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1.
Biomed Khim ; 65(3): 245-250, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31258149

RESUMO

The content of vasoactive compounds and arachidonic acid in the placenta and amniotic fluid was studied in full-term (39-40 weeks) physiological pregnancy and preeclampsia (PE). The content of metabolites of nitric oxide (NOx), endothelin-1, thromboxane B2 (TxB2), prostacycline (PGI2) and arachidonic acid was estimated using spectrophotometric, immunoenzyme methods and gas-liquid chromatography. It was found that in PE the content of vasoconstrictors, of endothelin and TxB2, increased in the placenta and amniotic fluid, while the content of vasodilators, PGI2 and NOx decreased. Despite the same directionality of changes in both studied objects, the degree of changes differed and was more pronounced in the placenta. A direct or inverse correlative relationship was found between various vasoactive components (depending on their effect on vascular tone). In the case of arachidonic acid changes in its content in PE correlated with the level of vasoactive compounds, the source of which it is. The revealed differences in the ratio of vasoactive components obviously play a pathogenetic role in the development of PE and its subsequent complications.


Assuntos
Líquido Amniótico/química , Ácido Araquidônico/análise , Placenta/química , Pré-Eclâmpsia , Endotelina-1/análise , Feminino , Humanos , Óxido Nítrico/análise , Gravidez , Prostaglandinas I/análise , Tromboxano B2/análise
2.
J Perinat Med ; 47(7): 765-770, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31348763

RESUMO

Background Bisphenol A (BPA) is an estrogenic, endocrine-disrupting compound widely used in the industry. It is also a ubiquitous environmental pollutant. Its presence was confirmed in human fetuses, which results from maternal exposure during pregnancy. The mechanisms behind maternal-fetal transfer, and relationships between pregnant women and fetal exposures remain unclear. The aim of this study was to assess the impact of maternal exposure to BPA on the exposure of the fetus. Methods Maternal plasma and amniotic fluid samples were collected from 52 pregnant women undergoing amniocentesis for prenatal diagnosis of chromosomal abnormalities. BPA was measured by gas chromatography-mass spectrometry (GC-MS). The permeability factor - a ratio of fetal-to-maternal BPA concentration - was used as a measure delineating the transplacental transfer of BPA. Results The median concentration of maternal plasma BPA was 8 times higher than the total BPA concentration in the amniotic fluid (8.69 ng/mL, range: 4.3 ng/mL-55.3 ng/mL vs. median 1.03 ng/mL, range: 0.3 ng/mL-10.1 ng/mL). There was no direct relationship between the levels of BPA in maternal plasma and amniotic fluid levels. The permeability factor, in turn, negatively correlated with fetal development (birth weight) (R = -0.54, P < 0.001). Conclusion Our results suggest that the risk of fetal BPA exposure depends on placental BPA permeability rather than the levels of maternal BPA plasma concentration and support general recommendations to become aware and avoid BPA-containing products.


Assuntos
Líquido Amniótico/química , Compostos Benzidrílicos , Peso ao Nascer/efeitos dos fármacos , Troca Materno-Fetal , Fenóis , Placenta , Adulto , Poluentes Ocupacionais do Ar/efeitos adversos , Poluentes Ocupacionais do Ar/sangue , Poluentes Ocupacionais do Ar/química , Compostos Benzidrílicos/efeitos adversos , Compostos Benzidrílicos/sangue , Compostos Benzidrílicos/química , Exposição Ambiental/prevenção & controle , Estrogênios não Esteroides/efeitos adversos , Estrogênios não Esteroides/sangue , Estrogênios não Esteroides/química , Feminino , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Exposição Materna/prevenção & controle , Permeabilidade , Fenóis/efeitos adversos , Fenóis/sangue , Fenóis/química , Placenta/metabolismo , Placenta/fisiopatologia , Gravidez , Segundo Trimestre da Gravidez
3.
J Obstet Gynaecol ; 39(7): 952-958, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31215267

RESUMO

Our objective was determining the effects of amniotic fluid (AF) and fetal cord blood (FCB) cotinine concentrations on pregnancy complications and the anthropometric measurements in the newborns whose mothers underwent amniocentesis. This study was conducted as a case-control study, in Turkey. A total of 250 pregnant women with amniocentesis indication were recruited into the study and the cotinine levels in the AF and FCB were determined. A smoking habit did not statistically affect the incidence of pregnancy complications (p>.05). The birth weights of the newborns were negatively correlated with the AF cotinine levels. The incidences of low birth weight, low Apgar scores and RDS were positively correlated with higher levels of cotinine in AF and FCB. It is important for healthcare staff to provide training and consultancy services for the health improvement of pregnant women and the prevention of smoking during pregnancy. Impact statement What is already known on this subject? The pre-pregnancy smoking habit usually continues during the pregnancy. A significant negative correlation was present between the foetal cord blood cotinine levels and the birth weight. What do the results of this study add? The anthropometric measurements of the newborns born from mothers with high AF cotinine levels were lower than newborns born from mothers with low amniotic fluid cotinine levels. Respiratory Distress syndrome is more often determined in newborns born from mothers with high AF cotinine levels. What are the implications of these findings for clinical practice and/or further research? Future studies should be performed to investigate the effects of cigarette smoking on the health problems, the growth characteristics and the neurological development of newborns and infants within the first year of life.


