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Sample records for gestational nutrient restriction

  1. Late gestational nutrient restriction

    DEFF Research Database (Denmark)

    Tygesen, Malin Plumhoff; Nielsen, Mette Olaf; Nørgaard, Peder

    2008-01-01

    We investigated the effect of 50% nutrient restriction during the last 6 weeks of gestation on twin-pregnant ewes' plasma glucose, non-esterified fatty acid, ß-hydroxybutyrate, insulin, IGF-1 and leptin concentrations and the effects on lamb birth weight and ewes' lactation performance. Plasma...

  2. The effect of maternal nutrient restriction during late gestation on muscle, bone and meat parameters in five month old lambs

    DEFF Research Database (Denmark)

    Tygesen, Malin Plumhoff; Harrison, Adrian Paul; Therkildsen, M.

    2007-01-01

    rate from birth to weaning, yet compensatory growth after weaning. No relation was found between maternal nutrient restriction during late gestation and meat quality in terms of proteolytic potential, myofibrillar fragmentation index or shear force measured in meat from 5 month old lambs. The data do...... not support the hypothesis of a long-term programming effect of maternal nutrient restriction during late gestation on meat ternderness. However, a long-term effect of maternal nutrient restirction was found for bone trowth. Femur weight was significantly reduced in L-lambs and cortical bone density and mean...

  3. Maternal nutrient restriction in early gestation upregulates myogenic genes in cattle fetal muscle tissue

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    Prenatal myogenesis is a critical factor in determining the muscle growth potential of cattle. We hypothesized that maternal nutrient restriction during early gestation would alter the transcriptome of fetal primordial muscle tissue in cattle. A total of 14 Angus-cross heifers were estrus synchroniz...

  4. Maternal nutrient restriction in mid-to-late gestation influences fetal mRNA expression in muscle tissues in beef cattle.

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    Paradis, Francois; Wood, Katie M; Swanson, Kendall C; Miller, Stephen P; McBride, Brian W; Fitzsimmons, Carolyn

    2017-08-18

    Manipulating maternal nutrition during specific periods of gestation can result in re-programming of fetal and post-natal development. In this experiment we investigated how a feed restriction of 85% compared with 140% of total metabolizable energy requirements, fed to cows during mid-to-late gestation, influences phenotypic development of fetuses and mRNA expression of growth (Insulin-Like Growth Factor family and Insulin Receptor (INSR)), myogenic (Myogenic Differentiation 1 (MYOD1), Myogenin (MYOG), Myocyte Enhancer Factor 2A (MEF2A), Serum Response Factor (SRF)) and adipogenic (Peroxisome Proliferator Activated Receptor Gamma (PPARG)) genes in fetal longissimus dorsi (LD) and semitendinosus (ST) muscle. DNA methylation of imprinted genes, Insulin Like Growth Factor 2 (IGF2) and Insulin Like Growth Factor 2 Receptor (IGF2R), and micro RNA (miRNA) expression, were also examined as potential consequences of poor maternal nutrition, but also potential regulators of altered gene expression patterns. While the nutrient restriction impacted dam body weight, no differences were observed in phenotypic fetal measurements (weight, crown-rump length, or thorax circumference). Interestingly, LD and ST muscles responded differently to the differential pre-natal nutrient levels. While LD muscle of restricted fetal calves had greater mRNA abundances for Insulin Like Growth Factor 1 and its receptor (IGF1 and IGF1R), IGF2R, INSR, MYOD1, MYOG, and PPARG, no significant differences were observed for gene expression in ST muscle. Similarly, feed restriction had a greater impact on the methylation level of IGF2 Differentially Methylated Region 2 (DMR2) in LD muscle as compared to ST muscle between treatment groups. A negative correlation existed between IGF2 mRNA expression and IGF2 DMR2 methylation level in both LD and ST muscles. Differential expression of miRNAs 1 and 133a were also detected in LD muscle. Our data suggests that a nutrient restriction of 85% as compared to 140

  5. Effects of dietary selenium supply and timing of nutrient restriction during gestation on maternal growth and body composition of pregnant adolescent ewes.

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    Carlson, D B; Reed, J J; Borowicz, P P; Taylor, J B; Reynolds, L P; Neville, T L; Redmer, D A; Vonnahme, K A; Caton, J S

    2009-02-01

    The objectives were to examine effects of dietary Se supplementation and nutrient restriction during defined periods of gestation on maternal adaptations to pregnancy in primigravid sheep. Sixty-four pregnant Western Whiteface ewe lambs were assigned to treatments in a 2 x 4 factorial design. Treatments were dietary Se [adequate Se (ASe; 3.05 microg/kg of BW) vs. high Se (HSe; 70.4 microg/kg of BW)] fed as Se-enriched yeast, and plane of nutrition [control (C; 100% of NRC requirements) vs. restricted (R; 60% of NRC requirements]. Selenium treatments were fed throughout gestation. Plane of nutrition treatments were applied during mid (d 50 to 90) and late gestation (d 90 to 130), which resulted in 4 distinct plane of nutrition treatments [treatment: CC (control from d 50 to 130), RC (restricted from d 50 to 90, and control d 90 to 130), CR (control from d 50 to 90, and restricted from d 90 to 130), and RR (restricted from d 50 to 130)]. All of the pregnant ewes were necropsied on d 132 +/- 0.9 of gestation (length of gestation approximately 145 d). Nutrient restriction treatments decreased ewe ADG and G:F, as a result, RC and CR ewes had similar BW and maternal BW (MBW) at necropsy, whereas RR ewes were lighter than RC and CR ewes. From d 90 to 130, the HSe-CC ewes had greater ADG (Se x nutrition; P = 0.05) than did ASe-CC ewes, whereas ADG and G:F (Se x nutrition; P = 0.08) were less for HSe-RR ewes compared with ASe-RR ewes. The CR and RR treatments decreased total gravid uterus weight (P = 0.01) as well as fetal weight (P = 0.02) compared with RC and CC. High Se decreased total (g; P = 0.09) and relative heart mass (g/kg of MBW; P = 0.10), but increased total and relative mass of liver (P RC. Total small intestine mass was similar between RC and CC ewes, but was markedly reduced (P RC than for CR ewes. Increased Se decreased jejunal DNA concentration (P = 0.07), total jejunal cell number (P = 0.03), and total proliferating jejunal cell number (P = 0.05) compared

  6. Moderate nutrient restriction influences expression of genes impacting production efficiencies of beef cattle in fetal liver, muscle and cerebrum by day 50 of gestation

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    We hypothesized that a moderate maternal nutrient restriction during the first 50 days of gestation in beef heifers would affect expression of genes impacting production efficiency phenotypes in the fetal liver, muscle and cerebrum. Fourteen Angus-cross heifers were estrus synchronized and assigned ...

  7. Moderate nutrient restriction influences transcript abundance of genes impacting production efficiencies of beef cattle in fetal liver, muscle, and cerebrum by d 50 of gestation

    Science.gov (United States)

    We hypothesized that a moderate maternal nutrient restriction during the first 50 d of gestation in beef heifers would affect transcript abundance of genes impacting production efficiency phenotypes in fetal liver, muscle, and cerebrum. Fourteen Angus-cross heifers were estrus synchronized and assig...

  8. Upregulation of growth signaling and nutrient transporters in cotyledons of early to mid-gestational nutrient restricted ewes

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    Ma, Yan; Zhu, Mei J.; Uthlaut, Adam B.; Nijland, Mark J.; Nathanielsz, Peter W.; Hess, Bret W.; Ford, Stephen P.

    2011-01-01

    Multiparous ewes received 100% (control, C, n=13) or 50% (nutrient restricted, NR, n=14) of NRC dietary requirements from d28-d78 of gestation. On d78, 5 C and 6 NR ewes were necropsied. The remaining 8 C and 8 NR ewes were fed to 100% of NRC from d78-d135 and necropsied. Maternal blood was collected at both necropsies and at weekly intervals for assay of glucose, insulin and leptin. Fetal blood was collected at d78 and d135 necropsies for assay of glucose and lipids. Cotyledonary (COT) tissue was evaluated for protein and mRNA expression [fatty acid transporter (FATP)1, FATP4, CD36, glucose transporter (GLUT)1 and GLUT3], mRNA expression only [placenta fatty acid binding protein (FABPpm) and lipoprotein lipase (LPL)], or expression of phosphorylated and total protein forms [AMP kinase (AMPK)α, acetyl-CoA carboxylase (ACC), extracellular signal-regulated kinase (Erk)1/2, mammalian target of rapamycin (mTOR) and protein kinase B (Akt)]. On d78, but not d135, placental and fetal weights were reduced (P ewes. Maternal circulating glucose, insulin and leptin levels were decreased in NR vs. C ewes on d78 (P ewes (P ewes. AMPK, ACC, and Erk1/2 activities were also increased (P ewes on d135. These data demonstrate placental adaptation to maternal NR through increasing nutrient transporter production and growth signaling activity. PMID:21292322

  9. Effect of maternal nutrient restriction and melatonin supplementation from mid to late gestation on vascular reactivity of maternal and fetal placental arteries.

    Science.gov (United States)

    Shukla, P; Lemley, C O; Dubey, N; Meyer, A M; O'Rourke, S T; Vonnahme, K A

    2014-07-01

    Maternal nutrient restriction and decreased scotophase concentrations of melatonin have been associated with severely compromised pregnancies. We hypothesized that melatonin supplementation in a compromised pregnancy enhances the bradykinin (BK)-induced relaxations of placental arteries thereby ensuring sufficient umbilical blood flow to the developing fetus. Pregnant ewes (n = 31) were fed an adequate (ADQ) or nutrient restricted (RES) diet supplemented with 5 mg of melatonin (MEL) or without melatonin (CON) from day 50 to 130 of gestation. On day 130 of gestation, the maternal (caruncular; CAR) and fetal (cotyledonary; COT) placental arteries were suspended in organ chambers for isometric tension recording. There were no treatment or dietary effects on CAR arteries for any vasoactive agent. However, in COT arteries, MEL ewes were more sensitive (P melatonin by nutritional level interaction (P melatonin by nutritional interaction (P = 0.04) for responsiveness to norepinephrine. The sensitivity of the COT arteries to norepinephrine in CON-RES ewes was decreased compared to CON-ADQ. Melatonin supplementation, regardless of maternal dietary intake, resulted in COT arteries having similar responsiveness to CON-RES ewes. An increase in placental vessel sensitivity to bradykinin-induced relaxation may contribute to melatonin-induced increases in umbilical artery blood flow. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Adult-onset obesity reveals prenatal programming of glucose-insulin sensitivity in male sheep nutrient restricted during late gestation.

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    Philip Rhodes

    Full Text Available BACKGROUND: Obesity invokes a range of metabolic disturbances, but the transition from a poor to excessive nutritional environment may exacerbate adult metabolic dysfunction. The current study investigated global maternal nutrient restriction during early or late gestation on glucose tolerance and insulin sensitivity in the adult offspring when lean and obese. METHODS/PRINCIPAL FINDINGS: Pregnant sheep received adequate (1.0M; CE, n = 6 or energy restricted (0.7M diet during early (1-65 days; LEE, n = 6 or late (65-128 days; LEL, n = 7 gestation (term approximately 147 days. Subsequent offspring remained on pasture until 1.5 years when all received glucose and insulin tolerance tests (GTT & ITT and body composition determination by dual energy x-ray absorptiometry (DXA. All animals were then exposed to an obesogenic environment for 6-7 months and all protocols repeated. Prenatal dietary treatment had no effect on birth weight or on metabolic endpoints when animals were 'lean' (1.5 years. Obesity revealed generalised metabolic 'inflexibility' and insulin resistance; characterised by blunted excursions of plasma NEFA and increased insulin(AUC (from 133 to 341 [s.e.d. 26] ng.ml(-1.120 mins during a GTT, respectively. For LEL vs. CE, the peak in plasma insulin when obese was greater (7.8 vs. 4.7 [s.e.d. 1.1] ng.ml(-1 and was exacerbated by offspring sex (i.e. 9.8 vs. 4.4 [s.e.d. 1.16] ng.ml(-1; LEL male vs. CE male, respectively. Acquisition of obesity also significantly influenced the plasma lipid and protein profile to suggest, overall, greater net lipogenesis and reduced protein metabolism. CONCLUSIONS: This study indicates generalised metabolic dysfunction with adult-onset obesity which also exacerbates and 'reveals' programming of glucose-insulin sensitivity in male offspring prenatally exposed to maternal undernutrition during late gestation. Taken together, the data suggest that metabolic function appears little compromised in young

  11. Effect of melatonin or maternal nutrient restriction on vascularity and cell proliferation in the ovine placenta.

    Science.gov (United States)

    Eifert, Adam W; Wilson, Matthew E; Vonnahme, Kimberly A; Camacho, Leticia E; Borowicz, Pawel P; Redmer, Dale A; Romero, Sinibaldo; Dorsam, Sheri; Haring, Jodie; Lemley, Caleb O

    2015-02-01

    Previously we reported increased umbilical artery blood flow in ewes supplemented with melatonin from mid- to late-pregnancy, while maternal nutrient restriction decreased uterine artery blood flow. To further unravel these responses, this study was designed to assess placental cell proliferation and vascularity following supplementation with melatonin or maternal nutrient restriction. For the first experiment, 31 primiparous ewes were supplemented with 5mg of melatonin per day (MEL) or no melatonin (CON) and allocated to receive 100% (adequate fed; ADQ) or 60% (restricted; RES) of their nutrient requirements from day 50 to 130 of gestation. To examine melatonin receptor dependent effects, a second experiment was designed utilizing 14 primiparous ewes infused with vehicle, melatonin, or luzindole (melatonin receptor 1 and 2 antagonist) from day 62 to 90 of gestation. For experiment 1, caruncle concentrations of RNA were increased in MEL-RES compared to CON-RES. Caruncle capillary area density and average capillary cross-sectional area were decreased in MEL-RES compared to CON-RES. Cotyledon vascularity was not different across dietary treatments. For experiment 2, placental cellular proliferation and vascularity were not affected by infusion treatment. In summary, melatonin interacted with nutrient restriction to alter caruncle vascularity and RNA concentrations during late pregnancy. Although melatonin receptor antagonism alters feto-placental blood flow, these receptor dependent responses were not observed in placental vascularity. Moreover, placental vascularity measures do not fully explain the alterations in uteroplacental blood flow. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Placental Nutrient Transport in Gestational Diabetic Pregnancies

    Directory of Open Access Journals (Sweden)

    Marisol Castillo-Castrejon

    2017-11-01

    Full Text Available Maternal obesity during pregnancy is rising and is associated with increased risk of developing gestational diabetes mellitus (GDM, defined as glucose intolerance first diagnosed in pregnancy (1. Fetal growth is determined by the maternal nutrient supply and placental nutrient transfer capacity. GDM-complicated pregnancies are more likely to be complicated by fetal overgrowth or excess adipose deposition in utero. Infants born from GDM mothers have an increased risk of developing cardiovascular and metabolic disorders later in life. Diverse factors, such as ethnicity, age, fetal sex, clinical treatment for glycemic control, gestational weight gain, and body mass index among others, represent a challenge for studying underlying mechanisms in GDM subjects. Determining the individual roles of glucose intolerance, obesity, and other factors on placental function and fetal growth remains a challenge. This review provides an overview of changes in placental macronutrient transport observed in human pregnancies complicated by GDM. Improved knowledge and understanding of the alterations in placenta function that lead to pathological fetal growth will allow for development of new therapeutic interventions and treatments to improve pregnancy outcomes and lifelong health for the mother and her children.

  13. Late foetal life nutrient restriction and sire genotype affect postnatal performance of lambs

    DEFF Research Database (Denmark)

    Tygesen, Malin Plumhoff; Tauson, Anne-Helen; Blache, D.

    2008-01-01

    This experiment investigates the effects of maternal nutrient restriction in late gestation on the offsprings' postnatal metabolism and performance. Forty purebred Shropshire twin lambs born to ewes fed either a high-nutrition diet (H) (according to standard) or a low-nutrition (L) diet (50% during...... the last 6 weeks of gestation) were studied from birth until 145 days of age. In each feeding group, two different sires were represented, ‘growth' (G) and ‘meat' (M), having different breeding indices for the lean : fat ratio. Post partum all ewes were fed the same diet. Lambs born to L-ewes had...... significantly lower birth weights and pre-weaning growth rates. This was especially pronounced in L-lambs born to the M-ram, which also had markedly lower pre-weaning glucose concentrations than the other three groups of lambs. L-lambs converted milk to live weight with an increased efficiency in week 3 of life...

  14. Maternal nutrient restriction during pregnancy impairs an endothelium-derived hyperpolarizing factor-like pathway in sheep fetal coronary arteries.

    Science.gov (United States)

    Shukla, Praveen; Ghatta, Srinivas; Dubey, Nidhi; Lemley, Caleb O; Johnson, Mary Lynn; Modgil, Amit; Vonnahme, Kimberly; Caton, Joel S; Reynolds, Lawrence P; Sun, Chengwen; O'Rourke, Stephen T

    2014-07-15

    The mechanisms underlying developmental programming are poorly understood but may be associated with adaptations by the fetus in response to changes in the maternal environment during pregnancy. We hypothesized that maternal nutrient restriction during pregnancy alters vasodilator responses in fetal coronary arteries. Pregnant ewes were fed a control [100% U.S. National Research Council (NRC)] or nutrient-restricted (60% NRC) diet from days 50 to 130 of gestation (term = 145 days); fetal tissues were collected at day 130. In coronary arteries isolated from control fetal lambs, relaxation to bradykinin was unaffected by nitro-l-arginine (NLA). Iberiotoxin or contraction with KCl abolished the NLA-resistant response to bradykinin. In fetal coronary arteries from nutrient-restricted ewes, relaxation to bradykinin was fully suppressed by NLA. Large-conductance, calcium-activated potassium channel (BKCa) currents did not differ in coronary smooth muscle cells from control and nutrient-restricted animals. The BKCa openers, BMS 191011 and NS1619, and 14,15-epoxyeicosatrienoic acid [a putative endothelium-derived hyperpolarizing factor (EDHF)] each caused fetal coronary artery relaxation and BKCa current activation that was unaffected by maternal nutrient restriction. Expression of BKCa-channel subunits did not differ in fetal coronary arteries from control or undernourished ewes. The results indicate that maternal undernutrition during pregnancy results in loss of the EDHF-like pathway in fetal coronary arteries in response to bradykinin, an effect that cannot be explained by a decreased number or activity of BKCa channels or by decreased sensitivity to mediators that activate BKCa channels in vascular smooth muscle cells. Under these conditions, bradykinin-induced relaxation is completely dependent on nitric oxide, which may represent an adaptive response to compensate for the absence of the EDHF-like pathway. Copyright © 2014 the American Physiological Society.

  15. Gestational food restriction decreases placental interleukin-10 expression and markers of autophagy and endoplasmic reticulum stress in murine intrauterine growth restriction.

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    Chu, Alison; Thamotharan, Shanthie; Ganguly, Amit; Wadehra, Madhuri; Pellegrini, Matteo; Devaskar, Sherin U

    2016-10-01

    Intrauterine growth restriction (IUGR) affects up to 10% of pregnancies and often results in short- and long-term sequelae for offspring. The mechanisms underlying IUGR are poorly understood, but it is known that healthy placentation is essential for nutrient provision to fuel fetal growth, and is regulated by immunologic inputs. We hypothesized that in pregnancy, maternal food restriction (FR) resulting in IUGR would decrease the overall immunotolerant milieu in the placenta, leading to increased cellular stress and death. Our specific objectives were to evaluate (1) key cytokines (eg, IL-10) that regulate maternal-fetal tolerance, (2) cellular processes (autophagy and endoplasmic reticulum [ER] stress) that are immunologically mediated and important for cellular survival and functioning, and (3) the resulting IUGR phenotype and placental histopathology in this animal model. After subjecting pregnant mice to mild and moderate FR from gestational day 10 to 19, we collected placentas and embryos at gestational day 19. We examined RNA sequencing data to identify immunologic pathways affected in IUGR-associated placentas and validated messenger RNA expression changes of genes important in cellular integrity. We also evaluated histopathologic changes in vascular and trophoblastic structures as well as protein expression changes in autophagy, ER stress, and apoptosis in the mouse placentas. Several differentially expressed genes were identified in FR compared with control mice, including a considerable subset that regulates immune tolerance, inflammation, and cellular integrity. In summary, maternal FR decreases the anti-inflammatory effect of IL-10 and suppresses placental autophagic and ER stress responses, despite evidence of dysregulated vascular and trophoblast structures leading to IUGR. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Extrauterine growth restriction: Universal problem among premature infants

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    Brunnella Alcantara Chagas de FREITAS

    2016-02-01

    Full Text Available ABSTRACT Objective: To analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. Methods: This is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalenceratios . Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possible confounding factors. Results: The frequency of extrauterine growth restriction was 24.0%. Most (85.0% small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-for-gestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores of non-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p <0.001 and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p =0.010. Conclusion: Extrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-for-gestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices

  17. Down-Regulation of Placental Transport of Amino Acids Precedes the Development of Intrauterine Growth Restriction in Maternal Nutrient Restricted Baboons.

    Science.gov (United States)

    Pantham, Priyadarshini; Rosario, Fredrick J; Weintraub, Susan T; Nathanielsz, Peter W; Powell, Theresa L; Li, Cun; Jansson, Thomas

    2016-11-01

    Intrauterine growth restriction (IUGR) is an important risk factor for perinatal complications and adult disease. IUGR is associated with down-regulation of placental amino acid transporter expression and activity at birth. It is unknown whether these changes are a cause or a consequence of human IUGR. We hypothesized that placental amino acid transport capacity is reduced prior to onset of reduced fetal growth in baboons with maternal nutrient restriction (MNR). Pregnant baboons were fed either a control (n = 8) or MNR diet (70% of control diet, n = 9) from Gestational Day 30. At Gestational Day 120 (0.65 of gestation), fetuses and placentas were collected. Microvillous (MVM) and basal (BM) plasma membrane vesicles were isolated. System A and system L transport activity was determined in MVM, and leucine transporter activity was assessed in BM using radiolabeled substrates. MVM amino acid transporter isoform expression (SNAT1, SNAT2, and SNAT4 and LAT1 and LAT2) was measured using Western blots. LAT1 and LAT2 expression were also determined in BM. Maternal and fetal plasma amino acids concentrations were determined using mass spectrometry. Fetal and placental weights were unaffected by MNR. MVM system A activity was decreased by 37% in MNR baboon placentas (P = 0.03); however MVM system A amino acid transporter protein expression was unchanged. MVM system L activity and BM leucine transporter activity were not altered by MNR. Fetal plasma concentrations of essential amino acids isoleucine and leucine were reduced, while citrulline increased (P growth trajectory. The reduction in plasma leucine and isoleucine in MNR fetuses may be caused by reduced activity of MVM system A, which is strongly coupled with system L essential amino acid uptake. Our findings indicate that reduced placental amino acid transport may be a cause rather than a consequence of IUGR due to inadequate maternal nutrition. © 2016 by the Society for the Study of Reproduction, Inc.

  18. Influence of nutrient restriction and melatonin supplementation of pregnant ewes on maternal and fetal pancreatic digestive enzymes and insulin-containing clusters.

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    Keomanivong, F E; Lemley, C O; Camacho, L E; Yunusova, R; Borowicz, P P; Caton, J S; Meyer, A M; Vonnahme, K A; Swanson, K C

    2016-03-01

    Primiparous ewes (n=32) were assigned to dietary treatments in a 2×2 factorial arrangement to determine effects of nutrient restriction and melatonin supplementation on maternal and fetal pancreatic weight, digestive enzyme activity, concentration of insulin-containing clusters and plasma insulin concentrations. Treatments consisted of nutrient intake with 60% (RES) or 100% (ADQ) of requirements and melatonin supplementation at 0 (CON) or 5 mg/day (MEL). Treatments began on day 50 of gestation and continued until day 130. On day 130, blood was collected under general anesthesia from the uterine artery, uterine vein, umbilical artery and umbilical vein for plasma insulin analysis. Ewes were then euthanized and the pancreas removed from the ewe and fetus, trimmed of mesentery and fat, weighed and snap-frozen until enzyme analysis. In addition, samples of pancreatic tissue were fixed in 10% formalin solution for histological examination including quantitative characterization of size and distribution of insulin-containing cell clusters. Nutrient restriction decreased (P⩽0.001) maternal pancreatic mass (g) and α-amylase activity (U/g, kU/pancreas, U/kg BW). Ewes supplemented with melatonin had increased pancreatic mass (P=0.03) and α-amylase content (kU/pancreas and U/kg BW). Melatonin supplementation decreased (P=0.002) maternal pancreatic insulin-positive tissue area (relative to section of tissue), and size of the largest insulin-containing cell cluster (P=0.04). Nutrient restriction decreased pancreatic insulin-positive tissue area (P=0.03) and percent of large (32 001 to 512 000 µm2) and giant (⩾512 001 µm2) insulin-containing cell clusters (P=0.04) in the fetus. Insulin concentrations in plasma from the uterine vein, umbilical artery and umbilical vein were greater (P⩽0.01) in animals receiving 100% requirements. When comparing ewes to fetuses, ewes had a greater percentage of medium insulin-containing cell clusters (2001 to 32 000 µm2) while fetuses

  19. The Effect of Activity Restriction on Infant's Birth Weight and Gestational Age at Birth: PRAMS Data Analysis.

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    Omar, Abeer

    2018-01-01

    Activity restriction is extensively prescribed for pregnant women with major comorbidities despite the lack of evidence to support its effectiveness in preventing preterm birth or low birth weight. To determine the moderation effect of home activity restriction for more than a week on infant's birth weight and gestational age at birth for high-risk women with obstetrical and medical comorbidities. A secondary analysis of 2004-2008 New York Pregnancy Risk Assessment Monitoring System was conducted with 1426 high-risk women. High-risk group included 41% of women treated with activity restriction and 59% of those not treated with activity restriction. Women with preterm premature rupture of membrane (PPROM) who were treated with activity restriction had a lower infant birth weight ( b = -202.85, p = ≤.001) and gestational age at birth ( b = -.91, p = ≤.001) than those without activity restriction. However, women with preterm labor and hypertensive disorders of pregnancy who were not treated with activity restriction had lower infant gestational age at birth ( b = -96, p = ≤.01) and ( b = -92, p = ≤.001), respectively, compared to those who were treated with activity restriction. Findings suggest a contrary effect of activity restriction on infants born to women with PPROM, which is a major reason for prescribing activity restriction. The current study results may trigger the need to conduct randomized control trials to determine the effect of severity of activity restriction on maternal and infant outcomes.

  20. Early Onset Intrauterine Growth Restriction in a Mouse Model of Gestational Hypercholesterolemia and Atherosclerosis

    Science.gov (United States)

    Busso, Dolores; Mascareño, Lilian; Salas, Francisca; Berkowitz, Loni; Santander, Nicolás; Quiroz, Alonso; Amigo, Ludwig; Valdés, Gloria; Rigotti, Attilio

    2014-01-01

    The susceptibility to develop atherosclerosis is increased by intrauterine growth restriction and prenatal exposure to maternal hypercholesterolemia. Here, we studied whether mouse gestational hypercholesterolemia and atherosclerosis affected fetal development and growth at different stages of gestation. Female LDLR KO mice fed a proatherogenic, high cholesterol (HC) diet for 3 weeks before conception and during pregnancy exhibited a significant increase in non-HDL cholesterol and developed atherosclerosis. At embryonic days 12.5 (E12.5), E15.5, and E18.5, maternal gestational hypercholesterolemia and atherosclerosis were associated to a 22–24% reduction in male and female fetal weight without alterations in fetal number/litter or morphology nor placental weight or structure. Feeding the HC diet exclusively at the periconceptional period did not alter fetal growth, suggesting that maternal hypercholesterolemia affected fetal weight only after implantation. Vitamin E supplementation (1,000 UI of α-tocopherol/kg) of HC-fed females did not change the mean weight of E18.5 fetuses but reduced the percentage of fetuses exhibiting body weights below the 10th percentile of weight (HC: 90% vs. HC/VitE: 68%). In conclusion, our results showed that maternal gestational hypercholesterolemia and atherosclerosis in mice were associated to early onset fetal growth restriction and that dietary vitamin E supplementation had a beneficial impact on this condition. PMID:25295255

  1. Changes in the metabolic profile of pregnant ewes to an acute feed restriction in late gestation.

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    Cal-Pereyra, L; Benech, A; González-Montaña, J R; Acosta-Dibarrat, J; Da Silva, S; Martín, A

    2015-05-01

    To detect early changes in the metabolic profile of pregnant ewes subject to acute feed restriction at 130 days of gestation, and to establish indicators of risk for ovine pregnancy toxaemia (OPT) for diagnostic purposes. Twenty Corriedale ewes with known mating dates, carrying a single fetus, were used. Ewes were maintained on meadow grasslands and at 130 days of gestation were randomly divided in two groups of 10 ewes. The control group had ad libitum access to pasture. Ewes in the restricted group were subjected to an acute feed restriction for a maximum of 144 hours (6 days), with free access to water. From the start (0 hours) until the end of feed restriction, blood samples were collected from all ewes to monitor concentrations of cortisol, non-esterified fatty acids (NEFA), ß-hydroxybutyrate (BOHB) daily, and glucose in plasma every 6 hours; urinary pH was also measured. Every 6 hours the food restricted ewes were observed to detect clinical signs of OPT e.g. apathy, grinding teeth, empty chewing movements, head leaning against the wall, tachypnea and not drinking water. In food-restricted ewes, concentrations of glucose decreased and differed from control ewes from 54 to 90 hours (pewes after 48 to 144 hours (pewes showed clinical signs of OPT after 102-132 hours. Mean concentrations of glucose, BOHB and cortisol differed between control and restricted ewes prior to the onset of clinical signs of OPT, after 48-96 hours of feed restriction (p<0.01). Mean gestational length, and time from birth to placental expulsion was not affected by the feed restriction. Our results suggest that concentrations of glucose, BOHB and cortisol in plasma may provide a precocious diagnosis of subclinical OPT, using values of 1.59 (SD 0.24) mmol/L, 2.26 (SD 1.03) mmol/L and 15.09 (SD 7.75) nmol/L, respectively. The identification of a potentially harmful metabolic imbalance could lead to the improvement of treatment success.

  2. Dietary sodium restriction in the prophylaxis of hypertensive disorders of pregnancy: effects on the intake of other nutrients.

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    van Buul, B J; Steegers, E A; Jongsma, H W; Rijpkema, A L; Eskes, T K; Thomas, C M; Baadenhuysen, H; Hein, P R

    1995-07-01

    Dietary sodium restriction is used in the Netherlands in the prophylaxis of preeclampsia. To study the effects of long-term sodium restriction on the intake of other nutrients and the outcome of pregnancy, 68 healthy nulliparous pregnant women were randomly assigned to either a low-sodium diet (20 mmol/24 h) or an unrestricted diet. The diet was consumed between week 14 of gestation and delivery. The dietary intakes of energy, fat, protein, carbohydrate, sodium, potassium, and calcium were estimated with the dietary-history technique. A low-sodium diet reduced the intake of protein (by approximately 15 g/24 h), fat (by 20 g/24 h), and calcium (by 350 mg/24 h) and tended to decrease the energy intake (by approximately 0.7 MJ/24 h). The intakes of carbohydrate and potassium did not differ between the groups. The maternal weight gain was less in the low-sodium group (6.0 +/- 3.7 compared with 11.7 +/- 4.7 kg). Mean birth weight was not significantly different (3.2 +/- 0.5 compared with 3.4 +/- 0.5 kg).

  3. Influence of Maternal Nutrient Restriction during the Period of ...

    African Journals Online (AJOL)

    Influence of Maternal Nutrient Restriction during the Period of Embryonic and Maximal Placental Growth on Organ Development in the Adult Sheep. ... Objective: It is apparent that maternal under nutrition at specific period during pregnancy has differential effects on placental and fetal development, such that the resulting ...

  4. Growth, meat and feed efficiency traits of lambs born to ewes submitted to energy restriction during mid-gestation.

    Science.gov (United States)

    Piaggio, L; Quintans, G; San Julián, R; Ferreira, G; Ithurralde, J; Fierro, S; Pereira, A S C; Baldi, F; Banchero, G E

    2018-02-01

    The objective of this study was to evaluate the effects of the energy restriction of gestation of adult ewes from day 45 to day 115 on lamb live performance parameters, carcass and meat traits. In experiment I, dietary energy was restricted at 70% of the metabolizable energy (ME) requirements, after which ewes were re-fed ad libitum until lambing. In experiment II, dietary energy was restricted at 60% of the ME requirements, and ewes were re-fed to ME requirements until lambing. All ewes grazed together from the end of the restriction periods to weaning. Lambs were weaned and lot fed until slaughter. Feed intake, weight gain and feed efficiency were recorded, and body fat thickness and ribeye area (REA) were measured in the longissimus thoracis muscle. After slaughter, carcass weight and yield, fat depth, carcass and leg length, and frenched rack and leg weights and yields were determined. Muscle fiber type composition, Warner-Bratzler shear force, pH and color were determined in the longissimus lumborum muscle. In experiment I, energy restriction followed by ad libitum feeding affected lamb birth weight (P0.05) were observed on later BW, REA, BF or carcass traits. Lambs born to non-restricted-fed ewes had higher (Penergy restriction followed by ME requirements feeding, affected (Pefficient (P=0.16) than lambs from unrestricted dams. Ribeye area and BF were not influenced by treatment. Treatment significantly affected slaughter weight, but had no effects on carcass yield and traits or on meat traits. The results obtained in both experiments indicate submitting ewes to energy restriction during gestation affects the performance of their progeny but the final outcome would depend on the ewe's re-feeding level during late gestation and the capacity of the offspring to compensate the in utero restriction after birth.

  5. Increasing fetal ovine number per gestation alters fetal plasma clinical chemistry values.

    Science.gov (United States)

    Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J

    2016-08-01

    Intrauterine growth restriction (IUGR) is interconnected with developmental programming of lifelong pathophysiology. IUGR is seen in human multifetal pregnancies, with stepwise rises in fetal numbers interfering with placental nutrient delivery. It remains unknown whether fetal blood analyses would reflect fetal nutrition, liver, and excretory function in the last trimester of human or ovine IUGR In an ovine model, we hypothesized that fetal plasma biochemical values would reflect progressive placental, fetal liver, and fetal kidney dysfunction as the number of fetuses per gestation rose. To determine fetal plasma biochemical values in singleton, twin, triplet, and quadruplet/quintuplet ovine gestation, we investigated morphometric measures and comprehensive metabolic panels with nutritional measures, liver enzymes, and placental and fetal kidney excretory measures at gestational day (GD) 130 (90% gestation). As anticipated, placental dysfunction was supported by a stepwise fall in fetal weight, fetal plasma glucose, and triglyceride levels as fetal number per ewe rose. Fetal glucose and triglycerides were directly related to fetal weight. Plasma creatinine, reflecting fetal renal excretory function, and plasma cholesterol, reflecting placental excretory function, were inversely correlated with fetal weight. Progressive biochemical disturbances and growth restriction accompanied the rise in fetal number. Understanding the compensatory and adaptive responses of growth-restricted fetuses at the biochemical level may help explain how metabolic pathways in growth restriction can be predetermined at birth. This physiological understanding is important for clinical care and generating interventional strategies to prevent altered developmental programming in multifetal gestation. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  6. Nutritional requirements and feeding recommendations for small for gestational age infants.

    Science.gov (United States)

    Tudehope, David; Vento, Maximo; Bhutta, Zulfiqar; Pachi, Paulo

    2013-03-01

    We define the small for gestational age (SGA) infant as an infant born ≥ 35 weeks' gestation and milk for SGA infants because it meets most of their nutritional requirements and provides short- and long-term benefits. Several distinct patterns of intrauterine growth restriction are identified among the heterogeneous grouping of SGA infants; each varies with regard to neonatal morbidities, requirements for neonatal management, postnatal growth velocities, neurodevelopmental progress, and adult health outcomes. There is much we do not know about nutritional management of the SGA infant. We need to identify and define: infants who have "true" growth restriction and are at high risk for adverse metabolic outcomes in later life; optimal growth velocity and "catch-up" growth rates that are conducive with life-long health and well being; global approaches to management of hypoglycemia; and an optimal model for postdischarge care. Large, rigorously conducted trials are required to determine whether aggressive feeding of SGA infants results in improved nutritional rehabilitation, growth, and neurodevelopmental outcomes. Before birth, maternal supplementation with specific nutrients reduces the rate and severity of growth restriction and may prevent nutrient deficiency states if infants are born SGA. After birth, the generally accepted goal is to provide enough nutrients to achieve postnatal growth similar to that of a normal fetus. In addition, we recommend SGA infants be allowed to "room in" with their mothers to promote breastfeeding, mother-infant attachment, and skin-to-skin contact to assist with thermoregulation. Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

  7. Skeletal muscle protein accretion rates and hindlimb growth are reduced in late gestation intrauterine growth-restricted fetal sheep.

    Science.gov (United States)

    Rozance, Paul J; Zastoupil, Laura; Wesolowski, Stephanie R; Goldstrohm, David A; Strahan, Brittany; Cree-Green, Melanie; Sheffield-Moore, Melinda; Meschia, Giacomo; Hay, William W; Wilkening, Randall B; Brown, Laura D

    2018-01-01

    Adults who were affected by intrauterine growth restriction (IUGR) suffer from reductions in muscle mass, which may contribute to insulin resistance and the development of diabetes. We demonstrate slower hindlimb linear growth and muscle protein synthesis rates that match the reduced hindlimb blood flow and oxygen consumption rates in IUGR fetal sheep. These adaptations resulted in hindlimb blood flow rates in IUGR that were similar to control fetuses on a weight-specific basis. Net hindlimb glucose uptake and lactate output rates were similar between groups, whereas amino acid uptake was significantly lower in IUGR fetal sheep. Among all fetuses, blood O 2 saturation and plasma glucose, insulin and insulin-like growth factor-1 were positively associated and norepinephrine was negatively associated with hindlimb weight. These results further our understanding of the metabolic and hormonal adaptations to reduced oxygen and nutrient supply with placental insufficiency that develop to slow hindlimb growth and muscle protein accretion. Reduced skeletal muscle mass in the fetus with intrauterine growth restriction (IUGR) persists into adulthood and may contribute to increased metabolic disease risk. To determine how placental insufficiency with reduced oxygen and nutrient supply to the fetus affects hindlimb blood flow, substrate uptake and protein accretion rates in skeletal muscle, late gestation control (CON) (n = 8) and IUGR (n = 13) fetal sheep were catheterized with aortic and femoral catheters and a flow transducer around the external iliac artery. Muscle protein kinetic rates were measured using isotopic tracers. Hindlimb weight, linear growth rate, muscle protein accretion rate and fractional synthetic rate were lower in IUGR compared to CON (P fetal norepinephrine and reduced IGF-1 and insulin. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

  8. Identification of placental nutrient transporters associated with intrauterine growth restriction and pre-eclampsia.

    Science.gov (United States)

    Huang, Xiao; Anderle, Pascale; Hostettler, Lu; Baumann, Marc U; Surbek, Daniel V; Ontsouka, Edgar C; Albrecht, Christiane

    2018-03-02

    Gestational disorders such as intrauterine growth restriction (IUGR) and pre-eclampsia (PE) are main causes of poor perinatal outcomes worldwide. Both diseases are related with impaired materno-fetal nutrient transfer, but the crucial transport mechanisms underlying IUGR and PE are not fully elucidated. In this study, we aimed to identify membrane transporters highly associated with transplacental nutrient deficiencies in IUGR/PE. In silico analyses on the identification of differentially expressed nutrient transporters were conducted using seven eligible microarray datasets (from Gene Expression Omnibus), encompassing control and IUGR/PE placental samples. Thereby 46 out of 434 genes were identified as potentially interesting targets. They are involved in the fetal provision with amino acids, carbohydrates, lipids, vitamins and microelements. Targets of interest were clustered into a substrate-specific interaction network by using Search Tool for the Retrieval of Interacting Genes. The subsequent wet-lab validation was performed using quantitative RT-PCR on placentas from clinically well-characterized IUGR/PE patients (IUGR, n = 8; PE, n = 5; PE+IUGR, n = 10) and controls (term, n = 13; preterm, n = 7), followed by 2D-hierarchical heatmap generation. Statistical evaluation using Kruskal-Wallis tests was then applied to detect significantly different expression patterns, while scatter plot analysis indicated which transporters were predominantly influenced by IUGR or PE, or equally affected by both diseases. Identified by both methods, three overlapping targets, SLC7A7, SLC38A5 (amino acid transporters), and ABCA1 (cholesterol transporter), were further investigated at the protein level by western blotting. Protein analyses in total placental tissue lysates and membrane fractions isolated from disease and control placentas indicated an altered functional activity of those three nutrient transporters in IUGR/PE. Combining bioinformatic analysis

  9. Leptin Intake at Physiological Doses Throughout Lactation in Male Wistar Rats Normalizes the Decreased Density of Tyrosine Hydroxylase-Immunoreactive Fibers in the Stomach Caused by Mild Gestational Calorie Restriction

    Directory of Open Access Journals (Sweden)

    Nara Szostaczuk

    2018-03-01

    Full Text Available Introduction: Gestational under nutrition in rats has been shown to decrease expression of sympathetic innervation markers in peripheral tissues of offspring, including the stomach. This has been linked to lower gastric secretion and decreased circulating levels of ghrelin. Considering the critical role of leptin intake during lactation in preventing obesity and reversing adverse developmental programming effects, we aimed to find out whether leptin supplementation may reverse the above mentioned alterations caused by mild gestational calorie restriction.Methods: Three groups of male rats were studied at a juvenile age (25 days old and during adulthood (3 and 6 months old: the offspring of ad libitum fed dams (controls, the offspring of dams that were diet restricted (20% from days 1 to 12 of gestation (CR, and CR rats supplemented with a daily oral dose of leptin (equivalent to 5 times the average amount they could receive each day from maternal milk throughout lactation (CR-Leptin. The density of TyrOH-immunoreactive (TyrOH+ fibers and the levels of Tyrosine hydroxylase (TyrOH—used as potential markers of functional sympathetic innervation—were measured in stomach. Plasma leptin and ghrelin levels were also determined.Results: Twenty five-day-old CR rats, but not CR-Leptin rats, displayed lower density of TyrOH+ fibers (−46% and TyrOH levels (−47% in stomach compared to controls. Alterations in CR animals were mitigated at 6 months of age, and differences were not significant. Adult CR-Leptin animals showed higher plasma ghrelin levels than CR animals, particularly at 3 months (+16%, and a lower leptin/ghrelin ratio (−28 and −37% at 3 and 6 months, respectively.Conclusion: Leptin intake during lactation is able to reverse the alterations in the density of TyrOH+ fibers in the stomach and normalize the increased leptin/ghrelin ratio linked to a mild gestational calorie restriction in rats, supporting the relevance of leptin as an

  10. Immediate metabolic consequences of intrauterine growth restriction and low birthweight.

    Science.gov (United States)

    Bhatia, Jatinder; Gates, Amy

    2013-01-01

    Optimal fetal growth resulting in a 'normally grown' term infant is of paramount importance for assuring a healthy start for postnatal growth and development. Fetal, infant and childhood growth restriction is an important clinical problem for obstetricians, neonatologists, pediatricians and globally, for public health. Worldwide, an estimated 20 million infants are born with low birthweight and a substantial proportion are small for gestational age. Many advances have been made in defining growth restriction by prenatal techniques, thus allowing the recognition of intrauterine growth restriction. Distinguishing infants who are small but have appropriate growth potential from those with growth restriction is important in order to apply obstetric surveillance, anticipate neonatal problems and plan for postneonatal guidance. It is clear that the fetus in growth-restricted pregnancies has limited supply of nutrients and oxygen. The resultant changes, if involving the placenta as well, can lead to circulatory and metabolic changes affecting both short- and long-term survival and development. In this paper, the causes and immediate consequence of being born with low birthweight, intrauterine growth restriction or small for gestational age will be discussed. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.

  11. Effect of maternal hypoglycaemia during gestation on materno-foetal nutrient transfer and embryo-foetal development

    DEFF Research Database (Denmark)

    Jensen, Vivi F.H.; Mølck, Anne Marie; Lykkesfeldt, Jens

    2018-01-01

    of the chorio-allantoic placental circulation. Maternal hypoglycaemia is accompanied by foetal hypoglycaemia and maternal counter-regulatory measures including a priority to keep nutrients in the maternal circulation by restricting their transfer to the foetus. Concomitantly, the foetus initiates its own...... counter-regulatory attempt to secure nutrients for its development and survival. Despite these measures, there is a general decrease in nutrient transfer to the foetus, which may have severe consequences for foetal development such as malformations and delayed skeletal development....

  12. p53 is required for brain growth but is dispensable for resistance to nutrient restriction during Drosophila larval development.

    Science.gov (United States)

    Contreras, Esteban G; Sierralta, Jimena; Glavic, Alvaro

    2018-01-01

    Animal growth is influenced by the genetic background and the environmental circumstances. How genes promote growth and coordinate adaptation to nutrient availability is still an open question. p53 is a transcription factor that commands the cellular response to different types of stresses. In adult Drosophila melanogaster, p53 regulates the metabolic adaptation to nutrient restriction that supports fly viability. Furthermore, the larval brain is protected from nutrient restriction in a phenomenon called 'brain sparing'. Therefore, we hypothesised that p53 may regulate brain growth and show a protective role over brain development under nutrient restriction. Here, we studied the function of p53 during brain growth in normal conditions and in animals subjected to developmental nutrient restriction. We showed that p53 loss of function reduced animal growth and larval brain size. Endogenous p53 was expressed in larval neural stem cells, but its levels and activity were not affected by nutritional stress. Interestingly, p53 knockdown only in neural stem cells was sufficient to decrease larval brain growth. Finally, we showed that in p53 mutant larvae under nutrient restriction, the energy storage levels were not altered, and these larvae generated adults with brains of similar size than wild-type animals. Using genetic approaches, we demonstrate that p53 is required for proper growth of the larval brain. This developmental role of p53 does not have an impact on animal resistance to nutritional stress since brain growth in p53 mutants under nutrient restriction is similar to control animals.

  13. Temporal proteomic analysis reveals defects in small-intestinal development of porcine fetuses with intrauterine growth restriction.

    Science.gov (United States)

    Wang, Xiaoqiu; Lin, Gang; Liu, Chuang; Feng, Cuiping; Zhou, Huaijun; Wang, Taiji; Li, Defa; Wu, Guoyao; Wang, Junjun

    2014-07-01

    The fetus/neonate with intrauterine growth restriction (IUGR) has a high perinatal mortality and morbidity rate, as well as reduced efficiency for nutrients utilization. Our previous studies showed alterations of intestinal proteome in IUGR piglets both at birth and during the nursing period. Considering the potential long-term impacts of fetal programming and substantial increases in amounts of amniotic fluid nutrients from mid-gestation in pigs, the present study involved IUGR porcine fetuses from days 60 to 110 of gestation (mid to late gestation). We identified 59 differentially expressed proteins in the fetal small intestine that are related to intestinal growth, development and reprogramming. Our results further indicated increased abundances of proteins and enzymes associated with oxidative stress, apoptosis and protein degradation, as well as decreased abundances of proteins that are required for maintenance of cell structure and motility, absorption and transport of nutrients, energy metabolism, and protein synthesis in the fetal gut. Moreover, IUGR from middle to late gestation was associated with reduced expression of intestinal proteins that participate in regulation of gene expression and signal transduction. Collectively, these findings provide the first evidence for altered proteomes in the small intestine of IUGR fetuses, thereby predisposing the gut to metabolic defects during gestation and neonatal periods. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Essential nutrient supplementation prevents heritable metabolic disease in multigenerational intrauterine growth-restricted rats

    Science.gov (United States)

    Goodspeed, Danielle; Seferovic, Maxim D.; Holland, William; Mcknight, Robert A.; Summers, Scott A.; Branch, D. Ware; Lane, Robert H.; Aagaard, Kjersti M.

    2015-01-01

    Intrauterine growth restriction (IUGR) confers heritable alterations in DNA methylation, rendering risk of adult metabolic syndrome (MetS). Because CpG methylation is coupled to intake of essential nutrients along the one-carbon pathway, we reasoned that essential nutrient supplementation (ENS) may abrogate IUGR-conferred multigenerational MetS. Pregnant Sprague-Dawley rats underwent bilateral uterine artery ligation causing IUGR in F1. Among the F2 generation, IUGR lineage rats were underweight at birth (6.7 vs. 8.0 g, P 30% elevated, P 5-fold less central fat mass, normal hepatic glucose efflux, and >70% reduced circulating triglycerides and very-LDLs compared with IUGR control-fed F2 offspring (P intrauterine growth-restricted rats. PMID:25395450

  15. Nutrient restriction induces failure of reproductive function and molecular changes in hypothalamus-pituitary-gonadal axis in postpubertal gilts.

    Science.gov (United States)

    Zhou, Dongsheng; Zhuo, Yong; Che, Lianqiang; Lin, Yan; Fang, Zhengfeng; Wu, De

    2014-07-01

    People on a diet to lose weight may be at risk of reproductive failure. To investigate the effects of nutrient restriction on reproductive function and the underlying mechanism, changes of reproductive traits, hormone secretions and gene expressions in hypothalamus-pituitary-gonadal axis were examined in postpubertal gilts at anestrus induced by nutrient restriction. Gilts having experienced two estrus cycles were fed a normal (CON, 2.86 kg/d) or nutrient restricted (NR, 1 kg/d) food regimens to expect anestrus. NR gilts experienced another three estrus cycles, but did not express estrus symptoms at the anticipated fourth estrus. Blood samples were collected at 5 days' interval for consecutive three times for measurement of hormone concentrations at the 23th day of the fourth estrus cycle. Individual progesterone concentrations of NR gilts from three consecutive blood samples were below 1.0 ng/mL versus 2.0 ng/mL in CON gilts, which was considered anestrus. NR gilts had impaired development of reproductive tract characterized by absence of large follicles (diameter ≥ 6 mm), decreased number of corepus lutea and atrophy of uterus and ovary tissues. Circulating concentrations of IGF-I, kisspeptin, estradiol, progesterone and leptin were significantly lower in NR gilts than that in CON gilts. Nutrient restriction down-regulated gene expressions of kiss-1, G-protein coupled protein 54, gonadotropin-releasing hormone, estrogen receptor α, progesterone receptor, leptin receptor, follicle-stimulating hormone and luteinizing hormone and insulin-like growth factor I in hypothalamus-pituitary-gonadal axis of gilts. Collectively, nutrient restriction resulted in impairment of reproductive function and changes of hormone secretions and gene expressions in hypothalamus-pituitary-gonadal axis, which shed light on the underlying mechanism by which nutrient restriction influenced reproductive function.

  16. Gestational Protein Restriction Impairs Glucose Disposal in the Gastrocnemius Muscles of Female Rats

    Science.gov (United States)

    Blesson, Chellakkan S.; Chinnathambi, Vijayakumar; Kumar, Sathish

    2017-01-01

    Gestational low-protein (LP) diet causes hyperglycemia and insulin resistance in adult offspring, but the mechanism is not clearly understood. In this study, we explored the role of insulin signaling in gastrocnemius muscles of gestational LP-exposed female offspring. Pregnant rats were fed a control (20% protein) or an isocaloric LP (6%) diet from gestational day 4 until delivery. Normal diet was given to mothers after delivery and to pups after weaning until necropsy. Offspring were euthanized at 4 months, and gastrocnemius muscles were treated with insulin ex vivo for 30 minutes. Messenger RNA and protein levels of molecules involved in insulin signaling were assessed at 4 months. LP females were smaller at birth but showed rapid catchup growth by 4 weeks. Glucose tolerance test in LP offspring at 3 months showed elevated serum glucose levels (P insulin levels. In gastrocnemius muscles, LP rats showed reduced tyrosine phosphorylation of insulin receptor substrate 1 upon insulin stimulation due to the overexpression of tyrosine phosphatase SHP-2, but serine phosphorylation was unaffected. Furthermore, insulin-induced phosphorylation of Akt, glycogen synthase kinase (GSK)–3α, and GSK-3β was diminished in LP rats, and they displayed an increased basal phosphorylation (inactive form) of glycogen synthase. Our study shows that gestational protein restriction causes peripheral insulin resistance by a series of phosphorylation defects in skeletal muscle in a mechanism involving insulin receptor substrate 1, SHP-2, Akt, GSK-3, and glycogen synthase causing dysfunctional GSK-3 signaling and increased stored glycogen, leading to distorted glucose homeostasis. PMID:28324067

  17. Nutritional plane and selenium supply during gestation impact yield and nutrient composition of colostrum and milk in primiparous ewes

    Science.gov (United States)

    Objectives were to investigate effects of nutritional plane and Se supply during gestation on yield and nutrient composition of colostrum and milk in first parity ewes. Rambouillet ewe lambs (n = 84, age = 240 +/- 17 d, BW = 52.1 +/- 6.2 kg), were allocated to 6 treatments in a 2 x 3 factorial array...

  18. Caspase dependent and independent mechanisms of apoptosis across gestation in a sheep model of placental insufficiency and intrauterine growth restriction.

    Science.gov (United States)

    Monson, Troy; Wright, Tanner; Galan, Henry L; Reynolds, Paul R; Arroyo, Juan A

    2017-05-01

    Increased placental apoptosis is a hallmark of intrauterine growth restricted (IUGR). Several molecules have been shown to be involved in the control of apoptosis during this disease. Our objective was to determine the expression of Bcl2, Bax, phospho XIAP, AIF, caspase 3 and 9, and telomerase activity across gestation in an ovine hyperthermia-induced model of IUGR. Pregnant sheep were placed in hyperthermic (HT) conditions to induce IUGR along with age-matched controls. Placental tissues were collected at 55 (early), 95 (mid-gestation) and 130 (near-term) days of gestational age (dGA) to determine the expression of apoptotic molecules during the development of IUGR. Compared to the control placenta, IGUR pregnancies showed: significantly reduced placental Bcl2 in early gestation (55 dGA) with a significant increase observed at mid gestation (95 dGA); decreased placental pXIAP at both mid and near term gestational days (95 and 130 dGA); placental AIF increased only at 55 dGA (early gestation); active caspase 3 increased at both mid and near term gestational days (95 and 130 dGA); caspase 9 only increased at mid gestation (95 dGA) and decreased Telomerase activity near term. Placental apoptosis, mediated in part by the apoptosis related molecule, participates in the development of IUGR. Findings from this study suggest a caspase-independent apoptotic pathway during early gestation and caspase-dependent apoptosis at mid and near term gestation. The data also implicate decreased activation of XIAP as a plausible factor involved in the control of placental apoptosis during IUGR.

  19. Manure sampling procedures and nutrient estimation by the hydrometer method for gestation pigs.

    Science.gov (United States)

    Zhu, Jun; Ndegwa, Pius M; Zhang, Zhijian

    2004-05-01

    Three manure agitation procedures were examined in this study (vertical mixing, horizontal mixing, and no mixing) to determine the efficacy of producing a representative manure sample. The total solids content for manure from gestation pigs was found to be well correlated with the total nitrogen (TN) and total phosphorus (TP) concentrations in the manure, with highly significant correlation coefficients of 0.988 and 0.994, respectively. Linear correlations were observed between the TN and TP contents and the manure specific gravity (correlation coefficients: 0.991 and 0.987, respectively). Therefore, it may be inferred that the nutrients in pig manure can be estimated with reasonable accuracy by measuring the liquid manure specific gravity. A rapid testing method for manure nutrient contents (TN and TP) using a soil hydrometer was also evaluated. The results showed that the estimating error increased from +/-10% to +/-30% with the decrease in TN (from 1000 to 100 ppm) and TP (from 700 to 50 ppm) concentrations in the manure. Data also showed that the hydrometer readings had to be taken within 10 s after mixing to avoid reading drift in specific gravity due to the settling of manure solids.

  20. The management of nutrients and potential eutrophication in estuaries and other restricted water bodies

    NARCIS (Netherlands)

    Elliott, M; de Jonge, V.N.

    Conceptual models are derived to indicate the signs and symptoms inherent in nutrient changes to brackish, estuarine and coastal areas of restricted circulation. These give a structured approach to detecting adverse symptoms of hypernutrification and eutrophication at all levels of biological

  1. Comparison of nutrient profiling schemes for restricting the marketing of food and drink to children.

    Science.gov (United States)

    Brinsden, H; Lobstein, T

    2013-08-01

    The food and beverage industry have made voluntary pledges to reduce children's exposure to the marketing of energy-dense foods and beverages, and in 2012 announced the replacement of company-specific nutrient profiling schemes with uniform sets of criteria from 2013 (in the USA) and 2014 (in the European Union [EU]). To compare the proposed USA and EU nutrient profiling schemes and three government-led schemes, paying particular attention to the differences in sugar criteria. Food and beverage products permitted to be advertised in the USA under pre-2013 criteria were examined using five nutrient profiling schemes: the forthcoming USA and EU schemes and three government-approved schemes: the US Interagency Working Group (IWG) proposals, the United Kingdom Office of Communications (OfCom) regulations and the Danish Forum co-regulatory Code. Under the new USA and EU nutrient profiling schemes, 88 (49%) and 73 (41%) of a total of 178 products would be permitted to be advertised, respectively. The US IWG permitted 25 (14%) products; the Ofcom regulations permitted 65 (37%) and the Danish Code permitted 13 (7%). Government-led schemes are significantly more restrictive than industry-led schemes, primarily due to their tougher sugar criteria. The Danish Forum (93%) and USA IWG scheme (86%) are the most restrictive of the five examined. Further harmonization of nutrient profiling schemes is needed to reduce children's exposure to the promotion of energy-dense foods. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

  2. Nutrient Restriction Increases Circulating and Hepatic Ceramide in Dairy Cows Displaying Impaired Insulin Tolerance.

    Science.gov (United States)

    Davis, Amanda N; Clegg, J L; Perry, C A; McFadden, J W

    2017-09-01

    The progression of insulin resistance in dairy cows represents a maternal adaptation to support milk production during heightened energy demand; however, excessive adipose tissue lipolysis can develop. In diabetic non-ruminants, the mechanisms that mediate insulin resistance involve the sphingolipid ceramide. We tested the hypothesis that ceramide accumulates in dairy cows experiencing lipolysis and insulin resistance. Nine dairy cows were utilized in a replicated 3 × 3 Latin square design. Cows were ad libitum fed, nutrient-restricted (NR), or NR with nicotinic acid (NA; 5 mg of NA/h per kg BW; delivered i.v.) for 34 h. When provided access, cows were ad libitum fed a mixed ration of grass hay and ground corn to meet requirements. Intake for NR cows was limited to vitamins and minerals. Nicotinic acid was administered to suppress lipolysis. Saline was infused in cows not provided NA. At 32 and 33 h of treatment, a liver biopsy and insulin tolerance test were performed, respectively. Samples were analyzed using colorimetry, immunoassay, and mass spectrometry. Nutrient restriction increased serum fatty acids and ceramide levels, and impaired insulin sensitivity; however, NA infusion was unable to prevent these responses. We also show that NR increases hepatic ceramide accumulation, a response that was positively associated with serum ceramide supply. Our data demonstrate that circulating and hepatic 24:0-Cer are inversely associated with systemic insulin tolerance, an effect not observed for the 16:0 moiety. In conclusion, our results suggest that ceramide accrual represents a metabolic adaptation to nutrient restriction and impaired insulin action in dairy cows.

  3. Effects of maternal protein or energy restriction during late gestation on immune status and responses to lipopolysaccharide challenge in postnatal young goats.

    Science.gov (United States)

    He, Z X; Sun, Z H; Yang, W Z; Beauchemin, K A; Tang, S X; Zhou, C S; Han, X F; Wang, M; Kang, J H; Tan, Z L

    2014-11-01

    Knowledge of maternal malnutrition of ruminants and effects on development of the immune system of their offspring is lacking. A study was conducted to investigate the effects of maternal protein or energy restriction during late gestation on immune status of their offspring at different ages. Sixty-three pregnant goats (local breed, Liuyang black goat, 22.2 ± 1.5 kg at d 90 of gestation) were fed control (CON, ME = 9.34 MJ/kg and CP = 12.5%, DM basis), 40% protein restricted (PR), or 40% energy restricted (ER) diets from d 91 of gestation to parturition, after which all animals received an adequate diet for nutritional recovery. Plasma concentrations of complement components (C3, C4), C-reactive protein (CRP) and immunoglobulins (IgG and IgM), jejunum cytokines (IL-2, IL-6, and IL-10) expression levels and morphology in the offspring were measured. Additionally, plasma concentration of complement and IL-6, and cytokines expression levels in gastrointestinal tract obtained at 6 wk from young goats were assessed under saline or lipopolysaccharide (LPS) challenging conditions. Maternal PR or ER decreased (P 0.05) plasma CRP concentration. The IL-10 mRNA expression of jejunum from PR kids was also less (P 0.05) in any plasma or tissue immune parameters among the 3 treatments. However, when given a LPS challenge, ER and PR kids had greater (P = 0.02) IL-6 concentration compared with CON kids. Our results suggest that both PR and ER during late gestation induced short-term as well as long-lasting alterations on immune responses in their offspring, which may make the animals more susceptible to a bacterial pathogen challenge. The present findings expand the existing knowledge in immunological mechanisms responsible for the development of disease in later life.

  4. Maternal nutrient restriction during pregnancy and lactation leads to impaired right ventricular function in young adult baboons.

    Science.gov (United States)

    Kuo, Anderson H; Li, Cun; Huber, Hillary F; Schwab, Matthias; Nathanielsz, Peter W; Clarke, Geoffrey D

    2017-07-01

    Maternal nutrient restriction induces intrauterine growth restriction (IUGR) and leads to heightened cardiovascular risks later in life. We report right ventricular (RV) filling and ejection abnormalities in IUGR young adult baboons using cardiac magnetic resonance imaging. Both functional and morphological indicators of poor RV function were seen, many of which were similar to effects of ageing, but also with a few key differences. We observed more pronounced RV changes compared to our previous report of the left ventricle, suggesting there is likely to be a component of isolated RV abnormality in addition to expected haemodynamic sequelae from left ventricular dysfunction. In particular, our findings raise the suspicion of pulmonary hypertension after IUGR. This study establishes that IUGR also leads to impairment of the right ventricle in addition to the left ventricle classically studied. Maternal nutrient restriction induces intrauterine growth restriction (IUGR), increasing later life chronic disease including cardiovascular dysfunction. Our left ventricular (LV) CMRI studies in IUGR baboons (8 M, 8 F, 5.7 years - human equivalent approximately 25 years), control offspring (8 M, 8 F, 5.6 years), and normal elderly (OLD) baboons (6 M, 6 F, mean 15.9 years) revealed long-term LV abnormalities in IUGR offspring. Although it is known that right ventricular (RV) function is dependent on LV health, the IUGR right ventricle remains poorly studied. We examined the right ventricle with cardiac magnetic resonance imaging in the same cohorts. We observed decreased ejection fraction (49 ± 2 vs. 33 ± 3%, P < 0.001), cardiac index (2.73 ± 0.27 vs. 1.89 ± 0.20 l min -1 m -2 , P < 0.05), early filling rate/body surface area (BSA) (109.2 ± 7.8 vs. 44.6 ± 7.3 ml s -1  m -2 , P < 0.001), wall thickening (61 ± 3 vs. 44 ± 5%, P < 0.05), and longitudinal shortening (26 ± 3 vs. 15 ± 2%, P < 0.01) in IUGR animals with increased

  5. Sildenafil citrate treatment enhances amino acid availability in the conceptus and fetal growth in an ovine model of intrauterine growth restriction.

    Science.gov (United States)

    Satterfield, M Carey; Bazer, Fuller W; Spencer, Thomas E; Wu, Guoyao

    2010-02-01

    Adequate placental blood flow is essential for the optimal delivery of nutrients from mother to fetus for conceptus growth. Restricted fetal development results from pathophysiological and environmental factors that alter utero-placental blood flow, placental function, and, therefore, nutrient availability in the fetus. To test this hypothesis, 0, 75, or 150 mg/d sildenafil citrate (Viagra) was administered subcutaneously from d 28 to 115 of gestation to either nutrient-restricted [50% of NRC requirements) or adequately-fed ewes (100% of NRC requirements). On d 115, maternal, fetal, and placental tissues and fluids were collected. Concentrations of total amino acids and polyamines in uterine venous and arterial sera, amniotic and allantoic fluids, and fetal umbilical venous serum were lower (P < 0.05) in nutrient-restricted ewes than in adequately fed ewes, as were the ratios of total amino acids in fetal umbilical venous serum to uterine arterial serum. Sildenafil citrate dose-dependently increased (P < 0.05) total amino acids and polyamines in amniotic fluid, allantoic fluid, and fetal serum without affecting values in maternal serum. Fetal weight was lower (P < 0.05) in nutrient-restricted ewes on d 115. Sildenafil citrate treatment dose-dependently increased (P < 0.05) fetal weight in both nutrient-restricted and adequately fed ewes. This study supports the hypothesis that long-term sildenafil citrate treatment enhances fetal growth, at least in part, by increasing the availability of amino acids in the conceptus. These findings may lead to the clinical use of sildenafil citrate in human pregnancies suspected to be at risk for intrauterine fetal growth retardation.

  6. Effects of melatonin or maternal nutrient restriction on vascularity and cell proliferation in the ovine placenta

    Science.gov (United States)

    Previously we reported increased umbilical artery blood flow in ewes supplemented with melatonin from mid- to late-pregnancy, while maternal nutrient restriction decreased uterine artery blood flow. To further unravel these responses, this study was designed to assess placental cell proliferation an...

  7. Gestational Protein Restriction Impairs Insulin-Regulated Glucose Transport Mechanisms in Gastrocnemius Muscles of Adult Male Offspring

    Science.gov (United States)

    Blesson, Chellakkan S.; Sathishkumar, Kunju; Chinnathambi, Vijayakumar

    2014-01-01

    Type II diabetes originates from various genetic and environmental factors. Recent studies showed that an adverse uterine environment such as that caused by a gestational low-protein (LP) diet can cause insulin resistance in adult offspring. The mechanism of insulin resistance induced by gestational protein restriction is not clearly understood. Our aim was to investigate the role of insulin signaling molecules in gastrocnemius muscles of gestational LP diet–exposed male offspring to understand their role in LP-induced insulin resistance. Pregnant Wistar rats were fed a control (20% protein) or isocaloric LP (6%) diet from gestational day 4 until delivery and a normal diet after weaning. Only male offspring were used in this study. Glucose and insulin responses were assessed after a glucose tolerance test. mRNA and protein levels of molecules involved in insulin signaling were assessed at 4 months in gastrocnemius muscles. Muscles were incubated ex vivo with insulin to evaluate insulin-induced phosphorylation of insulin receptor (IR), Insulin receptor substrate-1, Akt, and AS160. LP diet-fed rats gained less weight than controls during pregnancy. Male pups from LP diet–fed mothers were smaller but exhibited catch-up growth. Plasma glucose and insulin levels were elevated in LP offspring when subjected to a glucose tolerance test; however, fasting levels were comparable. LP offspring showed increased expression of IR and AS160 in gastrocnemius muscles. Ex vivo treatment of muscles with insulin showed increased phosphorylation of IR (Tyr972) in controls, but LP rats showed higher basal phosphorylation. Phosphorylation of Insulin receptor substrate-1 (Tyr608, Tyr895, Ser307, and Ser318) and AS160 (Thr642) were defective in LP offspring. Further, glucose transporter type 4 translocation in LP offspring was also impaired. A gestational LP diet leads to insulin resistance in adult offspring by a mechanism involving inefficient insulin-induced IR, Insulin receptor

  8. Proteome Differences in Placenta and Endometrium between Normal and Intrauterine Growth Restricted Pig Fetuses.

    Directory of Open Access Journals (Sweden)

    Fang Chen

    Full Text Available Uteroplacental tissue plays a key role in substance exchanges between maternal and fetal circulation, and, therefore, in the growth and development of fetuses. In this study, proteomics and western blotting were applied to investigate the changes of proteome in the placenta and endometrium of normal and intrauterine growth restriction (IUGR porcine fetuses during mid to late pregnancy (D60, 90, and 110 of gestation. Our results showed that proteins participating in cell structure, energy metabolism, stress response, cell turnover, as well as transport and metabolism of nutrients were differentially expressed in placenta and endometrium between normal and IUGR fetuses. Analysis of functions of these proteins suggests reductions in ATP production and nutrients transport, increases in oxidative stress and apoptosis, and impairment of cell metabolism in IUGR fetuses. Collectively, our findings aid in understanding of the mechanisms responsible for uteroplacental dysfunction in IUGR fetus, and are expected to provide new strategies to reduce fetal growth restriction in pigs and other mammals.

  9. Effects of different n-6 to n-3 polyunsaturated fatty acids ratio on reproductive performance, fecal microbiota and nutrient digestibility of gestation-lactating sows and suckling piglets.

    Science.gov (United States)

    Yin, Jia; Lee, Kwang Yong; Kim, Jong Keun; Kim, In Ho

    2017-11-01

    This study was conducted to evaluate the effects of dietary ratios of n-6:n-3 polyunsaturated fatty acids (PUFA) on reproductive performance, fecal microbiota and nutrient digestibility of gestation-lactating sows and suckling piglets. Fifteen primiparous sows (Landrace × Yorkshire) were randomly allotted into three treatments. Fed diets contained different ratios of n-6:n-3 PUFA, including 20:1, 15:1 and 10:1. No differences were detected among the treatments for average daily feed intake (ADFI) of sows and the back fat levels during lactation (P > 0.05). Body weight (BW) loss of sows after farrowing to weanling was greater in the 10:1 treatment compared with 15:1 or 20:1 (P  0.05). A great significant difference for fecal microbiota was in the 10:1 treatment compared with 20:1 and 15:1 treatments (P < 0.01). In conclusion, altering the ratio of n-6:n-3 PUFA in gestation-lactating sow diet had no difference on nutrient digestibility in gestation-lactating sows, but it can partially improve reproductive performance. © 2017 Japanese Society of Animal Science.

  10. Dietary -carbamylglutamate and rumen-protected -arginine supplementation ameliorate fetal growth restriction in undernourished ewes.

    Science.gov (United States)

    Zhang, H; Sun, L W; Wang, Z Y; Deng, M T; Zhang, G M; Guo, R H; Ma, T W; Wang, F

    2016-05-01

    This study was conducted with an ovine intrauterine growth restriction (IUGR) model to test the hypothesis that dietary -carbamylglutamate (NCG) and rumen-protected -Arg (RP-Arg) supplementation are effective in ameliorating fetal growth restriction in undernourished ewes. Beginning on d 35 of gestation, ewes were fed a diet providing 100% of NRC-recommended nutrient requirements, 50% of NRC recommendations (50% NRC), 50% of NRC recommendations supplemented with 20 g/d RP-Arg (providing 10 g/d of Arg), and 50% of NRC recommendations supplemented with 5 g/d NCG product (providing 2.5 g/d of NCG). On d 110, maternal, fetal, and placental tissues and fluids were collected and weighed. Ewe weights were lower ( ewes compared with adequately fed ewes. Maternal RP-Arg or NCG supplementation did not alter ( = 0.26) maternal BW in nutrient-restricted ewes. Weights of most fetal organs were increased ( ewes compared with 50% NRC-fed ewes. Supplementation of RP-Arg or NCG reduced ( ewes but had no effect on concentrations of lactate and GH. Maternal RP-Arg or NCG supplementation markedly improved ( ewes. These novel results indicate that dietary NCG and RP-Arg supplementation to underfed ewes ameliorated fetal growth restriction, at least in part, by increasing the availability of AA in the conceptus and provide support for its clinical use to ameliorate IUGR in humans and sheep industry production.

  11. Adequacy of nutrient intake in women with restrictive anorexia nervosa.

    Science.gov (United States)

    Chiurazzi, Chiara; Cioffi, Iolanda; De Caprio, Carmela; De Filippo, Emilia; Marra, Maurizio; Sammarco, Rosa; Di Guglielmo, Maria Luisa; Contaldo, Franco; Pasanisi, Fabrizio

    2017-06-01

    The aim of the present study was to assess energy and nutrient intake in a group of women with restrictive AN (r-AN) compared with a control group. Thirteen r-AN patients and 13 healthy female controls completed 7-d food records. Intake of macro- and micronutrients was compared between the two groups as well as to the Dietary Reference Intake for the Italian Population (LARN) for specific ages. Additionally, the r-AN patients underwent indirect calorimetry for measuring resting energy expenditure (REE). Total energy intake was significantly lower in the r-AN group than in controls (906 ± 224 vs 1660 ± 139, respectively; P nutritional gaps in these patients. According to these preliminary observations, nutritional counseling, mainly focused on calcium and vitamin D intake, should be suggested for healthy women, as well. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. High-Fibre feeding in gestation

    NARCIS (Netherlands)

    Meunier-Salaün, M.C.; Bolhuis, J.E.

    2015-01-01

    Gestating sows are usually fed low levels of feed, which may not provide sufficient satiety, and does not allow sows to fully fulfil their motivation to express foraging and feeding behaviours. Feed restriction may therefore lead to high occurrences of non-feeding oral activities, including

  13. Activity restriction among women with a short cervix.

    Science.gov (United States)

    Grobman, William A; Gilbert, Sharon A; Iams, Jay D; Spong, Catherine Y; Saade, George; Mercer, Brian M; Tita, Alan T N; Rouse, Dwight J; Sorokin, Yoram; Leveno, Kenneth J; Tolosa, Jorge E; Thorp, John M; Caritis, Steve N; Van Dorsten, J Peter

    2013-06-01

    To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less than 30 mm by midtrimester ultrasonography. Women were asked weekly whether they had been placed on pelvic, work, or nonwork rest. "Any activity restriction" was defined as being placed on any type of rest. Factors associated with any activity restriction were determined and the association between preterm birth and activity restriction was estimated with multivariable logistic regression. Of the 657 women in the trial, 646 (98%) responded to questions regarding activity restriction. Two hundred fifty-two (39.0%) were placed on any activity restriction at a median of 23.9 weeks (interquartile range 22.6-27.9 weeks). Women on activity restriction were older, more likely to have private insurance, less likely to be Hispanic, had a shorter cervical length, and were more likely to have funneling and intra-amniotic debris. Preterm birth at less than 37 weeks of gestation was more common among women placed on activity restriction (37% compared with 17%, Prestriction (adjusted odds ratio 2.37, 95% confidence interval 1.60-3.53). Results were similar for preterm birth at less than 34 weeks of gestation. Activity restriction did not reduce the rate of preterm birth in asymptomatic nulliparous women with a short cervix.

