88 research outputs found
Cord Blood Ischemia-Modified Albumin Levels in Normal and Intrauterine Growth Restricted Pregnancies
Ischemia-modified albumin (IMA) is a sensitive biomarker of cardiac
ischemia. Intrauterine growth restriction (IUGR) may imply fetal hypoxia,
resulting in blood flow centralization in favour of vital organs (brain, heart,
adrenals—“brain sparing effect”). Based on the latter, we
hypothesized that cord blood IMA levels should not differ between IUGR and
appropriate-for-gestational-age (AGA) full-term pregnancies. IMA was measured
in blood samples from doubly-clamped umbilical cords of 110 AGA and 57
asymmetric IUGR pregnancies. No significant differences in IMA levels
were documented between AGA and IUGR groups. IMA levels were elevated in
cases of elective cesarean section (P = .035), and offspring of
multigravidas (P = .021). In conclusion, “brain
sparing effect” is possibly responsible for the lack of differences in
cord blood IMA levels at term, between IUGR and AGA groups. Furthermore, higher
oxidative stress could account for the elevated IMA levels in cases of elective
cesarean section, and offspring of multigravidas
Insulin-Like Growth Factor (IGF)-I and Insulin in Normal and Growth-Restricted Mother/Infant Pairs
Insulin-like growth factor (IGF)-I and insulin are essential for fetal growth. We investigated perinatal changes of both factors in 40 mothers and their 20 appropriate-for-gestational-age (AGA) and 20 intrauterine-growth-restricted (IUGR) fetuses and neonates on day 1 (N1) and day 4 (N4) postpartum. Fetal and N1, but not N4, IGF-I levels were increased in AGA (P < .001 and P = .037, resp.). N1 insulin levels were lower in IUGR (P = .048). Maternal, fetal, and N1 IGF-I, and fetal insulin levels positively correlated with customized centiles (r = .374, P = .035, r = .608, P < .001, r = .485, P = .006, and r = .654, P = .021, resp.). Female infants presented elevated fetal and N4 IGF-I levels (P = .023 and P = .016, resp.). Positive correlations of maternal, fetal, and neonatal IGF-I levels, and fetal insulin levels with customized centiles underline implication of both hormones in fetal growth. IUGR infants present gradually increasing IGF-I levels. Higher IGF-I levels are documented in females
Perinatal Plasma Monocyte Chemotactic Protein-1 Concentrations in Intrauterine Growth Restriction
Monocyte-chemotactic-protein-1 (MCP-1) plays vital roles in immune response, angiogenesis, and pregnancy outcome. We investigated plasma MCP-1 concentrations in 40 mothers and their 20 intrauterine-growth-restricted (IUGR) and 20 appropriate-for-gestational-age (AGA) fetuses and neonates on postnatal days 1 (N1) and 4 (N4). Maternal and fetal MCP-1
concentrations were decreased (P<001 and P = .018, resp.), whereas N1 MCP-1 concentrations were elevated in
IUGR group (P = .012). In both groups, fetal MCP-1 concentrations were lower compared to N1 and N4 ones
(P = .045, P = .012, resp., for AGA, P
< .001 in each case for IUGR). Reduced maternal and fetal MCP-1
concentrations in IUGR may reflect failure of trophoblast invasion, suggesting that down-regulation of MCP-1 may be involved in the pathogenesis of IUGR. Increased MCP-1 concentrations in IUGR neonates and higher postnatal ones in all infants may be attributed to gradual initiation of ex utero angiogenesis, which is possibly enhanced in IUGR
Perinatal Changes of Cardiac Troponin-I in Normal and Intrauterine Growth-Restricted Pregnancies
Intrauterine growth restriction (IUGR) implies fetal hypoxia, resulting in blood flow redistribution and sparing of vital organs
(brain, heart). Serum cardiac Troponin-I (cTnI), a well-established marker of myocardial ischaemia, was measured in 40 mothers
prior to delivery, the doubly clamped umbilical cords (representing fetal state), and their 20 IUGR and 20 appropriate-forgestational-age (AGA) neonates on day 1 and 4 postpartum. At all time points, no differences in cTnI levels were observed between
the AGA and IUGR groups. Strong positive correlations were documented between maternal and fetal/neonatal values (r ≥ .498,
P ≤ .025 in all cases in the AGA and r ≥ .615,
P ≤ .009 in all cases in the IUGR group). These results may indicate (a) normal
heart function, due to heart sparing, in the IUGR group (b) potential crossing of the placental barrier by cTnI in both groups
Intrauterine growth restriction and adult disease: the role of adipocytokines
Intrauterine growth restriction (IUGR) is the failure of the fetus to
achieve his/her intrinsic growth potential, due to anatomical and/or
functional disorders and diseases in the feto-placental-maternal unit.
IUGR results in significant perinatal and long-term complications,
including the development of insulin resistance/metabolic syndrome in
adulthood.