Assuntos
Líquido Amniótico/química , Peso ao Nascer , Cotinina/sangue , Complicações na Gravidez/sangue , Fumar/efeitos adversos , Adulto , Antropometria , Estudos de Casos e Controles , Feminino , Sangue Fetal/química , Humanos , Recém-Nascido , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Fumar/sangue , Poluição por Fumaça de Tabaco/efeitos adversos , Turquia/epidemiologia
4.
Anal Chim Acta ; 1075: 1-26, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31196414

RESUMO

In recent years, advances in sensitive analytical techniques have encouraged the analysis of various compounds in biological fluids. While blood serum, blood plasma and urine still remain the golden standards in clinical, toxicological and forensic science, analyses of other body fluids, such as breast milk, exhaled breath condensate, sweat, saliva, amniotic fluid, cerebrospinal fluid, or capillary blood in form of dried blood spots are becoming more popular. This review article focuses on capillary electrophoresis and microchip electrophoresis of small ions and molecules (e.g. inorganic cations/anions, basic/acidic drugs, small acids/bases, amino acids, peptides and other low molecular weight analytes) in various less conventional human body fluids and hopes to stimulate further interest in the field.


Assuntos
Secreções Corporais/química , Líquidos Corporais/química , Íons/análise , Compostos Orgânicos/análise , Líquido Amniótico/química , Eletroforese Capilar/métodos , Eletroforese em Microchip/métodos , Humanos , Íons/líquido cefalorraquidiano , Compostos Orgânicos/líquido cefalorraquidiano
5.
J Steroid Biochem Mol Biol ; 193: 105412, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31202857

RESUMO

Intact steroid hormone biosynthesis is essential for growth and development of the human fetus and embryo. In the present study, gas chromatography-mass spectrometry was employed to characterize the steroidal milieu in amniotic fluid (n = 65; male: female = 35: 30) of mid-gestation (median: 18.8th week, range: 16.0th - 24.6th week) by a comprehensive targeted steroid hormone metabolomics approach. The levels of 52 steroids including pregnenolone and 17-OH-pregnenolone metabolites, dehydroepiandrosterone (DHEA) and its metabolites, progesterone and 17-OH-progesterone metabolites, sex hormones as well as corticosterone and cortisol metabolites were measured. The dominating steroids were the group of pregnenolone and 17-OH-pregnenolone metabolites (mean ± SD: 138.0 ± 59.3 ng/mL), followed by the group of progesterone and 17-OH-progesterone metabolites (107.3 ± 44.3 ng/mL), and thereafter DHEA and its metabolites (97.1 ± 56.5 ng/mL). With respect to sex steroids, only testosterone showed a significantly higher value in male fetuses (p < 0.0001). Of all estrogen metabolites, estriol showed by far the highest concentrations (33.2 ± 26.1 ng/mL). Interestingly, cortisol metabolites were clearly present (59.6 ± 13.6 ng/mL) though fetal de novo synthesis of cortisol is assumed to start from gestational 28th week onwards. Our comprehensive characterization of the steroidal milieu in amniotic fluid of mid-gestation shows presence of all relevant classes of steroid hormones and provides reference data. We conclude that the steroidal milieu in amniotic fluid mirrors the steroidome of the feto-placental unit.


Assuntos
Líquido Amniótico/química , Esteroides/análise , Adulto , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Idade Gestacional , Humanos , Masculino , Gravidez , Adulto Jovem
6.
BJOG ; 126(10): 1233-1241, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31033140

RESUMO

OBJECTIVE: Morbidity in fetuses affected by gastroschisis is mainly the result of bowel ischaemic and inflammatory processes. Experimental studies on animal models show that clearing amniotic fluid from the digestive secretions by amnioexchange procedures reduces the inflammatory process. We evaluated the benefit of the amnioexchange procedure for fetal gastroschisis in humans. DESIGN: Prospective, interventional, randomised study. SETTING: Eight referral centres for fetal medicine. POPULATION: Pregnant women carrying a fetus with gastroschisis. METHODS: We compared, in utero, amnioexchange with a sham procedure. The protocol included, in both arms, steroid injections at 30 weeks of gestation and the use of postnatal minimal enteral feeding. MAIN OUTCOME MEASURES: The primary outcome was a composite variable based on the duration of ventilation and parenteral nutrition. Secondary outcomes were the effectiveness and safety of the amnioexchange procedure, including the rate of perinatal death, time to full enteral feeding, primary closure, and late feeding disorders. RESULTS: Sixty-four patients were randomised. There was no difference in the composite criteria between the amnioexchange and control groups. Based on an intention-to-treat analysis, there were no significant between-group differences in pregnancy outcome or complications. When studying the relationship between digestive compounds and amniotic fluid inflammatory markers, a clear correlation was found between bile acid and both ferritin and interleukin 1ß (IL1ß). CONCLUSIONS: In humans, amnioexchange, as described in our protocol, is not an option for fetal care; however, we provide supplementary proof of the involvement of inflammation in the pathogenicity of gastroschisis and suggest that future research should aim at reducing inflammation. ClinicalTrials.gov: NCT00127946. TWEETABLE ABSTRACT: A prospective, interventional, randomised study shows no benefit of amnioexchange for fetal gastroschisis in humans.