  14. The Infant Born to a Woman with Gestational Diabetes.

    Science.gov (United States)

    Povinelli, Theresa; Lim, Caitlin; Raines, Deborah A

    2017-07-01

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. During pregnancy, women with GDM develop insulin resistance, which results in altered glucose tolerance. As a result, there are frequent episodes of hyperglycemia and high levels of circulating amino acids, increasing the transfer of nutrients to the fetus. This article discusses the role of the mother-baby nursing in the care of neonates born to women with gestational diabetes.

  15. Determination of gestational age by ultrasound.

    Science.gov (United States)

    Butt, Kimberly; Lim, Ken

    2014-02-01

    To assist clinicians in assigning gestational age based on ultrasound biometry. To determine whether ultrasound dating provides more accurate gestational age assessment than menstrual dating with or without the use of ultrasound. To provide maternity health care providers and researchers with evidence-based guidelines for the assignment of gestational age. To determine which ultrasound biometric parameters are superior when gestational age is uncertain. To determine whether ultrasound gestational age assessment is cost effective. Published literature was retrieved through searches of PubMed or MEDLINE and The Cochrane Library in 2013 using appropriate controlled vocabulary and key words (gestational age, ultrasound biometry, ultrasound dating). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English. There were no date restrictions. Searches were updated on a regular basis and incorporated in the guideline to July 31, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Accurate assignment of gestational age may reduce post-dates labour induction and may improve obstetric care through allowing the optimal timing of necessary interventions and the avoidance of unnecessary ones. More accurate dating allows for optimal performance of prenatal screening tests for aneuploidy. A national algorithm for the assignment of gestational age may reduce practice variations across Canada for clinicians and researchers. Potential harms include the possible reassignment of dates when significant fetal pathology

  16. Effects of dietary protein level on nutrients digestibility and reproductive performance of female mink (Neovison vison during gestation

    Directory of Open Access Journals (Sweden)

    Qingkui Jiang

    2015-06-01

    Full Text Available The objective of this study was to determine whether nutrient digestibility and reproductive performance of pregnant mink (Neovison vison were affected by different dietary protein levels. One hundred and twenty female mink were randomly assigned to four groups, receiving diets of fresh material with different protein levels. The dietary protein levels, expressed as percentage of dry matter (DM, were 32, 36, 40 and 44% respectively. These values corresponded to average 320, 360, 400 and 440 g protein/kg DM, respectively. Results were as follows. All of crude protein digestibility, nitrogen (N intake, N retention increased along with dietary protein level increasing. Low protein level (32% significantly reduced the above indicators (P < 0.05. DM digestibility and ether extract digestibility were not affected by dietary protein level. Results of mated females, barren females, kids per litter, live born kids per mated female, birth survival rate, and birth weight showed that mink achieved optimal reproductive performance when dietary protein level was 36%. In conclusion, dietary protein was anticipated to significantly influence some nutrients' utilization. Adopting the appropriate dietary protein level allow better reproduction performance. The most preferable reproductive performance was achieved when diet contained 275.5 g digestible protein per kg DM for female mink in gestation.

  17. Gestational Protein Restriction in Wistar Rats; Effect of Taurine Supplementation on Properties of Newborn Skeletal Muscle

    DEFF Research Database (Denmark)

    Larsen, Lea Hüche; Sandø-Pedersen, Sofie; Ørstrup, Laura Kofoed Hvidsten

    2017-01-01

    Taurine ameliorates changes occurring in newborn skeletal muscle as a result of gestational protein restriction in C57BL/6 mice, but taurine supplementation effects may be exaggerated in C57BL/6 mice due to their inherent excessive taurinuria.We examined if maternal taurine supplementation could...... by taurine supplementation (LP-Tau). LP-Tau offspring had significantly lower birth weight compared to controls. Gene expression profiling revealed 895 significantly changed genes, mainly an LP-induced down-regulation of genes involved in protein translation. Taurine fully or partially rescued 32......% of these changes, but with no distinct pattern as to which genes were rescued.Skeletal muscle taurine content in LP-Tau offspring was increased, but no changes in mRNA levels of the taurine synthesis pathway were observed. Taurine transporter mRNA levels, but not protein levels, were increased by LP diet...

  18. Brain metabolite alterations in infants born preterm with intrauterine growth restriction: association with structural changes and neurodevelopmental outcome.

    Science.gov (United States)

    Simões, Rui V; Muñoz-Moreno, Emma; Cruz-Lemini, Mónica; Eixarch, Elisenda; Bargalló, Núria; Sanz-Cortés, Magdalena; Gratacós, Eduard

    2017-01-01

    Intrauterine growth restriction and premature birth represent 2 independent problems that may occur simultaneously and contribute to impaired neurodevelopment. The objective of the study was to assess changes in the frontal lobe metabolic profiles of 1 year old intrauterine growth restriction infants born prematurely and adequate-for-gestational-age controls, both premature and term adequate for gestational age and their association with brain structural and biophysical parameters and neurodevelopmental outcome at 2 years. A total of 26 prematurely born intrauterine growth restriction infants (birthweight intrauterine growth restriction infants had slightly smaller brain volumes and increased frontal lobe white matter mean diffusivity compared with both prematurely born but adequate for gestational age and term adequate for gestational age controls. Frontal lobe N-acetylaspartate levels were significantly lower in prematurely born intrauterine growth restriction than in prematurely born but adequate for gestational age infants but increased in prematurely born but adequate for gestational age compared with term adequate-for-gestational-age infants. The prematurely born intrauterine growth restriction group also showed slightly lower choline compounds, borderline decrements of estimated glutathione levels, and increased myoinositol to choline ratios, compared with prematurely born but adequate for gestational age controls. These specific metabolite changes were locally correlated to lower gray matter content and increased mean diffusivity and reduced white matter fraction and fractional anisotropy. Prematurely born intrauterine growth restriction infants also showed a tendency for poorer neurodevelopmental outcome at 2 years, associated with lower levels of frontal lobe N-acetylaspartate at 1 year within the preterm subset. Preterm intrauterine growth restriction infants showed altered brain metabolite profiles during a critical stage of brain maturation, which

  19. Seasonal influence on the response of the somatotropic axis to nutrient restriction and re-alimentation in captive Steller sea lions (Eumetopias jubatus).

    Science.gov (United States)

    Richmond, Julie P; Jeanniard du Dot, Tiphaine; Rosen, David A S; Zinn, Steven A

    2010-03-01

    Fluctuations in availability of prey resources can impede acquisition of sufficient energy for maintenance and growth. By investigating the hormonal mechanisms of the somatotropic axis that link nutrition, fat metabolism, and lean tissue accretion, we can assess the physiological impact of decreased nutrient intake on growth. Further, species that undergo seasonal periods of reduced intake as a part of their normal life history may have a differential seasonal response to nutrient restriction. This experiment evaluated the influence of season and age on the response of the somatotropic axis, including growth hormone (GH), insulin-like growth factor (IGF)-I, and IGF-binding proteins (BP), to reduced nutrient intake and re-alimentation in Steller sea lions. Eight captive females (five juveniles, three sub-adults) were subject to 28-day periods of food restriction, controlled re-feeding, and ad libitum recovery in summer (long-day photoperiod) and winter (short-day photoperiod). Hormone concentrations were insensitive to type of fish fed (low fat pollock vs. high fat herring), but sensitive to energy intake. Body mass, fat, and IGF-I declined, whereas GH and IGFBP-2 increased during feed restriction. Reduced IGF-I and IGFBP with increased GH during controlled re-feeding suggest that animals did not reach positive energy balance until fed ad libitum. Increased IGF-I, IGFBP-2, IGFBP-3, and reduced GH observed in summer reflected seasonal differences in energy partitioning. There was a strong season and age effect in the response to restriction and re-alimentation, indicating that older, larger animals are better able to cope with stress associated with energy deficit, regardless of season.

  20. Distinguishing pathological from constitutional small for gestational age births in population-based studies.

    Science.gov (United States)

    Ananth, Cande V; Vintzileos, Anthony M

    2009-10-01

    Small for gestational age (SGA) can occur following a pathological process or may represent constitutionally small fetuses. However, distinguishing these processes is often difficult, especially in large studies, where the term SGA is often used as a proxy for restricted fetal growth. Since biologic variation in fetal size is largely a third trimester phenomenon, we hypothesized that the definition of SGA at term may include a sizeable proportion of constitutionally small fetuses. In contrast, since biologic variation in fetal size is not fully expressed in (early) preterm gestations, it is plausible that SGA in early preterm gestations would comprise a large proportion of growth restricted fetuses. We compared mortality and morbidity rates between SGA and appropriate for gestational age (AGA) babies. A population-based study of over 19million non-malformed, singleton births (1995-04) in the United States was performed. Gestational age (24-44weeks) was based on a clinical estimate. SGA and AGA were defined as sex-specific birthweight constitutionally small.

  1. Transplacental Nutrient Transport Mechanisms of Intrauterine Growth Restriction in Rodent Models and Humans.

    Science.gov (United States)

    Winterhager, Elke; Gellhaus, Alexandra

    2017-01-01

    Although the causes of intrauterine growth restriction (IUGR) have been intensively investigated, important information is still lacking about the role of the placenta as a link from adverse maternal environment to adverse pregnancy outcomes of IUGR and preterm birth. IUGR is associated with an increased risk of cardiovascular, metabolic, and neurological diseases later in life. Determination of the most important pathways that regulate transplacental transport systems is necessary for identifying marker genes as diagnostic tools and for developing drugs that target the molecular pathways. Besides oxygen, the main nutrients required for appropriate fetal development and growth are glucose, amino acids, and fatty acids. Dysfunction in transplacental transport is caused by impairments in both placental morphology and blood flow, as well as by factors such as alterations in the expression of insulin-like growth factors and changes in the mTOR signaling pathway leading to a change in nutrient transport. Animal models are important tools for systematically studying such complex events. Debate centers on whether the rodent placenta is an appropriate tool for investigating the alterations in the human placenta that result in IUGR. This review provides an overview of the alterations in expression and activity of nutrient transporters and alterations in signaling associated with IUGR and compares these findings in rodents and humans. In general, the data obtained by studies of the various types of rodent and human nutrient transporters are similar. However, direct comparison is complicated by the fact that the results of such studies are controversial even within the same species, making the interpretation of the results challenging. This difficulty could be due to the absence of guidelines of the experimental design and, especially in humans, the use of trophoblast cell culture studies instead of clinical trials. Nonetheless, developing new therapy concepts for IUGR will

  2. Transplacental Nutrient Transport Mechanisms of Intrauterine Growth Restriction in Rodent Models and Humans

    Directory of Open Access Journals (Sweden)

    Elke Winterhager

    2017-11-01

    Full Text Available Although the causes of intrauterine growth restriction (IUGR have been intensively investigated, important information is still lacking about the role of the placenta as a link from adverse maternal environment to adverse pregnancy outcomes of IUGR and preterm birth. IUGR is associated with an increased risk of cardiovascular, metabolic, and neurological diseases later in life. Determination of the most important pathways that regulate transplacental transport systems is necessary for identifying marker genes as diagnostic tools and for developing drugs that target the molecular pathways. Besides oxygen, the main nutrients required for appropriate fetal development and growth are glucose, amino acids, and fatty acids. Dysfunction in transplacental transport is caused by impairments in both placental morphology and blood flow, as well as by factors such as alterations in the expression of insulin-like growth factors and changes in the mTOR signaling pathway leading to a change in nutrient transport. Animal models are important tools for systematically studying such complex events. Debate centers on whether the rodent placenta is an appropriate tool for investigating the alterations in the human placenta that result in IUGR. This review provides an overview of the alterations in expression and activity of nutrient transporters and alterations in signaling associated with IUGR and compares these findings in rodents and humans. In general, the data obtained by studies of the various types of rodent and human nutrient transporters are similar. However, direct comparison is complicated by the fact that the results of such studies are controversial even within the same species, making the interpretation of the results challenging. This difficulty could be due to the absence of guidelines of the experimental design and, especially in humans, the use of trophoblast cell culture studies instead of clinical trials. Nonetheless, developing new therapy

  3. Impact of Second Trimester Maternal Dietary Intake on Gestational Weight Gain and Neonatal Birth Weight

    Directory of Open Access Journals (Sweden)

    Malshani L. Pathirathna

    2017-06-01

    Full Text Available Poor maternal nutrition is a major contributor to the high incidence of low birth weight deliveries in developing countries. This study aimed to assess the impact of second trimester maternal dietary intake on gestational weight gain and neonatal birth weight. A longitudinal study was conducted in a tertiary care hospital in Sri Lanka. Participants were 141 pregnant women at 18–24 weeks gestation who were followed up until delivery. Maternal dietary intake was assessed using a validated Food Frequency Questionnaire at 21.1 ± 1.8 gestational weeks. Gestational weight gain was examined at the end of 28 weeks gestation and at the end of pregnancy. Energy and nutrient intakes were calculated using NutriSurvey 2007 (EBISpro, Willstaett, Germany nutrient analysis software, modified for Sri Lankan foods. The mean total gestational weight gain of women with low carbohydrate intake (229–429 g/day was 2.2 kg less than that of women with moderate carbohydrate intake (430–629 g/day (95% confidence interval (CI 0.428–4.083 kg; p = 0.016. Similarly, babies of women with low carbohydrate intake were 312 g lighter compared with those of women with a moderate carbohydrate intake (95% CI 91–534 g; p = 0.006. Our results suggest that second trimester maternal carbohydrate intake has significant impacts on total gestational weight gain and neonatal birth weight.

  4. Assessing the adequacy of essential nutrient intake in obese dogs undergoing energy restriction for weight loss: a cohort study.

    Science.gov (United States)

    German, Alexander J; Holden, Shelley L; Serisier, Samuel; Queau, Yann; Biourge, Vincent

    2015-10-07

    Canine obesity is usually treated with dietary energy restriction, but data are limited regarding nutritional adequacy. The aim of the current study was to compare intake of essential nutrients with National Research Council recommendations in obese dogs during weight management with a purpose-formulated diet. Twenty-seven dogs were included in this non-randomised retrospective observational cohort study. All were determined to be systemically well, and without significant abnormalities based upon physical examination and clinicopathological assessments. The dogs underwent a controlled weight loss protocol of at least 182 days' duration using a high protein high fibre weight loss diet. Median, maximum, and minimum daily intakes of all essential nutrients were compared against NRC 2006 recommended allowances (RA) for adult dogs. Median weight loss was 28 % (16-40 %), mean daily energy intake was 61 kcal/kg(0.75) (44-74 kcal/kg(0.75)), and no clinical signs of nutrient deficiency were observed in any dog. Based upon the average nutrient content of the diet, daily intake of the majority of essential nutrients was greater than their NRC 2006 recommended allowance (RA per kg body weight(0.75)), except for selenium, choline, methionine/cysteine, tryptophan, magnesium, and potassium. However, apart from choline (2/27 dogs) and methionine/cysteine (2/27 dogs), all essential nutrients remained above NRC minimum requirements (MR) throughout the trial. When fed the diet used in the current study, daily intakes of most essential nutrients meet both their NRC 2006 RA and MR in obese dogs during weight loss. In light of absence of clinical signs of nutrient deficiency, it is unclear what significance intakes less that NRC cut-offs for some nutrients have (especially selenium and choline), and further studies are recommended.

  5. Intrauterine growth restriction and differential patterns of hepatic growth and expression of IGF1, PCK2, and HSDL1 mRNA in the sheep fetus in late gestation.

    Science.gov (United States)

    Gentili, Sheridan; Morrison, Janna L; McMillen, I Caroline

    2009-06-01

    Fetal adaptations to periods of substrate deprivation can result in the programming of glucose intolerance, insulin resistance, and metabolic dysfunction in later life. Placental insufficiency can be associated with either sparing or sacrifice of fetal liver growth, and these different responses may have different metabolic consequences. It is unclear what intrahepatic mechanisms determine the differential responses of the fetal liver to substrate restriction. We investigated the effects of placental restriction (PR) on liver growth and the hepatic expression of SLC2A1, IGF1, IGF2, IGF1R, IGF2R, PPARGC1A, PPARA, PRKAA1, PRKAA2, PCK2, and HSDL1 mRNA in fetal sheep at 140-145 days of gestation. A mean gestational arterial partial pressure of oxygen less than 17 mmHg was defined as hypoxic, and a relative liver of weight more than 2 SD below the mean liver weight of controls was defined as reduced liver growth. Fetuses therefore were defined as control-normoxic (C-N; n = 9), PR-normoxic (PR-N; n = 7), PR-hypoxic (PR-H; n = 8), or PR-hypoxic reduced liver growth (PR-H RLG; n = 4). Hepatic SLC2A1 mRNA expression was highest (P fetal substrate restriction may exist that protect the liver from decreased growth and, potentially, from a decreased responsiveness to the actions of insulin in postnatal life.

  6. Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy.

    Science.gov (United States)

    McCowan, Lesley M; Figueras, Francesc; Anderson, Ngaire H

    2018-02-01

    Small for gestational age is usually defined as an infant with a birthweight restriction refers to a fetus that has failed to reach its biological growth potential because of placental dysfunction. Small-for-gestational-age babies make up 28-45% of nonanomalous stillbirths, and have a higher chance of neurodevelopmental delay, childhood and adult obesity, and metabolic disease. The majority of small-for-gestational-age babies are not recognized before birth. Improved identification, accompanied by surveillance and timely delivery, is associated with reduction in small-for-gestational-age stillbirths. Internationally and regionally, detection of small for gestational age and management of fetal growth problems vary considerably. The aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines; and identify future research priorities in this field. A search of MEDLINE, Google, and the International Guideline Library identified 6 national guidelines on management of pregnancies complicated by fetal growth restriction/small for gestational age published from 2010 onwards. There is general consensus between guidelines (at least 4 of 6 guidelines in agreement) in early pregnancy risk selection, and use of low-dose aspirin for women with major risk factors for placental insufficiency. All highlight the importance of smoking cessation to prevent small for gestational age. While there is consensus in recommending fundal height measurement in the third trimester, 3 specify the use of a customized growth chart, while 2 recommend McDonald rule. Routine third-trimester scanning is not recommended for small-for-gestational-age screening, while women with major risk factors should have serial scanning in the third trimester. Umbilical artery Doppler studies in suspected small-for-gestational

  7. New Predictive Model at 11+0 to 13+6 Gestational Weeks for Early-Onset Preeclampsia With Fetal Growth Restriction.

    Science.gov (United States)

    Chang, Ying; Chen, Xu; Cui, Hong-Yan; Li, Xing; Xu, Ya-Ling

    2017-05-01

    The aim of the present study was to determine a predictive model for early-onset preeclampsia with fetal growth restriction (FGR) to be used at 11 +0 to 13 +6 gestational weeks, by combining the maternal serum level of pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PLGF), placental protein 13 (PP13), soluble endoglin (sEng), mean arterial pressure (MAP), and uterine artery Doppler. This was a retrospective cohort study of 4453 pregnant women. Uterine artery Doppler examination was conducted in the first trimester. Maternal serum PAPP-A, PLGF, PP13, and sEng were measured. Mean arterial pressure was obtained. Women were classified as with/without early-onset preeclampsia, and women with preeclampsia were classified as with/without FGR. Receiver operating characteristic analysis was performed to determine the value of the model. There were 30 and 32 pregnant women with early-onset preeclampsia with and without FGR. The diagnosis rate of early-onset preeclampsia with FGR was 67.4% using the predictive model when the false positive rate was set at 5% and 73.2% when the false positive rate was 10%. The predictive model (MAP, uterine artery Doppler measurements, and serum biomarkers) had some predictive value for the early diagnosis (11 +0 to 13 +6 gestational weeks) of early-onset preeclampsia with FGR.

  8. Fetal growth restriction is associated with malaria in pregnancy

    DEFF Research Database (Denmark)

    Briand, Valérie; Saal, Jessica; Ghafari, Caline

    2016-01-01

    BACKGROUND: Few studies have evaluated the effect of malaria on intrauterine growth restriction on the basis of the fetal growth rate, rather than just the small-for-gestational age z score. Here, we assessed the impact of malaria on IUGR, using data from a longitudinal, ultrasonography-based fol......BACKGROUND: Few studies have evaluated the effect of malaria on intrauterine growth restriction on the basis of the fetal growth rate, rather than just the small-for-gestational age z score. Here, we assessed the impact of malaria on IUGR, using data from a longitudinal, ultrasonography......-based follow-up study of Beninese women. METHODS: A total of 1016 women were followed up from gestational week 17 to delivery. Malaria was detected every month. Women underwent ultrasonography 4 times for gestational age determination and fetal biometry. We assessed the effect of malaria on birth weight......-for-gestational age z score (n = 735 women) and fetal growth velocity (n = 664), defined as a change in fetal weight z score over time. RESULTS: Malaria was detected in 43% of women. Fetal growth velocity was negative overall, decreasing further at the end of the third trimester. Women with ≥2 malarial parasite...

  9. Prenatal programming in an obese swine model: sex-related effects of maternal energy restriction on morphology, metabolism and hypothalamic gene expression.

    Science.gov (United States)

    Óvilo, Cristina; González-Bulnes, Antonio; Benítez, Rita; Ayuso, Miriam; Barbero, Alicia; Pérez-Solana, Maria L; Barragán, Carmen; Astiz, Susana; Fernández, Almudena; López-Bote, Clemente

    2014-02-01

    Maternal energy restriction during pregnancy predisposes to metabolic alterations in the offspring. The present study was designed to evaluate phenotypic and metabolic consequences following maternal undernutrition in an obese pig model and to define the potential role of hypothalamic gene expression in programming effects. Iberian sows were fed a control or a 50 % restricted diet for the last two-thirds of gestation. Newborns were assessed for body and organ weights, hormonal and metabolic status, and hypothalamic expression of genes implicated in energy homeostasis, glucocorticoid function and methylation. Weight and adiposity were measured in adult littermates. Newborns of the restricted sows were lighter (P control newborns of both the sexes (P metabolic stress by nutrient insufficiency. A lower hypothalamic expression of anorexigenic peptides (LEPR and POMC, P controls (Pmetabolic alterations in the offspring. Differences in gene expression at birth and higher growth and adiposity in adulthood suggest a female-specific programming effect for a positive energy balance, possibly due to overexposure to endogenous stress-induced glucocorticoids.

  10. Growth throughout childhood of children born growth restricted

    NARCIS (Netherlands)

    Beukers, Fenny; Rotteveel, Joost; van Weissenbruch, Mirjam M.; Ganzevoort, Wessel; van Goudoever, Johannes B.; van Wassenaer-Leemhuis, Aleid G.

    2017-01-01

    Many studies that examine growth in growth-restricted children at birth do not discriminate between fetal growth restriction (FGR) and small for gestational age (SGA). These terms however are not synonymous. In SGA, stunting and increased weight gain have been reported. We do not know if this holds

  11. Octreotide therapy and restricted fetal growth

    DEFF Research Database (Denmark)

    Geilswijk, Marianne; Andersen, Lise Lotte Torvin; Frost, Morten

    2017-01-01

    that octreotide treatment in pregnancy, as well as hypoglycemia in itself, may pose a risk of fetal growth restriction. During pregnancy, management of blood glucose levels in familial hyperinsulinemic hypoglycemia thus forms a medical dilemma. We report on pregnancy outcomes in a woman with symptomatic familial...... hyperinsulinemic hypoglycemia, type 3. During the patient's first pregnancy with a viable fetus octreotide treatment was instituted in gestational age 23 weeks to prevent severe hypoglycemic incidences. Fetal growth velocity declined, and at 37 weeks of gestation, intrauterine growth retardation was evident...... growth velocity was normal. We conclude that octreotide treatment during pregnancy may pose a risk of fetal growth restriction and warrants careful consideration. In some cases of familial hyperinsulinemic hypoglycemia, blood glucose levels can be successfully managed through diet only, also during...

  12. Intrauterine growth restriction: screening, diagnosis, and management.

    Science.gov (United States)

    Lausman, Andrea; Kingdom, John

    2013-08-01

    Intrauterine growth restriction (IUGR) is an obstetrical complication, which by definition would screen in 10% of fetuses in the general population. The challenge is to identify the subset of pregnancies affected with pathological growth restriction in order to allow intervention that would decrease morbidity and mortality. The purpose of this guideline is to provide summary statements and recommendations and to establish a framework for screening, diagnosis, and management of pregnancies affected with IUGR. Affected pregnancies are compared with pregnancies in which the fetus is at an appropriate weight for its gestational age. History, physical examination, and laboratory investigations including biochemical markers and ultrasound characteristics of IUGR are reviewed, and a management strategy is suggested. Published literature in English was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in January 2013 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and key words (fetal growth, restriction, growth retardation, IUGR, low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Implementation of the recommendations in this guideline should increase clinician recognition of IUGR and guide intervention where appropriate. Optimal long-term follow-up of neonates diagnosed as IUGR may improve their long-term health.

  13. Effects of water restriction following feeding on nutrient digestibilities, milk yield and composition and blood hormones in lactating Holstein cows under heat stress conditions

    Directory of Open Access Journals (Sweden)

    Jalil Ghassemi Nejad

    2015-08-01

    Full Text Available The effects of water restriction following feeding under heat stress conditions on nutrient digestibilities, milk yield and composition and some blood hormones in lactating Holstein cows were evaluated. The design was completely randomized with 30 high producing lactating Holstein cows (80.8±40.5 DIM which were assigned to two treatment groups (15 cows per treatment. Treatments were free access to water (FAW and 2 h water restriction (2hWR following feeding. Average temperature-humidity index (THI in the farm was over 80 throughout the experiment which defines heat stress conditions. Neutral detergent fibre, organic matter and ether extract digestibilities increased by water restriction (P0.05. Water intake was recorded daily during the digestibility period and was not different between FAW and 2hWR group (P>0.05. Fat corrected milk was higher in 2hWR group than FAW group (P0.05. Somatic cell counts were greater in 2hWR than FAW group (P0.05. Blood prolactin and growth hormone were higher in 2hWR group than the FAW group (P<0.05. It is concluded that water restriction for 2 hours following feeding improved nutrient digestibility of some dietary components and increased milk fat percentage in lactating Holstein cows under heat stress conditions.

  14. Maternal Therapy with Ad.VEGF-A165 Increases Fetal Weight at Term in a Guinea-Pig Model of Fetal Growth Restriction.

    Science.gov (United States)

    Swanson, Anna M; Rossi, Carlo A; Ofir, Keren; Mehta, Vedanta; Boyd, Michael; Barker, Hannah; Ledwozyw, Agata; Vaughan, Owen; Martin, John; Zachary, Ian; Sebire, Neil; Peebles, Donald M; David, Anna L

    2016-12-01

    In a model of growth-restricted sheep pregnancy, it was previously demonstrated that transient uterine artery VEGF overexpression can improve fetal growth. This approach was tested in guinea-pig pregnancies, where placental physiology is more similar to humans. Fetal growth restriction (FGR) was attained through peri-conceptual nutrient restriction in virgin guinea pigs. Ad.VEGF-A 165 or Ad.LacZ (1 × 10 10 vp) was applied at mid-gestation via laparotomy, delivered externally to the uterine circulation with thermosensitive gel. At short-term (3-8 days post surgery) or at term gestation, pups were weighed, and tissues were sampled for vector spread analysis, VEGF expression, and its downstream effects. Fetal weight at term was increased (88.01 ± 13.36 g; n = 26) in Ad.VEGF-A 165 -treated animals compared with Ad.LacZ-treated animals (85.52 ± 13.00 g; n = 19; p = 0.028). The brain, liver, and lung weight and crown rump length were significantly larger in short-term analyses, as well as VEGF expression in transduced tissues. At term, molecular analyses confirmed the presence of VEGF transgene in target tissues but not in fetal samples. Tissue histology analysis and blood biochemistry/hematological examination were comparable with controls. Uterine artery relaxation in Ad.VEGF-A 165 -treated dams was higher compared with Ad.LacZ-treated dams. Maternal uterine artery Ad.VEGF-A 165 increases fetal growth velocity and term fetal weight in growth-restricted guinea-pig pregnancy.

  15. New Approaches to Treatment of Severe Intrauterine Growth Restriction

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    Zhanar Kurmangali

    2014-12-01

    Full Text Available Introduction. Intrauterine growth restriction (IUGR is a leading cause of perinatal morbidity and mortality due to placental insufficiency. Currently, one of the new approaches to treating this disease is the injection of nutrients to the fetus through intravascular port-systems (catheters.Objective. To assess the impact of nutrient injections as treatment to fetuses with severe growth retardation.Materials and methods. Pregnant women with IUGR (abdominal circumference (AC < 5th percentile with the absence of diastolic flow in the umbilical artery and a fetal gestational age of less than 30 weeks were randomly divided into two groups. The treatment group included six pregnant women who had an intravascular port-system for the infusion of nutrients (amino acids and glucose in the umbilical vein of the fetus for 14 ± 3 days. The control group consisted of eight patients who received only traditional dynamic monitoring and delivery at the optimum time of pregnancy. Fetal status was assessed using ultrasound equipment Accuvix V20 (Medison, South Korea by examining indicators of biometry and Doppler study of blood flow in utero, umbilical arteries, middle cerebral artery, and ductus venosus with fetal vascular resistance index calculation - pulsatility index (PI. Criteria for blood flow disturbances in the vessels were considered PI values above normal values for their gestational age, which were defined as absence or reverse blood flow in a diastole in the umbilical artery.Results. In a comparative analysis of the two groups, the treatment led to a 44.7% increase in AC of the fetus (121.0 ± 11.5 mm and 219.3 ± 18.3 mm, respectively, p ˂ 0.001. In all cases, the profile of blood flow in the umbilical artery had a positive diastolic component. As a result, there was a 45.3% decrease in PI in the umbilical artery (2.14 ± 0.54 and 1.17 ± 0.15, respectively, p < 0.05. Average fetal weight in the study group was not significantly higher than the

  16. Polymorphism of the renalase gene in gestational diabetes mellitus.

    Science.gov (United States)

    Fatima, Syeda Sadia; Jamil, Zehra; Alam, Faiza; Malik, Hajira Zafar; Madhani, Sarosh Irfan; Ahmad, Muhammad Saad; Shabbir, Tayyab; Rehmani, Muhammed Noman; Rabbani, Amna

    2017-01-01

    Renalase is considered as a novel candidate gene for type 2 diabetes. In this study, we aimed to investigate the relationship of serum renalase and two single nucleotide polymorphisms with gestational diabetes mellitus. One hundred and ninety-eight normotensive pregnant females (n = 99 gestational diabetes mellitus; n = 99 euglycemic pregnant controls) were classified according to the International Association of the Diabetes and Pregnancy Study criteria. Fasting and 2-h post glucose load blood levels and anthropometric assessment was performed. Serum renalase was measured using enzyme-linked immunosorbent assay, whereas DNA samples were genotyped for renalase single nucleotide polymorphisms rs2576178 and rs10887800 using Polymerase chain reaction-Restriction fragment length polymorphism method. In an age-matched case control study, no difference was observed in the serum levels of renalase (p > 0.05). The variant rs10887800 showed an association with gestational diabetes mellitus and remained significant after multiple adjustments (p gestational diabetes. Although gestational diabetes mellitus is self-reversible, yet presence of this minor G allele might predispose to metabolic syndrome phenotypes in near the future.

  17. Effect of feed restriction on performance and postprandial nutrient metabolism in pigs co-infected with Mycoplasma hyopneumoniae and swine influenza virus.

    Directory of Open Access Journals (Sweden)

    Nathalie Le Floc'h

    Full Text Available As nutritional status and inflammation are strongly connected, feeding and nutritional strategies could be effective to improve the ability of pigs to cope with disease. The aims of this study were to investigate the impact of a feed restriction on the ability of pigs to resist and be tolerant to a coinfection with Mycoplasma hyopneumoniae (Mhp and the European H1N1 swine influenza virus, and the consequences for nutrient metabolism, with a focus on amino acids. Two groups of specific pathogen-free pigs were inoculated with Mhp and H1N1 21 days apart. One group was fed ad libitum, the other group was subjected to a two-week 40% feed restriction starting one week before H1N1 infection. The two respective mock control groups were included. Three days post-H1N1 infection, 200 g of feed was given to pigs previously fasted overnight and serial blood samples were taken over 4 hours to measure plasma nutrient concentrations. Throughout the study, clinical signs were observed and pathogens were detected in nasal swabs and lung tissues. Feed-restricted pigs presented shorter hyperthermia and a positive mean weight gain over the 3 days post-H1N1 infection whereas animals fed ad libitum lost weight. Both infection and feed restriction reduced postprandial glucose concentrations, indicating changes in glucose metabolism. Post-prandial plasma concentrations of the essential amino acids histidine, arginine and threonine were lower in co-infected pigs suggesting a greater use of those amino acids for metabolic purposes associated with the immune response. Altogether, these results indicate that modifying feeding practices could help to prepare animals to overcome an influenza infection. Connections with metabolism changes are discussed.

  18. Inflammatory markers in umbilical cord blood from small-for-gestational-age newborns

    DEFF Research Database (Denmark)

    Lausten-Thomsen, Ulrik; Olsen, Marianne; Greisen, Gorm

    2014-01-01

    This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA...... of elevated inflammatory markers in the cord blood from SGA infants compared to AGA infants, and consequently the results suggest an inflammatory component in intrauterine growth restriction (IUGR).......This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA...

  19. Effects of a Gestational Weight Gain Restriction Program for Obese Pregnant Women: Children's Weight Development during the First Five Years of Life.

    Science.gov (United States)

    Claesson, Ing-Marie; Sydsjö, Gunilla; Olhager, Elisabeth; Oldin, Carin; Josefsson, Ann

    2016-06-01

    Maternal prepregnancy obesity (BMI ≥30 kg/m(2)) and excessive gestational weight gain (GWG) have shown a strong positive association with a higher BMI and risk of obesity in the offspring. The aim of this study is to estimate the effect of a GWG restriction program for obese pregnant women on the children's BMI at 5 years of age and weight-for-length/height (WL/H) development from 2 months of age until 5 years of age. This was a follow-up study of 302 children (137 children in an intervention group and 165 children in a control group) whose mothers participated in a weight gain restriction program during pregnancy. BMI at five years of age did not differ between girls and boys in the intervention and control group. The degree of maternal GWG, women containing individual weekly visits and opportunity to participate in aqua aerobic classes, there were no differences between BMI or weight development among the offspring at 5 years of age in the intervention and control group.

  20. Fetal eyeball volume: relationship to gestational age and biparietal diameter.

    Science.gov (United States)

    Odeh, Marwan; Feldman, Yulia; Degani, Shimon; Grinin, Vitali; Ophir, Ella; Bornstein, Jacob

    2009-08-01

    To measure and determine normal values of the fetal eyeball volume between 14 and 40 weeks of gestation. The volume of the fetal eyeball was measured with three-dimensional ultrasound between 14 and 40 weeks of gestation using the VOCAL software.Only singleton pregnancies without fetal growth restriction, diabetes mellitus, hypertension or major fetal malformation were included. Over all, 203 women were studied. In 125 both eyeballs were measured while in 78 only one eyeball was measured. The volume of the eyeball correlated strongly with gestational age (right: R = 0.946, P eyeball volume and the BPD were: square of right eyeball = -0.180 + 0.187 BPD, square of left eyeball = -0.182 + 0.187 BPD. The volume of the eyeball has strong positive correlations with gestational age and BPD. Our data may be helpful in fetuses suspected of having eye anomalies.

  1. Alterations in expression of imprinted genes from the H19/IGF2 loci in a multigenerational model of intrauterine growth restriction (IUGR).

    Science.gov (United States)

    Gonzalez-Rodriguez, Pablo; Cantu, Jessica; O'Neil, Derek; Seferovic, Maxim D; Goodspeed, Danielle M; Suter, Melissa A; Aagaard, Kjersti M

    2016-05-01

    The H19/IGF2 imprinted loci have attracted recent attention because of their role in cellular differentiation and proliferation, heritable gene regulation, and in utero or early postnatal growth and development. Expression from the imprinted H19/IGF2 locus involves a complex interplay of 3 means of epigenetic regulation: proper establishment of DNA methylation, promoter occupancy of CTCF, and expression of microRNA-675. We have demonstrated previously in a multigenerational rat model of intrauterine growth restriction the epigenetic heritability of adult metabolic syndrome in a F2 generation. We have further demonstrated abrogation of the F2 adult metabolic syndrome phenotype with essential nutrient supplementation of intermediates along the 1-carbon pathway and shown that alterations in the metabolome precede the adult onset of metabolic syndrome. The upstream molecular and epigenomic mediators underlying these observations, however, have yet to be elucidated fully. In the current study, we sought to characterize the impact of the intrauterine growth-restricted lineage and essential nutrient supplementation on both levels and molecular mediators of H19 and IGF2 gene expression in the F2 generation. F2 intrauterine growth-restricted and sham lineages were obtained by exposing P1 (grandmaternal) pregnant dams to bilateral uterine artery ligation or sham surgery at gestational day 19.5. F1 pups were allocated to the essential nutrient supplemented or control diet at postnatal day 21, and bred at 6-7 weeks of age. Hepatic tissues from the resultant F2 offspring at birth and at weaning (day 21) were obtained. Bisulfite modification and sequencing was employed for methylation analysis. H19 and IGF2 expression was measured by quantitative polymerase chain reaction. Promoter occupancy was quantified by the use of chromatin immunoprecipitation, or ChIP, against CTCF insulator proteins. Growth-restricted F2 on control diet demonstrated significant down-regulation in H19

  2. Differential Receptor for Advanced Glycation End Products Expression in Preeclamptic, Intrauterine Growth Restricted, and Gestational Diabetic Placentas.

    Science.gov (United States)

    Alexander, Kristen L; Mejia, Camilo A; Jordan, Clinton; Nelson, Michael B; Howell, Brian M; Jones, Cameron M; Reynolds, Paul R; Arroyo, Juan A

    2016-02-01

    Receptor for advanced glycation end products (RAGE) is a receptor implicated in the modulation of inflammation. Inflammation has been associated with pregnancy pathologies including preeclampsia (PE), intrauterine growth restriction (IUGR), and gestational diabetes mellitus (GDM). Our objective was to examine placental RAGE expression in PE, IUGR, and GDM complications. Human placental tissues were obtained for RAGE determination using Q-PCR, immunohistochemistry, and Western blot. Invasive trophoblast cells were cultured and treated with AGES for RAGE activation studies. Compared to control placenta, we observed: (i) decreased RAGE gene expression during GDM, (ii) increased RAGE protein in the PE placenta, and (iii) decreased RAGE protein in the IUGR placenta. In trophoblast cells exposed AGEs, we observed: (i) decreased trophoblast invasion, (ii) increased c-Jun N-terminal kinases (JNK) and Extracellular signal-regulated kinases (ERK), and (iii) increased TNF-α and IL-1β secretion. We conclude that placental RAGE is activated during PE and that RAGE-mediated inflammation in the trophoblast involves increased pro-inflammatory cytokine secretion. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Cardiovascular adaptation to extrauterine life after intrauterine growth restriction.

    Science.gov (United States)

    Rodriguez-Guerineau, Luciana; Perez-Cruz, Miriam; Gomez Roig, María D; Cambra, Francisco J; Carretero, Juan; Prada, Fredy; Gómez, Olga; Crispi, Fátima; Bartrons, Joaquim

    2018-02-01

    Introduction The adaptive changes of the foetal heart in intrauterine growth restriction can persist postnatally. Data regarding its consequences for early circulatory adaptation to extrauterine life are scarce. The aim of this study was to assess cardiac morphometry and function in newborns with late-onset intrauterine growth restriction to test the hypothesis that intrauterine growth restriction causes cardiac shape and functional changes at birth. A comprehensive echocardiographic study was performed in 25 neonates with intrauterine growth restriction and 25 adequate-for-gestational-age neonates. Compared with controls, neonates with intrauterine growth restriction had more globular ventricles, lower longitudinal tricuspid annular motion, and higher left stroke volume without differences in the heart rate. Neonates with intrauterine growth restriction also showed subclinical signs of diastolic dysfunction in the tissue Doppler imaging with lower values of early (e') diastolic annular peak velocities in the septal annulus. Finally, the Tei index in the tricuspid annulus was higher in the intrauterine growth restriction group. Neonates with history of intrauterine growth restriction showed cardiac remodelling and signs of systolic and diastolic dysfunction. Overall, there was a significant tendency to worse cardiac function results in the right heart. The adaptation to extrauterine life occurred with more globular hearts, higher stroke volumes but a similar heart rate compared to adequate-for-gestational-age neonates.

  4. Moderate caloric restriction during gestation in rats alters adipose tissue sympathetic innervation and later adiposity in offspring.

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    Ana Paula García

    Full Text Available Maternal prenatal undernutrition predisposes offspring to higher adiposity in adulthood. Mechanisms involved in these programming effects, apart from those described in central nervous system development, have not been established. Here we aimed to evaluate whether moderate caloric restriction during early pregnancy in rats affects white adipose tissue (WAT sympathetic innervation in the offspring, and its relationship with adiposity development. For this purpose, inguinal and retroperitoneal WAT (iWAT and rpWAT, respectively were analyzed in male and female offspring of control and 20% caloric-restricted (from 1-12 d of pregnancy (CR dams. Body weight (BW, the weight, DNA-content, morphological features and the immunoreactive tyrosine hydroxylase and Neuropeptide Y area (TH+ and NPY+ respectively, performed by immunohistochemistry of both fat depots, were studied at 25 d and 6 m of age, the latter after 2 m exposure to high fat diet. At 6 m of life, CR males but not females, exhibited greater BW, and greater weight and total DNA-content in iWAT, without changes in adipocytes size, suggesting the development of hyperplasia in this depot. However, in rpWAT, CR males but not females, showed larger adipocyte diameter, with no changes in DNA-content, suggesting the development of hypertrophy. These parameters were not different between control and CR animals at the age of 25 d. In iWAT, both at 25 d and 6 m, CR males but not females, showed lower TH(+ and NPY(+, suggesting lower sympathetic innervation in CR males compared to control males. In rpWAT, at 6 m but not at 25 d, CR males but not females, showed lower TH(+ and NPY(+. Thus, the effects of caloric restriction during gestation on later adiposity and on the differences in the adult phenotype between internal and subcutaneous fat depots in the male offspring may be associated in part with specific alterations in sympathetic innervation, which may impact on WAT architecture.

  5. Ontogeny and nutritional programming of mitochondrial proteins in the ovine kidney, liver and lung.

    Science.gov (United States)

    Yakubu, D P; Mostyn, A; Hyatt, M A; Kurlak, L O; Budge, H; Stephenson, T; Symonds, M E

    2007-12-01

    This study investigated the developmental and nutritional programming of two important mitochondrial proteins, namely voltage-dependent anion channel (VDAC) and cytochrome c, in the sheep kidney, liver and lung. The effect of maternal nutrient restriction between early and mid-gestation (i.e. 28- to 80-day gestation, the period of maximal placental growth) on the abundance of these proteins was also examined in fetal and juvenile offspring. Fetuses were sampled at 80 and 140 days of gestation (term approximately 147 days), and postnatal animals at 1 and 30 days and 6 months of age. The abundance of VDAC peaked at 140 days of gestation in the lung, compared with 1 day after birth in the kidney and liver, whereas cytochrome c abundance was greatest at 140 days of gestation in the liver, 1 day after birth in the kidney and 6 months of age in lungs. This differential ontogeny in mitochondrial protein abundance between tissues was accompanied with very different tissue-specific responses to changes in maternal food intake. In the liver, maternal nutrient restriction only increased mitochondrial protein abundance at 80 days of gestation, compared with no effect in the kidney. In contrast, in the lung mitochondrial protein, abundance was raised near to term, whereas VDAC abundance was decreased by 6 months of age. These findings demonstrate the tissue-specific nature of mitochondrial protein development that reflects differences in functional adaptation after birth. The divergence in mitochondrial response between tissues to maternal nutrient restriction early in pregnancy further reflects these differential ontogenies.

  6. Sexual dimorphism in the fetal cardiac response to maternal nutrient restriction

    Energy Technology Data Exchange (ETDEWEB)

    Muralimanoharan, Sribalasubashini; Li, Cun; Nakayasu, Ernesto S.; Casey, Cameron P.; Metz, Thomas O.; Nathanielsz, Peter W.; Maloyan, Alina

    2017-07-01

    Poor maternal nutrition causes intrauterine growth restriction (IUGR); however, its effects on fetal cardiac development are unclear. We have developed a baboon model of moderate maternal undernutrition, leading to IUGR. We hypothesized that IUGR affects fetal cardiac structure and metabolism. Six control pregnant baboons ate ad-libitum (CTRL)) or 70% CTRL from 0.16 of gestation (G). Fetuses were euthanized at C-section at 0.9G under general anesthesia. Male but not female IUGR fetuses showed left ventricular fibrosis inversely correlated with birth weight. Expression of extracellular matrix protein TSP-1 was increased ( SMAD3 and ALK-1 were downregulated in male IUGRs with no difference in females. Autophagy was present in male IUGR evidenced by upregulation of ATG7 expression and lipidation LC3B. Global miRNA expression profiling revealed 56 annotated and novel cardiac miRNAs exclusively dysregulated in female IUGR, and 38 cardiac miRNAs were exclusively dysregulated in males (p<0.05). Fifteen (CTRL) and 23 (IUGR) miRNAs, were differentially expressed between males and. females (p<0.05) suggesting sexual dimorphism, which can be at least partially explained by differential expression of upstream transcription factors (e.g. HNF4α, and NFκB p50). Lipidomics analysis exhibited a net increase in diacylglycerol and plasmalogens, and a decrease in triglycerides and phosphatidylcholines. In summary, IUGR resulting from decreased maternal nutrition is associated with sex-dependent dysregulations in cardiac structure, miRNA expression, and lipid metabolism. If these changes persist postnatally, they may program offspring for higher later life cardiac risk.

  7. Proposed ethical guidelines and legislative framework for permitting gestational surrogacy in Singapore.

    Science.gov (United States)

    Heng, Boon Chin

    2007-09-01

    Gestational surrogacy is currently banned in Singapore but is much debated. Some ethical guidelines and legislation for permitting gestational surrogacy in Singapore are proposed and discussed including: (i) review and approval of gestational surrogacy by the Ministry of Health on a case-by-case basis; (ii) stringent guidelines for gonadotrophin stimulation, IVF and ICSI procedures in 'traditional' surrogacy; (iii) restriction of gestational surrogates to parous married women with stable family relationships; (iv) exclusion of foreign women from acting as gestational surrogates, except for close relatives of the recipient couple; (v) reimbursement and/or compensation of gestational surrogates based on the direct expenses model; (vi) exclusion of medical professionals from surrogate recruitment and reimbursement; (vii) the surrogacy contract must make it legally binding for the prospective recipient couple to accept the child, even if it is born with congenital deformities; (viii) stringent guidelines for combining surrogacy with egg donation from a third woman, who is neither the social nor gestational mother. Policymakers in Singapore should conduct a public referendum on the legalization of gestational surrogacy and actively consult the views of healthcare professionals, religious and community leaders, as well as the general public, before reaching any decision.

  8. Gestational Protein Restriction Increases Cardiac Connexin 43 mRNA levels in male adult rat offspring

    Science.gov (United States)

    Rossini, Kamila Fernanda; de Oliveira, Camila Andrea; Rebelato, Hércules Jonas; Esquisatto, Marcelo Augusto Marreto; Catisti, Rosana

    2017-01-01

    Background The dietary limitation during pregnancy influences the growth and development of the fetus and offspring and their health into adult life. The mechanisms underlying the adverse effects of gestational protein restriction (GPR) in the development of the offspring hearts are not well understood. Objectives The aim of this study was to evaluate the effects of GPR on cardiac structure in male rat offspring at day 60 after birth (d60). Methods Pregnant Wistar rats were fed a normal-protein (NP, 17% casein) or low-protein (LP, 6% casein) diet. Blood pressure (BP) values from 60-day-old male offspring were measured by an indirect tail-cuff method using an electro sphygmomanometer. Hearts (d60) were collected for assessment of connexin 43 (Cx43) mRNA expression and morphological and morphometric analysis. Results LP offspring showed no difference in body weight, although they were born lighter than NP offspring. BP levels were significantly higher in the LP group. We observed a significant increase in the area occupied by collagen fibers, a decrease in the number of cardiomyocytes by 104 µm2, and an increase in cardiomyocyte area associated with an increased Cx43 expression. Conclusion GPR changes myocardial levels of Cx43 mRNA in male young adult rats, suggesting that this mechanism aims to compensate the fibrotic process by the accumulation of collagen fibers in the heart interstitium. PMID:28678925

  9. Aging, adiposity, and calorie restriction.

    Science.gov (United States)

    Fontana, Luigi; Klein, Samuel

    2007-03-07

    Excessive calorie intake and subsequent obesity increases the risk of developing chronic disease and decreases life expectancy. In rodent models, calorie restriction with adequate nutrient intake decreases the risk of developing chronic disease and extends maximum life span. To evaluate the physiological and clinical implications of calorie restriction with adequate nutrient intake. Search of PubMed (1966-December 2006) using terms encompassing various aspects of calorie restriction, dietary restriction, aging, longevity, life span, adiposity, and obesity; hand search of journals that focus on obesity, geriatrics, or aging; and search of reference lists of pertinent research and review articles and books. Reviewed reports (both basic science and clinical) included epidemiologic studies, case-control studies, and randomized controlled trials, with quality of data assessed by taking into account publication in a peer-reviewed journal, number of animals or individuals studied, objectivity of measurements, and techniques used to minimize bias. It is not known whether calorie restriction extends maximum life span or life expectancy in lean humans. However, calorie restriction in adult men and women causes many of the same metabolic adaptations that occur in calorie-restricted rodents and monkeys, including decreased metabolic, hormonal, and inflammatory risk factors for diabetes, cardiovascular disease, and possibly cancer. Excessive calorie restriction causes malnutrition and has adverse clinical effects. Calorie restriction in adult men and women causes beneficial metabolic, hormonal, and functional changes, but the precise amount of calorie intake or body fat mass associated with optimal health and maximum longevity in humans is not known. In addition, it is possible that even moderate calorie restriction may be harmful in specific patient populations, such as lean persons who have minimal amounts of body fat.

  10. Galectins in angiogenesis: consequences for gestation.

    Science.gov (United States)

    Blois, Sandra M; Conrad, Melanie L; Freitag, Nancy; Barrientos, Gabriela

    2015-04-01

    Members of the galectin family have been shown to exert several roles in the context of reproduction. They contribute to placentation, maternal immune regulation and facilitate angiogenesis encompassing decidualisation and placenta formation during pregnancy. In the context of neo-vascularisation, galectins have been shown to augment signalling pathways that lead to endothelial cell activation, cell proliferation, migration and tube formation in vitro in addition to angiogenesis in vivo. Angiogenesis during gestation ensures not only proper foetal growth and development, but also maternal health. Consequently, restriction of placental blood flow has major consequences for both foetus and mother, leading to pregnancy diseases. In this review we summarise both the established and the emerging roles of galectin in angiogenesis and discuss the possible implications during healthy and pathological gestation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Dietary choice for a balanced nutrient intake increases the mean and reduces the variance in the reproductive performance of male and female cockroaches.

    Science.gov (United States)

    Bunning, Harriet; Bassett, Lee; Clowser, Christina; Rapkin, James; Jensen, Kim; House, Clarissa M; Archer, Catharine R; Hunt, John

    2016-07-01

    Sexual selection may cause dietary requirements for reproduction to diverge across the sexes and promote the evolution of different foraging strategies in males and females. However, our understanding of how the sexes regulate their nutrition and the effects that this has on sex-specific fitness is limited. We quantified how protein (P) and carbohydrate (C) intakes affect reproductive traits in male (pheromone expression) and female (clutch size and gestation time) cockroaches (Nauphoeta cinerea). We then determined how the sexes regulate their intake of nutrients when restricted to a single diet and when given dietary choice and how this affected expression of these important reproductive traits. Pheromone levels that improve male attractiveness, female clutch size and gestation time all peaked at a high daily intake of P:C in a 1:8 ratio. This is surprising because female insects typically require more P than males to maximize reproduction. The relatively low P requirement of females may reflect the action of cockroach endosymbionts that help recycle stored nitrogen for protein synthesis. When constrained to a single diet, both sexes prioritized regulating their daily intake of P over C, although this prioritization was stronger in females than males. When given the choice between diets, both sexes actively regulated their intake of nutrients at a 1:4.8 P:C ratio. The P:C ratio did not overlap exactly with the intake of nutrients that optimized reproductive trait expression. Despite this, cockroaches of both sexes that were given dietary choice generally improved the mean and reduced the variance in all reproductive traits we measured relative to animals fed a single diet from the diet choice pair. This pattern was not as strong when compared to the single best diet in our geometric array, suggesting that the relationship between nutrient balancing and reproduction is complex in this species.

  12. Screening, diagnosis, and management of intrauterine growth restriction.

    Science.gov (United States)

    Lausman, Andrea; McCarthy, Fergus P; Walker, Melissa; Kingdom, John

    2012-01-01

    To provide comprehensive background knowledge relevant to the SOGC Maternal-Fetal Medicine Committee-approved guideline entitled "Intrauterine Growth Restriction: Screening, Diagnosis, and Management." Publications in English were retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library in January 2011 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and any key words (fetal growth, restriction, growth retardation, intrauterine growth restriction [IUGR], low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized controlled trials or controlled clinical trials, and high-quality prospective and retrospective observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Evidence obtained from at least one properly randomized controlled trial, Cochrane Reviews, and high quality cohort data have been combined to provide clinicians with evidence to optimize their practice for screening, diagnosis, and management of intrauterine growth restriction. Considerable advances have been made to improve clinicians' ability to screen, diagnose, and manage pregnancies with suspected IUGR more effectively, including several properly randomized controlled trials. Pregnancies with late-onset IUGR may be managed equally effectively by early delivery or delayed delivery (with increased surveillance) anticipating favourable outcomes. By contrast, many aspects of the management of early-onset IUGR require further clinical trials.

  13. Maternal serum copeptin as a marker for fetal growth restriction

    Directory of Open Access Journals (Sweden)

    Ashraf A. Foda

    2013-09-01

    Conclusion: Maternal serum copeptin level can differentiate between the normal sized and small for gestational age fetuses. Also, it can differentiate between constitutionally small and growth restricted fetuses.

  14. Communication Profile of Primary School-Aged Children with Foetal Growth Restriction

    Science.gov (United States)

    Partanen, Lea Aulikki; Olsén, Päivi; Mäkikallio, Kaarin; Korkalainen, Noora; Heikkinen, Hanna; Heikkinen, Minna; Yliherva, Anneli

    2017-01-01

    Foetal growth restriction is associated with problems in neurocognitive development. In the present study, prospectively collected cohorts of foetal growth restricted (FGR) and appropriate for gestational age grown (AGA) children were examined at early school-age by using the Children's Communication Checklist-2 (CCC-2) to test the hypothesis that…

  15. Ontogeny and nutritional programming of the hepatic growth hormone-insulin-like growth factor-prolactin axis in the sheep.

    Science.gov (United States)

    Hyatt, Melanie A; Budge, Helen; Walker, David; Stephenson, Terence; Symonds, Michael E

    2007-10-01

    The liver is an important metabolic and endocrine organ in the fetus, but the extent to which its hormone receptor sensitivity is developmentally regulated in early life is not fully established. Therefore, we examined developmental changes in mRNA abundance for the GH receptor (GHR) and prolactin receptor (PRLR) plus IGF-I and -II and their receptors. Fetal and postnatal sheep were sampled at either 80 or 140 d gestation, 1 or 30 d, or 6 months of age. The effect of maternal nutrient restriction between early gestation to midgestation (i.e. 28-80 d gestation, the time of early liver growth) on gene expression was also examined in the fetus and juvenile offspring. Gene expression for the GHR, PRLR, and IGF-I receptor increased through gestation peaking at birth, whereas IGF-I was maximal near to term. In contrast, IGF-II mRNA decreased between midgestation and late gestation to increase after birth, whereas IGF-II receptor remained unchanged. A substantial decline in mRNA abundance for GHR, PRLR, and IGF-I receptor then occurred up to 6 months. Maternal nutrient restriction reduced GHR and IGF-II receptor mRNA abundance in the fetus, but caused a precocious increase in the PRLR. Gene expression for IGF-I and -II were increased in juvenile offspring born to nutrient-restricted mothers. In conclusion, there are marked differences in the ontogeny and nutritional programming of specific hormones and their receptors involved in hepatic growth and development in the fetus. These could contribute to changes in liver function during adult life.

  16. Circulating C19MC MicroRNAs in Preeclampsia, Gestational Hypertension, and Fetal Growth Restriction

    Directory of Open Access Journals (Sweden)

    Ilona Hromadnikova

    2013-01-01

    Full Text Available The objective of the study was to identify the profile of circulating C19MC microRNAs (miR-516-5p, miR-517*, miR-518b, miR-520a*, miR-520h, miR-525, and miR-526a in patients with established preeclampsia (n=63, fetal growth restriction (n=27, and gestational hypertension (n=23. We examined the correlation between plasmatic concentrations and expression levels of microRNAs and the severity of the disease with respect to clinical signs, requirements for the delivery, and Doppler ultrasound parameters. Using absolute and relative quantification approaches, increased extracellular C19MC microRNA levels (miR-516-5p, P=0.037, P=0.009; miR-517*, P=0.033, P=0.043; miR-520a*, P=0.001, P=0.009; miR-525, P=0.026, P=0.01; miR-526a, P=0.03, P=0.035 were detected in patients with preeclampsia. The association analysis pointed to no relationship between C19MC microRNA plasmatic concentrations and expression profile and identified risk factors for a poorer perinatal outcome. However, the dependence between the levels of plasmatic C19MC microRNAs and the pulsatility index in the middle cerebral artery and the values of cerebroplacental ratio was demonstrated. The study brought the interesting finding that the upregulation of miR-516-5p, miR-517*, miR-520a*, miR-525, and miR-526a is a characteristic phenomenon of established preeclampsia.

  17. Intrauterine Growth Restriction, Head Size at Birth, and Outcome in Very Preterm Infants.

    Science.gov (United States)

    Guellec, Isabelle; Marret, Stephane; Baud, Olivier; Cambonie, Gilles; Lapillonne, Alexandre; Roze, Jean-Christophe; Fresson, Jeanne; Flamant, Cyril; Charkaluk, Marie-Laure; Arnaud, Catherine; Ancel, Pierre-Yves

    2015-11-01

    To determine whether small head circumference (HC) or birth weight (BW) or both are associated with neonatal and long-term neurologic outcome in very preterm infants. All 2442 live births from the 1997 Epipage study between 26 and 32 weeks of gestational age in 9 regions of France were analyzed. A total of 1395 were tested at age 5 years for cognitive performance and 1315 with school performance reports at age 8 years. Symmetric growth restriction (SGR) was defined by HC and BW growth restriction by at least 1 of HC and BW growth restriction: head growth restriction (HGR) and weight growth restriction (WGR). Appropriate for gestational age was defined by both BW and HC >20th percentile. Compared with appropriate for gestational age, SGR was significantly associated with neonatal mortality (aOR 2.99, 95% CI 1.78-5.03), moderate and severe cognitive deficiency (aOR 1.65, 95% CI 1.01-2.71 and aOR 2.61, 95% CI 1.46-4.68, respectively), and poor school performance (aOR 1.79; 95% CI 1.13-2.83). HGR was significantly associated with severe cognitive deficiency (aOR 2.07, 95% CI 1.15-3.74). WGR was not significantly associated with cognitive or school performance despite higher rates of neonatal morbidity. SGR in preterm infants was associated with neonatal mortality and impaired cognitive and school performance. The outcome of asymmetric growth restriction differed according to HC. HGR was associated with impaired cognitive function; WGR was not. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. [Long-term outcome in context of intra uterine growth restriction and/or small for gestational age newborns].

    Science.gov (United States)

    Gascoin, G; Flamant, C

    2013-12-01

    To evaluate long-term outcome after history of intra-uterine growth restriction (IUGR) and/or birth small for gestational age (SGA). This systematic evidence review is based on Pubmed search, Cochrane library and experts recommendations. Neurodevelopmental evaluation at 2 years is lower in those infants, born premature or not. SGA is associated with a high risk of minor cognitive deficiencies, hyperactivity or attention deficit disorders at 5 years or scholar difficulties at 8 years. Those infants are at high risk of metabolic syndrome in adulthood. Most of them will catch up at 6 months for weight and 12 months for height. Even if IUGR is associated with high risk of bronchodysplasia, up to this day, the review of literature did not permit to evaluate respiratory outcome. Adults born SGA have good quality of live and normal professional insertion. One cohort study and more and more animal studies suggest potential trans generational effects. Infants born SGA and/or with history of IUGR are at high risk of minor cognitive deficiencies and scholar difficulties. They are also at high risk of metabolic syndrome in adulthood. However, prematurity seems to have a higher effect than IUGR and/or SGA on long-term outcomes. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Protein- and tryptophan-restricted diets induce changes in rat gonadal hormone levels.

    Science.gov (United States)

    Del Angel-Meza, A R.; Feria-Velasco, A; Ontiveros-Martínez, L; Gallardo, L; Gonzalez-Burgos, I; Beas-Zárate, C

    2001-04-01

    The release of gonadotrophic hormones starts at puberty and, along with the subsequent estral cyclicity, is subject to hormonal feedback systems and to the action of diverse neuroactive substances such as gamma amino butyric acid and catecholamines. This study shows the effect of the administration during 40 days of protein-restricted and corn-based (tryptophan- and lysine-deficient) diets on the serotonin concentration in medial hypothalamic fragments as well as in follicle-stimulating luteinizing hormones, 17-beta-estradiol and progesterone serum levels, and estral cyclicity in 60- and 100-day-old rats (young, mature, and in gestation). In young rats, a delay in vaginal aperture development, and a lengthening of the estral cycle to a continuous anestral state was observed, mainly in the group fed corn. This group showed a 25% decrease in the serotonin concentration compared with the protein-restricted group, which exhibited an increase of 9% over the control group. Luteinizing hormone levels decreased in 16% and 13%, whereas follicle-stimulating hormone increased in 13% and 5% in the young animals of restricted groups, respectively, compared with the control group. Serum progesterone levels decreased only in young restricted versus control animals, and no differences were seen among adult and gestational rats. Serum levels of 17-beta-estradiol in restricted animals showed different concentration patterns, mainly in the corn group, which was higher at the 20th gestational day, falling drastically postpartum. The results obtained in this study show serotonin to be a very important factor in the release of gonadotrophic hormones and the start of puberty.

  20. Electrographic imaging of recognition memory in 34-38 week gestation intrauterine growth restricted newborns.

    Science.gov (United States)

    Black, Linda S; deRegnier, Raye-Ann; Long, Jeffrey; Georgieff, Michael K; Nelson, Charles A

    2004-11-01

    Electrophysiological imaging of recognition memory using event-related potentials (ERPs) in intrauterine growth-restricted (IUGR) newborns allows assessment of recognition memory before the onset of multiple confounding variables. Animal models that reproduce the physiologic components associated with IUGR have demonstrated adverse effects on the hippocampus, a structure that is essential to normal memory processing. Previous electrophysiologic studies have demonstrated shortened auditory-evoked potential (AEP) and visual-evoked potential (VEP) latencies in IUGR infants suggesting accelerated neural maturation in response to the adverse in-utero environment. The hypothesis of the current study was that newborns with IUGR and head-sparing would demonstrate altered auditory recognition memory when compared to controls and that the configuration of the alteration would evidence advanced maturation but still be different from that of typically grown newborns. Twelve IUGR newborns born at 34-38 weeks gestation with head-sparing and 16 age-matched control newborns were tested with both a speech/nonspeech paradigm to assess auditory sensory processing and a novel (stranger's voice) and familiar (mother's voice) paradigm to assess recognition memory. In the recognition memory experiment, a three-way interaction of condition, lead, and group was identified for the lateral leads T4, CM3, and CM4 with the response to the mother being of much greater area in the IUGR cohort than in the controls. This ERP configuration has previously been reported for the midline leads in term newborns. The findings indicate that IUGR newborns with head-sparing have electrophysiologic evidence of accelerated maturation of cognitive processing suggesting an atypical process of maturation that may not support typical cognitive development.

  1. Locally derived traffic-related air pollution and fetal growth restriction: a retrospective cohort study.

    Science.gov (United States)

    Pereira, Gavin; Cook, Angus G; Haggar, Fatima; Bower, Carol; Nassar, Natasha

    2012-11-01

    Fetal growth restriction has been inconsistently associated with maternal exposure to elevated levels of traffic-related air pollution. We investigated the relationship between an individualised measure of fetal growth and maternal exposure to a specific marker for traffic-related air pollution. We estimated maternal residential exposure to a marker for traffic-related air pollution (nitrogen dioxide, NO2) during pregnancy for 23,452 births using temporally adjusted land-use regression. Logistic regression was used to investigate associations with small for gestational age and sex (SGA) and fetal growth restriction, defined as proportion of optimal birth weight (POBW) below the 10th percentile. Sub-populations investigated were: women who spent most time at home, women who did not move house, women with respiratory or circulatory morbidity, women living in low/middle/high socio-economic areas, women who delivered before 37 weeks gestation, and women who delivered from 37 weeks gestation. An IQR increase in traffic-related air pollution in the second trimester across all women was associated with an OR of 1.31 (95% CI 1.07 to 1.60) for fetal growth restriction. Effects on fetal growth restriction (low POBW) were highest among women who subsequently delivered before 37 weeks of gestation. Effects on SGA were highest among women who did not move house: OR 1.35 (95% CI 1.08 to 1.69). Larger effect sizes were observed for low POBW than for SGA. Exposure to traffic-related air pollution in mid to late pregnancy was associated with risk of SGA and low POBW in this study.

  2. Intrauterine growth restriction - part 2.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2016-12-01

    Small for gestational age (SGA) infants have been classically defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age, whereas intrauterine growth restriction (IUGR) has been defined as a rate of foetal growth that is less than normal for the population and for the growth potential of a specific infant. SGA infants have more frequent problems such as perinatal asphyxia, hypothermia, hypoglycaemia, polycythaemia and many more when compared with their appropriate for gestational age counterpart. They too have growth retardation and various major and subtle neurodevelopmental handicaps, with higher rates of perinatal and neonatal mortality. With the advent of newer technologies, even though the perinatal diagnosis of these SGA/IUGR foetuses has increased, but still perinatal morbidity and mortality rates are higher than normal foetuses and infants. In this part, we have covered neonatal IUGR classification, postnatal diagnosis, short-term and long-term complications faced by these IUGR infants.

  3. Morbility, clinical data and proteomic analysis of IUGR and AGA newborns at different gestational ages

    Directory of Open Access Journals (Sweden)

    M.D. Ruiz-González

    2016-12-01

    Full Text Available The data are related to the proteomic analysis of 43 newborns with intrauterine growth retardation (IUGR and 45 newborns with appropriate weight for gestational age (AGA carried out by separation via 2DE and analyzed by MS–TOF/TOF. All newborns were separated into three gestational age groups, "Very Preterm" 29–32 weeks, "Moderate Preterm" 33–36 weeks, and, "Term" ≥37weeks. From each newborn, blood was drawn three times from birth to 1 month life. High-abundant serum proteins were depleted, and the minority ones were separated by 2DE and analyzed for significant expression differences. The data reflect analytic and clinic variables analyzed globally and categorized by gestational age in relation to IUGR and the optimization of conditions for 2-DE separation. The data from this study are related to the research article entitled "Alterations of Protein Expression in Serum of Infants with Intrauterine Growth Restriction and Different Gestational Ages" (M.D. Ruis-González, M.D. Cañete, J.L. Gómez-Chaparro, N. Abril, R. Cañete, J. López-Barea, 2015 [1]. The present dataset of serum IUGR newborn proteome can be used as a reference for any study involving intrauterine growth restriction during the first month of life.

  4. Comparison of global nutrient profiling systems for restricting the commercial marketing of foods and beverages of low nutritional quality to children in Canada.

    Science.gov (United States)

    Labonté, Marie-Ève; Poon, Theresa; Mulligan, Christine; Bernstein, Jodi T; Franco-Arellano, Beatriz; L'Abbé, Mary R

    2017-12-01

    Background: The Canadian government recently committed to introduce legislation to restrict the commercial marketing of unhealthy foods and beverages to children. Objective: We compared the degree of strictness and agreement between nutrient profile (NP) models relevant to marketing restrictions by applying them in the Canadian context. Design: With the use of data from the University of Toronto 2013 Food Label Information Program ( n = 15,342 prepackaged foods), 4 NP models were evaluated: the Food Standards Australia New Zealand-Nutrient Profiling Scoring Criterion (FSANZ-NPSC), the WHO Regional Office for Europe (EURO) model, the Pan American Health Organization (PAHO) model, and a modified version of the PAHO model (Modified-PAHO), which did not consider the extent of food processing because the application of this characteristic was prone to ambiguity. The number and proportion of foods that would be eligible for marketing to children was calculated with the use of each model, overall and by food category. Results: The Modified-PAHO and PAHO models would permit only 9.8% (95% CI: 9.4%, 10.3%) and 15.8% (95% CI: 15.3%, 16.4%) of foods, respectively, followed by the EURO model [29.8% (95% CI: 29.0%, 30.5%)]. In contrast, the FSANZ-NPSC would consider almost half of prepackaged foods as eligible for marketing to children [49.0% (95% CI: 48.2%, 49.8%)]. Cross-classification analyses showed that only 8.1% of foods would be eligible based on all models (e.g., most pastas without sauce). Subanalyses showed that each model would be more stringent when evaluating food items that specifically target children on their package ( n = 747; from 1.9% of foods eligible under Modified-PAHO to 24.2% under FSANZ-NPSC). Conclusions: The degree of strictness and agreement vary greatly between NP models applicable to marketing restrictions. The discrepancies between models highlight the importance for policy makers to carefully evaluate the characteristics underlying such models

  5. Fetal Growth Restriction at the Limits of Viability

    NARCIS (Netherlands)

    Visser, G. H. A.; Bilardo, Caterina M.; Lees, Christopher

    2014-01-01

    The outcome of early small-for-gestational age and/or intrauterine growth-restricted fetuses is reviewed. In these fetuses the outcome appears to be considerably poorer than that of appropriately grown fetuses and this seems mainly to be caused by intrauterine malnutrition rather than by hypoxemia.

  6. Severe gestational hypertriglyceridemia: A practical approach for clinicians

    Science.gov (United States)

    Wong, Bertha; Ooi, Teik C

    2015-01-01

    Severe gestational hypertriglyceridemia is a potentially life threatening and complex condition to manage, requiring attention to a delicate balance between maternal and fetal needs. During pregnancy, significant alterations to lipid homeostasis occur to ensure transfer of nutrients to the fetus. In women with an underlying genetic predisposition or a secondary exacerbating factor, severe gestational hypertriglyceridemia can arise, leading to devastating complications, including acute pancreatitis. Multidisciplinary care, implementation of a low-fat diet with nutritional support, and institution of a hierarchical therapeutic approach are all crucial to reduce maternal and fetal morbidity. To avoid maternal pancreatitis, close surveillance of triglycerides throughout pregnancy with elective hospitalization for refractory cases is recommended. Careful dietary planning is required to prevent neural and retinal complications from fetal essential fatty acid deficiency. Questions remain about the safety of fibrates and plasmapheresis in pregnancy as well as the optimal timing for induction and delivery of these women. PMID:27512474

  7. Nutrient-intake-level-dependent regulation of intestinal development in newborn intrauterine growth-restricted piglets via glucagon-like peptide-2.

    Science.gov (United States)

    Liu, J; Liu, Z; Gao, L; Chen, L; Zhang, H

    2016-10-01

    The objective of the present study was to investigate the intestinal development of newborn intrauterine growth-restricted (IUGR) piglets subjected to normal nutrient intake (NNI) or restricted nutrient intake (RNI). Newborn normal birth weight (NBW) and IUGR piglets were allotted to NNI or RNI levels for 4 weeks from day 8 postnatal. IUGR piglets receiving NNI had similar growth performance compared with that of NBW piglets. Small intestine length and villous height were greater in IUGR piglets fed the NNI than that of piglets fed the RNI. Lactase activity was increased in piglets fed the NNI compared with piglets fed the RNI. Absorptive function, represented by active glucose transport by the Ussing chamber method and messenger RNA (mRNA) expressions of two main intestinal glucose transporters, Na+-dependent glucose transporter 1 (SGLT1) and glucose transporter 2 (GLUT2), were greater in IUGR piglets fed the NNI compared with piglets fed the RNI regimen. The apoptotic process, characterized by caspase-3 activity (a sign of activated apoptotic cells) and mRNA expressions of p53 (pro-apoptotic), bcl-2-like protein 4 (Bax) (pro-apoptotic) and B-cell lymphoma-2 (Bcl-2) (anti-apoptotic), were improved in IUGR piglets fed the NNI regimen. To test the hypothesis that improvements in intestinal development of IUGR piglets fed NNI might be mediated through circulating glucagon-like peptide-2 (GLP-2), GLP-2 was injected subcutaneously to IUGR piglets fed the RNI from day 8 to day 15 postnatal. Although the intestinal development of IUGR piglets fed the RNI regimen was suppressed compared with those fed the NNI regimen, an exogenous injection of GLP-2 was able to bring intestinal development to similar levels as NNI-fed IUGR piglets. Collectively, our results demonstrate that IUGR neonates that have NNI levels could improve intestinal function via the regulation of GLP-2.

  8. Amnioinfusion before 26 weeks' gestation for severe fetal growth restriction with oligohydramnios: preliminary pilot study.

    Science.gov (United States)

    Takahashi, Yuichiro; Iwagaki, Shigenori; Chiaki, Rika; Iwasa, Tomotake; Takenaka, Motoki; Kawabata, Ichiro; Itoh, Mitsuaki

    2014-03-01

    The prognosis for severe fetal growth restriction (FGR) with severe oligohydramnios before 26 weeks' gestation (WG) is currently poor; furthermore, its management is controversial. We report the innovative new management of FGR, such as therapeutic amnioinfusion and tocolysis. For FGR and severe oligohydramnios before 26 WG complicated with absent or reversed umbilical artery end-diastolic flow velocity and/or deceleration by ultrasonography, we performed transabdominal amnioinfusion with tocolysis. Cases with multiple anomalies were excluded. Survival rate and long-term prognosis were analyzed. Among 570 FGR cases, 18 were included in the study. Mean diagnosis and delivery were at 22.6 ± 2.0 and 28.7 ± 3.3 WG. Median birthweight was 625 g (-4.2 standard deviation). Final survival rate was 11/13 (85%). There were five fetal deaths. In seven cases, oligohydramnios improved. Growth was detected in 10/18 fetuses. Furthermore, 8/8 decelerations, 4/12 cases of reversed umbilical artery end-diastolic flow velocity, 7/14 cases of brain-sparing effect, and 6/13 venous Doppler abnormalities were improved. When we detected umbilical cord compression, 8/10 cases were rescued. Eleven infants were followed up for an average of 5 years; one case of cerebral palsy with normal development and 10 cases with intact motor functions without major neurological handicap were confirmed. In cases of extremely severe FGR before 26 WG with oligohydramnios and circulatory failure, amnioinfusion might be a promising, innovative tool. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  9. Maternal and fetal outcome of mothers with gestational diabetes mellitus attending BIRDEM Hospital.

