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lung maturity preterm

Anouk Bokslag, Mirjam van Weissenbruch, Ben Willem Mol, Christianne J M de Groot
Preeclampsia is a common pregnancy specific disease, that presents with hypertension and a variety of organ failures, including malfunction of kidneys, liver and lungs. At present, the only definitive treatment of preeclampsia is end the pregnancy and deliver the neonate and placenta. For women with mild preeclampsia in the preterm phase of pregnancy, expectant management is generally indicated to improve fetal maturity, often requiring maternal medical treatment. Last decades, more evidence is available that the underlying mechanism of preeclampsia, endothelial disease, is not limited to pregnancy but increases cardiovascular risk in later life...
September 19, 2016: Early Human Development
Andrew M South, Patricia A Nixon, Mark C Chappell, Debra I Diz, Gregory B Russell, Beverly M Snively, Hossam A Shaltout, James C Rose, T Michael O'Shea, Lisa K Washburn
BACKGROUND: Antenatal corticosteroid (ANCS) treatment hastens fetal lung maturity and improves survival of premature infants, but the long-term effects of ANCS are not well-described. Animal models suggest that ANCS increases the risk of cardiovascular disease through programmed changes in the renin-angiotensin (Ang)-aldosterone system (RAAS). We hypothesized that ANCS exposure alters the RAAS in adolescents born prematurely. METHODS: A cohort of 173 adolescents born prematurely was evaluated, of whom 92 were exposed to ANCS...
October 5, 2016: Pediatric Research
Carole R Mendelson, Alina P Montalbano, Lu Gao
Preterm birth remains the major cause of neonatal morbidity and mortality throughout the world. This is due, in part, to our incomplete understanding of the mechanisms that underlie the maintenance of pregnancy and the initiation of parturition at term. In this article, we review our current knowledge of the complex, interrelated and concerted mechanisms whereby progesterone maintains myometrial quiescence throughout most of pregnancy, as well as those that mediate the upregulation of the inflammatory response and decline in progesterone receptor function leading to parturition...
September 11, 2016: Journal of Steroid Biochemistry and Molecular Biology
Nicole Marquardt, Martin A Ivarsson, Erik Sundström, Elisabet Åkesson, Elisa Martini, Liv Eidsmo, Jenny Mjösberg, Danielle Friberg, Marius Kublickas, Sverker Ek, Gunilla Tegerstedt, Åke Seiger, Magnus Westgren, Jakob Michaëlsson
Amniotic fluid (AF) surrounds the growing fetus, and cells derived from AF are commonly used for diagnosis of genetic diseases. Intra-amniotic infections are strongly linked to preterm birth, which is the leading cause of perinatal mortality worldwide. Surprisingly little is known, however, about mature hematopoietic cells in AF, which could potentially be involved in immune responses during pregnancy. In this study, we show that the dominating population of viable CD45(+) cells in AF is represented by a subset of fetal CD103(+) group 3 innate lymphoid cells (ILCs) producing high levels of IL-17 and TNF...
September 2, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Yu-Cheng Wang, Oi-Wa Chan, Ming-Chou Chiang, Peng-Hong Yang, Shih-Ming Chu, Jen-Fu Hsu, Ren-Huei Fu, Reyin Lien
BACKGROUND: Red blood cell (RBC) transfusion is often considered a life-saving measure in critically ill neonates. The smallest and least mature infants tend to receive the largest amount of transfusions. RBC transfusion itself has also been suggested as an independent risk factor of poor clinical outcome in critical patients. Our aim is to study if there are associations between RBC transfusion and in-hospital mortality, short-term morbidities, and late neurodevelopmental outcome in extremely low birth weight (ELBW) preterm infants...
July 5, 2016: Pediatrics and Neonatology
Christine Schreiner, Felix Schreiner, Christoph Härtel, Matthias Heckmann, Axel Heep, Peter Bartmann, Joachim Woelfle, Andreas Müller, Egbert Herting, Wolfgang Göpel
BACKGROUND: Induction of lung maturation by prenatal steroid treatment has become the standard of care for pregnant women at risk for preterm birth. In addition to the beneficial effects on lung maturation, prenatal steroids have been shown to reduce the incidence of neonatal death, necrotizing enterocolitis, sepsis, and intraventricular hemorrhage. However, little is known about the role of interindividual differences in corticoid sensitivity arising from polymorphisms in the glucocorticoid receptor (GR) gene...
