Prevalence of Microbial Isolates Cultured from Endometrial Swab Samples Collected from United Kingdom Thoroughbred Mares from 2014 to 2020.

Determining whether endometrial microbial isolates are pathogens, contaminants, or even part of the "normal" microbiome is extremely complex, particularly given the absence of "gold standard" tests for endometritis. Population-level benchmarking and temporal monitoring can provide novel insights and a wider context to improve understanding. This study aimed to (i) estimate the prevalence of endometrial isolates from swabs of Thoroughbred broodmares in Newmarket, UK between 2014 and 2020; and (ii) evaluate the effects of year, mare age, and cytology findings on isolate prevalence. Generalised linear mixed models with a logit link, both null models and models using year of sampling, mare age, or cytology findings as predictors, were fitted to estimate isolate prevalence. Over the 7-year period, data were available from 18,996 endometrial-swab samples from 6050 mares on 290 premises. The overall isolate prevalence was 35.5% (95% confidence interval (CI) 33.0-37.9), and this varied significantly between years. The most prevalent isolates were ß-hemolytic Streptococcus (17.9; 95% CI: 17-19) and E. coli (10.3%; 95% CI: 9.0-11.6). Isolate prevalence increased with mare age except for E. coli isolates, and with increasing category of cytology findings except for α-hemolytic Streptococcus isolates. The results provide novel estimates of isolate prevalence and highlight knowledge gaps around potential complexities in the interpretation of findings.

The equine umbilical cord in clinically healthy pregnancies.

BACKGROUND: Excessive umbilical cord length (UCL) is associated with equine pregnancy loss. However, a lack of UCL reference values makes it difficult to define excessive UCL. Further, factors associated with differences in UCL are poorly understood. OBJECTIVES: To (i) report the total, allantoic and amniotic UCL in healthy term pregnancies in Thoroughbreds, (ii) describe the relationship between gestational age and UCL, fetal weight and crown rump length (CRL) using clinically normal pregnancies (CNPs) from mares dying during gestation, and (iii) identify associations between UCL and maternal age and parity, paternal age, and fetal sex. STUDY DESIGN: Cross-sectional. METHODS: Data including UCLs, fetal weight, CRL and maternal age, parity, paternal age and fetal sex were taken from CNPs from Thoroughbred mares dying during gestation (n = 32), and placentas from HTPs (n = 34) in England. Correlations were assessed using Spearman's rank with significant correlations estimated by locally weighted scatter plot smoothing (LOWESS). Regression plots were fitted to highly correlated variables to further assess and quantify relationships. Differences in UCL between categorical variables were assessed using Kruskall Wallis and Mann-Whitney U tests. RESULTS: The median total, amniotic and allantoic HTP UCLs were 53.5 cm (interquartile range [IQR] 16), 29.5 cm (IQR 7) and 25.0 cm (IQR 8) respectively. Gestational age and amniotic UCL were moderately correlated (rho = 0.53, p = 0.04), with LOWESS estimating an exponential increase followed by plateauing at around Day 200. Nonlinear associations were observed between fetal weight and gestational age and CRL (adjusted r2 = 0.98 and 0.95 respectively). A linear association was observed between gestational age and CRL: predicted CRL = -17.60 + 0.38 × gestational age, p < 0.001. MAIN LIMITATIONS: Limited availability of CNPs from mares dying during gestation. Estimated relationships can only approximate growth. CONCLUSIONS: This study provides important UCL and fetal size reference values, which may aid in assessing abnormalities. For the first time, associations between UCL and gestational age have been described.

Does inbreeding contribute to pregnancy loss in Thoroughbred horses?