    Science.gov (United States)

    Sajani, T T; Rahman, M T; Karim, M R

    2014-04-01

    Gestational diabetes mellitus, most of which progress to type-2 diabetes mellitus is increasing worldwide. Identification of gestational diabetes and control of glucose can reduce such complications and improve maternal and neonatal health. A hospital based cross sectional study was conducted to find out maternal and fetal outcome of gestational diabetes from January to July 2011. Data were collected from 109 gestational diabetes mothers attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital for delivery. Study revealed that gestational diabetes was more common among mothers aged >25 years old and multiparaous women. Mean gestational age of diagnosis was 16.82±9.54 weeks. Sixty eight (68%) mothers were diagnosed before 20 weeks of gestation and more than 90% mothers with gestational diabetes delivered by caesarean section. Mean pregnancy weight gain was 6.8±1.18kg. Adverse maternal outcome observed in 24% cases and adverse fetal outcome was present in 34% cases. In univariate analysis weeks of delivery and fasting blood sugar were statistically significantly associated with adverse pregnancy outcome. Babies born to mothers with only diet restriction had less birth weight than mothers with insulin therapy. Pregnancy thought to be the most vulnerable stage of women's life and protecting her health along with her fetus during this period yields a positive impact on the health of future generation. Particular attention should be given during antenatal period to initiate screening programme and treatment protocol for gestational diabetic mothers.

  10. Homocysteine in small-for-gestational age and appropriate-for-gestational age preterm neonates from mothers receiving folic acid supplementation.

    Science.gov (United States)

    Gomes, Thushari S; Lindner, Ulrike; Tennekoon, Kamani H; Karandagoda, Wimal; Gortner, Ludwig; Obeid, Rima

    2010-08-01

    Prematurity and small-for-gestational age (SGA) neonates are at risk for postnatal complications. Concentrations of total homocysteine (tHcy) might be related to neonatal outcome. We hypothesized that concentrations of tHcy are not related to growth restriction in neonates from mothers receiving 5 mg/day folic acid. We studied a total of 133 preterm neonates from normotensive mothers; SGA (n=96) and appropriate-for-gestational age (AGA, n=37). Concentrations of tHcy, folate and vitamin B12 were measured in venous umbilical cord plasma. AGA preterm neonates had higher mean birth weight (BW) compared to SGA preterms (2472 g vs. 2007 g; pgestational age (GA) (35.1 vs. 35.7 weeks; p=0.059). Concentrations of tHcy (4.86 vs. 4.95 micromol/L), folate (63.3 vs. 55.7 nmol/L), and vitamin B12 (409 vs. 394 pmol/L) were not significantly different between the groups. GA was a strong positive predictor, BW was a significant negative predictor of cord plasma folate. Vitamin B12 concentration was a significant negative predictor of cord tHcy. Concentrations of tHcy did not differ between SGA and AGA preterm neonates born to mothers supplemented with folic acid. This finding argues against a causal role for folate deficiency or increased tHcy in growth restriction.

  11. Food Availability in School Stores in Seoul, South Korea after Implementation of Food- and Nutrient-Based Policies

    Science.gov (United States)

    Choi, Seul Ki; Frongillo, Edward A.; Blake, Christine E.; Thrasher, James F.

    2017-01-01

    Background: To improve school store food environments, the South Korean government implemented 2 policies restricting unhealthy food sales in school stores. A food-based policy enacted in 2007 restricts specific food sales (soft drinks); and a nutrient-based policy enacted in 2009 restricts energy-dense and nutrient-poor (EDNP) food sales. The…

  12. Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies

    NARCIS (Netherlands)

    Leventakou, Vasiliki; Roumeliotaki, Theano; Martinez, David; Barros, Henrique; Brantsaeter, Anne Lise; Casas, Maribel; Charles, Marie Aline; Cordier, Sylvaine; Eggesbø, Merete; Van Eijsden, Manon; Forastiere, Francesco; Gehring, Ulrike; Govarts, Eva; Halldórsson, Thorhallur I.; Hanke, Wojciech; Haugen, Margaretha; Heppe, Denise H M; Heude, Barbara; Inskip, Hazel M.; Jaddoe, Vincent W V; Jansen, Maria; Kelleher, Cecily; Meltzer, Helle Margrete; Merletti, Franco; Moltó-Puigmartí, Carolina; Mommers, Monique; Murcia, Mario; Oliveira, Andreia; Olsen, Sjúrour F.; Pele, Fabienne; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Robinson, Siân M.; Stigum, Hein; Strøm, Marin; Sunyer, Jordi; Thijs, Carel; Viljoen, Karien; Vrijkotte, Tanja G M; Wijga, Alet H.; Kogevinas, Manolis; Vrijheid, Martine; Chatzi, Leda

    2014-01-01

    Background: Fish is a rich source of essential nutrients for fetal development, but in contrast, it is also a well-known route of exposure to environmental pollutants. Objective: We assessed whether fish intake during pregnancy is associated with fetal growth and the length of gestation in a panel

  13. Brain Development, Intelligence and Cognitive Outcome in Children Born Small for Gestational Age

    NARCIS (Netherlands)

    de Bie, H.M.A.; Oostrom, K.J.; Delemarre-van d Waal, H.A.

    2010-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with increased neonatal morbidity and mortality as well as short stature, cardiovascular disease, insulin resistance, diabetes mellitus type 2, dyslipidemia and end-stage renal

  14. Skeletal Muscle CAP Expression Increases after Dietary Restriction and Aerobic Training in Women with a History of Gestational Diabetes.

    Science.gov (United States)

    Ryan, Alice S; Serra, Monica C

    2016-01-01

    The purpose is to determine the effects of 6 months caloric restriction and aerobic training (3x/wk) (CR+AEX) on c-CBL associated protein (CAP) gene expression in women with a history of GDM. CAP is involved in cell signaling and protein ubiquitination, and is linked to the development of insulin resistance. Obese (BMI=32 ± 1 kg/m 2 , % fat=46 ± 2, X ± SEM), sedentary (VO2 max=21.2 ± 1.2 ml/kg/min), women aged 52 ± 2 years participated in 6 months D+WL (n=10) with body composition, fitness (VO2 max), and glucose tolerance testing. Insulin sensitivity was assessed during the last 30 min of 2-hour hyperinsulinemic-euglycemic clamps (40 mU.m -2 .min -1 ) pre and post interventions. Vastus lateralis skeletal muscle biopsies (n=7) were conducted and CAP, GLUT4 and glycogen synthase (GS) gene expression measured by RT-PCR. No change in FFM by DXA was observed, but body weight decreased 8% with losses of total body fat mass (Prestriction and aerobic training in women with a history of gestational diabetes.

  15. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age

    NARCIS (Netherlands)

    de Bie, Henrica M. A.; de Ruiter, Michiel B.; Ouwendijk, Mieke; Oostrom, Kim J.; Wilke, Marko; Boersma, Maria; Veltman, Dick J.; Delemarre-van de Waal, Henriette A.

    2015-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic

  16. Trends in All-Cause Mortality across Gestational Age in Days for Children Born at Term

    DEFF Research Database (Denmark)

    Wu, Chunsen; Sun, Yuelian; Nohr, Ellen Aagaard

    2015-01-01

    pattern was observed when analyses were restricted to children born to by mothers without pregnancy complications. CONCLUSIONS: This study demonstrates heterogeneity in mortality rates even among singletons born at term. The highest mortality was observed among children born 37 weeks of gestation, which......BACKGROUND: Term birth is a gestational age from 259 days to 293 days. However trends in mortality according to gestational ages in days have not yet been described in this time period. METHODS AND FINDINGS: Based on nation-wide registries, we conducted a population-based cohort study among all...... children born at term in Denmark from 1997 to 2004 to estimate differences in mortality across gestational ages in days among singletons born at term. We studied early-neonatal mortality, neonatal mortality, infant mortality, and five-year mortality. Children were followed from birth up to the last day...

  17. On the genetic mechanisms of nutrient-dependent lifespan and reproduction

    NARCIS (Netherlands)

    Zandveld, Jelle

    2017-01-01

    Dietary restriction (DR), a moderate reduction in nutrient intake, improves health or extends lifespan across many species. Moreover, recent insights have shown that also the effects of specific nutrients are of importance for the beneficial effects of DR rather than intake alone. However, we

  18. Changes in foetal liver T2* measurements by MRI in response to maternal oxygen breathing: application to diagnosing foetal growth restriction

    International Nuclear Information System (INIS)

    Morris, David M; Semple, Scott IK; Gilbert, Fiona J; Redpath, Thomas W; Ross, John AS; McVicar, Alexandra; Haggarty, Paul; Abramovich, David R; Smith, Norman

    2010-01-01

    The motivation of the project was to investigate the use of oxygen-challenge magnetic resonance imaging (OC-MRI) as a method of diagnosing foetal growth restriction. Foetal growth restriction is associated with restricted foetal oxygen supply and is also associated with increased risks of perinatal mortality and morbidity, and a number of serious and chronic health problems. Measurements of T2* relaxation time, an MRI parameter which increases with blood oxygenation, were made in the right lobe of the foetal liver in 80 singleton pregnancies, before and after the mother breathed oxygen. The groups consisted of 41 foetuses with normal growth and 39 with apparent growth restriction. The mean ± SD gestational age at scanning was 35 ± 3 weeks. Changes in foetal liver T2* on maternal oxygen breathing showed no significant difference between the groups therefore the OC-MRI protocol used in this study has no value in the diagnosis of foetal growth restriction. A secondary finding was that a significant positive correlation of T2* change with gestational age was observed. Future studies on the use of oxygen-challenge MRI to investigate foetal growth restriction may therefore need to control for gestational age at the time of MR scanning in order to observe any underlying foetal growth-related effects

  19. Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program.

    Science.gov (United States)

    Petrella, E; Malavolti, M; Bertarini, V; Pignatti, L; Neri, I; Battistini, N C; Facchinetti, F

    2014-09-01

    To determine whether changes in lifestyle in women with BMI > 25 could decrease gestational weight gain and unfavorable pregnancy outcomes. Women with BMI > 25 were randomized at 1st trimester to no intervention or a Therapeutic Lifestyle Changes (TLC) Program including diet (overweight: 1700 kcal/day, obese: 1800 kcal/day) and mild physical activity (30 min/day, 3 times/week). At baseline and at the 36th week women filled-in a Food Frequency Questionnaire. gestational weight gain, gestational diabetes mellitus, gestational hypertension, preterm delivery. Data stratified by BMI categories. Socio-demographic features were similar between groups (TLC: 33 cases, 28 cases). At term, gestational weight gain in obese women randomized to TLC group was lower (6.7 ± 4.3 kg) versus controls (10.1 ± 5.6 kg, p = 0.047). Gestational diabetes mellitus, gestational hypertension and preterm delivery were also significantly lower. TLC was an independent factor in preventing gestational weight gain, gestational diabetes mellitus, gestational hypertension. Significant changes in eating habits occurred in the TLC group, which increased the number of snacks, the intake of fruits-vegetables and decreased the consumption of sugar. A caloric restriction associated to changes in eating behavior and constant physical activity, is able to reduce gestational weight gain and related pregnancy complications in obese women.

  20. Maternal L-glutamine supplementation prevents prenatal alcohol exposure-induced fetal growth restriction in an ovine model.

    Science.gov (United States)

    Sawant, Onkar B; Wu, Guoyao; Washburn, Shannon E

    2015-06-01

    Prenatal alcohol exposure is known to cause fetal growth restriction and disturbances in amino acid bioavailability. Alterations in these parameters can persist into adulthood and low birth weight can lead to altered fetal programming. Glutamine has been associated with the synthesis of other amino acids, an increase in protein synthesis and it is used clinically as a nutrient supplement for low birth weight infants. The aim of this study was to explore the effect of repeated maternal alcohol exposure and L-glutamine supplementation on fetal growth and amino acid bioavailability during the third trimester-equivalent period in an ovine model. Pregnant sheep were randomly assigned to four groups, saline control, alcohol (1.75-2.5 g/kg), glutamine (100 mg/kg, three times daily) or alcohol + glutamine. In this study, a weekend binge drinking model was followed where treatment was done 3 days per week in succession from gestational day (GD) 109-132 (normal term ~147). Maternal alcohol exposure significantly reduced fetal body weight, height, length, thoracic girth and brain weight, and resulted in decreased amino acid bioavailability in fetal plasma and placental fluids. Maternal glutamine supplementation successfully mitigated alcohol-induced fetal growth restriction and improved the bioavailability of glutamine and glutamine-related amino acids such as glycine, arginine, and asparagine in the fetal compartment. All together, these findings show that L-glutamine supplementation enhances amino acid availability in the fetus and prevents alcohol-induced fetal growth restriction.

  1. Intrauterine growth restriction is associated with structural alterations in human umbilical cord and decreased nitric oxide-induced relaxation of umbilical vein.

    Science.gov (United States)

    Peyter, A-C; Delhaes, F; Baud, D; Vial, Y; Diaceri, G; Menétrey, S; Hohlfeld, P; Tolsa, J-F

    2014-11-01

    Intrauterine growth restriction (IUGR) affects ∼8% of all pregnancies and is associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiovascular diseases in adulthood. Despite identification of several risk factors, the mechanisms implicated in the development of IUGR remain poorly understood. In case of placental insufficiency, reduced delivery of oxygen and/or nutrients to the fetus could be associated with alterations in the umbilical circulation, contributing further to the impairment of maternal-fetal exchanges. We compared the structural and functional properties of umbilical cords from growth-restricted and appropriate for gestational age (AGA) term newborns, with particular attention to the umbilical vein (UV). Human umbilical cords were collected at delivery. Morphological changes were investigated by histomorphometry, and UV's reactivity by pharmacological studies. Growth-restricted newborns displayed significantly lower growth parameters, placental weight and umbilical cord diameter than AGA controls. Total cross-section and smooth muscle areas were significantly smaller in UV of growth-restricted neonates than in controls. Maximal vasoconstriction achieved in isolated UV was lower in growth-restricted boys than in controls, whereas nitric oxide-induced relaxation was significantly reduced in UV of growth-restricted girls compared to controls. IUGR is associated with structural alterations of the UV in both genders, and with a decreased nitric oxide-induced relaxation in UV of newborn girls, whereas boys display impaired vasoconstriction. Further investigations will allow to better understand the regulation of umbilical circulation in growth-restricted neonates, which could contribute to devise potential novel therapeutic strategies to prevent or limit the development of IUGR. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Wider stall space affects behavior, lesion scores, and productivity of gestating sows.

    Science.gov (United States)

    Salak-Johnson, J L; DeDecker, A E; Levitin, H A; McGarry, B M

    2015-10-01

    Limited space allowance within the standard gestation stall is an important welfare concern because it restricts the ability of the sow to make postural adjustments and hinders her ability to perform natural behaviors. Therefore, we evaluated the impacts of increasing stall space and/or providing sows the freedom to access a small pen area on sow well-being using multiple welfare metrics. A total of 96 primi- and multiparous crossbred sows were randomly assigned in groups of 4 sows/treatment across 8 replicates to 1 of 3 stall treatments (TRT): standard stall (CTL; dimensions: 61 by 216 cm), width-adjustable stall (flex stall [FLX]; dimensions: adjustable width of 56 to 79 cm by 216 cm), or an individual walk-in/lock-in stall with access to a small communal open-pen area at the rear of the stall (free-access stall [FAS]; dimensions: 69 by 226 cm). Lesion scores, behavior, and immune and productivity traits were measured at various gestational days throughout the study. Total lesion scores were greatest for sows in FAS and least for sows in FLX ( pregnancy progressed, lesion scores increased among sows in CTL ( postural behaviors and sham chew behavior were affected by TRT ( changes in postural behaviors, lesion severity scores, and other sow traits. Moreover, compromised welfare measures found among sows in various stall environments may be partly attributed to the specific constraints of each stall system such as restricted stall space in CTL, insufficient floor space in the open-pen area of the FAS system, and gate design of the FLX (e.g., direction of bars and feeder space). These results also indicate that parity and gestational day are additional factors that may exacerbate the effects of restricted stall space or insufficient pen space, further compromising sow well-being.

  3. Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler.

    LENUS (Irish Health Repository)

    Kennelly, M M

    2012-04-01

    To establish reference ranges using longitudinal data for aortic isthmus (AoI) Doppler indices in appropriate-for-gestational-age (AGA) fetuses and to document the longitudinal trends in a cohort of small-for-gestational-age (SGA) fetuses with normal umbilical artery Doppler and in fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler.

  4. Maternal–Fetal Nutrient Transport in Pregnancy Pathologies: The Role of the Placenta

    Directory of Open Access Journals (Sweden)

    Kendra Elizabeth Brett

    2014-09-01

    Full Text Available Appropriate in utero growth is essential for offspring development and is a critical contributor to long-term health. Fetal growth is largely dictated by the availability of nutrients in maternal circulation and the ability of these nutrients to be transported into fetal circulation via the placenta. Substrate flux across placental gradients is dependent on the accessibility and activity of nutrient-specific transporters. Changes in the expression and activity of these transporters is implicated in cases of restricted and excessive fetal growth, and may represent a control mechanism by which fetal growth rate attempts to match availability of nutrients in maternal circulation. This review provides an overview of placenta nutrient transport with an emphasis on macro-nutrient transporters. It highlights the changes in expression and activity of these transporters associated with common pregnancy pathologies, including intrauterine growth restriction, macrosomia, diabetes and obesity, as well as the potential impact of maternal diet. Molecular signaling pathways linking maternal nutrient availability and placenta nutrient transport are discussed. How sexual dimorphism affects fetal growth strategies and the placenta’s response to an altered intrauterine environment is considered. Further knowledge in this area may be the first step in the development of targeted interventions to help optimize fetal growth.

  5. HEARING FUNCTION IN PREMATURE CHILDREN WITH INTRAUTERINE GROWTH RESTRICTION

    Directory of Open Access Journals (Sweden)

    I. V. Rakhmanova

    2012-01-01

    Full Text Available Initial audiological test was performed in 136 premature children with various gestational age born from single fetation. The children were divided into 2 groups: prematures with intrauterine growth restriction (IUGR and prematures with normal weight for their gestational age (normotrophy. The study showed that the rate of passing the initial audiological test using the method of DPOAE was lower in both ears in children with IUGR, than in children with normotrophy. The correlation between the results of initial audiological test and birth weight was found: the lower was weight, the higher was risk of absence of acoustic response registration on initial examination.

  6. Perceived psychosocial stress and gestational weight gain among women with gestational diabetes.

    Directory of Open Access Journals (Sweden)

    Ai Kubo

    Full Text Available Growing evidence links perceived stress-a potentially modifiable psychosocial risk factor-with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis to examine associations between psychosocial stress during pregnancy and gestational weight gain among women with gestational diabetes. We used baseline data from the Gestational Diabetes's Effects on Moms (GEM study: 1,353 women with gestational diabetes who delivered a term singleton within Kaiser Permanente Northern California were included. Perceived stress near the time of gestational diabetes diagnosis was measured using the validated Perceived Stress Scale (PSS10. Gestational weight gain was categorized according to the 2009 Institute of Medicine recommendations. Binomial regression analyses adjusted for gestational age and maternal age at the time of gestational diabetes diagnosis, and race/ethnicity and estimated rate ratios (RR and their 95% confidence interval (CI. Among women with a normal pregravid Body Mass Index (BMI 18.5-24.9 kg/m2, there was a significant association between high (Q4 PSS score and risk of both exceeding and gaining below the Institute of Medicine recommendations compared to those with lower stress (Q1 [adjusted RR = 2.16 95% CI 1.45-3.21; RR = 1.39 95% CI 1.01-1.91, respectively.] Among women with pregravid overweight/obesity (BMI≥25 kg/m2, there was no association. Although the temporal relationship could not be established from this study, there may be a complex interplay between psychosocial stress and gestational weight gain among women with gestational diabetes. Further studies examining stress earlier in pregnancy, risk of developing gestational diabetes and excess/inadequate gestational weight gain are warranted to clarify these complex relationships.

  7. Epigenomics, gestational programming and risk of metabolic syndrome.

    Science.gov (United States)

    Desai, M; Jellyman, J K; Ross, M G

    2015-04-01

    Epigenetic mechanisms are emerging as mediators linking early environmental exposures during pregnancy with programmed changes in gene expression that alter offspring growth and development. There is irrefutable evidence from human and animal studies that nutrient and environmental agent exposures (for example, endocrine disruptors) during pregnancy may affect fetal/newborn development resulting in offspring obesity and obesity-associated metabolic abnormalities (metabolic syndrome). This concept of 'gestational programming' is associated with alterations to the epigenome (nongenomic) rather than changes in the DNA sequence (genomic). Epigenetic alterations induced by suboptimal maternal nutrition/endocrine factors include DNA methylation, histone modifications, chromatin remodeling and/or regulatory feedback by microRNAs, all of which have the ability to modulate gene expression and promote the metabolic syndrome phenotype. Recent studies have shown tissue-specific transcriptome patterns and phenotypes not only in the exposed individual, but also in subsequent progeny. Notably, the transmission of gestational programming effects to subsequent generations occurs in the absence of continued adverse environmental exposures, thus propagating the cycle of obesity and metabolic syndrome. This phenomenon may be attributed to an extrinsic process resulting from the maternal phenotype and the associated nutrient alterations occurring within each pregnancy. In addition, epigenetic inheritance may occur through somatic cells or through the germ line involving both maternal and paternal lineages. Since epigenetic gene modifications may be reversible, understanding how epigenetic mechanisms contribute to transgenerational transmission of obesity and metabolic dysfunction is crucial for the development of novel early detection and prevention strategies for programmed metabolic syndrome. In this review we discuss the evidence in human and animal studies for the role of

  8. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial.

    Science.gov (United States)

    Adu-Afarwuah, Seth; Lartey, Anna; Okronipa, Harriet; Ashorn, Per; Ashorn, Ulla; Zeilani, Mamane; Arimond, Mary; Vosti, Stephen A; Dewey, Kathryn G

    2017-04-01

    Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women ( n = 1320; gestation) were randomly assigned to receive 60 mg Fe + 400 μg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36 wk of gestation and 6 mo postpartum were analyzed, as were changes from estimated prepregnancy values. We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women ( n = 1015) had a mean ± SD weight gain of 7.4 ± 3.7 kg and changes of -1.0 ± 1.7 cm in MUAC and -2.8 ± 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequate GWG on the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups ( P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m 2 : 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively ( P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation

  9. Supply of nutrients and productive responses in dairy cows given diets based on restrictively fermented silage

    Directory of Open Access Journals (Sweden)

    P. HUHTANEN

    2008-12-01

    Full Text Available The objective of this paper is to review research which has evaluated the feeding of dairy cows with diets containing large proportions of grass silage. In Finland, milk production systems evolved are based on the use of restrictively fermented silages. Higher potential yields, smaller production risks than with cereal grains, short grazing period and high digestibility of grasses grown in northern latitudes have facilitated this development. Factors affecting nutrient supply from these diets are discussed. Digestibility is determined mainly by the stage of maturity at harvesting and it is not markedly affected by the level of energy and protein supplementation. Intake of grass silage is influenced both by digestibility and fermentation characteristics. Efficiency of microbial synthesis is high in animals given diets based on restrictively fermented silage but rumen fermentation pattern is characterised by low molar proportions of propionate. Production responses to additional concentrate are relatively small, especially when the amount of concentrate exceeds 10 kg day-1. High substitution of silage dry matter (DM, negative associative effects on digestion and partitioning of energy towards body tissues account for small production responses. Protein supplementation has consistently increased milk protein yield but responses do not appear to be related to the level of milk production, silage crude protein content, amount of concentrate or stage of lactation. The new protein evaluation system provides an accurate prediction of protein yield with the typical Finnish dairy cow diets. The high slopes (ca. 0.5 between protein supply and milk protein yield within experiments suggest that protein supply is suboptimal and protein supplements are used with a high efficiency.;

  10. Association of GSTs polymorphisms with risk of gestational diabetes mellitus.

    Science.gov (United States)

    Li, Yan; Li, Shaoru; Zhai, Qianqian; Hai, Jie; Wang, Di; Cao, Meng; Zhang, Qinggui

    2015-01-01

    We conducted a case-control study to investigate the association between GSTM1, GSTT1 and GSTP1 IIe105Val polymorphisms and development of gestational diabetes mellitus in a Chinese population. A total of 320 patients with gestational diabetes mellitus and 358 pregnancy subjects were consecutively collected between January 2013 and December 2014. Genotyping for detection of GSTM1, GSTT1 and GSTP1 IIe105Val was conducted by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) method. By Fisher's exact test, we found that the genotype distributions of GSTP1 IIe105Val were in line with the Hardy-Weinberg equilibrium in control subjects (P=0.57). By Chi-square test, we found significant differences in the genotype distributions of GSTM1 (χ(2)=11.49, P=0.001) and GSTT1 (χ(2)=18.50, Pgestational diabetes mellitus when compared with the present genotype, and the adjusted Ors (95% CI) were 1.71 (1.24-2.36) and 2.00 (1.44-2.79), respectively. However, the GSTP1 IIe105Val polymorphism was not associated with an elevated risk of gestational diabetes mellitus. In conclusion, we suggest that the GSTM1 null genotype and GSTT1 null genotype are correlated with an increased risk of gestational diabetes mellitus in a Chinese population.

  11. Reactive oxygen species are involved in lipopolysaccharide-induced intrauterine growth restriction and skeletal development retardation in mice.

    Science.gov (United States)

    Xu, De-Xiang; Chen, Yuan-Hua; Zhao, Lei; Wang, Hua; Wei, Wei

    2006-12-01

    Maternal infection is a cause of adverse developmental outcomes including embryonic resorption, intrauterine fetal death, and preterm labor. Lipopolysaccharide-induced developmental toxicity at early gestational stages has been well characterized. The purpose of the present study was to investigate the effects of maternal lipopolysaccharide exposure at late gestational stages on intrauterine fetal growth and skeletal development and to assess the potential role of reactive oxygen species in lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation. The timed pregnant CD-1 mice were intraperitoneally injected with lipopolysaccharide (25 to 75 microg/kg per day) on gestational day 15 to 17. To investigate the role of reactive oxygen species on lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation, the pregnant mice were injected with alpha-phenyl-N-t-butylnitrone (100 mg/kg, intraperitoneally) at 30 minutes before lipopolysaccharide (75 microg/kg per day, intraperitoneally), followed by an additional dose of alpha-phenyl-N-t-butylnitrone (50 mg/kg, intraperitoneally) at 3 hours after lipopolysaccharide. The number of live fetuses, dead fetuses, and resorption sites was counted on gestational day 18. Live fetuses in each litter were weighed. Crown-rump and tail lengths were examined and skeletal development was evaluated. Maternal lipopolysaccharide exposure significantly increased fetal mortality, reduced fetal weight and crown-rump and tail lengths of live fetuses, and retarded skeletal ossification in caudal vertebrae, anterior and posterior phalanges, and supraoccipital bone in a dose-dependent manner. Alpha-phenyl-N-t-butylnitrone, a free radical spin-trapping agent, almost completely blocked lipopolysaccharide-induced fetal death (63.2% in lipopolysaccharide group versus 6.5% in alpha-phenyl-N-t-butylnitrone + lipopolysaccharide group, P intrauterine growth restriction

  12. Gestational diabetes

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000896.htm Gestational diabetes To use the sharing features on this page, please enable JavaScript. Gestational diabetes is high blood sugar (glucose) that starts or ...

  13. Impact of energy and protein restriction on energy expenditure of gestation in twin-bearing ewes

    DEFF Research Database (Denmark)

    Kiani, Alishir; Chwalibog, Andrzej; Tauson, Anne-Helene

    2008-01-01

    weeks of gestation. Whole-body energy expenditure (EE) and retained energy (RE) were calculated from respiratory gaseous exchange combined with nitrogen balance at 7, 5 and 2 weeks prepartum. Twin lamb birth weight was lower in the R group compared to those in the A group (7.9 ± 0.31 vs 9.3 ± 0.19 kg, P...

  14. Comparison of gestational dating methods and implications ...

    Science.gov (United States)

    OBJECTIVES: Estimating gestational age is usually based on date of last menstrual period (LMP) or clinical estimation (CE); both approaches introduce potential bias. Differences in methods of estimation may lead to misclassificat ion and inconsistencies in risk estimates, particularly if exposure assignment is also gestation-dependent. This paper examines a'what-if' scenario in which alternative methods are used and attempts to elucidate how method choice affects observed results.METHODS: We constructed two 20-week gestational age cohorts of pregnancies between 2000 and 2005 (New Jersey, Pennsylvania, Ohio, USA) using live birth certificates : one defined preterm birth (PTB) status using CE and one using LMP. Within these, we estimated risk for 4 categories of preterm birth (PTBs per 106 pregnancies) and risk differences (RD (95% Cl s)) associated with exposure to particulate matter (PM2. 5).RESULTS: More births were classified preterm using LMP (16%) compared with CE (8%). RD divergences increased between cohorts as exposure period approached delivery. Among births between 28 and 31 weeks, week 7 PM2.5 exposure conveyed RDs of 44 (21 to 67) for CE and 50 (18 to 82) for LMP populations, while week 24 exposure conveyed RDs of 33 (11 to 56) and -20 (-50 to 10), respectively.CONCLUSIONS: Different results from analyses restricted to births with both CE and LMP are most likely due to differences in dating methods rather than selection issues. Results are sensitive t

  15. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial123

    Science.gov (United States)

    Vosti, Stephen A; Dewey, Kathryn G

    2017-01-01

    Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women (n = 1320; gestation) were randomly assigned to receive 60 mg Fe + 400 μg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36 wk of gestation and 6 mo postpartum were analyzed, as were changes from estimated prepregnancy values. We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women (n = 1015) had a mean ± SD weight gain of 7.4 ± 3.7 kg and changes of −1.0 ± 1.7 cm in MUAC and −2.8 ± 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequate GWG on the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups (P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m2: 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively (P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation is

  16. Heightened risk of preterm birth and growth restriction after a first-born son.

    Science.gov (United States)

    Bruckner, Tim A; Mayo, Jonathan A; Gould, Jeffrey B; Stevenson, David K; Lewis, David B; Shaw, Gary M; Carmichael, Suzan L

    2015-10-01

    In Scandinavia, delivery of a first-born son elevates the risk of preterm delivery and intrauterine growth restriction of the next-born infant. External validity of these results remains unclear. We test this hypothesis for preterm delivery and growth restriction using the linked California birth cohort file. We examined the hypothesis separately by race and/or ethnicity. We retrieved data on 2,852,976 births to 1,426,488 mothers with at least two live births. Our within-mother tests applied Cox proportional hazards (preterm delivery, defined as less than 37 weeks gestation) and linear regression models (birth weight for gestational age percentiles). For non-Hispanic whites, Hispanics, Asians, and American Indian and/or Alaska Natives, analyses indicate heightened risk of preterm delivery and growth restriction after a first-born male. The race-specific hazard ratios for preterm delivery range from 1.07 to 1.18. Regression coefficients for birth weight for gestational age percentile range from -0.73 to -1.49. The 95% confidence intervals for all these estimates do not contain the null. By contrast, we could not reject the null for non-Hispanic black mothers. Whereas California findings generally support those from Scandinavia, the null results among non-Hispanic black mothers suggest that we do not detect adverse outcomes after a first-born male in all racial and/or ethnic groups. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. ACR Appropriateness Criteria® Multiple Gestations.

    Science.gov (United States)

    Glanc, Phyllis; Nyberg, David A; Khati, Nadia J; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara Lynn; Poder, Liina; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M

    2017-11-01

    Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model. Screening for congenital heart disease is warranted in monochorionic twins because they have an increased rate of congenital cardiac anomalies. In addition, monochorionic twins have a higher risk of developing cardiac abnormalities in later gestation related to right ventricular outflow obstruction, in particular the subgroups with twin-twin transfusion syndrome or selective intrauterine growth restriction. Monochorionic twins have unique complications including twin-to-twin transfusion syndrome, twin embolization syndrome, and acardius, or twin-reversed arterial perfusion sequence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or

  18. Plasma Levels of Alanine Aminotransferase in the First Trimester Identify High Risk Chinese Women for Gestational Diabetes

    OpenAIRE

    Leng, Junhong; Zhang, Cuiping; Wang, Peng; Li, Nan; Li, Weiqin; Liu, Huikun; Zhang, Shuang; Hu, Gang; Yu, Zhijie; Ma, Ronald CW; Chan, Juliana CN; Yang, Xilin

    2016-01-01

    Alanine aminotransferase (ALT) predicts type 2 diabetes but it is uncertain whether it also predicts gestational diabetes mellitus (GDM). We recruited 17359 Chinese women with ALT measured in their first trimester. At 24?28?weeks of gestation, all women underwent a 50-gram 1-hour glucose challenge test (GCT) followed by a 75-gram 2-hour oral glucose tolerance test if GCT result was ?7.8?mmol/L. Restricted cubic spline analysis was used to examine full-range risk associations of ALT levels wit...

  19. Nutritional intra-amniotic therapy increases survival in a rabbit model of fetal growth restriction

    Science.gov (United States)

    Illa, Miriam; Pla, Laura; Zamora, Monica; Crispi, Fatima; Gratacos, Eduard

    2018-01-01

    Objective To evaluate the perinatal effects of a prenatal therapy based on intra-amniotic nutritional supplementation in a rabbit model of intrauterine growth restriction (IUGR). Methods IUGR was surgically induced in pregnant rabbits at gestational day 25 by ligating 40–50% of uteroplacental vessels of each gestational sac. At the same time, modified-parenteral nutrition solution (containing glucose, amino acids and electrolytes) was injected into the amniotic sac of nearly half of the IUGR fetuses (IUGR-T group n = 106), whereas sham injections were performed in the rest of fetuses (IUGR group n = 118). A control group without IUGR induction but sham injection was also included (n = 115). Five days after the ligation procedure, a cesarean section was performed to evaluate fetal cardiac function, survival and birth weight. Results Survival was significantly improved in the IUGR fetuses that were treated with intra-amniotic nutritional supplementation as compared to non-treated IUGR animals (survival rate: controls 71% vs. IUGR 44% p = 0.003 and IUGR-T 63% vs. IUGR 44% p = 0.02), whereas, birth weight (controls mean 43g ± SD 9 vs. IUGR 36g ± SD 9 vs. IUGR-T 35g ± SD 8, p = 0.001) and fetal cardiac function were similar among the IUGR groups. Conclusion Intra-amniotic injection of a modified-parenteral nutrient solution appears to be a promising therapy for reducing mortality among IUGR. These results provide an opportunity to develop new intra-amniotic nutritional strategies to reach the fetus by bypassing the placental insufficiency. PMID:29466434

  20. Variations in resting energy expenditure: impact on gestational weight gain.

    Science.gov (United States)

    Berggren, E K; O'Tierney-Ginn, P; Lewis, S; Presley, L; De-Mouzon, S Hauguel; Catalano, P M

    2017-10-01

    mass (r = -0.34, P = .02) and gestational weight gain (r = -0.29, P = .04). From before pregnancy through late gestation, the increase in resting energy expenditure (kilocalories per day) correlated positively with the change in fat-free mass (r = 0.44, P = .002) and negatively with the change in fat mass (r = -0.27, P = .06). The change in resting energy expenditure from before conception through late gestation correlated positively with changes in fat-free mass but negatively with fat mass accrual. Women with smaller increases in resting energy expenditure across pregnancy had greater gestational weight gain, specifically more adipose tissue. These data suggest that resting energy expenditure is an important factor in gestational weight gain, particularly excess fat mass accrual. Future lifestyle intervention studies need to consider clinically feasible means of estimating resting energy expenditure and, in response, tailor nutrient intake and composition recommendations. Implementing and testing such interventions would be a novel approach to improve compliance with gestational weight gain guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Role of the Small Intestine in Developmental Programming: Impact of Maternal Nutrition on the Dam and Offspring123

    Science.gov (United States)

    Meyer, Allison M; Caton, Joel S

    2016-01-01

    Small-intestinal growth and function are critical for optimal animal growth and health and play a major role in nutrient digestion and absorption, energy and nutrient expenditure, and immunological competence. During fetal and perinatal development, the small intestine is affected by the maternal environment and nutrient intake. In ruminants, altered small-intestinal mass, villi morphology, hypertrophy, hyperplasia, vascularity, and gene expression have been observed as a result of poor gestational nutrition or intrauterine growth restriction. Although many of these data come from fetal stages, data have also demonstrated that nutrition during mid- and late gestation affects lamb small-intestinal growth, vascularity, digestive enzyme activity, and gene expression at 20 and 180 d of age as well. The small intestine is known to be a highly plastic tissue, changing with nutrient intake and physiological state even in adulthood, and the maternal small intestine adapts to pregnancy and advancing gestation. In ruminants, the growth, vascularity, and gene expression of the maternal small intestine also adapt to the nutritional plane and specific nutrient intake such as high selenium during pregnancy. These changes likely alter both pre- and postnatal nutrient delivery to offspring. More research is necessary to better understand the role of the offspring and maternal small intestines in whole-animal responses to developmental programming, but programming of this plastic tissue seems to play a dynamic role in gestational nutrition impacts on the whole animal. PMID:27180380

  2. Placental mesenchymal dysplasia and intrauterine fetal growth restriction with doppler velocimetry alterations - a case report

    Directory of Open Access Journals (Sweden)

    Paula Vendruscolo Tozatti

    2014-06-01

    Full Text Available Placental mesenchymal dysplasia (PMD is a rare placental abnormality. We report a case of PMD associated with intrauterine growth restriction (IUGR, which was diagnosed by an ultrasound scan during the second trimester of pregnancy. A 36-year-old primiparous woman with signs of placental chorioangioma was referred to our hospital at the 23th gestational week. An ultrasonography revealed a small-for-gestational-age fetus with a large multicystic placenta. A serial Doppler sonographic assessment of umbilical and uterine artery blood flow showed a compromised fetus. A female, small-for-gestational-age baby was delivered by c-section at 28 weeks, and PMD was histopathologically confirmed.

  3. The effect of foetal growth restriction on the development of migraine and tension-type headache in adulthood. The HUNT Study.

    Directory of Open Access Journals (Sweden)

    Sigrid Børte

    Full Text Available There is little knowledge about how factors early in life affect the development of migraine and tension-type headache. We aimed to examine whether growth restriction in utero is associated with development of migraine and frequent tension-type headache in adults.The population-based Nord-Trøndelag Health Study (HUNT 3 contained a validated headache questionnaire, which differentiated between migraine and tension-type headache. These data were linked to information on weight and gestational age at birth from the Norwegian Medical Birth Registry. In total 4557 females and 2789 males, aged 19-41 years, were included in this registry-based study. Participants were categorized as appropriate for gestational age (AGA, 10th-90th percentile, small for gestational age (SGA, 3rd-10th percentile or very small for gestational age (VSGA, < 3rd percentile. Logistic regression was used to calculate odds ratios (OR with 95% confidence intervals (CI for migraine and tension-type headache, with exposure being growth restriction at birth.The effect of growth restriction on migraine was modified by sex, with a significant association in males (p<0.001, but not in females (p = 0.20. In particular, males born VSGA were at increased risk of developing migraine (OR 2.73, 95% CI 1.63-4.58, p<0.001, with an intermediate risk among those born SGA (OR 1.50, 95% CI 0.96-2.35, p = 0.08 compared to those born AGA. There was no significant association between growth restriction and frequent TTH (p = 0.051.Growth restriction was associated with increased risk of migraine in adulthood among males, but not among females. This suggests that migraine might, in part, be influenced by early life events, and that males seem to be particularly vulnerable.

  4. Role of fetal nutrient restriction and postnatal catch-up growth on structural and mechanical alterations of rat aorta.

    Science.gov (United States)

    Gutiérrez-Arzapalo, Perla Y; Rodríguez-Rodríguez, Pilar; Ramiro-Cortijo, David; López de Pablo, Ángel L; López-Giménez, María Rosario; Condezo-Hoyos, Luis; Greenwald, Stephen E; González, Maria Del Carmen; Arribas, Silvia M

    2017-12-26

    Intrauterine growth restriction (IUGR), induced by maternal undernutrition, leads to impaired aortic development. This is followed by hypertrophic remodelling associated with accelerated growth during lactation. Fetal nutrient restriction is associated with increased aortic compliance at birth and at weaning, but not in adult animals. This mechanical alteration may be related to a decreased perinatal collagen deposition. Aortic elastin scaffolds purified from young male and female IUGR animals also exhibit increased compliance, only maintained in adult IUGR females. These mechanical alterations may be related to differences in elastin deposition and remodelling. Fetal undernutrition induces similar aortic structural and mechanical alterations in young male and female rats. Our data argue against an early mechanical cause for the sex differences in hypertension development induced by maternal undernutrition. However, the larger compliance of elastin in adult IUGR females may contribute to the maintenance of a normal blood pressure level. Fetal undernutrition programmes hypertension development, males being more susceptible. Deficient fetal elastogenesis and vascular growth is a possible mechanism. We investigated the role of aortic mechanical alterations in a rat model of hypertension programming, evaluating changes at birth, weaning and adulthood. Dams were fed ad libitum (Control) or 50% of control intake during the second half of gestation (maternal undernutrition, MUN). Offspring aged 3 days, 21 days and 6 months were studied. Blood pressure was evaluated in vivo. In the thoracic aorta we assessed gross structure, mechanical properties (intact and purified elastin), collagen and elastin content and internal elastic lamina (IEL) organization. Only adult MUN males developed hypertension (systolic blood pressure: MUN males  = 176.6 ± 5.6 mmHg; Control males  = 136.1 ± 4.9 mmHg). At birth MUN rats were lighter, with smaller aortic cross-sectional area

  5. Left ventricular dimensions, systolic functions, and mass in term neonates with symmetric and asymmetric intrauterine growth restriction.

    Science.gov (United States)

    Cinar, Bahar; Sert, Ahmet; Gokmen, Zeynel; Aypar, Ebru; Aslan, Eyup; Odabas, Dursun

    2015-02-01

    Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we aimed to evaluate left ventricular dimensions, systolic functions, and mass in neonates with symmetric and asymmetric intrauterine growth restriction. We also assessed associated maternal risk factors, and compared results with healthy appropriate for gestational age neonates. In all, 62 asymmetric intrauterine growth restriction neonates, 39 symmetric intrauterine growth restriction neonates, and 50 healthy appropriate for gestational age neonates were evaluated by transthoracic echocardiography. The asymmetric intrauterine growth restriction group had significantly lower left ventricular end-systolic and end-diastolic diameters and posterior wall diameter in systole and diastole than the control group. The symmetric intrauterine growth restriction group had significantly lower left ventricular end-diastolic diameter than the control group. All left ventricular dimensions were lower in the asymmetric intrauterine growth restriction neonates compared with symmetric intrauterine growth restriction neonates (p>0.05), but not statistically significant except left ventricular posterior wall diameter in diastole (3.08±0.83 mm versus 3.54 ±0.72 mm) (pintrauterine growth restriction groups had significantly lower relative posterior wall thickness (0.54±0.19 versus 0.48±0.13 versus 0.8±0.12), left ventricular mass (9.8±4.3 g versus 8.9±3.4 g versus 22.2±5.7 g), and left ventricular mass index (63.6±29.1 g/m2 versus 54.5±24.4 g/m2 versus 109±28.8 g/m2) when compared with the control group. Our study has demonstrated that although neonates with both symmetric and asymmetric intrauterine growth restriction had lower left ventricular dimensions, relative

  6. Fetal growth disorders in twin gestations.

    LENUS (Irish Health Repository)

    Breathnach, Fionnuala M

    2012-06-01

    Twin growth is frequently mismatched. This review serves to explore the pathophysiologic mechanisms that underlie growth aberrations in twin gestations, the prenatal recognition of abnormal twin growth, and the critical importance of stratifying management of abnormal twin growth by chorionicity. Although poor in utero growth of both twins may reflect maternal factors resulting in global uteroplacental dysfunction, discordant twin growth may be attributed to differences in genetic potential between co-twins, placental dysfunction confined to one placenta only, or one placental territory within a shared placenta. In addition, twin-twin transfusion syndrome represents a distinct entity of which discordant growth is a common feature. Discordant growth is recognized as an independent risk factor for adverse perinatal outcome. Intertwin birth weight disparity of 18% or more should be considered to represent a discordance threshold, which serves as an independent risk factor for adverse perinatal outcome. At this cutoff, perinatal morbidity is found to increase both for the larger and the smaller twin within a discordant pair. There remains uncertainty surrounding the sonographic parameters that are most predictive of discordance. Although heightening of fetal surveillance in the face of discordant twin growth follows the principles applied to singleton gestations complicated by fetal growth restriction, the timing of intervention is largely influenced by chorionicity.

  7. Association analysis of calpain 10 gene variants/haplotypes with gestational diabetes mellitus among Mexican women.

    Science.gov (United States)

    Castro-Martínez, Anna Gabriela; Sánchez-Corona, José; Vázquez-Vargas, Adriana Patricia; García-Zapién, Alejandra Guadalupe; López-Quintero, Andres; Villalpando-Velazco, Héctor Javier; Flores-Martínez, Silvia Esperanza

    2018-02-28

    Gestational diabetes mellitus (GDM) is a metabolically complex disease with major genetic determinants. GDM has been associated with insulin resistance and dysfunction of pancreatic beta cells, so the GDM candidate genes are those that encode proteins modulating the function and secretion of insulin, such as that for calpain 10 (CAPN10). This study aimed to assess whether single nucleotide polymorphism (SNP)-43, SNP-44, SNP-63, and the indel-19 variant, and specific haplotypes of the CAPN10 gene were associated with gestational diabetes mellitus. We studied 116 patients with gestational diabetes mellitus and 83 women with normal glucose tolerance. Measurements of anthropometric and biochemical parameters were performed. SNP-43, SNP-44, and SNP-63 were identified by polymerase chain reaction (PCR)-restriction fragment length polymorphisms, while the indel-19 variant was detected by TaqMan qPCR assays.  The allele, genotype, and haplotype frequencies of the four variants did not differ significantly between women with gestational diabetes mellitus and controls. However, in women with gestational diabetes mellitus, glucose levels were significantly higher bearing the 3R/3R genotype than in carriers of the 3R/2R genotype of the indel-19 variant (p = 0.006). In conclusion, the 3R/3R genotype of the indel-19 variant of the CAPN-10 gene influenced increased glucose levels in these Mexican women with gestational diabetes mellitus.

  8. Premature brain aging in humans exposed to maternal nutrient restriction during early gestation

    NARCIS (Netherlands)

    Franke, Katja; Gaser, Christian; de Rooij, Susanne R.; Schwab, Matthias; Roseboom, Tessa J.

    2017-01-01

    Prenatal exposure to undernutrition is widespread in both developing and industrialized countries, causing irreversible damage to the developing brain, resulting in altered brain structure and decreased cognitive function during adulthood. The Dutch famine in 1944/45 was a humanitarian disaster, now

  9. CONSUMO, DIGESTIBILIDADE APARENTE E GLICEMIA DE BORREGAS NULÍPARAS GESTANTES E SUBMETIDAS A DOIS MANEJOS NUTRICIONAIS

    Directory of Open Access Journals (Sweden)

    Gilberto de Lima Macedo Junior

    2014-07-01

    Full Text Available The goal of this paper was to evaluate the intake and digestibility of nutrients and basal glucose of nulliparous ewe lambs in two stages of gestation and submited to two nutritional management: restricted and unrestricted. The experiment was conducted at the Veterinary School of the Federal University of Minas Gerais, in the laboratory of Animal Metabolism and Calorimetry in the months of June and July of 2006. Twenty nulliparous ewe lambs were used and they were divided into two nutritional management (restricted and unrestricted. The animals were kept in metabolism cages fitted with trough, water cooler (plastic bucket and salt shaker. The diets were composed of Tifton 85 hay chopped, experimental concentrate (corn bran, soybean meal and limestone and when needed was added more soybean meal to close the rations. The nutritional requirements were based on National Research Council (1985 and was respected division of gestation according to the recommendation of this committee. For animals kept in nutritional restriction were removed 15% of energy requirements in the form of total digestible nutrients (TDN and crude protein. The two experimental periods (100 days and 130 days of gestation had a duration of 20 days each, with 15 days for adaptation and five collections. The animals were distributed in a completely randomized design in a factorial arrangement (two nutritional management and two periods of gestation and assessments were made in the same animal. In the case of glucose were evaluated at 100, 110, 120, 130 and 140 days of gestation for 24 hours at the following times: 0, 3, 6, 9, 12, 15, 18, 21 and 24. The first collection (time 0 was performed before the first feeding . Among the times 6 and 9 animals received a second feed of the day. The dry matter intake (DMI in grams/day increased significantly between periods of gestation. There was no effect of nutritional management on dry matter digestibility (DMD as a function of nutrition

  10. Challenges in nourishing the intrauterine growth-restricted foetus - Lessons learned from studies in the intrauterine growth-restricted foetal sheep.

    Science.gov (United States)

    Hay, William W; Brown, Laura D; Rozance, Paul J; Wesolowski, Stephanie R; Limesand, Sean W

    2016-08-01

    Previous attempts to improve growth and development of the intrauterine growth-restricted (IUGR) foetus during pregnancy have not worked or caused harm. Our research identifies tissue-specific mechanisms underlying foetal growth restriction and then tests strategies to improve growth and ameliorate many of the metabolic problems before the infant is born. The goal of our studies is to reduce the impact of foetal growth restriction at critical stages of development on the lifelong complications of IUGR offspring. Defining specific mechanisms that cause growth restriction in the foetus might identify specific nutrients and hormones that could be given to the mother to improve foetal growth and reduce metabolic complications, using strategies first tested in our IUGR animal model. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. Nutrient regulation in a predator, the wolf spider Pardosa prativaga

    DEFF Research Database (Denmark)

    Jensen, Kim; Mayntz, David; Toft, Søren

    2011-01-01

    Nutrient balancing is well known in herbivores and omnivores, but has only recently been demonstrated in predators. To test how a predator might regulate nutrients when the prey varies in nutrient composition, we restricted juvenile Pardosa prativaga wolf spiders to diets of one of six fruit fly......, Drosophila melanogaster, prey types varying in lipid:protein composition during their second instar. We collected all fly remnants to estimate food and nutrient intake over each meal. The spiders adjusted their capture rate and nutrient extraction in response to prey mass and nutrient composition...... irrespective of energy intake. Intake was initially regulated to a constant lipid plus protein mass, but later spiders fed on prey with high proportions of protein increased consumption relative to spiders fed on other prey types. This pattern indicates that the spiders were prepared to overconsume vast...

  12. Endoglin in pregnancy complicated by fetal intrauterine growth restriction in normotensive and preeclamptic pregnant women: a comparison between preeclamptic patients with appropriate-for-gestational-age weight infants and healthy pregnant women.

    Science.gov (United States)

    Laskowska, Marzena; Laskowska, Katarzyna; Oleszczuk, Jan

    2012-06-01

    The aim of this study was to determine the maternal serum endoglin concentration in pregnancies with intrauterine growth restriction (IUGR) in the presence or absence of preeclampsia and to compare the results with preeclamptic pregnant women with appropriate-for-gestational-age weight infants and with healthy pregnant controls. The study was performed on 52 normotensive pregnant patients with pregnancy complicated by isolated IUGR, 33 patients with preeclampsia complicated by IUGR and 33 preeclamptic patients with appropriate-for-gestational-age weight infants. The control group consisted of 54 healthy normotensive pregnant patients with singleton uncomplicated pregnancies. The maternal serum endoglin concentrations were determined using a sandwich enzyme-linked immunosorbent assay assay. Our study revealed increased levels of endoglin in the serum of women with normotensive pregnancy complicated by isolated IUGR, and in both groups of preeclamptic patients with and without IUGR. The levels of endoglin were the highest in pregnancy complicated by fetal intrauterine growth restriction (IUGR) in the course of preeclampsia. The mean values were 12.2 ± 4.3 ng/ml in the IUGR group, 14.1 ± 3.6 ng/ml in preeclamptic patients with normal intrauterine fetal growth, 15.1 ± 3.2 ng/ml in preeclamptic pregnant women with IUGR and 10.6 ± 3.7 ng/ml in the healthy controls. We also found positive correlations between serum endoglin levels and systolic and diastolic blood pressure and inverse correlations between maternal endoglin and infant birth weight. Our results suggest that increased endoglin concentration may be at least responsible for the pathogenesis of preeclampsia and/or intrauterine fetal growth restriction. It seems that the pathomechanism underlying the development of preeclampsia and isolated IUGR is similar, but that their beginning or intensity may be different in these two pregnancy complications. The positive correlation between endoglin and

  13. Prenatal magnetic resonance imaging: brain normal linear biometric values below 24 gestational weeks

    International Nuclear Information System (INIS)

    Parazzini, C.; Righini, A.; Triulzi, F.; Rustico, M.; Consonni, D.

    2008-01-01

    Prenatal magnetic resonance (MR) imaging is currently used to measure quantitative data concerning brain structural development. At present, morphometric MR imaging studies have been focused mostly on the third trimester of gestational age. However, in many countries, because of legal restriction on abortion timing, the majority of MR imaging fetal examination has to be carried out during the last part of the second trimester of pregnancy (i.e., before the 24th week of gestation). Accurate and reliable normative data of the brain between 20 and 24 weeks of gestation is not available. This report provides easy and practical parametric support to assess those normative data. From a database of 1,200 fetal MR imaging studies, we retrospectively selected 84 studies of the brain of fetuses aged 20-24 weeks of gestation that resulted normal on clinical and radiological follow-up. Fetuses with proved or suspected infections, twin pregnancy, and fetuses of mothers affected by pathology that might have influenced fetal growth were excluded. Linear biometrical measurements of the main cerebral structures were obtained by three experienced pediatric neuroradiologists. A substantial interobserver agreement for each measurements was reached, and normative data with median, maximum, and minimum value were obtained for brain structures. The knowledge of a range of normality and interindividual variability of linear biometrical values for the developing brain between 20th and 24th weeks of gestation may be valuable in assessing normal brain development in clinical settings. (orig.)

  14. Prenatal magnetic resonance imaging: brain normal linear biometric values below 24 gestational weeks

    Energy Technology Data Exchange (ETDEWEB)

    Parazzini, C.; Righini, A.; Triulzi, F. [Children' s Hospital ' ' V. Buzzi' ' , Department of Radiology and Neuroradiology, Milan (Italy); Rustico, M. [Children' s Hospital ' ' V. Buzzi' ' , Department of Obstetrics and Gynecology, Milan (Italy); Consonni, D. [Fondazione IRCCS Ospedale Maggiore Policlinico, Unit of Epidemiology, Milan (Italy)

    2008-10-15

    Prenatal magnetic resonance (MR) imaging is currently used to measure quantitative data concerning brain structural development. At present, morphometric MR imaging studies have been focused mostly on the third trimester of gestational age. However, in many countries, because of legal restriction on abortion timing, the majority of MR imaging fetal examination has to be carried out during the last part of the second trimester of pregnancy (i.e., before the 24th week of gestation). Accurate and reliable normative data of the brain between 20 and 24 weeks of gestation is not available. This report provides easy and practical parametric support to assess those normative data. From a database of 1,200 fetal MR imaging studies, we retrospectively selected 84 studies of the brain of fetuses aged 20-24 weeks of gestation that resulted normal on clinical and radiological follow-up. Fetuses with proved or suspected infections, twin pregnancy, and fetuses of mothers affected by pathology that might have influenced fetal growth were excluded. Linear biometrical measurements of the main cerebral structures were obtained by three experienced pediatric neuroradiologists. A substantial interobserver agreement for each measurements was reached, and normative data with median, maximum, and minimum value were obtained for brain structures. The knowledge of a range of normality and interindividual variability of linear biometrical values for the developing brain between 20th and 24th weeks of gestation may be valuable in assessing normal brain development in clinical settings. (orig.)

  15. Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: Systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Langejans Marloes

    2008-08-01

    Full Text Available Abstract Background Reliable antenatal identification of pre-eclampsia and small for gestational age is crucial to judicious allocation of monitoring resources and use of preventative treatment with the prospect of improving maternal/perinatal outcome. The purpose of this systematic review was to determine the accuracy of five serum analytes used in Down's serum screening for prediction of pre-eclampsia and/or small for gestational age. Methods The data sources included Medline, Embase, Cochrane library, Medion (inception to February 2007, hand searching of relevant journals, reference list checking of included articles, contact with experts. Two reviewers independently selected the articles in which the accuracy of an analyte used in Downs's serum screening before the 25th gestational week was associated with the occurrence of pre-eclampsia and/or small for gestational age without language restrictions. Two authors independently extracted data on study characteristics, quality and results. Results Five serum screening markers were evaluated. 44 studies, testing 169,637 pregnant women (4376 pre-eclampsia cases and 86 studies, testing 382,005 women (20,339 fetal growth restriction cases met the selection criteria. The results showed low predictive accuracy overall. For pre-eclampsia the best predictor was inhibin A>2.79MoM positive likelihood ratio 19.52 (8.33,45.79 and negative likelihood ratio 0.30 (0.13,0.68 (single study. For small for gestational age it was AFP>2.0MoM to predict birth weight th centile with birth There were methodological and reporting limitations in the included studies thus studies were heterogeneous giving pooled results with wide confidence intervals. Conclusion Down's serum screening analytes have low predictive accuracy for pre-eclampsia and small for gestational age. They may be a useful means of risk assessment or of use in prediction when combined with other tests.

  16. Respostas pulmonares à restrição nutricional e à hiperoxia em coelhos prematuros Pulmonary responses to nutritional restriction and hyperoxia in premature rabbits

    Directory of Open Access Journals (Sweden)

    Marta M. G. B. Mataloun

    2006-06-01

    Full Text Available OBJETIVOS: Este modelo experimental foi desenvolvido para analisar os efeitos da restrição nutricional e da hiperoxia, durante 11 dias, sobre o peso e a morfometria pulmonares, em coelhos prematuros. MÉTODOS: Após cesárea, coelhos New Zealand White com idade gestacional de 28 dias foram randomizados nos seguintes grupos: dieta controle e ar ambiente, dieta controle e hiperoxia (> 95% O2, restrição nutricional e ar ambiente e restrição nutricional e hiperoxia (>95% O2. A restrição nutricional foi obtida com uma redução em 30% de todos os nutrientes da dieta controle. As lâminas de pulmão foram coradas com hematoxilina-eosina, resorcina-orceína modificada e picrosírius, sendo posteriormente realizada a análise morfométrica RESULTADOS: Observou-se um menor ganho de peso no grupo restrição nutricional e hiperoxia (p OBJECTIVES: To analyze the effects of nutritional restriction and hyperoxia on lung weight and pulmonary morphometry in premature rabbits during the first 11 days of life METHODS: New Zealand White rabbits were delivered by C-section at 28 days' gestational age and randomized into four groups: control diet and room air, control diet and hyperoxia (> 95% O2, nutritional restriction and room air and nutritional restriction and hyperoxia (> 95% O2. Nutritional restriction was achieved by reducing all nutrients by 30% in comparison with the control diet. Lung tissue slides were stained with hematoxylin-eosin, modified resorcin-orcein and picrosirius, before morphometric analysis was performed. RESULTS: From the fourth day onwards, less weight was gained by the nutritional restriction and hyperoxia group (p < 0.001 and from the sixth day on, by the nutritional restriction and room air group (p < 0.001, in comparison with their respective control groups. Nutritional restriction decreased alveoli number (p < 0.001 and collagen deposition (p < 0.001. Hyperoxia was responsible for reductions in number of alveoli (p < 0

  17. Effect of GSTM1, GSTT1, and GSTP1 IIe105Val polymorphisms on susceptiblity to gestational diabetes mellitus.

    Science.gov (United States)

    Qiu, Y H; Xu, Y L; Zhang, W H

    2016-06-03

    We investigate the role of the GSTM1, GSTT1, and GSTP1 IIe105Val genetic polymorphisms in the susceptibility to gestational diabetes mellitus. A total of 223 pregnant women with gestational diabetes mellitus and 265 healthy pregnant women were examined at The Second Affiliated Hospital of Shaanxi University of Chinese Medicine from May 2013 to November 2013. Genotyping for detection of GSTM1, GSTT1, and GSTP1 IIe105Val polymorphisms was conducted using the restriction fragment length polymorphism-polymerase chain reaction. There were statistically significant differences between patients with gestational diabetes mellitus and control subjects in terms of age (χ(2) = 6.68, P = 0.01) and BMI (t = 7.56, P gestational diabetes mellitus compared to the present genotype [adjusted OR (95%CI) = 1.85 (1.26-2.72)]. However, the unconditional logistic analysis revealed that GSTT1 and GSTP1 IIe105Val polymorphisms could not influence the risk of gestational diabetes mellitus in a Chinese population. In summary, we suggest that the GSTM1 gene polymorphism could influence the susceptibility to gestational diabetes mellitus in a Chinese population.

  18. Association between maternal vascular murmur and the small-for-gestational-age fetus with abnormal umbilical artery Doppler flow

    DEFF Research Database (Denmark)

    Riknagel, Diana; Farlie, Richard; Hedegaard, Morten

    2017-01-01

    OBJECTIVE: To investigate the association between maternal vascular murmurs (MVMs) and fetal growth restriction (defined as small-for-gestational-age [SGA] fetus) and abnormal Doppler pulsatility index (PI) of the uterine and/or umbilical arteries. METHODS: A cross-sectional study of women aged 1...

  19. Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy.

    Science.gov (United States)

    Cohen, Emily; Wong, Flora Y; Horne, Rosemary S C; Yiallourou, Stephanie R

    2016-06-01

    Intrauterine growth restriction (IUGR) refers to the situation where a fetus does not grow according to its genetic growth potential. One of the main causes of IUGR is uteroplacental vascular insufficiency. Under these circumstances of chronic oxygen and nutrient deprivation, the growth-restricted fetus often displays typical circulatory changes, which in part represent adaptations to the suboptimal intrauterine environment. These fetal adaptations aim to preserve oxygen and nutrient supply to vital organs such as the brain, the heart, and the adrenals. These prenatal circulatory adaptations are thought to lead to an altered development of the cardiovascular system and "program" the fetus for life long cardiovascular morbidities. In this review, we discuss the alterations to cardiovascular structure, function, and control that have been observed in growth-restricted fetuses, neonates, and infants following uteroplacental vascular insufficiency. We also discuss the current knowledge on early life surveillance and interventions to prevent progression into chronic disease.

  20. MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants.

    Science.gov (United States)

    Bruno, Christie J; Bengani, Shreyans; Gomes, William A; Brewer, Mariana; Vega, Melissa; Xie, Xianhong; Kim, Mimi; Fuloria, Mamta

    2017-01-01

    Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis. To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age. This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants. Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI. Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships. © 2017 S. Karger AG, Basel.

  1. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

    Science.gov (United States)

    Sharma, Deepak; Shastri, Sweta; Sharma, Pradeep

    2016-01-01

    Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR. PMID:27441006

  2. Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT Study.

    Science.gov (United States)

    Kent, Etaoin M; Breathnach, Fionnuala M; Gillan, John E; McAuliffe, Fionnuala M; Geary, Michael P; Daly, Sean; Higgins, John R; Hunter, Alyson; Morrison, John J; Burke, Gerard; Higgins, Shane; Carroll, Stephen; Dicker, Patrick; Manning, Fiona; Tully, Elizabeth; Malone, Fergal D

    2012-09-01

    We sought to evaluate the association between placental histological abnormalities and birthweight discordance and growth restriction in twin pregnancies. We performed a multicenter, prospective study of twin pregnancies. Placentas were examined for evidence of infarction, retroplacental hemorrhage, chorangioma, subchorial fibrin, or abnormal villus maturation. Association of placental lesions with chorionicity, birthweight discordance, and growth restriction were assessed. In all, 668 twin pairs were studied, 21.1% monochorionic and 78.9% dichorionic. Histological abnormalities were more frequent in placentas of smaller twins of birthweight discordant pairs (P = .02) and in placentas of small for gestational age infants (P = .0001) when compared to controls. The association of placental abnormalities with both birthweight discordance and small for gestational age was significant for dichorionic twins (P = .01 and .0001, respectively). No such association was seen in monochorionic twins. In a large, prospective, multicenter study, we observed a strong relationship between abnormalities of placental histology and birthweight discordance and growth restriction in dichorionic, but not monochorionic, twin pregnancies. Copyright © 2012 Mosby, Inc. All rights reserved.

  3. Metabolic, hormonal characteristics and genetic variants of TCF7L2 associated with development of gestational diabetes mellitus in Mexican women.

    Science.gov (United States)

    Reyes-López, Ruth; Pérez-Luque, Elva; Malacara, Juan Manuel

    2014-11-01

    Variation in TCF7L2 gene is associated with type 2 diabetes and with gestational diabetes mellitus in several populations, but there are no data in Mexican women with gestational diabetes mellitus. In this study, we examined metabolic and hormonal measurements as well as TCF7L2 genetic variants. We selected 108 pregnant women with normal glucose tolerance and 90 with gestational diabetes mellitus according to 2010 American Diabetes Association criteria matched for gestational week. We collected data on blood pressure, body mass index (BMI) and concentrations of blood glucose, HbA1c , lipids profile, insulin and glucagon-like peptide-1 (GLP-1). The genotyping of rs7903146 and rs12255372 polymorphisms were made with polymerase chain reaction-restriction fragment length polymorphism. Actual and pre-gestational BMI, fasting glucose and HbA1c were higher (p gestational diabetes mellitus women than euglycemic women. No significant differences were found for lipids, insulin and homeostasis model assessment-insulin resistance. Gestational diabetes mellitus women had high GLP-1 levels (32 vs 24, p gestational diabetes women was significantly higher than that in euglycemic women (χ²  = 8.96; p gestational diabetes mellitus (OR = 9.1, 95% CI 2.8-29, p gestational BMI and rs12255372 risk allele are independently associated with gestational diabetes. The elevated GLP-1 levels in gestational diabetes women suggested some abnormality in insulin secretion. The low β-cell function, high pre-gestational BMI and rs12255372 risk allele are risk factors independently associated with the development of gestational diabetes. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Maternal protein restriction induces alterations in insulin signaling and ATP sensitive potassium channel protein in hypothalami of intrauterine growth restriction fetal rats.

    Science.gov (United States)

    Liu, Xiaomei; Qi, Ying; Gao, Hong; Jiao, Yisheng; Gu, Hui; Miao, Jianing; Yuan, Zhengwei

    2013-01-01

    It is well recognized that intrauterine growth restriction leads to the development of insulin resistance and type 2 diabetes mellitus in adulthood. To investigate the mechanisms behind this "metabolic imprinting" phenomenon, we examined the impact of maternal undernutrition on insulin signaling pathway and the ATP sensitive potassium channel expression in the hypothalamus of intrauterine growth restriction fetus. Intrauterine growth restriction rat model was developed through maternal low protein diet. The expression and activated levels of insulin signaling molecules and K(ATP) protein in the hypothalami which were dissected at 20 days of gestation, were analyzed by western blot and real time PCR. The tyrosine phosphorylation levels of the insulin receptor substrate 2 and phosphatidylinositol 3'-kinase p85α in the hypothalami of intrauterine growth restriction fetus were markedly reduced. There was also a downregulation of the hypothalamic ATP sensitive potassium channel subunit, sulfonylurea receptor 1, which conveys the insulin signaling. Moreover, the abundances of gluconeogenesis enzymes were increased in the intrauterine growth restriction livers, though no correlation was observed between sulfonylurea receptor 1 and gluconeogenesis enzymes. Our data suggested that aberrant intrauterine milieu impaired insulin signaling in the hypothalamus, and these alterations early in life might contribute to the predisposition of the intrauterine growth restriction fetus toward the adult metabolic disorders.

  5. Potential adverse effects of antenatal melatonin as a treatment for intrauterine growth restriction: findings in pregnant sheep.

    Science.gov (United States)

    González-Candia, Alejandro; Veliz, Marcelino; Araya, Claudio; Quezada, Sebastian; Ebensperger, Germán; Serón-Ferré, María; Reyes, Roberto V; Llanos, Aníbal J; Herrera, Emilio A

    2016-08-01

    Intrauterine growth restriction is a condition in which the fetus has a birthweight and/or length Intrauterine growth restriction can be associated with various causes, among which is low uteroplacental perfusion and chronic hypoxia during gestation. Often, intrauterine growth-restricted fetuses have increased oxidative stress; therefore, agents that decrease oxidative stress and increase utero, placental, and umbilical perfusion have been proposed as a beneficial therapeutic strategy. In this scenario, melatonin acts as an umbilical vasodilator and a potent antioxidant that has not been evaluated in pregnancies under chronic hypoxia that induce fetal growth restriction. However, this neurohormone has been proposed as a pharmacologic therapy for complicated pregnancies. The aim of this study was to determine the effects of prenatal administration of melatonin during the last trimester of pregnancy on the biometry of the growth-restricted lambs because of developmental hypoxia. Further, we aimed to determine melatonin and cortisol levels and oxidative stress markers in plasma of pregnant ewes during the treatment. High-altitude pregnant sheep received either vehicle (n = 5; 5 mL 1.4% ethanol) or melatonin (n = 7; 10 mg/kg(-1)day(-1) in 5 mL 1.4% ethanol) daily during the last one-third of gestation. Maternal plasma levels of melatonin, cortisol, antioxidant capacity, and oxidative stress were determined along treatment. At birth, neonates were examined, weighed, and measured (biparietal diameter, abdominal diameter, and crown-rump length). Antenatal treatment with melatonin markedly decreased neonatal biometry and weight at birth. Additionally, melatonin treatment increased the length of gestation by 7.5% and shifted the time of delivery. Furthermore, the prenatal treatment doubled plasma levels of melatonin and cortisol and significantly improved the antioxidant capacity of the pregnant ewes. Our findings indicate that antenatal melatonin induces further

  6. Intrauterine growth restriction and prematurity influence regulatory T cell development in newborns.

    Science.gov (United States)

    Mukhopadhyay, Dhriti; Weaver, Laura; Tobin, Richard; Henderson, Stephanie; Beeram, Madhava; Newell-Rogers, M Karen; Perger, Lena

    2014-05-01

    The aim of this study was to determine the relationship of birth weight and gestational age with regulatory T cells (Tregs) in cord blood of human newborns. Cord blood mononuclear cells (CBMCs) of 210 newborns were analyzed using flow cytometry to identify Tregs (CD3(+), CD4(+), CD25(high), FoxP3(high)) and measure FoxP3 mean fluorescence intensity (MFI). Suppressive index (SI) was calculated as FoxP3 MFI per Treg. Mode of delivery had no significant effect on Tregs at birth. Term babies with growth restriction had fewer Tregs than their appropriate weight counterparts but equivalent SI. Preterm babies had higher percentages of Tregs, but lower SI than term controls. SI steadily increased through gestation. Intrauterine growth restriction is correlated with fewer circulating Tregs and prematurity with decreased functionality of Tregs compared to term appropriate weight infants. This may have implications in diseases such as necrotizing enterocolitis that disproportionately affect premature and lower birth weight infants. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. "COMPARISON OF MATERNAL AND FETAL/NEONATAL COMPLICATIONS IN GESTATIONAL AND PRE-GESTATIONAL DIABETES MELLITUS "

    OpenAIRE

    F. Akhlaghi A. B. Hamedi

    2005-01-01

    Presence of maternal diabetes mellitus (DM) during pregnancy has important consequences for both mother and child. To determine maternal and fetal/neonatal complications of gestational DM and compare them with pre-gestational DM, a prospective study was performed in 100 diabetic women delivered in our hospital from January 2001 to April 2002. Pregnancy outcome in 27 women with gestational DM and 73 women with pre-gestational DM and their offspring were studied and analyzed. The mean age of wo...

  8. Development of mammary glands of fat sheep submitted to restricted feeding during late pregnancy

    DEFF Research Database (Denmark)

    Nørgaard, Jan Værum; Nielsen, Mette Olaf; Theil, Peter Kappel

    2008-01-01

    Mammary gland development in sheep occurs mainly during puberty and pregnancy. We have investigated the effects of a late gestation feed restriction on mammary gland development in sheep. Five control ewes were slaughtered d -38 from parturition, whereas 10 ewes were fed ad libitum and another 10...

  9. Maternal Exposure to Bisphenol-A and Fetal Growth Restriction: A Case-Referent Study

    Directory of Open Access Journals (Sweden)

    Igor Burstyn

    2013-12-01

    Full Text Available We conducted a case-referent study of the effect of exposure to bisphenol-A on fetal growth in utero in full-term, live-born singletons in Alberta, Canada. Newborns <10 percentile of expected weight for gestational age and sex were individually matched on sex, maternal smoking and maternal age to referents with weight appropriate to gestational age. Exposure of the fetus to bisphenol-A was estimated from maternal serum collected at 15–16 weeks of gestation. We pooled sera across subjects for exposure assessment, stratified on case-referent status and sex. Individual 1:1 matching was maintained in assembling 69 case and 69 referent pools created from 550 case-referent pairs. Matched pools had an equal number of aliquots from individual women. We used an analytical strategy conditioning on matched set and total pool-level values of covariates to estimate individual-level effects. Pools of cases and referents had identical geometric mean bisphenol-A concentrations (0.5 ng/mL and similar geometric standard deviations (2.3–2.5. Mean difference in concentration between matched pools was 0 ng/mL, standard deviation: 1 ng/mL. Stratification by sex and control for confounding did not suggest bisphenol-A increased fetal growth restriction. Our analysis does not provide evidence to support the hypothesis that bisphenol-A contributes to fetal growth restriction in full-term singletons.

  10. Genetics Home Reference: gestational diabetes

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Gestational diabetes Gestational diabetes Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Gestational diabetes is a disorder characterized by abnormally high blood ...

