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Early fetal growth restriction

Unzila Ali Nayeri, Catalin S Buhimschi, Guomao Zhao, Irina A Buhimschi, Vineet Bhandari
We aimed to test the hypothesis that determinants of the perinatal clinical exposome related to the underlying etiology of premature birth (PTB) impact differently on select neonatal outcomes. We conducted a prospective longitudinal study of 377 singleton preterm neonates [gestational age (GA) at birth: 23-34 weeks] separated into three distinct contemporaneous newborn cohorts: i) spontaneous PTB in the setting of intra-amniotic infection/inflammation (yes-IAI, n = 116); ii) spontaneous PTB in the absence of IAI (no-IAI, n = 130), and iii) iatrogenic PTB for preeclampsia (iPTB-PE, n = 131)...
2018: PloS One
Mark A Underwood, Stephen Wedgwood, Satyan Lakshminrusimha, Robin H Steinhorn
In the premature infant, poor growth in utero (fetal growth restriction) and in the first weeks of life (postnatal growth restriction) are associated with increased risk for bronchopulmonary dysplasia and pulmonary hypertension. In this review, we summarize the epidemiologic data supporting these associations, present a novel rodent model of postnatal growth restriction and review five promising mechanisms by which poor nutrition may affect the developing lung. These observations support the hypothesis that nutritional and/or pharmacologic interventions early in life may be able to decrease risk of the pulmonary complications of extreme prematurity...
December 4, 2018: Canadian Journal of Physiology and Pharmacology
Jérôme Mairesse, Manuela Zinni, Julien Pansiot, Rahma Hassan-Abdi, Charlie Demene, Marina Colella, Christiane Charriaut-Marlangue, Aline Rideau Batista Novais, Mickael Tanter, Stefania Maccari, Pierre Gressens, Daniel Vaiman, Nadia Soussi-Yanicostas, Olivier Baud
Prematurity and fetal growth restriction (FGR) are frequent conditions associated with adverse neurocognitive outcomes. We have previously identified early deregulation of genes controlling neuroinflammation as a putative mechanism linking FGR and abnormal trajectory of the developing brain. While the oxytocin system was also found to be impaired following adverse perinatal events, its role in the modulation of neuroinflammation in the developing brain is still unknown. We used a double-hit rat model of perinatal brain injury induced by gestational low protein diet (LPD) and potentiated by postnatal injections of subliminal doses of interleukin-1β (IL1β) and a zebrafish model of neuroinflammation...
December 2, 2018: Glia
Eva Morsing, Mariya Malova, Anna Kahn, Jimmy Lätt, Isabella M Björkman-Burtscher, Karel Maršál, David Ley
Background: Children born very preterm (PT) after fetal growth restriction (FGR) exhibit cognitive impairment at early school age. The relationship between neurodevelopmental impairment and attained regional brain volumes is unknown. Methods: We studied 23 preterm children with FGR (PT-FGR), 24 matched preterm children AGA (PT-AGA), and 27 matched term AGA children (T-AGA) by measuring brain volumes with magnetic resonance imaging at early school age. Cognitive and motor functions were assessed by the Wechsler Intelligence Scales for Children and the ABC-Movement score...
2018: Frontiers in Physiology
Sumaiya Adam, Melantha Coetzee, Engela Magdalena Honey
Pena-Shokeir syndrome (PSS) type 1, also known as fetal akinesia deformation sequence, is a rare genetic syndrome that almost always results in intrauterine or early neonatal death. It is characterized by markedly decreased fetal movements, intrauterine growth restriction, joint contractures, short umbilical cord, and features of pulmonary hypoplasia. Antenatal diagnosis can be difficult. Ultrasound features are varied and may overlap with those of Trisomy 18. The poor prognosis of PSS is due to pulmonary hypoplasia, which is an important feature that distinguishes PSS from arthrogryposis multiplex congenital without pulmonary hypoplasia, which has a better prognosis...
2018: Application of Clinical Genetics
John Allotey, Shakila Thangaratinam
Early and accurate identification of pregnancies with growth-restricted or macrosomic babies has the potential to reduce perinatal complications with close monitoring, and by planning the setting and timing of delivery. Numerous studies have developed prognostic models to predict small and large for gestational age infants, which are surrogate measures for infants at risk of adverse perinatal outcomes (Campbell S, Ultrasound in obstetrics & gynecology 2014;43(1):3-10; McCowan LME et al. Plos One 2017; 12(1): e0169311)...
November 29, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Oliver Graupner, Javier U Ortiz, Bernhard Haller, Annette Wacker-Gussmann, Renate Oberhoffer, Bettina Kuschel, Joy Weyrich, Christoph Lees, Silvia M Lobmaier
PURPOSE: Fetal Doppler changes are well characterized in early-onset small-for-gestational-age (SGA) and fetal growth restriction (FGR) but less well characterized where the condition is late-onset. The aim of the study was to evaluate the role of computerized CTG (cCTG)-based short-term variation (STV) in late-onset SGA and FGR as an additional monitoring modality and to establish STV reference ranges in late third trimester healthy pregnancies. METHODS: Of 86 late-onset SGA fetuses diagnosed after 32 weeks, 66 were diagnosed with FGR...
