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1.
Pharm Res ; 38(4): 647-655, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33825113

ABSTRACT

PURPOSE: Fexofenadine is a well-identified in vivo probe substrate of P-glycoprotein (P-gp) and/or organic anion transporting polypeptide (OATP). This work aimed to investigate the transplacental pharmacokinetics of fexofenadine enantiomers with and without the selective P-gp inhibitor fluoxetine. METHODS: The chiral transplacental pharmacokinetics of fexofenadine-fluoxetine interaction was determined using the ex vivo human placenta perfusion model (n = 4). In the Control period, racemic fexofenadine (75 ng of each enantiomer/ml) was added in the maternal circuit. In the Interaction period, racemic fluoxetine (50 ng of each enantiomer/mL) and racemic fexofenadine (75 ng of each enantiomer/mL) were added to the maternal circulation. In both periods, maternal and fetal perfusate samples were taken over 90 min. RESULTS: The (S)-(-)- and (R)-(+)-fexofenadine fetal-to-maternal ratio values in Control and Interaction periods were similar (~0.18). The placental transfer rates were similar between (S)-(-)- and (R)-(+)-fexofenadine in both Control (0.0024 vs 0.0019 min-1) and Interaction (0.0019 vs 0.0021 min-1) periods. In both Control and Interaction periods, the enantiomeric fexofenadine ratios [R-(+)/S-(-)] were approximately 1. CONCLUSIONS: Our study showed a low extent, slow rate of non-enantioselective placental transfer of fexofenadine enantiomers, indicating a limited fetal fexofenadine exposure mediated by placental P-gp and/or OATP2B1. The fluoxetine interaction did not affect the non-enantioselective transplacental transfer of fexofenadine. The ex vivo placental perfusion model accurately predicts in vivo placental transfer of fexofenadine enantiomers with remarkably similar values (~0.17), and thus estimates the limited fetal exposure.


Subject(s)
Histamine H1 Antagonists, Non-Sedating/pharmacokinetics , Maternal-Fetal Exchange/drug effects , Placenta/metabolism , Terfenadine/analogs & derivatives , ATP Binding Cassette Transporter, Subfamily B/antagonists & inhibitors , ATP Binding Cassette Transporter, Subfamily B/metabolism , Area Under Curve , Drug Interactions , Female , Fluoxetine/administration & dosage , Fluoxetine/pharmacokinetics , Histamine H1 Antagonists, Non-Sedating/administration & dosage , Humans , Perfusion/instrumentation , Perfusion/methods , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Complications/immunology , Stereoisomerism , Terfenadine/administration & dosage , Terfenadine/pharmacokinetics
2.
BMC Med ; 17(1): 77, 2019 04 11.
Article in English | MEDLINE | ID: mdl-30971237

ABSTRACT

BACKGROUND: The uterine environment may influence telomere length at birth, which is essential for cellular function, aging, and disease susceptibility over the lifespan. However, little is known about the impact of toxic chemicals on early-life telomeres. Therefore, we assessed the potential impact of multiple toxic metals on relative telomere length (rTL) in the maternal blood, cord blood, and placenta, as well as the potential modifying effects of pro-oxidants. METHOD: In a mother-child cohort in northern Argentina (n = 169), we measured multiple toxic metals in the maternal blood or urine collected during late pregnancy, as well as the placenta and cord blood collected at delivery, using inductively coupled plasma mass spectrometry (ICP-MS). We assessed associations of log2-transformed metal concentrations with rTL, measured in maternal and cord blood leukocytes and the placenta by real-time PCR, using multivariable-adjusted linear regression. Additionally, we tested for modifications by antioxidants (zinc, selenium, folate, and vitamin D3). RESULTS: Exposure to boron and antimony during pregnancy was associated with shorter maternal rTL, and lithium with longer maternal rTL; a doubling of exposure was associated with changes corresponding to 0.2-0.4 standard deviations (SD) of the rTL. Arsenic concentrations in the placenta (n = 98), blood, and urine were positively associated with placental rTL, about 0.2 SD by doubled arsenic. In the cord blood (n = 88), only lead was associated with rTL (inversely), particularly in boys (p for interaction 0.09). Stratifying by newborn sex showed ten times stronger association in boys (about 0.6 SD) than in girls. The studied antioxidants did not modify the associations, except that with antimony. CONCLUSIONS: Elevated exposure to boron, lithium, arsenic, and antimony was associated with maternal or newborn rTL in a tissue-specific, for lead also sex-specific, manner. Nutritional antioxidants did not generally influence the associations.


