding for newborns.
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Affiliation(s)
| | | | | | - José Eduardo Corrente
- Institute of Biosciences of Botucatu, UNESP_Univ Estadual Paulista, São Paulo State, Brazil
| | - Verônyca Gonçalves Paula
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Univ Estadual Paulista_Unesp, Botucatu, São Paulo State, Brazil
| | - Debora Cristina Damasceno
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Univ Estadual Paulista_Unesp, Botucatu, São Paulo State, Brazil
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Sengul M, Karadas B, Acar-Sahan S, Simsek F, Horoz E, Özok IC, Temiz T. Functional and Histological Changes in Umbilical Artery and Myometrium Isolated from IUGR Complicated Pregnancies. Fetal Pediatr Pathol 2023; 42:845-859. [PMID: 37578058 DOI: 10.1080/15513815.2023.2245892] [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: 05/04/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
Objective: To investigate the relaxation responses mediated by L-type Ca2+ channels and big-conductance Ca2+-activated K+ (BKCa) channels and histological changes in the human umbilical artery (HUA) and myometrium smooth muscle isolated from pregnancies complicated with intrauterine growth restriction (IUGR).Methods: The muscle reactivity and the histology of the smooth muscle of the HUA and myometrium retrieved from 14 women with IUGR and 14 controls were investigated by the isolated tissue bath and immunohistochemical method.Results: In HUA, the maximum relaxation responses and pD2 values of nifedipine and NS11021 (BKCa channel opener) were significantly increased and significant histopathological changes are observed in the IUGR group.Conclusions: The pathogenesis of IUGR might be associated with the impairment in the functional responses of L-type Ca2+ channels and BKCa channels in HUA smooth muscle. The increased staining of myometrium and UC with HIF-1α in IUGR may indicate apoptosis, histological damage, and impaired fetal growth.
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Affiliation(s)
- Mustafa Sengul
- Department of Obstetrics and Gynecology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Baris Karadas
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Selin Acar-Sahan
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Fatma Simsek
- Department of Histology and Embryology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Ersan Horoz
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Işık Cem Özok
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Tijen Temiz
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
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Walia A, Berger VK, Gonzalez JM, Sobhani NC. Mode of delivery and neonatal outcomes with early preterm severe preeclampsia: does fetal growth restriction matter? J Matern Fetal Neonatal Med 2023; 36:2208251. [PMID: 37137495 DOI: 10.1080/14767058.2023.2208251] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Severe preeclampsia diagnosed at or prior to 34 weeks is an indication for preterm delivery. Many patients with severe preeclampsia develop fetal growth restriction as a result of the placental dysfunction associated with both conditions. The ideal mode of delivery in cases of preterm severe preeclampsia with fetal growth restriction remains controversial, with providers often proceeding directly to cesarean delivery rather than attempting a trial of labor due to theoretic concerns about the harms of labor in the face of placental dysfunction. There are limited data supporting this approach. This study evaluates whether the presence of fetal growth restriction affects the ultimate mode of delivery or neonatal outcomes among pregnancies with severe preeclampsia undergoing induction of labor at or before 34 weeks. METHODS This was a retrospective cohort study of singletons with severe preeclampsia undergoing induction of labor ≤ 34 weeks at a single center between January 2015 and April 2022. The primary predictor was fetal growth restriction, defined as estimated fetal weight < 10th percentile for gestational age on ultrasound. Mode of delivery and neonatal outcomes were compared between those with and without fetal growth restriction using Fisher's exact and Kruskal-Wallis tests, and multivariate logistic regression was used to obtain adjusted odds ratios. RESULTS 159 patients were included (N = 117 without fetal growth restriction, N = 42 with fetal growth restriction). There was no difference in vaginal delivery between the groups (70% vs 67%, p = .70). While those with fetal growth restriction had a higher incidence of respiratory distress syndrome and longer neonatal hospital stay, these differences were not statistically significant after adjusting for gestational age at delivery. There were no significant differences in other neonatal outcomes, including Apgar score, cord blood gases, intraventricular hemorrhage, necrotizing enterocolitis, neonatal sepsis, and neonatal demise. CONCLUSION For pregnancies complicated by severe preeclampsia that require delivery ≤ 34 weeks, the likelihood of successful vaginal delivery following induction of labor does not differ based on presence of fetal growth restriction. Furthermore, fetal growth restriction is not an independent risk factor for adverse neonatal outcomes in this population. Induction of labor should be considered a reasonable approach and should be routinely offered to patients with concurrent preterm severe preeclampsia and fetal growth restriction.
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Affiliation(s)
- Anjali Walia
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Victoria K Berger
- Maternal and Fetal Medicine, Sutter West Bay Medical Group, San Francisco, CA, USA
| | - Juan M Gonzalez
- Division of Maternal-Fetal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Nasim C Sobhani
- Division of Maternal-Fetal Medicine, University of California San Francisco, San Francisco, CA, USA
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25
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Juusela A, Jung E, Gallo DM, Bosco M, Suksai M, Diaz-Primera R, Tarca AL, Than NG, Gotsch F, Romero R, Chaiworapongsa T. Maternal plasma syndecan-1: a biomarker for fetal growth restriction. J Matern Fetal Neonatal Med 2023; 36:2150074. [PMID: 36597808 DOI: 10.1080/14767058.2022.2150074] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The identification of fetal growth disorders is an important clinical priority given that they increase the risk of perinatal morbidity and mortality as well as long-term diseases. A subset of small-for-gestational-age (SGA) infants are growth-restricted, and this condition is often attributed to placental insufficiency. Syndecan-1, a product of the degradation of the endothelial glycocalyx, has been proposed as a biomarker of endothelial damage in different pathologies. During pregnancy, a "specialized" form of the glycocalyx-the "syncytiotrophoblast glycocalyx"-covers the placental villi. The purpose of this study was to determine whether the concentration of maternal plasma syndecan-1 can be proposed as a biomarker for fetal growth restriction. STUDY DESIGN A cross-sectional study was designed to include women with normal pregnancy (n = 130) and pregnant women who delivered an SGA neonate (n = 50). Doppler velocimetry of the uterine and umbilical arteries was performed in women with an SGA fetus at the time of diagnosis. Venipuncture was performed within 48 h of Doppler velocimetry and plasma concentrations of syndecan-1 were determined by a specific and sensitive immunoassay. RESULTS (1) Plasma syndecan-1 concentration followed a nonlinear increase with gestational age in uncomplicated pregnancies (R2 = 0.27, p < .001); (2) women with a pregnancy complicated with an SGA fetus had a significantly lower mean plasma concentration of syndecan-1 than those with an appropriate-for-gestational-age fetus (p = .0001); (3) this difference can be attributed to fetal growth restriction, as the mean plasma syndecan-1 concentration was significantly lower only in the group of women with an SGA fetus who had abnormal umbilical and uterine artery Doppler velocimetry compared to controls (p = .00071; adjusted p = .0028). A trend toward lower syndecan-1 concentrations was also noted for SGA with abnormal uterine but normal umbilical artery Doppler velocimetry (p = .0505; adjusted p = .067); 4) among women with an SGA fetus, those with abnormal umbilical and uterine artery Doppler findings had a lower mean plasma syndecan-1 concentration than women with normal Doppler velocimetry (p = .02; adjusted p = .04); 5) an inverse relationship was found between the maternal plasma syndecan-1 concentration and the umbilical artery pulsatility index (r = -0.5; p = .003); and 6) a plasma syndecan-1 concentration ≤ 850 ng/mL had a positive likelihood ratio of 4.4 and a negative likelihood ratio of 0.24 for the identification of a mother with an SGA fetus who had abnormal umbilical artery Doppler velocimetry (area under the ROC curve 0.83; p < .001). CONCLUSION Low maternal plasma syndecan-1 may reflect placental diseases and this protein could be a biomarker for fetal growth restriction. However, as a sole biomarker for this condition, its accuracy is low.