August 11, 2016: Neonatology
Kjell Haram, Jan Helge Mortensen, Everett F Magann, John C Morrison
Antenatal corticosteroid therapy improves both fetal lung mechanism and gas exchange due to accelerated morphologic development of type one and two pneumocytes. This therapy also enhances the production of surfactant binding proteins and fetal lung antioxidant enzymes. In women with threatening preterm delivery, a single course is advocated between 24 and 34 weeks' gestation with either betamethasone (two doses of 12 mg 24 hours apart) or dexamethasone (4-doses of 6 mg at 12-h intervals). Such treatment reduces the rate of respiratory distress syndrome, comorbidity and mortality in neonates in the first 48 hours of life...
August 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
Cibele S Borges, Ana Flávia M G Dias, Josiane Lima Rosa, Patricia V Silva, Raquel F Silva, Aline L Barros, Marciana Sanabria, Marina T Guerra, Mary Gregory, Daniel G Cyr, Wilma De G Kempinas
Antenatal betamethasone is used for accelerating fetal lung maturation for women at risk of preterm birth. Altered sperm parameters were reported in adult rats after intrauterine exposure to betamethasone. In this study, male rat offspring were assessed for reproductive development after dam exposure to betamethasone (0.1mg/kg) or vehicle on Days 12, 13, 18 and 19 of pregnancy. The treatment resulted in reduction in the offspring body weight, delay in preputial separation, decreased seminal vesicle weight, testosterone levels and fertility, and increased testicular weight...
August 2016: Reproductive Toxicology
Isabel Torres-Cuevas, Maria Cernada, Antonio Nuñez, Javier Escobar, Julia Kuligowski, Consuelo Chafer-Pericas, Maximo Vento
Fetal life elapses in a relatively low oxygen environment. Immediately after birth with the initiation of breathing, the lung expands and oxygen availability to tissue rises by twofold, generating a physiologic oxidative stress. However, both lung anatomy and function and the antioxidant defense system do not mature until late in gestation, and therefore, very preterm infants often need respiratory support and oxygen supplementation in the delivery room to achieve postnatal stabilization. Notably, interventions in the first minutes of life can have long-lasting consequences...
2016: Frontiers in Pediatrics
Braden K Pew, R Alan Harris, Elena Sbrana, Milenka Cuevas Guaman, Cynthia Shope, Rui Chen, Sylvain Meloche, Kjersti Aagaard
BACKGROUND: Neonatal respiratory distress syndrome in preterm infants is a leading cause of neonatal death. Pulmonary insufficiency-related infant mortality rates have improved with antenatal glucocorticoid treatment and neonatal surfactant replacement. However, the mechanism of glucocorticoid-promoted fetal lung maturation is not understood fully, despite decades of clinical use. We previously have shown that genetic deletion of Erk3 in mice results in growth restriction, cyanosis, and early neonatal lethality because of pulmonary immaturity and respiratory distress...
September 2016: American Journal of Obstetrics and Gynecology
Sung Ae Kim, Seung Mi Lee, Byoung Jae Kim, Chan-Wook Park, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon
OBJECTIVE: The risk of neonatal respiratory morbidity between indicated deliveries vs. spontaneous deliveries has not been consistent in previous studies, in spite of the traditional belief that chronic intrauterine stress might have protective effect on fetal lung maturation. We hypothesized that the heterogeneous etiology of indicated preterm delivery may obscure the relationship between the etiologies of preterm birth and neonatal respiratory morbidity. To address this issue, we divided the indicated preterm birth (PTB) into medically-indicated (without fetal compromise) PTB and maternal/fetal-indicated PTB, and compared the neonatal respiratory morbidity according to the etiology of late PTB...
April 12, 2016: Journal of Perinatal Medicine
Adriano Rodríguez-Trujillo, Teresa Cobo, Irene Vives, Jordi Bosch, Marian Kacerovsky, David E Posadas, Martina A Ángeles, Eduard Gratacós, Bo Jacobsson, Montse Palacio
INTRODUCTION: The aim of this study was to evaluate, in women with preterm prelabor rupture of membranes (PPROM), the impact on short-term neonatal outcome of microbial invasion of the amniotic cavity (MIAC), intra-amniotic inflammation (IAI), and the microorganisms isolated in women with MIAC, when gestational age is taken into account. MATERIAL AND METHODS: Prospective cohort study. We included women with PPROM (22.0-34.0 weeks of gestation) with available information about MIAC, IAI and short-term neonatal outcome...
August 2016: Acta Obstetricia et Gynecologica Scandinavica
Hong-Ren Yu, Sung-Chou Li, Wan-Ning Tseng, You-Lin Tain, Chih-Cheng Chen, Jiunn-Ming Sheen, Mao-Meng Tiao, Ho-Chang Kuo, Chao-Cheng Huang, Kai-Sheng Hsieh, Li-Tung Huang
Glucocorticoids have been administered to mothers at risk of premature delivery to induce maturation of preterm fetal lungs and prevent the development of respiratory distress syndrome. Micro (mi)RNAs serve various crucial functions in cell proliferation, differentiation and organ development; however, few studies have demonstrated an association between miRNAs and lung development. The aim of the present study was to investigate alterations in the miRNA profiles of rat lung tissue following prenatal glucocorticoid therapy for fetal lung development...