Subject(s)
Antioxidants/administration & dosage , Environmental Exposure/analysis , Maternal Exposure , Maternal Nutritional Physiological Phenomena , Metals, Heavy/toxicity , Telomere Homeostasis/physiology , Telomere/physiology , Adolescent , Adult , Argentina/epidemiology , Child , Cohort Studies , Diet , Environmental Exposure/prevention & control , Female , Fetal Blood/drug effects , Fetal Blood/metabolism , Humans , Infant, Newborn , Male , Maternal Exposure/statistics & numerical data , Maternal Nutritional Physiological Phenomena/drug effects , Maternal-Fetal Exchange/drug effects , Maternal-Fetal Exchange/genetics , Metals, Heavy/analysis , Metals, Heavy/blood , Metals, Heavy/urine , Mothers , Placenta/drug effects , Placenta/metabolism , Pregnancy , Prenatal Exposure Delayed Effects/chemically induced , Prenatal Exposure Delayed Effects/epidemiology , Prenatal Exposure Delayed Effects/genetics , Prenatal Exposure Delayed Effects/prevention & control , Telomere/drug effects , Telomere Homeostasis/drug effects , Young Adult
3.
Nutrients ; 10(9)2018 Aug 23.
Article in English | MEDLINE | ID: mdl-30142890

ABSTRACT

We studied trends in fish intake among pregnant women living in the Madeira River Basin in Rondônia State, Brazil, to investigate the influence of maternal fish intake on anthropometric indices of children followed up to 5 years. Maternal fish intake was assessed using hair mercury concentrations of mothers and children at delivery and 6, 24, and 59 months. Data analysis was performed using a linear mixed-effect model. Mothers were predominantly young, had low incomes and limited schooling, and breastfed for >6 months. Only 1.9% of children had low birth weight. Anthropometric indices in approximately 80% of the study population showed Z-score values ranging from ≥-2 to ≤1. The influence of maternal fish intake on anthropometric indices, including height-to-age (H/A), weight-to-age (W/A), and weight-to-height (W/H) were not statistically significant after model adjustments. However, higher income and larger birth weight had a positive influence on H/A and W/A, whereas W/H gain was favored by higher maternal educational status and breastfeeding duration. Other variables (hemoglobin concentration and maternal age) had a positive significant influence on anthropometric indices. Maternal fish intake (or its attendant MeHg exposure) did not affect children growth. Nevertheless, it is advisable to avoid mercury-contaminated fish during pregnancy and childhood.


Subject(s)
Anthropometry , Diet , Maternal Exposure , Seafood , Adolescent , Anemia, Iron-Deficiency/blood , Animals , Birth Weight , Brazil , Child Development , Child, Preschool , Female , Fishes , Follow-Up Studies , Food Contamination/analysis , Hair/chemistry , Hemoglobins/metabolism , Humans , Infant , Male , Maternal Exposure/adverse effects , Maternal-Fetal Exchange/drug effects , Mercury/analysis , Pregnancy , Socioeconomic Factors , Young Adult
4.
Br J Clin Pharmacol ; 84(10): 2415-2421, 2018 10.
Article in English | MEDLINE | ID: mdl-29959798

ABSTRACT

AIMS: The present study evaluated the placental transfer and amniotic fluid distribution of bupivacaine enantiomers in health pregnant women and in human immunodeficiency virus (HIV)-infected pregnant women receiving epidural anaesthesia for caesarean section. METHODS: Twelve HIV-infected pregnant women (HIV group) were treated long-term (at least 8 weeks) with lopinavir/ritonavir (400/100 mg twice daily), and 12 healthy pregnant women (Control group) who submitted to epidural anaesthesia with racemic bupivacaine (75 mg) during caesarean section were investigated. At delivery, samples of maternal and fetal blood and amniotic fluid were collected (10-20 min after drug administration). RESULTS: The placental transfer ratio of bupivacaine enantiomers was significantly higher among the pregnant women from the HIV group when compared with those from the Control group (Mann-Whitney test, P ≤ 0.05). Placental transfer ratios (median and 25th - 75th percentiles) for (+)-(R)-bupivacaine were 0.58 (0.38-0.82) in the HIV group vs. 0.25 (0.18-0.33) in the Control group, and for (-)-(S)-bupivacaine, they were 0.54 (0.34-0.69) in the HIV group vs. 0.25 (0.19-0.29) in the Control group. The transplacental distribution of bupivacaine was stereoselective only in the HIV group. The umbilical artery/umbilical vein ratio and amniotic fluid/maternal vein ratio were low and nonstereoselective, and no statistically significant differences were observed between the groups. CONCLUSIONS: This study supports that the placental transfer of both bupivacaine enantiomers was 100% higher in HIV-pregnant women treated with lopinavir/ritonavir when compared with that in healthy pregnant women receiving epidural anaesthesia for caesarean section.