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Affiliation(s)
- Alexander Juusela
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Eunjung Jung
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Dahiana M Gallo
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.,Department of Obstetrics and Gynecology, University del Valle, Cali, Colombia
| | - Mariachiara Bosco
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.,Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Manaphat Suksai
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ramiro Diaz-Primera
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Adi L Tarca
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.,Department of Computer Science, Wayne State University College of Engineering, Detroit, MI, USA
| | - Nandor Gabor Than
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Systems Biology of Reproduction Research Group, Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary.,Maternity Private Clinic, Budapest, Hungary.,Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Francesca Gotsch
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.,Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, USA.,Detroit Medical Center, Detroit, MI, USA
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
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Nkobetchou M, Leruez-Ville M, Guilleminot T, Roux N, Petrilli G, Guimiot F, Saint-Frison MH, Deryabin I, Ville Y, Faure-Bardon V. SARS-CoV-2 infection as cause of in-utero fetal death: regional multicenter cohort study. Ultrasound Obstet Gynecol 2023; 62:867-874. [PMID: 37519281 DOI: 10.1002/uog.27439] [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] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Placental infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to placental insufficiency and in-utero fetal death (IUFD). The objective of this study was to confirm and quantify the extent to which fetoplacental infection with SARS-CoV-2 is a cause of fetal death. METHODS This was a multicenter retrospective cohort study of fetal deaths that underwent postmortem examination between January 2020 and January 2022 in three fetal pathology units in Paris, France. All cases of IUFD and termination of pregnancy (TOP) occurring in 31 maternity hospitals in the Paris region undergo detailed placental pathological examination in these units. Databases were searched for cases of IUFD and TOP. Cases with fetal malformation or cytogenetic abnormality were excluded to avoid bias. We included cases of IUFD with a placental or undetermined cause and cases of TOP in the context of severe intrauterine growth restriction (IUGR). Placentas were sent to a single virology unit for reverse-transcription polymerase chain reaction (RT-PCR) testing by a single laboratory technician blinded to the initial postmortem examination report. Our primary endpoint was the proportion of positive placental SARS-CoV-2 RT-PCR tests in the cohort. RESULTS Among 147 722 deliveries occurring over 2 years, 788 postmortem examinations for IUFD and TOP for severe IUGR were recorded, of which 462 (58.6%) were included. A total of 13/462 (2.8%) placentas tested positive for SARS-CoV-2 by RT-PCR. Wild-type virus and alpha and delta variants were identified. All positive cases had histological lesions consistent with placental dysfunction. There was a strong correlation between SARS-CoV-2 placentitis and the presence of chronic intervillositis and/or massive fibrin deposits in the placenta. When both lesion types were present, the specificity and negative predictive value for the diagnosis of placental SARS-CoV-2 infection were 0.99 (95% CI, 0.98-1.00) and 0.96 (95% CI, 0.94-0.98), respectively. CONCLUSIONS At the height of the SARS-CoV-2 pandemic, the cause of more than half of fetal deaths in the Paris area was determined by postmortem analysis to be of placental or undetermined origin. Of these cases, 2.8% were due to placental SARS-CoV-2 infection with a specific pattern of histological involvement. This study highlights the need for SARS-CoV-2 screening in stillbirth assessment. The impact of vaccination coverage remains to be established. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M Nkobetchou
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Maternity Department, Necker University Hospital, Paris, France
| | - M Leruez-Ville
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Virology Department, Necker University Hospital, Paris, France
| | - T Guilleminot
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Virology Department, Necker University Hospital, Paris, France
| | - N Roux
- Histopathology Department, Necker University Hospital, Paris, France
| | - G Petrilli
- Histopathology Department, Necker University Hospital, Paris, France
| | - F Guimiot
- Histopathology Department, Robert Debré Hospital, Paris, France
| | | | - I Deryabin
- Histopathology Department, Trousseau Hospital, Paris, France
| | - Y Ville
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Maternity Department, Necker University Hospital, Paris, France
| | - V Faure-Bardon
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Maternity Department, Necker University Hospital, Paris, France
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27
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Kanbay M, Copur S, Yildiz AB, Covic A, Covic A, Ciceri P, Magagnoli L, Cozzolino M. Intrauterine life to adulthood: a potential risk factor for chronic kidney disease. Nephrol Dial Transplant 2023; 38:2675-2684. [PMID: 37370229 DOI: 10.1093/ndt/gfad134] [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] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Indexed: 06/29/2023] Open
Abstract
Multiple risk factors for chronic kidney disease (CKD), one of the major causes of morbidity and mortality in the adult population globally, have been identified, including older age, male gender, family history, smoking, diabetes mellitus, hypertension, ischaemic heart diseases and various medications. Preterm delivery, affecting >10% of the newborns in the USA, is a global concern with increasing incidence in recent decades. Preterm birth has been linked to multiple medical comorbidities such as diabetes mellitus, hypertension and cardiovascular diseases, while its association with CKD has recently been investigated. Prematurity and intrauterine growth restriction (IUGR) have been associated with an increased risk for CKD, specific histopathological examination findings and CKD-associated risk factors such as diabetes mellitus, hypertension and dyslipidaemia. In this narrative review, our aim is to evaluate and summarize the association between the risk for CKD and prematurity, low birthweight and IUGR along with potential underlying pathophysiological mechanisms.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Abdullah B Yildiz
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Andreea Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Adrian Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Paola Ciceri
- Department of Health Sciences, Renal Division, University of Milan, Milan, Italy
| | - Lorenza Magagnoli
- Department of Health Sciences, Renal Division, University of Milan, Milan, Italy
| | - Mario Cozzolino
- Department of Health Sciences, Renal Division, University of Milan, Milan, Italy
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28
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Starodubtseva NL, Tokareva AO, Volochaeva MV, Kononikhin AS, Brzhozovskiy AG, Bugrova AE, Timofeeva AV, Kukaev EN, Tyutyunnik VL, Kan NE, Frankevich VE, Nikolaev EN, Sukhikh GT. Quantitative Proteomics of Maternal Blood Plasma in Isolated Intrauterine Growth Restriction. Int J Mol Sci 2023; 24:16832. [PMID: 38069155 PMCID: PMC10706154 DOI: 10.3390/ijms242316832] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
Intrauterine growth restriction (IUGR) remains a significant concern in modern obstetrics, linked to high neonatal health problems and even death, as well as childhood disability, affecting adult quality of life. The role of maternal and fetus adaptation during adverse pregnancy is still not completely understood. This study aimed to investigate the disturbance in biological processes associated with isolated IUGR via blood plasma proteomics. The levels of 125 maternal plasma proteins were quantified by liquid chromatography-multiple reaction monitoring mass spectrometry (LC-MRM MS) with corresponding stable isotope-labeled peptide standards (SIS). Thirteen potential markers of IUGR (Gelsolin, Alpha-2-macroglobulin, Apolipoprotein A-IV, Apolipoprotein B-100, Apolipoprotein(a), Adiponectin, Complement C5, Apolipoprotein D, Alpha-1B-glycoprotein, Serum albumin, Fibronectin, Glutathione peroxidase 3, Lipopolysaccharide-binding protein) were found to be inter-connected in a protein-protein network. These proteins are involved in plasma lipoprotein assembly, remodeling, and clearance; lipid metabolism, especially cholesterol and phospholipids; hemostasis, including platelet degranulation; and immune system regulation. Additionally, 18 proteins were specific to a particular type of IUGR (early or late). Distinct patterns in the coagulation and fibrinolysis systems were observed between isolated early- and late-onset IUGR. Our findings highlight the complex interplay of immune and coagulation factors in IUGR and the differences between early- and late-onset IUGR and other placenta-related conditions like PE. Understanding these mechanisms is crucial for developing targeted interventions and improving outcomes for pregnancies affected by IUGR.
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Affiliation(s)
- Natalia L. Starodubtseva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
- Moscow Institute of Physics and Technology, 141700 Moscow, Russia
| | - Alisa O. Tokareva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Maria V. Volochaeva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Alexey S. Kononikhin
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Alexander G. Brzhozovskiy
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Anna E. Bugrova
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, 119334 Moscow, Russia
| | - Angelika V. Timofeeva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Evgenii N. Kukaev
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
- V.L. Talrose Institute for Energy Problems of Chemical Physics, N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 119334 Moscow, Russia
| | - Victor L. Tyutyunnik
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Natalia E. Kan
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
| | - Vladimir E. Frankevich
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
- Laboratory of Translational Medicine, Siberian State Medical University, 634050 Tomsk, Russia
| | - Evgeny N. Nikolaev
- V.L. Talrose Institute for Energy Problems of Chemical Physics, N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 119334 Moscow, Russia
| | - Gennady T. Sukhikh
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (A.O.T.); (M.V.V.); (A.S.K.); (A.G.B.); (A.E.B.); (A.V.T.); (E.N.K.); (V.L.T.); (N.E.K.); (V.E.F.); (G.T.S.)
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29
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McCormack SE, Zemel BS. What's Past Is Prologue: Growth in Infants Born From Pregnancies Complicated by SARS-CoV-2 Infection. J Clin Endocrinol Metab 2023; 108:e1755-e1756. [PMID: 37061811 DOI: 10.1210/clinem/dgad219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/12/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Shana E McCormack
- Division of Endocrinology & Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Babette S Zemel
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
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30
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Rosario FJ, Urschitz J, Powell TL, Brown TL, Jansson T. Overexpression of the LAT1 in primary human trophoblast cells increases the uptake of essential amino acids and activates mTOR signaling. Clin Sci (Lond) 2023; 137:1651-1664. [PMID: 37861075 DOI: 10.1042/cs20230490] [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: 06/12/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/21/2023]
Abstract
The System L amino acid transporter, particularly the isoform Large Neutral Amino Acid Transporter Small Subunit 1 (LAT1) encoded by SLC7A5, is believed to mediate the transfer of essential amino acids in the human placenta. Placental System L amino acid transporter expression and activity is decreased in pregnancies complicated by IUGR and increased in fetal overgrowth. However, it remains unknown if changes in the expression of LAT1 are mechanistically linked to System L amino acid transport activity. Here, we combined overexpression approaches with protein analysis and functional studies in cultured primary human trophoblast (PHT) cells to test the hypothesis that SLC7A5 overexpression increases the uptake of essential amino acids and activates mTOR signaling in PHT cells. Overexpression of SLC7A5 resulted in a marked increase in protein expression of LAT1 in the PHT cells microvillous plasma membrane and System L amino acid transporter activity. Moreover, mTOR signaling was activated, and System A amino acid transporter activity increased following SLC7A5 overexpression, suggesting coordination of trophoblast amino transporter expression and activity to ensure balanced nutrient flux to the fetus. This is the first report showing that overexpression of LAT1 is sufficient to increase the uptake of essential amino acids in PHT cells, which activates mTOR, a master regulator of placental function. The decreased placental System L activity in human IUGR and the increased placental activity of this transporter system in some cases of fetal overgrowth may directly contribute to changes in fetal amino acid availability and altered fetal growth in these pregnancy complications.