BACKGROUND: Excessive inbreeding increases the probability of uncovering homozygous recessive genotypes and has been associated with an increased risk of retained placenta and lower semen quality. No genomic analysis has investigated the association between inbreeding levels and pregnancy loss. OBJECTIVES: To compare genetic inbreeding coefficients (F) of naturally occurring Thoroughbred Early Pregnancy Loss (EPLs), Mid and Late term Pregnancy Loss (MLPL) and Controls. The F value was hypothesised to be higher in cases of pregnancy loss (EPLs and MLPLs) than Controls. STUDY DESIGN: Observational case-control study. METHODS: Allantochorion and fetal DNA from EPL (n = 37, gestation age 14-65 days), MLPL (n = 94, gestational age 70 days-24 h post parturition) and Controls (n = 58) were genotyped on the Axiom Equine 670K SNP Genotyping Array. Inbreeding coefficients using Runs of Homozygosity (FROH) were calculated using PLINK software. ROHs were split into size categories to investigate the recency of inbreeding. RESULTS: MLPLs had significantly higher median number of ROH (188 interquartile range [IQR], 180.8-197.3), length of ROH (3.10, IQR 2.93-3.33), and total number of ROH (590.8, IQR 537.3-632.3), and FROH (0.26, IQR 0.24-0.28) when compared with the Controls and the EPLs (p < 0.05). There was no significant difference in any of the inbreeding indices between the EPLs and Controls. The MLPLs had a significantly higher proportion of long (>10 Mb) ROH (2.5%, IQR 1.6-3.6) than the Controls (1.7%, IQR 0.6-2.5), p = 0.001. No unique ROHs were found in the EPL or MLPL populations. MAIN LIMITATIONS: SNP-array data does not allow analysis of every base in the sequence. CONCLUSIONS: This first study of the effect of genomic inbreeding levels on pregnancy loss showed that inbreeding is a contributor to MLPL, but not EPL in the UK Thoroughbred population. Mating choices remain critical, because inbreeding may predispose to MLPL by increasing the risk of homozygosity for specific lethal allele(s).

Gestation Length is Associated With Early-Life Limb Deformities in Thoroughbred Foals.

Flexural and angular limb deformities (LD) are an important cause of early-life morbidity and mortality/euthanasia in Thoroughbred foals. The majority are congenital in origin but, to date, their precise aetiology is poorly understood. We hypothesized that maternal- and pregnancy-level factors, particularly those with potential to influence in-utero growth and development, could play an important role. The aim of this study was therefore to investigate associations between such factors and early-life LD in Thoroughbred foals. A birth cohort was established on seven farms across the United Kingdom and Ireland and details of veterinary interventions for LD in foals in the first six months of life prospectively recorded. Details of dams' signalment, breeding history and reproductive and veterinary history in the breeding season(s) of interest were retrieved retrospectively from stud farm and veterinary records. Associations between mare- and pregnancy-level factors and LD in offspring were assessed using multivariable logistic regression. Records were available for 275 pregnancies in 235 mares, over two breeding seasons. Pregnancies resulted in the birth of 272 live foals, 21% of which (n = 57/272, 95% CI, 16-26) required veterinary intervention for LD in the first six months of life. Odds of LD decreased by 4% per day increase in gestation length between 314 and 381 days (OR 0.96, 95% CI, 0.93-0.99, P = .01). Longer gestation length appears to reduce the odds of early-life LD, including within the normal range of gestation length for Thoroughbred foals. Further work is required to elucidate biological mechanisms behind this association.

Production of Mare Chorionic Girdle Organoids That Secrete Equine Chorionic Gonadotropin.

The equine chorionic girdle is comprised of specialized invasive trophoblast cells that begin formation approximately 25 days after ovulation (day 0) and invade the endometrium to become endometrial cups. These specialized trophoblast cells transition from uninucleate to differentiated binucleate trophoblast cells that secrete the glycoprotein hormone equine chorionic gonadotropin (eCG; formerly known as pregnant mare serum gonadotropin or PMSG). This eCG has LH-like activity in the horse but variable LH- and FSH-like activity in other species and has been utilized for these properties both in vivo and in vitro. To produce eCG commercially, large volumes of whole blood must be collected from pregnant mares, which negatively impacts equine welfare due to repeated blood collections and the birth of an unwanted foal. Attempts to produce eCG in vitro using long-term culture of chorionic girdle explants have not been successful beyond 180 days, with peak eCG production at 30 days of culture. Organoids are three-dimensional cell clusters that self-organize and can remain genetically and phenotypically stable throughout long-term culture (i.e., months). Human trophoblast organoids have been reported to successfully produce human chorionic gonadotropin (hCG) and proliferate long-term (>1 year). The objective of this study was to evaluate whether organoids derived from equine chorionic girdle maintain physiological functionality. Here we show generation of chorionic girdle organoids for the first time and demonstrate in vitro production of eCG for up to 6 weeks in culture. Therefore, equine chorionic girdle organoids provide a physiologically representative 3D in vitro model for chorionic girdle development of early equine pregnancy.