  11. NutrimiRAging: Micromanaging Nutrient Sensing Pathways through Nutrition to Promote Healthy Aging.

    Science.gov (United States)

    Micó, Víctor; Berninches, Laura; Tapia, Javier; Daimiel, Lidia

    2017-04-26

    Current sociodemographic predictions point to a demographic shift in developed and developing countries that will result in an unprecedented increase of the elderly population. This will be accompanied by an increase in age-related conditions that will strongly impair human health and quality of life. For this reason, aging is a major concern worldwide. Healthy aging depends on a combination of individual genetic factors and external environmental factors. Diet has been proved to be a powerful tool to modulate aging and caloric restriction has emerged as a valuable intervention in this regard. However, many questions about how a controlled caloric restriction intervention affects aging-related processes are still unanswered. Nutrient sensing pathways become deregulated with age and lose effectiveness with age. These pathways are a link between diet and aging. Thus, fully understanding this link is a mandatory step before bringing caloric restriction into practice. MicroRNAs have emerged as important regulators of cellular functions and can be modified by diet. Some microRNAs target genes encoding proteins and enzymes belonging to the nutrient sensing pathways and, therefore, may play key roles in the modulation of the aging process. In this review, we aimed to show the relationship between diet, nutrient sensing pathways and microRNAs in the context of aging.

  12. NutrimiRAging: Micromanaging Nutrient Sensing Pathways through Nutrition to Promote Healthy Aging

    Directory of Open Access Journals (Sweden)

    Víctor Micó

    2017-04-01

    Full Text Available Current sociodemographic predictions point to a demographic shift in developed and developing countries that will result in an unprecedented increase of the elderly population. This will be accompanied by an increase in age-related conditions that will strongly impair human health and quality of life. For this reason, aging is a major concern worldwide. Healthy aging depends on a combination of individual genetic factors and external environmental factors. Diet has been proved to be a powerful tool to modulate aging and caloric restriction has emerged as a valuable intervention in this regard. However, many questions about how a controlled caloric restriction intervention affects aging-related processes are still unanswered. Nutrient sensing pathways become deregulated with age and lose effectiveness with age. These pathways are a link between diet and aging. Thus, fully understanding this link is a mandatory step before bringing caloric restriction into practice. MicroRNAs have emerged as important regulators of cellular functions and can be modified by diet. Some microRNAs target genes encoding proteins and enzymes belonging to the nutrient sensing pathways and, therefore, may play key roles in the modulation of the aging process. In this review, we aimed to show the relationship between diet, nutrient sensing pathways and microRNAs in the context of aging.

  13. How to Treat Gestational Diabetes

    Science.gov (United States)

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  14. A comparison of low-carbohydrate vs. high-carbohydrate diets: energy restriction, nutrient quality and correlation to body mass index.

    Science.gov (United States)

    Bowman, Shanthy A; Spence, Joseph T

    2002-06-01

    To evaluate free-living adults' diets that ranged from very low to high amounts of carbohydrate for their energy content, nutritional quality and correlation to Body Mass Index. Adults ages 19 years and older, who had complete dietary intake data on day-1 of the USDA's 1994 to 1996 Continuing Survey of Food Intakes by Individuals (CSFII 1994-1996), were divided into four groups--very low, low, moderate and high carbohydrate--based on the percent total energy from carbohydrate. Mean energy, nutrient, food intakes and Body Mass Index values were compared among the groups. SUDAAN software package was used for the data analysis and pair-wise mean comparisons (p low-fat foods, grain products and fruits. This group also had the lowest sodium intake. Adults eating a high-carbohydrate diet are more likely to have Body Mass Index values below 25. A study of diets of free-living adults in the U.S. showed that diets high in carbohydrate were both energy restrictive and nutritious and may be adopted for successful weight management.

  15. Review: Neuroinflammation in intrauterine growth restriction.

    Science.gov (United States)

    Wixey, Julie A; Chand, Kirat K; Colditz, Paul B; Bjorkman, S Tracey

    2017-06-01

    Disruption to the maternal environment during pregnancy from events such as hypoxia, stress, toxins, inflammation, and reduced placental blood flow can affect fetal development. Intrauterine growth restriction (IUGR) is commonly caused by chronic placental insufficiency, interrupting supply of oxygen and nutrients to the fetus resulting in abnormal fetal growth. IUGR is a major cause of perinatal morbidity and mortality, occurring in approximately 5-10% of pregnancies. The fetal brain is particularly vulnerable in IUGR and there is an increased risk of long-term neurological disorders including cerebral palsy, epilepsy, learning difficulties, behavioural difficulties and psychiatric diagnoses. Few studies have focused on how growth restriction interferes with normal brain development in the IUGR neonate but recent studies in growth restricted animal models demonstrate increased neuroinflammation. This review describes the role of neuroinflammation in the progression of brain injury in growth restricted neonates. Identifying the mediators responsible for alterations in brain development in the IUGR infant is key to prevention and treatment of brain injury in these infants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Postnatal food restriction in the rat as a model for a low nephron endowment

    DEFF Research Database (Denmark)

    Schreuder, Michiel F.; Nyengaard, Jens Randel; Remmers, Floor

    2006-01-01

    A low nephron endowment may be associated with hypertension. Nephrogenesis is the process that leads to the formation of nephrons until week 36 of gestation in humans and may be inhibited by many factors like intrauterine growth restriction and premature birth. To study the consequences of a low ...

  17. Gestational Weight Gain-for-Gestational Age Z-Score Charts Applied across U.S. Populations.

    Science.gov (United States)

    Leonard, Stephanie A; Hutcheon, Jennifer A; Bodnar, Lisa M; Petito, Lucia C; Abrams, Barbara

    2018-03-01

    Gestational weight gain may be a modifiable contributor to infant health outcomes, but the effect of gestational duration on gestational weight gain has limited the identification of optimal weight gain ranges. Recently developed z-score and percentile charts can be used to classify gestational weight gain independent of gestational duration. However, racial/ethnic variation in gestational weight gain and the possibility that optimal weight gain differs among racial/ethnic groups could affect generalizability of the z-score charts. The objectives of this study were (1) to apply the weight gain z-score charts in two different U.S. populations as an assessment of generalisability and (2) to determine whether race/ethnicity modifies the weight gain range associated with minimal risk of preterm birth. The study sample included over 4 million live, singleton births in California (2007-2012) and Pennsylvania (2003-2013). We implemented a noninferiority margin approach in stratified subgroups to determine weight gain ranges for which the adjusted predicted marginal risk of preterm birth (gestation gain between California and Pennsylvania births, and among several racial/ethnic groups in California. The optimal ranges decreased as severity of prepregnancy obesity increased in all groups. The findings support the use of weight gain z-score charts for studying gestational age-dependent outcomes in diverse U.S. populations and do not support weight gain recommendations tailored to race/ethnicity. © 2017 John Wiley & Sons Ltd.

  18. Preterm Birth Reduces Nutrient Absorption With Limited Effect on Immune Gene Expression and Gut Colonization in Pigs

    DEFF Research Database (Denmark)

    Østergaard, Mette V; Cilieborg, Malene S.; Skovgaard, Kerstin

    2015-01-01

    The primary risk factors for necrotizing enterocolitis (NEC) are preterm birth, enteral feeding, and gut colonization. It is unclear whether feeding and colonization induce excessive expression of immune genes that lead to NEC. Using a pig model, we hypothesized that reduced gestational age would...... upregulate immune-related genes and cause bacterial imbalance after birth. Preterm (85%-92% gestation, n = 53) and near-term (95%-99% gestation, n = 69) pigs were delivered by cesarean section and euthanized at birth or after 2 days of infant formula or bovine colostrum feeding. At birth, preterm delivery...... reduced 5 of 30 intestinal genes related to nutrient absorption and innate immunity, relative to near-term pigs, whereas 2 genes were upregulated. Preterm birth also reduced ex vivo intestinal glucose and leucine uptake (40%-50%), but failed to increase cytokine secretions from intestinal explants...

  19. Features of newborns with intrauterine growth restriction (according to the data of perinatal center of the Saratov region

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2017-03-01

    Full Text Available Objective: to identify risk factors that adversely affect the development of fetus and child small for gestational age; to assess the incidence of the intrauterine development of fetus and newborn; to analyze the health indicators of these children. Material and Methods. Cases of 226 children (6.6% with diagnosed intrauterine growth restriction of the fetus were examined, including 134 of prematurity (59%. Results. The most common risk factors for the intrauterine development of the fetus were: violation of the utero-placental circulation — 196 cases, the uterine scar — 78 women, urinary tract infection — 94. Extragenital pathology was found in all women, the threat of termination of pregnancy in 109 cases, medical history of abortions in 106 women and 83 anaemia in women. Birth asphyxia was observed in 102 children (45%, prematurity in 71 cases (31.4%. Asphyxia of severe degree accounted 1 (0.5% premature and 1 (0.45% full-term baby. Asphyxia of moderate severity (4-6 points accounted 70 (30.9% preterm and 31 (13.7% full-term infants. The most common form of the intrauterine development of the fetus asymmetrical revealed 178 cases (79.1%. Conclusion: Perinatal factors such as medical abortion, urinary tract infection, extragenital pathology are preventable. The predominant form of the intrauterine development of the fetus is asymmetric form, symmetric and dysplastic revealed to a greater degree in premature infants. Children with low weight for gestational age should be adequately provided with the necessary nutrients, fortifiers, vitamins and in the process of rehabilitation — cerebropro-tective therapy.

  20. Carbohydrate Content in the GDM Diet: Two Views: View 2: Low-Carbohydrate Diets Should Remain the Initial Therapy for Gestational Diabetes

    OpenAIRE

    Mulla, Wadia R.

    2016-01-01

    IN BRIEF The appropriate dietary intervention for gestational diabetes mellitus (GDM) is not clear. Traditionally, a low-carbohydrate diet has been prescribed. Recently, there has been a movement to prescribe a diet higher in nutrient-dense carbohydrate as the initial treatment for GDM. At this time, there is insufficient outcome data to support this type of diet.

  1. Animal models for clinical and gestational diabetes: maternal and fetal outcomes.

    Science.gov (United States)

    Kiss, Ana Ci; Lima, Paula Ho; Sinzato, Yuri K; Takaku, Mariana; Takeno, Marisa A; Rudge, Marilza Vc; Damasceno, Débora C

    2009-10-19

    Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl) and mild diabetes (glycemia between 120 and 300 mg/dl) on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16), severe (n = 50) and mild diabetes (n = 30). At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Experimental models of severe diabetes during pregnancy reproduced maternal and fetal outcomes of pregnant women

  2. Animal models for clinical and gestational diabetes: maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Kiss Ana CI

    2009-10-01

    Full Text Available Abstract Background Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl and mild diabetes (glycemia between 120 and 300 mg/dl on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. Methods On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16, severe (n = 50 and mild diabetes (n = 30. At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Results Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Conclusion Experimental models of severe diabetes during pregnancy

  3. Improvement of aquaponic performance through micro- and macro-nutrient addition.

    Science.gov (United States)

    Ru, Dongyun; Liu, Jikai; Hu, Zhen; Zou, Yina; Jiang, Liping; Cheng, Xiaodian; Lv, Zhenting

    2017-07-01

    Aquaponics is one of the "zero waste" industry in the twenty-first century, and is considered to be one of the major trends for the future development of agriculture. However, the low nitrogen utilization efficiency (NUE) restricted its widely application. To date, many attempts have been conducted to improve its NUE. In the present study, effect of micro- and macro-nutrient addition on performance of tilapia-pak choi aquaponics was investigated. Results showed that the addition of micro- and macro-nutrients improved the growth of plant directly and facilitated fish physiology indirectly, which subsequently increased NUE of aquaponics from 40.42 to 50.64%. In addition, remarkable lower total phosphorus concentration was obtained in aquaponics with micro- and macro-nutrient addition, which was attributed to the formation of struvite. Most of the added micro-nutrients were enriched in plant root, while macro-nutrients mainly existed in water. Moreover, no enrichment of micro- and macro-nutrients in aquaponic products (i.e., fish and plant leaves) was observed, indicating that it had no influence on food safety. The findings here reported manifest that appropriate addition of micro- and macro-nutrients to aquaponics is necessary, and would improve its economic feasibility.

  4. Transplacental movement of inorganic lead in early and late gestation in the mouse

    International Nuclear Information System (INIS)

    Danielsson, B.R.G.; Dencker, L.; Lindgren, A.

    1983-01-01

    203 Pb(NO 3 ) 2 was administered i.v. to pregnant C57BL mice at different stages, from day 8 to day 18 of gestation. The whole animals or excised uteri were subjected to autoradiography or were autopsied for scintillation counting of excised organs. Lead appeared in embryonic and fetal tissues at all stages of gestation. Early (approx. day 8-11) lead was restricted mainly to the embryonic blood, suggesting that free lead was essentially not transferred to the embryo but may have been incorporated in the embryonic hemoglobin when the erythrocytes were formed in the yolk sac placenta (an extraembryonic membrane). From day 12 and later, an uptake was seen in the liver and the cartilaginous skeleton, and from day 14, a strong accumulation was found in calcified bone. This means that the overall fetal concentration increases successively with gestational age of the conceptus. The uptake in fetal liver may be related to the erythropoiesis taking place in the liver in later gestation. While an accumulation of lead was observed in proximal tubuli of the maternal kidney, no corresponding uptake occurred in the fetal kidney. Although lead is teratogenic, causing among others skeletal defects, no effect of inorganic lead in mM concentration was seen on a chondrogenic cell system in vitro. Due to the predominance of lead in hemoglobin, a mechanisms of teratogensis based on inhibition of fetal hemoglobin synthesis or function is discussed. (orig.)

  5. Gestational diabetes mellitus screening and outcomes.

    Science.gov (United States)

    Aktün, Hale Lebriz; Uyan, Derya; Yorgunlar, Betül; Acet, Mustafa

    2015-01-01

    To verify the usefulness of the World Health Organization criteria for the diagnosis of gestational diabetes mellitus in pregnant women and its effectiveness in the prevention of maternal and neonatal adverse results in women younger than 35 years without apparent risk factors for gestational diabetes mellitus. This is a retrospective study based on population involving 1360 pregnant women who delivered and who were followed-up in a university hospital in Istanbul. All women underwent the 75-g oral glucose tolerance test screening, usually in between the 24(th)-28(th) weeks of pregnancy. In all cases, the identification of gestational diabetes mellitus was determined in accordance with the World Health Organization criteria. Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn't showed any significant deviation between the groups. There was a moderate association between gestational diabetes mellitus and metabolic complications. Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organization criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatal weight.

  6. Modeling Fetal Weight for Gestational Age: A Comparison of a Flexible Multi-level Spline-based Model with Other Approaches

    Science.gov (United States)

    Villandré, Luc; Hutcheon, Jennifer A; Perez Trejo, Maria Esther; Abenhaim, Haim; Jacobsen, Geir; Platt, Robert W

    2011-01-01

    We present a model for longitudinal measures of fetal weight as a function of gestational age. We use a linear mixed model, with a Box-Cox transformation of fetal weight values, and restricted cubic splines, in order to flexibly but parsimoniously model median fetal weight. We systematically compare our model to other proposed approaches. All proposed methods are shown to yield similar median estimates, as evidenced by overlapping pointwise confidence bands, except after 40 completed weeks, where our method seems to produce estimates more consistent with observed data. Sex-based stratification affects the estimates of the random effects variance-covariance structure, without significantly changing sex-specific fitted median values. We illustrate the benefits of including sex-gestational age interaction terms in the model over stratification. The comparison leads to the conclusion that the selection of a model for fetal weight for gestational age can be based on the specific goals and configuration of a given study without affecting the precision or value of median estimates for most gestational ages of interest. PMID:21931571

  7. Restricting the marketing of foods and non-alcoholic beverages to children in South Africa: are all nutrient profiling models the same?

    Science.gov (United States)

    Wicks, Mariaan; Wright, Hattie; Wentzel-Viljoen, Edelweiss

    2016-12-01

    The WHO has called for governments to improve children's food environment by implementing restrictions on the marketing of 'unhealthy' foods to children. Nutrient profiling (NP) models are used to define 'unhealthy' foods and support child-directed food marketing regulations. The aim of the present study was to assess the suitability of the South African NP model (SANPM), developed and validated for health claim regulations, for child-directed food marketing regulations. The SANPM was compared with four NP models specifically developed for such regulations. A representative list of 197 foods was compiled by including all foods advertised on South African free-to-air television channels in 2014 and foods commonly consumed by South African children. The nutritional information of the foods was sourced from food packaging, company websites and a food composition table. Each individual food was classified by each of the five NP models. The percentage of foods that would be allowed according to the different NP models ranged from 6 to 45 %; the models also varied considerably with regard to the type of foods allowed for marketing to children. The majority of the pairwise comparisons between the NP models yielded κ statistics >0·4, indicating a moderate agreement between the models. An almost perfect pairwise agreement (κ=0·948) existed between the SANPM and the UK Food Standards Agency model (United Kingdom Office of Communication nutrient profiling model), a model extensively tested and validated for such regulations. The SANPM is considered appropriate for child-directed food marketing regulations in South Africa.

  8. Nutritional adequacy of energy restricted diets for young obese women.

    Science.gov (United States)

    O'Connor, Helen; Munas, Zahra; Griffin, Hayley; Rooney, Kieron; Cheng, Hoi Lun; Steinbeck, Katharine

    2011-01-01

    Energy restricted meal plans may compromise nutrient intake. This study used diet modelling to assess the nutritional adequacy of energy restricted meal plans designed for weight management in young obese women. Diet modelling of 6000 kJ/d animal protein based meal plans was performed using Australian nutrient databases with adequacy compared to the Australian Nutrient Reference Values (NRVs) for women (19-30 years). One diet plan was based on the higher carbohydrate (HC) version of the Australian Guide to Healthy Eating for women 19-60 years. An alternative higher protein (HP) plan was adapted from the CSIRO Total Wellbeing Diet. Vegan and lacto-ovo versions of these plans were also modelled and compared to the appropriate vegetarian NRVs. Both animal protein diets met the estimated average requirement (EAR) or adequate intake (AI) for all nutrients analysed. The recommended dietary intake (RDI) was also satisfied, except for iron. HC met 75±30% and HP 81±31% of the iron RDI when red meat and iron fortified cereal were both included three days a week, and remained below the RDI even when red meat was increased to seven days. Iron for the modified vegan (57±5% HC; 66±4% HP) and lacto-ovo (48±6% HC; 59±7% HP) plans was below the RDI and zinc below the EAR for the vegan (76±8% HC; 84±9% HP) plans. The 6000 kJ/d animal protein meal plans met the RDI for all nutrients except iron. Iron and zinc failed to meet the vegetarian RDI and EAR respectively for the vegan plans.

  9. Gestational Diabetes and Pregnancy

    Science.gov (United States)

    ... Pregnant Avoiding Pregnancy Zika and Pregnancy Articles Gestational Diabetes and Pregnancy Language: English (US) Español (Spanish) Recommend ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  10. Decreased liver triglyceride content in adult rats exposed to protein restriction during gestation and lactation: role of hepatic triglyceride utilization.

    Science.gov (United States)

    Qasem, Rani J; Li, Jing; Tang, Hee Man; Browne, Veron; Mendez-Garcia, Claudia; Yablonski, Elizabeth; Pontiggia, Laura; D'Mello, Anil P

    2015-04-01

    We have previously demonstrated that protein restriction throughout gestation and lactation reduces liver triglyceride content in adult rat offspring. However, the mechanisms mediating the decrease in liver triglyceride content are not understood. The aim of the current study was to use a new group of pregnant animals and their offspring and determine the contribution of increased triglyceride utilization via the hepatic fatty-acid oxidation and triglyceride secretory pathways to the reduction in liver triglyceride content. Pregnant Sprague-Dawley rats received either a control or a low protein diet throughout pregnancy and lactation. Pups were weaned onto laboratory chow on day 28 and killed on day 65. Liver triglyceride content was reduced in male, but not female, low-protein offspring, both in the fed and fasted states. The reduction was accompanied by a trend towards higher liver carnitine palmitoyltransferase-1a activity, suggesting increased fatty-acid transport into the mitochondrial matrix. However, medium-chain acyl coenzyme A dehydrogenase activity within the mitochondrial matrix, expression of nuclear peroxisome proliferator activated receptor-α, and plasma levels of β-hydroxybutyrate were similar between low protein and control offspring, indicating a lack of change in fatty-acid oxidation. Hepatic triglyceride secretion, assessed by blocking peripheral triglyceride utilization and measuring serum triglyceride accumulation rate, and the activity of microsomal transfer protein, were similar between low protein and control offspring. Because enhanced triglyceride utilization is not a significant contributor, the decrease in liver triglyceride content in male low-protein offspring is likely due to alterations in liver fatty-acid transport or triglyceride biosynthesis. © 2015 Wiley Publishing Asia Pty Ltd.

  11. Programming the offspring through altered uteroplacental hemodynamics: how maternal environment impacts uterine and umbilical blood flow in cattle, sheep and pigs.

    Science.gov (United States)

    Vonnahme, Kimberly A; Lemley, Caleb O

    2011-01-01

    As placental growth and vascularity precedes exponential fetal growth, not only is proper establishment of the placenta important, but also a continual plasticity of placental function throughout gestation. Inadequate maternal environment, such as nutritional plane, has been documented to alter fetal organogenesis and growth, thus leading to improper postnatal growth and performance in many livestock species. The timing and duration of maternal nutritional restriction appears to influence the capillary vascularity, angiogenic profile and vascular function of the placenta in cattle and sheep. In environments where fetal growth and/or fetal organogenesis are compromised, potential therapeutics may augment placental nutrient transport capacity and improve offspring performance. Supplementation of specific nutrients, including protein, as well as hormone supplements, such as indolamines, during times of nutrient restriction may assist placental function. Current use of Doppler ultrasonography has allowed for repeated measurements of uterine and umbilical blood flow including assessment of uteroplacental hemodynamics in cattle, sheep and swine. Moreover, these variables can be monitored in conjugation with placental capacity and fetal growth at specific time points of gestation. Elucidating the consequences of inadequate maternal intake on the continual plasticity of placental function will allow us to determine the proper timing and duration for intervention.

  12. Gestational diabetes mellitus results in a higher prevalence of small for gestational age babies

    LENUS (Irish Health Repository)

    Avalos, G

    2011-09-01

    Background and aims: Gestational Diabetes Mellitus (GDM) is associated with increased foetal and maternal morbidity and mortality. Previous studies have shown that babies of diabetic mothers are more likely to be large for gestational age (LGA). This retrospective study aimed to assess whether the converse may also be true, that there may also a higher rate of small for gestational age (SGA) amongst babies of mothers with GDM.\\r\

  13. Association of Maternal Vitamin C Status with Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Hedyeh Masoodi

    2015-01-01

    Full Text Available Background: The role of antioxidants in the etiology of gestational diabetes mellitus (GDM has been given limited attention. Vitamin C is a nutrient with radical quenching property and has been claimed to influence glucose tolerance. Aim: To study the association between vitamin C status (dietary intake and plasma concentrations and GDM. Material and Methods: Using a case-control design with 1:3 ratio we examined 42 pregnant women with GDM and 158 normal glucose tolerant (NGT gestational age-matched healthy pregnant women at an average of 26 weeks of gestation. Maternal vitamin C intake was determined using detailed semi food frequency questionnaire (SFFQ and 24 hour diet recall. Plasma vitamin C was determined using a spectrophotometric method in non-fasting samples. GDM was diagnosed by 75 gm oral glucose tolerance test (OGTT using International Association for Diabetes in Pregnancy Study Group (IADPSG criteria (fasting ≥92mg%, 1hour ≥180mg%, 2 hour ≥153mg %. Results: GDM women had lower median intake of vitamin C (35.0 mg/day vs. 66.7; p<0.001 and lower median plasma vitamin C concentration (45.9 µmol/L vs. 95.2; p<0.001 compared to NGT women. Plasma vitamin C concentration was inversely related to fasting, 1 hour and 2 hour post glucose plasma glucose concentrations (p<0.001. The associations remained significant after adjustment for age, income, pre-pregnancy BMI, and stress. Conclusion: Our findings suggest that low vitamin C intake as well as low plasma vitamin C concentration is associated with GDM. This association needs to be tested in a large prospective study and subsequently in a clinical trial

  14. Gestational dating by metabolic profile at birth: a California cohort study.

    Science.gov (United States)

    Jelliffe-Pawlowski, Laura L; Norton, Mary E; Baer, Rebecca J; Santos, Nicole; Rutherford, George W

    2016-04-01

    Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (PTBs and term births. Using a linear discriminate analyses-derived linear function, we were able to sort PTBs and term births accurately with sensitivities and specificities of ≥95% in both the training and testing subsets. Assignment of a specific week of gestation in those identified as PTBs resulted in the correct assignment of week ±2 weeks in 89.8% of all newborns in the training and 91.7% of those in the testing subset. When PTB rates were modeled using the metabolic dating algorithm compared to fetal ultrasound, PTB rates were 7.15% vs 6.11% in the training subset and 7.31% vs 6.25% in the testing subset. When considered in combination with birthweight and hours of age at test, metabolic profile evaluated within 8 days of birth appears to be a useful measure of PTB and, among those born preterm, of specific week of gestation ±2 weeks. Dating by metabolic profile may be useful in instances where there is no fetal ultrasound due to lack of availability or late entry into care. Copyright © 2016 The Authors. Published

  15. Weight six years after childbirth: a follow-up of obese women in a weight-gain restriction programmme.

    Science.gov (United States)

    Claesson, Ing-Marie; Josefsson, Ann; Sydsjö, Gunilla

    2014-05-01

    to compare weight development in an intervention group and a control group, six years after participation in a gestational weight-gain restriction programme. follow-up of a prospective intervention study. antenatal care clinics. a total of 129 women (88.4%) from the original intervention group and 166 women (88.8%) from the original control group. the women answered a study specific questionnaire, covering socio-demographic data and health- and weight status. after adjusting for socio-demographic factors, the mean weight was lower (4.1kg) among the women in the intervention group, compared to the controls (p=0.028). Furthermore, the mean weight change, e.g. the weight at the six year assessment compared with the weight at the start of the intervention at the first antenatal care visit, was greater in the intervention group than in the control group. The women in the intervention group had a larger mean weight change (-5.2kg), e.g. weighed less than the women in the control group (-1.9kg) (p=0.046). Mean weight change expressed in 5kg classes also showed a significant difference between the two groups (p=0.030). the results indicate that attending a gestational weight-gain-restriction programme can have a positive effect on weight up to six years after the intervention. a restrictive gestational weight gain can result in a positive weight development during the first years after childbirth. It might provide both short- and long term medical health benefits for the mother as well as the child. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Interactions between general and central obesity in predicting gestational diabetes mellitus in Chinese pregnant women: A prospective population-based study in Tianjin, China.

    Science.gov (United States)

    Han, Qian; Shao, Ping; Leng, Junhong; Zhang, Cuiping; Li, Wei; Liu, Guifeng; Zhang, Yuanyuan; Li, Yi; Li, Zhe; Ren, Yanfeng; Chan, Juliana C N; Yang, Xilin

    2018-01-01

    The aim of the present study was to define cut-off points of body mass index (BMI) and waist circumference (WC) for gestational diabetes mellitus (GDM) and to investigate any interactions between high BMI and high WC on the risk of GDM in pregnant Chinese women. From 2010 to 2012, 17 803 women in Tianjin, China, who were at 4-12 weeks gestation were recruited to the study. Gestational diabetes mellitus was diagnosed according to the criteria of the International Association of Diabetes and Pregnancy Study Group at 24-28 weeks gestation. Binary logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) while controlling for the confounding effects of traditional risk factors. Restricted cubic spline was used to identify cut-off points of WC and BMI, if any, for GDM. Gestational diabetes mellitus developed in 1383 (7.8%) women. The risk of GDM increased steeply with increasing WC from ≥78.5 cm and BMI ≥22.5 kg/m 2 . If BMI gestation were independently and synergistically associated with increased risks of GDM in Chinese pregnant women. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  17. Circulating soluble endoglin levels in pregnant women in Cameroon and Malawi--associations with placental malaria and fetal growth restriction.

    Science.gov (United States)

    Silver, Karlee L; Conroy, Andrea L; Leke, Rose G F; Leke, Robert J I; Gwanmesia, Philomina; Molyneux, Malcolm E; Taylor, Diane Wallace; Wallace, Diane Taylor; Rogerson, Stephen J; Kain, Kevin C

    2011-01-01

    Placental infections with Plasmodium falciparum are associated with fetal growth restriction resulting in low birth weight (LBW). The mechanisms that mediate these effects have yet to be completely described; however, they are likely to involve inflammatory processes and dysregulation of angiogenesis. Soluble endoglin (sEng), a soluble receptor of transforming growth factor (TGF)-β previously associated with preeclampsia in pregnant women and with severe malaria in children, regulates the immune system and influences angiogenesis. We hypothesized that sEng may play a role in development of LBW associated with placental malaria (PM). Plasma levels of sEng were measured in women (i) followed prospectively throughout pregnancy in Cameroon (n = 52), and (ii) in a case-control study at delivery in Malawi (n = 479). The relationships between sEng levels and gravidity, peripheral and placental parasitemia, gestational age, and adverse outcomes of PM including maternal anemia and LBW were determined. In the longitudinal cohort from Cameroon, 28 of 52 women (54%) experienced at least one malaria infection during pregnancy. In Malawi we enrolled two aparasitemic gravidity-matched controls for every case with PM. sEng levels varied over the course of gestation and were significantly higher in early and late gestation as compared to delivery (Pwomen and PM in Malawian women were each associated with elevated sEng levels following correction for gestational age and gravidity (p = 0.006 and p = 0.033, respectively). Increased sEng was also associated with the delivery of LBW infants in primigravid Malawian women (p = 0.017); the association was with fetal growth restriction (p = 0.003) but not pre-term delivery (p = 0.286). Increased circulating maternal sEng levels are associated with P. falciparum infection in pregnancy and with fetal growth restriction in primigravidae with PM.

  18. Comparison of two models of intrauterine growth restriction for early catch-up growth and later development of glucose intolerance and obesity in rats.

    Science.gov (United States)

    Shahkhalili, Yasaman; Moulin, Julie; Zbinden, Irene; Aprikian, Olivier; Macé, Katherine

    2010-01-01

    Two models of intrauterine growth restriction, maternal food restriction (FR), and dexamethasone (DEX) exposure were compared for early postnatal catch-up growth and later development of glucose intolerance and obesity in Sprague-Dawley rats. Mated dams were randomly divided into three groups at 10 days gestational age. Group FR was food restricted (50% of nongestating rats) during the last 11 days of gestation; Group DEX received DEX injections during the last week of gestation, and Group CON, the control group, had no intervention. Birth weight, catch-up growth, body weight, and food intake were measured in male offspring for 22 wk. Body composition, blood glucose, and plasma insulin in response to a glucose load were assessed at 8, 16, and 22 wk. Pups from both FR and DEX dams had similarly lower birth weights than CON (22% and 25%, P growth, which occurred during the suckling period, was much more rapid in FR than DEX offspring (6 vs. 25 days, 95% CI). Postweaning, there were no significant differences between groups in food intake, body weight, body fat, and plasma insulin, but baseline plasma glucose at 22 wk and 2-h glucose area-under-the-curve at 8 and 22 wk were greater only in FR vs. CON offspring (P restriction is a more sensitive model than DEX exposure for studies aimed at investigating the link between low birth weight, early postnatal catch-up growth, and later development of glucose intolerance.

  19. Influence of pre and postnatal energy restriction on the productive performance of ewes and lambs

    Directory of Open Access Journals (Sweden)

    Filipe Alexandre Boscaro de Castro

    2012-04-01

    Full Text Available The objective of this study was to evaluate the influence of feeding energy levels during the last third of gestation and lactation on performance of ewes and lambs up to weaning. The experiment was carried out in the sheep raising sector of Universidade Estadual de Londrina (UEL, from August to December of 2007. Thirty-two adult lambs with 105 days of gestation, average live weight of 57.55 kg and average body condition scores of 3.42 were used in the beginning of the experiment. The animals were confined in collective pens, distributed randomly in three treatments: 2.4; 2.2 and 2.0 Mcal of metabolizable energy (ME/kg of dry matter (DM. Feed supply was ad libitum during the last third of gestation and lactation. Weaning occurred at 70 days. Body weight, body condition score and milk production of ewes and body weight of the lambs were analyzed. There were no significant differences for body weight and body condition of ewes at lambing; however, the level of 2.4 Mcal enabled better results for those characteristics at weaning and higher gain in weight and body condition scoring during the experiment. Severe energetic restriction (2.0 Mcal ME/kg DM determined lower average daily milk production. Lambs from levels 2.4 and 2.2 presented similar weights in all measurements and were superior to those in level 2.0. Lambs from level 2.4 presented higher average weight gain from birth to weaning. The energetic restriction upon lambs at the end of gestation and during lactation limits the performance of ewes and lambs up to weaning.

  20. The Intrauterine Growth Restriction Phenotype: Fetal Adaptations and Potential Implications for Later Life Insulin Resistance and Diabetes

    Science.gov (United States)

    Thorn, Stephanie R.; Rozance, Paul J.; Brown, Laura D.; Hay, William W.

    2011-01-01

    The intrauterine growth restricted (IUGR) fetus develops unique metabolic adaptations in response to exposure to reduced nutrient supply. These adaptations provide survival value for the fetus by enhancing the capacity of the fetus to take up and use nutrients, thereby reducing the need for nutrient supply. Each organ and tissue in the fetus adapts differently, with the brain showing the greatest capacity for maintaining nutrient supply and growth. Such adaptations, if persistent, also have the potential in later life to promote nutrient uptake and storage, which directly lead to complications of obesity, insulin resistance, reduced insulin production, and type 2 diabetes. PMID:21710398

  1. Genetic influence on prolonged gestation

    DEFF Research Database (Denmark)

    Laursen, Maja; Bille, Camilla; Olesen, Annette Wind

    2004-01-01

    OBJECTIVE: The purpose of this study was to test a possible genetic component to prolonged gestation. STUDY DESIGN: The gestational duration of single, first pregnancies by both female and male twins was obtained by linking the Danish Twin Registry, The Danish Civil Registration System, and the D...... factors. CONCLUSION: Maternal genes influence prolonged gestation. However, a substantial paternal genetic influence through the fetus was not found....

  2. Gestational surrogacy.

    Science.gov (United States)

    Brinsden, Peter R

    2003-01-01

    Gestational surrogacy is a treatment option available to women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. IVF allows the creation of embryos from the gametes of the commissioning couple and subsequent transfer of these embryos to the uterus of a surrogate host. The indications for treatment include absent uterus, recurrent miscarriage, repeated failure of IVF and certain medical conditions. Treatment by gestational surrogacy is straightforward and follows routine IVF procedures for the commissioning mother, with the transfer of fresh or frozen-thawed embryos to the surrogate host. The results of treatment are good, as would be expected from the transfer of embryos derived from young women and transferred to fit, fertile women who are also young. Clinical pregnancy rates achieved in large series are up to 40% per transfer and series have reported 60% of hosts achieving live births. The majority of ethical or legal problems that have arisen out of surrogacy have been from natural or partial surrogacy arrangements. The experience of gestational surrogacy has been largely complication-free and early results of the follow-up of children, commissioning couples and surrogates are reassuring. In conclusion, gestational surrogacy arrangements are carried out in a few European countries and in the USA. The results of treatment are satisfactory and the incidence of major ethical or legal complications has been limited. IVF surrogacy is therefore a successful treatment for a small group of women who would otherwise not be able to have their own genetic children.

  3. Stable isotope tracer reveals that viviparous snakes transport amino acids to offspring during gestation.

    Science.gov (United States)

    Van Dyke, James U; Beaupre, Steven J

    2012-03-01

    Viviparity and placentation have evolved from oviparity over 100 times in squamate reptiles (lizards and snakes). The independent origins of placentation have resulted in a variety of placental morphologies in different taxa, ranging from simple apposition of fetal and maternal tissues to endotheliochorial implantation that is homoplasious with mammalian placentation. Because the eggs of oviparous squamates transport gases and water from the environment and calcium from the eggshell, the placentae of viviparous squamates are thought to have initially evolved to accomplish these functions from within the maternal oviduct. Species with complex placentae have also been shown to rely substantially, or even primarily, on placental transport of organic nutrients for embryonic nutrition. However, it is unclear whether species with only simple placentae are also capable of transporting organic nutrients to offspring. Among viviparous squamates, all of the snakes that have been studied thus far have been shown to have simple placentae. However, most studies of snake placentation are limited to a single lineage, the North American Natricinae. We tested the abilities of four species of viviparous snakes - Agkistrodon contortrix (Viperidae), Boa constrictor (Boidae), Nerodia sipedon (Colubridae: Natricinae) and Thamnophis sirtalis (Colubridae: Natricinae) - to transport diet-derived amino acids to offspring during gestation. We fed [(15)N]leucine to pregnant snakes, and compared offspring (15)N content with that of unlabeled controls. Labeled females allocated significantly more (15)N to offspring than did controls, but (15)N allocation did not differ among species. Our results indicate that viviparous snakes are capable of transporting diet-derived amino acids to their offspring during gestation, possibly via placentation.

  4. Impact of intrauterine growth restriction on preterm lung disease.

    Science.gov (United States)

    Sasi, Arun; Abraham, Vinita; Davies-Tuck, Miranda; Polglase, Graeme R; Jenkin, Graham; Miller, Suzanne L; Malhotra, Atul

    2015-12-01

    Intrauterine growth restriction (IUGR) is an important cause for prematurity and adversely influences prematurity-related morbidities. This study evaluates the impact of IUGR on respiratory outcomes in infants CLD), CLD or death, and need for home oxygen at discharge. Subgroup analysis by gestation-based stratification (CLD (45% vs. 17%, p = 0.0001), death (16% vs. 4.6%, p = 0.0001), CLD or death (46% vs. 21.5%, p = 0.0001), home oxygen rates (13.7% vs. 6.5%, p = 0.01) and duration of respiratory support was significantly higher in the IUGR group. IUGR emerged as the strongest predictor of CLD (adjusted OR, 95%CI: (8.4 [2, 35]) and CLD or death (12.7 [3, 54]) across all gestation. IUGR is a major risk factor for adverse short-term pulmonary outcomes as reflected by higher rates of CLD, CLD or death, and oxygen dependency at discharge in preterm infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. Healthy Food Intake Index (HFII – Validity and reproducibility in a gestational-diabetes-risk population

    Directory of Open Access Journals (Sweden)

    Jelena Meinilä

    2016-07-01

    Full Text Available Abstract Background The aim was to develop and validate a food-based diet quality index for measuring adherence to the Nordic Nutrition Recommendations (NNR in a pregnant population with high risk of gestational diabetes (GDM. Methods This study is a part of the Finnish Gestational Diabetes Prevention Study (RADIEL, a lifestyle intervention conducted between 2008 and 2014. The 443 pregnant participants (61 % of those invited, were either obese or had a history of GDM. Food frequency questionnaires collected at 1st trimester served for composing the HFII; a sum of 11 food groups (available score range 0–17 with higher scores reflecting higher adherence to the NNR. Results The average HFII of the participants was 10.2 (SD 2.8, range 2–17. Factor analysis for the HFII component matrix revealed three factors that explained most of the distribution (59 % of the HFII. As an evidence of the component relevance 9 out of 11 of the HFII components independently contributed to the total score (item-rest correlation coefficients <0.31. Saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, sucrose, and fiber intakes (among other nutrients showed linearity across the HFII categories (P ≤ 0.030 for all nutrients tested; the higher the HFII, the closer the nutrient intake to the recommended intake level. Educational attainment (P = 0.0045, BMI (P = 0.0098, smoking (P = 0.007, and leisure time physical exercise (P = 0.038 showed linearity across the HFII categories. Intra-class correlation coefficient for the HFII was 0.85 (CI 0.79, 0.90. Conclusions The HFII components reflect the food guidelines of the NNR, intakes of relevant nutrients, and characteristics known to vary with diet quality. It largely ignores energy intake, its components have independent contribution to the HFII, and it exhibits reproducibility. The main shortcomings are absence of red and processed meat component, and the validation in a

  6. Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation.

    LENUS (Irish Health Repository)

    Caritis, Steve N

    2012-11-01

    We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) concentration and gestational age at delivery and select biomarkers of potential pathways of drug action.

  7. Breast milk fat content of mothers to small-for-gestational-age infants.

    Science.gov (United States)

    Domany, K Armoni; Mandel, D; Kedem, M Hausman; Lubetzky, R

    2015-06-01

    Little is known about the composition of human milk (HM) expressed by mothers of asymmetrically growth-restricted infants. To test the null hypothesis that lactating mothers of small-for-gestational-age (SGA) infants produce milk with fat content similar to that of lactating mothers of infants whose growth is appropriate for gestational age (AGA). Fifty-six lactating mothers of newborns (26 SGA and 30 AGA) were recruited within the first 3 days of delivery. Creamatocrit (CMT) levels in HM were measured at 72 h, 7 days and 14 days postdelivery in capillary tubes after centrifugation at 9000 r.p.m. for 5 min. The groups did not differ in terms of maternal age, body mass index, gestational age (GA), pregnancy weight gain and parity. They differed significantly in terms of infant's birth weight by design. The mean CMT levels at the three time points were similar for the two groups. This remained true when timing of the sample (colostrum, transitional, mature milk) was introduced as a confounder in the analysis of variance (general linear model). Fat content of HM is not affected by fetal growth status. We suggest that mothers of SGA infants may be reassured that their milk contains adequate amount of fat that is appropriate for the growth of their infants.

  8. Is Cesarean Delivery Preferable in Twin Pregnancies at >=36 Weeks Gestation?

    Science.gov (United States)

    Dong, Yu; Luo, Zhong-Cheng; Yang, Zu-Jing; Chen, Lu; Guo, Yu-Na; Branch, Ware; Zhang, Jun; Huang, Hong

    2016-01-01

    Background The optimal mode of delivery in twin pregnancies remains controversial. A recent randomized trial did not find any benefit of planned cesarean vs. vaginal delivery at 32–38 weeks gestation, but the trial was not powered to detect a moderate effect. We aimed to evaluate the impact of cesarean delivery on perinatal mortality and severe neonatal morbidity in twin pregnancies at ≥32 weeks through a large database exploration approach with the power to detect moderate risk differences. Methods In a retrospective birth cohort study using the U.S. matched multiple births, 1995–2000 (the available largest multiple birth dataset), we compared perinatal outcomes in twins (n = 181,810 pregnancies) delivered at 32–41 weeks gestation without congenital anomalies. The primary outcome was a composite of perinatal death and severe neonatal morbidity. Cox regression was used to estimate the adjusted hazard ratio (aHR) controlling for the propensity to cesarean delivery, fetal characteristics (sex, birth weight, birth weight discordance, same-sex twin or not) and twin-cluster level dependence. Prospective risks were calculated using the fetuses-at-risk denominators. Results The overall rates of the primary outcome were slightly lower in intended cesarean (6.20%) vs. vaginal (6.45%) deliveries. The aHRs of the primary outcome were in favor of vaginal delivery at 32 (aHR = 1.06, p = 0.03) or 33 (aHR = 1.22, pcesarean delivery at 36 (aHR = 0.94, p = 0.004), 37, 38 and 39+ weeks (aHR: 0.72 to 0.78, all pcesarean vs. vaginal deliveries at 36+ weeks of gestation remained when the analyses were restricted to different-sex (dichorionic) twins (aHR = 0.84, 95% CI 0.80–0.88). Conclusion Cesarean delivery may be beneficial for perinatal outcomes overall in twin pregnancies at ≥36 weeks gestation. PMID:27227678

  9. Application of First Trimester Screening in the Prognostication of Small for Gestational Age

    Directory of Open Access Journals (Sweden)

    Reza Saeidi

    2018-05-01

    Full Text Available Background: Fetal growth restriction is defined as the failure of the fetus to achieve its full growth potential. The present study aimed to investigate the application of first trimester screening in the prediction of small for gestational age (SGA.Methods: This cohort study was conducted on the consecutive and unselected women with singleton pregnancies undergoing routine first-trimester examinations in a health center affiliated to Neyshabur University of Medical Sciences in Razavi Khorasan Iran during February 2014-March 2016. Subjects received a first-trimester visit by a physician, which included the entry of basic maternal characteristics, medical history, measurement of maternal weight and height, ultrasound examination for fetal anatomy, and measurement of crown-rump length to assess gestational age.Results: SGA was significantly correlated with maternal age, parity, and body mass index. Furthermore, a significant association was observed between SGA and smoking habits in the mothers.Conclusion: According to the results, first trimester screening was a useful method for the prediction of SGA.

  10. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

    Directory of Open Access Journals (Sweden)

    Henrica M A de Bie

    Full Text Available Intrauterine growth restriction (IUGR can lead to infants being born small for gestational age (SGA. SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI.18 children born appropriate for gestational age (AGA and 34 SGA born children (18 with and 16 without postnatal catch-up growth participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning. A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes.Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA.This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

  11. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

    Science.gov (United States)

    de Bie, Henrica M A; de Ruiter, Michiel B; Ouwendijk, Mieke; Oostrom, Kim J; Wilke, Marko; Boersma, Maria; Veltman, Dick J; Delemarre-van de Waal, Henriette A

    2015-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI). 18 children born appropriate for gestational age (AGA) and 34 SGA born children (18 with and 16 without postnatal catch-up growth) participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning). A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes. Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA. This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

  12. Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction.

    Science.gov (United States)

    Caradeux, J; Eixarch, E; Mazarico, E; Basuki, T R; Gratacós, E; Figueras, F

    2018-02-01

    Detection of fetal growth restriction (FGR) remains poor and most screening strategies rely on cross-sectional evaluation of fetal size during the third trimester. A longitudinal and individualized approach has been proposed as an alternative method of evaluation. The aim of this study was to compare second- to third-trimester longitudinal growth assessment to cross-sectional evaluation in the third trimester for the prediction of small-for-gestational age (SGA) and late FGR in low-risk singleton pregnancy. This was a prospective cohort study of 2696 unselected consecutive low-risk singleton pregnancies scanned at 21 ± 2 and 32 ± 2 weeks. For cross-sectional growth assessment, abdominal circumference (AC) measurements were transformed to z-values according the 21st-INTERGROWTH standards. Longitudinal growth assessment was performed by calculating the AC z-velocity and the second- to third-trimester AC conditional growth centile. Longitudinal assessment was compared with cross-sectional assessment at 32 weeks. Association of cross-sectional and longitudinal evaluations with SGA and late FGR was assessed by logistic regression analysis. Predictive performance was determined by receiver-operating characteristics curve analysis. In total, 210 (7.8%) newborns were classified as SGA and 103 (3.8%) as late FGR. Neither longitudinal measurement improved the association with SGA or late FGR provided by cross-sectional evaluation of AC z-score at 32 weeks. Areas under the curves of AC z-velocity and conditional AC growth were significantly smaller than those of cross-sectional AC z-scores (P third trimester has a low predictive capacity for SGA and late FGR in low-risk singleton pregnancy compared with cross-sectional growth evaluation. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

  13. Protein and Amino Acid Restriction, Aging and Disease: from yeast to humans

    OpenAIRE

    Mirzaei, Hamed; Suarez, Jorge A.; Longo, Valter D.

    2014-01-01

    Many of the effects of dietary restriction (DR) on longevity and health span in model organisms have been linked to reduced protein and amino acid (AA) intake and the stimulation of specific nutrient signaling pathways. Studies in yeast have shown that addition of serine, threonine, and valine in media promotes cellular sensitization and aging by activating different but connected pathways. Protein or essential AA restriction extends both lifespan and healthspan in rodent models. In humans, p...

  14. Gestational dating by metabolic profile at birth: a California cohort study

    Science.gov (United States)

    Jelliffe-Pawlowski, Laura L.; Norton, Mary E.; Baer, Rebecca J.; Santos, Nicole; Rutherford, George W.

    2016-01-01

    Background Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. Objective We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (PTBs and term births. Using a linear discriminate analyses-derived linear function, we were able to sort PTBs and term births accurately with sensitivities and specificities of ≥95% in both the training and testing subsets. Assignment of a specific week of gestation in those identified as PTBs resulted in the correct assignment of week ±2 weeks in 89.8% of all newborns in the training and 91.7% of those in the testing subset. When PTB rates were modeled using the metabolic dating algorithm compared to fetal ultrasound, PTB rates were 7.15% vs 6.11% in the training subset and 7.31% vs 6.25% in the testing subset. Conclusion When considered in combination with birthweight and hours of age at test, metabolic profile evaluated within 8 days of birth appears to be a useful measure of PTB and, among those born preterm, of specific week of gestation ±2 weeks. Dating by metabolic profile may be useful in instances where there is no fetal ultrasound due to lack of availability or late entry into care. PMID

  15. The management of gestational diabetes

    Directory of Open Access Journals (Sweden)

    N Wah Cheung

    2009-01-01

    Full Text Available N Wah CheungCentre for Diabetes and Endocrinology Research, Westmead Hospital, and University of Sydney, NSW, AustraliaAbstract: The incidence of gestational diabetes is increasing. As gestational diabetes is associated with adverse pregnancy outcomes, and has long-term implications for both mother and child, it is important that it is recognized and appropriately managed. This review will examine the pharmacological options for the management of gestational diabetes, as well as the evidence for blood glucose monitoring, dietary and exercise therapy. The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have added considerably to our knowledge in this area. As insulin therapy is effective and safe, it is considered the gold standard of pharmacotherapy for gestational diabetes, against which other treatments have been compared. The current experience is that the short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst short-term data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm.Keywords: gestational diabetes, insulin, oral antidiabetic agents, pregnancy, type 2 diabetes

  16. Effect of nutrient restriction and re-feeding on calpain family genes in skeletal muscle of channel catfish (Ictalurus punctatus.

    Directory of Open Access Journals (Sweden)

    Elena Preziosa

    Full Text Available BACKGROUND: Calpains, a superfamily of intracellular calcium-dependent cysteine proteases, are involved in the cytoskeletal remodeling and wasting of skeletal muscle. Calpains are generated as inactive proenzymes which are activated by N-terminal autolysis induced by calcium-ions. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we characterized the full-length cDNA sequences of three calpain genes, clpn1, clpn2, and clpn3 in channel catfish, and assessed the effect of nutrient restriction and subsequent re-feeding on the expression of these genes in skeletal muscle. The clpn1 cDNA sequence encodes a protein of 704 amino acids, Clpn2 of 696 amino acids, and Clpn3 of 741 amino acids. Phylogenetic analysis of deduced amino acid sequences indicate that catfish Clpn1 and Clpn2 share a sequence similarity of 61%; catfish Clpn1 and Clpn3 of 48%, and Clpn2 and Clpn3 of only 45%. The domain structure architectures of all three calpain genes in channel catfish are similar to those of other vertebrates, further supported by strong bootstrap values during phylogenetic analyses. Starvation of channel catfish (average weight, 15-20 g for 35 days influenced the expression of clpn1 (2.3-fold decrease, P<0.05, clpn2 (1.3-fold increase, P<0.05, and clpn3 (13.0-fold decrease, P<0.05, whereas the subsequent refeeding did not change the expression of these genes as measured by quantitative real-time PCR analysis. Calpain catalytic activity in channel catfish skeletal muscle showed significant differences only during the starvation period, with a 1.2- and 1.4- fold increase (P<0.01 after 17 and 35 days of starvation, respectively. CONCLUSION/SIGNIFICANCE: We have assessed that fasting and refeeding may provide a suitable experimental model to provide us insight into the role of calpains during fish muscle atrophy and how they respond to changes in nutrient supply.

  17. Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers.

    Science.gov (United States)

    Gaccioli, Francesca; Aye, Irving L M H; Sovio, Ulla; Charnock-Jones, D Stephen; Smith, Gordon C S

    2018-02-01

    Fetal growth restriction is a major determinant of perinatal morbidity and mortality. Screening for fetal growth restriction is a key element of prenatal care but it is recognized to be problematic. Screening using clinical risk assessment and targeting ultrasound to high-risk women is the standard of care in the United States and United Kingdom, but the approach is known to have low sensitivity. Systematic reviews of randomized controlled trials do not demonstrate any benefit from universal ultrasound screening for fetal growth restriction in the third trimester, but the evidence base is not strong. Implementation of universal ultrasound screening in low-risk women in France failed to reduce the risk of complications among small-for-gestational-age infants but did appear to cause iatrogenic harm to false positives. One strategy to making progress is to improve screening by developing more sensitive and specific tests with the key goal of differentiating between healthy small fetuses and those that are small through fetal growth restriction. As abnormal placentation is thought to be the major cause of fetal growth restriction, one approach is to combine fetal biometry with an indicator of placental dysfunction. In the past, these indicators were generally ultrasonic measurements, such as Doppler flow velocimetry of the uteroplacental circulation. However, another promising approach is to combine ultrasonic suspicion of small-for-gestational-age infant with a blood test indicating placental dysfunction. Thus far, much of the research on maternal serum biomarkers for fetal growth restriction has involved the secondary analysis of tests performed for other indications, such as fetal aneuploidies. An exemplar of this is pregnancy-associated plasma protein A. This blood test is performed primarily to assess the risk of Down syndrome, but women with low first-trimester levels are now serially scanned in later pregnancy due to associations with placental causes of

  18. Estimating Gestational Age From Ultrasound Fetal Biometrics.

    Science.gov (United States)

    Skupski, Daniel W; Owen, John; Kim, Sungduk; Fuchs, Karin M; Albert, Paul S; Grantz, Katherine L

    2017-08-01

    To compare the accuracy of a new formula with one developed in 1984 (and still in common use) and to develop and compare racial and ethnic-specific and racial and ethnic-neutral formulas. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons was a prospective cohort study that recruited women in four self-reported racial-ethnic groups-non-Hispanic black, Hispanic, non-Hispanic white, and Asian-with singleton gestations from 12 U.S. centers (2009-2013). Women with a certain last menstrual period confirmed by first-trimester ultrasonogram had longitudinal fetal measurements by credentialed study ultrasonographers blinded to the gestational age at their five follow-up visits. Regression analyses were performed with linear mixed models to develop gestational age estimating formulas. Repeated cross-validation was used for validation. The estimation error was defined as the mean squared difference between the estimated and observed gestational age and was used to compare the formulas' accuracy. The new formula estimated the gestational age (±2 SD) within ±7 days from 14 to 20 weeks of gestation, ±10 days from 21 to 27 weeks of gestation, and ±17 days from 28 to 40 weeks of gestation. The new formula performed significantly better than a formula developed in 1984 with an estimation error of 10.4 compared with 11.2 days from 21 to 27 weeks of gestation and 17.0 compared with 19.8 days at 28-40 weeks of gestation, respectively. Racial and ethnic-specific formulas did not outperform the racial and ethnic-neutral formula. The NICHD gestational age estimation formula is associated with smaller errors than a well-established historical formula. Racial and ethnic-specific formulas are not superior to a racial-ethnic-neutral one.

  19. Growth restriction in gastroschisis: quantification of its severity and exploration of a placental cause

    Directory of Open Access Journals (Sweden)

    Olsen Sam

    2011-10-01

    Full Text Available Abstract Background Gastroschisis patients are commonly small for gestational age (SGA, birth weight [BW] th centile. However, the extent, symmetry and causes of that growth restriction remain controversial. Methods We compared BW, crown-heel length (LT, occipitofrontal circumference (OFC and ponderal index (PI in 179 gastroschisis cases and 895 matched controls by univariate and multiple regression. Fetal ultrasounds (N = 80 were reviewed to determine onset of growth restriction. Placental histology was examined in 31 gastroschisis patients whose placental tissue was available and in 29 controls. Results Gastroschisis cases weighed less than controls (BW = 2400 ± 502 g vs. 2750 ± 532 g, p Conclusions Marked, relatively symmetric intrauterine growth restriction is an intrinsic part of gastroschisis. It begins early in the second trimester, and is associated with placental chorangiosis.

  20. Octreotide therapy and restricted fetal growth: pregnancy in familial hyperinsulinemic hypoglycemia

    Directory of Open Access Journals (Sweden)

    Marianne Geilswijk

    2017-02-01

    Full Text Available Hypoglycemia during pregnancy can have serious health implications for both mother and fetus. Although not generally recommended in pregnancy, synthetic somatostatin analogues are used for the management of blood glucose levels in expectant hyperinsulinemic mothers. Recent reports suggest that octreotide treatment in pregnancy, as well as hypoglycemia in itself, may pose a risk of fetal growth restriction. During pregnancy, management of blood glucose levels in familial hyperinsulinemic hypoglycemia thus forms a medical dilemma. We report on pregnancy outcomes in a woman with symptomatic familial hyperinsulinemic hypoglycemia, type 3. During the patient’s first pregnancy with a viable fetus octreotide treatment was instituted in gestational age 23 weeks to prevent severe hypoglycemic incidences. Fetal growth velocity declined, and at 37 weeks of gestation, intrauterine growth retardation was evident. During the second pregnancy with a viable fetus, blood glucose levels were managed through dietary intervention alone. Thus, the patient was advised to take small but frequent meals high in fiber and low in carbohydrates. Throughout pregnancy, no incidences of severe hypoglycemia occurred and fetal growth velocity was normal. We conclude that octreotide treatment during pregnancy may pose a risk of fetal growth restriction and warrants careful consideration. In some cases of familial hyperinsulinemic hypoglycemia, blood glucose levels can be successfully managed through diet only, also during pregnancy.

  1. Ethical issues in gestational surrogacy.

    Science.gov (United States)

    Ber, R

    2000-01-01

    The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing?

  2. Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes.

    Science.gov (United States)

    Leppänen, Marja; Aittasalo, Minna; Raitanen, Jani; Kinnunen, Tarja I; Kujala, Urho M; Luoto, Riitta

    2014-11-01

    The aim of this study was to examine the predictors of change in intensity-specific leisure-time physical activity (LTPA) during pregnancy, and the perceived support and barriers of LTPA in Finnish pregnant women at increased risk of gestational diabetes. The study population consisted of 399 pregnant women who participated in a randomized controlled trial aiming to prevent gestational diabetes. Evaluation of LTPA was based on a self-report at baseline, 26-28, and 36-37 weeks' gestation. Data on predictors of change, perceived support and barriers were collected with questionnaires and from the maternity cards. Multinomial logistic regression was used to assess associations between the variables. The average weekly minutes of light-intensity LTPA were 179 at baseline, 161 at 26-28 weeks' gestation, and 179 at 36-37 weeks' gestation. The corresponding minutes of moderate-to-vigorous-intensity LTPA were 187, 133 and 99. At 26-28 weeks' gestation, the strongest predictors for light-intensity LTPA were meeting the PA recommendations prior to pregnancy, having polytechnic education and working part-time, while having a physically active spouse prior to pregnancy was the strongest predictor for moderate-to-vigorous-intensity LTPA. The people and/or factors that encouraged women to LTPA the most were the spouse, a child, other family members and weather, whereas tiredness, nausea, perceived health, work and lack of time restricted their LTPA the most. The strongest predictors for maintaining LTPA during pregnancy were pre-pregnancy LTPA, education, working part-time and a spouse's LTPA. Most common barriers were perceived health, work and lack of time.

  3. How to monitor pregnancies complicated by fetal growth restriction and delivery before 32 weeks : post-hoc analysis of TRUFFLE study

    NARCIS (Netherlands)

    Ganzevoort, W.; Mensing van Charante, N.; Thilaganathan, B.; Prefumo, Federico; Arabin, B.; Bilardo, Caterina M.; Brezinka, C.; Derks, J. B.; Diemert, A.; Duvekot, Johannes J.; Ferrazzi, E.; Frusca, T.; Hecher, K.; Marlow, N.; Martinelli, P.; Ostermayer, E.; Papageorghiou, Aris T.; Schlembach, D.; Schneider, K. T M; Todros, T.; Valcamonico, A.; Visser, G. H.A.; van Wassenaer-Leemhuis, A.; Lees, Christoph C.; Wolf, H.; Aktas, Ayse; Borgione, Silvia; Chaoui, Rabih; Cornette, Jerome M J; Diehl, Thilo; van Eyck, J.; Fratelli, Nicola; van Haastert, I. C.; Lobmaier, Silvia; Lopriore, E.; Missfelder-Lobos, Hannah; Mansi, Giuseppina; Martelli, Paola; Maso, Gianpaolo; Maurer-Fellbaum, Ute; Mulder-De Tollenaer, Susanne; Napolitano, Raffaele; Oberto, Manuela; Oepkes, D.; Ogge, Giovanna; van der Post, Joris A. M.; Preston, Lucy; Raimondi, Francesco; Rattue, H.; Reiss, Irwin K M; Scheepers, L. S.; Skabar, Aldo; Spaanderman, M.; Weisglas-Kuperus, N.; Zimmermann, Andrea

    2017-01-01

    Objectives: In the recent TRUFFLE study, it appeared that, in pregnancies complicated by fetal growth restriction (FGR) between 26 and 32 weeks' gestation, monitoring of the fetal ductus venosus (DV) waveform combined with computed cardiotocography (CTG) to determine timing of delivery increased the

  4. Different types of dietary advice for women with gestational diabetes mellitus.

    Science.gov (United States)

    Han, Shanshan; Middleton, Philippa; Shepherd, Emily; Van Ryswyk, Emer; Crowther, Caroline A

    2017-02-25

    .14; one trial, 83 women; very low-quality evidence) or caesarean section (RR 0.66, 95% CI 0.29 to 1.47; one trial, 63 women; low-quality evidence). Energy-restricted versus no energy-restricted diet (three trials): no clear differences seen for: large-for-gestational age (RR 1.17, 95% CI 0.65 to 2.12; one trial, 123 infants; low-quality evidence); perinatal mortality (no events; two trials, 423 infants; low-quality evidence); pre-eclampsia (RR 1.00, 95% CI 0.51 to 1.97; one trial, 117 women; low-quality evidence); or caesarean section (RR 1.12, 95% CI 0.80 to 1.56; two trials, 420 women; low-quality evidence). DASH (Dietary Approaches to Stop Hypertension) diet versus control diet (three trials): no clear differences observed for: pre-eclampsia (RR 1.00, 95% CI 0.31 to 3.26; three trials, 136 women); however there were fewer caesarean sections in the DASH diet group (RR 0.53, 95% CI 0.37 to 0.76; two trials, 86 women). Low-carbohydrate versus high-carbohydrate diet (two trials): no clear differences seen for: large-for-gestational age (RR 0.51, 95% CI 0.13 to 1.95; one trial, 149 infants); perinatal mortality (RR 3.00, 95% CI 0.12 to 72.49; one trial, 150 infants); maternal hypertension (RR 0.40, 95% CI 0.13 to 1.22; one trial, 150 women); or caesarean section (RR 1.29, 95% CI 0.84 to 1.99; two trials, 179 women). High unsaturated fat versus low unsaturated fat diet (two trials): no clear differences observed for: large-for-gestational age (RR 0.54, 95% CI 0.21 to 1.37; one trial, 27 infants); pre-eclampsia (no cases; one trial, 27 women); hypertension in pregnancy (RR 0.54, 95% CI 0.06 to 5.26; one trial, 27 women); caesarean section (RR 1.08, 95% CI 0.07 to 15.50; one trial, 27 women); diabetes at one to two weeks (RR 2.00, 95% CI 0.45 to 8.94; one trial, 24 women) or four to 13 months postpartum (RR 1.00, 95% CI 0.10 to 9.61; one trial, six women). Low-GI versus high-fibre moderate-GI diet (one trial): no clear differences seen for: large-for-gestational age (RR 2

  5. Gestational diabetes: A clinical update

    DEFF Research Database (Denmark)

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance...

  6. Pregnancy-specific stress, fetoplacental haemodynamics, and neonatal outcomes in women with small for gestational age pregnancies: a secondary analysis of the multicentre Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction.

    Science.gov (United States)

    Levine, Terri A; Grunau, Ruth E; Segurado, Ricardo; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; O'Donoghue, Keelin; Hunter, Alyson; Morrison, John J; Burke, Gerard; Dicker, Patrick; Tully, Elizabeth C; Malone, Fergal D; Alderdice, Fiona A; McAuliffe, Fionnuala M

    2017-06-21

    To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes. This is a secondary analysis of data collected for a large-scale prospective observational study. This study was conducted in the seven major obstetric hospitals in Ireland and Northern Ireland. Participants included 331 women who participated in the Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction. Women with singleton pregnancies between 24 and 36 weeks gestation, estimated fetal weight <10th percentile and no major structural or chromosomal abnormalities were included. Serial Doppler ultrasound examinations of the umbilical and middle cerebral arteries between 20 and 42 weeks gestation, Pregnancy Distress Questionnaire (PDQ) scores between 23 and 40 weeks gestation and neonatal outcomes. Concerns about physical symptoms and body image at 35-40 weeks were associated with lower odds of abnormal UAPI (OR 0.826, 95% CI 0.696 to 0.979, p=0.028). PDQ score (OR 1.073, 95% CI 1.012 to 1.137, p=0.017), concerns about birth and the baby (OR 1.143, 95% CI 1.037 to 1.260, p=0.007) and concerns about physical symptoms and body image (OR 1.283, 95% CI 1.070 to 1.538, p=0.007) at 29-34 weeks were associated with higher odds of abnormal MCA PI. Concerns about birth and the baby at 29-34 weeks (OR 1.202, 95% CI 1.018 to 1.421, p=0.030) were associated with higher odds of AEDF. Concerns about physical symptoms and body image at 35-40 weeks were associated with decreased odds of neonatal intensive care unit admission (OR 0.635, 95% CI 0

  7. Gestational Diabetes Mellitus

    DEFF Research Database (Denmark)

    McIntyre, H David; Jensen, Dorte M; Jensen, Richard C

    2018-01-01

    OBJECTIVE: To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort. RESEARCH DESIGN AND METHODS: This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria....... FVPG measured at 28 weeks' gestation was related to pregnancy outcomes. RESULTS: With use of the World Health Organization 2013 threshold of FVPG ≥5.1 mmol/L, 40.1% of the cohort qualified as having GDM. There was no evidence of excess fetal growth, hypertension in pregnancy, or caesarean delivery...

  8. First trimester serum afamin concentrations are associated with the development of pre-eclampsia and gestational diabetes mellitus in pregnant women.

    Science.gov (United States)

    Tramontana, Allessandra; Dieplinger, Benjamin; Stangl, Gerhard; Hafner, Erich; Dieplinger, Hans

    2018-01-01

    Aim of this study was to assess the prognostic capability of afamin to predict pregnancy complications. First-trimester screening was consecutively performed in 4948 pregnant women, of whom 474 women developed pregnancy complications [gestational hypertension (n=84), pre-eclampsia (n=30), intrauterine growth restriction (n=107), preterm birth (n=44), and gestational diabetes mellitus (n=209)]. To each woman with pregnancy complications an uncomplicated pregnancy was matched for body mass index. Afamin serum concentrations were measured in 948 pregnant women at the first-trimester screening. Median afamin concentrations were significantly higher in women developing pre-eclampsia or gestational diabetes mellitus when compared to women with uncomplicated pregnancies (76mg/L vs. 65mg/L, p=0.001 and 80mg/L vs. 69mg/L, p65mg/L) was a strong and independent predictor for the development of pre-eclampsia (risk ratio, 24.58; 95%CI, 2.82-214.12; p=0.004) as well as gestational diabetes mellitus (risk ratio, 2.07; 95%CI, 1.33-3.22; p=0.001). In this large nested case-control study increased afamin concentrations were a strong and independent predictor for pre-eclampsia and gestational diabetes mellitus, suggesting a potential role of afamin as predictive marker for pregnancy-related metabolic disorders. Copyright © 2017. Published by Elsevier B.V.

  9. The implications of phasing out conventional nutrient supply in organic agriculture

    DEFF Research Database (Denmark)

    Oelofse, Myles; Jensen, Lars Stoumann; Magid, Jakob

    2013-01-01

    Soil fertility management in organic systems, regulated by the organic standards, should seek to build healthy, fertile soils and reduce reliance on external inputs. The use of nutrients from conventional sources, such as animal manures from conventional farms, is currently permitted......, with restrictions, in the organic regulations. However, the reliance of organic agriculture on the conventional system is considered problematic. In light of this, the organic sector in Denmark has recently decided to gradually phase out, and ultimately ban, the use of conventional manures and straws in organic...... agriculture in Denmark. Core focal areas for phasing out conventional nutrients are as follows: (1) amendments to crop selection and rotations, (2) alternative nutrient sources (organic wastes) and (3) increased cooperation between organic livestock and arable farmers. Using Denmark as a case, this article...

  10. Maternal Fish Consumption and Infant Birth Size and Gestation: New York State Angler Cohort Study

    Directory of Open Access Journals (Sweden)

    Weiner John M

    2003-06-01

    Full Text Available Abstract Background The scientific literature poses a perplexing dilemma for pregnant women with respect to the consumption of fish from natural bodies of water. On one hand, fish is a good source of protein, low in fat and a rich source of other nutrients all of which have presumably beneficial effects on developing embryos and fetuses. On the other hand, consumption of fish contaminated with environmental toxicants such as polychlorinated biphenyls (PCBs has been associated with decrements in gestation and birth size. Methods 2,716 infants born between 1986–1991 to participants of the New York State Angler Cohort Study were studied with respect to duration of maternal consumption of contaminated fish from Lake Ontario and its tributaries and gestation and birth size. Hospital delivery records (maternal and newborn were obtained for 92% of infants for the ascertainment of gestation (weeks, birth size (weight, length, chest, and head circumference and other known determinants of fetal growth (i.e., maternal parity, history of placental infarction, uterine bleeding, pregnancy loss or cigarette smoking and infant's race, sex and presence of birth defect. Duration of maternal fish consumption prior to the index infant's birth was categorized as: none; 1–2, 3–7, 8+ years, while birth weight (in grams, birth length (in centimeters, and head and chest circumference (in centimeters were left as continuous variables in multiple linear regression models. Birth size percentiles, ponderal indices and head to chest circumference ratios were computed to further assess proportionality and birth size in relation to gestational age. Results Analysis of variance failed to identify significant mean differences in gestation or any measure of birth size in relation to duration of maternal lifetime fish consumption. Multiple linear regressions identified gestational age, male sex, number of daily cigarettes, parity and placental infarction, as significant

  11. Screening for gestational diabetes mellitus

    NARCIS (Netherlands)

    van Leeuwen, M.

    2012-01-01

    Gestational diabetes mellitus is associated with increased risk of complications for mother and child. Along with the growing epidemic of obesity and type 2 diabetes, the prevalence of gestational diabetes is expected to rise. With adequate and timely treatment, the risk of complications is reduced.

  12. HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes.

    Science.gov (United States)

    Barquiel, Beatriz; Herranz, Lucrecia; Hillman, Natalia; Burgos, Ma Ángeles; Grande, Cristina; Tukia, Keleni M; Bartha, José Luis; Pallardo, Luis Felipe

    2016-06-01

    Maternal glucose and weight gain are related to neonatal outcome in women with gestational diabetes mellitus (GDM). The aim of this study was to explore the influence of average third-trimester HbA1c and excess gestational weight gain on GDM neonatal complications. This observational study included 2037 Spanish singleton pregnant women with GDM followed in our Diabetes and Pregnancy Unit. The maternal HbA1c level was measured monthly from GDM diagnosis to delivery. Women were compared by average HbA1c level and weight gain categorized into ≤ or > the current Institute of Medicine (IOM) recommendations for body mass index. The differential effects of these factors on large-for-gestational-age birth weight and a composite of neonatal complications were assessed. Women with an average third-trimester HbA1c ≥5.0% (n = 1319) gave birth to 7.3% versus 3.8% (p = 0.005) of large-for-gestational-age neonates and 22.0% versus 16.0% (p = 0.006) of neonates with complications. Women with excess gestational weight gain (n = 299) delivered 12.5% versus 5.2% (p gestational-age neonates and 24.7% versus 19.0% (p = 0.022) of neonates with complications. In an adjusted multiple logistic regression analysis among mothers exposed to the respective risk factors, ∼47% and 52% of large-for-gestational-age neonates and 32% and 37% of neonatal complications were potentially preventable by attaining an average third-trimester HbA1c level gestational weight gain. Average third-trimester HbA1c level ≥5% and gestational weight gain above the IOM recommendation are relevant risk factors for neonatal complications in mothers with gestational diabetes.

  13. Children’s Brain Development Benefits from Longer Gestation

    Directory of Open Access Journals (Sweden)

    Elysia Poggi Davis

    2011-02-01

    Full Text Available Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging (MRI in 100 healthy right-handed six to ten year old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in grey matter density. Further, the benefit of longer gestation for brain development was present even when only full term infants were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.