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Affiliation(s)
- Fredrick J Rosario
- Department of Obstetrics and Gynecology, University of Colorado, Anschutz Medical Campus, Aurora, CO, U.S.A
| | - Johann Urschitz
- Institute for Biogenesis Research, University of Hawaii, Honolulu, HI, U.S.A
| | - Theresa L Powell
- Department of Obstetrics and Gynecology, University of Colorado, Anschutz Medical Campus, Aurora, CO, U.S.A
- Institute for Biogenesis Research, University of Hawaii, Honolulu, HI, U.S.A
| | - Thomas L Brown
- Section of Neonatology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, U.S.A
- Department of Neuroscience, Cell Biology, and Physiology, Wright State University Boonshoft School of Medicine, Dayton, OH, U.S.A
| | - Thomas Jansson
- Department of Obstetrics and Gynecology, University of Colorado, Anschutz Medical Campus, Aurora, CO, U.S.A
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Meneghelli M, Peruzzo A, Priante E, Cavicchiolo ME, Bonadies L, Moschino L, De Terlizzi F, Verlato G. Bone Status and Early Nutrition in Preterm Newborns with and without Intrauterine Growth Restriction. Nutrients 2023; 15:4753. [PMID: 38004147 PMCID: PMC10675104 DOI: 10.3390/nu15224753] [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] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Intrauterine growth restriction (IUGR) together with preterm birth could be harmful to bone health. The aim of the study was to examine bone status in IUGR versus non-IUGR preterms and to analyze the nutritional management best correlated with its improvement. Newborns < 34 weeks of gestational age (wGA), 75 IUGR and 75 non-IUGR, admitted to the Neonatal Intensive Care Unit of the University Hospital of Padova were enrolled and monitored from birth until 36 wGA through anthropometry (weight, length, head circumference, lower limb length (LLL)), biochemistry, bone quantitative ultrasound assessment of bone status (metacarpus bone transmission time, mc-BTT, us) and nutritional intakes monitoring during parenteral nutrition. IUGR compared to non-IUGR showed lower mean mc-BTT (0.45 vs. 0.51, p = 0.0005) and plasmatic phosphate (1.45 vs. 1.79, p < 0.001) at birth. Mc-BTT at 36 wGA, though equal between groups, correlated in IUGR newborns with basal phosphate, mean total energy of the first week and month (positively) and days to reach full enteral feeding (negatively). Lower i.v. vitamin D intake, LLL and prolonged total parenteral nutrition predicted worse mc-BTT at 36 wGA in the enrolled infants. These results suggest that preterms and in particular IUGR newborns need special nutritional care to promote bone development.
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Affiliation(s)
- Marta Meneghelli
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Andrea Peruzzo
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Elena Priante
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Maria Elena Cavicchiolo
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Laura Moschino
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | | | - Giovanna Verlato
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
- Paediatric Nutrition Service, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy
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Verspyck E, Thill C, Ego A, Machevin E, Brasseur-Daudruy M, Ickowicz V, Blondel C, Degré S, Lefebure A, Braund S, Benichou J. Screening for small for gestational age infants in early vs late third-trimester ultrasonography: a randomized trial. Am J Obstet Gynecol MFM 2023; 5:101162. [PMID: 37717697 DOI: 10.1016/j.ajogmf.2023.101162] [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] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Recent studies have demonstrated that a routine third-trimester ultrasound scan may improve the detection of small for gestational age infants when compared with clinically indicated ultrasound scans but with no reported reduction in severe perinatal morbidity. Establishing the optimal gestational age for the third-trimester examination necessitates evaluation of the ability to detect small for gestational age infants and to predict maternal and perinatal outcomes. Intrauterine growth restriction most often corresponds with small for gestational age infants associated with pathologic growth patterns. OBJECTIVE This study aimed to assess the performance of routine early ultrasound scans vs late ultrasound scans during the third trimester of pregnancy to identify small for gestational age infants and fetuses with intrauterine growth restriction. STUDY DESIGN This was an open-label, randomized, parallel trial conducted in Upper Normandy, France, from 2012 to 2015. The study eligibility criteria were heathy, nulliparous women older than 18 years with gestational age determined using the crown-rump length at the first trimester routine scan and with no fetal malformation or suspected small for gestational age fetus at the routine second trimester scan. Pregnant women were randomly assigned to a third-trimester scan group at 31 weeks gestational age ±6 days (early ultrasound scan) or at 35 weeks gestational age ±6 days (late ultrasound scan). The primary outcome of this trial was the ability of a third trimester scan to predict small for gestational age infants (customized birth weight <10th percentile) and intrauterine growth restriction (customized birth weight RESULTS Results from 1853 women assigned to the early ultrasound scan group and 1848 women assigned to the late ultrasound scan group were analyzed. The sensitivity was found to be higher in the late ultrasound scan group than in the early ultrasound scan group, both for identifying small for gestational age infants (27%; 22%-32% vs 17%; 13%-22%; P=.004) and intrauterine growth restriction (44%; 35%-54% vs 18%; 11%-27%; P<.001). There was little difference in the specificity between the late ultrasound scan and early ultrasound scan groups in identifying cases of small for gestational age (97%; 96%-98% and 98%; 97%-99%, respectively; P=.04) and intrauterine growth restriction (96%; 95%-97% and 97%; 96%;-97%, respectively; P=.24). Overall, the maternal and neonatal outcomes were comparable between the early ultrasound scan and late ultrasound scan groups with the exception of additional (at least 1) ultrasound scans performed (25% in the early ultrasound scan group vs 19% in the late ultrasound scan group; P<.001). Rates of perinatal death (0.4% vs 0.8%; P=.12) and adverse perinatal outcomes (1.8% vs 2.7%; P=.08) were comparable between the early ultrasound scan and late ultrasound scan assigned groups, and the overall sensitivity to detect small for gestational age infants and intrauterine growth restriction, including in the last ultrasound scan performed before delivery, were also similar (30%; 25%-36% vs 26%; 21%-31%; P=.23; and 50%; 40%-60% vs 38%; 28%-48%; P=.07). CONCLUSION A late ultrasound scan performed in the third trimester increases the probability of detecting small for gestational age infants and intrauterine growth restriction with fewer additional scans reported than for the early ultrasound scan group. The overall perinatal outcome risk was comparable between the 2 groups. However, the overall sensitivity for detecting small for gestational age fetuses and intrauterine growth restriction, including in the last ultrasound scan performed before delivery, remains comparable between the late ultrasound scan and early ultrasound scan groups.
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Affiliation(s)
- Eric Verspyck
- Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France (Drs Verspyck, Brasseur-Daudruy, Braund, and Benichou).