Incidence of disease, injury and death in Thoroughbred foals and yearlings on stud farms in the UK and Ireland.

BACKGROUND: Up-to-date estimates of early-life morbidity and mortality in Thoroughbreds are lacking. METHODS: A birth cohort was established on Thoroughbred stud farms across the UK and Ireland. All veterinary interventions for disease or injury between birth and 18 months of age or leaving the study were recorded. Multilevel Poisson regression models with farm and foal as random effects were fitted to estimate incidence rates. RESULTS: Data were available for 3328 foal-months at risk for 275 foals on seven farms. The overall rates of disease and injury requiring veterinary intervention and mortality were 11.9 cases/100 foal-months at risk (95% confidence interval [CI] 8.6-16.2) and 0.2 cases/100 foal-months at risk (95% CI 0.1-0.4), respectively. Almost half (n = 133/273, 49%, 95% CI 43-55) of the live-born cohort required veterinary intervention for musculoskeletal disease or injury, equating to 5.8 cases/100 foal-months at risk (95% CI 4.1-8.2), predominantly reported as developmental orthopaedic disease (DOD). LIMITATIONS: Convenience sampling of participants may affect the generalisability of the findings. CONCLUSIONS: Rates of musculoskeletal disease and injury, in particular DOD, on Thoroughbred stud farms were high. Further work to identify modifiable risk factors and further understanding of the economic impact of these conditions and long-term consequences for musculoskeletal health and performance is required.

Antimicrobial resistance of endometrial bacterial isolates collected from UK Thoroughbred mares between 2014 and 2020.

BACKGROUND: Antimicrobial resistance (AMR) is important in equine reproduction, as antimicrobials have historically been widely used in the management of breeding mares. However, evidence of the characteristics of AMR in uterine isolates is limited in the UK. The objective of this retrospective study was therefore to describe temporal changes in AMR patterns of bacteria isolated from the endometrium of Thoroughbred broodmares in south-east England between 2014 and 2020. METHOD: Endometrial swabs were processed for microbiology and antimicrobial susceptibility testing (AST). For frequently isolated bacteria, changes in AMR patterns over time were assessed using a logistic regression model. RESULTS: From 18,996 endometrial swabs, 30.5% were positive for microbial culture. AST was performed on 2091 isolates, representing 1924 swabs collected from 1370 mares located at 132 premises. Beta-haemolytic Streptococcus (BHS, 52.5%) and Escherichia coli (25.8%) were most frequently isolated. In BHS, resistance to enrofloxacin (p = 0.02), nitrofurazone (p < 0.001) and oxytetracycline (p < 0.01) increased significantly between 2014 and 2020, while resistance to trimethoprim-sulfamethoxazole (p < 0.001) decreased. In E. coli, resistance to nitrofurazone increased (p = 0.04) and resistance to gentamycin (p = 0.02) and trimethoprim-sulfamethoxazole (p < 0.001) decreased. LIMITATIONS: Variations in the specimen collection protocols might have affected the frequency of isolates detected. CONCLUSION: Between 2014 and 2020, AMR changed in this bacterial population. However, there was no significant increase in resistance to penicillin (99.6% BHS susceptible), gentamycin (81.7% E. coli susceptible) or ceftiofur.

Populations of NK Cells and Regulatory T Cells in the Endometrium of Cycling Mares-A Preliminary Study.

