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1.
Sci Total Environ ; 731: 138341, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32408211

RESUMO

Human exposure to environmental organic pollutants (OPs) begins in the uterine life period by trans-placental transfer. Epidemiological studies have consistently demonstrated the vulnerability of human fetuses and infants to the effects of OPs because of their rapid growth and organ development, cell differentiation, and immaturity of metabolism. The aim of the present study was to evaluate the prenatal exposure to OPs characterized by different physicochemical properties using non-invasive biological samples (meconium and placenta). A total of 88 placenta and 53 meconium samples were collected in Ourense, a city located in northwestern Spain, at the delivery and after birth from mothers and their infants from the University Hospital of Ourense, respectively. Selective pressurized liquid extraction (SPLE) methodologies were used to determine the targeted OPs in the selected biological samples. Cleanup of extracts was performed by solid-phase extraction (SPE) using EZ-POP cartridges and detection by gas chromatography (GC) coupled to tandem mass spectrometry (QqQ-MS/MS). The targeted OPs were detected with the following mean level total concentration order polycyclic aromatic hydrocarbons (PAHs) > organophosphorus pesticides (OPPs) > non-dioxin like polychlorinated biphenyls (NDLPCBs) > pyrethroids (PYRs) > polybrominated diphenyl ethers (PBDEs) > dioxin like polychlorinated biphenyls (DLPCBs) > organochlorine pesticides (OCPs) for placenta and ΣNDLPCBs > ΣPAHs > ΣOCPs > ΣPYRs > ΣOPPs > ΣDLPCBs > ΣPBDEs for meconium, respectively. Significant correlations (p < .050) between the socio-demographic characteristics of the selected population (mother's parity, age, weight increase during pregnancy, place of living and smoking habits) and log transformed concentration of some of the targeted OPs (OCPs, PBDEs, PYRs, OPPs and PAHs) were detected. The results obtained shown the complementary information given by both biological samples selected. Nevertheless, additional research will be needed to gain an understanding of the trans-placental transfer of OPs, to choose the best biological matrix to evaluate the prenatal exposure to OPs in a correct way and to know their health implications.


Assuntos
Poluentes Ambientais/análise , Praguicidas/análise , Bifenilos Policlorados/análise , Efeitos Tardios da Exposição Pré-Natal , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Éteres Difenil Halogenados/análise , Humanos , Lactente , Recém-Nascido , Mecônio/química , Placenta/química , Gravidez , Espanha , Espectrometria de Massas em Tandem
2.
Nat Med ; 26(4): 599-607, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32094926

RESUMO

Mucosal immunity develops in the human fetal intestine by 11-14 weeks of gestation, yet whether viable microbes exist in utero and interact with the intestinal immune system is unknown. Bacteria-like morphology was identified in pockets of human fetal meconium at mid-gestation by scanning electron microscopy (n = 4), and a sparse bacterial signal was detected by 16S rRNA sequencing (n = 40 of 50) compared to environmental controls (n = 87). Eighteen taxa were enriched in fetal meconium, with Micrococcaceae (n = 9) and Lactobacillus (n = 6) the most abundant. Fetal intestines dominated by Micrococcaceae exhibited distinct patterns of T cell composition and epithelial transcription. Fetal Micrococcus luteus, isolated only in the presence of monocytes, grew on placental hormones, remained viable within antigen presenting cells, limited inflammation ex vivo and possessed genomic features linked with survival in the fetus. Thus, viable bacteria are highly limited in the fetal intestine at mid-gestation, although strains with immunomodulatory capacity are detected in subsets of specimens.