| | - Caroline Thill
- Department of Biostatistics, Rouen University Hospital, Rouen, France (Dr Thill)
| | - Anne Ego
- University Grenoble Alpes, CNRS, Public Health Department CHU Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG, 38000 Grenoble, France (Dr Ego); INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), FHU PREMA, Paris Descartes University, Paris, France (Dr Ego)
| | - Elise Machevin
- Department of Obstetrics and Gynecology, Evreux Hospital, Evreux, France (Dr Machevin)
| | - Marie Brasseur-Daudruy
- Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France (Drs Verspyck, Brasseur-Daudruy, Braund, and Benichou)
| | - Valentine Ickowicz
- Department of Obstetrics and Gynecology, Belvedere Hospital, Mont Saint Aignan, France (Dr Ickowicz)
| | - Caroline Blondel
- Department of Obstetrics and Gynecology, Mathilde Private Clinic, Rouen, France (Dr Blondel)
| | - Sophie Degré
- Department of Obstetrics and Gynecology, Le Havre Hospital, Le Havre, France (Dr Degré)
| | - Anne Lefebure
- Department of Obstetrics and Gynecology, Elbeuf Hospital, Elbeuf, France (Dr Lefebure)
| | - Sophia Braund
- Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France (Drs Verspyck, Brasseur-Daudruy, Braund, and Benichou)
| | - Jacques Benichou
- Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France (Drs Verspyck, Brasseur-Daudruy, Braund, and Benichou); Inserm U1018, University of Rouen and University Paris-Saclay, Rouen, France (Dr Benichou); Department of Biostatistics, Rouen University Hospital, Rouen, France (Dr Benichou)
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Jensen A, Neuhäuser G. Growth variables and obstetrical risk factors in newborns are associated with psychomotor development at preschool age. AJOG Glob Rep 2023; 3:100219. [PMID: 37719644 PMCID: PMC10504534 DOI: 10.1016/j.xagr.2023.100219] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Low birthweight resulting from preterm birth or fetal growth restriction is associated with poor neurocognitive development and child psychopathology affecting school performance and educational success. Prediction of developmental performance may therefore serve as a basis for early intervention strategies to improve educational success and mental health of our children in a timely manner. OBJECTIVE This study aimed to explore the predictive capacity of morphometric variables taken at birth and that of obstetrical risk factors to predict developmental performance at 4.3 (standard deviation, 0.8) years preschool age. We examined predicted Total psychomotor development score, predicted Developmental disability index, calculated Morphometric vitality index, and predicted Intelligence quotient, Maze test, and Neurologic examination optimality score in a large prospective screening (cranial ultrasound screening, n=5,301) and validation cohort (n=508,926). STUDY DESIGN In a single-center cohort observational study design (data collection done from 1984-1988, analysis done in 2022), a prospective cranial ultrasound screening study (1984-1988) was carried out on 5,301 live-born infants, including 571 (10.8%) preterm infants (≤36 weeks gestation), on the day of discharge of the mother at 5 to 8 days postpartum from a level 3 perinatal center. Predicted psychomotor development as assessed by predicted Total psychomotor development score, predicted Developmental disability index, calculated Morphometric vitality index, and predicted Intelligence quotient, Maze test, and Neurologic examination optimality score, was calculated. We related growth variables and obstetrical risk factors to Psychomotor development indices, and calculated Morphometric vitality index using odds ratios, receiver operating characteristics, analysis of variance, and multivariate analysis of variance. RESULTS The key result of our study is the observation that simple morphometric measures from newborns at birth like weight/head circumference ratio predict overall psychomotor development at 4.3 years (standard deviation, 0.8) of preschool age. Psychomotor development was assessed by predicted Total psychomotor development score, predicted Intelligence quotient, Maze test, and Neurologic examination optimality score, and related to weight/head circumference ratio in linear regression (P<.001) and ROC curve analyses (P<.001). Further, white matter damage strongly predicted adverse outcome in predicted Developmental disability index (P<.001). There was also a close correlation between calculated Morphometric vitality index and predicted Developmental disability index (P<.001). Finally, brain body weight ratio, weight/head circumference ratio, preterm birth, reduced Apgar at 10 minutes, weight/length ratio, and white matter damage yielded highest odds ratios for adverse outcome in predicted Total psychomotor development score and in predicted Developmental disability index (P<.001) and high effect sizes in reduced predicted Intelligence quotient, Maze test, and Neurologic examination optimality scores. CONCLUSION Simple morphometric data, birth variables, and obstetrical risk factors bear predictive capacity for neurocognitive performance in children at 4.3 years (standard deviation, 0.8) of age and hence provide a basis for parental consultation and early intervention to improve school performance, educational success, and mental health in developed and developing countries.
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Affiliation(s)
- Arne Jensen
- Campus Clinic Gynecology, Ruhr-University Bochum, Bochum, Germany (Dr Jensen)
| | - Gerhard Neuhäuser
- Department of Paediatric Neurology, University of Giessen, Giessen, Germany (Dr Neuhäuser)
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Mylrea-Foley B, Napolitano R, Gordijn S, Wolf H, Lees CC, Stampalija T. Do differences in diagnostic criteria for late fetal growth restriction matter? Am J Obstet Gynecol MFM 2023; 5:101117. [PMID: 37544409 DOI: 10.1016/j.ajogmf.2023.101117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Criteria for diagnosis of fetal growth restriction differ widely according to national and international guidelines, and further heterogeneity arises from the use of different biometric and Doppler reference charts, making the diagnosis of fetal growth restriction highly variable. OBJECTIVE This study aimed to compare fetal growth restriction definitions between Delphi consensus and Society for Maternal-Fetal Medicine definitions, using different standards/charts for fetal biometry and different reference ranges for Doppler velocimetry parameters. STUDY DESIGN From the TRUFFLE 2 feasibility study (856 women with singleton pregnancy at 32+0 to 36+6 weeks of gestation and at risk of fetal growth restriction), we selected 564 women with available mid-pregnancy biometry. For the comparison, we used standards/charts for estimated fetal weight and abdominal circumference from Hadlock, INTERGROWTH-21st, and GROW and Chitty. Percentiles for umbilical artery pulsatility index and its ratios with middle cerebral artery pulsatility index were calculated using Arduini and Ebbing reference charts. Sensitivity and specificity for low birthweight and adverse perinatal outcome were evaluated. RESULTS Different combinations of definitions and reference charts identified substantially different proportions of fetuses within our population as having fetal growth restriction, varying from 38% (with Delphi consensus definition, INTERGROWTH-21st biometric standards, and Arduini Doppler reference ranges) to 93% (with Society for Maternal-Fetal Medicine definition and Hadlock biometric standards). None of the different combinations tested appeared effective, with relative risk for birthweight <10th percentile between 1.4 and 2.1. Birthweight <10th percentile was observed most frequently when selection was made with the GROW/Chitty charts, slightly less with the Hadlock standard, and least frequently with the INTERGROWTH-21st standard. Using the Ebbing Doppler reference ranges resulted in a far higher proportion identified as having fetal growth restriction compared with the Arduini Doppler reference ranges, whereas Delphi consensus definition with Ebbing Doppler reference ranges produced similar results to those of the Society for Maternal-Fetal Medicine definition. Application of Delphi consensus definition with Arduini Doppler reference ranges was significantly associated with adverse perinatal outcome, with any biometric standards/charts. The Society for Maternal-Fetal Medicine definition could not accurately detect adverse perinatal outcome irrespective of estimated fetal weight standard/chart used. CONCLUSION Different combinations of fetal growth restriction definitions, biometry standards/charts, and Doppler reference ranges identify different proportions of fetuses with fetal growth restriction. The difference in adverse perinatal outcome may be modest, but can have a significant impact in terms of rate of intervention.
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Affiliation(s)
- Bronacha Mylrea-Foley
- Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom (Drs Mylrea-Foley and Lees); Department of Fetal Medicine, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom (Drs Mylrea-Foley and Lees)
| | - Raffaele Napolitano
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom (Dr Napolitano); Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, United Kingdom (Dr Napolitano)
| | - Sanne Gordijn
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (Dr Gordijn)
| | - Hans Wolf
- Department of Obstetrics and Gynecology, Amsterdam University Medical Center (Location AMC), University of Amsterdam, Amsterdam, The Netherlands (Dr Wolf)
| | - Christoph C Lees
- Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom (Drs Mylrea-Foley and Lees); Department of Fetal Medicine, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom (Drs Mylrea-Foley and Lees).
| | - Tamara Stampalija
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy (Dr Stampalija); Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy (Dr Stampalija)
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Singh A, Jaiswar SP, Priyadarshini A, Deo S. Linking of oxidative stress and mitochondrial DNA damage to the pathophysiology of idiopathic intrauterine growth restriction. Int J Health Sci (Qassim) 2023; 17:15-22. [PMID: 37929235 PMCID: PMC10624804] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Objective A common and serious pregnancy issue known as intrauterine growth restriction (IUGR) occurs when the fetus is unable to reach its full growth potential. Mitochondria are crucial to the development of the fetus and the placenta. We aimed to elucidate the role of oxidative stress parameters and markers of DNA damage. The integrity of the mitochondrial DNA (mtDNA) was studied. Materials and Methods Blood samples were collected from 48 females (cases and controls, respectively). Oxidative stress parameters were analyzed. DNA was extracted followed by high-performance liquid chromatography to study 8-OH-dG and mt DNA by real-time polymerase chain reaction. Western blot analysis was performed for nuclear-encoded mitochondrial proteins and DNA damage markers. Results When pregnant women were compared to non-pregnant women in their first, second, and third trimesters, a highly significant progressive drop in circulating mtDNA was found. In addition, mtDNA was considerably higher in mothers carrying IUGR fetuses than in healthy pregnancies. Sirtuin-3 protein expression was considerably suppressed in the IUGR placenta (P = 0.027), whereas Nrf1 expression was not statistically different from the control group in the IUGR. Increased oxidative stress led to greater DNA damage in IUGR. The highest concentrations of 8-OH-dG were found in IUGR with levels significantly higher than those in the non-pregnant group. Conclusion Our research sets the path for further investigation into mitochondrial anomalies in IUGR pregnancies and offers evidence for disturbed mitochondrial homeostasis. The mtDNA might offer a fresh perspective on the processes involved in physiological gestation. In addition, the presence of mtDNA may aid in the diagnosis of IUGR during pregnancy.