Endometrial immune cells are essential to support uterine functions across the estrous cycle and in preparation for pregnancy. It has been acknowledged that changes in phenotype and/or numbers of lymphocytes, such as regulatory T cells (Tregs) and NK cells, might result in lower fertility in women and mice. Little is known about equine endometrial immune cells across the estrous cycle. Here, we compared the populations of endometrial Tregs and NK cells in estrus and diestrus in mares. Endometrial biopsy and blood samples were taken in estrus and diestrus from 11 mares ages 4-12 years. Flow cytometry with anti-CD4, -CD25 and -FOXP3 and anti-NKp46 and -CD3 antibodies was used to determine the populations of Tregs and NK cells, respectively. The concentration of progesterone was measured with chemiluminescence immunoassay. The results were analyzed with paired Student t tests. The mean percentage of endometrial CD4+FOXP3+ Tregs was 13.7 ± 6.2% in diestrus and 14.5 ± 5.9% in estrus, while the mean percentage of endometrial CD4+FOXP3+CD25+ Tregs changed from 3.6 ± 2.1% in diestrus to 2 ± 2% in estrus (p = 0.0947). The mean proportion of CD3-NKp46+ lymphocytes in the endometrium was not significantly different, with 6 ± 1% in estrus and 6.5 ± 1.4% in diestrus. There was a large variation in the percentage of NK cells between mares of 2.1-12.7%. This study showed, for the first time, the presence of CD4+FOXP3+CD25+ Tregs and CD3-NKp46+ NK cells in the endometrium of non-pregnant cycling mares. The percentage of Tregs, and to a greater extent NK cells, showed large fluctuations between mares. Both Tregs and NK cells might be important for the preparation of the endometrium for semen deposition and pregnancy; however, further research is required.

Multivariable analysis to determine risk factors associated with abortion in mares.

Risk factors associated with equine reproductive efficiency have been identified along with those associated specifically with early pregnancy loss (EPL). In contrast, no studies have reported risk factors associated with abortion (loss between day 70 and 300 post-cover). Given the causes of abortion differ to those of EPL, likely too will the risk factors. A retrospective cohort study was carried out to identify risk factors associated with abortion in UK and Irish based Thoroughbreds, collecting data on 20 exposure variables over a five-year period. A generalized linear mixed model was utilized to evaluate the associations between exposure variables and abortion, with clustering of observations accounted for at the mare and farm level. Variables with a likelihood ratio test (LRT) p value <0.2 were entered into the model in a forward stepwise approach. Pregnancy outcome was available on 4,439 pregnancies from 2,510 mares. Having had two or more prior abortions (odds ratio (OR) 7.91, 95% confidence interval (CI) 2.86, 21.88), conceiving on the second or subsequent covered estrous cycle (OR 1.84, 95% CI 1.22, 2.78) and conceiving multiple conceptuses (OR 1.68, 95% CI 1.02, 2.76) were associated with an increased risk of abortion compared to null parous, first estrous cycle covers and singleton conceptions respectively. Increasing paternal age (OR 0.95, 95% CI 0.90, 0.99) was associated with a decreasing risk of abortion. Mare and farm variance were not significant in the final model, LRT p=0.43. These findings provide evidence-based data to inform Thoroughbred breeding management practices to help mitigate abortion risk.

Bayesian accuracy estimates and fit for purpose thresholds of cytology and culture of endometrial swab samples for detecting endometritis in mares.

The overall aim of this work was to identify the potential impact of misclassification errors associated with routine screening and diagnostic testing for endometritis in mares. Using Bayesian latent class models (BLCM), specific objectives were to: 1) estimate the diagnostic accuracy of cytology and culture of endometrial swab samples to detect endometritis in mares; 2) assess the impact of different cytology thresholds on test accuracy and misclassification costs; and 3) assess the sensitivity (Se) and specificity (Sp) of a diagnostic strategy including both tests interpreted in series and parallel. Diagnostic and pre-breeding endometrial swab samples collected from 3448 mares based at breeding premises located in the South East of England between 2014 and 2020 were retrospectively analysed. Culture results were classified as positive according to three different case definitions: (A) > 90% of the growth colonies were a monoculture; (B) pathogenic or pathogenic and non-pathogenic bacteria were identified; and (C) any growth was observed. Endometrial smears were graded based on the percent of polymorphonuclear cells (PMN) per high power field (HPF). A hierarchical BLCM was fitted using the cross-tabulated results of the three culture case definitions with a cytology threshold fixed at > 0.5% PMN. Fit for purpose cytology thresholds were proposed using a misclassification cost analysis in the context of good antimicrobial stewardship and for varying endometritis prevalence estimates. Median [95% Bayesian credible intervals (BCI)] cytology Se estimates were 6.5% (2.2-11.6), 6.4% (2.2-10.8) and 6.3% (2.2-10.8) for scenario A, B and C, respectively. Median (95% BCI) cytology Sp estimates were 88.8% (83.1-94.8), 88.9% (83.9-93.8) and 88.8% (84.0-93.8) for scenarios A, B and C, respectively. Median (95% BCI) culture Se estimates were 37.5% (29.9-46.0), 42.3% (33.8-51.1) and 46.4% (35.7-55.9) for scenarios A, B and C, respectively. Median (95% BCI) culture Sp estimates were 92.8% (84.3-99.0), 91.5% (82.5-98.0) and 90.8% (80.1-97.4) for scenarios A, B and C, respectively. Regardless of the culture case definition, Se and Sp of cytology (> 0.5% PMN) was lower than previously reported for swab samples in studies using histology as the reference standard test. The misclassification cost term decreased as the cytology threshold increased for all scenarios and all prevalence contexts, suggesting that, regardless of the endometritis prevalence in the population, increasing the cytology threshold would reduce the misclassification costs associated with false positive mares contributing to good antimicrobial stewardship.