Assuntos
Bactérias/crescimento & desenvolvimento , Feto/microbiologia , Microbioma Gastrointestinal , Intestinos/microbiologia , Viabilidade Microbiana , Autopsia , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Técnicas de Tipagem Bacteriana , Feminino , Feto/patologia , Feto/ultraestrutura , Microbioma Gastrointestinal/genética , Idade Gestacional , Humanos , Recém-Nascido , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Mucosa Intestinal/ultraestrutura , Intestinos/ultraestrutura , Lactobacillus/classificação , Lactobacillus/genética , Lactobacillus/isolamento & purificação , Mecônio/microbiologia , Micrococcaceae/classificação , Micrococcaceae/genética , Micrococcaceae/isolamento & purificação , Gravidez , Segundo Trimestre da Gravidez , RNA Ribossômico 16S/genética
3.
Sci Total Environ ; 707: 135528, 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-31780146

RESUMO

BACKGROUND: This pilot study was conducted to determine if we could identify intrauterine exposure to metals in meconium, as a measure of exposure for mother-child pairs living in proximity to a mining operation. OBJECTIVES: We used meconium as a means to measure metal exposure in utero. We set out to quantify the exposure to selected metals that are currently being mined and also are found in the Superfund site in Butte, Montana, and to compare it to that of Columbia, South Carolina, US, where mining is not occurring. METHODS: This cross-sectional study was conducted between May and November 2018. We received Institutional Review Board approval and we consented women following the birth of their newborns, and collected meconium within 24 h of birth, without any identifiers. Each laboratory used the same protocol for collection, transport, and storage; and the same laboratory protocol was used for the analysis of all samples. Samples were digested using standard acid/peroxide digestion methods and measured by inductively coupled plasma mass spectroscopy. RESULTS: We collected meconium specimens from 17 infants in Columbia, South Carolina and 15 infants in Butte, Montana. The concentrations found in Columbia were in the low µg kg-1 range (or less) and were similar to the low levels that have been identified in other studies of meconium. The magnitude of the differences in concentrations found in Butte compared to Columbia was 1792 times higher for Cu, 1650 times higher for Mn, and 1883 times higher for Zn. CONCLUSION: Using meconium to measure exposure of newborns has implications for risk assessment in a mining-exposed population. This approach was inexpensive and thorough. The magnitude of the differences in the metal levels identified from the two study sites suggests there is an urgent need for further research to learn if there are health consequences to these highly exposed infants.


Assuntos
Mecônio , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Metais , Montana , Projetos Piloto , South Carolina
4.
Sud Med Ekspert ; 62(6): 42-46, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825332

RESUMO

The objective of the study was to develop methods of determining the presence of meconium and feces in traces on material evidences and criteria for differential diagnostics of these secretions. The authors studied morphological, enzyme and pigment compositions of the samples of meconium obtained from fetus corpses, alive newborns, and that of feces obtained from adults, with the storage age at the laboratory from three days to two years. There are presented the study outcomes in traces on material evidences obtained by the following methods: light and luminescence microscopy with the use of starch-agar gel samples, substrate film method, a modified Pettenkofer reaction, spectrophotometry, and ascending thin layer chromatography. While studying meconium and feces, the authors revealed differences in their morphological, enzyme and pigment compositions; these data can be used in their differential diagnosis. The authors elaborated methods of determining the presence of the mentioned secretions; these methods could increase the efficiency of forensic biological examinations.


Assuntos
Mecônio , Adulto , Cromatografia em Camada Delgada , Diagnóstico Diferencial , Fezes , Medicina Legal/métodos , Humanos , Recém-Nascido
5.
Neonatal Netw ; 38(6): 329-335, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31712397

RESUMO

With the rise in genetic screening both pre- and postnatally, new variances in genes are being recognized. Some are of unknown significance, while other known genetic expressions have obvious phenotypical expressions. Transient neonatal diabetes mellitus is a result of the duplication of chromosome 6q24, but little is known about the phenotypic expression of a triplication of chromosome 6q24. This case study presents an infant with a postnatally diagnosed triplication of chromosome 6q24, meconium pseudocyst, and multiple congenital anomalies with unknown genetic significance.