  14. A role for neuronal cAMP responsive-element binding (CREB)-1 in brain responses to calorie restriction

    Science.gov (United States)

    Fusco, Salvatore; Ripoli, Cristian; Podda, Maria Vittoria; Ranieri, Sofia Chiatamone; Leone, Lucia; Toietta, Gabriele; McBurney, Michael W.; Schütz, Günther; Riccio, Antonella; Grassi, Claudio; Galeotti, Tommaso; Pani, Giovambattista

    2012-01-01

    Calorie restriction delays brain senescence and prevents neurodegeneration, but critical regulators of these beneficial responses other than the NAD+-dependent histone deacetylase Sirtuin-1 (Sirt-1) are unknown. We report that effects of calorie restriction on neuronal plasticity, memory and social behavior are abolished in mice lacking cAMP responsive-element binding (CREB)-1 in the forebrain. Moreover, CREB deficiency drastically reduces the expression of Sirt-1 and the induction of genes relevant to neuronal metabolism and survival in the cortex and hippocampus of dietary-restricted animals. Biochemical studies reveal a complex interplay between CREB and Sirt-1: CREB directly regulates the transcription of the sirtuin in neuronal cells by binding to Sirt-1 chromatin; Sirt-1, in turn, is recruited by CREB to DNA and promotes CREB-dependent expression of target gene peroxisome proliferator-activated receptor-γ coactivator-1α and neuronal NO Synthase. Accordingly, expression of these CREB targets is markedly reduced in the brain of Sirt KO mice that are, like CREB-deficient mice, poorly responsive to calorie restriction. Thus, the above circuitry, modulated by nutrient availability, links energy metabolism with neurotrophin signaling, participates in brain adaptation to nutrient restriction, and is potentially relevant to accelerated brain aging by overnutrition and diabetes. PMID:22190495

  15. Impact of Nutrient Restriction on the Structure of Listeria monocytogenes Biofilm Grown in a Microfluidic System

    Science.gov (United States)

    Cherifi, Tamazight; Jacques, Mario; Quessy, Sylvain; Fravalo, Philippe

    2017-01-01

    Biofilm formation by the pathogen Listeria monocytogenes is a major concern in food industries. The aim of this work was to elucidate the effect of nutrient limitation on both biofilm architecture and on the viability of the bacteria in microfluidic growth conditions. Biofilm formation by two L. monocytogenes strains was performed in a rich medium (BHI) and in a 10-fold diluted BHI (BHI/10) at 30°C for 24 h by using both static conditions and the microfluidic system Bioflux. In dynamic conditions, biofilms grown in rich and poor medium showed significant differences as well in structure and in the resulting biovolume. In BHI/10, biofilm was organized in a knitted network where cells formed long chains, whereas in the rich medium, the observed structure was homogeneous cellular multilayers. Biofilm biovolume production in BHI/10 was significantly higher than in BHI in these dynamic conditions. Interestingly, biovolume of dead cells in biofilms formed under limited nutrient conditions (BHI/10) was significantly higher than in biofilms formed in the BHI medium. In the other hand, in static conditions, biofilm is organized in a multilayer cells and dispersed cells in a rich medium BHI and poor medium BHI/10 respectively. There was significantly more biomass in the rich medium compared to BHI/10 but no difference was noted in the dead/damaged subpopulation showing how L. monocytogenes biofilm could be affected by the growth conditions. This work demonstrated that nutrient concentration affects biofilm structure and the proportion of dead cells in biofilms under microfluidic condition. Our study also showed that limited nutrients play an important role in the structural stability of L. monocytogenes biofilm by enhancing cell death and liberating extracellular DNA. PMID:28567031

  16. Impact of Nutrient Restriction on the Structure of Listeria monocytogenes Biofilm Grown in a Microfluidic System

    Directory of Open Access Journals (Sweden)

    Tamazight Cherifi

    2017-05-01

    Full Text Available Biofilm formation by the pathogen Listeria monocytogenes is a major concern in food industries. The aim of this work was to elucidate the effect of nutrient limitation on both biofilm architecture and on the viability of the bacteria in microfluidic growth conditions. Biofilm formation by two L. monocytogenes strains was performed in a rich medium (BHI and in a 10-fold diluted BHI (BHI/10 at 30°C for 24 h by using both static conditions and the microfluidic system Bioflux. In dynamic conditions, biofilms grown in rich and poor medium showed significant differences as well in structure and in the resulting biovolume. In BHI/10, biofilm was organized in a knitted network where cells formed long chains, whereas in the rich medium, the observed structure was homogeneous cellular multilayers. Biofilm biovolume production in BHI/10 was significantly higher than in BHI in these dynamic conditions. Interestingly, biovolume of dead cells in biofilms formed under limited nutrient conditions (BHI/10 was significantly higher than in biofilms formed in the BHI medium. In the other hand, in static conditions, biofilm is organized in a multilayer cells and dispersed cells in a rich medium BHI and poor medium BHI/10 respectively. There was significantly more biomass in the rich medium compared to BHI/10 but no difference was noted in the dead/damaged subpopulation showing how L. monocytogenes biofilm could be affected by the growth conditions. This work demonstrated that nutrient concentration affects biofilm structure and the proportion of dead cells in biofilms under microfluidic condition. Our study also showed that limited nutrients play an important role in the structural stability of L. monocytogenes biofilm by enhancing cell death and liberating extracellular DNA.

  17. Hypercaloric diet prevents sexual impairment induced by maternal food restriction.

    Science.gov (United States)

    Bernardi, M M; Macrini, D J; Teodorov, E; Bonamin, L V; Dalboni, L C; Coelho, C P; Chaves-Kirsten, G P; Florio, J C; Queiroz-Hazarbassanov, N; Bondan, E F; Kirsten, T B

    2017-05-01

    Prenatal undernutrition impairs copulatory behavior and increases the tendency to become obese/overweight, which also reduces sexual behavior. Re-feeding rats prenatally undernourished with a normocaloric diet can restore their physiological conditions and copulatory behavior. Thus, the present study investigated whether a hypercaloric diet that is administered in rats during the juvenile period prevents sexual impairments that are caused by maternal food restriction and the tendency to become overweight/obese. Female rats were prenatally fed a 40% restricted diet from gestational day 2 to 18. The pups received a hypercaloric diet from postnatal day (PND) 23 to PND65 (food restricted hypercaloric [FRH] group) or laboratory chow (food restricted control [FRC] group). Pups from non-food-restricted dams received laboratory chow during the entire experiment (non-food-restricted [NFR] group). During the juvenile period and adulthood, body weight gain was evaluated weekly. The day of balanopreputial separation, sexual behavior, sexual organ weight, hypodermal adiposity, striatal dopamine and serotonin, serum testosterone, and tumor necrosis factor α (TNF-α) were evaluated. The FRH group exhibited an increase in body weight on PND58 and PND65. The FRC group exhibited an increase in the latency to the first mount and intromission and an increase in serum TNF-α levels but a reduction of dopaminergic activity. The hypercaloric diet reversed all of these effects but increased adiposity. We concluded that the hypercaloric diet administered during the juvenile period attenuated reproductive impairments that were induced by maternal food restriction through increases in the energy expenditure but not the tendency to become overweight/obese. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Correlation between self-reported gestational age and ultrasound measurements

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes Grabow; Thomsen, Sten Grove

    2004-01-01

    BACKGROUND: We studied the agreement between different measurements of gestational age, i.e. self-reported gestational age in the Danish National Birth Cohort Study, ultrasound-estimated gestational age from the medical records in one Danish county and gestational age from the Danish National...

  19. Clinical diagnosis of gestational diabetes.

    Science.gov (United States)

    Ryan, Edmond A

    2013-12-01

    Gestational diabetes mellitus (GDM) diagnosis remains controversial. ACOG criteria are based on the long-term risk of maternal diabetes. ADA recently suggested diagnosing GDM with 1 elevated value on an oral glucose tolerance test based on a 1.75-fold risk of large-for-gestational age infants resulting in a 17.8% rate of GDM. Given the lack of neonatal-based outcomes for the traditional position and problems of reproducibility and benefit/harm balance of the ADA approach, an alternative is presented herein based on a 2-fold risk of a large-for-gestational age baby, requiring 2 separate abnormalities to reduce false positives giving a more balanced benefit/harm ratio (10% GDM rate).

  20. Effect of TV food advertising restriction on food environment for children in South Korea.

    Science.gov (United States)

    Lee, Youngmi; Yoon, Jihyun; Chung, Sang-Jin; Lee, Soo-Kyung; Kim, Hyogyoo; Kim, Soyoung

    2017-02-01

    This study attempted to determine the effects of restrictions on television (TV) food advertising on children's food environments in South Korea. It examined changes that occurred in the marketing mix of food companies following enactment of those restrictions. An on-line survey was conducted with marketers or R&D managers of 108 food companies. A questionnaire was used to inquire about changes that occurred in Product, Place, Price and Promotion as a result of the restrictions placed on TV food advertising. Analysis was performed on the data collected from the responding 63 food companies (58.3%). The results of their answers showed that among the four marketing mix components the restrictions exerted relatively stronger effects on Product. Effects were stronger on companies that produced foods within the product categories of Energy-Dense and Nutrient-Poor foods (EDNP companies) in comparison with companies that did not (non-EDNP companies). The restrictions exerted positive effects on EDNP companies with respect to compliance with labeling requirements and reinforcement of nutritional contents examination, as well as changes to products such as reducing unhealthy ingredients and fortifying nutrients. Overall, the results revealed the possibility that restrictions on TV food advertising could improve children's food environments by encouraging EDNP companies to make favorable product changes. On the one hand, the results also found that some food companies attempted to bypass the regulations by changing marketing channels from TV to others and by reducing product serving sizes. Thus, future measures should be implemented to prevent food companies from bypassing regulations and to control children's exposure to marketing channels other than TV.

  1. Reducing milking frequency during nutrient restriction has no effect on the hepatic transcriptome of lactating dairy cattle.

    Science.gov (United States)

    Grala, T M; Kay, J K; Phyn, C V C; Bionaz, M; Walker, C G; Rius, A G; Snell, R G; Roche, J R

    2013-12-01

    The objective of this study was to investigate if a reduced milking frequency altered the effect of dietary energy restriction on the hepatic transcriptome of grazing dairy cows during early lactation. Multiparous Holstein-Friesian and Holstein-Friesian × Jersey cows (n = 120) were milked twice daily (2×) from calving until 34 ± 6 days in milk (mean ± SD). Cows were then allocated to one of four treatments in a 2 × 2 factorial arrangement. Treatments consisted of two milking frequencies [2× or once daily (1×)] and two feeding levels for 3 wk: adequately fed (AF) or underfed (UF, 60% of AF). Liver tissue was biopsied from 12 cows per treatment after 3 wk of treatment, and the hepatic transcriptome was profiled with an Agilent 4 × 44k bovine microarray. Over 2,900 genes were differentially expressed in response to the energy restriction; however, no effects resulted from changes to milking frequency. This may indicate that after 3 wk of 1× milking, any changes to the liver transcriptome that may have occurred earlier have returned to normal. After 3 wk of energy restriction, gene expression patterns indicate that glucose-sparing pathways were activated, and gluconeogenesis was increased in UF cows. Genes involved in hepatic stress were upregulated in response to the energy restriction indicative of the pressure energy restriction places on liver function. Other pathways upregulated included "cytoskeletal remodeling," indicating that a 3 wk energy restriction resulted in molecular changes to assist tissue remodeling. Overall, 1× milking does not modify the hepatic transcriptome changes that occur in response to an energy restriction.

  2. Effect of a standardised dietary restriction protocol on multiple laboratory strains of Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Richard C Grandison

    Full Text Available Outcomes of lifespan studies in model organisms are particularly susceptible to variations in technical procedures. This is especially true of dietary restriction, which is implemented in many different ways among laboratories.In this study, we have examined the effect of laboratory stock maintenance, genotype differences and microbial infection on the ability of dietary restriction (DR to extend life in the fruit fly Drosophila melanogaster. None of these factors block the DR effect.These data lend support to the idea that nutrient restriction genuinely extends lifespan in flies, and that any mechanistic discoveries made with this model are of potential relevance to the determinants of lifespan in other organisms.

  3. Fetal programming and gestational diabetes mellitus.

    Science.gov (United States)

    Monteiro, Lara J; Norman, Jane E; Rice, Gregory E; Illanes, Sebastián E

    2016-12-01

    Gestational diabetes mellitus is defined by new-onset glucose intolerance during pregnancy. About 2-5% of all pregnant women develop gestational diabetes during their pregnancies and the prevalence has increased considerably during the last decade. This metabolic condition is manifested when pancreatic β-cells lose their ability to compensate for increased insulin resistance during pregnancy, however, the pathogenesis of the disease remains largely unknown. Gestational diabetes is strongly associated with adverse pregnancy outcome as well as with long-term adverse effects on the offspring which likely occurs due to epigenetic modifications of the fetal genome. In the current review we address gestational diabetes and the short and long term complications for both mothers and offspring focusing on the importance of fetal programming in conferring risk of developing diseases in adulthood. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Perceptions among women with gestational diabetes.

    Science.gov (United States)

    Parsons, Judith; Ismail, Khalida; Amiel, Stephanie; Forbes, Angus

    2014-04-01

    Women with gestational diabetes are at high risk of developing type 2 diabetes, which could be prevented or delayed by lifestyle modification. Lifestyle interventions need to take into account the specific situation of women with gestational diabetes. We aimed to gain a deeper understanding of women's experiences of gestational diabetes, their diabetes risk perceptions, and their views on type 2 diabetes prevention, to inform future lifestyle interventions. We conducted a metasynthesis that included 16 qualitative studies and identified 11 themes. Factors that require consideration when developing a type 2 diabetes prevention intervention in this population include addressing the emotional impact of gestational diabetes; providing women with clear and timely information about future diabetes risk; and offering an intervention that fits with women's multiple roles as caregivers, workers, and patients, and focuses on the health of the whole family.

  5. Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers.

    Science.gov (United States)

    Kho, E M; North, R A; Chan, E; Stone, P R; Dekker, G A; McCowan, L M E

    2009-09-01

    To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers. Prospective cohort study. Auckland, New Zealand and Adelaide, Australia. Nulliparous participants in the Screening for Pregnancy Endpoints (SCOPE) study. Self-reported smoking status was determined at 15 +/- 1 weeks' gestation. At the 20 +/- 1 week anatomy scan, uterine and umbilical Doppler resistance indices (RI) and fetal measurements were compared between smokers and nonsmokers. Umbilical and mean uterine artery Doppler RI values, abnormal umbilical and uterine Doppler (RI > 90th centile) and fetal biometry. Among the 2459 women, 248 (10%) were smokers. Smokers had higher umbilical RI [0.75 (SD 0.06) versus 0.73 (0.06), P gestation, women who smoke have higher umbilical artery RI, a surrogate measure for an abnormal placental villous vascular tree. This may contribute to later fetal growth restriction among smokers. Further research is needed to explore the clinical significance of these findings.

  6. Fetal cardiac function in late-onset intrauterine growth restriction vs small-for-gestational age, as defined by estimated fetal weight, cerebroplacental ratio and uterine artery Doppler.

    Science.gov (United States)

    Pérez-Cruz, M; Cruz-Lemini, M; Fernández, M T; Parra, J A; Bartrons, J; Gómez-Roig, M D; Crispi, F; Gratacós, E

    2015-10-01

    Among late-onset small fetuses, a combination of estimated fetal weight (EFW), cerebroplacental ratio (CPR) and mean uterine artery (UtA) pulsatility index (PI) can predict a subgroup of fetuses with poor perinatal outcome; however, the association of these criteria with fetal cardiac structure and function is unknown. Our aim was to determine the presence and severity of signs indicating cardiac dysfunction in small fetuses, classified as intrauterine growth-restricted (IUGR) or small-for-gestational age (SGA), according to EFW, CPR and UtA-PI. A cohort of 209 late-onset small fetuses that were delivered > 34 weeks of gestation was divided in two categories: SGA (n = 59) if EFW was between the 3(rd) and 9(th) centiles with normal CPR and UtA-PI; and IUGR (n = 150) if EFW was  95(th) centile. The small population was compared with 150 appropriately grown fetuses (controls). Fetal cardiac morphometry and function were assessed by echocardiography using two-dimensional M-mode, conventional and tissue Doppler. Compared with controls, both IUGR and SGA fetuses showed larger and more globular hearts (mean left sphericity index ± SD: controls, 1.8 ± 0.3; SGA, 1.5 ± 0.2; and IUGR, 1.6 ± 0.3; P < 0.01) and showed signs of systolic and diastolic dysfunction, including decreased tricuspid annular plane systolic excursion (mean ± SD: controls, 8.2 ± 1.1; SGA, 7.4 ± 1.2; and IUGR, 6.9 ± 1.1; P < 0.001) and increased left myocardial performance index (mean ± SD: controls, 0.45 ± 0.14; SGA, 0.51 ± 0.08; and IUGR, 0.57 ± 0.1; P < 0.001). Despite a perinatal outcome comparable to that of normal fetuses, the population of so-defined SGA fetuses showed signs of prenatal cardiac dysfunction. This supports the concept that at least a proportion of them are not 'constitutionally small' and that further research is needed. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  7. Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies.

    Science.gov (United States)

    Leventakou, Vasiliki; Roumeliotaki, Theano; Martinez, David; Barros, Henrique; Brantsaeter, Anne-Lise; Casas, Maribel; Charles, Marie-Aline; Cordier, Sylvaine; Eggesbø, Merete; van Eijsden, Manon; Forastiere, Francesco; Gehring, Ulrike; Govarts, Eva; Halldórsson, Thorhallur I; Hanke, Wojciech; Haugen, Margaretha; Heppe, Denise H M; Heude, Barbara; Inskip, Hazel M; Jaddoe, Vincent W V; Jansen, Maria; Kelleher, Cecily; Meltzer, Helle Margrete; Merletti, Franco; Moltó-Puigmartí, Carolina; Mommers, Monique; Murcia, Mario; Oliveira, Andreia; Olsen, Sjúrður F; Pele, Fabienne; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Robinson, Siân M; Stigum, Hein; Strøm, Marin; Sunyer, Jordi; Thijs, Carel; Viljoen, Karien; Vrijkotte, Tanja G M; Wijga, Alet H; Kogevinas, Manolis; Vrijheid, Martine; Chatzi, Leda

    2014-03-01

    Fish is a rich source of essential nutrients for fetal development, but in contrast, it is also a well-known route of exposure to environmental pollutants. We assessed whether fish intake during pregnancy is associated with fetal growth and the length of gestation in a panel of European birth cohort studies. The study sample of 151,880 mother-child pairs was derived from 19 population-based European birth cohort studies. Individual data from cohorts were pooled and harmonized. Adjusted cohort-specific effect estimates were combined by using a random- and fixed-effects meta-analysis. Women who ate fish >1 time/wk during pregnancy had lower risk of preterm birth than did women who rarely ate fish (≤ 1 time/wk); the adjusted RR of fish intake >1 but 1 but <3 times/wk and 15.2 g (95% CI: 8.9, 21.5 g) for ≥ 3 times/wk independent of gestational age. The association was greater in smokers and in overweight or obese women. Findings were consistent across cohorts. This large, international study indicates that moderate fish intake during pregnancy is associated with lower risk of preterm birth and a small but significant increase in birth weight.

  8. Gestational Trophoblastic Disease—Health Professional Version

    Science.gov (United States)

    Gestational trophoblastic disease (GTD) is a broad term encompassing both benign and malignant growths arising from products of conception in the uterus. GTDs contain paternal chromosomes and are placental in origin. Find evidence-based information on gestational trophoblastic disease treatment.

  9. The role of energy, nutrients, foods and dietary patterns in the development of gestational diabetes mellitus: a systematic review of observational studies

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Mishra, G.D.; Callaway, L.K.; Soedamah-Muthu, S.S.

    2016-01-01

    OBJECTIVE Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM.
    RESEARCH DESIGN AND METHODS Medline

  10. Gestational hypoxia induces preeclampsia-like symptoms via heightened endothelin-1 signaling in pregnant rats.

    Science.gov (United States)

    Zhou, Jianjun; Xiao, Daliao; Hu, Yali; Wang, Zhiqun; Paradis, Alexandra; Mata-Greenwood, Eugenia; Zhang, Lubo

    2013-09-01

    Preeclampsia is a life-threatening pregnancy disorder. However, its pathogenesis remains unclear. We tested the hypothesis that gestational hypoxia induces preeclampsia-like symptoms via heightened endothelin-1 (ET-1) signaling. Time-dated pregnant and nonpregnant rats were divided into normoxic and hypoxic (10.5% O2 from the gestational day 6-21) groups. Chronic hypoxia had no significant effect on blood pressure or proteinuria in nonpregnant rats but significantly increased blood pressure on day 12 (systolic blood pressure, 111.7 ± 6.1 versus 138.5 ± 3.5 mm Hg; P=0.004) and day 20 (systolic blood pressure, 103.4 ± 4.6 versus 125.1 ± 6.1 mm Hg; P=0.02) in pregnant rats and urine protein (μg/μL)/creatinine (nmol/μL) ratio on day 20 (0.10 ± 0.01 versus 0.20 ± 0.04; P=0.04), as compared with the normoxic control group. This was accompanied with asymmetrical fetal growth restriction. Hypoxia resulted in impaired trophoblast invasion and uteroplacental vascular remodeling. In addition, plasma ET-1 levels, as well as the abundance of prepro-ET-1 mRNA, ET-1 type A receptor and angiotensin II type 1 receptor protein in the kidney and placenta were significantly increased in the chronic hypoxic group, as compared with the control animals. Treatment with the ET-1 type A receptor antagonist, BQ123, during the course of hypoxia exposure significantly attenuated the hypoxia-induced hypertension and other preeclampsia-like features. The results demonstrate that chronic hypoxia during gestation induces preeclamptic symptoms in pregnant rats via heightened ET-1 and ET-1 type A receptor-mediated signaling, providing a molecular mechanism linking gestational hypoxia and increased risk of preeclampsia.

  11. Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term.

    OpenAIRE

    Khalil, A; Thilaganathan, B

    2017-01-01

    Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) - a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. The cerebroplacental ratio (CPR) is eme...

  12. Validity of Newborn Clinical Assessment to Determine Gestational Age in Bangladesh.

    Science.gov (United States)

    Lee, Anne Cc; Mullany, Luke C; Ladhani, Karima; Uddin, Jamal; Mitra, Dipak; Ahmed, Parvez; Christian, Parul; Labrique, Alain; DasGupta, Sushil K; Lokken, R Peter; Quaiyum, Mohammed; Baqui, Abdullah H

    2016-07-01

    Gestational age (GA) is frequently unknown or inaccurate in pregnancies in low-income countries. Early identification of preterm infants may help link them to potentially life-saving interventions. We conducted a validation study in a community-based birth cohort in rural Bangladesh. GA was determined by pregnancy ultrasound (distribution, agreement, and diagnostic accuracy of different clinical methods of GA assessment were determined compared with early ultrasound dating. In the live-born cohort (n = 1066), the mean ultrasound GA was 39.1 weeks (SD 2.0) and prevalence of preterm birth (births (community health worker prematurity scorecard [sensitivity/specificity: 70%/27%]; Capurro [5%/96%]; Eregie [75%/58%]; Bhagwat [18%/87%], foot length birth weight rates of fetal growth restriction. Copyright © 2016 by the American Academy of Pediatrics.

  13. Neonatal and infant outcomes in twin gestations with preterm premature rupture of membranes at 24-31 weeks of gestation.

    Science.gov (United States)

    Mendez-Figueroa, Hector; Dahlke, Joshua D; Viteri, Oscar A; Chauhan, Suneet P; Rouse, Dwight J; Sibai, Baha M; Blackwell, Sean C

    2014-08-01

    To describe the perinatal and infant and early childhood morbidity associated with preterm premature rupture of membranes (PROM) in a cohort of twin pregnancies evaluated prospectively with neonatal follow-up to 2 years of age. This was a secondary analysis of a randomized controlled trial of magnesium sulfate for prevention of cerebral palsy. Inclusion criteria were twin gestation with preterm PROM diagnosed between 24 0/7 and 31 6/7 weeks of gestation and planned expectant management. Latency (time from membrane rupture to delivery) and perinatal outcomes were evaluated by gestational age at membrane rupture. Long-term neonatal outcomes were also analyzed. Among 151 women who met inclusion criteria, the median gestational age at preterm PROM was 28.1 weeks (range 24.1-31.6 weeks). Approximately one-third of women achieved a latency of at least 1 week. Gestational age at preterm PROM (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.63-0.90 for each week after 24 weeks of gestation) and cervical dilation at admission (OR 0.66, 95% CI 0.49-0.90 for each centimeter of dilation) were inversely associated with a latency period of at least 1 week. There were no stillbirths (95% CI 0-1%), but the rate of neonatal mortality was 90 per 1,000 newborns (95% CI 57-112) with a 7.3% cerebral palsy rate among survivors (95% CI 4.4-10.3%). In twin pregnancies, preterm PROM from 24 to 31 weeks of gestation is associated with a neonatal mortality rate of 9.0% and an overall cerebral palsy rate of 7.3%. A longer latency period is associated with less advanced cervical dilation and later gestational age at PROM. LEVEL OF EVIEDENCE: II.

  14. DAF-2/insulin-like signaling in C. elegans modifies effects of dietary restriction and nutrient stress on aging, stress and growth.

    Directory of Open Access Journals (Sweden)

    Wendy B Iser

    2007-11-01

    Full Text Available Dietary restriction (DR and reduced insulin/IGF-I-like signaling (IIS are two regimens that promote longevity in a variety of organisms. Genetic analysis in C. elegans nematodes has shown that DR and IIS couple to distinct cellular signaling pathways. However, it is not known whether these pathways ultimately converge on overlapping or distinct targets to extend lifespan.We investigated this question by examining additional effects of DR in wildtype animals and in daf-2 mutants with either moderate or severe IIS deficits. Surprisingly, DR and IIS had opposing effects on these physiological processes. First, DR induced a stress-related change in intestinal vesicle trafficking, termed the FIRE response, which was suppressed in daf-2 mutants. Second, DR did not strongly affect expression of a daf-2- and stress-responsive transcriptional reporter. Finally, DR-related growth impairment was suppressed in daf-2 mutants.These findings reveal that an important biological function of DAF-2/IIS is to enhance growth and survival under nutrient-limited conditions. However, we also discovered that levels of DAF-2 pathway activity modified the effects of DR on longevity. Thus, while DR and IIS clearly affect lifespan through independent targets, there may also be some prolongevity targets that are convergently regulated by these pathways.

  15. DAF-2/insulin-like signaling in C. elegans modifies effects of dietary restriction and nutrient stress on aging, stress and growth.

    Science.gov (United States)

    Iser, Wendy B; Wolkow, Catherine A

    2007-11-28

    Dietary restriction (DR) and reduced insulin/IGF-I-like signaling (IIS) are two regimens that promote longevity in a variety of organisms. Genetic analysis in C. elegans nematodes has shown that DR and IIS couple to distinct cellular signaling pathways. However, it is not known whether these pathways ultimately converge on overlapping or distinct targets to extend lifespan. We investigated this question by examining additional effects of DR in wildtype animals and in daf-2 mutants with either moderate or severe IIS deficits. Surprisingly, DR and IIS had opposing effects on these physiological processes. First, DR induced a stress-related change in intestinal vesicle trafficking, termed the FIRE response, which was suppressed in daf-2 mutants. Second, DR did not strongly affect expression of a daf-2- and stress-responsive transcriptional reporter. Finally, DR-related growth impairment was suppressed in daf-2 mutants. These findings reveal that an important biological function of DAF-2/IIS is to enhance growth and survival under nutrient-limited conditions. However, we also discovered that levels of DAF-2 pathway activity modified the effects of DR on longevity. Thus, while DR and IIS clearly affect lifespan through independent targets, there may also be some prolongevity targets that are convergently regulated by these pathways.

  16. Correlation of VCAM-1 expression in serum, cord blood, and placental tissue with gestational hypertension associated with fetal growth restriction in women from Xingtai Hebei, China.

    Science.gov (United States)

    Zhang, H G; Guo, W; Gu, H F; Chen, S B; Wang, J Q; Qiao, Z X; Ma, H S; Geng, S X

    2016-08-26

    The aim of this study was to investigate the expression of vascular adhesion molecule (VCAM)-1 in the maternal serum, cord blood, and placental tissue of pregnant women from Xingtai, Hebei, with gestational hypertension (GH) combined with fetal growth restriction (FGR). A total of 108 patients with GH combined with FGR (GH-FGR), 60 patients with GH alone (GH), and 50 healthy pregnant women (control) were recruited to this study. VCAM- 1 expression was detected in the maternal serum and cord blood by enzyme-linked immunosorbent assay, and in the placental tissue by immunohistochemistry. VCAM-1 expression was significantly higher in the maternal serum of patients with GH-FGR (164.38 ± 60.35) and GH alone (103.85 ± 54.47) than in the serum of the control population (46.70 ± 21.79; P 0.05). Moreover, the VCAM-1 expression rates were significantly higher and lower in the vascular endothelial and trophoblastic cells of the placenta of patients with GH-FGR (74.71 and 56.1%) and GH (72.98 and 55.36%), respectively, compared to those in the control subjects (46.48 and 95.11%). Therefore, we concluded that VCAM- 1 plays an important role in the development and generation of GH. Additionally, the low VCAM-1 expression in the trophoblastic cell could be correlated to the pathogenesis and progression of GH.

  17. Nitrogen regulation of transpiration controls mass-flow acquisition of nutrients.

    Science.gov (United States)

    Matimati, Ignatious; Verboom, G Anthony; Cramer, Michael D

    2014-01-01

    Transpiration may enhance mass-flow of nutrients to roots, especially in low-nutrient soils or where the root system is not extensively developed. Previous work suggested that nitrogen (N) may regulate mass-flow of nutrients. Experiments were conducted to determine whether N regulates water fluxes, and whether this regulation has a functional role in controlling the mass-flow of nutrients to roots. Phaseolus vulgaris were grown in troughs designed to create an N availability gradient by restricting roots from intercepting a slow-release N source, which was placed at one of six distances behind a 25 μm mesh from which nutrients could move by diffusion or mass-flow (termed 'mass-flow' treatment). Control plants had the N source supplied directly to their root zone so that N was available through interception, mass-flow, and diffusion (termed 'interception' treatment). 'Mass-flow' plants closest to the N source exhibited 2.9-fold higher transpiration (E), 2.6-fold higher stomatal conductance (gs), 1.2-fold higher intercellular [CO2] (Ci), and 3.4-fold lower water use efficiency than 'interception' plants, despite comparable values of photosynthetic rate (A). E, gs, and Ci first increased and then decreased with increasing distance from the N source to values even lower than those of 'interception' plants. 'Mass-flow' plants accumulated phosphorus and potassium, and had maximum concentrations at 10mm from the N source. Overall, N availability regulated transpiration-driven mass-flow of nutrients from substrate zones that were inaccessible to roots. Thus when water is available, mass-flow may partially substitute for root density in providing access to nutrients without incurring the costs of root extension, although the efficacy of mass-flow also depends on soil nutrient retention and hydraulic properties.

  18. Overview: Cross-habitat flux of nutrients and detritus

    Science.gov (United States)

    Vanni, M.J.; DeAngelis, D.L.; Schindler, D.E.; Huxel, G.R.; Polis, G.A.; Power, M.E.; Huxel, G.R.

    2004-01-01

    Ecologists have long known that all ecosystems receive considerable quantities of materials from outside their boundaries (e.g., Elton 1927), and quantifying the magnitude of such fluxes has long been a central tenet of ecosystem ecology (e.g., Odum 1971). Thus, one might think that the consequences of such fluxes for food webs would be well understood. However, food webs have traditionally been viewed as if they were isolated from surrounding habitats, a habit that has been particularly persistent in the modeling of food webs. When fluxes from the outside have been considered, they have largely been restricted to constant inputs directly affecting the base of the food web (e.g., solar energy or nutrients), and usually only such issues as their effects on equilibrium conditions have been considered (e.g., the well-known relationships between nutrient inputs and average densities of various food web members).

  19. Gene expression patterns of vascular endothelial growth factor (VEGF-A) in human placenta from pregnancies with intrauterine growth restriction.

    Science.gov (United States)

    Szentpéteri, Imre; Rab, Attila; Kornya, László; Kovács, Péter; Joó, József Gábor

    2013-07-01

    In this study, we describe changes in gene expression pattern of vascular endothelial growth factor (VEGF)-A in human placenta obtained from pregnancies with intrauterine growth restriction using placenta from normal pregnancies as control. We compared gene expression of VEGF-A in placental samples from Intrauterine growth restriction (IUGR) pregnancies versus placenta obtained from normal pregnancies. Among potential confounders, important clinical informations were also analyzed. In the IUGR group, the VEGF-A gene was overexpressed compared to the normal pregnancy group (Ln 2(α)β-actin: 1.32; Ln 2(α)GADPH: 1.56). There was no correlation between the degree of growth restriction and VEGF-A gene expression (Ln 2(α)(0-5)percentile: 0.58; Ln 2(α)(5-10)percentile: 0.64). Within the IUGR group, there was a trend toward a positive correlation between placental VEGF-A gene activity and gestational age at delivery (Ln 2(α) 37 weeks: 1.35). Our findings suggest that the increase in placental expression of the VEGF-A gene and the resultant stimulation of angiogenesis are a response to hypoxic environment developing in the placental tissue in IUGR. Thus, it appears to be a secondary event rather than a primary factor in the development of IUGR There is a trend toward a positive correlation between gestational age and placental VEGF-A gene activity.

  20. Wheat shorts in diets of gestating swine.

    Science.gov (United States)

    Young, L G; King, G L

    1981-03-01

    Sixty-four gilts were assigned to be bred at first or third observed estrus and fed gestation diets of pelleted wheat shorts with a free choice mineral-vitamin supplement or fortified corn-soybean meal. Only the dietary effects are included in this report. The gilts were fed their respective diets starting at 25 days after insemination. The experiment continued through three gestation-lactation cycles. Females fed the wheat shorts received less digestible energy during gestation and weighed less at day 109 of gestation and days 1, 7 and 21 of lactation in each of the three gestation-lactation periods. Females fed wheat shorts had lighter pigs at birth, weaned more pigs per litter in each parity and returned to estrus more slowly after weaning than females fed a corn-soybean meal diet. Results of a metabolism trial conducted with 12 barrows revealed that wheat shorts contained approximately 2.93 kcal digestible energy/kg dry matter and had an apparent protein digestibility of 72%, compared with values of 4.0 kcal and 86%, respectively, for the corn-soybean meal diets.

  1. A new MONERIS in-Stream Retention Module to Account Nutrient Budget of a Temporary River in Cyprus

    OpenAIRE

    TZORAKI Ourania; COOPER David; DÖRFLINGER Gerald; PANAGOS Panagiotis

    2014-01-01

    The nature of the nutrient budget for temporary rivers differs from that for permanent rivers because of the restricted nature of flow, the lack of adequate dilution, and weather conditions which are conducive to the development of algal blooms. We analyse the nutrient budget of three tributaries of a temporary river in Cyprus, the Kouris, with the aid of the MONERIS model. MONERIS in-stream retention module was modified to account for a 1-dimensional advection - dispersion pollutants transpo...

  2. Gestational weight gain.

    Science.gov (United States)

    Kominiarek, Michelle A; Peaceman, Alan M

    2017-12-01

    Prenatal care providers are advised to evaluate maternal weight at each regularly scheduled prenatal visit, monitor progress toward meeting weight gain goals, and provide individualized counseling if significant deviations from a woman's goals occur. Today, nearly 50% of women exceed their weight gain goals with overweight and obese women having the highest prevalence of excessive weight gain. Risks of inadequate weight gain include low birthweight and failure to initiate breast-feeding whereas the risks of excessive weight gain include cesarean deliveries and postpartum weight retention for the mother and large-for-gestational-age infants, macrosomia, and childhood overweight or obesity for the offspring. Prenatal care providers have many resources and tools to incorporate weight and other health behavior counseling into routine prenatal practices. Because many women are motivated to improve health behaviors, pregnancy is often considered the optimal time to intervene for issues related to eating habits and physical activity to prevent excessive weight gain. Gestational weight gain is a potentially modifiable risk factor for a number of adverse maternal and neonatal outcomes and meta-analyses of randomized controlled trials report that diet or exercise interventions during pregnancy can help reduce excessive weight gain. However, health behavior interventions for gestational weight gain have not significantly improved other maternal and neonatal outcomes and have limited effectiveness in overweight and obese women. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Glycemic Status During Pregnancy in Gestational Diabetic & Non-Gestational Diabetic Women & its Effect on Maternal & Fetal Outcome

    Directory of Open Access Journals (Sweden)

    A P Sawant

    2012-01-01

    Full Text Available Aims & Objectives: 1.To study the time course of plasma glucose, in gestational diabetic and normal pregnant women. 2.To compare maternal outcome and fetal outcome in gestational diabetic and normal pregnant women. Materials and Methods: Five hundred pregnant individuals visiting the Antenatal Clinic of Rural Medical College, Loni in either half of the gestation were screened and gestational diabetes mellitus was diagnosed according to the WHO criteria. Results: The scope of diabetes and pregnancy encompasses not only diabetics marching through pregnancy but also, any form of abnormal glucose tolerance developing during gestation, termed as gestational diabetes, abnormal glucose tolerance of any etiology recognized or unrecognized starting before pregnancy or revealed during pregnancy, is associated with a high risk of a poor maternal and fetal outcomes. In our study we found a significantly higher incidence of caesarean section in-patients with GDM when compared with the normal group (67% versus 25%, P <0.001. In GDM cases, we observed fetal macrosomia, high birth weight etc. Naturally these are the factors, which add to the pre-existing unfavourable maternal factors affecting the process of labour adversely. We observed a significant difference in the incidence of preterm labour in between the GDM and non-GDM groups (22% Vs 13%, p<0.05. These individuals underwent a process of preterm labour at a gestational age of 32+3 weeks. Hyperglycemia and polyhydramnios are held responsible for preterm labour. The incidence rate of PIH was more in subjects with GDM as compared to the other group. However this difference failed to prove statistically significant at 5% level of significance. Though we did not get a significant difference in occurrence of PIH in between the GDM and non-GDM groups, we do agree with the comment that hyperglycemia earlier in the pregnancy is associated with greater incidence of PIH as three of the four cases who were diagnosed

  4. Prenatal Mechanistic Target of Rapamycin Complex 1 (m TORC1) Inhibition by Rapamycin Treatment of Pregnant Mice Causes Intrauterine Growth Restriction and Alters Postnatal Cardiac Growth, Morphology, and Function.

    Science.gov (United States)

    Hennig, Maria; Fiedler, Saskia; Jux, Christian; Thierfelder, Ludwig; Drenckhahn, Jörg-Detlef

    2017-08-04

    Fetal growth impacts cardiovascular health throughout postnatal life in humans. Various animal models of intrauterine growth restriction exhibit reduced heart size at birth, which negatively influences cardiac function in adulthood. The mechanistic target of rapamycin complex 1 (mTORC1) integrates nutrient and growth factor availability with cell growth, thereby regulating organ size. This study aimed at elucidating a possible involvement of mTORC1 in intrauterine growth restriction and prenatal heart growth. We inhibited mTORC1 in fetal mice by rapamycin treatment of pregnant dams in late gestation. Prenatal rapamycin treatment reduces mTORC1 activity in various organs at birth, which is fully restored by postnatal day 3. Rapamycin-treated neonates exhibit a 16% reduction in body weight compared with vehicle-treated controls. Heart weight decreases by 35%, resulting in a significantly reduced heart weight/body weight ratio, smaller left ventricular dimensions, and reduced cardiac output in rapamycin- versus vehicle-treated mice at birth. Although proliferation rates in neonatal rapamycin-treated hearts are unaffected, cardiomyocyte size is reduced, and apoptosis increased compared with vehicle-treated neonates. Rapamycin-treated mice exhibit postnatal catch-up growth, but body weight and left ventricular mass remain reduced in adulthood. Prenatal mTORC1 inhibition causes a reduction in cardiomyocyte number in adult hearts compared with controls, which is partially compensated for by an increased cardiomyocyte volume, resulting in normal cardiac function without maladaptive left ventricular remodeling. Prenatal rapamycin treatment of pregnant dams represents a new mouse model of intrauterine growth restriction and identifies an important role of mTORC1 in perinatal cardiac growth. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  5. Recent Declines in Induction of Labor by Gestational Age

    Science.gov (United States)

    ... for singleton births per 100 singleton births. Gestational age categories : Early preterm: Births prior to 34 completed weeks of ... delivery is managed for multiple gestation pregnancies. The primary measure used to determine gestational age is the interval between the first day of ...

  6. Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

    African Journals Online (AJOL)

    McRoy

    Key words: Diabetes mellitus, gestation, risk factors, Sudan. INTRODUCTION. Gestational diabetes mellitus (GDM) is a universal risk factor for maternal and neonatal morbidity and mortality.[1] Low gestational age, neonatal macrosomia, hypoglycemia, respiratory distress syndrome are frequent complications of GDM and ...

  7. Maternal determinants of intrauterine growth restriction in Goa, India: a case-control study

    Directory of Open Access Journals (Sweden)

    DD Motghare

    2014-01-01

    Full Text Available Objective: To study the maternal determinants of intrauterine growth restriction. Methods: A case-control study was conducted at a tertiary care Hospital in the year 2009. Ninety eight cases of intrauterine growth restriction were compared to 98 controls, matched for newborns sex and type of delivery. Data was collected by interviewing the mother using a structured pretested schedule and perusal of antenatal records. Intrauterine growth restriction was defined as occurring if birth weight of the newborn is below 10th percentile for gestational age on the intrauterine growth curve. Data was analyzed using SPSS software version 17 package. Percentages, odds ratios with 95% CI and multiple logistic regression analysis were used wherever appropriate. Results: Maternal age, education, socioeconomic status and number of antenatal visits were found to be the significant socio-demographic factors associated with Intrauterine growth restriction while, maternal height, parity, previous spontaneous abortion, direct obstetric morbidity, indirect obstetric morbidity and anemia were the maternal biological factors found to be significantly associated on bivariate analysis. Multiple logistic regression analysis identified parity, previous spontaneous abortion, direct obstetric morbidity, indirect obstetric morbidity and antenatal visits as significant maternal determinants of intrauterine growth restriction. Conclusions: A focus on good antenatal care, especially on high risk pregnancies would go a long way in reducing the problem of intrauterine growth restriction in the community thereby ensuring a safe and healthy future for our youngest generation.

  8. Understanding Gestational Diabetes: A Practical Guide to a Healthy Pregnancy.

    Science.gov (United States)

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    This brochure addresses the problem of gestational diabetes and answers the most frequently asked questions about the disease. It begins by defining gestational diabetes and discussing its cause, then addresses such topics as: (1) how gestational diabetes differs from other types of diabetes; (2) who is at risk for developing gestational diabetes…

  9. Am I at Risk for Gestational Diabetes?

    Science.gov (United States)

    ... they control their blood sugar levels. Babies whose mothers had gestational diabetes are at higher risk for certain health ... best way to improve outcomes for babies whose mothers have gestational diabetes. Later in Life Babies whose mothers had ...

  10. The effect of 1-week feed restriction on performance, digestibility of nutrients and digestive system development in the growing rabbit.

    Science.gov (United States)

    Tůmová, E; Volek, Z; Chodová, D; Härtlová, H; Makovický, P; Svobodová, J; Ebeid, T A; Uhlířová, L

    2016-01-01

    A 3 to 4 week feed restriction of about 20% to 25% of the free intake is widely applied in rabbit breeding systems to reduce post-weaning digestive disorders. However, a short intensive feed restriction is described in few studies and can be beneficial for growing rabbits due to a longer re-alimentation period. The aim of this study was to evaluate the effect of ad libitum (AL) and two restriction levels of feeding (50 and 65 g/rabbit per day) applied for 1 week on performance, gastrointestinal morphology and physiological parameters during the restriction and during the re-alimentation period. Rabbits were divided into three experimental groups: AL rabbits were fed AL, R1 rabbits were restricted from 42 to 49 days of age and received 50 g daily (29% of AL) and R2 rabbits were restricted at the same age and were fed 65 g of feed daily (37% of AL). In the 1(st) week after weaning and in the weeks after restriction, all the groups were fed AL. During the restriction period, daily weight gain (DWG) in R1 significantly dropped to 11% (experiment 1) and 5% (experiment 2) compared with rabbits in the AL group, although they were fed 29% of AL, whereas in the R2 group it decreased to 20% (experiment 1) and 10% (experiment 2). In the week following feed restriction, DWG in the restricted groups increased (Pdepth of crypts, which might be involved in the compensatory growth and defence mechanism.

  11. Ultrasound evaluation of cortical brain development in fetuses with intrauterine growth restriction.

    Science.gov (United States)

    Businelli, Caterina; de Wit, Charlotte; Visser, Gerard H A; Pistorius, Lourens R

    2014-09-10

    Abstract Objective: We evaluated the ultrasound appearance of brain volume and cortical development in fetuses with early growth restriction and placental insufficiency. Methods: We examined a cohort of 20 fetuses with severe intrauterine growth restriction (IUGR) and evidence of placental insufficiency by three-dimensional (3D) ultrasound between 24 and 34 weeks. We graded cortical development and measured the supratentorial intracranial volume. The cortical grading and volume were compared to data obtained from a reference population of 28 adequate for gestational age (AGA) fetuses. Results: Ultrasound examinations were performed in 20 fetuses with IUGR. The biometry and brain volume were significantly reduced in IUGR fetuses. There was evidence of accelerated cortical development in IUGR fetuses. Conclusion: This study confirms that the smaller brain volume in IUGR fetuses, with normal or accelerated cortical maturation as previously depicted with postnatal MRI examination, can be demonstrated by prenatal 3D ultrasound.

  12. Trends and outcomes of gestational surrogacy in the United States.

    Science.gov (United States)

    Perkins, Kiran M; Boulet, Sheree L; Jamieson, Denise J; Kissin, Dmitry M

    2016-08-01

    To evaluate trends and reproductive outcomes of gestational surrogacy in the United States. Retrospective cohort study. Infertility clinics. IVF cycles transferring at least one embryo. Use of a gestational carrier. Trends in gestational carrier cycles during 1999-2013, overall and for non-U.S. residents; reproductive outcomes for gestational carrier and nongestational carrier cycles during 2009-2013, stratified by the use of donor or nondonor oocytes. Of 2,071,984 assisted reproductive technology (ART) cycles performed during 1999-2013, 30,927 (1.9%) used a gestational carrier. The number of gestational carrier cycles increased from 727 (1.0%) in 1999 to 3,432 (2.5%) in 2013. Among gestational carrier cycles, the proportion with non-U.S. residents declined during 1999-2005 (9.5% to 3.0%) but increased during 2006-2013 (6.3% to 18.5%). Gestational carrier cycles using nondonor oocytes had higher rates of implantation (adjusted risk ratio [aRR], 1.22; 95% confidence interval [CI], 1.17-1.26), clinical pregnancy (aRR, 1.14; 95% CI, 1.10-1.19), live birth (aRR, 1.17; 95% CI, 1.12-1.21), and preterm delivery (aRR, 1.14; 95% CI, 1.05-1.23) compared with nongestational carrier cycles. When using donor oocytes, multiple birth rates were higher among gestational carrier compared with nongestational carrier cycles (aRR, 1.13; 95% CI, 1.08-1.19). Use of gestational carriers increased during 1999-2013. Gestational carrier cycles had higher rates of ART success than nongestational carrier cycles, but multiple birth and preterm delivery rates were also higher. These risks may be mitigated by transferring fewer embryos given the higher success rates among gestational carrier cycles. Published by Elsevier Inc.

  13. [Gestational diabetes insipidus during a twin pregnancy].

    Science.gov (United States)

    De Mesmay, M; Rigouzzo, A; Bui, T; Louvet, N; Constant, I

    2013-02-01

    Gestational diabetes insipidus is an uncommon clinical disease whose prevalence is approximately two to three pregnancies per 100,000. It may be isolated or associated with preeclampsia. We report a case of gestational diabetes insipidus in a twin pregnancy, originally isolated during two months, and secondarily complicated by HELLP-syndrome. We recall the specific pathophysiology of polyuric-polydipsic syndrome during pregnancy and summarize its various causes. Finally, we discuss the indications, in case of isolated gestational diabetes insipidus, of treatment by dDAVP. Copyright © 2013. Published by Elsevier SAS.

  14. Hormones of Adipose Tissue and Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    O.S. Payenok

    2013-10-01

    Full Text Available Obesity and gestational diabetes are the risk factors for complications both in the mother and in the fetus. Adipose tissue hormones (leptin, adiponectin, resistin are secreted by the human placenta and regulate the function of trophoblast. The review presents data from the literature on the role of adipocytokines in the development of gestational diabetes and preeclampsia in obese women. The article considers the criteria and algorithms for the diagnosis of gestational diabetes recommended by the World Health Organization and the International Association of Diabetes and Pregnancy Study Group.

  15. Mortality and morbidity pattern in small-for gestational age and appropriate-for-gestational age very preterm babies: a hospital based study

    International Nuclear Information System (INIS)

    Muhammad, T.; Khattak, A.A.; Rehman, S.U.

    2009-01-01

    Very preterm babies are important group of paediatric babies who require special attention. These babies are known to have increased risk of morbidity and mortality. Studying the morbidity and mortality pattern for this important paediatric group can help in better understanding of their care in the hospital settings. Objective of the study was to compare the mortality and morbidity pattern in Small-for-gestational age and appropriate-for-gestational age very preterm babies. This hospital based prospective (cohort) study was conducted at the department of Paediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from March 2008 to April 2009. One hundred Small-for-gestational age (SGA) live born very preterm babies were compared with 100 appropriate-for-gestational age (AGA) very preterm babies having similar gestational ages. Information regarding gestational age, birth weight, mortality, and morbidity (in terms of various biochemical and clinical markers) were recorded on a pre-designed questionnaire. Data analysis was done using SPSS version 15. Results were interpreted in terms of descriptive (mean, proportions, standard deviation) and inferential statistical tests (with p-values). There was no difference between the two groups (SGA Vs AGA) with regards to gestational age and gender of the babies The mean weight of SGA babies was significantly lower as compared to AGA babies (1.1+-0.16 Kg Vs 1.5+-0.2 Kg; p=0.001). As compared to AGA babies, the SGA babies had a higher mortality (40% Vs 22%, p=0.006), and higher morbidity in terms of hyperbilirubinaemia (67% Vs 51%, p=0.02) and hypocalcaemia (24% Vs 10%, p=0.02). The difference in the mortality between the two groups was more prominent in babies with gestational age < 31 weeks (71.4% for SGA as compared to 39.3 % for AGA very preterm babies with gestational age < 31 weeks). Very preterm SGA infants have significantly higher mortality and morbidity in comparison to the AGA babies. In deciding

  16. ACOG Committee Opinion No. 660: Family Building Through Gestational Surrogacy.

    Science.gov (United States)

    2016-03-01

    Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. The practice of gestational surrogacy involves a woman known as a gestational carrier who agrees to bear a genetically unrelated child with the help of assisted reproductive technologies for an individual or couple who intend(s) to be the legal and rearing parent(s), referred to as the intended parent(s). Obstetrician-gynecologists may become involved in gestational surrogacy through caring for the gestational carrier or by caring for the intended parent(s). Although gestational surrogacy increases options for family building, this treatment also involves ethical, medical, psychosocial, and legal complexities that must be taken into account to minimize risks of adverse outcomes for the gestational carrier, intended parent(s), and resulting children. The purpose of this document is to provide an overview of gestational surrogacy and to describe the ethical responsibilities for obstetrician-gynecologists who take part in the care of women who participate in these arrangements.

  17. Short-term moderate energy restriction does not affect indicators of oxidative stress and genotoxicity in humans

    NARCIS (Netherlands)

    Velthuis-te Wierik, E.J.M.; Leeuwen, R.E.W. van; Hendriks, H.F.J.; Verhagen, H.; Loft, S.; Poulsen, H.E.; Berg, H. van den

    1995-01-01

    Restriction of energy intake (ER), without malnutrition of essential nutrients, has repeatedly been demonstrated to increase longevity in rodents. In the antioxidant theory of aging the lack of balance between the generation of free radicals and free radical scavenging was thought to be a main

  18. WERF Nutrient Challenge investigates limits of nutrient removal technologies.

    Science.gov (United States)

    Neethling, J B; Clark, D; Pramanik, A; Stensel, H D; Sandino, J; Tsuchihashi, R

    2010-01-01

    The WERF Nutrient Challenge is a multi-year collaborative research initiative established in 2007 to develop and provide current information about wastewater treatment nutrients (specifically nitrogen and phosphorus in wastewater), their characteristics, and bioavailability in aquatic environments to help regulators make informed decisions. The Nutrient Challenge will also provide data on nutrient removal so that treatment facilities can select sustainable, cost-effective methods and technologies to meet permit limits. To meet these goals, the Nutrient Challenge has teamed with a wide array of utilities, agencies, consultants, universities and other researchers and practitioners to collaborate on projects that advance these goals. The Nutrient Challenge is focusing on a different approach to collaborating and leveraging resources (financial and intellectual) on research projects by targeting existing projects and research that correspond with its goals and funding those aspects that the Nutrient Challenge identified as a priority. Because the Nutrient Challenge is focused on collaboration, outreach is an absolutely necessary component of its effectiveness. Through workshops, webinars, a web portal and online compendium, published papers, and conference lectures, the Nutrient Challenge is both presenting important new information, and soliciting new partnerships.

  19. Physiological alterations associated with intrauterine growth restriction in fetal pigs: Causes and insights for nutritional optimization.

    Science.gov (United States)

    Wang, Junjun; Feng, Cuiping; Liu, Ting; Shi, Meng; Wu, Guoyao; Bazer, Fuller W

    2017-09-01

    Intrauterine growth restriction (IUGR) remains a major problem in swine production since the associated low birth weight leads to high rates of pre-weaning morbidity and mortality plus permanent retardation of growth and development. Complex biological events-including genetics, epigenetics, maternal maturity, maternal nutrition, placenta efficiency, uterine capacity, and other environmental factors-can affect fetal growth and development during late gestation, as well as maturity of oocytes, duration of estrus, and both implantation and placentation of conceptuses in uteri of sows. Understanding the physiological changes related to initiation and progress of IUGR are, therefore, of great importance to formulate nutritional strategies that can mitigate IUGR in gilts and sows. Altering the nutritional status of sows prior to mating and during early-, mid-, and late-gestation may be effective at increasing the uniformity of oocytes and conceptuses, decreasing variation among conceptuses during elongation and implantation, and preventing increases in within-litter variation in fetal weights during late gestation. This review summarizes current progress on physiological alterations responsible for IUGR fetuses, as well as possible nutritional interventions to prevent the initiation and continuation of IUGR in gilts and sows. © 2017 Wiley Periodicals, Inc.

  20. The gestational age pattern of human mortality

    DEFF Research Database (Denmark)

    Schöley, Jonas; Vaupel, James W.; Jacobsen, Rune

    -infant lifetable by gestational age spanning week 23 until week 100 after the last menstrual period of the mother. This joint lifetable shows a remarkable regularity in the gestational age profile of fetal- and infant mortality: Mortality rates are declining over the whole observed age range with the exception......In order to check hypotheses about the cause for "ontogenescense" -- the phenomenon of a declining force of mortality prior to maturity -- I analyse data on human mortality by gestational age. Based on extensive microdata on births, fetal- and infant deaths in the US 2009 I calculate a joint fetal...... of a "birth hump" peaking week 38. The absolute rate of decline slows down over age. The observed gestational age pattern of the force of mortality is consistent with three hypotheses concerning the causes for ontogenescense: 1) Adaptation: as the organism growths it becomes more resilient towards death, 2...

  1. Cognitive ability in adolescents born small for gestational age

    DEFF Research Database (Denmark)

    Jensen, Rikke Beck; Juul, Anders; Larsen, Torben

    2015-01-01

    cognitive ability in late adolescence. Full-scale IQ was positively related to head circumference (HC) in adolescence (B: 1.30, 95% CI: 0.32-2.28, p=0.01). HC at birth and three months was positively associated with full-scale IQ. Catch-up growth in the group of SGA children was associated......BACKGROUND: Small size at birth may be associated with impaired cognitive ability later in life. The aim of this study was to examine the effect of being born small for gestational age (SGA), with or without intrauterine growth restriction (IUGR) on cognitive ability in late adolescence. STUDY...... with a significantly increased height, larger HC, increased levels of insulin-like growth factor-I (IGF-I) and increased full-scale IQ compared to those born SGA without catch-up growth. CONCLUSION: SGA and IUGR may not be harmful for adult cognitive ability, at least not in individuals born at near-term. However...

  2. Mechanisms leading to increased risk of preterm birth in growth-restricted guinea pig pregnancies.

    Science.gov (United States)

    Palliser, Hannah K; Kelleher, Meredith A; Welsh, Toni N; Zakar, Tamas; Hirst, Jonathan J

    2014-02-01

    Intrauterine growth restriction (IUGR) is a risk factor for preterm labor; however, the mechanisms of the relationship remain unknown. Prostaglandin (PG), key stimulants of labor, availability is regulated by the synthetic enzymes, prostaglandin endoperoxidases 1 and 2 (PTGS1 and 2), and the metabolizing enzyme, 15-hydroxyprostaglandin dehydrogenase (HPGD). We hypothesized that IUGR increases susceptibility to preterm labor due to the changing balance of synthetic and metabolizing enzymes and hence greater PG availability. We have tested this hypothesis using a surgically induced IUGR model in guinea pigs, which results in significantly shorter gestation. Myometrium, amnion, chorion, and placentas were collected from sham operated or IUGR pregnancies, and PTGS1 and HPGD protein expression were quantified throughout late gestation (>62 days) and labor. The PTGS1 expression was significantly upregulated in the myometrium of IUGR animals, and chorionic HPGD expression was markedly decreased (P production over metabolism in IUGR pregnancies leads to a greater susceptibility to preterm birth.

  3. Factors affecting gestation duration in the bitch.

    Science.gov (United States)

    Eilts, Bruce E; Davidson, Autumn P; Hosgood, Giselle; Paccamonti, Dale L; Baker, David G

    2005-07-15

    A retrospective analysis was performed to determine the effects of age, breed, parity, and litter size on the duration of gestation in the bitch. Bitches at two locations were monitored from breeding to whelping. A total of 764 litters whelped from 308 bitches (36 large hounds, 34 Golden Retrievers, 23 German Shepherd Dogs (GSD), and 215 Labrador Retrievers). By breed, the number of whelpings was 152, 72, 58, and 482 for the hounds, Golden Retrievers, German Shepherd Dogs, and Labrador Retrievers, respectively. Whelping was predicted to be 57 d from the first day of cytologic diestrus in the hounds or 65 d from the initial progesterone rise in the other breeds. The average gestation duration (calculated as 8 d prior to Day 1 of cytologic diestrus in hounds or measured from the initial progesterone rise in other breeds) by breed (days +/- S.D.) was 66.0 +/- 2.8, 64.7 +/- 1.5, 63.6 +/- 2.1, and 62.9 +/- 1.3 for the hounds, Golden Retrievers, German Shepherd Dogs, and Labrador Retrievers, respectively. The relationship of age, breed, parity, and litter size with the difference in gestation duration was evaluated using log linear modeling. Age or parity had no effect on gestation duration. Compared to Labrador Retrievers, the German Shepherd Dogs, Golden Retrievers and hounds were more likely to have a longer gestation duration; three, four and nearly eight times as likely, respectively. Bitches whelping four or fewer pups were significantly more likely to have a longer gestation duration than those whelping five or more pups; the prolongation averaging 1 d.

  4. Maternal protein restriction during lactation induces early and lasting plasma metabolomic and hepatic lipidomic signatures of the offspring in a rodent programming model.

    Science.gov (United States)

    Martin Agnoux, Aurore; El Ghaziri, Angélina; Moyon, Thomas; Pagniez, Anthony; David, Agnès; Simard, Gilles; Parnet, Patricia; Qannari, El Mostafa; Darmaun, Dominique; Antignac, Jean-Philippe; Alexandre-Gouabau, Marie-Cécile

    2018-05-01

    Perinatal undernutrition affects not only fetal and neonatal growth but also adult health outcome, as suggested by the metabolic imprinting concept. However, the exact mechanisms underlying offspring metabolic adaptations are not yet fully understood. Specifically, it remains unclear whether the gestation or the lactation is the more vulnerable period to modify offspring metabolic flexibility. We investigated in a rodent model of intrauterine growth restriction (IUGR) induced by maternal protein restriction (R) during gestation which time window of maternal undernutrition (gestation, lactation or gestation-lactation) has more impact on the male offspring metabolomics phenotype. Plasma metabolome and hepatic lipidome of offspring were characterized through suckling period and at adulthood using liquid chromatography-high-resolution mass spectrometry. Multivariate analysis of these fingerprints highlighted a persistent metabolomics signature in rats suckled by R dams, with a clear-cut discrimination from offspring fed by control (C) dams. Pups submitted to a nutritional switch at birth presented a metabolomics signature clearly distinct from that of pups nursed by dams maintained on a consistent perinatal diet. Control rats suckled by R dams presented transiently higher branched-chain amino acid (BCAA) oxidation during lactation besides increased fatty acid (FA) β-oxidation, associated with preserved insulin sensitivity and lesser fat accretion that persisted throughout their life. In contrast, IUGR rats displayed permanently impaired β-oxidation, associated to increased glucose or BCAA oxidation at adulthood, depending on the fact that pups experienced slow postnatal or catch-up growth, as suckled by R or C dams, respectively. Taken together, these findings provide evidence for a significant contribution of the lactation period in metabolic programming. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Lean body mass in small for gestational age and appropriate for gestational age infants

    International Nuclear Information System (INIS)

    Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

    1988-01-01

    Dual photon absorptiometry using 153 Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation

  6. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study.

    Science.gov (United States)

    Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

    2015-11-21

    Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15-24; 69 of 352 fetuses) for selective ultrasonography and 57% (51-62; 199 of 352 fetuses) for universal ultrasonography (relative sensitivity 2

  7. Maternal rhabdomyolysis and twin fetal death associated with gestational diabetes insipidus.

    Science.gov (United States)

    Price, Joan T; Schwartz, Nadav

    2013-08-01

    Gestational diabetes insipidus is a rare, transient complication of pregnancy typically characterized by polyuria and polydipsia that may lead to mild electrolyte abnormalities. More severe sequelae of gestational diabetes insipidus are uncommon. We present a case of a 25-year-old woman at 23 weeks of gestation in a dichorionic-diamniotic twin pregnancy who developed severe symptomatic gestational diabetes insipidus complicated by rhabdomyolysis and death of both fetuses. Maternal rhabdomyolysis caused by gestational diabetes insipidus is extremely rare. Early recognition and treatment of gestational diabetes insipidus is necessary to prevent maternal and fetal morbidity and mortality.

  8. Gestational age at birth and risk of intellectual disability without a common genetic cause.

    Science.gov (United States)

    Heuvelman, Hein; Abel, Kathryn; Wicks, Susanne; Gardner, Renee; Johnstone, Edward; Lee, Brian; Magnusson, Cecilia; Dalman, Christina; Rai, Dheeraj

    2017-12-06

    Preterm birth is linked to intellectual disability and there is evidence to suggest post-term birth may also incur risk. However, these associations have not yet been investigated in the absence of common genetic causes of intellectual disability, where risk associated with late delivery may be preventable. We therefore aimed to examine risk of intellectual disability without a common genetic cause across the entire range of gestation, using a matched-sibling design to account for unmeasured confounding by shared familial factors. We conducted a population-based retrospective study using data from the Stockholm Youth Cohort (n = 499,621) and examined associations in a nested cohort of matched outcome-discordant siblings (n = 8034). Risk of intellectual disability was greatest among those born extremely early (adjusted OR 24 weeks  = 14.54 [95% CI 11.46-18.44]), lessening with advancing gestational age toward term (aOR 32 weeks  = 3.59 [3.22-4.01]; aOR 37 weeks  = 1.50 [1.38-1.63]); aOR 38 weeks  = 1.26 [1.16-1.37]; aOR 39 weeks = 1.10 [1.04-1.17]) and increasing with advancing gestational age post-term (aOR 42 weeks  = 1.16 [1.08-1.25]; aOR 43 weeks  = 1.41 [1.21-1.64]; aOR 44 weeks  = 1.71 [1.34-2.18]; aOR 45 weeks  = 2.07 [1.47-2.92]). Associations persisted in a cohort of matched siblings suggesting they were robust against confounding by shared familial traits. Risk of intellectual disability was greatest among children showing evidence of fetal growth restriction, especially when birth occurred before or after term. Birth at non-optimal gestational duration may be linked causally with greater risk of intellectual disability. The mechanisms underlying these associations need to be elucidated as they are relevant to clinical practice concerning elective delivery around term and mitigation of risk in post-term children.

  9. Secular trends in gestational age and birthweight in twins.

    Science.gov (United States)

    Gielen, M; van Beijsterveldt, C E M; Derom, C; Vlietinck, R; Nijhuis, J G; Zeegers, M P A; Boomsma, D I

    2010-09-01

    In recent decades, the overall rate of preterm births has increased. The aim of the present study was to examine whether this trend is also seen for multiple gestations. More specifically, we examined if there has been a decrease in gestational age for live born monozygotic (MZ) and dizygotic (DZ) twins and if there has been a simultaneous change in birthweight. The contributions of fertility treatments and Caesarean sections were taken into consideration. All analyses were carried out in two large European twin cohorts. Cross-sectional study of 6310 live born twin pairs, born between 1964-2007, from the Belgian East Flanders Prospective Twin Survey and 14,712 twin pairs, born between 1990-2006, from the Netherlands Twin Register. Multiple regression analyses were performed with gestational age as outcome variable, and multilevel analysis with birthweight as outcome variable. All analyses were performed with and without adjustment for zygosity, parity, maternal age, mode of conception and delivery and, for the analyses of birthweight, gestational age. Gestational age decreased in a linear fashion from 1964 to 2007 with a decrease of 0.25 days per year in a similar way for MZ and DZ twins. Changes in birthweight depended on gestational age: up to 32 weeks, birthweight decreased and after 32 weeks birthweight increased. The frequency of infertility treatment and Caesarean sections, primiparity and advanced maternal age increased over the years, but none of these factors influenced the secular trends in gestational age and birthweight. The decrease in gestational age and change in birthweight in twins are sources of concern, especially for very preterm twins, for whom birthweight decreased. For twins born after 32 weeks, an increase in birthweight was observed and this is very likely the explanation for the decrease in gestational age.

  10. Serum chromium levels in gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    P G Sundararaman

    2012-01-01

    Full Text Available Objective: To measure serum chromium level in women with gestational diabetes mellitus (GDM from Chennai, South India. Materials and Methods: Thirty women with gestational diabetes, 60 age matched controls. Inclusion criteria: Gestational age 22-28 weeks, age group 20-35 years. Exclusion Criteria: Gestational age beyond 28 weeks, malnutrition or presence of infection. Serum chromium was measured using inductive couple plasma emission spectrometer. Results: Serum chromium levels of women with GDM, 1.59+/-0.02 ng/ml (range: 0.16-4.0 ng/ml were lower than in controls (4.58+/-0.62 ng/ml; range 0.82-5.33 ng/ml (P < 0.001. However, there were no significant differences among cases and controls when subdivided by parity. Conclusions: Women with GDM from a South Indian city had lower levels of serum chromium compared to pregnant women without GDM. Studies may be done whether chromium supplementation is useful in this group of women.

  11. Ultrasound Measurements of Thyroid Gland Volume at 36 Weeks' Corrected Gestational Age in Extremely Preterm Infants Born before 28 Weeks' Gestation.

    Science.gov (United States)

    Ng, Sze May; Turner, Mark A; Avula, Shivaram

    2018-01-01

    Thyroid ultrasound is a non-invasive imaging tool and provides good evaluation of thyroid anatomy, location, vascularisation, and echogenicity. The aim of this study was to assess thyroid function and thyroid volume in extremely preterm infants born before 28 weeks' gestation evaluated at 36 weeks' corrected gestational age (CGA) compared to term infants' normative data in the literature. In this largest prospective UK study of extremely premature infants born at less than 28 weeks' gestation, thyroid volume measurement was assessed at 36 weeks' CGA. Fifty-five extremely preterm infants (28 males) who were born before 28 weeks' gestation were recruited to the study. All infants had ultrasound assessment of the thyroid gland at 36 weeks' CGA. We also prospectively measured thyroid stimulating hormone (TSH) and free thyroxine (FT 4 ) in all infants at the time of recruitment (within 5 days of birth), at days 14, 21, and 28, and at 36 weeks' CGA. The mean thyroid volume was measured at 0.57 mL (SD ±0.18). There was no association between mean thyroid volume and thyroid function (TSH or FT 4 ). No associations were found between mean thyroid volume and gestation or birth weight in these infants. Our findings provide a reference range with a mean thyroid volume of 0.57 mL (SD ±0.18) in this extremely preterm age group if less than 28 weeks' gestation. Thyroid volume at birth can vary from country to country due to variations in iodine intake as well as gestational age.

  12. The effect of dietary restriction on reproduction: a meta-analytic perspective

    OpenAIRE

    Walling, Craig; Moatt, Joshua; Nakagawa, Shinichi; Lagisz, Malgorzata

    2016-01-01

    Background Dietary restriction (DR), a reduction in the amount of food or particular nutrients eaten, is the most consistent environmental manipulation to extend lifespan and protect against age related diseases. Current evolutionary theory explains this effect as a shift in the resolution of the trade-off between lifespan and reproduction. However, recent studies have questioned the role of reproduction in mediating the effect of DR on longevity and no study has quantitatively investigated t...

  13. Polycystic ovary disease. A risk factor for gestational diabetes?

    Science.gov (United States)

    Lanzone, A; Caruso, A; Di Simone, N; De Carolis, S; Fulghesu, A M; Mancuso, S

    1995-04-01

    We investigated the impact of pregestationally elevated insulin plasma levels on glycemic control in pregnant women with polycystic ovary disease (PCOD). Twelve patients with PCOD who became pregnant within six months following evaluation of their metabolic status were the study subjects. Four were obese and six (two obese) had a hyperinsulinemic response to the oral glucose tolerance test (OGTT). They were tested with the OGTT at 28-30 weeks of gestation. We also tested 12 normal patients and 10 consecutive patients with gestational diabetes; all were at the same gestational age. Plasma levels of insulin and glucose were determined in the samples collected for a period of four hours after glucose load (100 g). All PCOD patients significantly increased their insulin secretion in pregnancy. The hyperinsulinemic PCOD patients developed gestational diabetes (two patients) and impaired gestational glucose tolerance (three patients). The area under the insulin curve was greater in PCOD patients than in control and gestational diabetes patients (P PCOD may develop a derangement of glycemic control, probably related to their pregestational insulinemic status.

  14. Baseline HbA1c to Identify High-Risk Gestational Diabetes: Utility in Early vs Standard Gestational Diabetes.

    Science.gov (United States)

    Sweeting, Arianne N; Ross, Glynis P; Hyett, Jon; Molyneaux, Lynda; Tan, Kris; Constantino, Maria; Harding, Anna Jane; Wong, Jencia

    2017-01-01

    The increasing prevalence of gestational diabetes mellitus (GDM) necessitates risk stratification directing limited antenatal resources to those at greatest risk. Recent evidence demonstrates that an early pregnancy glycated hemoglobin (HbA1c ≥5.9% (41 mmol/mol) predicts adverse pregnancy outcomes. To determine the optimal HbA1c threshold for adverse pregnancy outcomes in GDM in a treated multiethnic cohort and whether this differs in women diagnosed HbA1c (single-laboratory) measurement at the time of GDM diagnosis. Maternal clinical and pregnancy outcome data were collected prospectively. The association between baseline HbA1c and adverse pregnancy outcomes in early vs standard GDM. HbA1c was measured at a median of 17.6 ± 3.3 weeks' gestation in early GDM (n = 844) and 29.4 ± 2.6 weeks' gestation in standard GDM (n = 2254). In standard GDM, HbA1c >5.9% (41 mmol/mol) was associated with the greatest risk of large-for-gestational-age (odds ratio [95% confidence interval] = 2.7 [1.5-4.9]), macrosomia (3.5 [1.4-8.6]), cesarean section (3.6 [2.1-6.2]), and hypertensive disorders (2.6 [1.1-5.8]). In early GDM, similar HbA1c associations were seen; however, lower HbA1c correlated with the greatest risk of small-for-gestational-age (P trend = 0.004) and prevalence of neonatal hypoglycemia. Baseline HbA1c >5.9% (41 mmol/mol) identifies an increased risk of large-for-gestational-age, macrosomia, cesarean section, and hypertensive disorders in standard GDM. Although similar associations are seen in early GDM, higher HbA1c levels do not adequately capture risk-limiting utility as a triage tool in this cohort. Copyright © 2017 by the Endocrine Society

  15. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study.

    Science.gov (United States)

    Alberico, Salvatore; Montico, Marcella; Barresi, Valentina; Monasta, Lorenzo; Businelli, Caterina; Soini, Valentina; Erenbourg, Anna; Ronfani, Luca; Maso, Gianpaolo

    2014-01-15

    It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson's chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia. Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia. Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored.

  16. Transvaginal ultrasound in threatened abortions with empty gestational sacs.

    Science.gov (United States)

    Tongsong, T; Wanapirak, C; Srisomboon, J; Sirichotiyakul, S; Polsrisuthikul, T; Pongsatha, S

    1994-09-01

    To determine whether transvaginal ultrasound criteria alone can distinguish viable from non-viable gestational sacs at a single examination. A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non-viable gestation on subsequent transvaginal sonography. The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non-viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non-viability. An MSD of > or = 17 mm that lacked an embryo and an MSD of > or = 13 mm without visible yolk sac were reliable predictors of non-viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD > or = 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non-viable gestations could be reliably identified without any false-positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non-viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non-viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. In most cases, transvaginal sonographic criteria alone can distinguish viable from non-viable empty gestational sacs at a single examination.

  17. Combined Influence of Gestational Weight Gain and Estimated Fetal Weight on Risk Assessment for Small- or Large-for-Gestational-Age Birth Weight: A Prospective Cohort Study.

    Science.gov (United States)

    Pugh, Sarah J; Hinkle, Stefanie N; Kim, Sungduk; Albert, Paul S; Newman, Roger; Grobman, William A; Wing, Deborah A; Grantz, Katherine L

    2018-04-01

    To evaluate the frequency with which gestational weight gain and estimated fetal weight do not track across gestation and to assess the risk of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight as a function of tracking. This study included a pregnancy cohort (2009-2013) of 2438 women from 4 racial/ethnic groups in the United States. We calculated race- and trimester-specific gestational weight gain and estimated fetal weight z scores. The prevalence of how often gestational weight gain and estimated fetal weight did not or did directly track was examined by grouping z scores into measure-specific categories (1 SD) and then examining 2-measure combinations. Trimester-specific relative risks for SGA and LGA births were estimated with a gestational weight gain and estimated fetal weight z score interaction. We estimated coefficients for selected gestational weight gain and estimated fetal weight values (-1 SD, 0 SD, and +1 SD) compared with the referent of 0 SD for both measures. Small and large for gestational age were calculated as birth weight below the 10th and at or above the 90th percentiles, respectively. Gestational weight gain and estimated fetal weight were within 1 SD 55.5%, 51.5%, and 48.2% of the time in the first, second, and third trimesters, respectively. There was no significant interaction between gestational weight gain and estimated fetal weight on the risk of SGA in the first and second trimesters (interaction term P = .48; P = .79). In the third trimester, there was a significant interaction (P = .002), resulting in a 71% (95% confidence interval, 1.45-2.02) increased risk of SGA when estimated fetal weight was low and gestational weight gain was high. These relationships were similar for the risk of LGA. Deviations in either measure, even in the presence of average gestational weight gain or estimated fetal weight, still suggest an increased risk of SGA and LGA. © 2017 by the American Institute of

  18. Attitudes towards gestational diabetes among a multiethnic cohort in Australia.

    Science.gov (United States)

    Carolan, Mary; Steele, Cheryl; Margetts, Heather

    2010-09-01

    This study aimed to examine the attitudes and beliefs towards gestational diabetes of a multiethnic sample of pregnant women with gestational diabetes. Women from non-Caucasian background are disproportionately represented in gestational diabetes statistics. This is of particular importance in multicultural Australia, where increasing numbers of non-Caucasian women give birth. Cross-sectional survey. The Diabetes Attitude Scale, version 3 was administered to 200 women with gestational diabetes from Vietnamese, Indian, Filipino and Caucasian backgrounds. A total of 143 questionnaires were returned indicating a response rate of 71·5%. There were significant between group differences in terms of educational level (p = 0·001) and English fluency (p = 0·001). Lower educational level, though not English language fluency, was associated with poorer appreciation of gestational diabetes as a serious condition and also with a lower valuing of tight glucose control. This effect was seen irrespective of ethnic group. Indian and Vietnamese women indicated a lower valuing of patient autonomy and also reported less negative psychological effects than Caucasian and Filipino women. Women from non-Caucasian ethnicities may be at risk of poorer self-management of gestational diabetes related to lower education, lower health literacy and a lower appreciation of gestational diabetes as a serious condition. Nurses and midwives provide information and advice to women with gestational diabetes. Knowledge about factors that impact on attitude towards gestational diabetes among multiethnic populations is important for developing educational programmes to address their needs. © 2010 Blackwell Publishing Ltd.