Date of birth and purchase price as foals or yearlings are associated with Thoroughbred flat race performance in the United Kingdom and Ireland.

Background: Thoroughbred breeders aim to have foals born early in the season, but scientific evidence on the advantages for race performance is scarce and contradictory. Methods: The association between date of birth and purchase price as foal/yearling, with race performance by the end of the second and third years of life of Thoroughbreds racing in flat races in the United Kingdom (UK) and Ireland (IRE) was assessed using negative binomial and zero-inflated negative binomial models on the entire 2014-2015 UK/IRE foal crops (n = 28,282). Results: In total, 6666 and 9456 horses raced in UK/IRE flat racing by the end of their second and third years of life. Prize money and prize money per start decreased with each additional day beyond 1 January that the foal was born. Purchase price as foal and yearling was negatively associated with the number of races run, while it was positively associated with prize money and prize money per start by the end of the third year of life. Conclusions: Foals born early in the season had higher earnings by the end of their second and third years of life than foals born later. Differences were more marked among males than females. The most expensive horses sold as foals or yearlings ran fewer races but earned more prize money and prize money per start than less expensive horses. Results from this population-based analyses may inform strategies and management practices aiming to maximise horses' racing performance potential and increase financial returns.

Mixed-Effects Modelling of the Risk Factors Associated with Multiple Pregnancies in Thoroughbred Mares.

Multiple pregnancies (MPs) are commonly diagnosed during breeding management of mares. Whilst some studies have reported on factors associated with the risk of MPs, few have utilised multivariable data analysis to control for confounding variables. A prospective cohort study of Thoroughbred broodmares was conducted with information collected on 27 factors. Mixed-effects logistic regression was used to determine risk factors for MPs. Mare, stallion, stud, and veterinarian were evaluated as random effects. The prevalence of MPs in 1754 mares and 2245 pregnancies was 16.06% (95% confidence interval [CI] = 14.54, 17.58). Multiple ovulations (OR = 15.57, 95% CI = 11.88, 20.53) and treatment with cloprostenol (OR = 1.35, 95% CI = 1.015, 1.80) were associated with increased odds of MPs following multivariable analysis. Mares that foaled at the start of the breeding season (OR = 0.66, 95% CI = 0.47, 0.94), conceived at the second or more oestrus cycles (OR = 0.60, 95% CI= 0.43, 0.84), or identified with a uterine cyst (OR = 0.63, 95% CI = 0.40, 0.97) were at reduced odds of conceiving MPs. Mare, stallion, stud, and veterinarian were not associated with MPs. These findings provide possible explanations as to why the prevalence of MPs but not MOs have increased over the last decade.

Environmental constraints and pathologies that modulate equine placental genes and development.