Assuntos
Líquido Amniótico/química , Cloretos/administração & dosagem , Drenagem/métodos , Doenças Fetais/terapia , Gastrosquise/terapia , Cuidado Pré-Natal/métodos , Cloreto de Sódio/administração & dosagem , Adulto , Biomarcadores/análise , Cloretos/farmacocinética , Drenagem/efeitos adversos , Feminino , Doenças Fetais/diagnóstico , Gastrosquise/diagnóstico , Idade Gestacional , Humanos , Mediadores da Inflamação/análise , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Cloreto de Sódio/farmacocinética
7.
Clin Chim Acta ; 495: 185-190, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30978326

RESUMO

Very-long-chain fatty acids (VLCFAs), including hexacosanoic, tetracosanoic, and docosanoic acids, are peroxisomal disease markers, whose abnormal accumulation warrants prompt detection for timely, effective treatment. This study aimed to establish and validate a robust liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based method to simultaneously quantify VLCFAs and provide reference intervals among Chinese individuals, quantify VLCFAs in pregnancy, and explore potential associations between plasma and amniotic fluid. Analytes were extracted via water-bath incubation with HCl and liquid-liquid extraction. Method linearity, limit of detection/quantitation, precision, carryover, and recovery were evaluated according to Clinical and Laboratory Standard Institute (CLSI) guidelines. VLCFAs showed good reproducibility based on low within-run coefficient variations (CVs) and total CVs, and correlation coefficients of linearity were > 0.99. The reference interval of C22:0, C24:0, and C26:0 were 32.0-73.4 µmol/L, 30.3-72.0 µmol/L, and 0.20-0.71 µmol/L, respectively; C24:0/C22:0 and C26:0/C22:0 ratios were 0.75-1.28 and 0.005-0.0139, respectively. Plasma and amniotic fluid of the same pregnant women displayed no significant correlation in the second trimester. This study presents the simple, efficient, accurate, and robust LC-MS/MS method to simultaneously detect C22:0, C24:0, and C26:0 without derivatization; it can be used to establish reference intervals among Chinese individuals and has diagnostic and other clinical applications.


Assuntos
Análise Química do Sangue/normas , Ácidos Graxos/análise , Ácidos Graxos/química , Líquido Amniótico/química , China , Cromatografia Líquida , Ácidos Graxos/sangue , Feminino , Humanos , Limite de Detecção , Gravidez , Valores de Referência , Espectrometria de Massas em Tandem , Fatores de Tempo
8.
Ann Saudi Med ; 39(2): 87-91, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30955017

RESUMO

BACKGROUND: In 2015, the Neonatal Resuscitation Program (NRP) guidelines were updated to recommend that nonvigorous infants delivered through meconium-stained amniotic fluid (MSAF) do not require routine intubation and tracheal suction. OBJECTIVE: Explore the implications of 2015 NRP guidelines on delivery room management and outcome of infants born through MSAF. DESIGN: Retrospective cohort study. SETTINGS: King Abdul-Aziz University Hospital (KAUH). PATIENTS AND METHODS: All term ( greater than or equal 37 weeks) infants born in KAUH through MSAF between January 1, 2016, and December 31, 2017, were included. Patients were divided into two groups according to the date of birth: period 1 (January 1, 2016, to December 31, 2016), before the implementation of the new NRP guidelines; period 2 (January 1, 2017, to December 31, 2017), after the implementation. MAIN OUTCOME MEASURES: Outcomes of infants born through MSAF. SAMPLE SIZE: 420 infants. RESULTS: A majority of infants (n=261) were born in period 1 and 159 after in period 2. No differences were found in the booking status of mothers, cesarean section rate, and number of deliveries attended by physicians between the 2 cohorts. Infants in both cohorts were of similar gestational age, birth weight, and gender. A nonsignificant lower rate of intubation at birth (2.3% vs 0.6%), admission to neonatal intensive care unit (3.8% vs 3.1%), and meconium aspiration syndrome (1.5% vs 0.6%) were found in period 2 compared with period 1. Only 1 infant died in period 1. CONCLUSION: After the implementation of 2015 NRP guidelines, fewer infants were intubated at birth for MSAF. No difference was observed in the rate of associated morbidities and mortality. LIMITATIONS: A single-center retrospective study of misclassification bias because some of the medical staff started practicing the new guidelines before the official implementation. CONFLICT OF INTEREST: None.


