Nerve growth factor and its functional receptor TrkA are up-regulated in murine decidual tissue of stress-triggered and substance P-mediated abortion.

PROBLEM: Stress, elicited by environmental and social conditions, is known to affect the homeostasis of the nervous, endocrine and immune systems. In pregnancy, perceived stress results in a predomination of inflammatory abortion-associated Th1 cytokines over immunosuppressive, pregnancy-protective-associated Th2 cytokines, putatively via neuropeptide substance P (SP). Nerve growth factor (NGF), an important trophic factor for sympathetic neurons, has been implicated in the responsiveness of immune-competent cells through its functional receptor, tropomyosin receptor kinase (TrkA). Thus, the aim of the present study was to identify a cross-talk between distinct neurotrophic and immune mediators in pregnancy maintenance. METHOD OF STUDY: Using immune fluorescence, we evaluated decidual and placental expression of NGF and TrkA on gestation day (gd) 13.5 in the abortion-prone mouse model CBA/J x DBA/2J in (1) CBA/J female control mice; (2) CBA/J mice exposed to stress on gd 5.5; and (3) CBA/J mice injected with SP on gd 5.5 to mimick stress perception. RESULTS: Stress and SP injection significantly increased the abortion rate and up-regulated decidual NGF and TrkA expression compared with the control. Stress, but not SP injection down-regulated placental NGF, whereas no changes in placental TrkA were observed. CONCLUSION: Our data suggest a functional role for NGF in stress-triggered, SP-mediated abortion.

Iron deficiency is prevalent in a sample of pregnant women at delivery in Germany.

OBJECTIVE: To determine the prevalence and risk factors of iron deficiency in pregnancy, since iron supplements are not routine in Germany. STUDY DESIGN: Soluble transferrin receptor (sTfR), ferritin, hemoglobin (Hb), C-reactive protein (CRP) and leucocyte counts were determined in venous blood samples of 378 women before delivery; 191 of them filled in a questionnaire. Statistical analysis was performed using SPSS 9.0.1. RESULTS: CRP and leucocyte count correlated significantly with ferritin values, while sTfR values were independent. Iron deficiency (sTfR >3.3 mg/dl) was found in 40.7% of pregnant women, and anemia (Hb<11.0 g/dl) in 13.6%. Non-German nationality, low educational level and young maternal age were significant risk factors for iron deficiency, while alcohol use in pregnancy, iron and folic acid supplements were protective. After adjusting for all other factors in a logistic regression equation, not taking any iron supplements in pregnancy (odd ratios (OR) 3.3 and 95% confidence interval (CI) 1.1-9.4), and young maternal age (OR 2.86 and 95% CI 1.1-7.7) remained significant risks. CONCLUSION: Iron deficiency in pregnant women in Germany is prevalent; it could be prevented by routine iron supplements.