Equine placental development is a long process with unique features. Implantation occurs around 40 days of gestation (dpo) with the presence of a transient invasive placenta from 25-35 to 100-120 dpo. The definitive, non-invasive placenta remains until term (330 days). This definitive placenta is diffuse and epitheliochorial, exchanging nutrients, gas and waste with the endometrium through microvilli, called microcotyledons. These are lined by an external layer of haemotrophic trophoblast. Moreover, histotrophic exchange remains active through the histotrophic trophoblast located along the areolae. Placental development is dependent on the maternal environment that can be affected by several factors (e.g. nutrition, metabolism, age, embryo technologies, pathologies) that may affect fetal development as well as long-term offspring health. The first section of the review focuses on normal placental development as well as definitive placental structure. Differences between the various regions of the placenta are also highlighted. The latter sections provide an overview of the effects of the maternal environment and reproductive pathologies, respectively, on trophoblast/placental gene expression and structure. So far, only pre-implantation and late gestation/term data are available, which demonstrate important placental plasticity in response to environmental variation, with genes involved in oxidative stress and tissue differentiation mostly involved in the pre-implantation period, whereas genes involved in feto-placental growth and nutrient transfers are mostly perturbed at term.

Lethal variants of equine pregnancy: is it the placenta or foetus leading the conceptus in the wrong direction?

Embryonic and foetal loss remain one of the greatest challenges in equine reproductive health with 5-10% of established day 15 pregnancies and a further 5-10% of day 70 pregnancies failing to produce a viable foal. The underlying reason for these losses is variable but ultimately most cases will be attributed to pathologies of the environment of the developing embryo and later foetus, or a defect intrinsic to the embryo itself that leads to lethality at any stage of gestation right up to birth. Historically, much research has focused on the maternal endometrium, endocrine and immune responses in pregnancy and pregnancy loss, as well as infectious agents such as pathogens, and until recently very little was known about the both small and large genetic variants associated with reduced foetal viability in the horse. In this review, we first introduce key aspects of equine placental and foetal development. We then discuss incidence, risk factors and causes of pregnancy loss, with the latter focusing on genetic variants described to date that can impact equine foetal viability.

Preliminary testing of psychometric properties of the 'student perceptions of veterinary interprofessional education and work scale' (SP-VIEWS).

Responsibility for the provision of veterinary care and services is increasingly shared between veterinary surgeons/veterinarians and registered veterinary nurses/veterinary technicians. Interprofessional education of these clinical professionals is not widespread but is growing. Understanding students' perceptions of veterinary interprofessional education and working is therefore important; however, no validated scale exists to assess this. This study aimed to create and test the psychometric properties of a 'Student perceptions of veterinary interprofessional education and work scale' (SP-VIEWS). A scale was built using scales previously validated in other contexts, plus statements informed by veterinary interprofessional research, and sent to veterinary and veterinary nursing students at six UK institutions. Exploratory Factor Analysis (EFA) on a randomly-selected half of the responses (n = 260) suggested a model with 16 items grouped within three factors: 'Benefits of learning with the other profession', 'Leadership and speaking up' and 'Teams and benefits of teamwork'. Confirmatory Factor Analysis (CFA) on the remaining 260 responses demonstrated appropriate fit based on conventional parameters, such as goodness of fit index. Overall internal consistency was good (Cronbach's alpha 0.82). CFA demonstrated that SP-VIEWS showed adequate, though not excellent, fit to the data. Future research should evaluate SP-VIEWS in other universities and countries.

First reported case of fragile foal syndrome type 1 in the Thoroughbred caused by PLOD1 c.2032G>A.