Assuntos
Anormalidades Múltiplas/diagnóstico , Cistos/congênito , Diabetes Mellitus/diagnóstico , Mecônio , Cistos/diagnóstico , Humanos , Recém-Nascido , Masculino
6.
EBioMedicine ; 49: 354-363, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31685443

RESUMO

BACKGROUND: Mothers are the primary source of bacteria for newborns, but it is unclear whether mother-to-newborn transmission occurs prior to, during or after birth. Similarly, the effect of the delivery mode on neonatal microorganisms has been the focus of controversy. METHODS: Healthy maternal and neonatal pairs that underwent vaginal birth and caesarean section were enrolled in this study. Meconium, placenta, membrane and amniotic fluid samples for newborns and vaginal, rectal and oral samples for mothers were collected. All samples were amplified and sequenced by a 16S rRNA gene primer set targeting bacteria and archaea. FINDINGS: A total of 550 samples from 36 mother-neonate pairs with vaginal births and 42 mother-neonate pairs with caesarean sections were included in this study. The negative controls showed that the data analysis in this study was not affected by contamination. There was a high diversity of microbial communities in the pregnancy environment of the foetus. Meconium samples could be divided into three distinct types that were not influenced by the delivery method. INTERPRETATION: The distribution patterns of bacterial communities in the meconium, placenta, and foetal membranes were highly similar and had nothing to do with the mode of delivery. For approximately half of the placental microorganisms, the same sequence could be found in the vaginal, rectal, and oral samples of the mother.


Assuntos
Parto Obstétrico , Mecônio/microbiologia , Microbiota , Adulto , Líquido Amniótico/microbiologia , Archaea/fisiologia , Feminino , Humanos , Recém-Nascido , Filogenia , Placenta/microbiologia , Gravidez
7.
Drug Metab Rev ; 51(4): 524-532, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31595802

RESUMO

Fetal Alcohol Spectrum Disorder (FASD) describes the wide range of adverse physical, behavioral and cognitive effects resulting from ethanol exposure during embryonic and fetal development. Identification of children suffering from FASD is often difficult, as abuse of ethanol during pregnancy is a heavily stigmatized behavior that receives little prenatal screening attention in routine care. Over the last 3 decades, measurement of the ethanol metabolites fatty acid ethyl esters (FAEE) has emerged as a useful tool to detect in the neonatal period fetal alcohol exposure starting from mid gestation. This review aims at updating clinicians and researchers on the validity and utility of this biological marker in two aspects: The association with adverse fetal outcomes and in generating population estimates of fetal alcohol exposure.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Ácidos Graxos/metabolismo , Transtornos do Espectro Alcoólico Fetal/metabolismo , Mecônio/metabolismo , Efeitos Tardios da Exposição Pré-Natal , Consumo de Bebidas Alcoólicas/efeitos adversos , Animais , Ésteres/análise , Ésteres/metabolismo , Ácidos Graxos/análise , Feminino , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Transtornos do Espectro Alcoólico Fetal/etiologia , Humanos , Recém-Nascido , Troca Materno-Fetal , Mecônio/química , Gravidez
8.
Environ Res ; 179(Pt A): 108724, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31627028

RESUMO

Meconium is formed early in gestation and it is normally not excreted until after birth. Thus it may provide a longer and cumulative record of exposure to mercury (Hg). The present study aims to speciate Hg in meconium samples (N = 488) from Slovenian and Croatian new-borns prenatally exposed to low levels of methyl-Hg (MeHg) from maternal seafood intake and to Hg0 from maternal dental amalgam fillings. We had complete data of total Hg (THg) and MeHg in meconium and THg in maternal hair (MH), while THg and MeHg in maternal blood (MB) were available only for Croatian mothers. Personal data namely maternal seafood intake, age, pre-pregnancy BMI, parity, smoking, estimated gestational age at birth, sex, and birth weight were available for the majority of participants, except the number of dental amalgams which was in most cases missing for Croatian mothers. The median THg concentration in meconium was 11.1 (range: 0.41-375.2) ng/g and inorganic Hg (Hg(II)) presented 98.8% (range: 82%-100%, CV: 2%) of THg. We observed significant correlation between meconium and MH Hg levels, with the highest correlation between hair THg and meconium MeHg. Correlation analysis including MB (available only for Croatian population) showed a significant positive correlation between THg in meconium and THg in MB (Rs = 0.642). Additionally, MeHg from MB was correlated with MeHg in meconium (Rs = 0.898), while the correlation between Hg(II) in MB and meconium was positive, but not significant. Maternal seafood intake was significantly correlated with meconium MeHg (Rs = 0.498) and Hg(II) (Rs = 0.201). Multiple linear regression (performed on the Slovenian population, N = 143) confirmed a positive association between meconium MeHg and seafood intake. Furthermore, meconium Hg(II) was positively associated with the number of maternal dental amalgam fillings, but linear regression models did not confirm correlation between seafood intake and meconium Hg(II) levels. We assume that Hg0 released from maternal dental amalgam fillings and MeHg from seafood intake were both transported through the placental barrier and portioned between different foetal compartments including meconium. Weak correlation between maternal seafood intake and Hg(II) levels in meconium suggests that there is certain evidence of MeHg demethylation. However, because this correlation was not confirmed by the multiple regression, MeHg demethylation during prenatal life cannot be neither confirmed nor excluded. Further investigations at higher level of exposure are needed to confirm this observations. We can conclude that meconium is a suitable biomarker for MeHg and Hg0 exposure during pregnancy. However, comparability of the results reported in meconium in different studies is hindered by a lack of standardized sampling protocols, storage, and analysis.