  19. Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

    Science.gov (United States)

    Bruner, David I.; Pritchard, Amy M.; Clarke, Jonathan

    2013-01-01

    While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. PMID:24106538

  20. Are physical activity levels linked to nutrient adequacy? Implications for cancer risk.

    Science.gov (United States)

    Csizmadi, Ilona; Kelemen, Linda E; Speidel, Thomas; Yuan, Yan; Dale, Laura C; Friedenreich, Christine M; Robson, Paula J

    2014-01-01

    Cancer prevention guidelines recommend a healthy body mass index, physical activity, and nutrient intake from food rather than supplements. Sedentary individuals may restrict energy intake to prevent weight gain and in so doing may compromise nutritional intake. We conducted a cross-sectional analysis to determine if adequacy of micronutrients is linked to physical activity levels (PALs) in healthy-weight adults. Tomorrow Project participants in Alberta, Canada (n = 5333), completed past-year diet and physical activity questionnaires. The percent meeting Dietary Reference Intakes (DRIs) was reported across low and high PAL groups, and the relation between PAL and percent achieved DRI was determined using multiple linear regression analyses. Overall, genders (P physical activity to include having a more favorable impact on nutrient adequacy.

  1. Activity restriction increases deoxypyridinoline excretion in hospitalized high-risk pregnant women.

    Science.gov (United States)

    Vanderspank, Dana; Bernier, Suzanne M; Sopper, Maggie M; Watson, Patricia; Mottola, Michelle F

    2014-01-01

    Activity restriction (AR), one of the most common interventions used in high-risk pregnancies, may exacerbate loss of bone mass. The purpose of this study was to determine changes over time in bone resorption in hospitalized AR women during late pregnancy. This was a short-term prospective study conducted in two tertiary-care obstetric hospitals. We measured urinary deoxypyridinoline (Dpd) excretion, a marker of bone resorption, once per week in a convenience sample of 14 hospitalized AR women in the third trimester and compared values at 28-31 and 34-36 weeks' gestation to those of 11 ambulatory control women. Both groups completed a bone-loading questionnaire, 3-day food intake record, and pedometer step counts at the same gestational age. Urinary Dpd excretion increased from Days 1-7 (2.60 ± 0.32 nmol/mmol creatinine) to Days 22-28 (5.36 ± 0.83 nmol/mmol creatinine; p ≤ .05). Dpd excretion was higher in AR women (4.51 ± 0.31 nmol/mmol creatinine) than ambulatory women (2.72 ± 0.39 nmol/mmol creatinine) at 34-36 weeks' gestation (p ≤ .05). Energy intake between ambulatory and AR women was not different (p ≥ .05). All women met the daily requirements for calcium and vitamin D intake during pregnancy. Average daily pedometer steps for the AR women were significantly less compared to controls (1,329 ± 936 and 8,024 ± 1,890 steps/day, respectively; p ≤ .05). AR leads to increased bone resorption in hospitalized pregnant women, which may impact future risk of developing osteopenia and osteoporosis.

  2. Hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery

    International Nuclear Information System (INIS)

    Ramzan, M.; Razzaq, A.; Kiyani, A.N.

    2017-01-01

    To determine the frequency of hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery. Study Design: Cross sectional study. Place and Duration of Study: Neonatal Intensive Care Unit (NICU), Military Hospital Rawalpindi, from Dec 2011 to Jul 2012. Material and Methods: We included 383 small for gestational age (SGA) neonates admitted in NICU. Blood glucose levels were checked in all neonates. Variables included in study were gestational age, gender, birth weight and mode of delivery. Results: Out of 383 SGA neonates enrolled by non-probability consecutive sampling, 191 (49.87%) were males and 192 (50.13%) were females. Out of these 203 (53%) were preterm, 165 (43.08%) were delivered at term and 15 (3.92%) were post-term SGA neonates with mean gestational age of 34 weeks 5 days. Out of the total 383 SGA neonates 208 (54.31%) developed hypoglycemia during stay in NICU and 175 (45.69%) remained euglycemic. Extremely low birth weight (ELBW) neonates were at highest risk to develop hypoglycemia (82.35%). It was seen that SGA neonates delivered by instrumental vaginal delivery had highest risk of developing hypoglycemia i.e. 20 (76.92) out of 26 neonates. Out of 103 vaginal deliveries 41 (39.81%) had hypoglycemia and out of 254 Caesarean section 147 (57.87%) had hypoglycemia. Conclusion: Low birth weight neonates delivered by instrumental vaginal delivery were found to be at a higher risk of developing hypoglycemia. (author)

  3. Gestational Protein Restriction Increases Cardiac Connexin 43 mRNA levels in male adult rat offspring.

    Science.gov (United States)

    Rossini, Kamila Fernanda; Oliveira, Camila Andrea de; Rebelato, Hércules Jonas; Esquisatto, Marcelo Augusto Marreto; Catisti, Rosana

    2017-07-01

    The dietary limitation during pregnancy influences the growth and development of the fetus and offspring and their health into adult life. The mechanisms underlying the adverse effects of gestational protein restriction (GPR) in the development of the offspring hearts are not well understood. The aim of this study was to evaluate the effects of GPR on cardiac structure in male rat offspring at day 60 after birth (d60). Pregnant Wistar rats were fed a normal-protein (NP, 17% casein) or low-protein (LP, 6% casein) diet. Blood pressure (BP) values from 60-day-old male offspring were measured by an indirect tail-cuff method using an electro sphygmomanometer. Hearts (d60) were collected for assessment of connexin 43 (Cx43) mRNA expression and morphological and morphometric analysis. LP offspring showed no difference in body weight, although they were born lighter than NP offspring. BP levels were significantly higher in the LP group. We observed a significant increase in the area occupied by collagen fibers, a decrease in the number of cardiomyocytes by 104 µm2, and an increase in cardiomyocyte area associated with an increased Cx43 expression. GPR changes myocardial levels of Cx43 mRNA in male young adult rats, suggesting that this mechanism aims to compensate the fibrotic process by the accumulation of collagen fibers in the heart interstitium. A limitação dietética durante a gravidez influencia o crescimento e desenvolvimento do feto e da prole e sua saúde na vida adulta. Os mecanismos subjacentes dos efeitos adversos da restrição proteica gestacional (RPG) no desenvolvimento dos corações da prole não são bem compreendidos. Avaliar os efeitos da RPG sobre a estrutura cardíaca em filhotes machos de ratas aos 60 dias após o nascimento (d60). Ratos fêmeas Wistar grávidas foram alimentadas com uma dieta de proteína normal (PN, 17% caseína) ou de baixa proteína (BP, caseína 6%). Os valores de pressão arterial (PA) de descendentes do sexo masculino de

  4. Iron, Oxidative Stress and Gestational Diabetes

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    Taifeng Zhuang

    2014-09-01

    Full Text Available Both iron deficiency and hyperglycemia are highly prevalent globally for pregnant women. Iron supplementation is recommended during pregnancy to control iron deficiency. The purposes of the review are to assess the oxidative effects of iron supplementation and the potential relationship between iron nutrition and gestational diabetes. High doses of iron (~relative to 60 mg or more daily for adult humans can induce lipid peroxidation in vitro and in animal studies. Pharmaceutical doses of iron supplements (e.g., 10× RDA or more for oral supplements or direct iron supplementation via injection or addition to the cell culture medium for a short or long duration will induce DNA damage. Higher heme-iron intake or iron status measured by various biomarkers, especially serum ferritin, might contribute to greater risk of gestational diabetes, which may be mediated by iron oxidative stress though lipid oxidation and/or DNA damage. However, information is lacking about the effect of low dose iron supplementation (≤60 mg daily on lipid peroxidation, DNA damage and gestational diabetes. Randomized trials of low-dose iron supplementation (≤60 mg daily for pregnant women are warranted to test the relationship between iron oxidative stress and insulin resistance/gestational diabetes, especially for iron-replete women.

  5. Management of Very Early-onset Fetal Growth Restriction: Results from 92 Consecutive Cases.

    Science.gov (United States)

    Hoellen, Friederike; Beckmann, Annika; Banz-Jansen, Constanze; Weichert, Jan; Rody, Achim; Bohlmann, Michael K

    2016-01-01

    To evaluate management of early-onset intrauterine growth restriction (IUGR) and to define outcome according to obstetric setting. During an 11-year period (2000-2011), data of patients presenting with IUGR and preterm delivery of less than 30 weeks of gestation at a tertiary perinatal center were retrospectively reviewed. A total of 92 pregnancies were investigated. Delivery was indicated for fetal reasons in 38 out of 92 patients. Sixteen children of our cohort died within one year post partum, out of which eight had suffered from severe early-onset IUGR causing iatrogenic preterm delivery. Concerning the fetal outcome, gestational age at delivery and antenatal exposure to corticosteroids were found to be crucial. In some cases, respiratory distress syndrome prophylaxis and a "wait and see" approach to management in favor of a prolongation of the pregnancy might be favorable. Randomized prospective trials in early-onset IUGR with threatened preterm deliveries are needed in order to define guidelines for an individually tailored management of early-onset preterm infants. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  6. Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

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    K. H. Odubamowo

    2014-01-01

    Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

  7. Allocation of Nutrients to Somatic Tissues in Young Ovariectomized Grasshoppers

    Science.gov (United States)

    Judd, Evan T.; Hatle, John D.; Drewry, Michelle D.; Wessels, Frank J.; Hahn, Daniel A.

    2010-01-01

    The disposable soma hypothesis predicts that when reproduction is reduced, life span is increased because more nutrients are invested in the soma, increasing somatic repair. Rigorously testing the hypothesis requires tracking nutrients from ingestion to allocation to the soma or to reproduction. Fruit flies on life-extending dietary restriction increase allocation to the soma “relative” to reproduction, suggesting that allocation of nutrients can be associated with extension of life span. Here, we use stable isotopes to track ingested nutrients in ovariectomized grasshoppers during the first oviposition cycle. Previous work has shown that ovariectomy extends life span, but investment of protein in reproduction is not reduced until after the first clutch of eggs is laid. Because ovariectomy does not affect investment in reproduction at this age, the disposable soma hypothesis would predict that ovariectomy should also not affect investment in somatic tissues. We developed grasshopper diets with distinct signatures of 13C and 15N, but that produced equivalent reproductive outputs. These diets are, therefore, appropriate for the reciprocal switches in diet needed for tracking ingested nutrients. Incorporation of stable isotopes into eggs showed that grasshoppers are income breeders, especially for carbon. Allocation to the fat body of nitrogen ingested as adults was slightly increased by ovariectomy; this was our only result that was not consistent with the disposable soma hypothesis. In contrast, ovariectomy did not affect allocation of nitrogen to femoral muscles. Further, allocation of carbon to the fat body or femoral muscles did not appear to be affected by ovariectomy. Total anti-oxidant activities in the hemolymph and femoral muscles were not affected by ovariectomy. These experiments showed that allocation of nutrients was altered little by ovariectomy in young grasshoppers. Additional studies on older individuals are needed to further test the disposable

  8. Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

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    Lawrence H. Lin

    Full Text Available Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: “Gestational trophoblastic disease AND Ultrasonography, Doppler.” Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. (1 Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. (2 There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. (3 Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. (4 Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. CONCLUSION: Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia.

  9. Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

    Science.gov (United States)

    Lin, Lawrence H; Bernardes, Lisandra S; Hase, Eliane A; Fushida, Koji; Francisco, Rossana P V

    2015-12-01

    Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: "Gestational trophoblastic disease AND Ultrasonography, Doppler." Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. (1) Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. (2) There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. (3) Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. (4) Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia.

  10. Gestational Trophoblastic Disease -Choriocarcinoma

    International Nuclear Information System (INIS)

    Bozik, M.

    2011-01-01

    Gestational trophoblastic tumors are a group of a diseases from the benign hydatidiform mole, through the invasive mole to the highly malignant form of a choriocarcinoma. Choriocarcinoma is a rare tumor and it is the most malignant and aggressive neoplasm of all the gestational trophoblastic diseases. It grows rapidly and metastasizes to the lung, liver, and, less frequently, to the brain. The author presents the case of a 26-year-old woman who is indicated to the CT examination for suspected brain tumor based on the previous examinations. The patient was diagnosed with metastatic choriocarcinoma to the brain, kidney and adrenal gland on the basis of an anamnesis by her husband, a high value of beta-hCG and a gynecological examination. (author)

  11. ACOG Committee Opinion No. 660 Summary: Family Building Through Gestational Surrogacy.

    Science.gov (United States)

    Ryan, Ginny L

    2016-03-01

    Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. The practice of gestational surrogacy involves a woman known as a gestational carrier who agrees to bear a genetically unrelated child with the help of assisted reproductive technologies for an individual or couple who intend(s) to be the legal and rearing parent(s), referred to as the intended parent(s). Obstetrician-gynecologists may become involved in gestational surrogacy through caring for the gestational carrier or by caring for the intended parent(s). Although gestational surrogacy increases options for family building, this treatment also involves ethical, medical, psychosocial, and legal complexities that must be taken into account to minimize risks of adverse outcomes for the gestational carrier, intended parent(s), and resulting children. The purpose of this document is to provide an overview of gestational surrogacy and to describe the ethical responsibilities for obstetrician-gynecologists who take part in the care of women who participate in these arrangements.

  12. Preeclampsia and gestational hypertension are associated with childhood blood pressure independently of family adiposity measures: the Avon Longitudinal Study of Parents and Children.

    Science.gov (United States)

    Geelhoed, J J Miranda; Fraser, Abigail; Tilling, Kate; Benfield, Li; Davey Smith, George; Sattar, Naveed; Nelson, Scott M; Lawlor, Debbie A

    2010-09-21

    Offspring of women with hypertensive disorders of pregnancy are at increased risk of cardiovascular complications later in life, but the mechanisms underlying these associations are unclear. Our aim was to examine whether adjusting for birth weight and familial adiposity changed the association of hypertensive disorders of pregnancy with offspring blood pressure. Using data from 6343 nine-year-old participants in the Avon Longitudinal Study of Parents and Children, we examined the association between hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) and offspring blood pressure. Both preeclampsia and gestational hypertension were associated with systolic and diastolic blood pressures in the 9-year-old offspring; after adjustment for parental and own adiposity and for other potential confounders, the mean difference in systolic blood pressure was 2.05 mm Hg (95 confidence interval, 0.72 to 3.38) and 2.04 mm Hg (95 confidence interval, 1.42 to 2.67) for preeclampsia and gestational hypertension, respectively, compared with those with no hypertensive disorders of pregnancy. Equivalent results for diastolic blood pressure were 1.00 mm Hg (95 confidence interval, -0.01 to 2.10) and 1.07 mm Hg (95 confidence interval, 0.60 to 1.54). The association of preeclampsia with offspring systolic and diastolic blood pressures attenuated toward the null with further adjustment for birth weight and gestational age, whereas these adjustments did not attenuate the association of gestational hypertension with offspring blood pressure. The associations of hypertensive disorders of pregnancy with higher offspring blood pressure are not explained by familial adiposity. The mechanisms linking preeclampsia and gestational hypertension with offspring blood pressure may differ, with the former mediated at least in part by the effect of preeclampsia on intrauterine growth restriction.

  13. Volumetric MRI study of the intrauterine growth restriction fetal brain

    International Nuclear Information System (INIS)

    Polat, A.; Barlow, S.; Ber, R.; Achiron, R.; Katorza, E.

    2017-01-01

    Intrauterine growth restriction (IUGR) is a pathologic fetal condition known to affect the fetal brain regionally and associated with future neurodevelopmental abnormalities. This study employed MRI to assess in utero regional brain volume changes in IUGR fetuses compared to controls. Retrospectively, using MRI images of fetuses at 30-34 weeks gestational age, a total of 8 brain regions - supratentorial brain and cavity, cerebral hemispheres, temporal lobes and cerebellum - were measured for volume in 13 fetuses with IUGR due to placental insufficiency and in 21 controls. Volumes and their ratios were assessed for difference using regression models. Reliability was assessed by intraclass correlation coefficients (ICC) between two observers. In both groups, all structures increase in absolute volume during that gestation period, and the rate of cerebellar growth is higher compared to that of supratentorial structures. All structures' absolute volumes were significantly smaller for the IUGR group. Cerebellar to supratentorial ratios were found to be significantly smaller (P < 0.05) for IUGR compared to controls. No other significant ratio differences were found. ICC showed excellent agreement. The cerebellar to supratentorial volume ratio is affected in IUGR fetuses. Additional research is needed to assess this as a radiologic marker in relation to long-term outcome. (orig.)

  14. Volumetric MRI study of the intrauterine growth restriction fetal brain

    Energy Technology Data Exchange (ETDEWEB)

    Polat, A.; Barlow, S.; Ber, R.; Achiron, R.; Katorza, E. [Tel Aviv University, Sackler School of Medicine, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer (Israel)

    2017-05-15

    Intrauterine growth restriction (IUGR) is a pathologic fetal condition known to affect the fetal brain regionally and associated with future neurodevelopmental abnormalities. This study employed MRI to assess in utero regional brain volume changes in IUGR fetuses compared to controls. Retrospectively, using MRI images of fetuses at 30-34 weeks gestational age, a total of 8 brain regions - supratentorial brain and cavity, cerebral hemispheres, temporal lobes and cerebellum - were measured for volume in 13 fetuses with IUGR due to placental insufficiency and in 21 controls. Volumes and their ratios were assessed for difference using regression models. Reliability was assessed by intraclass correlation coefficients (ICC) between two observers. In both groups, all structures increase in absolute volume during that gestation period, and the rate of cerebellar growth is higher compared to that of supratentorial structures. All structures' absolute volumes were significantly smaller for the IUGR group. Cerebellar to supratentorial ratios were found to be significantly smaller (P < 0.05) for IUGR compared to controls. No other significant ratio differences were found. ICC showed excellent agreement. The cerebellar to supratentorial volume ratio is affected in IUGR fetuses. Additional research is needed to assess this as a radiologic marker in relation to long-term outcome. (orig.)

  15. The Effects of Mild Gestational Hyperglycemia on Exclusive Breastfeeding Cessation

    Directory of Open Access Journals (Sweden)

    Sergio Verd

    2016-11-01

    Full Text Available Gestational diabetes increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure, but the best cut-off point for gestational diabetes is unknown. The purpose of this study was to evaluate the association between mild gestational glucose tolerance impairment and the early cessation of exclusive breastfeeding (EBF. This is an observational study of 768 women with full term pregnancies that were screened for gestational diabetes at 24–28 weeks gestation. Subjects were divided into two groups: those with a normal 1-h glucose challenge test and those with an elevated 1-h glucose challenge test but still did not qualify for gestational diabetes. We constructed multivariable logistic regression models using data from 616 women with normal gestational glucose tolerance and 152 women with an isolated positive 1-h glucose challenge test. The risk of early exclusive breastfeeding cessation was found to increase in women with mildly impaired glucose tolerance during pregnancy (adjusted OR, 1.65; 95% CI: 1.11, 2.45. Risks of early EBF cessation were also independently associated with the amount of neonatal weight loss and admission to the neonatal ward. Instead, parity was associated with a decreased risk for shorter EBF duration. Insulin resistance—even in the absence of gestational diabetes mellitus—may be an impeding factor for EBF.

  16. Exercise: An Alternative Therapy for Gestational Diabetes.

    Science.gov (United States)

    Artal, Raul

    1996-01-01

    Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

  17. Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Russo, Lindsey M; Nobles, Carrie; Ertel, Karen A; Chasan-Taber, Lisa; Whitcomb, Brian W

    2015-03-01

    Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with an increased incidence of pregnancy complications, adverse pregnancy outcomes, and maternal and fetal risks of chronic health conditions later in life. Physical activity has been proposed to reduce the risk of GDM and is supported by observational studies, but experimental research assessing its effectiveness is limited and conflicting. We aimed to use meta-analysis to synthesize existing randomized controlled studies of physical activity and GDM. We searched MEDLINE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for eligible studies. The following combination of keywords was used: (pregnant or pregnancy or gestation or gestate or gestational or maternity or maternal or prenatal) AND (exercise or locomotion or activity or training or sports) AND (diabetes or insulin sensitivity or glucose tolerance) AND (random* or trial). Eligibility was restricted to studies that randomized participants to an exercise-only-based intervention (ie, separate from dietary interventions) and presented data regarding GDM risk. Two authors performed the database search, assessment of eligibility, and abstraction of data from included studies, and a third resolved any discrepancies. A total of 469 studies was retrieved, of which 10 met inclusion criteria and could be used for analysis (3,401 participants). Fixed-effects models were used to estimate summary relative risk (RR) and 95% confidence interval (CI) and I to assess heterogeneity. There was a 28% reduced risk (95% CI 9-42%) in the intervention group compared with the control group (RR 0.72, P=.005). Heterogeneity was low (I=12%) and nonsignificant (P=.33). The results from this meta-analysis suggest that physical activity in pregnancy provides a slight protective effect against the development of GDM. Studies evaluating type, timing, duration, and compliance of physical activity regimens are warranted to best inform

  18. Protecting New Zealand children from exposure to the marketing of unhealthy foods and drinks: a comparison of three nutrient profiling systems to classify foods.

    Science.gov (United States)

    Mhurchu, Cliona Ni; Mackenzie, Tara; Vandevijvere, Stefanie

    2016-09-09

    Promotion of unhealthy foods and drinks is a significant, modifiable risk factor for child obesity and diet-related non-communicable diseases. We compared three accepted nutrient profiling systems: the Health Star Rating (HSR), the Ministry of Health Food and Beverage Classification System (FBCS) and the World Health Organization (WHO) Regional Office for Europe Nutrient Profiling Model, to identify the best system to protect New Zealand children from exposure to the marketing of unhealthy foods and beverages. 13,066 packaged foods from the 2014 New Zealand Nutritrack database were classified as 'restricted' or 'not restricted' as per the WHO model; 'everyday/sometimes' or 'occasional' as per the FBCS model; and 'foods that met the criteria for all three systems or none of the systems, and the types of food products classified as 'restricted' under the WHO model but classified as 'everyday/sometimes' (FBCS model) or as having >3.5 stars, were determined. Under any of the three nutrient profiling systems, approximately one-third (29-39%) of New Zealand packaged foods would be permitted to be marketed to children. The WHO Model would permit marketing of 29% of products; the HSR system would permit 36%; and the FBCS system would permit 39%. The WHO Model restricts marketing of unhealthy foods more effectively than the other two systems. The HSR and FBCS systems would permit marketing of a number of food products of concern, particularly high-sugar breakfast cereals, fruit juices and ready meals. The WHO Regional Office for Europe Nutrient Profiling Model should underpin the Advertising Standards Authority revised Children's Code for Advertising Food. The effectiveness of the new Code in reducing New Zealand children's exposure to marketing of unhealthy foods and drinks should be subject to evaluation by an independent body.

  19. Neuropsychological development in preschool children born with asymmetrical intrauterine growth restriction and impact of postnatal head growth.

    Science.gov (United States)

    Klaric, Andrea Simić; Galić, Slavka; Kolundzić, Zdravko; Bosnjak, Vlatka Mejaski

    2013-07-01

    Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (Pmotor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth-restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

  20. Greater early and mid-pregnancy gestational weight gain are associated with increased risk of gestational diabetes mellitus: A prospective cohort study.

    Science.gov (United States)

    Zhong, Chunrong; Li, Xiating; Chen, Renjuan; Zhou, Xuezhen; Liu, Chaoqun; Wu, Jiangyue; Xu, Shangzhi; Wang, Weiye; Xiao, Mei; Xiong, Guoping; Wang, Jing; Yang, Xuefeng; Hao, Liping; Yang, Nianhong

    2017-12-01

    Gestational diabetes mellitus is associated with adverse short- and long-term consequences for both the mother and the offspring. To examine the relationship between the rates of gestational weight gain (RGWG) during early and mid-pregnancy and the risk of gestational diabetes mellitus (GDM). 2090 singleton pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) without overt diabetes before pregnancy were analyzed in our study. Gestational weight were measured regularly in every antenatal visit. Gestational diabetes mellitus was assessed with the 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. Multivariable logistic regression was performed to estimate effect of RGWG on GDM. A total of 8.3% (n = 173) of pregnant women were diagnosed with GDM. Women with elevated rate of gestational weight gain prior to glucose screening test (RGWG-PG) increased the risk of GDM (adjusted p-trend = 0.004; odds ratios (OR) 1.64, 95% confidence intervals (CI) 1.01-2.68 and OR 2.30,95% CI 1.44-3.66 for 0.297-0.384 kg/wk and 0.385 kg/wk or more vs. 0.213 kg/wk or less, respectively). Women with greater rate of gestational weight gain in the first trimester (RGWG-F) increased the risk of GDM (adjusted p-trend = 0.048; OR 1.83, 95% CI 1.14-2.94 and OR 1.76, 95% CI 1.10-2.83 for 0.086-0.200 kg/wk and 0.201 kg/wk or more vs. -0.025 kg/wk or less, respectively). The rate of gestational weight gain in the second trimester (RGWG-S) was significantly associated with GDM only among women with RGWG-F more than 0.086 kg/wk (adjusted p-trend = 0.035; OR 2.04, 95% CI 1.16-3.59 for 0.658 kg/wk or more vs. 0.418 kg/wk or less). Greater early pregnancy weight gain are associated with increased risk of GDM. Elevated weight gain in mid-pregnancy increased the risk of GDM only among pregnant women with greater weight gain in the first trimester. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All

  1. The Therapeutic Effect of Zuogui Wan in Gestational Diabetes Mellitus Rats

    Science.gov (United States)

    Feng, Qianjin; Niu, Xin; Liu, Xinshe; Xu, Kaixia; Yang, Xiangzhu; Wang, Huifeng

    2014-01-01

    In this experiment, we established an animal model of gestational diabetes mellitus rats using streptozotocin. Using the rat model of GDM, the pregnant rats in 1-19d were divided into three groups: (1) Zuogui Wan gestational diabetes mellitus group (group I, n = 12), (2) gestational diabetes mellitus rats as the control group (group II, n = 11), and (3) rats of normal pregnancy group (group III, n = 11). Compared with gestational diabetes mellitus rats as the control group, Zuogui Wan can change the indexes of fasting blood glucose, body weight, total cholesterol, insulin, and metabolism cage index significantly in Zuogui Wan gestational diabetes mellitus group. We can conclude that Zuogui Wan has the therapeutic effect on gestational diabetes mellitus. PMID:25136475

  2. Gestational diabetes mellitus in Tanzania : public health perspectives

    NARCIS (Netherlands)

    Mwanri, A.W.

    2015-01-01

    Gestational diabetes mellitus in Tanzania – public health perspectives

    Abstract

    Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or

  3. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    OpenAIRE

    Burlina, S.; Dalfr?, M. G.; Chilelli, N. C.; Lapolla, A.

    2016-01-01

    The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of contai...

  4. Isolating the role of elevated Phlda2 in asymmetric late fetal growth restriction in mice

    Directory of Open Access Journals (Sweden)

    Simon J. Tunster

    2014-10-01

    Full Text Available Pleckstrin homology-like domain family A member 2 (PHLDA2 is a maternally expressed imprinted gene whose elevated expression has been linked to fetal growth restriction in a number of human studies. In mice, Phlda2 negatively regulates placental growth and limits the accumulation of placental glycogen. We previously reported that a three-copy transgene spanning the Phlda2 locus drove a fetal growth restriction phenotype late in gestation, suggesting a causative role for PHLDA2 in human growth restriction. However, in this mouse model, Phlda2 was overexpressed by fourfold, alongside overexpression of a second imprinted gene, Slc22a18. Here, we genetically isolate the role of Phlda2 in driving late fetal growth restriction in mice. We furthermore show that this Phlda2-driven growth restriction is asymmetrical, with a relative sparing of the brain, followed by rapid catch-up growth after birth, classic features of placental insufficiency. Strikingly, fetal growth restriction showed strain-specific differences, being apparent on the 129S2/SvHsd (129 genetic background and absent on the C57BL6 (BL6 background. A key difference between these two strains is the placenta. Specifically, BL6 placentae possess a more extensive endocrine compartment and substantially greater stores of placental glycogen. Taken together, these data support a direct role for elevated Phlda2 in limiting fetal growth but also suggest that growth restriction only manifests when there is limited placental reserve. These findings should be taken into account in interpreting the results from human studies.

  5. Nutrient cycling strategies.

    NARCIS (Netherlands)

    Breemen, van N.

    1995-01-01

    This paper briefly reviews pathways by which plants can influence the nutrient cycle, and thereby the nutrient supply of themselves and of their competitors. Higher or lower internal nutrient use efficiency positively feeds back into the nutrient cycle, and helps to increase or decrease soil

  6. Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

    Directory of Open Access Journals (Sweden)

    David I Bruner

    2013-09-01

    Full Text Available While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. [West J Emerg Med. 2013;14(5:444–447.

  7. Prevention of preterm delivery in twin gestations (PREDICT)

    DEFF Research Database (Denmark)

    Rode, L; Klein, K; Nicolaides, K H

    2011-01-01

    -blind, placebo-controlled randomized trial performed in 17 centers in Denmark and Austria. Women with twin gestations were randomized to daily treatment with progesterone pessaries or apparently identical placebo pessaries, starting from 20-24 weeks until 34 weeks' gestation. Primary outcome was incidence...

  8. Fasting glycaemia to simplify screening for gestational diabetes.

    Science.gov (United States)

    Ryser Rüetschi, J; Jornayvaz, F R; Rivest, R; Huhn, E A; Irion, O; Boulvain, M

    2016-12-01

    Recommendations in Switzerland on screening for gestational diabetes endorse the International Association of Diabetes in Pregnancy Study Group consensus. As universal testing is time consuming and glucose loading is unpleasant, the recommendations include a simplification, not performing the glucose loading in women with fasting glycaemia fasting glycaemia was fasting glycaemia. The prevalence of gestational diabetes was 10.9% in our population. Among 251 women with gestational diabetes, fasting glycaemia was ≥5.1 mmol/l in 119 women (47.4%), between 4.4 and fasting glycaemia between 4.4 and fasting glycaemia is an attractive alternative to universal screening with the complete 75-g glucose tolerance test. This strategy is, however, slightly less sensitive than previously reported in higher-risk populations. Fasting glycaemia can be considered as an alternative to the complete test for gestational diabetes screening. © 2016 Royal College of Obstetricians and Gynaecologists.

  9. Salmonella enterica serovar Enteritidis enterocolitis during late stages of gestation induces an adverse pregnancy outcome in the murine model.

    Directory of Open Access Journals (Sweden)

    Mariángeles Noto Llana

    Full Text Available Foodborne diseases caused by Salmonella enterica serovar Enteritidis (S. Enteritidis are a significant health problem. Pregnancy, state of immunological tolerance, is a predisposing condition for the development of infections with intracellular pathogens. Salmonella species can cause pregnancy complications such as chorioamnionitis, transplacental fetal infection, pre term labor, abortions, neonatal and maternal septicemia. However, the specific mechanisms by which Salmonella infections trigger these alterations are not clear. In the present work, using a self-limiting enterocolitis murine model, we show that the ingestion of a low dose of S. Enteritidis at late stages of pregnancy (day 15 of gestation is sufficient to induce massive maternal infection. We found that Salmonella infection leads to 40% of pre term delivery, 33% of abortion and fetal growth restriction. Placental dysfunction during S. Enteritidis enterocolitis was confirmed through cellular infiltration and hypoxia markers (MPO activity and COX-1 and COX-2 expression, respectively. Apoptosis in placental tissue due to Salmonella infection was also evident at day 18 of gestation when investigated by morphometric procedure, DNA fragmentation and Fas/FasL expression. Also, the expression of IFN-γ, TNF-α, IL-17 and IL-10 was up regulated in response to Salmonella not only in placenta, but also in amniotic fluid and maternal serum. Altogether, our results demonstrate that S. Enteritidis enterocolitis during late stages of gestation causes detrimental effect on pregnancy outcome.

  10. [Placental gene activity of significant angiogenetic factors in the background of intrauterine growth restriction].

    Science.gov (United States)

    Kovács, Péter; Rab, Attila; Szentpéteri, Imre; Joó, József Gábor; Kornya, László

    2017-04-01

    Placental vascular endothelial growth factor A (VEGF-A) gene and endoglin gene are both overexpressed in placental samples obtained from pregnancies with intrauterine growth restriction compared to normal pregnancies. In the background of these changes a mechanism can be supposed, in which the increased endoglin activity in intrauterine growth restriction (IUGR) leads to impaired placental circulation through an antioangiogenetic effect. This results in the development of placental vascular dysfunction and chronic fetal hypoxia. It is chronic hypoxia that turns on VEGF-A as a compensatory mechanism to improve fetal vascular blood supply by promoting placental blood vessel formation. Although the maternal serum placental growth factor (PlGF) level is a potential predictor for both IUGR and praeeclampsia, placental PlGF gene activity may be less of an active in the regulation of placental circulation in IUGR pregnancies during the later stages of gestation. Orv. Hetil., 2017, 158(16), 612-617.

  11. Gestational Diabetes and Women

    Centers for Disease Control (CDC) Podcasts

    This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.

  12. Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight.

    Science.gov (United States)

    Zhao, R; Xu, L; Wu, M L; Huang, S H; Cao, X J

    2018-02-01

    Evidence suggests that pre-pregnancy body mass index and gestational weight gain have impact on pregnancy and birth weight, yet whether maternal gestational weight gain has a differential effect on the rates of adverse birth weight among women with different pre-pregnancy body mass index categories are unknown. We selected 1617 children matched with their mothers as study subjects. The subjects were divided into three categories: weight gain below the American Institute of Medicine guidelines, weight gain within the American Institute of Medicine guidelines and weight gain above the American Institute of Medicine guidelines. The prevalence of pre-pregnancy underweight and overweight/obese women was 16.3% and 12.3%. And nearly 15.2% of the women had gestational weight gain below American Institute of Medicine guideline, 52.1% of the women had gestational weight gain above American Institute of Medicine guideline. Maternal overweight and obese was associated with increased risk for macrosomia and large-for-gestational age. Women had gestational weight gain below American Institute of Medicine guideline were more likely to have low birth weight and small-for-gestational age than women who had gestational weight gain within American Institute of Medicine guideline. Furthermore, the risks for macrosomia and large-for-gestational age were increased in women with above American Institute of Medicine guideline. And for women with a normal weight before pregnancy, gestational weight gain above the American Institute of Medicine guidelines were associated with higher rates of macrosomia and large-for-gestational age, compared with the women of similar pre-pregnancy weight category but with gestational weight gain within the American Institute of Medicine guidelines. Women with abnormal pre-pregnancy body mass index and gestational weight gain are at risk for adverse birth weight outcomes. Moreover, gestational weight gain has a differential effect on the rates of adverse

  13. Gestational diabetes: How risky are the mothers of rural Bengal,India

    OpenAIRE

    Sonali Sain

    2012-01-01

    Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA) risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28...

  14. Maternal hepatitis B infection and gestational diabetes mellitus.

    Science.gov (United States)

    Lao, Terence T; Chan, Ben C P; Leung, Wing-Cheong; Ho, Lai-Fong; Tse, Ka-Yu

    2007-07-01

    This retrospective cohort study was performed to examine the relationship between maternal hepatitis B virus infection, as indicated by the surface antigen status, with the development of gestational diabetes mellitus in a normal-risk Chinese obstetric population. Maternal demographics, risk factors, and pregnancy outcome of 13,683 singleton pregnancies delivering in 1998-2001 were analysed according to maternal hepatitis B surface antigen status, which was routinely screened. Multiple logistic regression analysis was performed to examine the role of hepatitis B infection in the development of gestational diabetes mellitus. The 1138 women (8.3%) with hepatitis B infection had lower mean weight and body mass index, similar prevalence of chronic medical diseases and smokers, but increased prevalence of gestational diabetes mellitus, which remained significant (odds ratio 1.24, 95% confidence interval 1.01-1.51) after adjustment for confounding variables. However, there was no difference in pregnancy outcome. Our results confirmed the independent association between hepatitis B infection with gestational diabetes mellitus. The magnitude of chronic hepatitis B infection in the developing world and certain ethnic groups could have contributed to the high prevalence of gestational and possibly type 2 diabetes in these populations. Further studies on the long-term implications of our finding are warranted.

  15. Outcomes for Gestational Carriers Versus Traditional Surrogates in the United States.

    Science.gov (United States)

    Fuchs, Erika L; Berenson, Abbey B

    2018-05-01

    Little is known about the obstetric and procedural outcomes of traditional surrogates and gestational carriers. Participants included 222 women living in the United States who completed a brief online survey between November 2015 and February 2016. Differences between gestational carriers (n = 204) and traditional surrogates (n = 18) in demographic characteristics, pregnancy outcomes, and procedural outcomes were examined using chi-squared tests, Fisher's exact tests, and t-tests. Out of 248 eligible respondents, 222 surveys were complete, for a response rate of 89.5%. Overall, obstetric outcomes were similar among gestational carriers and traditional surrogates. Traditional surrogates were more likely than gestational carriers to have a Center for Epidemiologic Studies Depression Scale Revised score of 16 or higher (37.5% vs. 4.0%). Gestational carriers reported higher mean compensation ($27,162.80 vs. $17,070.07) and were more likely to travel over 400 miles (46.0% vs. 0.0%) than traditional surrogates. Procedural differences, but not differences in obstetric outcomes, emerged between gestational carriers and traditional surrogates. To ensure that both traditional surrogates and gestational carriers receive optimal medical care, it may be necessary to extend practice guidelines to ensure that traditional surrogates are offered the same level of care offered to gestational carriers.

  16. Metyrapone alleviates deleterious effects of maternal food restriction on lung development and growth of rat offspring.

    Science.gov (United States)

    Paek, David S; Sakurai, Reiko; Saraswat, Aditi; Li, Yishi; Khorram, Omid; Torday, John S; Rehan, Virender K

    2015-02-01

    Maternal food restriction (MFR) causes intrauterine growth restriction, a known risk factor for developing chronic lung disease. However, it is unknown whether this negative outcome is gender specific or preventable by blocking the MFR-induced hyperglucocorticoidism. Using a well-established rat model, we used metyrapone (MTP), an inhibitor of glucocorticoid synthesis, to study the MFR-induced lung changes on postnatal day (p) 21 in a gender-specific manner. From embryonic day 10 until delivery, pregnant dams were fed either an ad libitum diet or a 50% caloric restricted diet with or without MTP supplementation. Postnatally, the offspring were fed ad libitum from healthy dams until p21. Morphometric, Western blot, and immunohistochemical analysis of the lungs demonstrated that MTP mitigated the MFR-mediated decrease in alveolar count, decrease in adipogenic protein peroxisome proliferator-activated receptor γ, increase in myogenic proteins (fibronectin, α-smooth muscle actin, and calponin), increase in Wnt signaling intermediates (lymphoid enhancer-binding factor 1 and β-catenin), and increase in glucocorticoid receptor (GR) levels. The MFR-induced lung phenotype and the effects of MTP were similar in both genders. To elucidate the mechanism of MFR-induced shift of the adipogenic-to-myogenic phenotype, lung fibroblasts were used to independently study the effects of (1) nutrient restriction and (2) excess steroid exposure. Nutrient deprivation increased myogenic proteins, Wnt signaling intermediates, and GR, all changes blocked by protein supplementation. MTP also blocked, likely by normalizing nicotinamide adenine dinucleotide phosphate levels, the corticosterone-induced increase in myogenic proteins, but had no effect on GR levels. In summary, protein restriction and increased glucocorticoid levels appear to be the key players in MFR-induced lung disease, affecting both genders. © The Author(s) 2014.

  17. Fluoxetine effect on gestation and fetal development

    Directory of Open Access Journals (Sweden)

    Ösz Bianca Eugenia

    2014-08-01

    Full Text Available The prenatal exposure to selective serotonin reuptake inhibitors (SSRIs is very controversial. There is no conclusive evidence for increased risk of malformations after SSRI use in pregnancy. The aim of the study was to determine how fluoxetine is affecting gestation and fetal development in rats. Twenty sexually mature female Wistar rats weighting between 250-260 g received 20 mg/kg body weight fluoxetine from the first day of gestation and during the entire gestation period.The drug was administered by oral route. Healthy, primipareus animals were selected along with 20 female Wistar rats, as control group. Mature males were caged with virgin females for an entire week. Rat’s behaviour during gestation, after birth and rats body weight was examined. The number of healthy pups was also noted. The females not giving birth after 21 days to any pup were anesthetized (halothane through gas scavenging apparatus untilled death and the gravid uterus were dissected out and examined. Compared to the controlled group, in which weight gain was more significant, the animals from the experimental group had a slight increase in body weight. The weight gain normally induced by gestation, is less significant in fluoxetine treated rats due to the increase serotonin levels in the brain. The uteri examination of pregnant rats showed an increase in the number of dead and resorbed rat embryos. Preclinical studies suggest that the inclusion of fluoxetine in pregnancy category C is justified and the appropriateness of its administration in pregnancy is still an unresolved issue.

  18. Gestational diabetes: How risky are the mothers of rural Bengal, India

    OpenAIRE

    Sonali Sain; Prianka Mukhopadhyay; Tushar Kanti Saha; Ritu Ghosh

    2013-01-01

    Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA) risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28 weeks were interv...

  19. Duration of gestation in pregnant dogs carrying cloned fetuses.

    Science.gov (United States)

    Kim, Min Jung; Oh, Hyun Ju; Park, Jung Eun; Kim, Geon A; Park, Eun Jung; Jo, Young Kwang; Lee, Byeong Chun

    2013-01-15

    The aim of this study was to investigate gestation duration and the physiologic characteristics of pregnant dogs bearing cloned fetuses, especially in the prepartum period. A retrospective study was performed to compare gestation duration in females pregnant with cloned (somatic cell nuclear transfer) fetuses (cloned group) with those bearing noncloned fetuses (control group), and effects of litter size, birth weight, and breed of somatic cell donors on gestation duration in the cloned group were evaluated. Clinical delivery onset signs associated with serum progesterone concentration and rectal temperature were also compared in both groups. The gestation duration calculated from day of ovulation was significantly longer in the cloned (62.8 ± 0.3 days) versus the control group (60.9 ± 0.5 days; P dogs bearing cloned fetuses might be because of the smaller litter size in this group. Also, the weaker drop in serum progesterone levels in the prepartum period in cloned dog pregnancies indicates that the parturition signaling process might be altered resulting in longer gestation periods. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Diagnostic criteria for gestational diabetes mellitus (WS 331-2011)

    Institute of Scientific and Technical Information of China (English)

    Medical Service Specialty Standard Committee of Mi

    2012-01-01

    The criteria provide the screening and diagnosis for gestational diabetes mellitus and it should be applied to all medical institutions and health care practitioners for gestational diabetes mellitus (DM) diagnosis in China.

  1. Identification of Differentially Abundant Proteins of Edwardsiella ictaluri during Iron Restriction.

    Directory of Open Access Journals (Sweden)

    Pradeep R Dumpala

    Full Text Available Edwardsiella ictaluri is a Gram-negative facultative anaerobe intracellular bacterium that causes enteric septicemia in channel catfish. Iron is an essential inorganic nutrient of bacteria and is crucial for bacterial invasion. Reduced availability of iron by the host may cause significant stress for bacterial pathogens and is considered a signal that leads to significant alteration in virulence gene expression. However, the precise effect of iron-restriction on E. ictaluri protein abundance is unknown. The purpose of this study was to identify differentially abundant proteins of E. ictaluri during in vitro iron-restricted conditions. We applied two-dimensional difference in gel electrophoresis (2D-DIGE for determining differentially abundant proteins and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF/TOF MS for protein identification. Gene ontology and pathway-based functional modeling of differentially abundant proteins was also conducted. A total of 50 unique differentially abundant proteins at a minimum of 2-fold (p ≤ 0.05 difference in abundance due to iron-restriction were detected. The numbers of up- and down-regulated proteins were 37 and 13, respectively. We noted several proteins, including EsrB, LamB, MalM, MalE, FdaA, and TonB-dependent heme/hemoglobin receptor family proteins responded to iron restriction in E. ictaluri.

  2. Differential correlations between maternal hair levels of tobacco and alcohol with fetal growth restriction clinical subtypes.

    Science.gov (United States)

    Sabra, Sally; Malmqvist, Ebba; Almeida, Laura; Gratacos, Eduard; Gomez Roig, Maria Dolores

    2018-08-01

    Maternal exposure to tobacco and alcohol is a known cause, among others, for fetal growth restriction (FGR). Clinically, FGR can be subclassified into two forms: intrauterine growth restriction (IUGR) and small for gestational age (SGA), based on the severity of the growth retardation, and abnormal uterine artery Doppler or cerebro-placental ratio. This study aimed at investigating any differential correlation between maternal exposures to these toxins with the two clinical forms of FGR. Therefore, a case-control study was conducted in Barcelona, Spain. Sixty-four FGR subjects, who were further subclassified into IUGR (n = 36) and SGA (n = 28), and 89 subjects matched appropriate-for-gestational age (AGA), were included. The levels of nicotine (NIC) and ethyl glucuronide (EtG), biomarkers of tobacco and alcohol exposure, respectively, were assessed in the maternal hair in the third trimester. Our analysis showed 65% of the pregnant women consumed alcohol, 25% smoked, and 19% did both. The odds ratios (ORs) of IUGR were 21 times versus 14 times for being SGA with maternal heavy smoking, while with alcohol consumption the ORs for IUGR were 22 times versus 37 times for the SGA group. The differential correlations between these toxins with the two subtypes of FGR suggest different mechanisms influencing fetal weight. Our alarming data of alcohol consumption during pregnancy should be considered for further confirmation among Spanish women. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Nutrient-Deprived Retinal Progenitors Proliferate in Response to Hypoxia: Interaction of the HIF-1 and mTOR Pathway

    Directory of Open Access Journals (Sweden)

    Helena Khaliullina

    2016-05-01

    Full Text Available At a cellular level, nutrients are sensed by the mechanistic Target of Rapamycin (mTOR. The response of cells to hypoxia is regulated via action of the oxygen sensor Hypoxia-Inducible Factor 1 (HIF-1. During development, injury and disease, tissues might face conditions of both low nutrient supply and low oxygen, yet it is not clear how cells adapt to both nutrient restriction and hypoxia, or how mTOR and HIF-1 interact in such conditions. Here we explore this question in vivo with respect to cell proliferation using the ciliary marginal zone (CMZ of Xenopus. We found that both nutrient-deprivation and hypoxia cause retinal progenitors to decrease their proliferation, yet when nutrient-deprived progenitors are exposed to hypoxia there is an unexpected rise in cell proliferation. This increase, mediated by HIF-1 signalling, is dependent on glutaminolysis and reactivation of the mTOR pathway. We discuss how these findings in non-transformed tissue may also shed light on the ability of cancer cells in poorly vascularised solid tumours to proliferate.

  4. The hepatic transcriptome of young suckling and aging intrauterine growth restricted male rats.

    Science.gov (United States)

    Freije, William A; Thamotharan, Shanthie; Lee, Regina; Shin, Bo-Chul; Devaskar, Sherin U

    2015-04-01

    Intrauterine growth restriction leads to the development of adult onset obesity/metabolic syndrome, diabetes mellitus, cardiovascular disease, hypertension, stroke, dyslipidemia, and non-alcoholic fatty liver disease/steatohepatitis. Continued postnatal growth restriction has been shown to ameliorate many of these sequelae. To further our understanding of the mechanism of how intrauterine and early postnatal growth affects adult health we have employed Affymetrix microarray-based expression profiling to characterize hepatic gene expression of male offspring in a rat model of maternal nutrient restriction in early and late life. At day 21 of life (p21) combined intrauterine and postnatal calorie restriction treatment led to expression changes in circadian, metabolic, and insulin-like growth factor genes as part of a larger transcriptional response that encompasses 144 genes. Independent and controlled experiments at p21 confirm the early life circadian, metabolic, and growth factor perturbations. In contrast to the p21 transcriptional response, at day 450 of life (d450) only seven genes, largely uncharacterized, were differentially expressed. This lack of a transcriptional response identifies non-transcriptional mechanisms mediating the adult sequelae of intrauterine growth restriction. Independent experiments at d450 identify a circadian defect as well as validate expression changes to four of the genes identified by the microarray screen which have a novel association with growth restriction. Emerging from this rich dataset is a portrait of how the liver responds to growth restriction through circadian dysregulation, energy/substrate management, and growth factor modulation. © 2014 Wiley Periodicals, Inc.

  5. Gender- and Gestational Age-Specific Body Fat Percentage at Birth.

    LENUS (Irish Health Repository)

    Hawkes, Colin P

    2011-08-08

    Background: There is increasing evidence that in utero growth has both immediate and far-reaching influence on health. Birth weight and length are used as surrogate measures of in utero growth. However, these measures poorly reflect neonatal adiposity. Air-displacement plethysmography has been validated for the measurement of body fat in the neonatal population. Objective: The goal of this study was to show the normal reference values of percentage body fat (%BF) in infants during the first 4 days of life. Methods: As part of a large population-based birth cohort study, fat mass, fat-free mass, and %BF were measured within the first 4 days of life using air-displacement plethsymography. Infants were grouped into gestational age and gender categories. Results: Of the 786 enrolled infants, fat mass, fat-free mass, and %BF were measured in 743 (94.5%) infants within the first 4 days of life. %BF increased significantly with gestational age. Mean (SD) %BF at 36 to 37 weeks\\' gestation was 8.9% (3.5%); at 38 to 39 weeks\\' gestation, 10.3% (4%); and at 40 to 41 weeks\\' gestation, 11.2% (4.3%) (P < .001). Female infants had significantly increased mean (SD) %BF at 38 to 39(11.1% [3.9%] vs 9.8% [3.9%]; P = .012) and at 40 to 41 (12.5% [4.4%] vs 10% [3.9%]; P < .001) weeks\\' gestation compared with male infants. Gender- and gestational age-specific centiles were calculated, and a normative table was generated for reference. Conclusion: %BF at birth is influenced by gestational age and gender. We generated accurate %BF centiles from a large population-based cohort.

  6. Neonatal outcomes according to different therapies for gestational diabetes mellitus,

    Directory of Open Access Journals (Sweden)

    Amanda L. da Silva

    Full Text Available Abstract: Objectives: To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus. Methods: This was a retrospective cohort study. The study population comprised pregnant women with gestational diabetes treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for gestational diabetes mellitus. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, Apgar at 1 and 5 min, and need for intensive care unit admission. Results: The sample consisted of 705 pregnant women. The neonatal outcomes were analyzed based on the treatment received. Women treated with metformin were less likely to have children who were small for gestational age (95% CI: 0.09-0.66 and more likely to have a newborn adequate for gestational age (95% CI: 1.12-3.94. Those women treated with insulin had a lower chance of having a preterm child (95% CI: 0.02-0.78. The combined treatment with insulin and metformin resulted in higher chance for a neonate to be born large for gestational age (95% CI: 1.14-11.15 and lower chance to be born preterm (95% CI: 0.01-0.71. The type of treatment did not affect the mode of delivery, Apgar score, and intensive care unit admission. Conclusions: The pediatrician in the delivery room can expect different outcomes for diabetic mothers based on the treatment received.

  7. Cats during gestation and lactation fed with canned food ad libitum: energy and protein intake, development of body weight and body composition.

    Science.gov (United States)

    Wichert, B; Signer, M; Uebelhart, D

    2012-12-01

    The NRC recommendations for cats for energy and protein supply during gestation and lactation are based on limited data. This study aimed to answer the question: Can the energy requirement be met with canned food or is the volume restrictive? Therefore, balance trials were conducted in 10 queens before mating, during the 4th and 7th week of gestation and during the 2nd and 6th week of lactation. The cats were fed with canned food ad libitum. Additionally, the body composition of the queens was measured by dual-energy X-ray absorptiometry (Dexa) before mating, after parturition and after weaning. Eight of 10 cats presented increased body fat content and lean body mass during gestation. The weight loss during lactation led to a loss of lean body mass, but only six cats lost body fat of widely differing amounts. It was evident that the queens' dry matter intake was consistent with that of queens fed ad libitum with dry food. The cats lost lean body mass during lactation and had negative protein balances in the 2nd week of lactation. This seems to be physiological in early lactation. Nevertheless, the protein recommendations for lactation seem to be too low. © 2011 Blackwell Verlag GmbH.

  8. Working hours and risk of gestational hypertension and pre-eclampsia.

    Science.gov (United States)

    Chang, Pei-Jen; Chu, Li-Ching; Hsieh, Wu-Shiun; Chuang, Yi-Li; Lin, Shio-Jean; Chen, Pau-Chung

    2010-01-01

    The potential impact of employment on maternal health, particularly in relation to gestational hypertension and pre-eclampsia, has been subject to research. However, there is limited evidence on associations between shift work and long working hours on the incidence of these conditions. To evaluate potential associations between maternal shift work and long working hours during pregnancy and gestational hypertension or pre-eclampsia. Multistage stratified systematic sampling was used to recruit 24 200 post-partum women from the Taiwan national birth registration database in 2005. Subjects underwent home interview 6 months after their deliveries by structured questionnaire to obtain characteristics of maternal employment and potential confounders. Diagnosis of gestational hypertension and pre-eclampsia was obtained from the birth registration. There was no association between employment status and gestational hypertension or pre-eclampsia. Also, no significant association between gestational hypertension or pre-eclampsia and maternal shift work or long working hours during pregnancy was found in all or primiparous women. There was no convincing evidence that maternal shift work or long working hours had a higher risk of gestational hypertension or pre-eclampsia. However, further research is warranted to confirm these negative findings.

  9. The effects of polycystic ovary syndrome on gestational diabetes mellitus.

    Science.gov (United States)

    Aktun, Hale Lebriz; Yorgunlar, Betul; Acet, Mustafa; Aygun, Banu Kumbak; Karaca, Nilay

    2016-01-01

    The aim of this study was to explore the inter-relationship between polycystic ovary syndrome and gestational diabetes mellitus, and demonstrate maternal and fetal outcomes. This was a case-control study in 1360 pregnant women who received a diagnosis of gestational diabetes mellitus between 24 and 28 weeks of gestational age. Among all diagnosed with gestational diabetes mellitus, 150 pregnant women had received a polycystic ovary syndrome, and 160 women who did not have polycystic ovary syndrome were designated as controls. The incidence of pregnancy-induced hypertension was 26.3% and 12% in the case and control groups, respectively. Preeclampsia was seen at an incidence of 12% and 6% in case and in control groups, respectively. The difference in neonatal hypoglycemia between the two groups was statistically significant, with an incidence of 17% and 5% in the case and in control groups, respectively. This study demonstrated that the presence of polycystic ovary syndrome along with gestational diabetes mellitus increases the risk of pregnancy induced hypertension by 2.4 fold, preeclampsia by 2 fold and neonatal hypoglycemia by 3.2 fold, compared to gestational diabetes mellitus alone.

  10. Irregular menses: an independent risk factor for gestational diabetes mellitus.

    Science.gov (United States)

    Haver, Mary Claire; Locksmith, Gregory J; Emmet, Emily

    2003-05-01

    Our purpose was to determine whether a history of irregular menses predicts gestational diabetes mellitus independently of traditional risk factors. We analyzed demographic characteristics, body mass index, and menstrual history of 85 pregnant women with gestational diabetes mellitus and compared them with 85 systematically selected control subjects who were matched for age, race, and delivery year. Subjects with pregestational diabetes mellitus, previous gestational diabetes mellitus, family history of diabetes mellitus, weight >200 pounds, previous macrosomic infants, or previous stillbirth were excluded. Demographic characteristics between case and control groups were similar. Mean body mass index was higher among cases (26.5 kg/m(2)) versus control subjects (24.5 kg/m(2), P =.004). Irregular cycles were more prevalent in the cases (24% vs 7%, P =.006). With the use of body mass index as a stratification factor, menstrual irregularity maintained a strong association with gestational diabetes mellitus (P =.014). A history of irregular menstrual cycles was a significant independent predictor of gestational diabetes mellitus. If selective screening is implemented for gestational diabetes mellitus, such history should be considered in the decision of whom to test.

  11. Factors associated with delivery at or after 28 weeks gestation in women with bulging fetal membranes before 26 weeks gestation.

    Science.gov (United States)

    Ito, Akiko; Maseki, Yoshiaki; Ikeda, Sayako; Tezuka, Atsuko; Kuribayashi, Momoko; Furuhashi, Madoka

    2017-09-01

    To elucidate the factors that contribute to prolonged pregnancy and promote neonate survival in women with bulging fetal membranes. A database was reviewed to identify women with singleton pregnancies who underwent amniocentesis on admission to determine amniotic fluid neutrophil elastase levels before 26 + 0 weeks gestation between July 2001 and January 2015. Following delivery, the placentas of these patients were examined for histologic chorioamnionitis. Ninety-seven women delivered before 28 weeks gestation, and 117 women delivered at or after 28 weeks gestation. Rescue cerclage performed via the McDonald procedure (adjusted odds ratio [aOR]: 3.78; 95% confidence interval [CI]: 1.35-11.80) was associated with a higher likelihood of reaching at least 28 weeks gestation before delivery, whereas protruding membranes (aOR: 0.38; 95% CI: 0.18-0.78), elevated amniotic neutrophil elastase levels (≥0.15 μg/ml) (aOR, 0.41; 95% CI: 0.20-0.82) and elevated peripheral C-reactive protein levels (≥0.4 mg/dl) (aOR: 0.34; 95% CI: 0.180.65) were associated with a significantly reduced likelihood of reaching this gestational age before delivery. Among women who underwent rescue cerclage, amniorrhexis was associated with a negative prognosis (aOR: 0.18; 95% CI: 0.05-0.51). Intra-amniotic inflammation, protrusion of fetal membranes and amniorrhexis are factors that may prevent pregnancy prolongation. Rescue cerclage improves pregnancy outcomes.

  12. Maternal glycated haemoglobin, pre-gestational weight, pregnancy weight gain and risk of large-for-gestational-age babies: a Danish cohort study of 209 singleton Type 1 diabetic pregnancies

    DEFF Research Database (Denmark)

    Nielsen, Gunnar Lauge; Dethlefsen, Claus; Møller, Anna Margrethe

    2007-01-01

    between glycated haemoglobin (HbA1c) and relative risk of delivering an LGA baby was quantified based on logistic regression models and stratified analysis controlling for the five covariates. Results We included 209 singleton pregnancies with assessable HbA1c values of which 59% [95% confidence interval......Aims To examine the association between maternal glycated haemoglobin in the second half of diabetic pregnancies and the relative risk of delivering large-for-gestational-age (LGA) babies, controlling for maternal body mass index (BMI) before pregnancy, weight gain, age, White class and smoking...... (CI) 52-65%] terminated with an LGA baby. Increasing levels of HbA1c, BMI and weight gain were all associated with increasing risk of delivering an LGA baby. Analyses stratified according to maternal BMI showed that the association between HbA1c and risk of delivering an LGA baby was restricted...

  13. Diagnostic protocol for gestational diabetes mellitus (GDM) (IADPSG/ADA, 2011): influence on the occurrence of GDM and mild gestational hyperglycemia (MGH) and on the perinatal outcomes.

    Science.gov (United States)

    Sirimarco, Mariana Pinto; Guerra, Helena Maciel; Lisboa, Eduardo Guimarães; Vernini, Joice Monalisa; Cassetari, Bianca Nicolosi; de Araujo Costa, Roberto Antonio; Rudge, Marilza Vieira Cunha; de Mattos Paranhos Calderon, Iracema

    2017-01-01

    In August 2011, the Specialized Center for Diabetes and Pregnancy of the Botucatu Medical School/Unesp adopted a new diagnostic protocol for gestational diabetes mellitus, recommended by the American Diabetes Association and the International Association of the Diabetes and Pregnancy Study Group. The glycemic profile was evaluated using the 75-g oral glucose tolerance test (OGTT) used to diagnose mild gestational hyperglycemia, recognized and treated in our department as gestational diabetes mellitus. The cost-effectiveness of the new guidelines and the continued need for the evaluation of the glycemic profile, as part of our Service protocol, are controversial and require further investigation. We aimed to assess the impact of the new guidelines on the evaluation of mild gestational hyperglycemia and gestational diabetes mellitus, the incidence of adverse perinatal outcomes, and the association between the 75-g OGTT and the glycemic profile for the diagnosis of mild gestational hyperglycemia. This cross-sectional study was performed identifying a convenience sample of pregnant women and their newborns. The women used our Service for diagnostic procedures, prenatal care and delivery, both before (January 2008 to August 14, 2011) and after (August 15, 2011 to December 2014) the protocol modification. The following variables were compared, following stratification according to diagnostic protocol: prevalence of gestational diabetes mellitus and mild gestational hyperglycemia, newborns large for gestational age, macrosomia, first cesarean delivery, and newborn hospital stay. Statistical analysis was performed using Poisson regression, the Student's t test, the Chi square or Fisher's exact test and risk estimate. The statistical significance threshold was set at 95% (p gestational hyperglycemia, despite a normal 75-g OGTT. The new guidelines did not affect perinatal outcome. These results support the validity of maintaining the glycemic profile as part of the

  14. Molecular mechanisms of intrauterine growth restriction.

    Science.gov (United States)

    Gurugubelli Krishna, Rao; Vishnu Bhat, B

    2017-07-10

    Intrauterine growth restriction (IUGR) is a pregnancy specific disease characterized by decreased growth rate of fetus than the normal growth potential at particular gestational age. In the current scenario it is a leading cause of fetal and neonatal morbidity and mortality. In the last decade exhilarating experimental studies from several laboratories have provided fascinating proof for comprehension of molecular basis of IUGR. Atypical expression of enzymes governed by TGFβ causes the placental apoptosis and altered expression of TGFβ due to hyper alimentation causes impairment of lung function. Crosstalk of cAMP with protein kinases plays a prominent role in the regulation of cortisol levels. Increasing levels of NOD1 proteins leads to development of IUGR by increasing the levels of inflammatory mediators. Increase in leptin synthesis in placental trophoblast cells is associated with IUGR. In this review, we emphasize on the regulatory mechanisms of IUGR and its associated diseases. They may help improve the in-utero fetal growth and provide a better therapeutic intervention for prevention and treatment of IUGR.

  15. Gestational surrogacy: Viewpoint of Iranian infertile women.

    Science.gov (United States)

    Rahmani, Azad; Sattarzadeh, Nilofar; Gholizadeh, Leila; Sheikhalipour, Zahra; Allahbakhshian, Atefeh; Hassankhani, Hadi

    2011-09-01

    Surrogacy is a popular form of assisted reproductive technology of which only gestational form is approved by most of the religious scholars in Iran. Little evidence exists about the Iranian infertile women's viewpoint regarding gestational surrogacy. To assess the viewpoint of Iranian infertile women toward gestational surrogacy. This descriptive study was conducted at the infertility clinic of Tabriz University of Medical Sciences, Iran. The study sample consisted of 238 infertile women who were selected using the eligible sampling method. Data were collected by using a researcher developed questionnaire that included 25 items based on a five-point Likert scale. Data analysis was conducted by SPSS statistical software using descriptive statistics. Viewpoint of 214 women (89.9%) was positive. 36 (15.1%) women considered gestational surrogacy against their religious beliefs; 170 women (71.4%) did not assume the commissioning couple as owners of the baby; 160 women (67.2%) said that children who were born through surrogacy would better not know about it; and 174 women (73.1%) believed that children born through surrogacy will face mental problems. Iranian infertile women have positive viewpoint regarding the surrogacy. However, to increase the acceptability of surrogacy among infertile women, further efforts are needed.

  16. Association of Group Prenatal Care With Gestational Weight Gain.

    Science.gov (United States)

    Kominiarek, Michelle A; Crockett, Amy; Covington-Kolb, Sarah; Simon, Melissa; Grobman, William A

    2017-04-01

    To compare gestational weight gain among women in group prenatal care with that of women in individual prenatal care. In this retrospective cohort study, women who participated in group prenatal care from 2009 to 2015 and whose body mass indexes (BMIs) and gestational weight gain were recorded were matched with the next two women who had the same payer type, were within 2-kg/m prepregnancy BMI and 2-week gestational age at delivery, and had received individual prenatal care. Bivariate comparisons of demographics and antenatal complications were performed for women in group and individual prenatal care, and weight gain was categorized as "below," "met," or "exceeded" goals according to the 2009 Institute of Medicine guidelines. Logistic regression analysis estimated the association between excessive weight gain and model of care, with adjustment for confounders, stratified by BMI. Women in group prenatal care (n=2,117) were younger and more commonly non-Hispanic black, nulliparous, and without gestational diabetes (P≤.005 for all). Women in group prenatal care more commonly exceeded the weight gain goals (55% compared with 48%, Pprenatal care, compared with individual prenatal care, is associated with excessive gestational weight gain.

  17. Zinc-Associated Variant in SLC30A8 Gene Interacts With Gestational Weight Gain on Postpartum Glycemic Changes: A Longitudinal Study in Women With Prior Gestational Diabetes Mellitus.

    Science.gov (United States)

    Wang, Tiange; Liu, Huikun; Wang, Leishen; Huang, Tao; Li, Weiqin; Zheng, Yan; Heianza, Yoriko; Sun, Dianjianyi; Leng, Junhong; Zhang, Shuang; Li, Nan; Hu, Gang; Qi, Lu

    2016-12-01

    Zinc transporter 8 genetic variant SLC30A8 has been associated with postpartum risk of type 2 diabetes among women with gestational diabetes mellitus (GDM). Gestational weight gain is one of the strongest risk factors for postpartum hyperglycemia. We assessed the interaction between type 2 diabetes-associated SLC30A8 rs13266634 and gestational weight gain on 1-5 years of postpartum glycemic changes in 1,071 women with prior GDM in a longitudinal study. Compared with gestation of 26-30 weeks, postpartum levels of fasting glucose, oral glucose tolerance test 2-h glucose, and hemoglobin A 1c (HbA 1c ) increased across rs13266634 TT, CT, and CC genotypes in women with excessive gestational weight gain, whereas opposite genetic associations were found in women with inadequate or adequate gestational weight gain. Postpartum changes in fasting glucose per additional copy of the C allele were -0.18, -0.04, and 0.12 mmol/L in women with inadequate, adequate, and excessive gestational weight gain, respectively (P for interaction = 0.002). We also found similar interactions for changes in 2-h glucose and HbA 1c (P for interaction = 0.003 and 0.005, respectively). Our data indicate that gestational weight gain may modify SLC30A8 variant on long-term glycemic changes, highlighting the importance of gestational weight control in the prevention of postpartum hyperglycemia in women with GDM. © 2016 by the American Diabetes Association.

  18. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    Directory of Open Access Journals (Sweden)

    S. Burlina

    2016-01-01

    Full Text Available The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected.

  19. Fetal Adrenal Demedullation Lowers Circulating Norepinephrine and Attenuates Growth Restriction but not Reduction of Endocrine Cell Mass in an Ovine Model of Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Melissa A. Davis

    2015-01-01

    Full Text Available Placental insufficiency is associated with fetal hypoglycemia, hypoxemia, and elevated plasma norepinephrine (NE that become increasingly pronounced throughout the third trimester and contribute to intrauterine growth restriction (IUGR. This study evaluated the effect of fetal adrenal demedullation (AD on growth and pancreatic endocrine cell mass. Placental insufficiency-induced IUGR was created by exposing pregnant ewes to elevated ambient temperatures during mid-gestation. Treatment groups consisted of control and IUGR fetuses with either surgical sham or AD at 98 days gestational age (dGA; term = 147 dGA, a time-point that precedes IUGR. Samples were collected at 134 dGA. IUGR-sham fetuses were hypoxemic, hypoglycemic, and hypoinsulinemic, and values were similar in IUGR-AD fetuses. Plasma NE concentrations were ~5-fold greater in IUGR-sham compared to control-sham, control-AD, and IUGR-AD fetuses. IUGR-sham and IUGR-AD fetuses weighed less than controls. Compared to IUGR-sham fetuses, IUGR-AD fetuses weighed more and asymmetrical organ growth was absent. Pancreatic β-cell mass and α-cell mass were lower in both IUGR-sham and IUGR-AD fetuses compared to controls, however, pancreatic endocrine cell mass relative to fetal mass was lower in IUGR-AD fetuses. These findings indicate that NE, independently of hypoxemia, hypoglycemia and hypoinsulinemia, influence growth and asymmetry of growth but not pancreatic endocrine cell mass in IUGR fetuses.

  20. Fetal Adrenal Demedullation Lowers Circulating Norepinephrine and Attenuates Growth Restriction but not Reduction of Endocrine Cell Mass in an Ovine Model of Intrauterine Growth Restriction

    Science.gov (United States)

    Davis, Melissa A.; Macko, Antoni R.; Steyn, Leah V.; Anderson, Miranda J.; Limesand, Sean W.

    2015-01-01

    Placental insufficiency is associated with fetal hypoglycemia, hypoxemia, and elevated plasma norepinephrine (NE) that become increasingly pronounced throughout the third trimester and contribute to intrauterine growth restriction (IUGR). This study evaluated the effect of fetal adrenal demedullation (AD) on growth and pancreatic endocrine cell mass. Placental insufficiency-induced IUGR was created by exposing pregnant ewes to elevated ambient temperatures during mid-gestation. Treatment groups consisted of control and IUGR fetuses with either surgical sham or AD at 98 days gestational age (dGA; term = 147 dGA), a time-point that precedes IUGR. Samples were collected at 134 dGA. IUGR-sham fetuses were hypoxemic, hypoglycemic, and hypoinsulinemic, and values were similar in IUGR-AD fetuses. Plasma NE concentrations were ~5-fold greater in IUGR-sham compared to control-sham, control-AD, and IUGR-AD fetuses. IUGR-sham and IUGR-AD fetuses weighed less than controls. Compared to IUGR-sham fetuses, IUGR-AD fetuses weighed more and asymmetrical organ growth was absent. Pancreatic β-cell mass and α-cell mass were lower in both IUGR-sham and IUGR-AD fetuses compared to controls, however, pancreatic endocrine cell mass relative to fetal mass was lower in IUGR-AD fetuses. These findings indicate that NE, independently of hypoxemia, hypoglycemia and hypoinsulinemia, influence growth and asymmetry of growth but not pancreatic endocrine cell mass in IUGR fetuses. PMID:25584967

  1. Behavioural symptoms of attention deficit/hyperactivity disorder in preterm and term children born small and appropriate for gestational age: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Kajantie Eero

    2010-12-01

    Full Text Available Abstract Background It remains unclear whether it is more detrimental to be born too early or too small in relation to symptoms of attention deficit/hyperactivity disorder (ADHD. Thus, we tested whether preterm birth and small body size at birth adjusted for gestational age are independently associated with symptoms of ADHD in children. Methods A longitudinal regional birth cohort study comprising 1535 live-born infants between 03/15/1985 and 03/14/1986 admitted to the neonatal wards and 658 randomly recruited non-admitted infants, in Finland. The present study sample comprised 828 children followed up to 56 months. The association between birth status and parent-rated ADHD symptoms of the child was analysed with multiple linear and logistic regression analyses. Results Neither prematurity (birth Conclusions Intrauterine growth restriction, reflected in SGA status and lower birth weight, rather than prematurity or lower gestational age per se, may increase risk for symptoms of ADHD in young children.

  2. Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation.

    Science.gov (United States)

    Boghossian, Nansi S; Geraci, Marco; Edwards, Erika M; Horbar, Jeffrey D

    2018-02-01

    To identify the relative risks of mortality and morbidities for small for gestational age (SGA) infants in comparison with non-SGA infants born at 22 to 29 weeks' gestation. Data were collected (2006-2014) on 156 587 infants from 852 US centers participating in the Vermont Oxford Network. We defined SGA as sex-specific birth weight thin plate spline term on GA by SGA were used to calculate the adjusted relative risks and 95% confidence intervals for outcomes by GA. Compared with non-SGA infants, the risk of patent ductus arteriosus decreased for SGA infants in early GA and then increased in later GA. SGA infants were also at increased risks of mortality, respiratory distress syndrome, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. These risks of adverse outcomes, however, were not homogeneous across the GA range. Early-onset sepsis was not different between the 2 groups for the majority of GAs, although severe intraventricular hemorrhage was decreased among SGA infants for only gestational week 24 through week 25. SGA was associated with additional risks to mortality and morbidities, but the risks differed across the GA range. Copyright © 2018 by the American Academy of Pediatrics.

  3. Neighbourhood food environment and gestational diabetes in New York City

    OpenAIRE

    Janevic, Teresa; Borrell, Luisa N.; Savitz, David A.; Herring, Amy H.; Rundle, Andrew

    2010-01-01

    The association between neighbourhood characteristics and gestational diabetes has not been examined previously. We investigated the relationship between the number of healthy food outlets (supermarkets; fruit/vegetable and natural food stores), and unhealthy food outlets (fast food; pizza; bodegas; bakeries; convenience, candy/nut and meat stores) in census tract of residence, and gestational diabetes in New York City. Gestational diabetes, census tract and individual-level covariates were a...

  4. Neonatal outcomes according to different therapies for gestational diabetes mellitus.

    Science.gov (United States)

    Silva, Amanda L da; Amaral, Augusto R do; Oliveira, Daniela S de; Martins, Lisiane; Silva, Mariana R E; Silva, Jean Carl

    To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus. This was a retrospective cohort study. The study population comprised pregnant women with gestational diabetes treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for gestational diabetes mellitus. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, Apgar at 1 and 5min, and need for intensive care unit admission. The sample consisted of 705 pregnant women. The neonatal outcomes were analyzed based on the treatment received. Women treated with metformin were less likely to have children who were small for gestational age (95% CI: 0.09-0.66) and more likely to have a newborn adequate for gestational age (95% CI: 1.12-3.94). Those women treated with insulin had a lower chance of having a preterm child (95% CI: 0.02-0.78). The combined treatment with insulin and metformin resulted in higher chance for a neonate to be born large for gestational age (95% CI: 1.14-11.15) and lower chance to be born preterm (95% CI: 0.01-0.71). The type of treatment did not affect the mode of delivery, Apgar score, and intensive care unit admission. The pediatrician in the delivery room can expect different outcomes for diabetic mothers based on the treatment received. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Humanin (HN and glucose transporter 8 (GLUT8 in pregnancies complicated by intrauterine growth restriction.