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Affiliation(s)
- Apurva Singh
- Department of Obstetrics and Gynecology, KGMU, Lucknow, Uttar Pradesh, India
- Photobiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Shyam Pyari Jaiswar
- Department of Obstetrics and Gynecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Apala Priyadarshini
- Department of Obstetrics and Gynecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Sujata Deo
- Department of Obstetrics and Gynecology, KGMU, Lucknow, Uttar Pradesh, India
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Zhao W, Kelly AC, Luna-Ramirez RI, Bidwell CA, Anderson MJ, Limesand SW. Decreased Pyruvate but Not Fatty Acid Driven Mitochondrial Respiration in Skeletal Muscle of Growth Restricted Fetal Sheep. Int J Mol Sci 2023; 24:15760. [PMID: 37958743 PMCID: PMC10648961 DOI: 10.3390/ijms242115760] [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: 09/22/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
Fetuses with intrauterine growth restriction (FGR) have impaired oxidative and energy metabolism, with persistent consequences on their postnatal development. In this study, we test the hypothesis that FGR skeletal muscle has lower mitochondrial respiration rate and alters the transcriptomic profiles associated with energy metabolism in an ovine model. At late gestation, mitochondrial oxygen consumption rates (OCRs) and transcriptome profiles were evaluated in the skeletal muscle collected from FGR and control fetuses. The ex vivo mitochondrial OCRs were reduced (p < 0.01) in permeabilized FGR soleus muscle compared to the control muscle but only with pyruvate as the metabolic substrate. Mitochondrial OCRs were similar between the FGR and control groups for palmitoyl-carnitine (fatty acid-driven) or pyruvate plus palmitoyl-carnitine metabolic substrates. A total of 2284 genes were differentially expressed in the semitendinosus muscle from growth restricted fetuses (false discovery rate (FDR) ≤ 0.05). A pathway analysis showed that the upregulated genes (FGR compared to control) were overrepresented for autophagy, HIF-1, AMPK, and FOXO signaling pathways (all with an FDR < 0.05). In addition, the expression of genes modulating pyruvate's entry into the TCA cycle was downregulated, whereas the genes encoding key fatty acid oxidation enzymes were upregulated in the FGR muscle. These findings show that FGR skeletal muscle had attenuated mitochondrial pyruvate oxidation, possibly associated with the inability of pyruvate to enter into the TCA cycle, and that fatty acid oxidation might compensate for the attenuated energy metabolism. The current study provided phenotypic and molecular evidence for adaptive deficiencies in FGR skeletal muscle.
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Affiliation(s)
- Weicheng Zhao
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ 85719, USA; (W.Z.); (A.C.K.); (R.I.L.-R.); (M.J.A.)
| | - Amy C. Kelly
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ 85719, USA; (W.Z.); (A.C.K.); (R.I.L.-R.); (M.J.A.)
| | - Rosa I. Luna-Ramirez
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ 85719, USA; (W.Z.); (A.C.K.); (R.I.L.-R.); (M.J.A.)
| | | | - Miranda J. Anderson
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ 85719, USA; (W.Z.); (A.C.K.); (R.I.L.-R.); (M.J.A.)
| | - Sean W. Limesand
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ 85719, USA; (W.Z.); (A.C.K.); (R.I.L.-R.); (M.J.A.)
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Amdi C, Larsen C, Jensen KMR, Tange EØ, Sato H, Williams AR. Intrauterine growth restriction in piglets modulates postnatal immune function and hepatic transcriptional responses independently of energy intake. Front Physiol 2023; 14:1254958. [PMID: 37916220 PMCID: PMC10617784 DOI: 10.3389/fphys.2023.1254958] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction: Insufficient prenatal nutrition can affect fetal development and lead to intrauterine growth restriction (IUGR). The aim of this study was to investigate hepatic transcriptional responses and innate immune function in piglets suffering from IUGR compared to normal-sized piglets at 3 days of age and explore whether the provision of an energy-rich supplement at birth could modulate these parameters. Methods: A total of 68 piglets were included in the study. Peripheral blood mononuclear cells were harvested for LPS stimulation, and organs were harvested post-mortem to quantify relative weights. Liver tissue was utilized for RNA sequencing coupled with gene-set enrichment analysis. Results: IUGR resulted in increased expression of genes such as PDK4 and substantial alterations in transcriptional pathways related to metabolic activity (e.g., citric acid and Krebs cycles), but these changes were equivalent in piglets given an energy-rich supplement or not. Transcriptomic analysis and serum biochemistry suggested altered glucose metabolism and a shift toward oxidation of fatty acids. IUGR piglets also exhibited suppression of genes related to innate immune function (e.g., CXCL12) and pathways related to cell proliferation (e.g., WNT and PDGF signaling). Moreover, they produced less IL-1β in response to LPS stimulation and had lower levels of blood eosinophils than normal-sized piglets. Discussion: Taken together, our results indicate that IUGR results in early-life alterations in metabolism and immunity that may not be easily restored by the provision of exogenous energy supplementation.
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Affiliation(s)
- C. Amdi
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Powel JE, Chavan NR, Zantow EW, Bialko MF, Farley LG, McCormick KM, Tomlinson TM. Risk of adverse perinatal outcomes in pregnancies with "small" fetuses not meeting Delphi consensus criteria for fetal growth restriction. Am J Obstet Gynecol 2023; 229:447.e1-447.e13. [PMID: 37767605 DOI: 10.1016/j.ajog.2023.04.037] [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] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Previous research endeavors examining the association between clinical characteristics, sonographic indices, and the risk of adverse perinatal outcomes in pregnancies complicated by fetal growth restriction have been hampered by a lack of agreement regarding its definition. In 2016, a consensus definition was reached by an international panel of experts via the Delphi procedure, but as it currently stands, this has not been endorsed by all professional organizations. OBJECTIVE This study aimed to assess whether an independent association exists between estimated fetal weight and/or abdominal circumference of <10th percentile and adverse perinatal outcomes when consensus criteria for growth restriction are not met. STUDY DESIGN Data were derived from a passive prospective cohort of singleton nonanomalous pregnancies at a single academic tertiary care institution (2010-2022) that fell into 3 groups: (1) consecutive fetuses that met the Delphi criteria for fetal growth restriction, (2) small-for-gestational-age fetuses that failed to meet the consensus criteria, and (3) fetuses with birthweights of 20th to 80th percentile randomly selected as an appropriately grown (appropriate-for-gestational-age) comparator group. This nested case-control study used 1:1 propensity score matching to adjust for confounders among the 3 groups: fetal growth restriction cases, small-for-gestational-age cases, and controls. Our primary outcome was a composite: perinatal demise, 5-minute Apgar score of <7, cord pH of ≤7.10, or base excess of ≥12. Pregnancy characteristics with a P value of <.2 on univariate analyses were considered for incorporation into a multivariable model along with fetal growth restriction and small-for-gestational-age to evaluate which outcomes were independently predictive of adverse perinatal outcomes. RESULTS Overall, 2866 pregnancies met the inclusion criteria. After propensity score matching, there were 2186 matched pairs, including 511 (23%), 1093 (50%), and 582 (27%) patients in the small-for-gestational-age, appropriate-for-gestational-age, and fetal growth restriction groups, respectively. Moreover, 210 pregnancies (10%) were complicated by adverse perinatal outcomes. None of the pregnancies with small-for-gestational-age OR appropriate-for-gestational-age fetuses resulted in perinatal demise. Twenty-three of 511 patients (5%) in the small-for-gestational-age group had adverse outcomes based on 5-minute Apgar scores and/or cord gas results compared with 77 of 1093 patients (7%) in the appropriate-for-gestational-age group (odds ratio, 0.62; 95% confidence interval, 0.39-1.00). Furthermore, 110 of 582 patients (19%) with fetal growth restriction that met the consensus criteria had adverse outcomes (odds ratio, 3.08; 95% confidence interval, 2.25-4.20), including 34 patients with perinatal demise or death before discharge. Factors independently associated with increased odds of adverse outcomes included chronic hypertension, hypertensive disorders of pregnancy, and early-onset fetal growth restriction. Small-for-gestational age was not associated with the primary outcome after adjustment for 6 other factors included in a model predicting adverse perinatal outcomes. The bias-corrected bootstrapped area under the receiver operating characteristic curve for the model was 0.72 (95% confidence interval, 0.66-0.74). The bias-corrected bootstrapped area under the receiver operating characteristic curve for a 7-factor model predicting adverse perinatal outcomes was 0.72 (95% confidence interval, 0.66-0.74). CONCLUSION This study found no evidence that fetuses with an estimated fetal weight and/or abdominal circumference of 3rd to 9th percentile that fail to meet the consensus criteria for fetal growth restriction (based on Doppler waveforms and/or growth velocity of ≥32 weeks) are at increased risk of adverse outcomes. Although the growth of these fetuses should be monitored closely to rule out evolving growth restriction, most cases are healthy constitutionally small fetuses. The management of these fetuses in the same manner as those with suspected pathologic growth restriction may result in unnecessary antenatal testing and increase the risk of iatrogenic complications resulting from preterm or early term delivery of small fetuses that are at relatively low risk of adverse perinatal outcomes.
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Affiliation(s)
- Jennifer E Powel
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, MO
| | - Niraj R Chavan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, MO
| | - Emily W Zantow
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, MO
| | - Matthew F Bialko
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, MO
| | | | | | - Tracy M Tomlinson
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, MO.
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AbdelHafez FF, Klausen C, Zhu H, Yi Y, Leung PCK. Growth differentiation factor myostatin regulates epithelial-mesenchymal transition genes and enhances invasion by increasing serine protease inhibitors E1 and E2 in human trophoblast cells. FASEB J 2023; 37:e23204. [PMID: 37738042 DOI: 10.1096/fj.202300740r] [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: 04/14/2023] [Revised: 06/21/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
Placental insufficiency disorders, including preeclampsia and intrauterine growth restriction, are major obstetric complications that can have devastating effects on both the mother and the fetus. These syndromes have underlying poor placental trophoblast cell invasion into uterine tissues. Placental invasion is controlled by many hormones and growth factors. Myostatin (MSTN) is a transforming growth factor-β superfamily member recognized for its important role in muscle growth control. MSTN has also been shown to be secreted and functioning in the placenta, and its serum and/or placental levels were found to be upregulated in preeclampsia and intrauterine growth restriction. Considering that the mechanistic role of MSTN in placentation remains poorly understood, we hypothesized that MSTN uses ALK4/5-SMAD2/3/4 signaling to increase human trophoblast invasion through a group of epithelial-mesenchymal transition genes including SERPINE2, PAI-1, and SOX4. mRNA sequencing of control and MSTN-treated primary human trophoblast cells (n = 5) yielded a total of 610 differentially expressed genes (false discovery rate <0.05) of which 380 genes were upregulated and 230 were downregulated. These differentially expressed genes were highly enriched in epithelial-mesenchymal transition genes, and a subset including SERPINE2, PAI-1, and SOX4 was investigated for its role in MSTN-induced trophoblast cell invasion. We found that MSTN induced upregulation of SERPINE2 via ALK4/5-SMAD2/3/4 signaling; however, SMAD2 was not involved in MSTN-induced PAI-1 upregulation. SOX4 was involved in MSTN-induced upregulation of SERPINE2, but not PAI-1. Collectively, this study discovers novel molecular mechanisms of MSTN-induced human trophoblast cell invasion and provides insight into the functional consequences of its dysregulation in placental insufficiency disorders.