Assuntos
Poluentes Ambientais/análise , Exposição Materna/estatística & dados numéricos , Mecônio/química , Mercúrio/análise , Biomarcadores , Feminino , Cabelo , Humanos , Recém-Nascido , Compostos de Metilmercúrio/análise , Gravidez , Alimentos Marinhos
9.
Medicine (Baltimore) ; 98(39): e17079, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574807

RESUMO

Advancements in diagnostic modalities have improved the diagnosis of meconium peritonitis (MP) both in utero and ex utero. This study aimed to determine the efficacy of prompt prenatal and postnatal diagnoses of MP on the postnatal outcomes of these patients.We conducted a retrospective chart review of neonates with MP admitted to the Mackay Memorial Hospital Systems from 2005 to 2016. The prenatal diagnoses, postnatal presentations, surgical indications, operative methods, types of MP, operative findings, associated anomalies, morbidities, patient outcomes, and survival rates were analyzed. Morbidities included postoperative adhesion ileus, bacteremia, and short bowel syndrome. We also performed subgroup analyses of the morbidity and survival rates of prenatally versus postnatally diagnosed patients, as well as inborn versus outborn neonates.Thirty-seven neonates with MP were enrolled. Of this number, 24 (64.9%) were diagnosed prenatally. Twenty-two (59.5%) were born preterm. The most common prenatal sonographic findings included fetal ascites followed by dilated bowel loops. Abdominal distention was the most frequent postnatal symptom. Thirty-four (91.9%) neonates underwent surgery, whereas 3 were managed conservatively. Volvulus of the gastrointestinal tract was the most frequent anatomic anomaly. The total morbidity and survival rates were 37.8% and 91.9%, respectively. The morbidity and survival rates did not differ significantly between prenatally and postnatally diagnosed patients (37.5% vs 33.3%, P = 1.00; 91.7% vs 92.3%, P = 1.00, respectively). Inborn and outborn patients did not differ in terms of morbidity and survival rates (27.3% vs 53.3%, P = .17; 100% vs 80.0%, P = .06, respectively).Although not statistically significant, inborn MP neonates had higher survival rates when compared with outborn MP neonates. Prompt postnatal management at tertiary centers seemed crucial.


Assuntos
Mecônio , Peritonite/diagnóstico por imagem , Ultrassonografia Pré-Natal , Ascite/etiologia , Dilatação Patológica/etiologia , Diagnóstico Precoce , Feminino , Humanos , Recém-Nascido , Volvo Intestinal/etiologia , Intestinos/patologia , Avaliação de Resultados da Assistência ao Paciente , Peritonite/complicações , Peritonite/mortalidade , Peritonite/terapia , Gravidez , Estudos Retrospectivos , Taxa de Sobrevida , Tempo para o Tratamento
10.
Rev Gaucha Enferm ; 40: e20180419, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31576969

RESUMO

OBJECTIVE: To analyze the adequacy of prenatal care in a Birth Center and the causes associated with maternal and newborn transfers to the hospital. METHODS: Cross-sectional study of the care provided at the only Birth Center in Rio de Janeiro, from 2009 to 2014. Statistical analyzes were based on the χ2 test and Prevalence Ratio (PR). RESULTS: Suitable prenatal care was predominant (42.8%) and there was no association (p = 0.55) with the transfers. Maternal transfer is caused by the ruptured amniotic sac (PR = 2.09, 95% CI 1.62-2.70) and altered fetal heart rates (PR = 3.06, 95% CI, 2.13-4.39). Newborn transfers are associated with the presence of meconium in the amniotic fluid (PR = 2.40, 95% CI 1.30-4.43); Apgar below 7 (PR = 5.33, 95% CI 2.65-10.73); and ventilatory assistance at birth (PR = 9.41, 95% CI 5.52-16.04). CONCLUSION: Complications during intrapartum care are the causes associated with transfers.