Subject(s)
Anesthetics, Local/pharmacokinetics , Bupivacaine/pharmacokinetics , HIV Infections/drug therapy , HIV Protease Inhibitors/adverse effects , Lopinavir/adverse effects , Pregnancy Complications, Infectious/drug therapy , Ritonavir/adverse effects , Adult , Amniotic Fluid/chemistry , Anesthesia, Epidural/adverse effects , Anesthesia, Epidural/methods , Anesthesia, Obstetrical/adverse effects , Anesthesia, Obstetrical/methods , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Case-Control Studies , Cesarean Section/adverse effects , Drug Combinations , Female , Fetal Blood/chemistry , Humans , Maternal-Fetal Exchange/drug effects , Permeability , Placenta/drug effects , Placenta/metabolism , Pregnancy
5.
Br J Clin Pharmacol ; 84(9): 2075-2087, 2018 09.
Article in English | MEDLINE | ID: mdl-29873094

ABSTRACT

AIMS: Buprenorphine (BUP) is approved by the US Food and Drug Administration for the treatment of opioid addiction. The current dosing regimen of BUP in pregnant women is based on recommendations designed for nonpregnant adults. However, physiological changes during pregnancy may alter BUP exposure and efficacy. The objectives of this study were to develop a physiologically-based pharmacokinetic (PBPK) model for BUP in pregnant women, to predict changes in BUP exposure at different stages of pregnancy, and to demonstrate the utility of PBPK modelling in optimizing BUP pharmacotherapy during pregnancy. METHODS: A full PBPK model for BUP was initially built and validated in healthy subjects. A fetoplacental compartment was included as a combined compartment in this model to simulate pregnancy induced anatomical and physiological changes. Further, gestational changes in physiological parameters were incorporated in this model. The PBPK model predictions of BUP exposure in pregnancy and during the postpartum period were compared to published data from a prospective clinical study. RESULTS: The predicted BUP plasma concentration-time profiles in the virtual pregnant populations are consistent with the observed data in the 2nd and 3rd trimesters, and the postpartum period. The differences in the predicted means of dose normalized area under the plasma drug concentration-time curve up to 12 h, average concentration and maximum concentration were within ±25% of the corresponding observed means with the exception of average concentration in the 3rd trimester (-26.3%). CONCLUSION: PBPK model-based simulation may be a useful tool to optimize BUP pharmacotherapy during pregnancy, obviating the need to perform pharmacokinetic studies in each trimester and the postpartum period that normally require intensive blood sampling.


Subject(s)
Buprenorphine/pharmacokinetics , Models, Biological , Narcotic Antagonists/pharmacokinetics , Opiate Substitution Treatment/methods , Opioid-Related Disorders/rehabilitation , Pregnancy Complications/rehabilitation , Administration, Sublingual , Adult , Area Under Curve , Buprenorphine/administration & dosage , Buprenorphine/adverse effects , Computer Simulation , Female , Humans , Maternal-Fetal Exchange/drug effects , Narcotic Antagonists/administration & dosage , Narcotic Antagonists/adverse effects , Opiate Substitution Treatment/adverse effects , Placenta/metabolism , Pregnancy , Prospective Studies , Tissue Distribution
6.
Clin. biomed. res ; 36(4): 179-186, 2016. ilus
Article in English | LILACS | ID: biblio-831517

ABSTRACT

Caffeine consumption during pregnancy has been shown in the scientific literature to be associated with teratogenicity such as low birth weight, fetal malformations, and miscarriage. However, the morphological alterations of the offspring of dams exposed during pregnancy have not been consistently described, and the mechanisms why they occur remain elusive. Thus, we aimed to characterize the offspring malformations induced by moderate and high doses of caffeine during pregnancy. Dams were divided into three groups: control, moderate (0.3 g/L), and high dose (1.0 g/L) of caffeine, which was provided in the drinking water beginning on gestational day 1 and continuing throughout the entire gestation. At moderate doses, only one of the dams had stillborn pups, although no macroscopic malformations were observed. High doses of caffeine induced significantly more malformations (P<0.001) and early death (before P4). The malformations observed were related to fetal development and cardiovascular alterations, namely bruises, macrocephaly with short limbs, abnormal development (or absence) of head structures and limbs, labial malformations, hydrops fetalis, and poor placental formation. We discussed the proposed mechanisms by which caffeine might induce these phenotypes, which may involve down-regulation of adenosine A1 receptors, and increased mothers' catecholamines. Our findings further confirm the evidence of the teratogenic effects of high doses of caffeine administered during pregnancy. These findings support the recommendation to avoid caffeine exposure during pregnancy (AU)