Assuntos
Líquido Amniótico/química , Parto Obstétrico/normas , Doenças do Recém-Nascido/terapia , Síndrome de Aspiração de Mecônio/terapia , Mecônio , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/normas , Intubação Intratraqueal/normas , Masculino , Guias de Prática Clínica como Assunto , Gravidez , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Sucção/normas
9.
J Perinat Med ; 47(5): 493-499, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-30817305

RESUMO

Objective To assess the value of incorporating amniotic fluid (AF) analysis in the management of patients with clinical chorioamnionitis. Methods This was a retrospective cohort study of all women carrying a singleton fetus and managed at our center between 2000 and 2009. We included only those women suspected of chorioamnionitis based on one or more of the following: (1) uterine tenderness, (2) maternal fever, (3) maternal and/or fetal tachycardia and (4) purulent discharge. The management was deemed to be justified if (1) pregnancy was terminated <24 weeks and histology confirmed chorioamnionitis; (2) delivery was performed expeditiously after initial assessment and histology confirmed chorioamnionitis; (3) delivery was delayed for 2-7 days and the patient completed a course of antenatal steroids before 34 weeks; and (4) delivery was delayed ≥7 days and histology was not indicative of chorioamnionitis, or delivery occurred after 37 weeks. Univariate and logistic regression analyses were used as appropriate. Results Of the 77 women with suspected chorioamnionitis, AF analysis was performed in 43 (55.8%) cases, and the management was justified in 63 (81.8%) cases based on the aforementioned criteria. Stepwise regression analysis confirmed AF analysis as a predictor of justified management. The rates of composite morbidity, neonatal sepsis, neonatal death and admissions to neonatal intensive care unit were lower in the justified management group. Conclusion Incorporation of AF analysis into clinical assessment does improve the management of suspected chorioamnionitis.


Assuntos
Líquido Amniótico/química , Corioamnionite/diagnóstico , Corioamnionite/terapia , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Gravidez , Estudos Retrospectivos
10.
In Vivo ; 33(2): 433-439, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30804122

RESUMO

BACKGROUND/AIM: The study aimed to examine whether resistin is present in second trimester amniotic fluid from pregnancies with trisomy 18 and 13 and evaluate its concentration in comparison with euploid pregnancies. PATIENTS AND METHODS: The study included 37 women who underwent amniocentesis. Eleven fetuses had trisomy 18, 3 had trisomy 13, while 23 had a normal karyotype. RESULTS: Resistin was detected in all cases. The mean level of resistin in trisomy 18 was statistically significantly lower compared to euploid controls. Resistin levels in all abnormal cases were below its median concentration in euploid controls. ROC analysis showed very good prognostic value for both trisomies. CONCLUSION: Resistin is a constituent of mid-trimester amniotic fluid of pregnancies with trisomies 13 and 18, exhibiting lower levels than those in euploid fetuses. The reduced levels of resistin in amniotic fluid may be associated with early changes in metabolic pathways and immunoinflammatory responses.


Assuntos
Líquido Amniótico/química , Segundo Trimestre da Gravidez/genética , Resistina/genética , Síndrome da Trissomía do Cromossomo 18/genética , Adulto , Cromossomos Humanos Par 13/genética , Feminino , Idade Gestacional , Humanos , Gravidez , Resistina/química , Síndrome da Trissomía do Cromossomo 18/patologia
11.
J Trace Elem Med Biol ; 52: 136-142, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30732874

RESUMO

The aim of the study was to determine the correlations between body mass index (BMI) values before pregnancy and the concentrations of selected elements (Mg, Co, Cu, Zn, Sr, Cd, Ba, Pb, U, Ca, Cr, Al, Mn, V, Fe) in blood serum and amniotic fluid (AF) in pregnant women. Elemental analysis of serum and amniotic fluid in 225 Polish women (Caucasian/white) showed a relationship between the concentration of minerals in the above-mentioned samples and the pre-pregnancy BMI. Analysis of blood serum was performed by using ICP-MS and it demonstrated that iron concentration was significantly lower in overweight and obese women. Being underweight in pregnant women was associated with a significantly lower concentration of magnesium and cobalt in the blood serum. Both underweight and overweight women were associated with significantly lower concentrations of calcium and strontium in the blood serum. The concentration of cobalt was significantly higher in underweight women. The concentration of lead in the blood serum of overweight and obese women was significantly higher than in other groups. Analysis of the AF showed that the concentration of copper was significantly lower in overweight and obese women, and the concentration of manganese and vanadium significantly higher than in other groups of women. A deficiency in essential minerals and an excess of heavy metals in women may be associated with abnormal body weight and this is important in the etiopathogenesis of pregnancy and fetal development disorders.