Assuntos
Centros de Assistência à Gravidez e ao Parto , Transferência de Pacientes , Cuidado Pré-Natal/normas , Adolescente , Adulto , Âmnio , Líquido Amniótico , Índice de Apgar , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Frequência Cardíaca Fetal , Humanos , Recém-Nascido , Mecônio , Mães , Gravidez , Ruptura Espontânea , Adulto Jovem
11.
Cir Pediatr ; 32(3): 158-163, 2019 Jul 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31486310

RESUMO

OBJECTIVE: To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in the context of acute fetal intestinal disease. MATERIAL AND METHODS: Three male fetuses have been diagnosed of meconium periorchitis in our Unit of Fetal Medicine in the last 5 years. Their prenatal ultrasound diagnoses were: testicular tumor (n=1); Meconium periorchitis with acute fetal intestinal perforation (n=2). Gestational age at diagnosis was 33, 34 and 35 weeks. Ultrasound signs at diagnosis were: Increased size of scrotal zone, with hyperechogenic lesions inside and permanence of peritoneum-vaginal canal; at abdominal zone, echographic signs of intestinal disease with or without meconium peritonitis were found (hyperechogenic lesions, edema of intestinal loops and ascites). All three neonates were assessed postnatally by ultrasound and therapeutic indication. RESULTS: Fetal ultrasound findings influenced both evolution and termination of pregnancy. The diagnosis of meconium periorchitis was confirmed postnatally in all cases: in the 1st case, delivered at term, scrotal tumoral pathology was ruled out and did not require abdominal surgery; the other 2 patients were delivered at the same week of prenatal diagnosis and an inguinal-scrotal surgery with intestinal approach because of meconium peritonitis was performed. No patient underwent orchiectomy, maintaining the teste-epididymal binomial intact. CONCLUSION: Prenatal ultrasound diagnosis of meconium periorchitis requires a strict ultrasound follow-up of the fetus as it is a specific marker of intestinal perforation, which can lead to the termination of pregnancy and avoid appearance of complicated meconium peritonitis.


Assuntos
Perfuração Intestinal/etiologia , Mecônio , Orquite/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Gravidez , Adulto Jovem
12.
Saudi Med J ; 40(8): 836-839, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31423522

RESUMO

A subcapsular hematoma of the liver is often found during autopsy in stillborn infants rather than clinically. It is usually asymptomatic unless ruptured; thus, the diagnosis is often delayed or missed. Rupture of a subcapsular hematoma in a premature neonate causes massive intraabdominal hemorrhage, which is associated with high mortality. Thus, early recognition and treatment to avoid rupture are imperative. We describe a case of life-threatening hemorrhage from a subcapsular hematoma of the liver during emergent laparotomy for mechanical obstruction in an 860 g premature neonate and discuss the appropriate preoperative preparation and anesthetic management for this case.


Assuntos
Perda Sanguínea Cirúrgica , Parada Cardíaca/terapia , Hematoma/terapia , Obstrução Intestinal/cirurgia , Complicações Intraoperatórias/terapia , Hepatopatias/terapia , Ruptura Espontânea/terapia , Emergências , Evolução Fatal , Hemostasia Cirúrgica , Humanos , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Lactente Extremamente Prematuro , Recém-Nascido , Intestino Delgado/cirurgia , Laparotomia , Masculino , Mecônio
13.
Malawi Med J ; 31(2): 150-154, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31452849