BACKGROUND: Warmblood Fragile Foal Syndrome Type 1 (WFFS) is an autosomal recessive disorder reported previously only in warmbloods and thought to be caused by a variant in the gene procollagen-lysine,2-oxoglutarate 5-dioxygenase 1 (PLOD1, c.2032G>A, p.Gly678Arg). Given the presentation of this Thoroughbred case, we hypothesised that a similar genetic mechanism caused this phenotype. OBJECTIVES: To describe the pathological and genetic findings on a foal presenting to a veterinary practice in the UK with skin lesions similar to other Ehlers-Danlos Syndromes, including those documented for warmbloods with WFFS. STUDY DESIGN: A single case report describing a genetic investigation. METHODS: A Thoroughbred foal presenting as dystocia was euthanised for multiple skin lesions and developmental abnormalities. DNA extracted from the foal was tested for the PLOD1 variant (c.2032G>A, p.Gly678Arg) using the commercially available assay. To confirm causality and further interrogate potential novel causes of Ehlers-Danlos Syndrome, 1799 functional candidate genes, including PLOD1, were analysed using whole genome sequencing data generated from DNA extracted from the foal's muscle. These data were compared to 34 control samples from at least 11 other breeds. Variants were prioritised for further evaluation based on predicted impact on protein function. RESULTS: Post-mortem evaluation concluded that this foal suffered from a condition of collagen dysplasia. The foal was homozygous for the c.2032G>A PLOD1 variant. Only two other missense variants identified from whole genome sequencing data were also computationally predicted to be deleterious to protein function, (NPHP3 c.1253T>C, p.Leu418Pro, EPDR1 c.154G>C, p.Glu52Gln). Neither of these genes have been linked to similar phenotypes, or Ehlers-Danlos Syndrome in humans or other species and thus further investigation of these variants as the cause of EDS was not warranted. MAIN LIMITATIONS: This study is a single case report in the Thoroughbred with no additional cases from this breed yet identified to replicate this finding. CONCLUSIONS: Given the clinical presentation similar to WFFS, homozygosity for the PLOD1 variant, and absence of another more plausible causal variant from the WGS experiment, we conclude that PLOD1 c.2032G>A is the likely cause of this foal's condition. This is the first documented evidence of fragile foal syndrome caused by the PLOD1 variant in a breed outside of warmbloods, the Thoroughbred. We therefore recommend a change in the name of this disorder to fragile foal syndrome type 1 (FFS) and utilisation of genetic testing in Thoroughbreds to avoid producing affected foals.

Retrospective analysis of the population dynamics and racing outcomes of the 2014 and 2015 UK and Ireland Thoroughbred foal crops.

BACKGROUND: Up-to-date figures on early losses of Thoroughbreds from the racing industry can inform strategies to improve retention and incentivise traceability of Thoroughbreds during this early life period. METHODS: Data on Thoroughbred mares bred in 2013-2014 and training, racing and sales information of their live offspring were analysed. The proportions and 95% confidence intervals (95% CI) of the entire 2014-2015 United Kingdom and Ireland foal crops that entered training, raced, were imported and/or exported between birth and the end of their third year of life, as well as the racing performance of these horses as 2- and 3-year-olds were described. RESULTS: A total of 20,661 mares produced 28,282 live foals. Of them, 47.2% (95% CI: 46.7-47.8; n = 13,354) entered training by the end of their third year of life. Of these, 10,595 (79.3%; 95% CI: 78.7-80.0) raced at least once. Around 20% (n = 5712) of horses were exported by the end of their third year of life, of which 3526 (61.7%) had been in training. The overall mortality during the study period was 7.6% (n = 2123). CONCLUSION: A considerable proportion of Thoroughbreds had not entered training by 3 years of age but of those that had, the proportion that raced at least once was high. Further research is needed to establish reasons for premature losses from the industry.

Fetal morphological features and abnormalities associated with equine early pregnancy loss.

BACKGROUND: Early pregnancy loss (EPL) occurs in approximately 8% of equine pregnancies, although the aetiology is mostly unknown and embryonic/fetal morphological abnormalities associated with EPL are not defined. OBJECTIVES: To compare the morphology of EPL to clinically normal embryos/fetuses and previously described embryonic/fetal developmental milestones. To identify morphological abnormalities associated with equine EPL. STUDY DESIGN: Observational case-control study. METHODS: Embryos/fetuses were obtained from clinically normal Thoroughbred and pony pregnancies (n = 11) and following EPL from Thoroughbred mares (n = 27). The crown-rump length (CRL) of embryos/fetuses was measured and macroscopic morphology and developmental age were determined independently by three blinded examiners. Sagittal sections of EPL (n = 13) and control (n = 6) embryos/fetuses were assessed microscopically. Fisher's exact test was used to determine significance (P < .05) and correlations were expressed by Pearson coefficient. RESULTS: Age and CRL were strongly positively correlated in clinically normal Thoroughbred and reference (n = 15, R = .9 (95% CI: 0.8-1.0), R2  = .9, P < .0001) but not EPL embryos/fetuses (n = 19, R = .1 (95% CI: -0.4 to 0.5), R2  = .01, P = .75). Relative to controls, the CRL of EPL embryos/fetuses was smaller, with evidence of intrauterine growth retardation (IUGR) in 3/8 fetuses assessed. In 9/13 EPL embryos/fetuses, nonspecific neural tissue alterations were identified including disruption of developing pros-, mes- and rhombencephalon and the presence of haemosiderin, indicating premortem haemorrhage. Failed neural tube closure was identified in 1/13 EPL embryos/fetuses. Subcutaneous haemorrhage was present in 14/27 EPL embryos/fetuses. MAIN LIMITATIONS: Autolysis significantly affected 15/27 EPL embryos/fetuses, excluding them from complete assessment. The IUGR reference cut-off values were based on a small number of controls. CONCLUSIONS: Morphological features associated with equine EPL were a mismatch between embryonic/fetal size and age, and alterations of the developing neural tissue and localised subcutaneous haemorrhage. Failed neural tube closure was confirmed as a rare specific abnormality.