Assuntos
Líquido Amniótico/química , Índice de Massa Corporal , Minerais/análise , Adolescente , Adulto , Feminino , Humanos , Gravidez , Adulto Jovem
12.
Gene ; 697: 48-56, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-30790652

RESUMO

BACKGROUND: Autosomal recessive disorder is closely correlated with congenital fetal malformation. The mutation of WDR35 may lead to short rib-polydactyly syndrome (SRP), asphyxiating thoracic dystrophy (ATD, Jeune syndrome) and Ellis van Creveld syndrome. The purpose of this study is to investigate the role of WDR35 in fetal anomaly. RESULTS: The fetuses presented malformation with abnormal head shape, cardiac dilatation, pericardial effusion, and non-displayed left pulmonary artery and left lung. After the detection of genomic DNA (gDNA) in amniotic fluid cells (AFC), chromosomal rearrangement was found in arr[hg19] 2p25.3p23.3. It was revealed through multiple PCR-DHPLC that MYCN, WDR35, LPIN1, ODC1, KLF11 and NBAS contained duplicated copy numbers in 2p25.3p23.3. AF-MSCs were mostly positive for CD44, CD105, negative for CD34 and CD14. Western Blot test showed that WDR35-encoded protein was decreased in the patients' AFC compared to that in normal pregnant women. In the patients' amniotic fluid-derived mesenchymal stem cells (AF-MSCs), WDR35 overexpression could repair cilia formation, and the overexpression of WDR35 or Gli2 could significantly enhance ALP activity and expressions of osteogenic differentiation marker genes, including RUNXE2, OCN, BSP and ALP. However, WDR35 silencing in C3H10T1/2 cells could remarkably inhibit cilia formation and osteogenic differentiation. This inhibitory effect could be attenuated by Gli2 overexpression. CONCLUSIONS: The results demonstrated that copy number variation (CNV) of WDR35 may lead to skeletal dysplasia and fetal anomaly, and that down-regulated WDR35 may damage the cilia formation and sequentially indirectly regulate Gli signal, which would eventually result in negative regulation of osteogenic differentiation.


Assuntos
Doenças do Desenvolvimento Ósseo/genética , Osteogênese/fisiologia , Proteínas/genética , Adulto , Líquido Amniótico/química , Líquido Amniótico/citologia , Animais , Doenças do Desenvolvimento Ósseo/metabolismo , Diferenciação Celular/fisiologia , Cílios/genética , Cílios/fisiologia , Variações do Número de Cópias de DNA , Feminino , Desenvolvimento Fetal/genética , Proteínas Hedgehog , Humanos , Células-Tronco Mesenquimais/patologia , Camundongos , Camundongos Endogâmicos C3H , Fenótipo , Polimorfismo de Nucleotídeo Único , Gravidez , Proteínas/metabolismo
13.
Turk Patoloji Derg ; 35(2): 107-118, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30632121

RESUMO

OBJECTIVE: Meconium passage during labour is a quite common finding. Studies describing correlation between meconium stained liquor, fetal distress and specific placental pathology are sparse. This case control study had been designed to ascertain these lacunae of knowledge. MATERIAL AND METHOD: Placentae from 41 cases of otherwise uncomplicated antenatal and intranatal pregnancies with meconium stained liquor at 37 completed weeks of gestation were studied, both grossly and microscopically, comparing them with controls of 41 cases of clear liquor. Apgar score of all newborns at 1 minute and 5 minutes were recorded and correlated with histopathological findings. RESULTS: Both cases and controls were found to be age matched. Meconium stained liquor was associated with more caesarian section than the clear ones. Significant correlation was found with meconium stained liquor and low Apgar scores. Histopathology of placenta revealed many statistically significant associations between specific placental histopathology in meconium stained liquor and depressed Apgar score. Evidence of placental vasculopathy rather than meconium induced placental damage came out as the potential culprit in causing a low Apgar score in this case control study. CONCLUSION: Placental vascular changes have a role in meconium staining of liquor. If timely interventions are taken, the chance of development of fetal distress is low.