RESUMO

Background: Delayed meconium passage is usually a signal to congenital distal bowel dysfunction. Timing of meconium passage may vary depending on race, sex and several perinatal factors. Understanding the timing and associated perinatal factors in any given population will help in prompt diagnosis and adequate management of cases in that population. Objectives: To determine the timing of first meconium passage amongst Nigerian neonates, and evaluate the impact of various associated perinatal factors. Materials and Methods: A cross-sectional study using interviewer-administered questionnaires to obtain data from mothers of apparently normal infants attending the postnatal clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Data acquisition and analysis were done using SPSS version 20. A P-value of < 0.05 was adjudged statistically significant. Results: There were 276 male and 277 female infants. Mean birth weight was 3.4kg and mean gestational age at delivery 38.8weeks. The median age at presentation was 42days. Preterm deliveries were in 6.3%(32/510) and 3.7%(20/536) weighed less than 2.5kg at birth. Sixty-five percent (339/519) had spontaneous vertex delivery and 35%(180/519) had caesarean delivery. Passage of first meconium was within 24hours in 56.6%(307/543) and in 48hours 91.3%(496/543) had passed meconium. Fifty-four percent (54%, 288/537) commenced breastfeeding within 24hours and 85% (n=456/537) within 48hours. Exclusive breastfeeding was done in 61.5%(326/533) of subjects. Timing of first meconium passage was significantly affected by gestational age at delivery (p<0.001), mode of delivery (p<0.01), birth weight (p=0.02), first minute APGAR score (p<0.001), timing of commencement of breastfeeding (p<0.001) and feeding before breastfeeding is commenced (p = 0.02). Conclusion: Compared to other studies, we found smaller proportion of neonates passing meconium in the first 24 hours. Term neonates, birth weight ≥ 2.5kg, spontaneous vertex delivery, high Apgar score, commencement of breastfeeding within 24 hours of birth, feeding before breastfeeding is commenced, are perinatal factors associated with earlier first meconium passage.


Assuntos
Defecação/fisiologia , Recém-Nascido/fisiologia , Mecônio/fisiologia , Índice de Apgar , Peso ao Nascer , Aleitamento Materno , Parto Obstétrico , Feminino , Humanos , Recém-Nascido Prematuro , Masculino , Nigéria , Nascimento Prematuro , Fatores de Tempo
14.
J Perinatol ; 39(10): 1349-1355, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31320720

RESUMO

OBJECTIVE: The objective of this study is to compare pregnancy outcomes in deliveries complicated by primary meconium-stained amniotic fluid (MSAF, present at membrane rupture) and secondary MSAF (transitioned from clear to MSAF during labor). METHODS: The medical records and neonatal charts of all deliveries ≥ 370/7 weeks between October 2008 and July 2018 were reviewed. The primary outcome was composite adverse neonatal outcome that included early neonatal complications. RESULTS: Of 30,215 deliveries during the study period, 4302 (14.2 %) were included: 3845 (89.4%) in the primary MSAF group and 457 (10.6%) in the secondary MSAF group. The rate of the primary outcome was higher in the secondary MSAF group (p = 0.006). This association remained significant after controlling for background confounders. The secondary MSAF group had higher rate of cesarean deliveries (CDs) and assisted vaginal deliveries. There was a higher rate of composite adverse neonatal outcome when secondary MSAF was diagnosed < 3 vs. >3 h before delivery (p = 0.004). CONCLUSION: Secondary MSAF was associated with higher rates of adverse neonatal outcome, CDs, and assisted vaginal deliveries, compared with primary MSAF.


Assuntos
Líquido Amniótico , Doenças do Recém-Nascido/epidemiologia , Mecônio , Complicações do Trabalho de Parto , Resultado da Gravidez , Cesárea , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/etiologia , Trabalho de Parto , Masculino , Gravidez , Prevalência
15.
J Pharm Biomed Anal ; 175: 112743, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31330282

RESUMO

Prenatal exposure to maternal ethanol leads to serious physical and mental irreversible disabilities. Ethyl glucuronide (EtG) is a direct metabolite of alcohol and its measurement in neonatal meconium has been established as the best biomarker to assess prenatal exposure to social and excessive gestational ethanol. We developed and validated the first gas chromatography tandem mass spectrometry method to quantify EtG extracted from meconium by a simple solid phase extraction pretreatment. The method was linear from limit of quantification (2 ng/g) to 200 ng/g matrix with good determination coefficient (r2 = 0.99). Recovery of EtG from meconium was always higher than 70% and intra-assay and inter-assay precision and accuracy were always better than 10%. Robustness of the developed GC-MS/MS method was tested by analysing 150 real samples coming from a previous national epidemiological project pre-screened through an ultra-chromatography tandem mass spectrometry assay obtaining a good comparability of results obtained by the two methods.