Subject(s)
Animals , Female , Pregnancy , Rats , Caffeine/toxicity , Congenital Abnormalities , Heart Defects, Congenital/chemically induced , Pregnancy , Caffeine/administration & dosage , Down-Regulation/drug effects , Maternal-Fetal Exchange/drug effects , Receptor, Adenosine A1
7.
Reprod Sci ; 22(7): 791-7, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25563756

ABSTRACT

BACKGROUND: Neonatal effects of drugs administered to mothers before delivery depend on the quantity that crosses the placental barrier, which is determined by the pharmacokinetics of the drug in the mother, fetus, and placenta. Diabetes mellitus can alter the kinetic disposition and the metabolism of drugs. This study investigated the placental transfer of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in pregnant women with gestational diabetes mellitus (GDM) submitted to peridural anesthesia. PATIENTS AND METHODS: A total of 10 normal pregnant women (group 1) and 6 pregnant women with GDM (group 2) were studied, all at term. The patients received 200 mg 2% lidocaine hydrochloride by the peridural locoregional route. Maternal blood samples were collected at the time of delivery and, after placental expulsion, blood samples were collected from the intervillous space, umbilical artery, and vein for determination of lidocaine and MEGX concentrations and analysis of the placental transfer of the drug. RESULTS: The following respective lidocaine ratios between the maternal and the fetal compartments were obtained for groups 1 and 2: umbilical vein/maternal peripheral blood, 0.60 and 0.46; intervillous space/maternal blood, 1.01 and 0.88; umbilical artery/umbilical vein, 0.77 and 0.91; and umbilical vein/intervillous space, 0.53 and 0.51. The following MEGX ratios for groups 1 and 2 were, respectively, fetal/maternal, 0.43 and 0.97; intervillous space/maternal blood, 0.64 and 0.90; umbilical artery/umbilical vein, 1.09 and 0.99; and umbilical vein/intervillous space, 0.55 and 0.78. CONCLUSION: Gestational diabetes mellitus did not affect the transplacental transfer of lidocaine but interfered with the transfer of MEGX, acting as a mechanism facilitating the transport of the metabolite.


Subject(s)
Anesthesia, Epidural/methods , Anesthetics, Local/blood , Diabetes, Gestational/blood , Lidocaine/blood , Maternal-Fetal Exchange/physiology , Placenta/metabolism , Adult , Anesthetics, Local/administration & dosage , Diabetes, Gestational/diagnosis , Female , Humans , Lidocaine/administration & dosage , Maternal-Fetal Exchange/drug effects , Placenta/drug effects , Pregnancy , Tissue Distribution/drug effects , Tissue Distribution/physiology , Young Adult
8.
J Expo Sci Environ Epidemiol ; 21(6): 609-14, 2011.
Article in English | MEDLINE | ID: mdl-21750576

ABSTRACT

Prenatal exposure to dichlorodiphenyldichloroethylene (DDE) is associated with decreased motor development during the first year of life, though the effects of DDE in the neonatal stage are not conclusive. The main aim of this study was to evaluate the association between prenatal DDE exposure and neonatal neurodevelopment in a cohort from four municipalities in the state of Morelos, Mexico. The children (265), born from pregnancies with no perinatal complications, were evaluated at 1 month of age (± 7 days) for the presence of abnormal reflexes with the Brazelton Scale (NBAS), neurological soft signs with the Graham-Rosenblith Scale, as well as mental and psychomotor development by the Bayley Scales of Infant Development. Maternal DDE concentrations during each trimester of the pregnancy were determined by gas chromatography. Multiple linear and ordinal logistic models assessed the association between DDE and the outcomes of interest. Prenatal exposure to DDE was associated with a non-significant increase in neurological soft signs (6-8%) and a decrease in psychomotor (ß(1T) = -0.02) and mental (ß(2T) = -0.03 and ß(3T) = -0.19) development. Our results are consistent with previous studies and suggest that prenatal DDE exposure is not associated with neurological functions present in the neonatal stage.