Assuntos
Líquido Amniótico/química , Sofrimento Fetal/diagnóstico , Mecônio , Placenta/patologia , Complicações na Gravidez/patologia , Adulto , Índice de Apgar , Peso ao Nascer , Estudos de Casos e Controles , Cesárea/estatística & dados numéricos , Emergências , Feminino , Sangue Fetal/química , Sofrimento Fetal/complicações , Sofrimento Fetal/etiologia , Mortalidade Fetal , Idade Gestacional , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Síndrome de Aspiração de Mecônio/complicações , Síndrome de Aspiração de Mecônio/etiologia , Morbidade , Placenta/irrigação sanguínea , Gravidez , Complicações na Gravidez/etiologia , Fatores de Risco , Adulto Jovem
14.
Mol Autism ; 10: 1, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30647876

RESUMO

Background: Evidence has indicated that some non-inherited factors such as exposure to environmental pollutants are associated with neurodevelopment disorders like autism spectrum disorder (ASD). Studies report that endocrine disrupting compounds (EDCs), including polychlorinated biphenyls, organochlorine pesticides, perfluoroalkyl substances (PFAS), and some metals, have adverse effects on the fetal neurodevelopment. The aim of this study was to measure the amniotic fluid (AF) levels of EDCs and metals as well as the receptor transactivities induced by AF and investigate the possible link between prenatal exposure to EDCs and heavy metals and ASD risk. Methods: In this case-control study, we included AF samples of 75 ASD cases and 135 frequency-matched controls and measured the levels of the endogenous sex hormones, PFAS, and elements including heavy metals. The combined effect of endogenous hormones and EDCs on the receptor of estrogen (ER), androgen (AR), aryl hydrocarbon (AhR), and thyroid hormone-like activity were also determined and expressed as receptor ligand equivalents. We assessed the associations of AF levels of chemicals, sex hormones, and receptor activities with ASD risk using unconditional logistical regression analyses. To control for multiple comparisons, the false discovery rate (FDR) was used and q values less than 0.25 were designated as statistical significance. Results: PFAS and metals were detectable in AF samples. The ASD cases had significantly lower AF levels of PFAS than controls, and the adjusted odds ratio (OR) was 0.410 (95% CI 0.174, 0.967; p = 0.042; FDR q value = 0.437) for perfluorooctane sulfonate (PFOS). The principal component, including PFAS congeners, copper, iron, and estrogenic activity, was significantly inversely associated with ASD risk (adjusted OR = 0.100; 95% CI 0.016, 0.630; p = 0.014; FDR q value = 0.098).Testosterone level in AF weakly associated with ASD risk (adjusted OR = 1.002; 95% CI 1.000, 1.004; p = 0.05). However, after multiple comparison correction, the association was not significant (FDR q value = 0.437). No significant associations between AF-induced receptor transactivities and ASD risk were observed. The adjusted OR was 2.176 (95%CI 0.115, 41.153) for the ratio of the combined androgenic activity to combined estrogenic activity. Conclusions: The presence of PFAS and heavy metals in AF indicates that they can cross the placenta. The inverse association between levels of PFAS congeners in AF and ASD risk might relate to the weak estrogenic activities and anti-androgenic activities of PFAS.The observed tendency of positive association between the ratio of combined androgenic effect to the combined estrogenic effect and ASD risk needs further studies to explore whether EDCs together with endogenous hormones play a role in the development of ASD.


Assuntos
Líquido Amniótico/química , Transtorno do Espectro Autista/etiologia , Disruptores Endócrinos/análise , Metais Pesados/análise , Adolescente , Adulto , Animais , Transtorno do Espectro Autista/epidemiologia , Células CHO , Estudos de Casos e Controles , Criança , Cricetinae , Cricetulus , Disruptores Endócrinos/toxicidade , Feminino , Humanos , Recém-Nascido , Masculino , Metais Pesados/toxicidade , Pessoa de Meia-Idade
15.
J Obstet Gynaecol Res ; 45(4): 824-829, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30623540

RESUMO

AIM: To test the hypothesis that altered A Disintegrin and Metalloproteinase Domains with Thrombospondins motifs (ADAMTS) is implicated in the etiopathogenesis of gestational diabetes mellitus (GDM). METHODS: All pregnant women who underwent elective amniocentesis for karyotype analysis between January 1, 2016, and January 1, 2018, were included in this study. From this cohort, the study group consisting of 20 patients diagnosed with GDM was selected and compared against a control group consisting of 20 age- and body mass index (BMI)-matched patients without GDM. ADAMTS4, ADAMTS5, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels were compared in the second trimester amniotic fluid of patients with GDM and normoglycemic pregnant women. RESULTS: No significant differences were observed between GDM and control groups regarding age, BMI, gestational age at amniocentesis and indication for amniocentesis. Mean amniotic fluid ADAMTS4 and ADAMTS5 levels were significantly increased in the GDM group compared with the control group (253.5 ± 18.7 pg/mL and 188.5 ± 21.3 pg/mL, P < 0.001; 192.9 ± 16.4 pg/mL and 154.8 ± 19.9 pg/mL, P = 0.021, respectively). Significant increases in IL-6 and TNF-α levels were also detected in the amniotic fluid of GDM patients relative to controls (136.2 ± 17.3 pg/mL and 98.3 ± 11.5 pg/mL, P < 0.001; 154.2 ± 12.5 pg/mL and 86.2 ± 10.8 pg/mL, P < 0.001, respectively). CONCLUSION: The data presented here suggest that increased levels of ADAMTS4, ADAMTS5, IL-6 and TNF-α may play an important role in the progression of GDM.