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Affiliation(s)
- Faten F AbdelHafez
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Christian Klausen
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hua Zhu
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yuyin Yi
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter C K Leung
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
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Calek E, Binder J, Palmrich P, Eibensteiner F, Thajer A, Kainz T, Harreiter K, Berger A, Binder C. Effects of Intrauterine Growth Restriction (IUGR) on Growth and Body Composition Compared to Constitutionally Small Infants. Nutrients 2023; 15:4158. [PMID: 37836441 PMCID: PMC10574227 DOI: 10.3390/nu15194158] [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] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Intrauterine growth restriction (IUGR) is associated with multiple morbidities including growth restriction and impaired neurodevelopment. Small for gestational age (SGA) is defined as a birth weight <10th percentile, regardless of the etiology. The term is commonly used as a proxy for IUGR, but it may represent a healthy constitutionally small infant. Differentiating between IUGR and constitutionally small infants is essential for the nutritional management. (2) Infants born at <37 weeks of gestation between 2017 and 2022, who underwent body composition measurement (FFM: fat-free mass; FM: fat mass) at term-equivalent age, were included in this study. Infants with IUGR and constitutionally small infants (SGA) were compared to infants appropriate for gestational age (AGA). (3) A total of 300 infants (AGA: n = 249; IUGR: n = 40; SGA: n = 11) were analyzed. FFM (p < 0.001) and weight growth velocity (p = 0.022) were significantly lower in IUGR compared to AGA infants, but equal in SGA and AGA infants. FM was not significantly different between all groups. (4) The FFM Z-score was significantly lower in IUGR compared to AGA infants (p = 0.017). Being born constitutionally small compared to AGA had no impact on growth and body composition. These data showed that early aggressive nutritional management is essential in IUGR infants to avoid impaired growth and loss of FFM.
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Affiliation(s)
- Elisabeth Calek
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.C.); (A.T.); (T.K.); (K.H.); (A.B.)
| | - Julia Binder
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (J.B.); (P.P.)
| | - Pilar Palmrich
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (J.B.); (P.P.)
| | - Felix Eibensteiner
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Alexandra Thajer
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.C.); (A.T.); (T.K.); (K.H.); (A.B.)
| | - Theresa Kainz
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.C.); (A.T.); (T.K.); (K.H.); (A.B.)
| | - Karin Harreiter
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.C.); (A.T.); (T.K.); (K.H.); (A.B.)
| | - Angelika Berger
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.C.); (A.T.); (T.K.); (K.H.); (A.B.)
| | - Christoph Binder
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.C.); (A.T.); (T.K.); (K.H.); (A.B.)
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Paz Y Miño MF, Pauta M, Meler E, Matas I, Mazarico E, Camacho A, Segura M, Figueras F, Borrell A. Postnatal genetic and neurodevelopmental assessment in infants born at term with severely low birth weight of non-placental origin. Ultrasound Obstet Gynecol 2023; 62:361-368. [PMID: 36840980 DOI: 10.1002/uog.26188] [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] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine the frequency of genetic syndromes and childhood neurodevelopmental impairment in non-malformed infants born at term with severely low birth weight and no evidence of placental insufficiency. METHODS This case series was constructed from the data of infants delivered at term between 2013 and 2018 with severely low birth weight, defined as birth weight more than 2.5 SD below the mean, with normal maternal and fetal Doppler (umbilical artery, fetal middle cerebral artery, cerebroplacental ratio and uterine artery) and no maternal hypertensive disorder during pregnancy or fetal structural anomaly on prenatal ultrasound examination. Clinical exome sequencing and copy number variation (CNV) analysis were performed using DNA extracted from the children's saliva. Cognitive and psychomotor development was evaluated using the Bayley Scales of Infant and Toddler Development, 3rd edition or the Wechsler Intelligence Scale for Children, 5th edition tests, according to the child's age at testing. RESULTS Among the 36 405 infants born within the study period, 274 (0.75%) had a birth weight below -2.5 SD, of whom 98 met the inclusion criteria. Among the 63 families contacted, seven (11%) reported a postnatal diagnosis of a genetic syndrome and a further 18 consented to participate in the study. Median gestational age at delivery was 38.0 (interquartile range (IQR), 37.3-38.5) weeks and median birth weight was 2020 (IQR, 1908-2248) g. All 18 children showed a normal result on clinical exome sequencing and CNV analysis, but six (33%) obtained a low score on neurodevelopmental testing. CONCLUSION Non-malformed severely small term infants with no clinical or Doppler signs of placental insufficiency present a high rate of genetic syndromes and neurodevelopmental impairment during childhood. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M F Paz Y Miño
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic Barcelona and Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - M Pauta
- IDIBAPS, University of Barcelona, Fetal i+D Fetal Medicine Research, Barcelona, Catalonia, Spain
| | - E Meler
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic Barcelona and Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - I Matas
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic Barcelona and Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - E Mazarico
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic Barcelona and Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - A Camacho
- Mental Health and Perinatal Nursing, Hospital Clínic Barcelona, Barcelona, Catalonia, Spain
| | - M Segura
- qGenomics, Esplugues de Llobregat, Catalonia, Spain
| | - F Figueras
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic Barcelona and Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
- IDIBAPS, University of Barcelona, Fetal i+D Fetal Medicine Research, Barcelona, Catalonia, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - A Borrell
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic Barcelona and Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
- IDIBAPS, University of Barcelona, Fetal i+D Fetal Medicine Research, Barcelona, Catalonia, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Catalonia, Spain
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White MR, Yates DT. Dousing the flame: reviewing the mechanisms of inflammatory programming during stress-induced intrauterine growth restriction and the potential for ω-3 polyunsaturated fatty acid intervention. Front Physiol 2023; 14:1250134. [PMID: 37727657 PMCID: PMC10505810 DOI: 10.3389/fphys.2023.1250134] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/14/2023] [Indexed: 09/21/2023] Open
Abstract
Intrauterine growth restriction (IUGR) arises when maternal stressors coincide with peak placental development, leading to placental insufficiency. When the expanding nutrient demands of the growing fetus subsequently exceed the capacity of the stunted placenta, fetal hypoxemia and hypoglycemia result. Poor fetal nutrient status stimulates greater release of inflammatory cytokines and catecholamines, which in turn lead to thrifty growth and metabolic programming that benefits fetal survival but is maladaptive after birth. Specifically, some IUGR fetal tissues develop enriched expression of inflammatory cytokine receptors and other signaling cascade components, which increases inflammatory sensitivity even when circulating inflammatory cytokines are no longer elevated after birth. Recent evidence indicates that greater inflammatory tone contributes to deficits in skeletal muscle growth and metabolism that are characteristic of IUGR offspring. These deficits underlie the metabolic dysfunction that markedly increases risk for metabolic diseases in IUGR-born individuals. The same programming mechanisms yield reduced metabolic efficiency, poor body composition, and inferior carcass quality in IUGR-born livestock. The ω-3 polyunsaturated fatty acids (PUFA) are diet-derived nutraceuticals with anti-inflammatory effects that have been used to improve conditions of chronic systemic inflammation, including intrauterine stress. In this review, we highlight the role of sustained systemic inflammation in the development of IUGR pathologies. We then discuss the potential for ω-3 PUFA supplementation to improve inflammation-mediated growth and metabolic deficits in IUGR offspring, along with potential barriers that must be considered when developing a supplementation strategy.
