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Ενδομήτρια υπολειπόμενη αύξηση και οστικός μεταβολισμός

By Δέσποινα Μπριάνα

Abstract

This thesis consists of two parts, the GENERAL and the SPECIFIC The General Part includes the following chapters: I. Intrauterine growth restriction (IUGR) This chapter describes the history, definition and epidemiology of IUGR and the clinical importance of distinguishing IUGR from SGA (small for gestational age) neonates. The etiology of IUGR (anatomical and/or functional disorders and diseases in the feto-placental-maternal unit), the determination of gestational age and the methods used to detect IUGR (clinical or imaging) are emphasized. The importance of customized fetal growth charts and the distinction of symmetric vs. asymmetric IUGR for future prognosis, is highlighted. Finally, this chapter includes the treatment and postnatal management, while morbidity, short- and long term consequences and mortality rates are also discussed. ΙΙ. IUGR and bone disease in adult life This part analyzes the groups of studies, which suggest that the risk of osteoporosis might be modified by environmental influences during early life. These studies include: (1) bone mineral measurements undertaken in cohorts of adults whose detailed birth and/or childhood records have been preserved, (2) detailed physiological studies exploring the relationship between candidate endocrine systems that may be programmed (GH/IGF-1; hypothalamic-pituitary adrenal, gonadal steroid) and age-related bone loss, (3) studies characterizing the nutrition, body builds, and lifestyles of pregnant women and relating these to the bone mass of their newborn offspring, (4) studies relating childhood growth rates to the later risk of hip fracture. ΙΙΙ. Bone metabolism in the fetus and neonate This chapters refers to bone histology and pathophysiology, while the definitions of bone density and mineralization are analyzed. Furthermore, the mechanisms underlying the skeletal adaptations during fetal and postnatal life, the intrauterine mineral accretion and the physiological changes in mineral homeostasis at birth, are extensively described. Finally, the factors affecting the transplacental transfer of calcium and phosphorus are emphasized. IV. Bone metabolism in the IUGR fetus and neonate The results of a small number of older studies, which explored bone formation and resorption in small for gestational age (SGA) fetuses and neonates, as well as bone density in those infants at birth, are documented. V. Biochemical markers of bone metabolism This chapter analyzes the production and function of biochemical markers of bone turnover, which are reliable indices for measuring changes of bone formation and resorption, reflecting the dynamics of bone metabolism at the cellular level. Due to limitations in the use of bone densitometry during pregnancy and the perinatal period, biochemical markers of bone turnover provide an excellent alternative to examine the state of the skeleton.The Specific part includes the following: I. Hypothesis and Aim This study was based on the hypothesis that circulating markers of bone metabolism may differ between IUGR and appropriate for gestational age (AGA) fetuses and neonates, since the former present with low bone mass at birth and increased risk for osteoporosis development in adult life. Therefore, we aimed to determine, for the first time to our knowledge, circulating concentrations of biochemical indices of bone metabolism in AGA and IUGR pregnancies, and associate them with various maternal and fetal anthropometric/clinical variables...

Topics: Ενδομήτρια υπολειπόμενη αύξηση, Οστά, Μεταβολισμός, Έμβρυο, Νεογνά, Κύηση, Βιοχημικοί δείκτες οστικού μεταβολισμού, Οστεοπόρωση, Intrauterine growth restriction, Bones, Metabolism, Fetus, Neonates, Pregnancy, Biochemical parameters of bone metabolism, Osteoporosis
Publisher: National and Kapodistrian University of Athens
Year: 2010
DOI identifier: 10.12681/eadd/24260
OAI identifier:
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