Assuntos
Proteína ADAMTS4/metabolismo , Proteína ADAMTS5/metabolismo , Líquido Amniótico/química , Diabetes Gestacional/metabolismo , Interleucina-6/metabolismo , Segundo Trimestre da Gravidez/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adulto , Feminino , Humanos , Gravidez
16.
J Matern Fetal Neonatal Med ; 32(21): 3627-3632, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29685073

RESUMO

Objective: To identify the level of amniotic fluid lactate (AFL), placental growth factor (PLGF), and vascular endothelial growth factor (VEGF) at second trimester amniocentesis, and to compare levels in normal pregnancies with pregnancies ending in a miscarriage, an intrauterine growth restricted fetus (IUGR) or decreased fetal movements. Study design: A prospective cohort study. Amniotic fluid was consecutively collected at amniocentesis in 106 pregnancies. Fetal wellbeing at delivery was evaluated from medical files and compared with the levels of AFL, VEGF, and PLGF at the time of amniocentesis. Results: The median level of AFL was 6.9 mmol/l, VEGF 0.088 pg/ml, and PLGF 0.208 pg/ml. The median levels of AFL in pregnancies ended in miscarriage were significantly higher (10.7 mmol/l) compared to those with a live new-born (6.9 mmol/L, p = .02). The levels of VEGF (p = .2) and PLGF (p = .7) were not affected. In pregnancies with an IUGR, the median level of AFL was higher compared to those with normal fetal growth (p = .003). No differences VEGF (p = .5), but significant lower PLGF were found in IUGR pregnancies (p = .03). Conclusions: Pregnancies ending in a miscarriage or with IUGR had significantly higher median values of AFL but lower values of PLGF in the amniotic fluid at the time of second trimester amniocentesis compared to normal pregnancies.


Assuntos
Líquido Amniótico/metabolismo , Biomarcadores/metabolismo , Feto/fisiologia , Resultado da Gravidez , Segundo Trimestre da Gravidez/metabolismo , Aborto Espontâneo/diagnóstico , Aborto Espontâneo/metabolismo , Adulto , Amniocentese , Líquido Amniótico/química , Biomarcadores/análise , Estudos de Casos e Controles , Feminino , Sofrimento Fetal/diagnóstico , Sofrimento Fetal/metabolismo , Sofrimento Fetal/fisiopatologia , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/metabolismo , Movimento Fetal/fisiologia , Viabilidade Fetal , Humanos , Recém-Nascido , Ácido Láctico/análise , Ácido Láctico/metabolismo , Fator de Crescimento Placentário/análise , Fator de Crescimento Placentário/metabolismo , Gravidez , Fator A de Crescimento do Endotélio Vascular/análise , Fator A de Crescimento do Endotélio Vascular/metabolismo
17.
J Steroid Biochem Mol Biol ; 185: 47-56, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30031148

RESUMO

Growth and development of an embryo or fetus during human pregnancy mainly depend on intact hormone biosynthesis and metabolism in maternal amniotic fluid (AF). We investigated the hormonal milieu in AF and developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of 14 sulfated and 6 unconjugated steroids in AF. 65 A F samples (male: female = 35: 30) of mid-gestation ranging from 16th week of gestation to 25th week of gestation were analyzed. Reference data of 20 steroid levels in AF of healthy women were provided. 13 sulfated and 3 unconjugated steroids were for the first time quantified in AF by LC-MS/MS. Highest concentrations were found for pregnenolone sulfate (PregS: mean ±â€¯SD, 8.6 ±â€¯3.7 ng/mL), 17α-hydroxypregnenolone sulfate (17OHPregS: 4.9 ±â€¯2.0 ng/mL), epitestosterone sulfate (eTS: 7.3 ±â€¯3.6 ng/mL), 16α-hydroxydehydroepiandrosterone sulfate (16OH-DHEAS: 21.5 ±â€¯10.7 ng/mL), androsterone sulfate (AnS: 9.2 ±â€¯7.4 ng/mL), estrone sulfate (E1S: 3.0 ±â€¯3.0 ng/mL), estriol 3-sulfate (E3S: 8.1 ±â€¯4.0 ng/mL) and estriol (E3: 1.2 ±â€¯0.4 ng/mL). Only testosterone (T) showed a significant sex difference (p < 0.0001). Correlations between AF steroids mirrored the steroid metabolism of the feto-placental unit, and not only confirmed the classical steroid pathway, but also pointed to a sulfated steroid pathway.