Incidence and causes of pregnancy loss after Day 70 of gestation in Thoroughbreds.

BACKGROUND: Pregnancy loss after Day 70 of gestation manifests as abortion, stillbirth or perinatal death. While previous studies have reported the diagnoses of laboratory submissions, none have quantified the incidence and causes of abortions, stillbirths and perinatal mortality at a population level. OBJECTIVES: To report the incidence and causes of pregnancy loss after Day 70 of gestation in a cohort of Thoroughbreds. STUDY DESIGN: Retrospective cohort study. METHODS: Outcomes of Day 70 pregnancies were collected from eight Thoroughbred farms over the 2013-2017 breeding seasons. Stud, veterinary and laboratory records were supplemented with publicly available data. Cause of loss was categorised using custom criteria. RESULTS: Data were collected on 3,586 pregnancies from 1,802 mares. The incidence risk of a pregnancy failing to produce a live foal at 24 hours post parturition was 7.3% (95% confidence interval (CI) 6.5-8.2, equating to 7.3 cases per 100 Day-70 pregnancies). The incidence of pregnancy loss between Day 70 and 300 of gestation, Day 301-315 and stillbirth/perinatal death was 4.0% (95% CI 3.4-4.7), 0.3% (95% CI 0.2-0.6) and 1.4% (95% CI 1.1-1.9) respectively. Of the pregnancy losses where tissue was available, 61.1% were submitted for post-mortem examination. The incidence risk of loss due to umbilical cord-related pathologies was 1.5% (95% CI 1.1-1.9), 0.4% (95% CI 0.2-0.6) for noninfectious placental disease and 0.3% (95% CI 0.2-0.6) for both infectious placentitis and Equine Herpesvirus infection. No primary diagnosis was made in 11.2% of the cases which underwent full post-mortem examination. MAIN LIMITATIONS: It was not possible to differentiate between intra-partum stillbirth and early post-partum death. CONCLUSION: Pregnancy loss after Day 70 of gestation is a significant source of loss in the Thoroughbred with umbilical cord-related pathologies being the most commonly diagnosed cause. Reporting the incidence of pregnancy loss at a population level with clear case definitions will allow for accurate global comparisons.

Whole genome analysis reveals aneuploidies in early pregnancy loss in the horse.

The first 8 weeks of pregnancy is a critical time, with the majority of pregnancy losses occurring during this period. Abnormal chromosome number (aneuploidy) is a common finding in human miscarriage, yet is rarely reported in domestic animals. Equine early pregnancy loss (EPL) has no diagnosis in over 80% of cases. The aim of this study was to characterise aneuploidies associated with equine EPL. Genomic DNA from clinical cases of spontaneous miscarriage (EPLs; 14-65 days of gestation) and healthy control placentae (various gestational ages) were assessed using a high density genotyping array. Aneuploidy was detected in 12/55 EPLs (21.8%), and 0/15 healthy control placentae. Whole genome sequencing (30X) and digital droplet PCR (ddPCR) validated results. The majority of these aneuploidies have never been reported in live born equines, supporting their embryonic/fetal lethality. Aneuploidies were detected in both placental and fetal compartments. Rodents are currently used to study how maternal ageing impacts aneuploidy risk, however the differences in reproductive biology is a limitation of this model. We present the first evidence of aneuploidy in naturally occurring equine EPLs at a similar rate to human miscarriage. We therefore suggest the horse as an alternative to rodent models to study mechanisms resulting in aneuploid pregnancies.