Subject(s)
Child Development/drug effects , Dichlorodiphenyl Dichloroethylene/toxicity , Insecticides/toxicity , Prenatal Exposure Delayed Effects/chemically induced , Cohort Studies , Dichlorodiphenyl Dichloroethylene/metabolism , Female , Humans , Infant , Infant, Newborn , Insecticides/metabolism , Male , Maternal-Fetal Exchange/drug effects , Mexico/epidemiology , Motor Activity , Neonatal Screening/methods , Pregnancy , Prenatal Exposure Delayed Effects/epidemiology , Prenatal Exposure Delayed Effects/metabolism , Psychomotor Performance
9.
Eur J Clin Pharmacol ; 67(10): 1027-33, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21538144

ABSTRACT

BACKGROUND: The use of metformin throughout gestation by pregnant women with polycystic ovary syndrome (PCOS) significantly reduces the number of first trimester spontaneous abortions and the rate of occurrence of gestational diabetes. OBJECTIVE: The objective of this study was to investigate the pharmacokinetics and the placental transfer of metformin in pregnant women with PCOS. PATIENTS AND METHODS: Eight pregnant women with PCOS taking 850 mg metformin every 12 h during the third trimester of pregnancy were evaluated. Maternal blood samples were collected at steady state during the dose interval (0-12 h). Maternal and umbilical cord blood samples were also obtained at delivery. Metformin plasma concentrations were analyzed by high-performance liquid chromatography, and pharmacokinetic parameters were determined using a non-compartmental model. Data are reported as median and minimum and maximum values. RESULTS: Metformin pharmacokinetic parameters were: t(½), 3.8 (2.8-5.4) h; t(max), 2.0 (0.5-3.0) h; C(max), 1.4 (0.5-2.1) mg/L; C(mean), 0.5 (0.2-0.9) mg/L; AUC(0-12), 6.4 (1.1-9.2) mg h/L; Cl/f, 105 (60-274) L/h; Vd/f, 551 (385-1173) L; median fluctuation, 89 (79-95)%. Umbilical/maternal metformin plasma concentration ratios were 0.7 (0.4-1.3). CONCLUSION: Metformin oral clearance (Cl/f) had increased in our patients relative to nonpregnant healthy volunteers or diabetic patients. Therefore, lower plasma metformin concentrations were observed for nondiabetic pregnant women with PCOS. Future studies should be conducted to demonstrate the therapeutic efficacy of metformin during pregnancy. Caution is warranted as umbilical/maternal metformin plasma concentrations ratios of around 0.7 require metformin dosage adjustment.


Subject(s)
Hypoglycemic Agents/pharmacokinetics , Metformin/pharmacokinetics , Polycystic Ovary Syndrome/metabolism , Pregnancy Complications, Neoplastic/metabolism , Adolescent , Adult , Female , Fetal Blood , Humans , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/blood , Hypoglycemic Agents/therapeutic use , Maternal-Fetal Exchange/drug effects , Metformin/adverse effects , Metformin/blood , Metformin/therapeutic use , Polycystic Ovary Syndrome/drug therapy , Pregnancy , Pregnancy Complications, Neoplastic/drug therapy , Pregnancy Trimester, Third/drug effects , Young Adult
10.
Hum Exp Toxicol ; 28(8): 451-9, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19744971

ABSTRACT

It is known that pesticides cross the placental barrier and can cause alterations in the development of placental structures resulting in adverse effects in reproduction. The objectives of this study were to investigate the effects of pesticide exposure during pregnancy on placental maturity and to evaluate the relationship between placental maturity, gestational age and birth weight. We collected the placentas from singleton pregnancies from women exposed (n = 9) and non-exposed (n = 45 full-term and n = 31 preterm) to pesticides as evaluated geographically, by questionnaire and by acetylcholinesterase levels. Placental morphometry from the central and peripheral regions was examined by microscopy and staining with hematoxylin and eosin. The placental maturity index (PMI) was estimated by dividing the number of epithelial plates in terminal villi to their thickness in 1 mm(2) of the placental parenchyma. Gestational age, birth weight and the following characteristics of the mother were also recorded: pre-pregnancy body mass index, weight gain during pregnancy and hemoglobin concentrations. Birth weight and the gestational age were correlated with PMI (r = .54 and r = .44, respectively; p < .01). Pesticide exposure was associated with a higher PMI (beta = 7.38, p = .01) after adjusting by variables related to placental maturity. In conclusion, the results suggest a relationship between prenatal exposure to pesticides and placental maturity and may potentially affect the nutrient transport from the mother to the fetus.


