Safety and fortification with folic acid in neonatal period

Folic acid, the essential vitamin, and its active forms are substantial parts of many biochemical processes in the human body. In the period of rapid growth of organism or in cell growth, body’s demands for folate increase. Its impact in neonatal period varies even in premature newborns. Fortification with folic acid and its substitution in the treatment of anaemia are the important parts in the comprehensive care in premature newborns. To determine optimal dose in this group of patients is difficult. The determination of red blood cell folate concentration levels is the most accurate indicator of long-term folate level status in the body. Unmetabolised folic acid in circulation of newborns could have potentially adverse effects. Toxicity of folic acid is not a concern as folate is water-soluble and easily excreted by kidneys when in excess but on the other side growing organism of preterm newborn and disruption of metabolic balance could be potential risks

Experimental modeling of hypoxia in pregnancy and early postnatal life

The important role of equilibrium of environmental factors during the embryo-fetal period is undisputable. Women of reproductive age are increasingly exposed to various environmental risk factors such as hypoxia, prenatal viral infections, use of drugs, smoking, complications of birth or stressful life events. These early hazards represent an important risk for structural and/or functional maldevelopment of the fetus and neonates. Impairment of oxygen/energy supply during the pre- and perinatal period may affect neuronal functions and induce cell death. Thus when death of the newborn is not occurring following intrauterine hypoxia, various neurological deficits, including hyperactivity, learning disabilities, mental retardation, epilepsy, cerebral palsy, dystonia etc., may develop both in humans and in experimental animals. In our animal studies we used several approaches for modeling hypoxia in rats during pregnancy and shortly after delivery, i.e. chronic intrauterine hypoxia induced by the antiepileptic drug phenytoin, neonatal anoxia by decreased oxygen saturation in 2-day-old pups. Using these models we were able to test potential protective properties of natural (vitamin E, melatonin) and synthetic (stobadine) compounds. Based on our results, stobadine was also able to reduce hypoxia-induced hyperactivity and the antioxidant capacity of stobadine exceeded that of vitamin E and melatonin, and contrary to vitamin E, stobadine had no adverse effects on developing fetus and offspring

Evaluation of developmental neurotoxicity: some important issues focused on neurobehavioral development

Exposure of the developing organism to industrial chemicals and physical factors represents a serious risk factor for the development of neurobehavioral disorders, such as attention-deficit hyperactivity disorder, autism and mental retardation. Appropriate animal models are needed to test potentially harmful effects and mechanisms of developmental neurotoxicity of various chemical substances. However, there are significant human vs. rat differences in the brain developmental profile which should be taken into account in neurotoxicity studies. Subtle behavioral alterations are hard to detect by traditional developmental toxicity and teratogenicity studies, and in many cases they remain hidden. They can however be revealed by using special behavioral, endocrine and/or pharmacological challenges, such as repeated behavioral testing, exposure to single stressful stimulus or drugs. Further, current neurobehavioral test protocols recommend to test animals up to their adulthood. However some behavioral alterations, such as anxiety-like behavior or mental deficiency, may become manifest in later periods of development. Our experimental and scientific experiences are highly suggestive for a complex approach in testing potential developmental neurotoxicity. Strong emphasis should be given on repeated behavioral testing of animals up to senescence and on using proper pharmacological and/or stressful challenges

Zika virus infection from a newborn point of view. TORCH or TORZiCH?

Zika virus (ZIKV) belongs to the group of viruses called arboviruses. Congenital Zika syndrome is a new disease with infectious teratogenic aetiology. The clinical symptoms are divided into morphological and functional. Most severe complication is the foetal brain disruption sequence that includes severe microcephaly, anomalies of the eyes and congenital contractions of joints. The aim of this paper was to review available facts about Zika virus infection from a newborn point of view in a form of the summary of all important information. Zika virus infection is a problem of past, present and future. Epidemics may occur because of global climate changes, also in countries where natural conditions for life of mosquitos are not present. This clearly indicates the need to continue developing of vaccines and specific antiviral drugs. Until this happens, we must adhere individual preventive measures. Zika virus has proven to us how it can affect the health of adults and neonates but also thinking of healthy people. Newborns with microcephaly on the front pages of the media caused in 2015 panic and fear around the world – for this reason education of people is necessary. Due to serious congenital disorders associated with ZIKV infection and global impact of virus we suggest modifying old acronym TORCH for new TORZiCH to accent the position of Zika virus

Position of folic acid in fortification of nutrition in neonatal period

<br /><table style="height: 514px;" border="0" cellspacing="0" cellpadding="0" width="664" align="left"><tbody><tr><td style="padding-top: 3.1pt; padding-right: 0cm; padding-bottom: 3.1pt; padding-left: 0cm;" height="514" align="left" valign="top"><p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph; line-height: 115%; tab-stops: 21.3pt; mso-element: frame; mso-element-frame-width: 498.1pt; mso-element-frame-height: 379.3pt; mso-element-frame-vspace: 3.1pt; mso-element-wrap: around; mso-element-anchor-vertical: page; mso-element-anchor-horizontal: page; mso-element-left: 50.3pt; mso-element-top: 57.8pt; mso-height-rule: exactly;"><span style="font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-GB;" lang="EN-GB">Folic acid is an essential vitamin which has been known in recent 50 years. It plays an important role in period of neurogenesis. The substitution of folic acid is one of the important parts in the complex treatment of anaemia in premature newborns. It is also a component of artificial milk formulae or breast milk following mother&rsquo;s intake. Fortification of foods with folic acid for population in the world is still discussed. To determine optimal dose of folic acid in premature newborns is difficult. Daily recommended doses of folic acid in infants under the six months were identified. The needs of folic acid in newborns vary. It depends upon the gestational age, body reserves at birth or maternal status of folates during gravidity. On the other hand there is a risk of accumulation of unmetabolised folic acid in circulation of newborns after mandatory folic acid fortification in some countries, which were reported in some studies. The safe upper limits of folic acid intake in premature newborns are not known. </span></p> <p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph; line-height: 115%; tab-stops: 21.3pt; mso-element: frame; mso-element-frame-width: 498.1pt; mso-element-frame-height: 379.3pt; mso-element-frame-vspace: 3.1pt; mso-element-wrap: around; mso-element-anchor-vertical: page; mso-element-anchor-horizontal: page; mso-element-left: 50.3pt; mso-element-top: 57.8pt; mso-height-rule: exactly;"><span style="font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-GB;" lang="EN-GB">In this review article authors inform about the clear positive effect of folic acid in prenatal and neonatal period, but excessive doses of folic acid could present risk of accumulation and possible adverse effects. To follow up these notions further studies are required.</span></p></td></tr></tbody></table