November 16, 2018: Archives of Gynecology and Obstetrics
Kristin D Gerson, Anna M Modest, Jonathan L Hecht, Brett C Young
AIM: Fetal membranes are composed of the amnion and chorion, which fuse during the early second trimester. Persistent separation confers increased risk of adverse perinatal outcomes. This study characterizes sonographic and placental findings associated with persistent amnion-chorion (AC) membrane separation. METHODS: This is a case series of 23 patients carrying singleton pregnancies with persistent AC membrane separation after 16 weeks' gestation diagnosed by ultrasound from 2010 to 2016 at our institution...
November 8, 2018: Journal of Obstetrics and Gynaecology Research
Jing Zhu, Rong Huang, Jinwen Zhang, Weiping Ye, Jun Zhang
Clinical trials and meta-analyses have demonstrated that low-dose aspirin can reduce the risk of preeclampsia and fetal growth restriction in high-risk pregnant women. Current obstetric guidelines recommend that the administration of low-dose aspirin to prevent preeclampsia be initiated after 12 weeks' gestation. This starting time was chosen to minimize possible risks of maternal bleeding and fetal anomalies. However, evidence from reproductive medicine, where low-dose aspirin is commonly recommended to use before and in early pregnancy, as well as existing literature, does not support these concerns...
December 2018: Medical Hypotheses
Markus Abeln, Iris Albers, Ulrike Peters-Bernard, Kerstin Flächsig-Schulz, Elina Kats, Andreas Kispert, Stephen Tomlinson, Rita Gerardy-Schahn, Anja Münster-Kühnel, Birgit Weinhold
The negatively charged sugar sialic acid (Sia) occupies the outermost position in the bulk of cell surface glycans. Lack of sialylated glycans due to genetic ablation of the Sia activating enzyme CMP-sialic acid synthase (CMAS) resulted in embryonic lethality around day 9.5 post coitum (E9.5) in mice. Developmental failure was caused by complement activation on trophoblasts in Cmas-/- implants accompanied by infiltration of maternal neutrophils at the fetal-maternal interface, intrauterine growth restriction, impaired placental development and a thickened Reichert's membrane...
November 1, 2018: Journal of Clinical Investigation
Amir Aviram, Christopher Sherman, John Kingdom, Arthur Zaltz, Jon Barrett, Nir Melamed
INTRODUCTION: While early and late fetal growth restriction have been suggested to be distinct entities, the optimal gestational age cut-off that differentiates the two conditions is currently unclear and has been arbitrarily set in previous studies between 32 and 37 weeks. We aimed to use placental pathology findings to determine that optimal gestational age cut-off between early and late fetal growth restriction. MATERIAL AND METHODS: A retrospective cohort study of all women with singleton gestation who gave birth to a neonate diagnosed as small-for-gestational age (small-for-gestational age, defined as birth weight<10th percentile for gestational age) at a tertiary referral center between January 2001 and December 2015, and for whom placental pathology was available...
October 29, 2018: Acta Obstetricia et Gynecologica Scandinavica
Laura Marchi, Lucia Pasquini, Ayten Elvan-Taspinar, Caterina Maddalena Bilardo
PURPOSE:  To investigate hemodynamic effects after antenatal corticosteroids (ACS) administration in appropriate for gestational age (AGA) and early growth restricted (GR) fetuses by measurement of Doppler cardiovascular function parameters. MATERIALS AND METHODS:  Prospective cohort study. AGA and GR singleton pregnancies receiving ACS for fetal lung maturation between 24 + 0 - 33 + 6 weeks were enrolled. Feto-placental vascular hemodynamics were studied by: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, renal artery (RenA) PI...
October 26, 2018: Ultraschall in der Medizin
Neeraj Kulkarni, Deepti Pinto Rosario, Liji Sarah David, Reeta Vijayaselvi, Manisha Madhai Beck
Objective: 1. To find out the stillbirth rate in the year 2017 at Christian Medical College, a tertiary care perinatal center in South India. 2. To find out causes for the various stillbirths that occurred using the ReCoDe classification. Material and Methods: Medical records of the women with stillbirths between 1st January to 31st December 2017 were retrieved and analyzed by SPSS software (IBM, version 23). The study was approved by institutional review board Minute no: 11273 Retro dated 28/3/2018...
October 26, 2018: Journal of the Turkish German Gynecological Association
Yehudit Michelson, Yaniv Lustig, Shira Avivi, Eli Schwartz, Amos Danielli
Background: Zika virus has created global alarm as it has been associated with catastrophic fetal abnormalities, including microcephaly, spontaneous abortion, and intrauterine growth restriction. Current serological assays that detect antiviral antibodies suffer from low sensitivity and high cross-reactivity among different flaviviruses. Methods: Here, utilizing a novel Magnetic Modulation Biosensing (MMB) system and the Zika non-structural 1 (NS1) protein, we show highly sensitive and specific Zika serological assays...