    Directory of Open Access Journals (Sweden)

    Carla Janzen

    Full Text Available Intrauterine growth restriction (IUGR results from a lack of nutrients transferred to the developing fetus, particularly oxygen and glucose. Increased expression of the cytoprotective mitochondrial peptide, humanin (HN, and the glucose transporter 8, GLUT8, has been reported under conditions of hypoxic stress. However, the presence and cellular localization of HN and GLUT8 in IUGR-related placental pathology remain unexplored. Thus, we undertook this study to investigate placental expression of HN and GLUT8 in IUGR-affected versus normal pregnancies.We found 1 increased HN expression in human IUGR-affected pregnancies on the maternal aspect of the placenta (extravillous trophoblastic (EVT cytoplasm compared to control (i.e. appropriate for gestational age pregnancies, and a concomitant increase in GLUT8 expression in the same compartment, 2 HN and GLUT8 showed a protein-protein interaction by co-immunoprecipitation, 3 elevated HN and GLUT8 levels in vitro under simulated hypoxia in human EVT cells, HTR8/SVneo, and 4 increased HN expression but attenuated GLUT8 expression in vitro under serum deprivation in HTR8/SVneo cells.There was elevated HN expression with cytoplasmic localization to EVTs on the maternal aspect of the human placenta affected by IUGR, also associated with increased GLUT8 expression. We found that while hypoxia increased both HN and GLUT8, serum deprivation increased HN expression alone. Also, a protein-protein interaction between HN and GLUT8 suggests that their interaction may fulfill a biologic role that requires interdependency. Future investigations delineating molecular interactions between these proteins are required to fully uncover their role in IUGR-affected pregnancies.

  6. Cardiovascular function in term fetal sheep conceived, gestated and studied in the hypobaric hypoxia of the Andean altiplano.

    Science.gov (United States)

    Herrera, Emilio A; Rojas, Rodrigo T; Krause, Bernardo J; Ebensperger, Germán; Reyes, Roberto V; Giussani, Dino A; Parer, Julian T; Llanos, Aníbal J

    2016-03-01

    High-altitude hypoxia causes intrauterine growth restriction and cardiovascular programming. However, adult humans and animals that have evolved at altitude show certain protection against the effects of chronic hypoxia. Whether the highland fetus shows similar protection against high altitude gestation is unclear. We tested the hypothesis that high-altitude fetal sheep have evolved cardiovascular compensatory mechanisms to withstand chronic hypoxia that are different from lowland sheep. We studied seven high-altitude (HA; 3600 m) and eight low-altitude (LA; 520 m) pregnant sheep at ∼90% gestation. Pregnant ewes and fetuses were instrumented for cardiovascular investigation. A three-period experimental protocol was performed in vivo: 30 min of basal, 1 h of acute superimposed hypoxia (∼10% O2) and 30 min of recovery. Further, we determined ex vivo fetal cerebral and femoral arterial function. HA pregnancy led to chronic fetal hypoxia, growth restriction and altered cardiovascular function. During acute superimposed hypoxia, LA fetuses redistributed blood flow favouring the brain, heart and adrenals, whereas HA fetuses showed a blunted cardiovascular response. Importantly, HA fetuses have a marked reduction in umbilical blood flow versus LA. Isolated cerebral arteries from HA fetuses showed a higher contractile capacity but a diminished response to catecholamines. In contrast, femoral arteries from HA fetuses showed decreased contractile capacity and increased adrenergic contractility. The blunting of the cardiovascular responses to hypoxia in fetuses raised in the Alto Andino may indicate a change in control strategy triggered by chronic hypoxia, switching towards compensatory mechanisms that are more cost-effective in terms of oxygen uptake. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  7. EAMJ Feb. gestation.indd

    African Journals Online (AJOL)

    2009-02-02

    Feb 2, 2009 ... Majority of the women studied were at a gestation of 8 to 11 weeks (38.9%). Most patients ... foetal risks, and management and follow-up of both entities are .... thyrotoxicosis in Asian women in Singapore and found-out that the ...

  8. Intra-gestational sac injection for tubal pregnancy: an interventional approach

    International Nuclear Information System (INIS)

    Wang Yitang; Sun Xiaobo; Xu Xiaojun; Zhang Feiyue; Wu Ke; Song Yingxin; Han Mingjun

    2002-01-01

    Objective: It's an investigation of the procedure, effects and clinical application of the interventional intra-gestational sac injection as a treatment of tubal pregnancy. Methods: Under DSA guidance a selective salpingography was performed and MTX was injected into the gestational sac or oviduct. The procedure was performed in 13 cases with oviductal pregnancy before the gestational sac ruptured. Results: Technical success was obtained in all cases. The serum HCG began to fall in 7 days after the procedure, and dropped to normal level in 2-4 weeks of the procedure. Conclusion: Interventional selective salpingography and intra-gestational sac injection is a simple, safe and effective treatment of the un-ruptured tubal pregnancy

  9. A STUDY ON PLACENTAL MORPHOLOGY IN GESTATIONAL DIABETES

    Directory of Open Access Journals (Sweden)

    Katadi Venkata Sudha Madhuri

    2017-01-01

    Full Text Available BACKGROUND Gestational Diabetes Mellitus (GDM refers to any degree of glucose intolerance with onset or first recognition during pregnancy. Maternal diabetes constitutes an unfavourable environment for embryonic and foetoplacental development. The histomorphological changes in the placenta are associated with increased perinatal morbidity, increased risk of diabetes in the offspring and the mother in the ensuing years of life. Present study aims to study the morphological changes in the placenta along with maternal and foetal outcomes in pregnancies complicated by GDM. MATERIALS AND METHODS A descriptive observational case-controlled study was conducted from January 2013 to November 2016 in King George Hospital, Visakhapatnam. Hundred and sixty four women diagnosed with GDM and hundred women with normal gestation were enrolled in the study. Foetal surveillance was done by Doppler ultrasound and kick count technique during the gestation. Foetal and maternal outcome was evaluated and compared to the outcome of normal gestation. Placental specimens from term gestations (38-42 weeks diagnosed with GDM and normal full-term gestations were studied to assess the morphological parameters. Statistical analysis was done using descriptive statistical measures. RESULTS In the present study, 62.19% of the GDM cases terminated as normal gestations. Recurrent UTI was the most common complication (14.02% during the antenatal period. 17.68% of the foetuses from GDM mothers presented with macrosomia, however, there were no cases of congenital anomalies or shoulder dystocia. Placental tissue from the GDM cases was larger, heavier and more cotyledonous as compared to placenta from normal subjects. The umbilical cord showed eccentric and central attachment in all the controls and most of the cases and 5.48% of the cases showed marginal attachment of the umbilical cord. CONCLUSION The study describes the various maternal, foetal and placental outcomes in pregnancies

  10. Evaluación de la severidad, proporcionalidad y riesgo de muerte de recién nacidos de muy bajo peso con restricción del crecimiento fetal: análisis multicéntrico sudamericano An assessment of the severity, proportionality and risk of mortality of very low birth weight infants with fetal growth restriction: a multicenter South American analysis

    Directory of Open Access Journals (Sweden)

    Carlos Grandi

    2005-06-01

    Full Text Available OBJETIVOS: 1 evaluar la severidad y la proporcionalidad de los PEG para diferentes grados de prematurez; 2 estimar el riesgo de mortalidad de los PEG según la severidad y proporcionalidad. MATERIAL Y MÉTODOS: Diseño observacional y analítico. Población: todos los recién nacidos de muy bajo peso (RNMPB entre 25 y 36 semanas que mantiene el grupo NEOCOSUR (n = 1.518. Índices antropométricos: a peso de nacimiento (PN 0,55 y la transformación z del índice ponderal (Ponderal Index, PI = g/cm³ x 100. Restricción del crecimiento intrauterino (RCIU asimétrico: score z OBJECTIVES: To evaluate the clinical severity and proportionality of small for gestational age, very low birth weight neonates (< 1,500 g and to estimate the neonatal mortality risk associated with the condition of being small for gestational age according to the degree of severity and proportionality. METHODS: Observational design. All of the NEOCOSUR Collaborative Group's very low birth weight infants (25-36 weeks' gestation were included (n = 1,518. Anthropometric indices: birth weight < 3rd and 10th percentile. Severity (fetal growth ratio = observed weight/mean birth weight for gestational age; no growth restriction: fetal growth ratio 0.90-1.10, mild: fetal growth ratio 0.80-0.89, moderate: fetal growth ratio 0.75-0.79 and severe: fetal growth ratio < 0.75. Proportionality: coefficient of bimodality and z score for ponderal index (PI = g/cm³ *100. Neonatal mortality until discharge. RESULTS: < 3rd percentile: 13.5% (p < 0.001; < 10th percentile: 31% (p < 0.001; fetal growth ratio: 0.90±0.21 (p < 0.001, mild restriction: 20.8%, moderate restriction: 8.7% and severe restriction: 32.6%. Coefficient of bimodality: 0.53; PI z score < -1: 8%. Maternal hypertensive disease was systematically associated with being small for gestational age (aOR 1.20, 95% CI 0.86-1.67, fetal growth ratio < 0.89 (aOR 1.71, 1.24-2.36 and PI z score < -1 (aOR 1.60, 1.03-2.41. Adjusted odds ratios

  11. Nutrient-enriched formula milk versus human breast milk for preterm infants following hospital discharge.

    Science.gov (United States)

    Henderson, G; Fahey, T; McGuire, W

    2007-10-17

    Preterm infants are often growth-restricted at hospital discharge. Feeding infants after hospital discharge with nutrient-enriched formula milk instead of human breast milk might facilitate "catch-up" growth and improve development. To determine the effect of feeding nutrient-enriched formula compared with human breast milk on growth and development of preterm infants following hospital discharge. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007), MEDLINE (1966 - May 2007), EMBASE (1980 - May 2007), CINAHL (1982 - May 2007), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials that compared feeding preterm infants following hospital discharge with nutrient-enriched formula compared with human breast milk. The standard methods of the Cochrane Neonatal Review Group were used, with separate evaluation of trial quality and data extraction by two review authors. No eligible trials were identified. There are no data from randomised controlled trials to determine whether feeding preterm infants following hospital discharge with nutrient-enriched formula milk versus human breast milk affects growth and development. Mothers who wish to breast feed, and their health care advisors, would require very clear evidence that feeding with a nutrient-enriched formula milk had major advantages for their infants before electing not to feed (or to reduce feeding) with maternal breast milk. If evidence from trials that compared feeding preterm infants following hospital discharge with nutrient-enriched versus standard formula milk demonstrated an effect on growth or development, then this might strengthen the case for undertaking trials of nutrient-enriched formula milk versus human breast milk.

  12. Fasting, circadian rhythms, and time restricted feeding in healthy lifespan

    Science.gov (United States)

    Longo, Valter D.; Panda, Satchidananda

    2016-01-01

    Summary Feeding in most animals is confined to a defined period, leaving short periods of fasting that coincide with sleep. Fasting enables organisms to enter alternative metabolic phases, which rely less on glucose and more on ketone body-like carbon sources. Both intermittent and periodic fasting result in benefits ranging from prevention to the enhanced treatment of diseases. Similarly, time-restricted feeding (TRF), in which feeding time is restricted to certain hours of the day, allows the daily fasting period to last >12 h, thus imparting pleiotropic benefits in multiple organisms. Understanding the mechanistic link between nutrients and the fasting benefits is leading to the identification of fasting mimicking diets (FMDs) that achieve changes similar to those caused by fasting. Given the pleiotropic and sustained benefits of TRF and FMD, both basic science and translational research are warranted to develop fasting-associated interventions into effective and inexpensive treatments with the potential to improve healthspan. PMID:27304506

  13. Low-Salt Intake during Mating or Gestation in Rats Is Associated with Low Birth and Survival Rates of Babies

    Directory of Open Access Journals (Sweden)

    Ranna Chou

    2014-01-01

    Full Text Available We investigated the influence of maternal salt restriction during mating or gestation on birth rate and offspring growth in Dahl salt-sensitive rats (DS. DS were divided into 5 groups: DS fed a low-salt (0.3% NaCl, w/w (DS-low or high-salt (4% NaCl, w/w diet (DS-high during mating and DS-high or DS-low during gestation, and DS fed regular chow (0.75% NaCl, w/w (DS-regular throughout mating and gestation. During the unspecified periods, the rats were given regular chow. DS-low during mating delivered fewer infants than high-salt mothers (P<0.05. The birth rate on regular chow was 87%. Six out of 11 DS-low rats during pregnancy produced pups while the rats fed a high-salt diet all delivered pups (P<0.025. The pup survival rate was 67% for high-salt mothers during mating and 54% for mothers on a low-salt diet. The pup survival rate was 95% for mothers on a high-salt diet during pregnancy and 64% for mothers on a low-salt diet (P<0.0001. Seven out of 8 DS-regular rats during mating delivered 59 neonates. However, 66% of the neonates survived. A low-salt diet during mating or pregnancy lowers birth rate and the neonates from low-salt mothers during pregnancy were more likely to die than those from high-salt mothers.

  14. The Nutrient Density of Snacks: A Comparison of Nutrient Profiles of Popular Snack Foods Using the Nutrient-Rich Foods Index.

    Science.gov (United States)

    Hess, Julie; Rao, Goutham; Slavin, Joanne

    2017-01-01

    Background: Although Americans receive almost a quarter of their daily energy from snacks, snacking remains a poorly defined and understood eating occasion. However, there is little dietary guidance about choosing snacks. Families, clinicians, and researchers need a comprehensive approach to assessing their nutritional value. Objective: To quantify and compare the nutrient density of commonly consumed snacks by their overall nutrient profiles using the Nutrient-Rich Foods (NRF) Index 10.3. Methods: NRF Index scores were calculated for the top 3 selling products (based on 2014 market research data) in different snack categories. These NRF scores were averaged to provide an overall nutrient-density score for each category. Results: Based on NRF scores, yogurt (55.3), milk (52.5), and fruit (30.1) emerged as the most nutrient-dense snacks. Ice cream (-4.4), pies and cakes (-11.1), and carbonated soft drinks (-17.2) emerged as the most nutrient-poor snacks. Conclusions: The NRF Index is a useful tool for assessing the overall nutritional value of snacks based on nutrients to limit and nutrients to encourage.

  15. A systematic review and meta-analysis of the nutrient content of preterm and term breast milk.

    Science.gov (United States)

    Gidrewicz, Dominica A; Fenton, Tanis R

    2014-08-30

    Breast milk nutrient content varies with prematurity and postnatal age. Our aims were to conduct a meta-analysis of preterm and term breast milk nutrient content (energy, protein, lactose, oligosaccharides, fat, calcium, and phosphorus); and to assess the influence of gestational and postnatal age. Additionally we assessed for differences by laboratory methods for: energy (measured vs. calculated estimates) and protein (true protein measurement vs. the total nitrogen estimates). Systematic review results were summarized graphically to illustrate the changes in composition over time for term and preterm milk. Since breast milk fat content varies within feeds and diurnally, to obtain accurate estimates we limited the meta-analyses for fat and energy to 24-hour breast milk collections. Forty-one studies met the inclusion criteria: 26 (843 mothers) preterm studies and 30 (2299 mothers) term studies of breast milk composition. Preterm milk was higher in true protein than term milk, with differences up to 35% (0.7 g/dL) in colostrum, however, after postnatal day 3, most of the differences in true protein between preterm and term milk were within 0.2 g/dL, and the week 10-12 estimates suggested that term milk may be the same as preterm milk by that age. Colostrum was higher than mature milk for protein, and lower than mature milk for energy, fat and lactose for both preterm and term milk. Breast milk composition was relatively stable between 2 and 12 weeks. With milk maturation, there was a narrowing of the protein variance. Energy estimates differed whether measured or calculated, from -9 to 13%; true protein measurement vs. the total nitrogen estimates differed by 1 to 37%. Although breast milk is highly variable between individuals, postnatal age and gestational stage (preterm versus term) were found to be important predictors of breast milk content. Energy content of breast milk calculated from the macronutrients provides poor estimates of measured energy, and protein

  16. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  17. Characterizing gestational weight gain in a cohort of Indigenous Australian women.

    Science.gov (United States)

    Schumacher, Tracy L; Weatherall, Loretta; Keogh, Lyniece; Sutherland, Kathryn; Collins, Clare E; Pringle, Kirsty G; Rae, Kym M

    2018-05-01

    to determine the adequacy of gestational weight gain for a cohort of Indigenous Australian women and investigate whether it is associated with pre-pregnancy body mass index. analysis of observational data collected from a longitudinal cohort study that follows Indigenous Australian women through pregnancy. women recruited through antenatal clinics in regional and remote towns in NSW, Australia to the Gomeroi gaaynggal program. 110 pregnant women who either identified as being an Indigenous Australian or as carrying an Indigenous child. measurements included weight and height, self-reported pre-pregnancy weight and smoking status, parity and health conditions that may contribute to gestational weight gain, such as hypertensive or diabetic disorders. Compared to the 2009 Institute of Medicine recommendations for gestational weight gain and based on prepregnancy body mass index, the rate of adequate gestational weight gain in this cohort was very low (15%). 32% of women had inadequate weight gain and 54% had excessive weight gain. The highest rate of excessive gestational weight gain was found in overweight women (74%), with rates of 48% and 50% found in healthy and obese (all classes) categories, respectively. Parity (coefficient 4.5, p<0.01) and hypertension (coefficient 4.8, p = 0.04) were found to be significantly associated with gestational weight gain in mixed model linear regression. few women gained adequate gestational weight gain in this study. Culturally acceptable ways of addressing this issue are needed for this group of women, as inadequate and excessive rates of gestational weight gain have health implications for women and their offspring. a systematic approach to addressing gestational weight gain within antenatal care is required, including asking about diet and exercise, for all women identifying as Indigenous Australian. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Perinatal outcome in relation to fetal sex in offspring to mothers with pre-gestational and gestational diabetes--a population-based study.

    Science.gov (United States)

    Persson, M; Fadl, H

    2014-09-01

    The objective of the present study was to investigate if perinatal outcome differs with fetal sex in pregnancies with maternal Type 1 diabetes, Type 2 diabetes or gestational diabetes. This was a population-based cohort study, with data from the Medical Birth Registry in Sweden throughout the period 1998-2007. Singleton pregnancies with maternal Type 1 diabetes (n = 4092), Type 2 diabetes (n = 412) and gestational diabetes (n = 8602) were identified based on the International Classification of Diseases, 10th edition code. For comparison, 905 565 pregnancies without diabetes were included. The primary outcome was a composite outcome, consisting of any of the following diagnoses: perinatal mortality rate, major malformation, preterm delivery, acute respiratory disorders and neonatal hypoglycaemia. Logistic regression was used to obtain odds ratios for adverse outcomes in male offspring within the diabetic and reference cohorts, respectively. In pregnancies with diabetes, maternal characteristics did not differ with fetal sex, except for a higher rate of Caesarean delivery in male offspring of women with Type 1 diabetes. Male infants to mothers with Type 1 diabetes and gestational diabetes had significantly increased odds of respiratory disorders [adjusted odds ratio (confidence interval) Type 1 diabetes: 1.50 (1.12-2.02); gestational diabetes: 1.81 (1.27-2.57)]. Male infants to mothers with gestational diabetes also had significantly increased odds of major malformations [adjusted odds ratio: 1.44 (1.07-1.93)]. In offspring of mothers with Type 2 diabetes, odds ratios of most outcomes were higher in male infants; however, not significantly different from female infants. In pregnancies without diabetes, male infants had significantly higher odds of all adverse outcomes, except perinatal mortality rate. The risk of adverse perinatal outcome in offspring of mothers with Type 1 diabetes and gestational diabetes did not differ by sex, except for a higher risk in male

  19. Gestational weight gain among minority adolescents predicts term birth weight.

    Science.gov (United States)

    Ekambaram, Maheswari; Irigoyen, Matilde; DeFreitas, Johelin; Rajbhandari, Sharina; Geaney, Jessica Lynn; Braitman, Leonard Edward

    2018-03-07

    In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ = 0.36, P gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

  20. Influence of Maternal Undernutrition and Overfeeding on Cardiac Ciliary Neurotrophic Factor Receptor and Ventricular Size in Fetal Sheep

    Science.gov (United States)

    Dong, Feng; Ford, Stephen P.; Nijland, Mark J.; Nathanielsz, Peter W.; Ren, Jun

    2008-01-01

    Intrauterine nutrition status is reported to correlate with risk of cardiovascular diseases in adulthood. Either under- or over-nutrition during early to mid gestation contributes to altered fetal growth and ventricular geometry. This study was designed to examine myocardial expression of ciliary neurotrophic factor receptor α (CTNFRα) and its down-stream mediator signal transducer and activator of transcription 3 (STAT3) on maternal under- or over-nutrition-induced changes in fetal heart weight. Multiparous ewes were fed with 50% (nutrient-restricted, NR), 100% (control) or 150% (overfed, OF) of NRC requirements from 28 to 78 days of gestation (dG; Term 148 dG). Ewes were euthanized on day 78, and the gravid uteri and fetuses recovered. Ventricular protein expression of CTNFRα, STAT3, phosphorylated STAT3, insulin-like growth factor I receptor (IGF-1R) and IGF binding protein 3 (IGFBP3) were quantitated using western blot. Plasma cortisol levels were higher in both NR and OF fetuses whereas plasma IGF-1 levels were lower and higher, in NR and OF fetuses. Fetal weights were reduced by 29.9% in NR ewes and were increased by 22.2% in fetuses from OF ewes compared to control group. Nutrient restriction did not affect fetal heart or ventricular weights whereas overfeeding increased heart and ventricular weights. Protein expression of CTNFRα in fetal ventricular tissue was reduced in OF group whereas STAT3 and pSTAT3 levels were reduced in both NR and OF groups. Expression of IGF-1R and IGFBP3 was unaffected in either NR or OF group. These data suggested that compared with maternal undernutrition, intrauterine overfeeding during early to mid gestation is associated with increases fetal blood concentrations of cortisol and IGF-1 in association with ventricular hypertrophy where reduced expression of CNTFRα and STAT3 may play a role. PMID:17869083

  1. Small for Gestational Age and Magnesium: Intrauterine magnesium deficiency may induce metabolic syndrome in later life

    Directory of Open Access Journals (Sweden)

    Junji Takaya

    2015-12-01

    Full Text Available Magnesium deficiency during pregnancy as a result of insufficient or low intake of magnesium is common in developing and developed countries. Previous reports have shown that intracellular magnesium of cord blood platelets is lower among small for gestational age (SGA groups than that of appropriate for gestational age (AGA groups, suggesting that intrauterine magnesium deficiency may result in SGA. Additionally, the risk of adult-onset diseases such as insulin resistance syndrome is greater among children whose mothers were malnourished during pregnancy, and who consequently had a low birth weight. In a number of animal models, poor nutrition during pregnancy leads to offspring that exhibit pathophysiological changes similar to human diseases. The offspring of pregnant rats fed a magensium restricted diet have developed hypermethylation in the hepatic 11β-hydroxysteroid dehydrogenase-2 promoter. These findings indicate that maternal magnesium deficiencies during pregnancy influence regulation of non-imprinted genes by altering the epigenetic regulation of gene expression, thereby inducing different metabolic phenotypes. Magnesium deficiency during pregnancy may be responsible for not only maternal and fetal nutritional problems, but also lifelong consequences that affect the offspring throughout their life. Epidemiological, clinical, and basic research on the effects of magnesium deficiency now indicates underlying mechanisms, especially epigenetic processes.

  2. Maternal Obesity, Gestational Weight Gain, and Asthma in Offspring.

    Science.gov (United States)

    Polinski, Kristen J; Liu, Jihong; Boghossian, Nansi S; McLain, Alexander C

    2017-11-09

    Obesity is common among women of childbearing age; intrauterine exposure to maternal obesity or gestational weight gain may influence the development of asthma in early childhood. We examined the relationships of maternal obesity and gestational weight gain with asthma in offspring. We used data from the Early Childhood Longitudinal Study-Birth Cohort, which has a nationally representative sample of children followed from birth in 2001 through age 4 (n = 6,450). Asthma was based on parental report of a medical professional's diagnosis. We used generalized estimating equation binomial models to compute adjusted odds ratios (ORs) of childhood asthma with maternal obesity and 4 measures of gestational weight gain. Compared with children of normal-weight mothers, children of obese mothers had increased risk of asthma (adjusted OR, 1.63; 95% confidence interval [CI], 1.26-2.12) by age 4, and children born to overweight mothers had similar risk (adjusted OR, 1.25; 95% CI, 0.99-1.59). Extreme-low weight gain (gain (≥25 kg) were associated with increased risk of asthma; however, the following measures were not significant predictors of asthma: meeting gestational weight gain recommendations of the Institute of Medicine, total gestational weight gain, and weekly rate of weight gain in the second and third trimesters. Extreme-low or extreme-high gestational weight gain and maternal obesity are risk factors for early childhood asthma, further evidence of the long-term impact of intrauterine exposure on children and the need to target preconception care to improve child health indicators.

  3. Gestational surrogacy: Viewpoint of Iranian infertile women

    Directory of Open Access Journals (Sweden)

    Azad Rahmani

    2011-01-01

    Full Text Available Background: Surrogacy is a popular form of assisted reproductive technology of which only gestational form is approved by most of the religious scholars in Iran. Little evidence exists about the Iranian infertile women′s viewpoint regarding gestational surrogacy. Aim: To assess the viewpoint of Iranian infertile women toward gestational surrogacy. Setting and Design: This descriptive study was conducted at the infertility clinic of Tabriz University of Medical Sciences, Iran. Materials and Methods: The study sample consisted of 238 infertile women who were selected using the eligible sampling method. Data were collected by using a researcher developed questionnaire that included 25 items based on a five-point Likert scale. 0 Statistical Analysis: Data analysis was conducted by SPSS statistical software using descriptive statistics. 0 Results: Viewpoint of 214 women (89.9% was positive. 36 (15.1% women considered gestational surrogacy against their religious beliefs; 170 women (71.4% did not assume the commissioning couple as owners of the baby; 160 women (67.2% said that children who were born through surrogacy would better not know about it; and 174 women (73.1% believed that children born through surrogacy will face mental problems. Conclusion: Iranian infertile women have positive viewpoint regarding the surrogacy. However, to increase the acceptability of surrogacy among infertile women, further efforts are needed.

  4. Numerical simulations of river discharges, nutrient flux and nutrient dispersal in Jakarta Bay, Indonesia

    International Nuclear Information System (INIS)

    Wulp, Simon A. van der; Damar, Ario; Ladwig, Norbert; Hesse, Karl-J.

    2016-01-01

    The present application of numerical modelling techniques provides an overview of river discharges, nutrient flux and nutrient dispersal in Jakarta Bay. A hydrological model simulated river discharges with a total of 90 to 377 m 3 s −1 entering Jakarta Bay. Daily total nitrogen and total phosphorus loads ranged from 40 to 174 tons and 14 to 60 tons, respectively. Flow model results indicate that nutrient gradients are subject to turbulent mixing by tides and advective transport through circulation driven by wind, barotropic and baroclinic pressure gradients. The bulk of nutrient loads originate from the Citarum and Cisadane rivers flowing through predominantly rural areas. Despite lower nutrient loads, river discharges from the urban area of Jakarta exhibit the highest impact of nutrient concentrations in the near shore area of Jakarta Bay and show that nutrient concentrations were not only regulated by nutrient loads but were strongly regulated by initial river concentrations and local flow characteristics. - Highlights: • Full overview of river discharges, nutrient flux and nutrient levels in Jakarta Bay • Important overview of nutrient flux from individual rivers • Simulations identify the principal drivers of water circulation and nutrient gradient. • Nutrient dispersion model includes the local effects of the Java Sea current system.

  5. Nutrients in Energy and One-Carbon Metabolism: Learning from Metformin Users

    Directory of Open Access Journals (Sweden)

    Fedra Luciano-Mateo

    2017-02-01

    Full Text Available Metabolic vulnerability is associated with age-related diseases and concomitant co-morbidities, which include obesity, diabetes, atherosclerosis and cancer. Most of the health problems we face today come from excessive intake of nutrients and drugs mimicking dietary effects and dietary restriction are the most successful manipulations targeting age-related pathways. Phenotypic heterogeneity and individual response to metabolic stressors are closely related food intake. Understanding the complexity of the relationship between dietary provision and metabolic consequences in the long term might provide clinical strategies to improve healthspan. New aspects of metformin activity provide a link to many of the overlapping factors, especially the way in which organismal bioenergetics remodel one-carbon metabolism. Metformin not only inhibits mitochondrial complex 1, modulating the metabolic response to nutrient intake, but also alters one-carbon metabolic pathways. Here, we discuss findings on the mechanism(s of action of metformin with the potential for therapeutic interpretations.

  6. Auditory brainstem response in neonates: influence of gender and weight/gestational age ratio

    Directory of Open Access Journals (Sweden)

    Rosanna M. Giaffredo Angrisani

    2013-12-01

    Full Text Available OBJECTIVE: To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR in preterm (PT and term (T newborns. METHODS: 176 newborns were evaluated by ABR; 88 were preterm infants - 44 females (22 small and 22 appropriate for gestational age and 44 males (22 small and 22 appropriate for gestational age. The preterm infants were compared to 88 term infants - 44 females (22 small and 22 appropriate for gestational age and 44 males (22 small and 22 appropriate for gestational age. All newborns had bilateral presence of transient otoacoustic emissions and type A tympanometry. RESULTS: No interaural differences were found. ABR response did not differentiate newborns regarding weight/gestational age in males and females. Term newborn females showed statistically shorter absolute latencies (except on wave I than males. This finding did not occur in preterm infants, who had longer latencies than term newborns, regardless of gender. CONCLUSIONS: Gender and gestational age influence term infants' ABR, with lower responses in females. The weight/gestational age ratio did not influence ABR response in either groups.

  7. Protein restriction does not affect body temperature pattern in female mice.

    Science.gov (United States)

    Kato, Goro A; Shichijo, Hiroki; Takahashi, Toshihiro; Shinohara, Akio; Morita, Tetsuo; Koshimoto, Chihiro

    2017-10-30

    Daily torpor is a physiological adaptation in mammals and birds characterized by a controlled reduction of metabolic rate and body temperature during the resting phase of circadian rhythms. In laboratory mice, daily torpor is induced by dietary caloric restriction. However, it is not known which nutrients are related to daily torpor expression. To determine whether dietary protein is a key factor in inducing daily torpor in mice, we fed mice a protein-restricted (PR) diet that included only one-quarter of the amount of protein but the same caloric level as a control (C) diet. We assigned six non-pregnant female ICR mice to each group and recorded their body weights and core body temperatures for 4 weeks. Body weights in the C group increased, but those in the PR group remained steady or decreased. Mice in both groups did not show daily torpor, but most mice in a food-restricted group (n=6) supplied with 80% of the calories given to the C group exhibited decreased body weights and frequently displayed daily torpor. This suggests that protein restriction is not a trigger of daily torpor; torpid animals can conserve their internal energy, but torpor may not play a significant role in conserving internal protein. Thus, opportunistic daily torpor in mice may function in energy conservation rather than protein saving.

  8. Differences in the utilization of gestational surrogacy between states in the U.S.

    Science.gov (United States)

    Perkins, Kiran M; Boulet, Sheree L; Levine, Aaron D; Jamieson, Denise J; Kissin, Dmitry M

    2018-04-01

    Gestational surrogacy policy in the USA varies by state, but information on state differences is lacking. This study used data from the National Assisted Reproductive Technology Surveillance System from 2010 to 2014 to calculate state differences in gestational carrier cycle characteristics. Of the 662,165 in-vitro fertilization cycles in the USA between 2010 and 2014, 16,148 (2.4%) used gestational carriers. Non-USA residents accounted for 18.3% of gestational carrier cycles, and 29.1% of gestational carrier cycles by USA residents were performed in a state other than the state of residence of the intended parent. USA gestational surrogacy practice varies by state, potentially impacting patients' access to surrogacy services.

  9. Brain tumor initiating cells adapt to restricted nutrition through preferential glucose uptake.

    Science.gov (United States)

    Flavahan, William A; Wu, Qiulian; Hitomi, Masahiro; Rahim, Nasiha; Kim, Youngmi; Sloan, Andrew E; Weil, Robert J; Nakano, Ichiro; Sarkaria, Jann N; Stringer, Brett W; Day, Bryan W; Li, Meizhang; Lathia, Justin D; Rich, Jeremy N; Hjelmeland, Anita B

    2013-10-01

    Like all cancers, brain tumors require a continuous source of energy and molecular resources for new cell production. In normal brain, glucose is an essential neuronal fuel, but the blood-brain barrier limits its delivery. We now report that nutrient restriction contributes to tumor progression by enriching for brain tumor initiating cells (BTICs) owing to preferential BTIC survival and to adaptation of non-BTICs through acquisition of BTIC features. BTICs outcompete for glucose uptake by co-opting the high affinity neuronal glucose transporter, type 3 (Glut3, SLC2A3). BTICs preferentially express Glut3, and targeting Glut3 inhibits BTIC growth and tumorigenic potential. Glut3, but not Glut1, correlates with poor survival in brain tumors and other cancers; thus, tumor initiating cells may extract nutrients with high affinity. As altered metabolism represents a cancer hallmark, metabolic reprogramming may maintain the tumor hierarchy and portend poor prognosis.

  10. Microarray analysis of subcutaneous adipose tissue from mature cows with divergent body weight gain after feed restriction and realimentation

    Directory of Open Access Journals (Sweden)

    H.C. Cunningham

    2018-02-01

    Full Text Available Body weight response to periods of feed restriction and realimentation is critical and relevant to the agricultural industry. The purpose of this study was to evaluate differentially expressed genes identified in subcutaneous adipose tissue collected from cows divergent in body weight (BW gain after feed restriction and realimentation. We compared adipose samples from cows with greater gain based on average daily gain (ADG during realimentation with samples from cows with lesser gain. Specifically, there were four comparisons including two comparing the high and low gain animals across each feeding period (feed restriction and realimentation and two that compared differences in feed restriction and realimentation across high or low gain classifications. Using microarray analysis, we provide a set of differentially expressed genes identified between the high and low gain at both periods of nutrient restriction and realimentation. These data identify multiple differentially expressed genes between these two phenotypes across both nutritional environments. Keywords: Beef cows, Subcutaneous fat, Transcriptome

  11. Approaches and uncertainties in nutrient budgets; Implications for nutrient management and environmental policies

    NARCIS (Netherlands)

    Oenema, O.; Kros, J.; Vries, de W.

    2003-01-01

    Nutrient budgets of agroecosystems are constructed either (i) to increase the understanding of nutrient cycling, (ii) as performance indicator and awareness raiser in nutrient management and environmental policy, or (iii) as regulating policy instrument to enforce a certain nutrient management

  12. Maternal undernutrition during the pre- and post-conception periods in twin-bearing hairsheep ewes: effects on fetal and placental development at mid-gestation.

    Science.gov (United States)

    Macías-Cruz, Ulises; Vicente-Pérez, Ricardo; Mellado, Miguel; Correa-Calderón, Abelardo; Meza-Herrera, Cesar A; Avendaño-Reyes, Leonel

    2017-10-01

    To evaluate the effects of pre- and post-conception undernutrition (UN) on fetal and placental development at mid-gestation, 28 Katahdin × Pelibuey multiparous ewes were blocked by weight and assigned to the following four dietary treatments (n = 7 each): ewes fed 100% (control) or 60% of their nutritional requirements 30 days before mating (UNPre), 50 days after mating (UNPost) or during both periods (UNB). Four twin-bearing ewes were selected per treatment at day 50 post-conception and then slaughtered at day 75 of gestation to analyze their fetuses. Control fetuses were heavier (P ewes than UNB ewes, but not relative to ewes of other treatments. The number of placentomes per ewe and placental efficiency were unaffected by UN treatments. Compared to control, only UNB ewes exhibited variations (P ewes than placentas of control ewes (P ewes carrying twins is mainly altered when nutritional restriction occurs simultaneously before conception and during the first third of pregnancy.

  13. Screening for gestational diabetes: examining a breakfast meal test ...

    African Journals Online (AJOL)

    Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal ...

  14. Nutrition modulation of human aging: The calorie restriction paradigm.

    Science.gov (United States)

    Das, Sai Krupa; Balasubramanian, Priya; Weerasekara, Yasoma K

    2017-11-05

    Globally, the aging population is growing rapidly, creating an urgent need to attenuate age-related health conditions, including metabolic disease and disability. A promising strategy for healthy aging based on consistently positive results from studies with a variety of species, including non-human primates (NHP), is calorie restriction (CR), or the restriction of energy intake while maintaining intake of essential nutrients. The burgeoning evidence for this approach in humans is reviewed and the major study to date to address this question, CALERIE (Comprehensive Assessment of the Long-term Effects of Reducing Intake of Energy), is described. CALERIE findings indicate the feasibility of CR in non-obese humans, confirm observations in NHP, and are consistent with improvements in disease risk reduction and potential anti-aging effects. Finally, the mechanisms of CR in humans are reviewed which sums up the fact that evolutionarily conserved mechanisms mediate the anti-aging effects of CR. Overall, the prospect for further research in both NHP and humans is highly encouraging. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. CXC chemokine ligand 16 is increased in gestational diabetes mellitus and preeclampsia and associated with lipoproteins in gestational diabetes mellitus at 5 years follow-up.

    Science.gov (United States)

    Lekva, Tove; Michelsen, Annika E; Aukrust, Pål; Paasche Roland, Marie Cecilie; Henriksen, Tore; Bollerslev, Jens; Ueland, Thor

    2017-11-01

    Women with a history of gestational diabetes mellitus and preeclampsia are at increased risk of cardiovascular disease later in life, but the mechanism remains unclear. The aim of the study was to evaluate the association between CXC chemokine ligand 16 and indices of glucose metabolism, dyslipidemia and systemic inflammation in gestational diabetes mellitus and preeclampsia. This sub-study of the population-based prospective cohort included 310 women. Oral glucose tolerance test was performed during pregnancy and 5 years later along with lipid analysis. CXC chemokine ligand 16 was measured in plasma (protein) and peripheral blood mononuclear cells (messenger RNA) during pregnancy and at follow-up. Circulating CXC chemokine ligand 16 was higher in gestational diabetes mellitus women early in pregnancy and at follow-up, while higher in preeclampsia women late in pregnancy compared to control women. Messenger RNA of CXC chemokine ligand 16 in peripheral blood mononuclear cells were lower in gestational diabetes mellitus and preeclampsia women compared to control women. Increased circulating CXC chemokine ligand 16 level was associated with a higher apolipoprotein B and low-density lipoprotein cholesterol in gestational diabetes mellitus women but not in normal pregnancy at follow-up. Our study shows that women with gestational diabetes mellitus and preeclampsia had a dysregulated CXC chemokine ligand 16 during pregnancy, and in gestational diabetes mellitus, the increase in CXC chemokine ligand 16 early in pregnancy and after 5 years was strongly associated with their lipid profile.

  16. Small intestinal growth measures are correlated with feed efficiency in market weight cattle, despite minimal effects of maternal nutrition during early to midgestation.

    Science.gov (United States)

    Meyer, A M; Hess, B W; Paisley, S I; Du, M; Caton, J S

    2014-09-01

    We hypothesized that gestational nutrition would affect calf feed efficiency and small intestinal biology, which would be correlated with feed efficiency. Multiparous beef cows (n = 36) were individually fed 1 of 3 diets from d 45 to 185 of gestation: native grass hay and supplement to meet NRC recommendations (control [CON]), 70% of CON NEm (nutrient restricted [NR]), or a NR diet with a RUP supplement (NR+RUP) to provide similar essential AA as CON. After d 185 of gestation, cows were managed as a single group, and calf individual feed intake was measured with the GrowSafe System during finishing. At slaughter, the small intestine was dissected and sampled. Data were analyzed with calf sex as a block. There was no effect (P ≥ 0.33) of maternal treatment on residual feed intake, G:F, DMI, ADG, or final BW. Small intestinal mass did not differ (P ≥ 0.38) among treatments, although calf small intestinal length tended (P = 0.07) to be greater for NR than NR+RUP. There were no differences (P ≥ 0.20) in calf small intestinal density or jejunal cellularity, proliferation, or vascularity among treatments. Jejunal soluble guanylate cyclase mRNA was greater (P RUP than CON and NR. Residual feed intake was positively correlated (P ≤ 0.09) with small intestinal mass and relative mass and jejunal RNA content but was negatively correlated (P ≤ 0.09) with jejunal mucosal density and DNA concentration. Gain:feed was positively correlated (P ≤ 0.09) with jejunal mucosal density, DNA, protein, and total cells and was negatively correlated (P ≤ 0.05) with small intestinal relative mass, jejunal RNA, and RNA:DNA. Dry matter intake was positively correlated (P ≤ 0.09) with small intestinal mass, relative mass, length, and density as well as jejunal DNA and protein content, total cells, total vascularity, and kinase insert domain receptor and endothelial nitric oxide synthase 3 mRNA and was negatively correlated (P = 0.02) with relative small intestinal length. In this

  17. Maternal outcomes and follow-up after gestational diabetes mellitus

    Science.gov (United States)

    Kim, C.

    2014-01-01

    Gestational diabetes mellitus reflects impaired maternal insulin secretion relative to demand prior to pregnancy, as well as temporary metabolic stressors imposed by the placenta and fetus. Thus, after delivery, women with gestational diabetes have increased risk of diabetes and recurrent gestational diabetes because of their underlying impairment, which may be further exacerbated by fat accretion during pregnancy and post-partum deterioration in lifestyle behaviours. This hypothetical model is discussed in greater detail, particularly the uncertainty regarding pregnancy as an accelerator of β-cell decline and the role of gestational weight gain. This report also presents risk estimates for future glucose intolerance and diabetes and reviews modifiable risk factors, particularly body mass and lifestyle alterations, including weight loss and breastfeeding. Non-modifiable risk factors such as race/ethnicity and insulin use during pregnancy are also discussed. The review concludes with current literature on lifestyle modification, recommendations for post-partum glucose screening, and future directions for research to prevent maternal disease. PMID:24341443

  18. [Chinese neonatal birth weight curve for different gestational age].

    Science.gov (United States)

    Zhu, Li; Zhang, Rong; Zhang, Shulian; Shi, Wenjing; Yan, Weili; Wang, Xiaoli; Lyu, Qin; Liu, Ling; Zhou, Qin; Qiu, Quanfang; Li, Xiaoying; He, Haiying; Wang, Jimei; Li, Ruichun; Lu, Jiarong; Yin, Zhaoqing; Su, Ping; Lin, Xinzhu; Guo, Fang; Zhang, Hui; Li, Shujun; Xin, Hua; Han, Yanqing; Wang, Hongyun; Chen, Dongmei; Li, Zhankui; Wang, Huiqin; Qiu, Yinping; Liu, Huayan; Yang, Jie; Yang, Xiaoli; Li, Mingxia; Li, Wenjing; Han, Shuping; Cao, Bei; Yi, Bin; Zhang, Yihui; Chen, Chao

    2015-02-01

    Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve. A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system. the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1. A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method. Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

  19. Doppler ultrasound scan during normal gestation: umbilical circulation

    International Nuclear Information System (INIS)

    Ruiz, T.; Sabate, J.; Martinez-Benavides, M. M.; Sanchez-Ramos, J.

    2002-01-01

    To determine normal umbilical circulation patterns by means of Doppler ultrasound scan in a healthy gestating population without risk factors and with normal perinatal results, and to evaluate any occurring modifications relative to gestational age by obtaining records kept during pregnancy. One hundred and sixteen pregnant women carrying a single fetus have been studied. These women had no risk factors, with both clinical and analytical controls, as well as ultrasound scans, all being normal. There were performed a total of 193 Doppler ultrasound scans between weeks 15 and 41 of gestation, with blood-flow analysis in the arteries and vein of the umbilical cord. The obtained information was correlated with parameters that evaluate fetal well-being (fetal monitoring and/or oxytocin test) and perinatal result (delivery type, birth weight, Apgar score). Statistical analysis was performed with the programs SPSS 6.0.1 for Windows and EPIINFO 6.0.4. With pulsed Doppler, the umbilical artery in all cases demonstrated a biphasic morphology with systolic and diastolic components and without retrograde blood flow. As the gestation period increased, there was observed a progressive decrease in resistance along with an increase in blood-flow velocity during the diastolic phase. The Doppler ultrasound scan is a non-invasive method that permits the hemodynamic study of umbilical blood circulation. A knowledge of normal blood-flow signal morphology, as well as of the normal values for Doppler indices in relation to gestational age would permit us to utilize this method in high-risk pregnancies. (Author) 30 refs

  20. Recombinant human erythropoietin and blood transfusion in low-birth weight preterm infants under restrictive transfusion guidelines

    International Nuclear Information System (INIS)

    Badiee, Z.; Pourmirzaiee, Mohmmad A.; Naseri, F.; Kelishadi, R.

    2006-01-01

    To compare the number and volume of red blood cell transfusions (RBCTs) in very low birth weight infants under restrictive red blood cell transfusion guidelines with and without erythropoietin administration. In a controlled clinical trial conducted at the neonatal intensive care unit of Alzahra Hospital, Isfahan, Iran, between April 2002 to April 2004, 60 premature infants with gestational age up to 34 weeks, birth weight up to 1500 g, and postnatal age between 8 and 14 days were included. The newborns were randomized into 2 groups: Group 1 received 3 doses of 400 IU/kg erythropoietin per week for 6 weeks, and Group 2 received no treatment aside from their conventional medications. The 2 groups did not differ significantly with respect to their mean gestational age, birth weight and hematocrit at the study entry. Fewer transfusions were administered to those receiving erythropoietin (26.7% versus 50%, p=0.03), but there was no statistically significant difference between groups with respect to volume of transfusion. Compared with the placebo group, the infants receiving erythropoietin had a higher mean hematocrit (34% +/- 4.3 versus 29% +/- 5.9, p<0.001) and absolute reticulocyte count (57 +/- 19 versus 10 +/- 4.8 x 106, p<0.001) at the end of the study. We found no significant difference in the incidence of thrombocytopenia and leukopenia between the 2 groups. We conclude that when the restrictive RBCT guidelines were followed, treatment with erythropoietin can be useful in reduction of the number of RBCTs. (author)

  1. Increment of absolute neutrophil count in the third trimester and increased risk of small-for-gestational-age birth: Hirakata Risk Associated with Pregnancy Assessment Research (HIRAPAR).

    Science.gov (United States)

    Harita, Nobuko; Kariya, Masatoshi; Hayashi, Tomoshige; Sato, Kyoko Kogawa; Nakamura, Kimihiko; Endo, Ginji; Narimoto, Katsuhiko

    2012-09-01

    Small-for-gestational-age (SGA) infants, who have growth restriction, have higher perinatal morbidity and mortality. Excessive inflammatory reaction such as neutrophil activation has been observed in pregnant women whose offspring had restricted fetal growth, but the association between white blood cell (WBC) counts and SGA birth has not yet been assessed. We therefore examined the association of WBC count and its change with the risk of SGA birth. We enrolled 2356 pregnant women who had full-term singleton delivery at a private maternity hospital in Hirakata, Japan. SGA was defined as under the 10th percentile of birthweight for gestational age, baby sex, and mother's parity according to the Japanese neonatal anthropometric charts renewed in 2010. Blood samples were measured in the first and third trimesters. We performed multiple logistic regression analysis to assess associations between total and differential WBC counts and SGA birth. Women with SGA birth tended to have higher total WBC count in the third trimester compared with women who did not have SGA birth. This tendency was not observed for total WBC count in the first trimester. After adjustment for age, height, body mass index at entry, smoking habit, weekly gestational weight gain, and pregnancy-induced hypertension, higher total WBC count in the third trimester was associated with an increased risk of SGA birth. Total WBC count in the first trimester did not show any significant association with SGA birth. The ratio of total WBC count in the third trimester to that in the first trimester was associated with SGA birth; the odds ratio for 1 unit increase was 3.02 (95% CI: 1.54-5.92). Regarding differential WBC counts in the third trimester, neutrophil count but not lymphocyte count was associated positively with SGA birth. Higher total WBC and absolute neutrophil counts in the third trimester were associated with SGA birth. In addition, greater ratio of increase in total WBC counts during pregnancy

  2. Secular trends in gestational age and birthweight in twins

    NARCIS (Netherlands)

    Gielen, M.; van Beijsterveldt, C.E.M.; Derom, C.A.; Vlietinck, R; Nijhuis, J.G.; Zeegers, M.P.A.; Boomsma, D.I.

    2010-01-01

    Background: In recent decades, the overall rate of preterm births has increased. The aim of the present study was to examine whether this trend is also seen for multiple gestations. More specifically, we examined if there has been a decrease in gestational age for live born monozygotic (MZ) and

  3. Intrauterine growth restriction is a direct consequence of localized maternal uropathogenic Escherichia coli cystitis.

    Directory of Open Access Journals (Sweden)

    Michael Bolton

    Full Text Available Despite the continually increasing rates of adverse perinatal outcomes across the globe, the molecular mechanisms that underlie adverse perinatal outcomes are not completely understood. Clinical studies report that 10% of pregnant women will experience a urinary tract infection (UTI and there is an association of UTIs with adverse perinatal outcomes. We introduced bacterial cystitis into successfully outbred female mice at gestational day 14 to follow pregnancy outcomes and immunological responses to determine the mechanisms that underlie UTI-mediated adverse outcomes. Outbred fetuses from mothers experiencing localized cystitis displayed intrauterine growth restriction (20-80% as early as 48 hours post-infection and throughout the remainder of normal gestation. Robust infiltration of cellular innate immune effectors was observed in the uteroplacental tissue following introduction of UTI despite absence of viable bacteria. The magnitude of serum proinflammatory cytokines is elevated in the maternal serum during UTI. This study demonstrates that a localized infection can dramatically impact the immunological status as well as the function of non-infected distal organs and tissues. This model can be used as a platform to determine the mechanism(s by which proinflammatory changes occur between non-contiguous genitourinary organs.

  4. Intrauterine Growth Restriction Is a Direct Consequence of Localized Maternal Uropathogenic Escherichia coli Cystitis

    Science.gov (United States)

    Bolton, Michael; Horvath, Dennis J.; Li, Birong; Cortado, Hanna; Newsom, David; White, Peter; Partida-Sanchez, Santiago; Justice, Sheryl S.

    2012-01-01

    Despite the continually increasing rates of adverse perinatal outcomes across the globe, the molecular mechanisms that underlie adverse perinatal outcomes are not completely understood. Clinical studies report that 10% of pregnant women will experience a urinary tract infection (UTI) and there is an association of UTIs with adverse perinatal outcomes. We introduced bacterial cystitis into successfully outbred female mice at gestational day 14 to follow pregnancy outcomes and immunological responses to determine the mechanisms that underlie UTI-mediated adverse outcomes. Outbred fetuses from mothers experiencing localized cystitis displayed intrauterine growth restriction (20–80%) as early as 48 hours post-infection and throughout the remainder of normal gestation. Robust infiltration of cellular innate immune effectors was observed in the uteroplacental tissue following introduction of UTI despite absence of viable bacteria. The magnitude of serum proinflammatory cytokines is elevated in the maternal serum during UTI. This study demonstrates that a localized infection can dramatically impact the immunological status as well as the function of non-infected distal organs and tissues. This model can be used as a platform to determine the mechanism(s) by which proinflammatory changes occur between non-contiguous genitourinary organs PMID:22470490

  5. Modeling farm nutrient flows in the North China Plain to reduce nutrient losses

    NARCIS (Netherlands)

    Zhao, Zhanqing; Bai, Zhaohai; Wei, Sha; Ma, Wenqi; Wang, Mengru; Kroeze, Carolien; Ma, Lin

    2017-01-01

    Years of poor nutrient management practices in the agriculture industry in the North China Plain have led to large losses of nutrients to the environment, causing severe ecological consequences. Analyzing farm nutrient flows is urgently needed in order to reduce nutrient losses. A farm-level

  6. Vasopressin and oxytocin levels during normal pregnancy: effects of chronic dietary sodium restriction.

    Science.gov (United States)

    van der Post, J A; van Buul, B J; Hart, A A; van Heerikhuize, J J; Pesman, G; Legros, J J; Steegers, E A; Swaab, D F; Boer, K

    1997-03-01

    Neurohypophysial hormones are thought to be involved in alterations in fluid balance during pregnancy and delivery. In the course of normal pregnancy intravascular volume is increased whereas sodium restriction is thought to reduce plasma volume and cardiac output. In the present study, we measured the effect of long-term severe sodium restriction on vasopressin (AVP) and oxytocin (OT) levels during normal pregnancy and after delivery. Fifty-nine healthy nulliparous women were randomized either for a low sodium diet (20 mmol sodium daily) or for a normal diet from week 12 of pregnancy onwards. Circulating plasma levels and urinary excretion of AVP and OT, their neurophysins (Np-AVP and Np-OT) and AVP bound to platelets were determined at regular intervals during pregnancy and after delivery. After completion of the study, women on a sodium-restricted diet were compared with control women on a normal diet using repeated measurement ANOVA with adjustment for potentially confounding variables. After randomization, a reduction in urinary sodium excretion of, on average, 40-82% was found. In general, no effect of sodium restriction could be demonstrated on the various parameters (0.53 sodium restriction compared with non-smokers having a normal diet (P = 0.018). For all parameters, clear changes were found in the course of pregnancy and puerperium (P pregnancy. After birth, free plasma AVP, platelet-bound AVP, OT, osmolality, sodium and potassium increased, while Np-AVP and Np-OT decreased. Although elevated Np-AVP and Np-OT levels during pregnancy seem to indicate increased release of neurohypophysial hormones, pregnancy up to 36 weeks of gestation is accompanied by low circulating AVP and OT levels. Long-term severe sodium restriction diminishes urinary AVP excretion in (non-smoking) pregnant women, without changing circulating levels of AVP and OT, despite the known reduction in circulating volume. The reduced circulating (platelet-bound) AVP levels during pregnancy

  7. Decreased plasma chemerin levels in women with gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Hare, K J; Bonde, L; Svare, J A

    2014-01-01

    circulating chemerin levels, which may act to reduce pregnancy-induced insulin resistance and prevent glucose intolerance. Women with gestational diabetes, however, have severely reduced chemerin levels that remain low after delivery, which may contribute to the insulin resistance, glucose intolerance......AIMS: To evaluate fasting and post-prandial serum chemerin levels in pregnant women with and without gestational diabetes, and again following delivery when normal glucose homeostasis is re-established. METHODS: Chemerin levels were measured in serum from nine women with gestational diabetes......, and from eight age- and BMI-matched pregnant women with normal glucose tolerance during two meal tests: in the third trimester and 3-4 months post partum. All women with gestational diabetes re-established normal glucose tolerance after delivery. RESULTS: Meal intake did not affect serum chemerin levels...

  8. Review of gestational diabetes mellitus effects on vascular structure and function.

    Science.gov (United States)

    Jensen, Louise A; Chik, Constance L; Ryan, Edmond A

    2016-05-01

    Vascular dysfunction has been described in women with a history of gestational diabetes mellitus. Furthermore, previous gestational diabetes mellitus increases the risk of developing Type 2 diabetes mellitus, a risk factor for cardiovascular disease. Factors contributing to vascular changes remain uncertain. The aim of this review was to summarize vascular structure and function changes found to occur in women with previous gestational diabetes mellitus and to identify factors that contribute to vascular dysfunction. A systematic search of electronic databases yielded 15 publications from 1998 to March 2014 that met the inclusion criteria. Our review confirmed that previous gestational diabetes mellitus contributes to vascular dysfunction, and the most consistent risk factor associated with previous gestational diabetes mellitus and vascular dysfunction was elevated body mass index. Heterogeneity existed across studies in determining the relationship of glycaemic levels and insulin resistance to vascular dysfunction. © The Author(s) 2016.

  9. Gestational surrogacy in Australia 2004-2011: treatment, pregnancy and birth outcomes.

    Science.gov (United States)

    Wang, Alex Y; Dill, Sandra K; Bowman, Mark; Sullivan, Elizabeth A

    2016-06-01

    Information on gestational surrogacy arrangement and outcomes is limited in Australia. This national population study investigates the epidemiology of gestational surrogacy arrangement in Australia: treatment procedures, pregnancy and birth outcomes. A retrospective study was conducted of 169 intended parents cycles and 388 gestational carrier cycles in Australia in 2004-2011. Demographics were compared between intended parents and gestational carrier cycles. Pregnancy and birth outcomes were compared by number of embryos transferred. Over half (54%) intended parents cycles were in women aged surrogacy treatment, including 9 liveborn twins. Of these, 22% (16) were preterm and 14% (10) were low birthweight. Preterm birth was 13% for liveborn babies following SET, lower than the 31% or liveborn babies following DET. To avoid adverse outcomes for both carriers and babies, SET should be advocated in all gestational surrogacy arrangements. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Is Doppler prediction of anemia effective in the growth-restricted fetus?

    Science.gov (United States)

    Makh, D S; Harman, C R; Baschat, A A

    2003-11-01

    To evaluate the utility of middle cerebral artery (MCA) and umbilical artery (UA) Doppler to predict anemia in intrauterine growth restricted (IUGR) fetuses. Fetuses with an abdominal circumference complete blood count was determined from a peripheral venous sample drawn at delivery. Anemia was defined as a hemoglobin value of references ranges by Mari et al. and Kurmanavicius et al.) were related to hemoglobin using linear regression analysis. In addition, UA absent end-diastolic velocity (AEDV), brain sparing (MCA PI > 2 SDs below gestational age mean), low CPR (> 2 SDs below gestational age mean) and an elevated MCA PSV (> 2 SDs) were evaluated for their predictive accuracy for anemia. Of 97 IUGR neonates 23 were anemic (23.7%). The MCA PSV was significantly related to hemoglobin using either reference range (Mari et al., F = 22.1577, Kurmanavicius et al., F = 21.8188, P < 0.001, respectively). However, using categorical cut-offs as well as regression analysis none of the Doppler parameters could be identified to provide clinically useful prediction of anemia. Parameters of MCA and UA vascular impedance and MCA PSV are significantly related to anemia in IUGR neonates. Despite this relationship the predictive accuracy is unacceptable for the clinical application in the setting of IUGR. Altered cardiovascular dynamics in IUGR fetuses may be responsible for this effect. Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.

  11. Gestational Weight Gain and Pregnancy Outcomes in 481 Obese Glucose-Tolerant Women

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Ovesen, Per; Beck-Nielsen, Henning

    2005-01-01

    OBJECTIVE: To investigate the effect of gestational weight gain in obese glucose-tolerant women. RESEARCH DESIGN AND METHODS: We performed a historical cohort study of 481 women with prepregnancy BMI > or = 30 kg/m2 and a normal 2-h 75-g oral glucose tolerance test (OGTT) during the third trimester......-weight women (3,478 g). In multivariate analyses, increasing weight gain was associated with significantly higher rates of hypertension (OR 4.8 [95% CI for group 4 vs. group 1: 1.7-13.1]), cesarean section (3.5 [1.6-7.8]), induction of labor (3.7 [1.7-8.0]), and large-for-gestational-age infants (4.7 [2.......0-11.0]). There was no difference in rates of small-for-gestational-age infants. Significant predictors for birth weight (determined by multiple linear regression) were gestational weight gain, 2-h OGTT result, pre-gestational BMI, maternal age, gestational age, and smoking. CONCLUSIONS: Increasing weight gain in obese women...

  12. Metabolic disorders in adipocytokine imbalance and gestational complications

    Directory of Open Access Journals (Sweden)

    Natalya B. Chabanova

    2017-06-01

    Full Text Available Adipose tissue as an endocrine organ synthesizes a large number of biologically active substances, adipocytokines, which have both local and systemic effects influencing the vascular wall, tissue sensitivity to insulin, glucose metabolism, and systemic inflammation. The data obtained from clinical and experimental studies demonstrate the close relationship between the imbalance of adipocytokines and pregnancy complications such as insulin resistance, gestational diabetes, and preeclampsia. In this connection, close attention of obstetrician-gynecologists and endocrinologists is focused on etiopathogenic aspects of the formation of gestational complications with metabolic disorders caused by an imbalance of adipocytokines with maternal obesity and to the search for markers of these disorders. The review presents the current literature data on adipose tissue hormones and their influence on the course of a gestational process.

  13. Sonographic monitoring of complications and anomalies in twin gestations

    International Nuclear Information System (INIS)

    Coleman, B.G.; Grumbach, K.; Arger, P.H.; Mintz, M.C.; Arenson, R.L.; Mennuti, M.T.; Gabbe, S.G.

    1986-01-01

    One hundred sixty-eight twin gestations were evaluated to assess the role of US in the diagnosis of obstetric complications and anomalies. US revealed the following complications: symptomatic polyhydramnios (eight cases), myomas (seven), placenta previa (three), and abruption (five). Fetal anomalies included twin-twin transfusion syndrome (two), acardiac anomaly (two), chromosomal abnormality (two), anencephaly (one), hydrocephaly (one), and conjoined twins (two). In 26 gestations intrauterine fetal demise or neonatal death involved one or both twins for a total of 42 deaths, constituting a mortality of 12.5%. No maternal deaths occurred. The impact of sonographic monitoring on the obstetric management of twin gestations is emphasized

  14. Microbial enzyme activity, nutrient uptake and nutrient limitation in forested streams

    Science.gov (United States)

    Brian H. Hill; Frank H. McCormick; Bret C. Harvey; Sherri L. Johnson; Melvin L. Warren; Colleen M. Elonen

    2010-01-01

    The flow of organic matter and nutrients from catchments into the streams draining them and the biogeochemical transformations of organic matter and nutrients along flow paths are fundamental processes instreams (Hynes,1975; Fisher, Sponseller & Heffernan, 2004). Microbial biofilms are often the primary interface for organic matter and nutrient uptake and...

  15. Cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers.

    Science.gov (United States)

    Vela-Huerta, M; Aguilera-López, A; Alarcón-Santos, S; Amador, N; Aldana-Valenzuela, C; Heredia, A

    2007-09-01

    To compare cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers. Color Doppler echocardiography was performed in 113 (22 large for gestational age infants of diabetic mothers, 21 of nondiabetic mothers and 70 adequate for gestational age newborns) full-term infants. Pulmonary arterial pressure was significantly higher in infants of diabetic mothers than in those of nondiabetic mothers and normal infants at 24 h (38.5 vs. 32.5, and 35.5 mmHg, respectively). However, slow fall in this parameter was shown in all large for gestational age infants. Open ductus arteriosus was frequent in all large for gestational age infants, but its closure was significantly delayed in infants of diabetic mothers. Septal hypertrophy was higher in infants of diabetic mothers than in large for gestational age infants of nondiabetic mothers. Large for gestational age infants born from nondiabetic mothers showed delayed fall in pulmonary arterial pressure similar to those born from diabetic mothers but showed lower proportion of septal hypertrophy. Patent ductus arteriosus persisted for longer period of time in all large for gestational age infants than in normal infants, but its closure was significantly delayed in infants of diabetic mothers.

  16. Impact of chronic hypoxemia on blood flow to the brain, heart, and adrenal gland in the late-gestation IUGR sheep fetus.

    Science.gov (United States)

    Poudel, Rajan; McMillen, I Caroline; Dunn, Stacey L; Zhang, Song; Morrison, Janna L

    2015-02-01

    In the fetus, there is a redistribution of cardiac output in response to acute hypoxemia, to maintain perfusion of key organs, including the brain, heart, and adrenal glands. There may be a similar redistribution of cardiac output in the chronically hypoxemic, intrauterine growth-restricted fetus. Surgical removal of uterine caruncles in nonpregnant ewe results in the restriction of placental growth (PR) and intrauterine growth. Vascular catheters were implanted in seven control and six PR fetal sheep, and blood flow to organs was determined using microspheres. Placental and fetal weight was significantly reduced in the PR group. Despite an increase in the relative brain weight in the PR group, there was no difference in blood flow to the brain between the groups, although PR fetuses had higher blood flow to the temporal lobe. Adrenal blood flow was significantly higher in PR fetuses, and there was a direct relationship between mean gestational PaO2 and blood flow to the adrenal gland. There was no change in blood flow, but a decrease in oxygen and glucose delivery to the heart in the PR fetuses. In another group, there was a decrease in femoral artery blood flow in the PR compared with the Control group, and this may support blood flow changes to the adrenal and temporal lobe. In contrast to the response to acute hypoxemia, these data show that there is a redistribution of blood flow to the adrenals and temporal lobe, but not the heart or whole brain, in chronically hypoxemic PR fetuses in late gestation. Copyright © 2015 the American Physiological Society.

  17. The Effect of Diet Based on Body Mass Index on Pregnancy Outcomes in 20 – 35 Year Old Pregnant Mothers with Gestational Diabetes Mellitus (GDM Referred to Arash Hospital

    Directory of Open Access Journals (Sweden)

    Abotaleb Beigi

    2018-01-01

    Conclusion: Calorie restriction based on BMI in case group compared to control group was not effective about more pregnancy outcomes such as average weight gain at the end of pregnancy, Insulin requirement, weight of newborns at birth, macrosomia baby birth, Having high blood pressure, intra uterine growth retardation, gestational age in delivery, infant blood calcium. but infant blood sugar in case group was less than control group significantly.

  18. Patterns in foliar nutrient resorption stoichiometry at multiple scales: controlling factors and ecosystem consequences (Invited)

    Science.gov (United States)

    Reed, S.; Cleveland, C. C.; Davidson, E. A.; Townsend, A. R.

    2013-12-01

    During leaf senescence, nutrient rich compounds are transported to other parts of the plant and this 'resorption' recycles nutrients for future growth, reducing losses of potentially limiting nutrients. Variations in leaf chemistry resulting from nutrient resorption also directly affect litter quality, in turn, regulating decomposition rates and soil nutrient availability. Here we investigated stoichiometric patterns of nitrogen (N) and phosphorus (P) resorption efficiency at multiple spatial scales. First, we assembled a global database to explore nutrient resorption among and within biomes and to examine potential relationships between resorption stoichiometry and ecosystem nutrient status. Next, we used a forest regeneration chronosequence in Brazil to assess how resorption stoichiometry linked with a suite of other nutrient cycling measures and with ideas of how nutrient limitation may change over secondary forest regrowth. Finally, we measured N:P resorption ratios of six canopy tree species in a Costa Rican tropical forest. We calculated species-specific resorption ratios and compared them with patterns in leaf litter and topsoil nutrient concentrations. At the global scale, N:P resorption ratios increased with latitude and decreased with mean annual temperature (MAT) and precipitation (MAP; P1 in latitudes >23°. Focusing on tropical sites in our global dataset we found that, despite fewer data and a restricted latitudinal range, a significant relationship between latitude and N:P resorption ratios persisted (PAmazon Basin chronosequence of regenerating forests, where previous work reported a transition from apparent N limitation in younger forests to P limitation in mature forests, we found N resorption was highest in the youngest forest, whereas P resorption was greatest in the mature forest. Over the course of succession, N resorption efficiency leveled off but P resorption continued to increase with forest age. In Costa Rica, though we found species

  19. A multiscale analysis of nutrient transport and biological tissue growth in vitro

    KAUST Repository

    O'Dea, R. D.

    2014-10-15

    © The authors 2014. In this paper, we consider the derivation of macroscopic equations appropriate to describe the growth of biological tissue, employing a multiple-scale homogenization method to accommodate explicitly the influence of the underlying microscale structure of the material, and its evolution, on the macroscale dynamics. Such methods have been widely used to study porous and poroelastic materials; however, a distinguishing feature of biological tissue is its ability to remodel continuously in response to local environmental cues. Here, we present the derivation of a model broadly applicable to tissue engineering applications, characterized by cell proliferation and extracellular matrix deposition in porous scaffolds used within tissue culture systems, which we use to study coupling between fluid flow, nutrient transport, and microscale tissue growth. Attention is restricted to surface accretion within a rigid porous medium saturated with a Newtonian fluid; coupling between the various dynamics is achieved by specifying the rate of microscale growth to be dependent upon the uptake of a generic diffusible nutrient. The resulting macroscale model comprises a Darcy-type equation governing fluid flow, with flow characteristics dictated by the assumed periodic microstructure and surface growth rate of the porous medium, coupled to an advection-reaction equation specifying the nutrient concentration. Illustrative numerical simulations are presented to indicate the influence of microscale growth on macroscale dynamics, and to highlight the importance of including experimentally relevant microstructural information to correctly determine flow dynamics and nutrient delivery in tissue engineering applications.

  20. Diagnostic value of newborn foot length to predict gestational age

    Directory of Open Access Journals (Sweden)

    Mutia Farah Fawziah

    2017-08-01

    Full Text Available Background  Identification of gestational age, especially within 48 hours of birth, is crucial for newborns, as the earlier preterm status is detected, the earlier the child can receive optimal management. Newborn foot length is an anthropometric measurement which is easy to perform, inexpensive, and potentially efficient for predicting gestational age. Objective  To analyze the diagnostic value of newborn foot length in predicting gestational age. Methods  This diagnostic study was performed between October 2016 and February 2017 in the High Care Unit of Neonates at Dr. Moewardi General Hospital, Surakarta. A total of 152 newborns were consecutively selected and underwent right foot length measurements before 96 hours of age. The correlation between newborn foot length to classify as full term and gestational age was analyzed with Spearman’s correlation test because of non-normal data distribution. The cut-off point of newborn foot length was calculated by receiver operating characteristic (ROC curve and diagnostic values of newborn foot length were analyzed by 2 x 2 table with SPSS 21.0 software. Results There were no significant differences between male and female newborns in terms of gestational age, birth weight, choronological age, and newborn foot length (P>0.05. Newborn foot length and gestational age had a significant correlation (r=0.53; P=0.000. The optimal cut-off newborn foot length to predict full term status was 7.1 cm. Newborn foot length below 7.1 cm had sensitivity 75%, specificity 98%, positive predictive value 94.3%, negative predictive value 90.6%, positive likelihood ratio 40.5, negative likelihood ratio 0.25, and post-test probability 94.29%, to predict preterm status in newborns. Conclusion  Newborn foot length can be used to predict gestational age, especially for the purpose of differentiating between preterm and full term newborns.

  1. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

    Science.gov (United States)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

    2017-05-01

    The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. Repeatability of metabolic responses to a nutrient deficiency in early and mid lactation and implications for robustness of dairy cows.

    Science.gov (United States)

    Gross, J J; Bruckmaier, R M

    2015-12-01

    Nutrient partitioning toward the mammary gland during insufficient energy and nutrient supply is a strategy to ensure survival of the offspring in mammalian species. This homeorhetic priority of the mammary gland is also present in the modern dairy cow, in particular in early lactation. However, despite similar metabolic loads, the adaptive response to a given metabolic load varies considerably among animals. The aim of this study was to investigate if individual cows respond in a consistent manner to a negative energy balance (NEB) in early and mid lactation. Twenty-five dairy cows experienced the usual NEB after parturition and were subjected to a second 3-wk NEB induced by feed restriction in mid lactation. Animals were retrospectively ranked according to their highest plasma nonesterified fatty acid (NEFA) concentration in wk 1 to 4 postpartum. The animals with the 33% highest and 33% lowest values were selected and classified either as the high response (HR) or low response (LR) group. Before parturition, no differences in the studied parameters, dry matter intake, energy balance, concentrations of glucose, NEFA, β-hydroxybutyrate, cholesterol, triglycerides, growth hormone, and insulin-like growth factor-1, were detected between LR and HR. After parturition, milk yield and energy-corrected milk yield was higher for HR compared with LR in wk 2 to 14 and wk 1 to 6, respectively. During feed restriction in wk 15 to 17 postpartum, no differences in energy-corrected milk between LR and HR were found. Energy balance was more negative in HR during the NEB in early lactation, but not different from LR during feed restriction in mid lactation. Although plasma concentrations of glucose, growth hormone, triglycerides, and cholesterol showed group differences in early lactation, but not during feed restriction, the plasma concentrations of NEFA, β-hydroxybutyrate, and insulin-like growth factor-1 in HR changed repeatedly to a greater extent during the NEB at the 2

  3. Influence of genotype and feeding strategy on pig performance, plasma concentrations of micro nutrients, immune responses and faecal microbiota composition of growing-finishing pigs in a forage-based system

    DEFF Research Database (Denmark)

    Kongsted, Anne Grete; Nørgaard, Jan Værum; Jensen, Søren Krogh

    2015-01-01

    In free-range pig production it is important to reduce the input of nutrients from supplementary feed to reduce nutrient leaching and improve the resource efficiency of the system. A promising development might be to encourage foraging behaviour of the pigs. However, very little is known about pi...... significantly to the nutritional supply of pigs fed restrictedly with supplementary feed. There are indications that the mineral content of the premix is not needed in a forage-based free-range system but cautious need to be taken with regards to the vitamin A, D, E supply.......In free-range pig production it is important to reduce the input of nutrients from supplementary feed to reduce nutrient leaching and improve the resource efficiency of the system. A promising development might be to encourage foraging behaviour of the pigs. However, very little is known about pigs......) of either a traditional (Tamworth×(Landrace×Yorkshire)) or a ‘modern’ crossbreed (Duroc×(Landrace×Yorkshire)) fed a pelleted diet as supplementary feed either according to recommendations (NORM), or restrictedly with (RES+) or without (RES–) a supplementary vitamin and mineral mixture. The pigs ‘strip...

  4. Early detection of diabetes after pregnancy complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Nielsen, Jane Hyldgård; Overgaard, Charlotte; Olesen, Christinna Rebecca

    Title: Early detection of diabetes after pregnancy complicated by gestational diabetes Background: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. 40% of women with a history gestational diabetes mellitus (GDM...... of health consequences for women. Aims: Examine the extent of participation in follow-up screening in the Danish Region of North Jutland, and the possible consequences of nonattendance. Methods: A register based study. In Danish national registers 2171 birthing women whose pregnancy was complicated by GDM...

  5. N-Acetylcysteine, a glutathione precursor, reverts vascular dysfunction and endothelial epigenetic programming in intrauterine growth restricted guinea pigs.