Subject(s)
Birth Weight/drug effects , Environmental Pollutants/toxicity , Maternal Exposure/adverse effects , Pesticides/toxicity , Placenta/drug effects , Cross-Sectional Studies , Female , Gestational Age , Hemoglobins/analysis , Humans , Infant, Newborn , Maternal-Fetal Exchange/drug effects , Mexico , Organ Size/drug effects , Pilot Projects , Placenta/pathology , Pregnancy , Weight Gain/drug effects
11.
J Pediatr ; 154(1): 10-6, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18990408

ABSTRACT

OBJECTIVE: To examine effects of maternal smoking during pregnancy on newborn neurobehavior at 10 to 27 days. STUDY DESIGN: Participants were 56 healthy infants (28 smoking-exposed, 28 unexposed) matched on maternal social class, age, and alcohol use. Maternal smoking during pregnancy was determined by maternal interview and maternal saliva cotinine. Postnatal smoke exposure was quantified by infant saliva cotinine. Infant neurobehavior was assessed through the NICU Network Neurobehavioral Scale. RESULTS: Smoking-exposed infants showed greater need for handling and worse self-regulation (P < .05) and trended toward greater excitability and arousal (P < .10) relative to matched, unexposed infants (all moderate effect sizes). In contrast to prior studies of days 0 to 5, no effects of smoking-exposure on signs of stress/abstinence or muscle tone emerged. In stratified, adjusted analyses, only effects on need for handling remained significant (P < .05, large effect size). CONCLUSIONS: Effects of maternal smoking during pregnancy at 10 to 27 days are subtle and consistent with increased need for external intervention and poorer self-regulation. Along with parenting deficits, these effects may represent early precursors for long-term adverse outcomes from maternal smoking during pregnancy. That signs of abstinence shown in prior studies of 0- to 5-day-old newborns did not emerge in older newborns provides further evidence for the possibility of a withdrawal process in exposed infants.


Subject(s)
Infant Behavior , Maternal Exposure , Smoking/adverse effects , Adult , Cotinine/analysis , Female , Humans , Infant Behavior/drug effects , Infant, Newborn , Male , Maternal-Fetal Exchange/drug effects , Neonatal Abstinence Syndrome/epidemiology , Pilot Projects , Pregnancy , Prenatal Exposure Delayed Effects , Saliva/chemistry , Smoking/epidemiology , Young Adult
13.
Pediatr Res ; 61(4): 456-61, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17515871

ABSTRACT

This study explores the effects of light maternal ethanol consumption during pregnancy on the appearance of minor malformations in neonates as well as on the contractile properties of their umbilical cord arteries (UCAs). Clinical external findings of newborns of women declaring light ethanol consumption during any period of their pregnancies [ethanol-exposed group (E group), n=79] were compared with those of nonexposed mothers [nonexposed to ethanol group (NE group), n=100]. Women who smoked or had any associated pathology were excluded. E group mothers consumed, on average, 200-250 mL ethanol/trimester (upper limit 700 mL/trimester). Sixty-six percent of the neonates in the E group presented at least one minor malformation (retromicrognathia and minor anomalies of the auricular/preauricular area were the more common), whereas only 16% of the NE group did (p=0.0000). The percentage of children exhibiting Apgar scores <7 was significantly greater in the E group (11% versus 2%, p=0.0119). UCAs from the E group developed significantly less contractile force (p<0.05) than those of the NE group when exposed to 1 microM serotonin (5-HT) or to a high K+ depolarizing solution. This difference persisted after inhibition of endothelial release of nitric oxide (NO) and prostacyclin. In conclusion, even light drinking should be considered a risk during pregnancy.


Subject(s)
Alcohol Drinking/adverse effects , Maternal-Fetal Exchange/drug effects , Maternal-Fetal Exchange/physiology , Prenatal Exposure Delayed Effects/chemically induced , Umbilical Arteries/drug effects , Adult , Ear/abnormalities , Female , Humans , Micrognathism/chemically induced , Nose/abnormalities , Pregnancy , Prenatal Exposure Delayed Effects/physiopathology , Random Allocation , Umbilical Arteries/physiopathology
14.
Birth Defects Res A Clin Mol Teratol ; 73(9): 634-7, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16104005

ABSTRACT

BACKGROUND: The concomitant occurrence of breast cancer and pregnancy is relatively uncommon. We report the case of a patient with syndactyly, cleft hands, and absence of distal finger phalanges associated with maternal exposure to chemotherapeutic agents during the first trimester of pregnancy. These associations have not been previously described. CASE: The patient was born by normal delivery after 38 weeks of pregnancy. His mother became pregnant while receiving chemotherapy (cyclophosphamide, 5-fluorouracil, and adriamycin) for breast cancer, and the fetus was exposed to these drugs from conception to the 16th week of pregnancy. At birth, anomalies were observed, including a high-arched palate, microcephaly, a flat nasal bridge, bilateral syndactyly in the first and second fingers with a hand cleft between the second and third fingers and hypoplasia of the fifth fingers, and dystrophic nail of the fourth finger of the left hand. The patient's growth and development were deficient. CONCLUSIONS: The malformations associated with in utero exposure to these chemotherapeutic agents are highly variable, but growth deficiency and anomalies of the craniofacial region and limbs are the most common. The pattern of malformations in children who were congenitally exposed to chemotherapeutic agents appears to be directly related to the age at and duration of exposure, rather than to the specific drug itself. Effective contraception is essential for the safe use of a potential teratogen in nonpregnant women of reproductive age.