The thrifty phenotype hypothesis holds that intrauterine malnutrition
leads to an adaptive response that alters the fetal metabolic and
hormonal milieu designed for intrauterine survival. This fetal
programming predisposes to an increased susceptibility for chronic
diseases. Although the mechanisms controlling intrauterine growth are
poorly understood, adipose tissue may play an important role in linking
poor fetal growth to the subsequent development of adult diseases.
Adipose tissue secretes a number of hormones, called adipocytokines,
important in modulating metabolism and recently involved in intrauterine
growth.
This review aims to summarize reported findings concerning the role of
adipocytokines (leptin, adiponectin, ghrelin, tumor necrosis factor
(TNF), interleukin-6 (IL6), visfatin. resistin, apelin) in early life,
while attempting to speculate mechanisms through which differential
regulation of adipocytokines in IUGR may influence the risk for
development of chronic diseases in later life
The role of adipocytokines in fetal growth
Cumulative evidence suggests that the origins of obesity may occur
during fetal development. In this respect, the concept of
“developmental programming” was introduced and supported by
experimental and epidemiological data. This concept supports the idea
that the nutritional and hormonal status during pregnancy could
irreversibly interfere in metabolism control. The mechanisms responsible
for this developmental programming remain poorly documented. However,
recent research indicates that adipocytokines may play a critical role
in this process. Thus, leptin, adiponectin, and the recently identified
resistin, visfatin, and apelin, all exert effects on fat, muscle, and
liver cells early in life. The aforementioned adipocytokines are
secreted by adipocytes and human placenta during fetal life and may play
a major role in the etiopathogenesis of the metabolic syndrome. This
review will focus on the intrauterine expression of adipocytokines,
their contribution to the hormonal control of fetal growth, and their
role in restricted and exaggerated intrauterine growth
Adipocytokines in Normal and Complicated Pregnancies
Human pregnancy is characterized by insulin resistance, traditionally
attributed to the effects of placental hormones. Normal
pregnancy-induced insulin resistance is further enhanced in pregnancy
complications, associated with disturbed placental function, such as
gestational diabetes mellitus, preeclampsia, and intrauterine growth
restriction. Compelling evidence suggests that these pregnancy disorders
are associated with future development of maternal metabolic syndrome.
However, the pathogenetic mechanisms underlying the association between
abnormal placental development, insulin resistance, and maternal
metabolic syndrome are not fully understood. A large body of evidence
has recently supported the role of adipose tissue in the regulation of
insulin resistance in both nonpregnant and pregnant participants. In
this respect, adipocytokines, which are adipocyte-derived hormones, have
been implicated in the regulation of maternal metabolism and gestational
insulin resistance. Adipocytokines, including leptin, adiponectin, tumor
necrosis factor alpha, interleukin 6, as well as the newly discovered
resistin, visfatin, and apelin, are also known to be produced within the
intrauterine environment. However, data concerning the pattern of
adipocytokines secretion in normal and complicated pregnancies are still
limited and partially contradictory. Given the importance of adipose
tissue and its hormones in terms of adequate metabolic control and
energy homeostasis, we present a review of published data related to the
role of adipocytokines in pregnancy, especially in relation to pregnancy
complications. Focus will be placed on the functions and other potential
roles of the novel adipocytokines resistin, visfatin, and apelin
Small for gestational age birth weight: impact on lung structure and function
Accumulating data suggest that prenatal compromises leading to
intrauterine growth restriction (IUGR) increase the risk for respiratory
deficiencies after birth. In this respect, a growing body of
epidemiological evidence in infants, children and adults indicates that
small for gestational (SGA) birth weight can adversely affect lung
function, thus questioning the widely accepted concept that IUGR
accelerates lung maturation and improves outcome.
Although the mechanisms responsible for the relationship between SGA and
later lung dysfunction remain poorly documented, animal data indicate
that intrauterine lung development can be adversely affected by factors
associated with IUGR, namely reduced substrate supply, fetal hypoxemia
and hypercortisolemia. Thus, it is suggested that fetal adaptations to
intrauterine undernutrition result in permanent changes in lung
structure, which in turn lead to chronic airflow obstruction.
The purpose of this review is to describe and discuss the effects of
IUGR on lung structure and function. (C) 2012 Elsevier Ltd. All rights
reserved
Ancient Greek view of perinatal risk issues: from myth to reality
Perinatology is a new medical discipline, originating in the 1960s, and aiming to prevent, diagnose and treat problems to the mother, fetus and neonate, prior, during and after delivery. As above issues, applying to perinatology, are diachronically present, it is of interest to explore how they were previously viewed and coped with, particularly in ancient times.
Ancient Greece is considered the cradle of Western medicine. Thus, the reasonable question arises, what did Ancient Greeks think about unusual conditions, encountered around delivery, like premature birth, small for gestational age babies, twin pregnancy, as well as inability to give birth vaginally, and thus to apply what we nowadays call an emergency cesarean section
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