Assuntos
Líquido Amniótico/química , Segundo Trimestre da Gravidez/fisiologia , Esteroides/análise , 17-alfa-Hidroxipregnenolona/análise , Androsterona/análise , Cromatografia Líquida , Desidroepiandrosterona/análise , Epitestosterona/análise , Estriol/análogos & derivados , Estriol/análise , Estrona/análogos & derivados , Estrona/análise , Feminino , Idade Gestacional , Humanos , Masculino , Gravidez , Pregnenolona/análise , Espectrometria de Massas em Tandem
18.
Women Birth ; 32(2): e259-e263, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29954687

RESUMO

BACKGROUND: Meconium stained amniotic fluid commonly occurs postdates ( >40 weeks gestation) indicating fetal maturity. Previous literature indicates that different ethnicities mature at different rates. AIM: To compare the rate of meconium stained amniotic fluid of Australian-born and non-Australian born women. METHODS: A retrospective correlation study design was implemented, using data collected in the birth outcomes system at one tertiary hospital. Data was collected from all women who gave birth to a term (>/=37 weeks gestation), singleton, liveborn baby between January 1st to December 31st, 2014. Maternal country of birth was used for comparison. Categorical data was analyzed using Chi-Square test for Independence. Continuous variables were assessed for normality, and differences were compared using an Independent t-test or a Mann-Whitney U test. All tests were two-tailed and p<0.05 was considered statistically significant. RESULTS: 3,041 women were included; 1131 Australian-born and 1910 non-Australian born. Meconium stained amniotic fluid occurred more frequently in non-Australian born women compared to Australian-born women (23.5% vs. 19.8 p=0.02). Their babies were significantly smaller (Mean=3265g, Standard Deviation 463.8 vs Mean=3442g, Standard Deviation 499.2, p<0.001), with no difference in gestational length (Mean=39.4, Standard Deviation 1.28 vs Mean=39.5, Standard Deviation 1.18, p=0.06). Increasing gestational age had the strongest association with meconium stained amniotic fluid; >/=42 weeks gestation occurring 3.52 (95% Confidence Interval: 2.00, 6.22, p=<0.001) more than <40 weeks gestation. CONCLUSION: Maternity health services should record ethnicity and region of birth to provide individualised care as women born overseas often have poorer perinatal outcomes when compared to Australian-born women.


Assuntos
Líquido Amniótico/química , Idade Gestacional , Mecônio/metabolismo , Adolescente , Adulto , Austrália , Feminino , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Adulto Jovem
19.
Biol Trace Elem Res ; 189(1): 45-54, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30097982

RESUMO

The objective of this study was to determine the concentration and the reference ranges of essential and toxic elements in amniotic fluid (AF) and maternal serum (MS) at birth. This study was conducted among 175 healthy pregnant Caucasian European women aged 18-42. AF and maternal blood samples were collected during delivery. An inductively coupled plasma mass spectrometry (ICP-MS) technique was used to determine the levels of Mg, Co, Cu, Zn, Sr, Cd, Ba, Pb, U, Ca, Cr, Al, Mn, V, Fe, As, Se and Sb in AF and MS. The range of reference values was calculated for all analyzed elements in the serum and AF. The mean concentrations of elements, except Pb, were generally higher in MS than in AF. Multiple regression analysis showed that the maternal/newborn body mass (MBM/NBM) ratio was a strong negative predictor (among maternal age and gravidity) of Mg concentration in amniotic fluid. In the serum, MBN/NBM ratio was a strong positive predictor of Cu concentration. Moreover, regression analysis showed that maternal age was an independent positive predictor of the Se level in maternal serum. The reference value ranges of 18 essential and toxic elements were established in AF and MS among a population of healthy pregnant Polish women at delivery. The level of Mg, Co, Cu, Ca and Se in AF and MS can be determined by maternal age and MBM/NBM ratio. These results can be useful in counseling individuals with pregnancies affected by exposure to one of the parameters under investigation.


Assuntos
Líquido Amniótico/química , Oligoelementos/análise , Oligoelementos/sangue , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Análise Multivariada , Gravidez , Análise de Regressão , Adulto Jovem
20.
Int J Environ Health Res ; 29(2): 130-139, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30185063

RESUMO

We conducted a cross-sectional study in the Hospital Universitario de Canarias (Tenerife, Canary Islands, Spain) measuring 22 inorganic elements in amniotic fluid (AF) samples obtained from 65 pregnant women. ICP-MS was used for quantification of inorganic elements. Newborn parameters at delivery were all within the normal range. Concentrations of all elements were detected in measurable amounts in AF. The concentration of elements was similar to those reported in the literature. The concentrations of the most dangerous heavy metals - Cd, Cr, Ni, Hg and Pb - were lower than those reported by other authors. This study demonstrates that toxic inorganic elements pass into and accumulate in AF. The presence of such pollutants in contact with developing embryos from the intrauterine period could exert adverse health effects that deserve future investigations.


Assuntos
Líquido Amniótico/química , Arsênico/análise , Poluentes Ambientais/análise , Metais/análise , Adolescente , Adulto , Estudos Transversais , Monitoramento Ambiental , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Espanha , Adulto Jovem
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