Subject(s)
Abnormalities, Drug-Induced/etiology , Abnormalities, Multiple/chemically induced , Antineoplastic Combined Chemotherapy Protocols/toxicity , Breast Neoplasms/drug therapy , Pregnancy Complications, Neoplastic/drug therapy , Teratogens/toxicity , Abnormalities, Drug-Induced/diagnostic imaging , Abnormalities, Drug-Induced/pathology , Abnormalities, Multiple/diagnostic imaging , Abnormalities, Multiple/pathology , Adult , Antibiotics, Antineoplastic/toxicity , Antimetabolites, Antineoplastic/toxicity , Antineoplastic Agents, Alkylating/toxicity , Child, Preschool , Cyclophosphamide/toxicity , Developmental Disabilities/chemically induced , Doxorubicin/toxicity , Drug Therapy, Combination , Female , Fluorouracil/toxicity , Humans , Male , Maternal-Fetal Exchange/drug effects , Microcephaly/chemically induced , Pregnancy , Pregnancy Complications, Neoplastic/etiology , Pregnancy Trimester, Third , Radiography , Syndactyly/diagnostic imaging , Syndactyly/etiology
15.
Chirality ; 16(2): 65-71, 2004 Feb.
Article in English | MEDLINE | ID: mdl-14712468

ABSTRACT

The aim of the present study was to investigate the stereoselectivity in the kinetic disposition and the transplacental distribution of bupivacaine in term parturients during labor. Maternal age ranged from 18-37 years and fetal gestational age from 37.6-41.5 weeks. Healthy parturients (n = 23) received epidural 0.5% racemic bupivacaine alone (group A) or combined with epinephrine (group B). Maternal venous blood was sampled at regular intervals until 8 h after drug administration and umbilical venous blood was obtained at delivery. Bupivacaine enantiomers were determined in plasma samples by HPLC using a Chiralcel(R) OD-R column and a UV detector. One- or two-compartment models were fitted to data and differences between the (+)-(R) and (-)-(S) enantiomers were compared with the paired Wilcoxon test (P< 0.05). The influence of epinephrine was evaluated using the unpaired Mann-Whitney test (P< 0.05). The disposition of bupivacaine in maternal plasma was stereoselective, with higher V(d/f) (140.60 vs. 132.81 L for group A and 197.86 vs. 169.46 L for group B) and C(l/f) (29.00 vs. 25.43 L/h for group A and 33.15 vs. 26.39 L/h for group B) and lower t(1/2)beta (3.24 vs. 3.30 h for group A and 4.36 vs. 4.45 h for group B) being observed for (+)-(R)-bupivacaine. The combined administration of epinephrine resulted in higher V(d/f) (197.86 vs. 140.60 L for (+)-(R) and 169.46 vs. 132.81 L for (-)-(S)) and t(1/2)beta values (4.36 vs. 3.24 h for (+)-(R) and 4.45 vs. 3.30 h for (-)-(S)). The transplacental distribution of bupivacaine was stereoselective only when bupivacaine was administered without epinephrine (group B), with a higher cord blood/maternal blood ratio being observed for (-)-(S)-bupivacaine (0.40 vs. 0.35). Chirality 16:65-71, 2004.


Subject(s)
Bupivacaine/chemistry , Bupivacaine/pharmacokinetics , Parturition/physiology , Vasoconstrictor Agents/administration & dosage , Adolescent , Adult , Bupivacaine/administration & dosage , Bupivacaine/blood , Epinephrine/administration & dosage , Epinephrine/pharmacology , Female , Fetal Blood/drug effects , Fetal Blood/metabolism , Humans , Kinetics , Maternal Age , Maternal-Fetal Exchange/drug effects , Pregnancy , Stereoisomerism , Vasoconstrictor Agents/pharmacology
16.
Rev. méd. Chile ; 128(10): 1093-100, oct. 2000. tab, graf
Article in Spanish | LILACS | ID: lil-277201