March 2016: Experimental and Therapeutic Medicine
Raed Salim, Abeer Suleiman, Raul Colodner, Zohar Nachum, Lee H Goldstein, Eliezer Shalev
BACKGROUND: The association between maternal serum concentration of betamethasone given for fetal lung maturity and perinatal outcome has not been investigated. This may be due to an absence of a reliable method for measuring serum betamethasone concentrations. We aimed in the current study to assess the feasibility of a specific ELISA kit to measure the concentrations of betamethasone in maternal serum and to examine the trend of sequential measurements after a course of betamethasone for fetal lung maturity...
2016: Reproductive Biology and Endocrinology: RB&E
América Aime Corona-Gutiérrez, Araceli Olivares-Ramírez, Sergio Fajardo-Dueñas
BACKGROUND: Despite the known benefits of antenatal corticosteroids therapy its use in clinical practice is not generalized. OBJECTIVE: To identify factors related to antenatal corticosteroids non administration. METHODS: Cross-sectional and descriptive study that included patients admitted to Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", who had indication for antenatal corticosteroids therapy but did not receive it. Variables: antenatal corticosteroids therapy prescription, factors related to antenatal corticosteroids therapy non administration and lapsed time between diagnosis and birth...
October 2015: Ginecología y Obstetricia de México
Zarqa Saif, Rebecca M Dyson, Hannah K Palliser, Ian M R Wright, Nick Lu, Vicki L Clifton
The placental glucocorticoid receptor (GR) is central to glucocorticoid signalling and for mediating steroid effects on pathways associated with fetal growth and lung maturation but the GR has not been examined in the guinea pig placenta even though this animal is regularly used as a model of preterm birth and excess glucocorticoid exposure. Guinea pig dams received subcutaneous injections of either vehicle or betamethasone at 24 and 12 hours prior to preterm or term caesarean-section delivery. At delivery pup and organ weights were recorded...
2016: PloS One
Reshama Navathe, Vincenzo Berghella
Tocolytics have been used for over 60 years for women with preterm labor, which ultimately can lead to preterm birth (PTB). Diagnosing preterm labor is challenging, but use of objective tests such as transvaginal ultrasound of cervical length assists in the identification of women at the highest risk for PTB. Once preterm labor has been diagnosed, clinicians can choose from a variety of drug classes (cyclooxygenase inhibitors, calcium channel blockers, and betamimetics) to achieve the primary goal of delaying delivery by 48 hours, thereby allowing time for administration of corticosteroids for fetal lung maturity, and if appropriate, starting magnesium sulfate for fetal neuroprotection...
February 2016: American Journal of Perinatology
Ivana Mižíková, Rory E Morty
Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth that contributes significantly to morbidity and mortality in neonatal intensive care units. BPD results from life-saving interventions, such as mechanical ventilation and oxygen supplementation used to manage preterm infants with acute respiratory failure, which may be complicated by pulmonary infection. The pathogenic pathways driving BPD are not well-delineated but include disturbances to the coordinated action of gene expression, cell-cell communication, physical forces, and cell interactions with the extracellular matrix (ECM), which together guide normal lung development...
2015: Frontiers in Medicine
Jose María Lloreda-Garcia, Ana Lorente-Nicolás, Francisca Bermejo-Costa, Juan Martínez-Uriarte, Rocío López-Pérez
INTRODUCTION: Magnesium sulphate administration is recommended for foetal neuroprotection in pregnant women at imminent risk of early preterm birth. OBJECTIVE: To evaluate the relationship between intrapartum magnesium sulphate for foetal neuroprotection and delivery room resuscitation of preterm infants less 32 weeks. PATIENTS AND METHOD: A prospective observational study was conducted on preterm infants less 32 weeks exposed to magnesium sulphate for neuroprotection, and a comparison made with another historic group immediately before starting this treatment...
July 2016: Revista Chilena de Pediatría
Chan-Wook Park, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon
OBJECTIVE: To determine if fetal growth restriction (FGR) in the setting of sterile intra-uterine milieu would be associated with a decrease in respiratory distress syndrome (RDS) of preterm-neonates. METHODS: The relationship between FGR and neonatal RDS was examined in 92 singleton preterm-neonates (gestational age [GA]: 24.5-33.4 weeks) born to mothers with sterile intra-uterine milieu, which consisted of both sterile amniotic fluid (AF), and inflammation-free placenta...
August 2016: Pediatric Pulmonology
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