October 18, 2018: Journal of Infectious Diseases
Viola Seravalli, Mariarosaria Di Tommaso, Felice Petraglia
The main challenges in pregnancies affected by fetal growth restriction consist in identifying signs of disease progression and determining the appropriate timing of delivery. The risk of continuing the pregnancy must be balanced with the risk of prematurity, which depends on gestational age. To allow appropriate monitoring of the growth-restricted fetus, several surveillance tests are available. These include ultrasound Doppler velocimetry of feto-placental vessels, cardiotocography, and amniotic fluid evaluation...
October 11, 2018: Minerva Ginecologica
Jie Hu, Yang Peng, Tongzhang Zheng, Bin Zhang, Wenyu Liu, Chuansha Wu, Minmin Jiang, Joseph M Braun, Simin Liu, Stephen L Buka, Aifen Zhou, John Pierce Wise, Yiming Zhang, Yangqian Jiang, Chen Hu, Xiaomei Chen, Zheng Huang, Dan Zheng, Kunchong Shi, Xichi Zhang, Ashley Truong, Zhengmin Qian, Wei Xia, Yuanyuan Li, Shunqing Xu
BACKGROUND: Identification of windows of heightened vulnerability to environmental factors has substantial public health implications. Prenatal exposure to vanadium has been linked to adverse birth outcomes; however, critical windows for such exposure during fetal growth remain unknown. We aimed to assess trimester-specific associations of vanadium exposure with ultrasound measures of fetal growth and birth size in a Chinese longitudinal cohort. METHODS: The present study was embedded in our ongoing prospective prenatal cohort study at the Wuhan Women and Children Medical Care Center (Wuhan, Hubei, China)...
October 2018: Lancet. Planetary Health
Ina Olmer Specht, Inge Huybrechts, Peder Frederiksen, Eva Steliarova-Foucher, Veronique Chajes, Berit Lilienthal Heitmann
BACKGROUND: Causes of most childhood hematopoietic neoplasms are unknown. Early age of occurrence suggests prenatal etiology. Positive associations have been reported between industrially produced trans-fatty acids (iTFAs) and risks of some cancers in adults. iTFAs are pro-inflammatory and adversely affect the beneficial effects of essential fatty acids, the latter is diminishing tumor growth. In 2004 Denmark legislated against the use of iTFA in foodstuffs. Using the entire population, we investigated if the changes in the legislation as a proxy to the reduced exposure to iTFA had affected the incidence of childhood hematopoietic neoplasms...
October 8, 2018: European Journal of Clinical Nutrition
Andrea Busnelli, Debora Lattuada, Stefania Ferrari, Marco Reschini, Barbara Colciaghi, Edgardo Somigliana, Luigi Fedele, Enrico Ferrazzi
Inflammation and oxidative stress are intrinsically linked to early poor placentation, typical of pregnancies complicated by preeclampsia associated with intrauterine growth restriction (PE-IUGR). Low mitochondrial DNA copy number (mtDNAcn) in peripheral blood constitutes a good peripheral surrogate marker of inflammation and oxidative stress. On these basis, we explored a possible correlation between mtDNAcn in peripheral blood in the first trimester of pregnancy and the PE-IUGR onset. To shed light on this issue, we setup a nested case-control study from a prospective cohort of pregnant women undergoing first-trimester aneuploidies screening...
October 8, 2018: Reproductive Sciences
Georgios Valsamakis, George Chrousos, George Mastorakos
Stress is one of the commonest and underappreciated causes of reproductive frailty in women. The stress system leads to adaptive responses via mobilization of hormonal systems. Adaptability and resistance to stress are fundamental to life. The response to stressors depends on the type of stressor, the timing and duration of stress, the genetic predisposition, personality characteristics, and the way of coping with stress. The hypothalamic-pituitary-adrenal (HPA) axis has a direct inhibitory action on the hypothalamic-pituitary-ovarian (HPO) axis at multiple levels...
September 22, 2018: Psychoneuroendocrinology
Nicoletta Charolidi, Amanda J Host, Sandra Ashton, Zoe Tryfonos, Karin Leslie, Baskaran Thilaganathan, Judith E Cartwright, Guy S Whitley
Failure of the placental capillary network to develop normally is associated with early onset fetal growth restriction (FGR) and pre-eclampsia (PE). Although the symptoms are observed at term, the problem begins in the first trimester. However, investigations at this clinically relevant time are hindered by difficulties in identifying earlystage pregnancies that are at risk of developing FGR/PE. Using uterine artery Doppler ultrasound in the first trimester as a proxy measure of poor placentation, we have identified pregnancies at increased risk of developing early onset FGR/PE...
October 5, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
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