ABSTRACT

Background: Fetal drug addiction is a serious public health problem. In the United States 10 to 15 percent of children have been exposed "in utero" to cocaine. In a Chilean public health service, more than 200 offspring of cocaine free base abuser have been detected. Aim: To analyze the clinical and social features of 100 children exposed to cocaine free base during fetal development. Patients and methods: Clinical features of children born from cocaine free base consume mothers were described at birth. During subsequent follow up, growth and development, disease episodes, developmental alterations and social situation were recorded. Data was compared with other newborns from the same health service. Results: Compared to their normal counterparts, exposed children has a lower birth weight, the frequency of premature babies was thrice higher, and small-for-gestational age children were four times more common. There was also a higher prevalence of cardiac malformations, seizures and apnea. Hospital admissions were more frequent, prolonged and required more complex facilities. During follow up, undernutrition and stunting were more prevalent. Psychomotor retardation was present in 67 percent of children and behavioral disturbances in 93 percent. Most of these children are governmental protection. Conclusions: Strategies to prevent drug abuse during pregnancy and its devastating medical and social consequences should be urgently developed


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Fetal Diseases/epidemiology , Fetal Growth Retardation/etiology , Maternal-Fetal Exchange/drug effects , Abnormalities, Drug-Induced/epidemiology , Cocaine-Related Disorders/complications , Pregnancy Complications , Nutritional Status , Follow-Up Studies , Fetal Development/drug effects , Alcoholism/complications , Fetal Diseases/etiology , Socioeconomic Factors , Fetal Alcohol Spectrum Disorders/epidemiology , Hospitalization/statistics & numerical data , Infant, Very Low Birth Weight , Cocaine-Related Disorders/epidemiology
18.
Neurotoxicol Teratol ; 21(4): 451-65, 1999.
Article in English | MEDLINE | ID: mdl-10440489

ABSTRACT

The purpose of this study was to determine whether the behavioral development pattern was altered by a pre- and postnatal exposure to 2,4-Dichlorophenoxyacetic acid (2,4-D). Pregnant rats were daily orally exposed to 70 mg/kg/day of 2,4-D from gestation day (GD) 16 to postnatal day (PND) 23. After weaning, the pups were assigned to one of the two subgroups: T1 (fed with untreated diet until PND 90) and T2 (maintained with 2,4-D diet until PND 90). Effects on offsprings were evaluated with a neurotoxicological test battery. Neuromotor reflexes, spontaneous motor activity, serotonin syndrome, circling, and catalepsy were analyzed during various postnatal ages. 2,4-D neonatal exposure induced delay of the ontogeny of righting reflex and negative geotaxis accompanied by motor abnormalities, stereotypic behaviors (excessive grooming and vertical head movements), and hyperactivity in the open field. Adult rats of both sexes (T2 group) showed a diminution of ambulation and rearing, while excessive grooming responses were only observed in T2 males. Besides, these animals manifested serotonin syndrome behaviors, catalepsy, and right-turning preference. Some behaviors were reversible, but others were permanent, and some were only expressed after pharmacological challenges.


Subject(s)
2,4-Dichlorophenoxyacetic Acid/toxicity , Animals, Newborn/physiology , Behavior, Animal/drug effects , Herbicides/toxicity , Maternal-Fetal Exchange/drug effects , Amphetamine/pharmacology , Animals , Antipsychotic Agents/pharmacology , Body Weight/drug effects , Central Nervous System Stimulants/pharmacology , Drug Interactions , Female , Haloperidol/pharmacology , Pregnancy , Rats , Rats, Wistar , Sex Factors
19.
Neurotoxicol Teratol ; 21(4): 467-70, 1999.
Article in English | MEDLINE | ID: mdl-10440490

ABSTRACT

Monensin, a growth-promoting agent and coccidiostat used in veterinary medicine, was studied in terms of its effects on the development of female rats and their offspring when added to the diet. Young female rats received 100 or 300 ppm monensin mixed with powdered chow diet until adulthood, when they were mated and their offspring were evaluated for physical and neurobehavioural development. The data showed that 1) exposure to the higher monensin concentration reduced female body weight; no deaths occurred after exposure to the two monensin concentrations; 2) the offspring of the experimental group receiving 300 ppm monensin presented a weight reduction from 10 to 21 days of lactation; 3) incisor eruption was delayed only in females after exposure to the 100 ppm concentration. We conclude that exposure to monensin during development induces toxicity in female rats and has a notable adverse effect on growth with some limited effects on selective milestones of physical and functional development of the offspring during the postnatal period.


Subject(s)
Behavior, Animal/drug effects , Coccidiostats/toxicity , Maternal-Fetal Exchange/drug effects , Monensin/toxicity , Animals , Body Weight/drug effects , Dose-Response Relationship, Drug , Female , Incisor/drug effects , Male , Pregnancy , Rats , Rats, Wistar , Sex Factors
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