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Affiliation(s)
| | - Dustin T. Yates
- Stress Physiology Laboratory, Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE, United States
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Lip-Sosa DL, Pérez-Cruz M, Ahumada-Droguett P, Ribas-Prats T, Puertollano M, García-Gómez MA, Mazarico E, Eixarch E, Escera C, Gómez-Roig MD. Corpus callosum-fastigium and tectal lengths in late-onset small fetuses. Ultrasound Obstet Gynecol 2023; 62:226-233. [PMID: 36722073 DOI: 10.1002/uog.26169] [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] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 11/19/2022] [Accepted: 12/06/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To investigate measurements on neurosonography of midbrain morphology, including corpus callosum-fastigium length and tectal length, in late-onset small fetuses subclassified as small-for-gestational-age (SGA) or growth-restricted (FGR). METHODS This was a case-control study of consecutive singleton pregnancies delivered at term at a single center between January 2019 and July 2021, including those with late-onset smallness (estimated fetal weight (EFW) < 10th centile) and appropriate-for-gestational-age controls matched by age at neurosonography. Small fetuses were further subdivided into SGA (EFW between 3rd and 9th centile and normal fetoplacental Doppler) and FGR (EFW < 3rd centile or EFW < 10th centile with abnormal cerebroplacental ratio and/or uterine artery Doppler). Transvaginal neurosonography was performed at a mean ± SD gestational age of 33 ± 1 weeks in all fetuses to evaluate corpus callosum-fastigium length and tectal length in the midsagittal plane. Intra- and interobserver agreement was evaluated using the intraclass correlation coefficient and Bland-Altman plots. RESULTS A total of 70 fetuses with late-onset smallness (29 with SGA and 41 with FGR) and 70 controls were included. Compared with controls, small fetuses showed significantly shorter corpus callosum-fastigium length (median (interquartile range), 44.7 (43.3-46.8) mm vs 43.7 (42.4-45.5) mm, P < 0.001) and tectal length (mean ± SD, 10.5 ± 0.9 vs 9.6 ± 1.0 mm, P < 0.001). These changes were more prominent in FGR fetuses, with a linear trend across groups according to severity of smallness. Corpus callosum-fastigium length and tectal length measurements showed excellent intra- and interobserver reliability. CONCLUSIONS Small fetuses exhibited shorter corpus callosum-fastigium length and tectal length compared with controls, and these differences were more pronounced in fetuses with more severe smallness. These findings illustrate the potential value of midbrain measurements assessed on neurosonography as biomarkers for brain development in a high-risk population. However, further studies correlating these parameters with postnatal functional tests and follow-up are needed. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D L Lip-Sosa
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - M Pérez-Cruz
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, Madrid, Spain
| | - P Ahumada-Droguett
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - T Ribas-Prats
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Brainlab-Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - M Puertollano
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Brainlab-Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - M A García-Gómez
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - E Mazarico
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, Madrid, Spain
| | - E Eixarch
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| | - C Escera
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Brainlab-Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - M D Gómez-Roig
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, Madrid, Spain
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Whitlock AE, Moskowitzova K, Kycia I, Zurakowski D, Fauza DO. Morphometric, Developmental, and Anti-Inflammatory Effects of Transamniotic Stem Cell Therapy (TRASCET) on the Fetal Heart and Lungs in a Model of Intrauterine Growth Restriction. Stem Cells Dev 2023; 32:484-490. [PMID: 37358376 DOI: 10.1089/scd.2023.0040] [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] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Transamniotic stem cell therapy (TRASCET) with mesenchymal stem cells (MSCs) can attenuate placental inflammation and minimize intrauterine growth restriction (IUGR). We sought to determine whether MSC-based TRASCET could mitigate fetal cardiopulmonary effects of IUGR. Pregnant Sprague-Dawley dams were exposed to alternating 12-h hypoxia (10.5% O2) cycles in the last fourth of gestation. Their fetuses (n = 155) were divided into 4 groups. One group remained untreated (n = 42), while three groups received volume-matched intra-amniotic injections of either saline (sham; n = 34), or of syngeneic amniotic fluid-derived MSCs, either in their native state (TRASCET; n = 36) or "primed" by exposure to interferon-gamma and interleukin-1beta before administration in vivo (TRASCET-primed; n = 43). Normal fetuses served as additional controls (n = 30). Multiple morphometric and biochemical analyses were performed at term for select markers of cardiopulmonary development and inflammation previously shown to be affected by IUGR. Among survivors (75%; 117/155), fetal heart-to-body weight ratio was increased in both the sham and untreated groups (P < 0.001 for both) but normalized in the TRASCET and TRASCET-primed groups (P = 0.275, 0.069, respectively). Cardiac b-type natriuretic peptide levels were increased in all hypoxia groups compared with normal (P < 0.001), but significantly decreased from sham and untreated in both TRASCET groups (P < 0.0001-0.005). Heart tumor necrosis factor-alpha levels were significantly elevated in sham and TRASCET groups (P = 0.009, 0.002), but normalized in the untreated and TRASCET-primed groups (P = 0.256, 0.456). Lung transforming growth factor-beta levels were significantly increased in both sham and untreated groups (P < 0.001, 0.003), but normalized in both TRASCET groups (P = 0.567, 0.303). Similarly, lung endothelin-1 levels were elevated in sham and untreated groups (P < 0.001 for both), but normalized in both TRASCET groups (P = 0.367, 0.928). We conclude that TRASCET with MSCs decreases markers of fetal cardiac strain, insufficiency, and inflammation, as well as of pulmonary fibrosis and hypertension in the rodent model of IUGR.
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Affiliation(s)
- Ashlyn E Whitlock
- Department of Surgery, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Kamila Moskowitzova
- Department of Surgery, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Ina Kycia
- Department of Surgery, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - David Zurakowski
- Department of Surgery, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Dario O Fauza
- Department of Surgery, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
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Shen J, Li J, Tao X, Feng Y, Li B. Antenatal diagnosis and management of pregnancy luteoma: A case report and literature review. Medicine (Baltimore) 2023; 102:e34521. [PMID: 37505122 PMCID: PMC10378968 DOI: 10.1097/md.0000000000034521] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Pregnancy luoteomas are tumor-like ovarian lesions that emerge during pregnancy and spontaneously regress after delivery. Antenatal diagnosis is infrequently reported, and unnecessary surgery appears to be common in literature reports. CASE SUMMARY A 28-year-old primigravida with bilateral adnexal masses was discovered at 32 + 5 weeks during prenatal ultrasound evaluation. Combined with clinical presentation, auxiliary examinations including blood test, magnetic resonance imaging, gastroscopy, and consultation of multi-disciplinary team, we successfully made a diagnosis of pregnancy luteoma and provided conservative management recommendations. A cesarean section was conducted on this patient at 34 + 2 weeks of gestation due to fetal distress. The newborn was small for gestational age but normal in appearance. We performed biopsies of the adnexal masses, which were confirmed to be pregnancy luteomas using both intraoperative frozen section and final pathological diagnosis. Serum testosterone, cancer antigen 125, and alpha-fetoprotein levels gradually declined and normalized on postoperative day 28. The masses significantly decreased in size as shown by ultrasonic and magnetic resonance imaging examination on postoperative day 7, with the ovaries returning to their normal size by postoperative day 30. CONCLUSION Prenatal diagnosis of pregnancy luteoma poses a challenge, requiring hormonal examinations, ultrasound, magnetic resonance imaging, and gastrointestinal endoscopy for identification. Caution must be exercised to avoid overtreatment. While additional cases are needed to summarize the imaging features and effects of excess hormones on the both mother and fetus, further research is necessary for a comprehensive understanding.
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Affiliation(s)
- Junhua Shen
- Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, P.R. China
| | - Jingyi Li
- Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Xia Tao
- Department of Ultrasonography, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Yan Feng
- Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, P.R. China
| | - Baohua Li
- Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
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Domingues RR, Wiltbank MC, Hernandez LL. Maternal serotonin: implications for the use of selective serotonin reuptake inhibitors during gestation†. Biol Reprod 2023; 109:17-28. [PMID: 37098165 PMCID: PMC10344603 DOI: 10.1093/biolre/ioad046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/06/2023] [Revised: 04/10/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023] Open
Abstract
Maternal use of antidepressants has increased throughout the last decades; selective serotonin reuptake inhibitors (SSRI) are the most prescribed antidepressants. Despite the widespread use of SSRI by women during reproductive age and pregnant women, an increasing amount of research warns of possible detrimental effects of maternal use of SSRI during pregnancy including low birthweight/small for gestational age and preterm birth. In this review, we revisited the impact of maternal use of SSRI during pregnancy, its impact on serotonin homeostasis in the maternal and fetal circulation and the placenta, and its impact on pregnancy outcomes-particularly intrauterine growth restriction and preterm birth. Maternal use of SSRI increases maternal and fetal serotonin. The increase in maternal circulating serotonin and serotonin signaling likely promotes vasoconstriction of the uterine and placental vascular beds decreasing blood perfusion to the uterus and consequently to the placenta and fetus with potential impact on placental function and fetal development. Several adverse pregnancy outcomes are similar between women, sheep, and rodents (decreased placental size, decreased birthweight, shorter gestation length/preterm birth, neonatal morbidity, and mortality) highlighting the importance of animal studies to assess the impacts of SSRI. Herein, we address the complex interactions between maternal SSRI use during gestation, circulating serotonin, and the regulation of blood perfusion to the uterus and fetoplacental unit, fetal growth, and pregnancy complications.