Assuntos
Glucuronatos/química , Mecônio/química , Biomarcadores/química , Etanol/química , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Recém-Nascido , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Extração em Fase Sólida/métodos , Espectrometria de Massas em Tandem/métodos
16.
Artigo em Inglês | MEDLINE | ID: mdl-31279971

RESUMO

New psychoactive substances have been introduced into the market in the last years due to their unregulated status. Synthetic cathinones are one of their main representatives, and they have shown to produce neonatal complications. It is important to have objective tools to identify in utero exposure to drugs that have shown to produce neonatal complications. An analytical method was developed and fully validated for the determination of common synthetic cathinones, including methylone, methedrone, mephedrone, 3,4-methylenedioxypyrovalerone (MDPV), (±)-4-fluoromethamphetamine and 4-fluoromethcathinone in meconium. Meconium (0.25 ±â€¯0.02 g) was homogenized with methanol by sonication for 30 min. After centrifugation, the sample was extracted with Oasis MCX columns. The analysis was performed by LC-MS/MS using an Atlantis T3 column (3 µm, 2.1 × 50 mm) and a gradient with acetonitrile and 0.1% formic acid in water. Method validation included the following parameters: selectivity (no endogenous or exogenous interferences), limits of detection (n = 3, 0.5-1 ng/g) and quantification (n = 3, 1-2 ng/g), linearity (n = 5, LOQ-200 ng/g), imprecision (n = 15, 0% to 10%), accuracy (n = 15, 87.3% to 97.8%), matrix effect (n = 10, -76% to -28.1%), extraction efficiency (n = 6, 63.7% to 91.3%), total process efficiency (n = 6, 16% to 60.2%) and stability for 72 h in the autosampler (n = 3, %loss = -6.7% to 5.1%). The method was applied to 28 meconium specimens.


Assuntos
Alcaloides/análise , Cromatografia Líquida de Alta Pressão/métodos , Mecônio/química , Espectrometria de Massas em Tandem/métodos , Adulto , Alcaloides/síntese química , Feminino , Humanos , Gravidez , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
17.
Nagoya J Med Sci ; 81(2): 227-232, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31239591

RESUMO

Neonates who swallow a considerable amount of maternal blood may exhibit vomiting and suckling disorder during the first few days of the postnatal period. Some clinicians treat these neonates with gastric lavage (GL) to prevent vomiting and the establishment of enteral feeding empirically, but there was no study assessing the effect of GL for neonates with coffee-ground emesis. We designed a multicenter randomized controlled trial to evaluate the efficacy and safety of GL in neonates with coffee-ground emesis. Vigorous neonates with birth weight ranging from 2500 g to 3999 g and gestational age between 37w0d and 41w6d who presented with coffee-ground emesis on more than twice and diagnosed as false melena, were divided into two groups using computerized randomization. We defined feeding intolerance (FI) as (1) ≥2 vomiting episodes in 4h or ≥3 episodes in 24h and/or (2) feeding failure on at least two occasions because of retching or poor sucking. Primary outcome is percentage of infants who present FI within 24 hours from admission. We also assessed the residual volumes, number of vomiting episodes, percentage of weight reduction at postnatal day 4, rates of body weight gain at 1 month of age, and peak serum total bilirubin value before discharge. To our knowledge, this is the first study to evaluate the safety and efficacy of GL for neonates with coffee-ground emesis. This trial is registered at UMIN Clinical Trials Registry as UMIN000026483.


Assuntos
Lavagem Gástrica/métodos , Vômito/terapia , Peso ao Nascer/fisiologia , Feminino , Humanos , Recém-Nascido , Masculino , Mecônio/química , Estudos Prospectivos , Software
20.
J Pediatr ; 209: 259, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30928145
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