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Affiliation(s)
- Rafael R Domingues
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Endocrinology and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Milo C Wiltbank
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Endocrinology and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laura L Hernandez
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Endocrinology and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Dogan Z, Guven ESG, Albayrak M, Guven S. Prenatal Sonographic Three-dimensional Virtual Organ Computer-assisted Analysis Thymic Volume Calculation May Predict Intrauterine Growth Restriction. J Med Ultrasound 2023; 31:201-205. [PMID: 38019797 PMCID: PMC10668909 DOI: 10.4103/jmu.jmu_34_22] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/16/2022] [Accepted: 08/29/2022] [Indexed: 12/01/2023] Open
Abstract
Background Intrauterine growth restriction (IUGR) refers to fetuses that are small for their gestational age. There is no effective test to predict this disease. The aim of our study is whether fetal three-dimensional (3D) ultrasonography (USG)-assisted thymus volume (TV) measurement predicts IUGR cases. Methods Fetal 3D USG thymus measurement between 15 and 24 weeks of gestation was performed in a total of 100 women of reproductive age. Fetal TV was measured using the virtual organ computer-assisted analysis system program. All cases were followed up in terms of pregnancy complications until delivery. Results IUGR was developed in six cases in total. In cases with IUGR, mean fetal TV was found to be statistically significantly lower than in healthy cases without it. When the fetal TV was taken as 0.1645, the sensitivity was calculated as 89.5% and the specificity as 50% for predicting IUGR. The use of low fetal volume parameters is a significant and good indicator for predicting IUGR according to the binary logistic regression analysis result. Conclusion According to the results of this study, 3D fetal TV measurement may be used in routine second-trimester sonographic anomaly screening to predict the development of fetal IUGR. In this way, fetal mortality and morbidity caused by IUGR may be reduced.
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Affiliation(s)
- Zeki Dogan
- Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Emine Seda Guvendag Guven
- Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Albayrak
- Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Suleyman Guven
- Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Taeidi E, Ranjbar A, Montazeri F, Mehrnoush V, Darsareh F. Machine Learning-Based Approach to Predict Intrauterine Growth Restriction. Cureus 2023; 15:e41448. [PMID: 37546140 PMCID: PMC10403995 DOI: 10.7759/cureus.41448] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Creating a prediction model incorporating multiple risk factors for intrauterine growth restriction is vital. The current study employed a machine learning model to predict intrauterine growth restriction. METHODS This cross-sectional study was carried out in a tertiary hospital in Bandar Abbas, Iran, from January 2020 to January 2022. Women with singleton pregnancies above the gestational age of 24 weeks who gave birth during the study period were included. Exclusion criteria included multiple pregnancies and fetal anomalies. Four statistical learning algorithms were used to build a predictive model: (1) Decision Tree Classification, (2) Random Forest Classification, (3) Deep Learning, and (4) the Gradient Boost Algorithm. The candidate predictors of intrauterine growth restriction for all models were chosen based on expert opinion and prior observational cohorts. To investigate the performance of each algorithm, some parameters, including the area under the receiver operating characteristic curve (AUROC), accuracy, precision, and sensitivity, were assessed. RESULTS Of 8683 women who gave birth during the study period, 712 were recorded as having intrauterine growth restriction, with a frequency of 8.19%. Comparing the performance parameters of different machine learning algorithms showed that among all four machine learning models, Deep Learning had the greatest performance to predict intrauterine growth restriction with an AUROC of 0.91 (95% confidence interval, 0.85-0.97). The importance of the variables revealed that drug addiction, previous history of intrauterine growth restriction, chronic hypertension, preeclampsia, maternal anemia, and COVID-19 were weighted factors in predicting intrauterine growth restriction. CONCLUSIONS A machine learning model can be used to predict intrauterine growth restriction. The Deep Learning model is an accurate algorithm for predicting intrauterine growth restriction.
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Affiliation(s)
- Elham Taeidi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN
| | - Amene Ranjbar
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN
| | - Farideh Montazeri
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN
| | - Vahid Mehrnoush
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN
| | - Fatemeh Darsareh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN
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Jing Y, Gan M, Xie Z, Ma J, Chen L, Zhang S, Zhao Y, Niu L, Wang Y, Zhu L, Shen L. Characteristics of microRNAs in Skeletal Muscle of Intrauterine Growth-Restricted Pigs. Genes (Basel) 2023; 14:1372. [PMID: 37510277 PMCID: PMC10379088 DOI: 10.3390/genes14071372] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
microRNAs are a class of small RNAs that have been extensively studied, which are involved in many biological processes and disease occurrence. The incidence of intrauterine growth restriction is higher in mammals, especially multiparous mammals. In this study, we found that the weight of the longissimus dorsi of intrauterine growth-restricted pigs was significantly lower than that of normal pigs. Then, intrauterine growth-restricted pig longissimus dorsi were used to characterize miRNA expression profiles by RNA sequencing. A total of 333 miRNAs were identified, of which 26 were differentially expressed. Functional enrichment analysis showed that these differentially expressed miRNAs regulate the expression of their target genes (such as PIK3R1, CCND2, AKT3, and MAP3K7), and these target genes play an important role in the proliferation and differentiation of skeletal muscle through signaling pathways such as the PI3K-Akt, MAPK, and FoxO signaling pathways. Furthermore, miRNA-451 was significantly upregulated in IUGR pig skeletal muscle. Overexpression of miR-451 in C2C12 cells significantly promoted the expression of Mb, Myod, Myog, Myh1, and Myh7, suggesting that miR-451 may be involved in the regulation of the myoblastic differentiation of C2C12 cells. Our results reveal the role of miRNA-451 in regulating myogenic differentiation of skeletal muscle in pigs with intrauterine growth restriction.
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Affiliation(s)
- Yunhong Jing
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Mailin Gan
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Zhongwei Xie
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Jianfeng Ma
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Lei Chen
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Shunhua Zhang
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Ye Zhao
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Lili Niu
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Yan Wang
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Li Zhu
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
| | - Linyuan Shen
- Key Laboratory of Livestock and Poultry Multi-Omics, College of Animal and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resource Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China
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Guillot E, Lemay A, Allouche M, Vitorino Silva S, Coppola H, Sabatier F, Dignat-George F, Sarre A, Peyter AC, Simoncini S, Yzydorczyk C. Resveratrol Reverses Endothelial Colony-Forming Cell Dysfunction in Adulthood in a Rat Model of Intrauterine Growth Restriction. Int J Mol Sci 2023; 24:ijms24119747. [PMID: 37298697 DOI: 10.3390/ijms24119747] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Individuals born after intrauterine growth restriction (IUGR) are at risk of developing cardiovascular diseases (CVDs). Endothelial dysfunction plays a role in the pathogenesis of CVDs; and endothelial colony-forming cells (ECFCs) have been identified as key factors in endothelial repair. In a rat model of IUGR induced by a maternal low-protein diet, we observed an altered functionality of ECFCs in 6-month-old males, which was associated with arterial hypertension related to oxidative stress and stress-induced premature senescence (SIPS). Resveratrol (R), a polyphenol compound, was found to improve cardiovascular function. In this study, we investigated whether resveratrol could reverse ECFC dysfunctions in the IUGR group. ECFCs were isolated from IUGR and control (CTRL) males and were treated with R (1 μM) or dimethylsulfoxide (DMSO) for 48 h. In the IUGR-ECFCs, R increased proliferation (5'-bromo-2'-deoxyuridine (BrdU) incorporation, p < 0.001) and improved capillary-like outgrowth sprout formation (in Matrigel), nitric oxide (NO) production (fluorescent dye, p < 0.01), and endothelial nitric oxide synthase (eNOS) expression (immunofluorescence, p < 0.001). In addition, R decreased oxidative stress with reduced superoxide anion production (fluorescent dye, p < 0.001); increased Cu/Zn superoxide dismutase expression (Western blot, p < 0.05); and reversed SIPS with decreased beta-galactosidase activity (p < 0.001), and decreased p16ink4a (p < 0.05) and increased Sirtuin-1 (p < 0.05) expressions (Western blot). No effects of R were observed in the CTRL-ECFCs. These results suggest that R reverses long-term ECFC dysfunctions related to IUGR.
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Affiliation(s)
- Estelle Guillot
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Anna Lemay
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Manon Allouche
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Sara Vitorino Silva
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Hanna Coppola
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Florence Sabatier
- Center from Cardiovascular and Nutrition Research (C2VN), Institut National de la Santé Et de la Recherche Médicale (INSERM), Aix Marseille Université, UMR-S 1263, UFR de Pharmacie, Campus Santé, 13385 Marseille, France
- Institut National de Recherche pour L'Agriculture, L'Alimentation et L'Environnement (INRAe), Aix Marseille Université, UMR-S 1263, UFR de Pharmacie, Campus Santé, 13385 Marseille, France
| | - Françoise Dignat-George
- Center from Cardiovascular and Nutrition Research (C2VN), Institut National de la Santé Et de la Recherche Médicale (INSERM), Aix Marseille Université, UMR-S 1263, UFR de Pharmacie, Campus Santé, 13385 Marseille, France
- Institut National de Recherche pour L'Agriculture, L'Alimentation et L'Environnement (INRAe), Aix Marseille Université, UMR-S 1263, UFR de Pharmacie, Campus Santé, 13385 Marseille, France
| | - Alexandre Sarre
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Anne-Christine Peyter
- Neonatal Research Laboratory, Clinic of Neonatology, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Stéphanie Simoncini
- Center from Cardiovascular and Nutrition Research (C2VN), Institut National de la Santé Et de la Recherche Médicale (INSERM), Aix Marseille Université, UMR-S 1263, UFR de Pharmacie, Campus Santé, 13385 Marseille, France
- Institut National de Recherche pour L'Agriculture, L'Alimentation et L'Environnement (INRAe), Aix Marseille Université, UMR-S 1263, UFR de Pharmacie, Campus Santé, 13385 Marseille, France
| | - Catherine Yzydorczyk
- DOHaD Laboratory, Division of pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
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