    Science.gov (United States)

    Herrera, Emilio A; Cifuentes-Zúñiga, Francisca; Figueroa, Esteban; Villanueva, Cristian; Hernández, Cherie; Alegría, René; Arroyo-Jousse, Viviana; Peñaloza, Estefania; Farías, Marcelo; Uauy, Ricardo; Casanello, Paola; Krause, Bernardo J

    2017-02-15

    Intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial epigenetic programming of the umbilical vessels. There is no evidence that this epigenetic programming is occurring on systemic fetal arteries. In IUGR guinea pigs we studied the functional and epigenetic programming of endothelial nitric oxide synthase (eNOS) (Nos3 gene) in umbilical and systemic fetal arteries, addressing the role of oxidative stress in this process by maternal treatment with N-acetylcysteine (NAC) during the second half of gestation. The present study suggests that IUGR endothelial cells have common molecular markers of programming in umbilical and systemic arteries. Notably, maternal treatment with NAC restores fetal growth by increasing placental efficiency and reverting the functional and epigenetic programming of eNOS in arterial endothelium in IUGR guinea pigs. In humans, intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial programming in umbilical vessels. We aimed to determine the effects of maternal antioxidant treatment with N-acetylcysteine (NAC) on fetal endothelial function and endothelial nitric oxide synthase (eNOS) programming in IUGR guinea pigs. IUGR was induced by implanting ameroid constrictors on uterine arteries of pregnant guinea pigs at mid gestation, half of the sows receiving NAC in the drinking water (from day 34 until term). Fetal biometry and placental vascular resistance were followed by ultrasound throughout gestation. At term, umbilical arteries and fetal aortae were isolated to assess endothelial function by wire-myography. Primary cultures of endothelial cells (ECs) from fetal aorta, femoral and umbilical arteries were used to determine eNOS mRNA levels by quantitative PCR and analyse DNA methylation in the Nos3 promoter by pyrosequencing. Doppler ultrasound measurements showed that NAC reduced placental vascular resistance

  6. A role for autophagy in the extension of lifespan by dietary restriction in C. elegans.

    Directory of Open Access Journals (Sweden)

    Malene Hansen

    2008-02-01

    Full Text Available In many organisms, dietary restriction appears to extend lifespan, at least in part, by down-regulating the nutrient-sensor TOR (Target Of Rapamycin. TOR inhibition elicits autophagy, the large-scale recycling of cytoplasmic macromolecules and organelles. In this study, we asked whether autophagy might contribute to the lifespan extension induced by dietary restriction in C. elegans. We find that dietary restriction and TOR inhibition produce an autophagic phenotype and that inhibiting genes required for autophagy prevents dietary restriction and TOR inhibition from extending lifespan. The longevity response to dietary restriction in C. elegans requires the PHA-4 transcription factor. We find that the autophagic response to dietary restriction also requires PHA-4 activity, indicating that autophagy is a transcriptionally regulated response to food limitation. In spite of the rejuvenating effect that autophagy is predicted to have on cells, our findings suggest that autophagy is not sufficient to extend lifespan. Long-lived daf-2 insulin/IGF-1 receptor mutants require both autophagy and the transcription factor DAF-16/FOXO for their longevity, but we find that autophagy takes place in the absence of DAF-16. Perhaps autophagy is not sufficient for lifespan extension because although it provides raw material for new macromolecular synthesis, DAF-16/FOXO must program the cells to recycle this raw material into cell-protective longevity proteins.

  7. Gestational surrogacy: Psychosocial aspects

    Directory of Open Access Journals (Sweden)

    Nicolás Ruiz-Robledillo

    2016-12-01

    Full Text Available Innovation in assisted reproductive technologies together with increased infertility and new family structures are increasing the use of gestational surrogacy as a means to have children. Before, during and after the process, it is necessary to study the psychosocial characteristics of triad members: the gestational surrogate, intended parents, and offspring. Research has indicated positive adaptation to the process and benefits for all members of the triad. Altruism is the main motivation of surrogates. Notably, psychological well-being has been found to be higher in individuals who have become parents through surrogacy than in those who have used egg donation or have followed a natural process of conception. Moreover, no differences in psychosocial characteristics have been observed in the offspring, compared with children born through natural conception or egg donation. Results highlight the positive aspects of surrogacy. Future research should investigate psychosocial factors that modulate the process, acting as risk and protective factors for well-being of the triad members, and identify the optimal profiles of surrogates for the process to be a success.

  8. Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women.

    Science.gov (United States)

    Cole-Lewis, Heather J; Kershaw, Trace S; Earnshaw, Valerie A; Yonkers, Kimberly Ann; Lin, Haiqun; Ickovics, Jeannette R

    2014-09-01

    There is evidence that pregnancy-specific stress is associated with preterm birth. The purpose of this study is to examine the association between change in pregnancy-specific stress over the course of pregnancy and birth outcomes (i.e., preterm birth and gestational age) in an understudied but vulnerable group using a theoretically derived model. Multivariate linear and logistic regression techniques were used to examine the association between pregnancy-specific stress (measured in second and third trimester) and length of gestation (i.e., preterm birth and gestational age) among a sample of 920 Black and/or Latina adolescent and young women. Second trimester pregnancy-specific stress was not associated with preterm birth or gestational age. Third trimester pregnancy-specific stress was associated with preterm birth but not with gestational age. Change in pregnancy-specific stress between second and third trimester was significantly associated with increased likelihood of preterm delivery and shortened gestational age, even after controlling for important biological, behavioral, psychological, interpersonal, and sociocultural risk factors. Findings emphasize the importance of measuring pregnancy-specific stress across pregnancy, as the longitudinal change from second to third trimester was significantly associated with length of gestation measured both as a dichotomous variable (preterm birth) and a continuous variable (gestational age). Furthermore, this is the first study to observe the association of pregnancy-specific stress with length of gestation in this understudied population-unique in age, race, and ethnicity. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  9. Genetic Associations with Gestational Duration and Spontaneous Preterm Birth

    DEFF Research Database (Denmark)

    Zhang, G.; Feenstra, B.; Bacelis, J.

    2017-01-01

    . METHODS: We performed a genomewide association study in a discovery set of samples obtained from 43,568 women of European ancestry using gestational duration as a continuous trait and term or preterm (... of 8643 women) to test for replication of genomic loci that had significant genomewide association (Pdiscovery set. RESULTS: In the discovery and replication data sets, four loci (EBF1, EEFSEC, AGTR2, and WNT4) were...... significantly associated with gestational duration. Functional analysis showed that an implicated variant in WNT4 alters the binding of the estrogen receptor. The association between variants in ADCY5 and RAP2C and gestational duration had suggestive significance in the discovery set and significant evidence...

  10. 78 FR 11210 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

    Science.gov (United States)

    2013-02-15

    ... Development Conference: Diagnosing Gestational Diabetes Mellitus AGENCY: National Institutes of Health, HHS... ``Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus.'' The conference will be open to... http://prevention.nih.gov/cdp/ . SUPPLEMENTARY INFORMATION: Gestational diabetes mellitus (GDM) is a...

  11. Conservative management of preterm premature rupture of membranes beyond 32 weeks' gestation: is it worthwhile?

    Science.gov (United States)

    Tsafrir, Z; Margolis, G; Cohen, Y; Cohen, A; Laskov, I; Levin, I; Mandel, D; Many, A

    2015-01-01

    We aimed to investigate whether conservative management of preterm premature rupture of membranes (PPROM) at 32-34 weeks' gestation improves outcome. In this retrospective analysis of singleton pregnancies, the study group included patients with PPROM at 28-34 weeks' gestation and the control group included patients presented with spontaneous preterm delivery at 28-34 weeks' gestation. Both groups were subdivided according to gestational age - early (28-31 weeks' gestation) versus late (32-34 weeks' gestation). Adverse neonatal outcome included neonatal death, intraventricular haemorrhage grade 3/4, respiratory distress syndrome, periventricular leucomalacia and neonatal sepsis. The study and control groups included 94 and 86 women, respectively. The study group had a lower incidence of adverse neonatal outcome at the earlier weeks (28-31), compared with the control group at the same gestational age. In contrast, at 32-34 weeks' gestation no difference in the risk for adverse neonatal outcome was noticed. Additionally, within the study group, chorioamnionitis rate was significantly higher among those who delivered at 32-34 weeks' gestation (p < 0.01). No advantage for conservative management of PPROM was demonstrated beyond 31 weeks' gestation. Moreover, conservative management of PPROM at 32-34 weeks' gestation may expose both mother and neonate to infectious morbidity.

  12. Energy and nutrient deposition and excretion in the reproducing sow: model development and evaluation

    DEFF Research Database (Denmark)

    Hansen, A V; Strathe, A B; Theil, Peter Kappel

    2014-01-01

    requirements for maintenance, and fetal and maternal growth were described. In the lactating module, a factorial approach was used to estimate requirements for maintenance, milk production, and maternal growth. The priority for nutrient partitioning was assumed to be in the order of maintenance, milk...... production, and maternal growth with body tissue losses constrained within biological limits. Global sensitivity analysis showed that nonlinearity in the parameters was small. The model outputs considered were the total protein and fat deposition, average urinary and fecal N excretion, average methane...... emission, manure carbon excretion, and manure production. The model was evaluated using independent data sets from the literature using root mean square prediction error (RMSPE) and concordance correlation coefficients. The gestation module predicted body fat gain better than body protein gain, which...

  13. Enamel defect of deciduous teeth in small gestational age children

    Directory of Open Access Journals (Sweden)

    Willyanti S Syarif

    2010-06-01

    Full Text Available Background: Enamel defect could be caused by genetic and environmental factors in prenatal period. Meanwhile, prenatal malnutrition could also cause small gestational age (SGA. Small Gestational Age is the term used for a neonatal baby with birthweight below the -2SD normal value or 10th percentile on the intrauterine Lubchenco curve. This condition is due to intra-uterine growth restriction, and eventually ends up with several developmental defects of organs, including teeth. In fact, deciduous tooth development has a critical phase within this development period. Purpose: The aim of this study is not only to find out the incidence of enamel defect in SGA children, but also to know the percentage of SGA risk factor to develop enamel defect. Method: This was a epidemiology research with consecutive admission technique. It consisted of 153 SGA children aged 9–48 months. Next, the Ponderal index was used to assign SGA types, symmetrical or asymmetrical one-in this study 59 and 94 respectively. On the other hand, three hundred and ninety Appropriate for Gestational Age (AGA children aged 4–48 months were also included in the study as a control group. Enamel defect then was determined by intraoral examination, classified into hypoplasia and hypocalcifications. Chi-square test was finally used to determine the relative risk ratio between the SGA and the control AGA children. Result: The result of this research showed that incidence of enamel defect in SGA children was 86.92%, meanwhile, that in AGA children was 23.08%, 66.00% of which were commonly suffered from hypocalcification. With p<0.05 it is also known that SGA children has the risk of enamel defect with hypocalcification, about 79% higher than AGA children. Conclusion: It could be concluded that 79% of SGA children had the risk of deciduous tooth enamel defect with hypocalcification as the most.Latar belakang: Defek email dapat terjadi karena faktor genetik dan lingkungan sistemik yang

  14. The influence of maternal islet beta-cell autoantibodies in conjunction with gestational hyperglycemia on neonatal outcomes.

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    Zhe Li

    Full Text Available To determine the predictive value of the presence of maternal islet beta-cell autoantibodies with respect to neonatal outcomes.A total of 311 pregnant women with abnormal 75 g oral glucose tolerance test (OGTT results were enrolled in this study. Maternal glutamic acid decarboxylase autoantibodies (GADA, islet cell autoantibodies (ICA and insulin autoantibodies (IAA were tested in fasting blood both on the day following the routine OGTT and before delivery. The birth weight, Apgar score, blood glucose and outcomes of each neonate were later evaluated and recorded.1. In this study, 33.9% of the pregnant women with gestational hyperglycemia had detectable levels of one or more types of anti-islet cell antibodies in the third trimester. The proportion of women who produced GADA and/or ICA was significantly higher in the group of women with gestational hyperglycemia than in the control group (P<0.05. The groups similarly differed in the proportion of women who tested positive for any anti-islet cell antibody (P<0.05. 2. Of the patients in our study, those who produced GADA exhibited an increase in uterine and umbilical arterial pulsatility indexes (PIs during the third trimesters compared with the control group (P˂0.05. Additionally, an increased frequency of fetal growth restriction (FGR was observed in the infants of women who produced IAA during pregnancy compared with those without autoantibodies (P˂0.05. 3. The rate of newborn admission to the neonatal intensive care unit (NICU was significantly associated with the presence of maternal ICA during the third trimester (OR, 6.36; 95% CI, 1.22-33.26. 4. The incidence of neonatal asphyxia was associated with the presence of maternal GADA in both the second (OR, 10.44; 95% CI, 1.46-74.92 and the third (OR, 8.33; 95% CI, 1.45-47.82 trimesters.Approximately one-third of the women with gestational hyperglycemia produced anti-islet cell antibodies. The incidence of FGR was higher in women with

  15. Gestational diabetes: How risky are the mothers of rural Bengal, India

    Directory of Open Access Journals (Sweden)

    Sonali Sain

    2013-01-01

    Full Text Available Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28 weeks were interviewed using a predesigned schedule adapted from American Diabetes Association and WHO guidelines and their clinical and obstetrical examination was done. Mothers identified with at least 1 risk factor were advised for screening by Glucose Challenge test (GCT. Those with a positive result were confirmed by Glucose Tolerance Test. Out of 625 antenatal mothers, majority i.e. 60.32% of the mothers were exposed to low risk for developing gestational diabetes. Among 248 (39.68% mothers who had at least one risk factor, 20.56% were GCT positive amounting to 8.16% of the total population. 11.69% of the mothers with positive risk factors were GTT positive amounting to 56.86% of GCT positive mothers. This accounted for 4.64% of the total study population. Thus this method of preliminary screening for risk factors of gestational diabetes undertaken in all antenatal mothers followed by confirmatory testing in those found to be risk factor positive can provide a feasible alternative in increasing the yield for detection of gestational diabetes articularly in a low resource setting.

  16. Gestational diabetes mellitus screening, management and outcomes in the Cook Islands.

    Science.gov (United States)

    Aung, Yin Yin May; Sowter, Martin; Kenealy, Timothy; Herman, Josephine; Ekeroma, Alec

    2015-04-17

    To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose greater than or equal to 7.8 mmol/L) was followed by a 75 g oral glucose tolerance test (gestational diabetes mellitus diagnosed if fasting glucose greater than or equal to 5.2 mmol/L or 2-hour glucose greater than or equal to 8.0 mmol/L; pregnancy impaired glucose tolerance if positive screen and negative diagnostic test). Uptake of the screening programme rose from 49.0% to 99.6% by the end of the study period. 646 women had a glucose challenge; for 186/646 (28.8%) the challenge was positive; 183 had an oral glucose tolerance test; 89/646 (13.8%) had pregnancy impaired glucose tolerance; 94/646 (13.9%) had gestational diabetes mellitus. Median maternal weight gain was 6 kg (gestational diabetes mellitus) and 10 kg (normal glucose tolerance); caesarean section rates were 25% and 11% respectively; baby birthweights were not significantly different. 59 women with gestational diabetes mellitus had a post-natal glucose tolerance test at their 6-week check and 21 (35.6%) had diabetes confirmed. The gestational diabetes mellitus screening programme has a high uptake and current management appears effective in reducing maternal and fetal weight gain. A proposed new screening programme is outlined.

  17. Maternal protein restriction affects gene expression and enzyme activity of intestinal disaccharidases in adult rat offspring

    International Nuclear Information System (INIS)

    Pinheiro, D.F.; Pacheco, P.D.G.; Alvarenga, P.V.; Buratini, J. Jr; Castilho, A.C.S.; Lima, P.F.; Sartori, D.R.S.; Vicentini-Paulino, M.L.M.

    2013-01-01

    This study investigated the consequences of intrauterine protein restriction on the gastrointestinal tract and particularly on the gene expression and activity of intestinal disaccharidases in the adult offspring. Wistar rat dams were fed isocaloric diets containing 6% protein (restricted, n = 8) or 17% protein (control, n = 8) throughout gestation. Male offspring (n = 5-8 in each group) were evaluated at 3 or 16 weeks of age. Maternal protein restriction during pregnancy produced offspring with growth restriction from birth (5.7 ± 0.1 vs 6.3 ± 0.1 g; mean ± SE) to weaning (42.4 ± 1.3 vs 49.1 ± 1.6 g), although at 16 weeks of age their body weight was similar to control (421.7 ± 8.9 and 428.5 ± 8.5 g). Maternal protein restriction also increased lactase activity in the proximal (0.23 ± 0.02 vs 0.15 ± 0.02), medial (0.30 ± 0.06 vs 0.14 ± 0.01) and distal (0.43 ± 0.07 vs 0.07 ± 0.02 U·g -1 ·min -1 ) small intestine, and mRNA lactase abundance in the proximal intestine (7.96 ± 1.11 vs 2.38 ± 0.47 relative units) of 3-week-old offspring rats. In addition, maternal protein restriction increased sucrase activity (1.20 ± 0.02 vs 0.91 ± 0.02 U·g -1 ·min -1 ) and sucrase mRNA abundance (4.48 ± 0.51 vs 1.95 ± 0.17 relative units) in the duodenum of 16-week-old rats. In conclusion, the present study shows for the first time that intrauterine protein restriction affects gene expression of intestinal enzymes in offspring

  18. Maternal protein restriction affects gene expression and enzyme activity of intestinal disaccharidases in adult rat offspring

    Energy Technology Data Exchange (ETDEWEB)

    Pinheiro, D.F.; Pacheco, P.D.G.; Alvarenga, P.V.; Buratini, J. Jr; Castilho, A.C.S.; Lima, P.F.; Sartori, D.R.S.; Vicentini-Paulino, M.L.M. [Departamento de Fisiologia, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP (Brazil)

    2013-03-15

    This study investigated the consequences of intrauterine protein restriction on the gastrointestinal tract and particularly on the gene expression and activity of intestinal disaccharidases in the adult offspring. Wistar rat dams were fed isocaloric diets containing 6% protein (restricted, n = 8) or 17% protein (control, n = 8) throughout gestation. Male offspring (n = 5-8 in each group) were evaluated at 3 or 16 weeks of age. Maternal protein restriction during pregnancy produced offspring with growth restriction from birth (5.7 ± 0.1 vs 6.3 ± 0.1 g; mean ± SE) to weaning (42.4 ± 1.3 vs 49.1 ± 1.6 g), although at 16 weeks of age their body weight was similar to control (421.7 ± 8.9 and 428.5 ± 8.5 g). Maternal protein restriction also increased lactase activity in the proximal (0.23 ± 0.02 vs 0.15 ± 0.02), medial (0.30 ± 0.06 vs 0.14 ± 0.01) and distal (0.43 ± 0.07 vs 0.07 ± 0.02 U·g{sup -1}·min{sup -1}) small intestine, and mRNA lactase abundance in the proximal intestine (7.96 ± 1.11 vs 2.38 ± 0.47 relative units) of 3-week-old offspring rats. In addition, maternal protein restriction increased sucrase activity (1.20 ± 0.02 vs 0.91 ± 0.02 U·g{sup -1}·min{sup -1}) and sucrase mRNA abundance (4.48 ± 0.51 vs 1.95 ± 0.17 relative units) in the duodenum of 16-week-old rats. In conclusion, the present study shows for the first time that intrauterine protein restriction affects gene expression of intestinal enzymes in offspring.

  19. Optimizing postpartum care for the patient with gestational diabetes mellitus.

    Science.gov (United States)

    Martinez, Noelle G; Niznik, Charlotte M; Yee, Lynn M

    2017-09-01

    Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be diabetes mellitus. Based on existing evidence, we propose best practices for the postpartum care of women with gestational diabetes mellitus: (1) enhanced patient support for identifying long-term health care providers, (2) patient-centered medical home utilization when possible, (3) patient and provider test reminders, and (4) formalized obstetrician-primary care provider hand offs using the Situation Background Assessment Recommendation (SBAR) mnemonic. These strategies deserve future investigation to solidify a multilevel approach for identifying and preventing the continuum of diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Labour induction with gestational hypertension: A great obstetric challenge.

    Science.gov (United States)

    Khaskheli, Meharun-Nissa; Baloch, Shahla; Sheeba, Aneela; Baloch, Sarmad; Khan, Fahad

    2017-01-01

    To observe the fetomaternal morbidity and mortality with induction of labour in pregnant women with gestational hypertension. The subjected study population included was 138 pregnant women with gestational hypertension. These pregnant women were between 34-40 weeks of gestational period in whom labour was induced, while the pregnant women who had labour induction for other reasons were excluded. These women were registered on the predesigned proforma. The data was collected and analyzed on SPSS version 21. Out of the 138 cases, mean age of the women was 25.93±5.037, prim gravid women were 78(56.5%), gestational period in majority of these women 71(51.4%) varied between 35-38 weeks. The common presenting symptoms were oedema 119(86.23%), headache 90(65.21%). Labour induction in majority of the cases 81(58.7%) was carried with prosten pessary. The Caesarean section was needed in 39(28.3%) women in emergency due to maternal and fetal reasons or due to failed induction. Maternal complications were uncontrolled hypertension 23(16.7%), intensive care unit admission 21(15.2%), fits 15(10.9%), post partum haemorrhage 13(9.4%). Fetal complications were birth asphyxia 49(35.5%), neonatal intensive care unit admission 17(12.3%), neonatal death 14(10.1%). The emergency Caesarean section rate was quite high with induction of labour in pregnant women with gestational diabetes. The maternal morbidity as well as fetal morbidity and mortality rate was also high.

  1. Deoiledjatropha seed cake is a useful nutrient for pullulan production

    Directory of Open Access Journals (Sweden)

    Choudhury Anirban

    2012-03-01

    Full Text Available Abstract Background Ever increasing demand for fossil fuels is a major factor for rapid depletion of these non-renewable energy resources, which has enhanced the interest of finding out alternative sources of energy. In recent years jatropha seed oil has been used extensively for production of bio-diesel and has shown significant potential to replace petroleum fuels at least partially. De-oiled jatropha seed cake (DOJSC which comprises of approximately 55 to 65% of the biomass is a byproduct of bio-diesel industry. DOJSC contains toxic components like phorbol esters which restricts its utilization as animal feed. Thus along with the enhancement of biodiesel production from jatropha, there is an associated problem of handling this toxic byproduct. Utilization of DOJSC as a feed stock for production of biochemicals may be an attractive solution to the problem. Pullulan is an industrially important polysaccharide with several potential applications in food, pharmaceuticals and cosmetic industries. However, the major bottleneck for commercial utilization of pullulan is its high cost. A cost effective process for pullulan production may be developed using DOJSC as sole nutrient source which will in turn also help in utilization of the byproduct of bio-diesel industry. Results In the present study, DOJSC has been used as a nutrient for production of pullulan, in place of conventional nutrients like yeast extract and peptone. Process optimization was done in shake flasks, and under optimized conditions (8% DOJSC, 15% dextrose, 28°C temperature, 200 rpm, 5% inoculum, 6.0 pH 83.98 g/L pullulan was obtained. The process was further validated in a 5 L laboratory scale fermenter. Conclusion This is the first report of using DOJSC as nutrient for production of an exopolysaccharide. Successful use of DOJSC as nutrient will help in finding significant application of this toxic byproduct of biodiesel industry. This in turn also have a significant impact on

  2. The Estimation of Gestational Age at Birth in Database Studies.

    Science.gov (United States)

    Eberg, Maria; Platt, Robert W; Filion, Kristian B

    2017-11-01

    Studies on the safety of prenatal medication use require valid estimation of the pregnancy duration. However, gestational age is often incompletely recorded in administrative and clinical databases. Our objective was to compare different approaches to estimating the pregnancy duration. Using data from the Clinical Practice Research Datalink and Hospital Episode Statistics, we examined the following four approaches to estimating missing gestational age: (1) generalized estimating equations for longitudinal data; (2) multiple imputation; (3) estimation based on fetal birth weight and sex; and (4) conventional approaches that assigned a fixed value (39 weeks for all or 39 weeks for full term and 35 weeks for preterm). The gestational age recorded in Hospital Episode Statistics was considered the gold standard. We conducted a simulation study comparing the described approaches in terms of estimated bias and mean square error. A total of 25,929 infants from 22,774 mothers were included in our "gold standard" cohort. The smallest average absolute bias was observed for the generalized estimating equation that included birth weight, while the largest absolute bias occurred when assigning 39-week gestation to all those with missing values. The smallest mean square errors were detected with generalized estimating equations while multiple imputation had the highest mean square errors. The use of generalized estimating equations resulted in the most accurate estimation of missing gestational age when birth weight information was available. In the absence of birth weight, assignment of fixed gestational age based on term/preterm status may be the optimal approach.

  3. Prevalence of gestational diabetes mellitus in Europe: A meta-analysis.

    Science.gov (United States)

    Eades, Claire E; Cameron, Dawn M; Evans, Josie M M

    2017-07-01

    Estimates of the prevalence of gestational diabetes vary widely. It is important to have a clear understanding of the prevalence of this condition to be able to plan interventions and health care provision. This paper describes a meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe. Four electronic databases were systematically searched in May 2016. English language articles reporting gestational diabetes mellitus prevalence using universal screening in general pregnant population samples from developed countries in Europe were included. All papers identified by the search were screened by one author, and then half screened independently by a second author and half by a third author. Data were extracted by one author. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. A total of 3258 abstracts were screened, with 40 studies included in the review. Overall prevalence of gestational diabetes mellitus was 5.4% (3.8-7.8). Maternal age, year of data collection, country, area of Europe, week of gestation at testing, and diagnostic criteria were found to have a significant univariate effect on GDM prevalence, and area, week of gestation at testing and year of data collection remained statistically significant in multivariate analysis. Quality category was significant in multivariate but not univariate analysis. This meta-analysis shows prevalence of GDM that is at the upper end of previous estimates in Europe. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Pregnancy outcome following gestational exposure to azithromycin

    Directory of Open Access Journals (Sweden)

    Woodland C Cindy

    2006-05-01

    Full Text Available Abstract Background Azithromycin is an azalide antibiotic with an extensive range of indications and has become a common treatment option due to its convenient dosing regimen and therapeutic advantages. Human studies addressing gestational use of azithromycin have primarily focused on antibiotic efficacy rather than fetal safety. Our primary objective was to evaluate the possibility of teratogenic risk following gestational exposure to azithromycin. Methods There were 3 groups of pregnant women enrolled in our study: 1 women who took azithromycin. 2 women exposed to non-teratogenic antibiotics for similar indications, and 3 women exposed to non-teratogenic agents. They were matched for gestational age at time of call, maternal age, cigarette and alcohol consumption. Rates of major malformations and other endpoints of interest were compared among the three groups. Results Pregnancy outcome of 123 women in each group was ascertained. There were no statistically significant differences among the three groups in the rates of major malformations; 3.4% (exposed versus 2.3% (disease matched and 3.4% (non teratogen or any other endpoints that were examined. In the azithromycin group, 88 (71.6% women took the drug during the first trimester Conclusion Results suggest that gestational exposure to azithromycin is not associated with an increase in the rate of major malformations above the baseline of 1–3%. Our data adds to previous research showing that macrolide antibiotics, as a group, are generally safe in pregnancy and provides an evidence-based option for health professionals caring for populations with chlamydia.

  5. Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis.

    Science.gov (United States)

    Gong, Li-Li; Liu, He; Liu, Li-Hong

    2016-04-01

    Hypothyroidism disorders and gestational diabetes are among the most common endocrinopathies during pregnancy. We conducted a meta-analysis to investigate whether hypothyroidism in pregnancy is associated with gestational diabetes risk. Published literature from PubMed and EMBASE were searched for eligible publications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a fixed- or random-effects model. Seven articles described the relationship between hypothyroidism and risk of gestational diabetes. This meta-analysis revealed that overt hypothyroidism was associated with an increased risk of gestational diabetes (OR 1.892, 95% CI 1.679-2.132, p hypothyroidism, with the OR of 1.558 (95% CI 1.292-1.877, p hypothyroidism was 1.749 (95% CI 1.586-1.928, p hypothyroidism may be a risk factor for gestational diabetes. Copyright © 2016. Published by Elsevier B.V.

  6. Large for Gestational Age (LGA)

    Science.gov (United States)

    ... mother Other risk factors for having large-for-gestational-age newborns include Maternal obesity Having had previous LGA babies Genetic abnormalities or syndromes (for example, Beckwith-Wiedemann syndrome or Sotos syndrome) Excessive weight gain during pregnancy (the fetus gets more calories as ...

  7. Association between placentome size, measured using transrectal ultrasonography, and gestational age in cattle.

    Science.gov (United States)

    Adeyinka, F D; Laven, R A; Lawrence, K E; van Den Bosch, M; Blankenvoorde, G; Parkinson, T J

    2014-03-01

    The aim of this study was to estimate whether fetal age could be accurately estimated using placentome size. Fifty-eight cows with confirmed conception dates in two herds were used for the study. The length of the long axis and cross-sectional area of placentomes close to the cervix were measured once every 10 days between approximately 60-130 days of gestation and once every 15 days between 130-160 days of gestation. Four to six placentomes were measured using transrectal ultrasonography in each uterine horn. A linear mixed model was used to establish the factors that were significantly associated with log mean placentome length and to create an equation to predict gestational age from mean placentome length. Limits of agreement analysis was then used to evaluate whether the predictions were sufficiently accurate for mean placentome length to be used, in practice, as a method of determining gestational age. Only age of gestation (puterine horn (p=0.048) were found to have a significant effect on log mean placentome length. From the three models used to predict gestational age the one that used log mean placentome length of all placentomes, adjusting for the effect of horn, had the smallest 95% limits of agreement; ±33 days. That is, predicted gestational age had a 95% chance of being between 33 days greater and 33.7 days less than actual age. This is approximately twice that reported in studies using measurement of fetal size. Measurement of placentomes near to the cervix using transrectal ultrasonography was easily achieved. There was a significant association between placentome size and gestational age, but between-cow variation in placentome size and growth resulted in poor agreement between placentome size and gestational age. Although placentomes can be easily visualised during diagnosis of pregnancy using transrectal ultrasonography, mean placentome size should not be used to estimate gestational age.

  8. Placental transfer of 60Co as a function of gestation age

    International Nuclear Information System (INIS)

    Zylicz, E.; Zablotna, R.; Szot, Z.

    1976-01-01

    The transfer of 60 Co from mother to foetus in relation to the time of gestation was examined 24 hrs after injecting 5 μCi of 60 CoCl 2 to the pregnant rat on 15th - 21st day of gestation. The radioactivity of foetuses, placentae as well as liver, kidney and femur of mother was determined. It was found that activity of 60 Co transferred to the foetus body increased with the time of gestation. (author)

  9. Numerical simulations of river discharges, nutrient flux and nutrient dispersal in Jakarta Bay, Indonesia.

    Science.gov (United States)

    van der Wulp, Simon A; Damar, Ario; Ladwig, Norbert; Hesse, Karl-J

    2016-09-30

    The present application of numerical modelling techniques provides an overview of river discharges, nutrient flux and nutrient dispersal in Jakarta Bay. A hydrological model simulated river discharges with a total of 90 to 377m(3)s(-1) entering Jakarta Bay. Daily total nitrogen and total phosphorus loads ranged from 40 to 174tons and 14 to 60tons, respectively. Flow model results indicate that nutrient gradients are subject to turbulent mixing by tides and advective transport through circulation driven by wind, barotropic and baroclinic pressure gradients. The bulk of nutrient loads originate from the Citarum and Cisadane rivers flowing through predominantly rural areas. Despite lower nutrient loads, river discharges from the urban area of Jakarta exhibit the highest impact of nutrient concentrations in the near shore area of Jakarta Bay and show that nutrient concentrations were not only regulated by nutrient loads but were strongly regulated by initial river concentrations and local flow characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Amino acid profiling in the gestational diabetes mellitus

    OpenAIRE

    Rahimi, Najmeh; Razi, Farideh; Nasli-Esfahani, Ensieh; Qorbani, Mostafa; Shirzad, Nooshin; Larijani, Bagher

    2017-01-01

    Background The prevalence of gestational diabetes mellitus (GDM) is increasing globally which is associated with various side effects for mothers and fetus. It seems that metabolomic profiling of the amino acids may be useful in early diagnosis of metabolic diseases. This study aimed to explore the association of the amino acids profiles with GDM. Methods Eighty three pregnant women with gestational age ?25?weeks were randomly selected among pregnant women referred to prenatal care clinic in ...

  11. Depression during gestation in adolescent mothers interferes with neonatal neurobehavior

    Directory of Open Access Journals (Sweden)

    Marina Carvalho de Moraes Barros

    2013-12-01

    Full Text Available Objective: To compare the neurobehavior of neonates born to adolescent mothers with and without depression during gestation. Methods: This prospective cross-sectional study included healthy term neonates born to adolescent mothers with untreated depression during gestation, without exposure to legal or illicit drugs, and compared them with infants born to adolescent mothers without psychiatric disorders. Maternal psychiatric diagnoses were assessed by the Composite International Diagnostic Interview (CIDI 2.1 and neonatal neurobehavior by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS at 24 to 72 hours of life. Neurobehavioral outcomes were analyzed by ANOVA adjusted for confounders. Results: 37 infants born to mothers with depression during gestation were compared to 332 infants born to mothers without psychiatric disorders. Infants of mothers with depression had smaller head circumferences. Significant interactions of maternal depression and male gender, gestational age > 40 weeks, regional anesthesia during delivery, vaginal delivery, and infant head circumference ≥ 34 cm were found. Worse performance was noted in the following neonatal neurobehavioral parameters: arousal, excitability, lethargy, hypotonicity, and signs of stress and abstinence. Conclusion: Infants born to adolescent mothers with depression exhibit some behavioral changes in the first days of life. These changes are associated with infant sex, gestational age, type of anesthesia, mode of delivery, and head circumference.

  12. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta

    2017-01-01

    evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. RESULTS: The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792...

  13. Introduction of microbial nutrients in a nuclear fuel waste disposal vault as a result of excavation and operation activities

    Energy Technology Data Exchange (ETDEWEB)

    Stroes-Gascoyne, S; Gascoyne, M; Onagi, D; Thomas, D A; Hamon, C J; Watson, R; Porth, R J

    1996-08-01

    A nuclear fuel waste disposal vault would not likely be a sterile environment. Bacterial activity would be expected in those areas of the vault conducive to bacterial life, i.e., where effects of heat, moisture content, radiation and compaction would not prevent or severely restrict bacterial life and where suitable and sufficient nutrients would be present. An inventory of bacterial nutrients that would be emplaced `intentionally` with vault materials (fuel waste, waste containers, buffer and backfill materials) has been made previously. This report assesses bacterial nutrients that would be added `inadvertently` to a vault in the form of residues of materials used to excavate and operate a vault. Measurements of blasting material residues in the various water supplies, excavated broken rock (muck) and in cores drilled in old and new tunnel walls were made at AECL`s Underground Research Laboratory. Results show that the largest potential nutrient addition (both carbon and nitrogen) to a vault would result from using untreated excavated broken rock as part of the backfill. (author). 16 refs., 4 tabs., 10 figs.

  14. Introduction of microbial nutrients in a nuclear fuel waste disposal vault as a result of excavation and operation activities

    International Nuclear Information System (INIS)

    Stroes-Gascoyne, S.; Gascoyne, M.; Onagi, D.; Thomas, D.A.; Hamon, C.J.; Watson, R.; Porth, R.J.

    1996-08-01

    A nuclear fuel waste disposal vault would not likely be a sterile environment. Bacterial activity would be expected in those areas of the vault conducive to bacterial life, i.e., where effects of heat, moisture content, radiation and compaction would not prevent or severely restrict bacterial life and where suitable and sufficient nutrients would be present. An inventory of bacterial nutrients that would be emplaced 'intentionally' with vault materials (fuel waste, waste containers, buffer and backfill materials) has been made previously. This report assesses bacterial nutrients that would be added 'inadvertently' to a vault in the form of residues of materials used to excavate and operate a vault. Measurements of blasting material residues in the various water supplies, excavated broken rock (muck) and in cores drilled in old and new tunnel walls were made at AECL's Underground Research Laboratory. Results show that the largest potential nutrient addition (both carbon and nitrogen) to a vault would result from using untreated excavated broken rock as part of the backfill. (author). 16 refs., 4 tabs., 10 figs

  15. Growth of non-Saccharomyces yeasts affects nutrient availability for Saccharomyces cerevisiae during wine fermentation.

    Science.gov (United States)

    Medina, Karina; Boido, Eduardo; Dellacassa, Eduardo; Carrau, Francisco

    2012-07-02

    Yeast produces numerous secondary metabolites during fermentation that impact final wine quality. Although it is widely recognized that growth of diverse non-Saccharomyces (NS) yeast can positively affect flavor complexity during Saccharomyces cerevisiae wine fermentation, the inability to control spontaneous or co-fermentation processes by NS yeast has restricted their use in winemaking. We selected two NS yeasts from our Uruguayan native collection to study NS-S. cerevisiae interactions during wine fermentation. The selected strains of Hanseniaspora vineae and Metschnikowia pulcherrima had different yeast assimilable nitrogen consumption profiles and had different effects on S. cerevisiae fermentation and growth kinetics. Studies in which we varied inoculum size and using either simultaneous or sequential inoculation of NS yeast and S. cerevisiae suggested that competition for nutrients had a significant effect on fermentation kinetics. Sluggish fermentations were more pronounced when S. cerevisiae was inoculated 24h after the initial stage of fermentation with a NS strain compared to co-inoculation. Monitoring strain populations using differential WL nutrient agar medium and fermentation kinetics of mixed cultures allowed for a better understanding of strain interactions and nutrient addition effects. Limitation of nutrient availability for S. cerevisiae was shown to result in stuck fermentations as well as to reduce sensory desirability of the resulting wine. Addition of diammonium phosphate (DAP) and a vitamin mix to a defined medium allowed for a comparison of nutrient competition between strains. Addition of DAP and the vitamin mix was most effective in preventing stuck fermentations. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Declines in Birth weight and Fetal Growth Independent of Gestational Length

    Science.gov (United States)

    Morisaki, Naho; Esplin, M. Sean; Varner, Michael W.; Henry, Erick; Oken, Emily

    2014-01-01

    Objective Birth weight is decreasing in the US and elsewhere, even among term singletons, although trends in most maternal characteristics should contribute to increased birth weight. Some studies have attributed this decline to the simultaneous decrease in gestational length. Methods Using data from Intermountain Healthcare, where a successful initiative reduced the number of early term (37–38 week) elective deliveries, we examined trends in birth weight, small-for-gestational-age (SGA), and large-for-gestational-age (LGA) among 219,694 singleton infants born July 2000 to December 2008 at 37–41 weeks gestation. Results Over the 8.5 years, births through scheduled deliveries at 37–38 weeks decreased (9.4% to 4.4%), but overall scheduled deliveries increased (29% to 34%) and mean gestational age at birth (39.1 weeks) did not change. Mean birth weight (3410g to 3383g) and LGA (9.0% to 7.4%) both decreased, whereas SGA increased (7.5% to 8.2%). In multivariable analyses adjusting for maternal and infant characteristics, birth weight decreased (36g; 95% CI: 31, 42), especially among infants born at 37–38 weeks (40g; 30, 49) or that had medical indications for urgent deliveries (48g; 34, 63). Odds of LGA decreased (0.84; 0.80, 0.88) and odds of SGA increased (1.14; 1.08, 1.20). Conclusion Even in a population where gestation length did not change, birth weight and fetal growth declined. Decrease in not only gestational length but in fetal growth as well is likely to be contributing to the widely observed recent decrease in birth weight. PMID:23262927

  17. Self-management of gestational diabetes among Chinese migrants: A qualitative study.

    Science.gov (United States)

    Wah, Yat Yin Eric; McGill, Margaret; Wong, Jencia; Ross, Glynis P; Harding, Anna-Jane; Krass, Ines

    2018-04-21

    Gestational diabetes mellitus is one of the most common complications of pregnancy. Women with Gestational diabetes are at increased risk of serious health outcomes, such as pre-eclampsia, obstructed labor, and the development of Type 2 diabetes later in life. Chinese migrants, the third largest cultural group in Australia, are more likely to develop Gestational diabetes than Australian-born women. However, to date, Gestational diabetes self-management has not been investigated in this population. To explore the understanding and self-management experiences of Gestational diabetes among Chinese migrants. Data were collected through individual semi-structured face-to-face interviews. Participants were recruited from the antenatal clinic at the Royal Prince Alfred Hospital. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. Although the majority of participants demonstrated a good understanding of Gestational diabetes, some did not understand the principles behind healthcare advice and faced challenges in self-management. Confusion about self-monitoring of blood glucose and fear of insulin were also evident. Participants relied on both formal and informal sources of information. Some had difficulty obtaining adequate support. Cultural influences on self-management included meeting family needs, Chinese diet and use of Chinese medicines. To assist Chinese women with Gestational diabetes to better self-manage their condition, there is a need for clinicians to: (1) provide more effective diabetes education to ensure clear understanding of self-management principles; (2) actively elicit and respond to women's confusion and concerns; (3) provide women with adequate practical support; and (4) develop greater cultural awareness. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  18. Gestational diabetes mellitus in Greenland

    DEFF Research Database (Denmark)

    Pedersen, Michael Lynge; Olesen, Jesper; Jørgensen, M. E.

    2016-01-01

    Background. Within the last 20 years, the prevalence of gestational diabetes mellitus (GDM) has been reported to be increasing worldwide in correlation with ethnic and geographic variations. The actual prevalence of GDM throughout all of Greenland remains unknown. Objective. The aim of this study...

  19. Acculturation and gestational weight gain in a predominantly puerto rican population

    Directory of Open Access Journals (Sweden)

    Tovar Alison

    2012-11-01

    Full Text Available Abstract Background Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. Methods We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952. Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation (measured via a psychological acculturation scale, generation in the US, place of birth and spoken language preference was assessed in early pregnancy. Results Adjusting for age, parity, perceived stress, gestational age, and prepregnancy weight, women who had at least one parent born in Puerto Rico/Dominican Republic (PR/DR and both grandparents born in PR/DR had a significantly higher mean total gestational weight gain (0.9 kg for at least one parent born in PR/DR and 2.2kg for grandparents born in PR/DR and rate of weight gain (0.03 kg/wk for at least one parent born in PR/DR and 0.06 kg/wk for grandparents born in PR/DR vs. women who were of PR/DR born. Similarly, women born in the US had significantly higher mean total gestational weight gain (1.0 kg and rate of weight gain (0.03 kg/wk vs. women who were PR/ DR born. Spoken language preference and psychological acculturation were not significantly associated with total or rate of pregnancy weight gain. Conclusion We found that psychological acculturation was not associated with gestational weight gain while place of birth and higher generation in the US were significantly associated with higher gestational weight gain. We interpret these findings to suggest the potential importance of the

  20. Acculturation and gestational weight gain in a predominantly Puerto Rican population.

    Science.gov (United States)

    Tovar, Alison; Chasan-Taber, Lisa; Bermudez, Odilia I; Hyatt, Raymond R; Must, Aviva

    2012-11-21

    Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952). Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation (measured via a psychological acculturation scale, generation in the US, place of birth and spoken language preference) was assessed in early pregnancy. Adjusting for age, parity, perceived stress, gestational age, and prepregnancy weight, women who had at least one parent born in Puerto Rico/Dominican Republic (PR/DR) and both grandparents born in PR/DR had a significantly higher mean total gestational weight gain (0.9 kg for at least one parent born in PR/DR and 2.2 kg for grandparents born in PR/DR) and rate of weight gain (0.03 kg/wk for at least one parent born in PR/DR and 0.06 kg/wk for grandparents born in PR/DR) vs. women who were of PR/DR born. Similarly, women born in the US had significantly higher mean total gestational weight gain (1.0 kg) and rate of weight gain (0.03 kg/wk) vs. women who were PR/ DR born. Spoken language preference and psychological acculturation were not significantly associated with total or rate of pregnancy weight gain. We found that psychological acculturation was not associated with gestational weight gain while place of birth and higher generation in the US were significantly associated with higher gestational weight gain. We interpret these findings to suggest the potential importance of the US "obesogenic" environment in influencing unhealthy

  1. High dietary fiber during late gestation reduces the rate of stillborn piglets

    DEFF Research Database (Denmark)

    Feyera, Takele; Højgaard, Camilla Kaae; Vinther, Jens

    2017-01-01

    The beneficial effects of dietary fiber in the diet of gestating sows have been thoroughly investigated from behavioral and welfare prospective. However, there is limited information whether dietary fiber is beneficial from a reproductive point of view. Therefore, the present study aimed to inves......The beneficial effects of dietary fiber in the diet of gestating sows have been thoroughly investigated from behavioral and welfare prospective. However, there is limited information whether dietary fiber is beneficial from a reproductive point of view. Therefore, the present study aimed...... assigned to the control and treatment group, respectively. Sows in the control group were fed according to normal feeding strategy of the herd, fed a standard gestation diet until 1 week before expected parturition, fed a transition diet until day 5 of lactation and a standard lactation diet until weaning....... Sows in the treatment group were fed as the control group but part of the gestation diet (from day 102 to 108 of gestation) and part of the transition diet (from day 109 of gestation until farrowing) was replaced by a fiber rich supplement. Thus, 350 and 700 g/d of the supplement replaced part...

  2. Efficacy of probiotic supplement for gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Pan, Jiajia; Pan, Qiangwei; Chen, Yumei; Zhang, Hongping; Zheng, Xiaodong

    2017-09-19

    Probiotic supplement might be beneficial for gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of probiotic supplement in gestational diabetes mellitus. PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of probiotic supplement in gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were fasting serum insulin and fasting plasma glucose. Meta-analysis was performed using the fixed-effect or random-effect model. Six RCTs involving 830 patients were included in the meta-analysis. Overall, compared with control intervention in gestational diabetes mellitus, probiotic supplementation intervention was found to significantly reduce fasting serum insulin (Std. mean difference = -0.95; 95% CI = -1.73 to -0.17; p gestational age (Std. mean difference = 0.07; 95% CI = -0.20-0.34; p = .63), and gestational weight (Std. mean difference = -0.11; 95% CI = -0.38-0.16; p = .43). Compared with control intervention in gestational diabetes mellitus, probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting serum insulin, but had no substantial influence on fasting plasma glucose, gestational age and gestational weight.

  3. Gestational Age at First Antenatal Care Visit in Malawi.

    Science.gov (United States)

    Mkandawire, Paul

    2015-11-01

    This paper examines the gestational age at first antenatal care (ANC) visit and factors associated with timely initiation of ANC in Malawi in a context where maternal and child health services are generally provided for free. Lognormal survival models are applied to Demographic and Health Survey data from a nationally representative sample of women (n = 13,588) of child-bearing age. The findings of this study show that less than 30 % of pregnant women initiate ANC within the World Health Organization recommended gestational timeframe of 16 weeks or earlier. The hazard analysis shows a gradient in the initiation of ANC by maternal education level, with least educated mothers most likely to delay their first ANC visit. However, after adjusting for variables capturing intimate partner violence in the multivariate models, the effect of maternal education attenuated and lost statistical significance. Other significant predictors of gestational age at first ANC include media exposure, perceived distance from health facility, age, and birth order. The findings of the study link domestic violence directly with the gestational age at which mothers initiate ANC, suggesting that gender-based violence may operate through delayed initiation of ANC to undermine maternal and child health outcomes.

  4. Both food restriction and high-fat diet during gestation induce low birth weight and altered physical activity in adult rat offspring: the "Similarities in the Inequalities" model.

    Directory of Open Access Journals (Sweden)

    Fábio da Silva Cunha

    Full Text Available We have previously described a theoretical model in humans, called "Similarities in the Inequalities", in which extremely unequal social backgrounds coexist in a complex scenario promoting similar health outcomes in adulthood. Based on the potential applicability of and to further explore the "similarities in the inequalities" phenomenon, this study used a rat model to investigate the effect of different nutritional backgrounds during gestation on the willingness of offspring to engage in physical activity in adulthood. Sprague-Dawley rats were time mated and randomly allocated to one of three dietary groups: Control (Adlib, receiving standard laboratory chow ad libitum; 50% food restricted (FR, receiving 50% of the ad libitum-fed dam's habitual intake; or high-fat diet (HF, receiving a diet containing 23% fat. The diets were provided from day 10 of pregnancy until weaning. Within 24 hours of birth, pups were cross-fostered to other dams, forming the following groups: Adlib_Adlib, FR_Adlib, and HF_Adlib. Maternal chow consumption and weight gain, and offspring birth weight, growth, physical activity (one week of free exercise in running wheels, abdominal adiposity and biochemical data were evaluated. Western blot was performed to assess D2 receptors in the dorsal striatum. The "similarities in the inequalities" effect was observed on birth weight (both FR and HF groups were smaller than the Adlib group at birth and physical activity (both FR_Adlib and HF_Adlib groups were different from the Adlib_Adlib group, with less active males and more active females. Our findings contribute to the view that health inequalities in fetal life may program the health outcomes manifested in offspring adult life (such as altered physical activity and metabolic parameters, probably through different biological mechanisms.

  5. PP038. Are women with gestational hypertension or preeclampsia at an increased long term risk of kidney function impairment?

    Science.gov (United States)

    Bhattacharya, S; Ayansina, D; Black, C; Hall, S; Afolabi, E; Millar, C

    2012-07-01

    Preeclampsia is known to cause impairment of kidney function in pregnancy, which manifests as proteinuria. Previous studies have found an association between preeclampsia and kidney disease but were restricted in their numbers or had a short follow up time. To assess the long term effects of hypertensive disorders of pregnancy on kidney function in later life. From the Aberdeen maternity and neonatal databank (AMND), we identified the first singleton pregnancy of all women with date of birth on or before 30th June 1969. These women were linked by means of their identifying information to the local renal biochemistry database (GRBD). GRBD captures all kidney function tests from primary and secondary care in the health region. A cohort study design was used to assess the odds ratios with 95% confidence intervals for chronic kidney disease stage 1-5 (predefined based on internationally accepted KDOQI definition) occurring at least 1year following delivery. Those with gestational hypertension and preeclampsia were compared to normotensive women using multivariate logistic regression to adjust for potential confounders. A total of 14675 women who had been linked to the RBD and had complete information regarding age, socio-economic class, smoking category, and body mass index (BMI) were included in a multivariate model. The unadjusted odds ratio (95% confidence interval) of having chronic kidney disease (according to previously stated definition) in preeclamptic women was 2.04 (1.53,2.71) and that in women with gestational hypertension was 1.37 (1.15,1.65), while the adjusted odds ratio (95% confidence interval) of having chronic kidney disease was 1.93 (1.44,2.57) and 1.36 (1.13,1.63) in preeclamptic women and women with gestational hypertension respectively compared to women who were normotensive in their first pregnancy. Women who had gestational hypertension or preeclampsia in their first pregnancy had a higher risk of impairment of renal function compared to women

  6. Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

    Science.gov (United States)

    Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

    2013-01-01

    Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 pnutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

  7. Changing Survival Rate of Infants Born Before 26 Gestational Weeks

    Science.gov (United States)

    Rahman, Asad; Abdellatif, Mohamed; Sharef, Sharef W.; Fazalullah, Muhammad; Al-Senaidi, Khalfan; Khan, Ashfaq A.; Ahmad, Masood; Kripail, Mathew; Abuanza, Mazen; Bataclan, Flordeliza

    2015-01-01

    Objectives: This study aimed to evaluate the changing survival rate and morbidities among infants born before 26 gestational weeks at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective study assessed the mortality and morbidities of all premature infants born alive at 23–26 gestational weeks at SQUH between June 2006 and May 2013. Infants referred to SQUH within 72 hours of birth during this period were also included. Electronic records were reviewed for gestational age, gender, birth weight, maternal age, mode and place of delivery, antenatal steroid administration, morbidity and outcome. The survival rate was calculated and findings were then compared with those of a previous study conducted in the same hospital from 1991 to 1998. Rates of major morbidities were also calculated. Results: A total of 81 infants between 23–26 gestational weeks were admitted to the neonatal unit during the study period. Of these, 58.0% were male and 42.0% were female. Median gestational age was 25 weeks and mean birth weight was 770 ± 150 g. Of the 81 infants, 49 survived. The overall survival rate was 60.5% compared to 41% reported in the previous study. Respiratory distress syndrome (100.0%), retinopathy of prematurity (51.9%), bronchopulmonary dysplasia (34.6%), intraventricular haemorrhage (30.9%) and patent ductus arteriosus (28.4%) were the most common morbidities. Conclusion: The overall survival rate of infants between 23–26 gestational weeks during the study period had significantly improved in comparison to that found at the same hospital from 1991 to 1998. There is a need for the long-term neurodevelopmental follow-up of premature infants. PMID:26357555

  8. Brain development, intelligence and cognitive outcome in children born small for gestational age.

    Science.gov (United States)

    de Bie, H M A; Oostrom, K J; Delemarre-van de Waal, H A

    2010-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with increased neonatal morbidity and mortality as well as short stature, cardiovascular disease, insulin resistance, diabetes mellitus type 2, dyslipidemia and end-stage renal disease in adulthood. In addition, SGA children have decreased levels of intelligence and cognition, although the effects are mostly subtle. The overall outcome of each child is the result of a complex interaction between intrauterine and extrauterine factors. Animal and human studies show structural alterations in the brains of individuals with IUGR/SGA. The presence of growth hormone (GH) receptors in the brain implies that the brain is also a target for GH. Exogenous GH theoretically has the ability to act on the brain. This is exemplified by the effects of GH on cognition in GH-deficient adults. In SGA children, data on the effect of exogenous GH on intelligence and cognition are scant and contradictory.

  9. Birth weight centiles by gestational age for twins born in south India.

    Science.gov (United States)

    Premkumar, Prasanna; Antonisamy, Belavendra; Mathews, Jiji; Benjamin, Santhosh; Regi, Annie; Jose, Ruby; Kuruvilla, Anil; Mathai, Mathews

    2016-03-24

    Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Of 1530 twin pregnancies delivered during the study period (1991-2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.

  10. Correction of systematic bias in ultrasound dating in studies of small-for-gestational-age birth: an example from the Iowa Health in Pregnancy Study.

    Science.gov (United States)

    Harland, Karisa K; Saftlas, Audrey F; Wallis, Anne B; Yankowitz, Jerome; Triche, Elizabeth W; Zimmerman, M Bridget

    2012-09-01

    The authors examined whether early ultrasound dating (≤20 weeks) of gestational age (GA) in small-for-gestational-age (SGA) fetuses may underestimate gestational duration and therefore the incidence of SGA birth. Within a population-based case-control study (May 2002-June 2005) of Iowa SGA births and preterm deliveries identified from birth records (n = 2,709), the authors illustrate a novel methodological approach with which to assess and correct for systematic underestimation of GA by early ultrasound in women with suspected SGA fetuses. After restricting the analysis to subjects with first-trimester prenatal care, a nonmissing date of the last menstrual period (LMP), and early ultrasound (n = 1,135), SGA subjects' ultrasound GA was 5.5 days less than their LMP GA, on average. Multivariable linear regression was conducted to determine the extent to which ultrasound GA predicted LMP dating and to correct for systematic misclassification that results after applying standard guidelines to adjudicate differences in these measures. In the unadjusted model, SGA subjects required a correction of +1.5 weeks to the ultrasound estimate. With adjustment for maternal age, smoking, and first-trimester vaginal bleeding, standard guidelines for adjudicating differences in ultrasound and LMP dating underestimated SGA birth by 12.9% and overestimated preterm delivery by 8.7%. This methodological approach can be applied by researchers using different study populations in similar research contexts.

  11. Serum YKL-40 and gestational diabetes - an observational cohort study

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J

    2016-01-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...... records. Sixty-eight women (5.8%) developed GDM. Serum YKL-40 increased from gestational age (GA) 12 weeks and the following weeks in the women who developed GDM and was independent of BMI, parity, and maternal age (OR = 2.69, 95% CI: 1.45-5.00, p = 0.002). No association was found between serum YKL-40...

  12. Predictive factors for birth weight of newborns of mothers with gestational diabetes mellitus.

    Science.gov (United States)

    Silva, Sara de Oliveira Corrêa da; Saunders, Cláudia; Zajdenverg, Lenita; Moreira, Luciana Novaes; Heidelmann, Sonaly Petronilho; Pereira, Ariane Cristine Dos Santos; Padilha, Patricia de Carvalho

    2018-04-01

    To evaluate the predictive factors of birth weight (BW) of newborns of women with gestational diabetes mellitus (GDM). A cross-sectional study was performed among pregnant women with GDM treated in a public maternity unit, Brazil. We selected 283 pregnant women, with nutritional follow-up initiated till the 28th gestational week, singleton pregnancy, without chronic diseases and with birth weight information of the newborns. The predictive factors of BW were identified by multivariate linear regression. Mean maternal age was 31.2 ± 5.8 years; 64.4% were non-white; 70.1% were pre-gestational overweight or obese. Mean BW was 3234.3 ± 478.8 g. An increase of 1 kg of weight in the first and third trimesters increased BW by 21 g (p = 0.01) and 27 g (p = 0.03), respectively. Similarly, the other predictive factors of BW were pre-gestational body mass index (β = 17.16, p = 0.02) and postprandial plasma glucose in the third trimester (β = 4.14, p = 0.008), in the model adjusted by gestational age at delivery (β = 194.68, p gestational age at birth, and maternal pre-gestational and gestational anthropometric characteristics. Maternal glycaemic levels may also influence BW. The results may contribute to a review of prenatal routines for pregnant women with GDM. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Gender-specific heart rate dynamics in severe intrauterine growth-restricted fetuses.

    Science.gov (United States)

    Gonçalves, Hernâni; Bernardes, João; Ayres-de-Campos, Diogo

    2013-06-01

    Management of intrauterine growth restriction (IUGR) remains a major issue in perinatology. The objective of this paper was the assessment of gender-specific fetal heart rate (FHR) dynamics as a diagnostic tool in severe IUGR. FHR was analyzed in the antepartum period in 15 severe IUGR fetuses and 18 controls, matched for gestational age, in relation to fetal gender. Linear and entropy methods, such as mean FHR (mFHR), low (LF), high (HF) and movement frequency (MF), approximate, sample and multiscale entropy. Sensitivities and specificities were estimated using Fisher linear discriminant analysis and the leave-one-out method. Overall, IUGR fetuses presented significantly lower mFHR and entropy compared with controls. However, gender-specific analysis showed that significantly lower mFHR was only evident in IUGR males and lower entropy in IUGR females. In addition, lower LF/(MF+HF) was patent in IUGR females compared with controls, but not in males. Rather high sensitivities and specificities were achieved in the detection of the FHR recordings related with IUGR male fetuses, when gender-specific analysis was performed at gestational ages less than 34 weeks. Severe IUGR fetuses present gender-specific linear and entropy FHR changes, compared with controls, characterized by a significantly lower entropy and sympathetic-vagal balance in females than in males. These findings need to be considered in order to achieve better diagnostic results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Transnational gestational surrogacy: does it have to be exploitative?

    Science.gov (United States)

    Kirby, Jeffrey

    2014-01-01

    This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings (such as rural, western India), is exploitative of surrogate women. Arising out of consideration of the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative.

  15. Maternal Exposure to Bisphenol-A and Fetal Growth Restriction: A Case-Referent Study

    Science.gov (United States)

    Burstyn, Igor; Martin, Jonathan W.; Beesoon, Sanjay; Bamforth, Fiona; Li, Qiaozhi; Yasui, Yutaka; Cherry, Nicola M.

    2013-01-01

    We conducted a case-referent study of the effect of exposure to bisphenol-A on fetal growth in utero in full-term, live-born singletons in Alberta, Canada. Newborns bisphenol-A was estimated from maternal serum collected at 15–16 weeks of gestation. We pooled sera across subjects for exposure assessment, stratified on case-referent status and sex. Individual 1:1 matching was maintained in assembling 69 case and 69 referent pools created from 550 case-referent pairs. Matched pools had an equal number of aliquots from individual women. We used an analytical strategy conditioning on matched set and total pool-level values of covariates to estimate individual-level effects. Pools of cases and referents had identical geometric mean bisphenol-A concentrations (0.5 ng/mL) and similar geometric standard deviations (2.3–2.5). Mean difference in concentration between matched pools was 0 ng/mL, standard deviation: 1 ng/mL. Stratification by sex and control for confounding did not suggest bisphenol-A increased fetal growth restriction. Our analysis does not provide evidence to support the hypothesis that bisphenol-A contributes to fetal growth restriction in full-term singletons. PMID:24336026

  16. Serum adiponectin levels in gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Abhijit Bhograj

    2016-01-01

    Full Text Available Introduction: Gestational diabetes mellitus (GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.[1] Pregnancy is a unique situation in which there is a physiological temporary increase in insulin resistance (IR. The mechanisms responsible for the gestational-induced IR are not completely understood. The current study was undertaken to compare adiponectin levels during 24–28 weeks period of gestation in drug-naive newly diagnosed GDM women with a cohort of normoglycemic pregnant women. Subjects and Methods: A total of 47 pregnant women in the age group of 18–40 years were included in this cross-sectional study, of which 13 were GDM cases and 34 were normoglycemic controls. Serum adiponectin level was analyzed by enzyme-linked immunosorbent assay. Results: The mean adiponectin level was 16.92 ng/ml (standard deviation [SD] = 2.78 and 19.38 ng/ml (SD = 2.71 in case and control groups, respectively, and the difference was found to be statistically significant (P = 0.008. Conclusion: Our study demonstrated decreased serum adiponectin levels in women with GDM when compared with age- and body mass index-matched euglycemic pregnant women.

  17. Birth Weight, Gestational Age, and Infantile Colic

    DEFF Research Database (Denmark)

    Milidou, Ioanna; Søndregaard, Charlotte; Jensen, Morten Søndergaard

    Background Infantile colic is a condition of unknown origin characterized by paroxysms of crying during the first months of life. A few studies have identified low birth weight (BW) as a risk factor among infants born at term, while the association between gestational age (GA) and infantile colic...... interviews of the mother during pregnancy and post partum. Adjusted odds ratios (OR) with 95% confidence intervals (in brackets) are presented. Infantile colic was defined as crying for more than three hours per day and for more than three days per week (modified Wessel’s criteria). Results A total of 4...... with GA gestational weeks 32-40. Finally, after adjusting for GA...

  18. Analysis of national representative opinion surveys concerning gestational surrogacy in Japan.

    Science.gov (United States)

    Suzuki, Kohta; Hoshi, Kazuhiko; Minai, Junko; Yanaihara, Takumi; Takeda, Yasuhisa; Yamagata, Zentaro

    2006-05-01

    Although gestational surrogacy offers several advantages, this procedure has given rise to some ethical and legal issues. We aimed to clarify the factors affecting the attitude of the Japanese toward gestational surrogacy. Cross-sectional study. Nationwide opinion surveys concerning assisted reproductive technologies (ART) were carried out in 1999 and 2003. Participants included 2568 and 3647 people from the general public surveyed in 1999 and 2003, respectively (1564 people received only the questionnaire, and 2083 people received a questionnaire and brochure about ART). Multivariate-adjusted odds ratio and 95% confidence interval from logistic regression models for factors affecting the attitude toward gestational surrogacy. In both surveys, approximately half of respondents approved of gestational surrogacy; 20-30% disapproved of the procedure. People with high socioeconomic status clearly expressed their opinion on this issue. A liberal attitude toward gender role promoted approval of gestational surrogacy; a liberal attitude toward family had the opposite effect. Our findings suggest that socioeconomic status affects people's expression of their opinion regarding this issue, while attitudes toward this procedure were influenced by individual belief. Considering socioeconomic status and diversity of individual belief is required for further discussion on this topic.

  19. Hidden from view: Canadian gestational surrogacy practices and outcomes, 2001-2012.

    Science.gov (United States)

    White, Pamela M

    2016-05-01

    This paper raises some troubling questions about the fertility treatments provided to Canadian gestational surrogates, women not genetically related to the child that they carry. Using information published between 2003 and 2012 by Canada's Assisted Reproduction Registry, the paper traces the growing incidence of births to gestational surrogates. The transfer of more than one embryo increases the chance of pregnancy and the incidence of multiple births, and while the incidence of multiple births has declined overall since 2010, gestational surrogates consistently experience a higher proportion of multiple births and experienced higher levels of multiple embryo transfers. In 2012, just 26% of gestational surrogates received a single embryo transfer compared to 47% of other in vitro fertilisation (IVF) patients. The paper suggests that renewed attention needs to be paid to the counselling provided to gestational surrogates and treatment consenting mechanisms used by IVF clinics and that review of the 2007 Canadian Medical Association surrogate treatment guidelines is warranted. Finally, the paper describes the difficulties in obtaining accurate data about Canadian assisted reproductive medicine. Without good data, it becomes far more difficult to identify the possibility of potentially harmful practices. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Nutrient synchrony in preruminant calves

    NARCIS (Netherlands)

    Borne, van den J.J.G.C.

    2006-01-01

    In animal nutrition, the nutrient composition of the daily feed supply is composed to match the nutrient requirements for the desired performance. The time of nutrient availability within a day is usually considered not to affect the fate of nutrients. The aim of this thesis was to evaluate effects

  1. Human immune cells' behavior and survival under bioenergetically restricted conditions in an in vitro fracture hematoma model

    Science.gov (United States)

    Hoff, Paula; Maschmeyer, Patrick; Gaber, Timo; Schütze, Tabea; Raue, Tobias; Schmidt-Bleek, Katharina; Dziurla, René; Schellmann, Saskia; Lohanatha, Ferenz Leonard; Röhner, Eric; Ode, Andrea; Burmester, Gerd-Rüdiger; Duda, Georg N; Perka, Carsten; Buttgereit, Frank

    2013-01-01

    The initial inflammatory phase of bone fracture healing represents a critical step for the outcome of the healing process. However, both the mechanisms initiating this inflammatory phase and the function of immune cells present at the fracture site are poorly understood. In order to study the early events within a fracture hematoma, we established an in vitro fracture hematoma model: we cultured hematomas forming during an osteotomy (artificial bone fracture) of the femur during total hip arthroplasty (THA) in vitro under bioenergetically controlled conditions. This model allowed us to monitor immune cell populations, cell survival and cytokine expression during the early phase following a fracture. Moreover, this model enabled us to change the bioenergetical conditions in order to mimic the in vivo situation, which is assumed to be characterized by hypoxia and restricted amounts of nutrients. Using this model, we found that immune cells adapt to hypoxia via the expression of angiogenic factors, chemoattractants and pro-inflammatory molecules. In addition, combined restriction of oxygen and nutrient supply enhanced the selective survival of lymphocytes in comparison with that of myeloid derived cells (i.e., neutrophils). Of note, non-restricted bioenergetical conditions did not show any similar effects regarding cytokine expression and/or different survival rates of immune cell subsets. In conclusion, we found that the bioenergetical conditions are among the crucial factors inducing the initial inflammatory phase of fracture healing and are thus a critical step for influencing survival and function of immune cells in the early fracture hematoma. PMID:23396474

  2. The Long-Term Effects of Prematurity and Intrauterine Growth Restriction on Cardiovascular, Renal, and Metabolic Function

    Directory of Open Access Journals (Sweden)

    Patricia Y. L. Chan

    2010-01-01

    Full Text Available Objective. To determine relative influences of intrauterine growth restriction (IUGR and preterm birth on risks of cardiovascular, renal, or metabolic dysfunction in adolescent children. Study Design. Retrospective cohort study. 71 periadolescent children were classified into four groups: premature small for gestational age (SGA, premature appropriate for gestational age (AGA, term SGA, and term AGA. Outcome Measures. Systolic blood pressure (SBP, augmentation index (Al, glomerular filtration rate (GFR following protein load; plasma glucose and serum insulin levels. Results. SGA had higher SBP (average 4.6 mmHg and lower GFR following protein load (average 28.5 mL/min/1.73 m2 than AGA. There was no effect of prematurity on SBP (P=.4 or GFR (P=.9. Both prematurity and SGA were associated with higher AI (average 9.7% and higher serum insulin levels 2 hr after glucose load (average 15.5 mIU/L than all other groups. Conclusion. IUGR is a more significant risk factor than preterm birth for later systolic hypertension and renal dysfunction. Among children born preterm, those who are also SGA are at increased risk of arterial stiffness and metabolic dysfunction.

  3. [Multiple gestation epidemiology--15 years survey].

    Science.gov (United States)

    Rodrigues, Carla T; Branco, Miguel R; Ferreira, Isabel D; Nordeste, Ana; Fonseca, Margarida; Taborda, Adelaide; Silva, Isabel S; Almeida, Maria do Céu

    2005-01-01

    Between January of 1987 and December of 2001 were born 1243 twins related to 609 multiple pregnancies, in Maternidade Bissaya-Barreto. Data were grouped in periods of three years and several parameters were studied. The rate of multiple gestation has increased probably due to the contribution of the assisted conception techniques, and to the increase of the number of multiple fetal pregnancies (two or more) and to the increase of the mother age. These more frequent obstetric problems were preterm birth, gestational hypertension and abnormal sonographic data of fetal growth. The average age of delivery was 34 weeks and the birth weight has decreased. The most important factors for neonatal morbidity were hyaline membranous disease, intraventricular haemorrhage and the twin-twin transfusion syndrome. The neonatal mortality decreased in the last studied period.

  4. Exposure to Folate Receptor Alpha Antibodies during Gestation and Weaning Leads to Severe Behavioral Deficits in Rats: A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Jeffrey M Sequeira

    Full Text Available The central nervous system continues to develop during gestation and after birth, and folate is an essential nutrient in this process. Folate deficiency and folate receptor alpha autoantibodies (FRα-AuAb have been associated with pregnancy-related complications and neurodevelopmental disorders. In this pilot study, we investigated the effect of exposure to FRα antibodies (Ab during gestation (GST, the pre-weaning (PRW, and the post weaning (POW periods on learning and behavior in adulthood in a rat model. In the open field test and novel object recognition task, which examine locomotor activity and anxiety-like behavior, deficits in rats exposed to Ab during gestation and pre-weaning (GST+PRW included more time spent in the periphery or corner areas, less time in the central area, frequent self-grooming akin to stereotypy, and longer time to explore a novel object compared to a control group; these are all indicative of increased levels of anxiety. In the place avoidance tasks that assess learning and spatial memory formation, only 30% of GST+PRW rats were able to learn the passive place avoidance task. None of these rats learned the active place avoidance task indicating severe learning deficits and cognitive impairment. Similar but less severe deficits were observed in rats exposed to Ab during GST alone or only during the PRW period, suggesting the extreme sensitivity of the fetal as well as the neonatal rat brain to the deleterious effects of exposure to Ab during this period. Behavioral deficits were not seen in rats exposed to antibody post weaning. These observations have implications in the pathology of FRα-AuAb associated with neural tube defect pregnancy, preterm birth and neurodevelopmental disorders including autism.

  5. Drugs Approved for Gestational Trophoblastic Disease

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for gestational trophoblastic disease. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  6. Hysteroscopic Differences in the Gestational Sac in Asymptomatic Blighted Ovum and Viable Pregnancy at Early Gestation

    Directory of Open Access Journals (Sweden)

    Fu-Tsai Kung

    2005-12-01

    Conclusions: The anatomic alterations of the gestational sac reflect impending sac necrosis and abortion in early-stage pregnancy loss. There were no morphologic differences between the two groups in the pattern of capillary distribution on the endometrium or the implantation base.

  7. Energy metabolism and nutrient oxidation in the pregnant mink (Mustela vison) as a model for other carnivores.

    Science.gov (United States)

    Tauson, A H; Elnif, J; Hansen, N E

    1994-12-01

    The mink is a strict carnivore and a seasonal breeder, which may be used as an experimental model for other carnivores. The present investigation comprised a total of 44 balance experiments, each including a 24-h measurement of heat production by indirect calorimetry, carried out from mating until close to parturition. For observations with a nonprotein respiratory quotient between 0.7 and 1.0 (n = 42), quantitative oxidation of nutrients was calculated. The weight gain of the uterus during pregnancy was studied in 41 females killed either before mating, before implantation, after implantation or in mid or late true gestation, and energy retention was calculated. Heat production did not increase with advancing stage of gestation. Mean energy retention was low and in some individuals with repeated measurements even negative, indicating that part of the energy requirement for pregnancy may be supplied by mobilization of body reserves. This was reflected by a high level (42%) of fat oxidation in relation to total heat production. Protein oxidation accounted for 38% of heat production. The weight gain of the uterus during pregnancy could be described by logarithmic functions. Energy deposition in fetal tissue was low and only averaged approximately 350 kJ 47 d after mating.

  8. Resting-state oscillatory activity in children born small for gestational age: a magnetoencephalographic study

    Directory of Open Access Journals (Sweden)

    Maria eBoersma

    2013-09-01

    Full Text Available Growth restriction in utero during a period that is critical for normal growth of the brain, has previously been associated with deviations in cognitive abilities and brain anatomical and functional changes. We measured magnetoencephalography (MEG in 4-7 year old children to test if children born small for gestational age (SGA show deviations in resting-state brain oscillatory activity. Children born SGA children with postnatally spontaneous catch-up growth (SGA+; 6 boys, 7 girls; mean age 6.3 y (SD=0.9 and children born appropriate for gestational age (AGA; 7 boys, 3 girls; mean age 6.0 y (SD=1.2 participated in a resting-state MEG study. We calculated absolute and relative power spectra and used nonparametric statistics to test for group differences. SGA+ and AGA born children showed no significant differences in absolute and relative power except for reduced absolute gamma band power in SGA children. At time of MEG investigation, SGA+ children showed was significantly lower head circumference (HC and a trend toward lower IQ, however there was no association of HC or IQ with absolute or relative power. Except for reduced absolute gamma band power, our findings suggest normal brain activity patterns at school age in a group of children born SGA in which spontaneous catch-up growth of bodily length after birth occurred. Although previous findings suggest that being born SGA alters brain oscillatory activity early in neonatal life, we show that these neonatal alterations do not persist at early school age when spontaneous postnatal catch-up growth occurs after birth.

  9. Gene expression of placental hormones regulating energy balance in small for gestational age neonates.

    Science.gov (United States)

    Struwe, Ellen; Berzl, Gabriele M; Schild, Ralf L; Dötsch, Jörg

    2009-01-01

    Fetal growth restriction is associated with an increased risk for metabolic and cardiovascular disease in later life. To further elucidate mechanisms that might be involved in the process of prenatal programming, we measured the adipokines leptin, resistin, and adiponectin and the GH-releasing hormone ghrelin in the placenta of small for gestational age (SGA) neonates. The control group included 24 placentas of appropriate for gestational age (AGA) newborns, in the study group were 16 placentas of SGA neonates. Gene expression of leptin, resistin, adiponectin, and ghrelin was examined. For hormones showing alterations in gene regulation placental protein expression was measured by Western blot. Placental mRNA expression of leptin was significantly increased in SGA placentas (p=0.0035, related to beta-actin). Protein concentration was increased, as well. There were no differences in placental resistin, adiponectin, or ghrelin gene expressions between SGA neonates and controls. Leptin was the only hormone to demonstrate a significant inverse correlation with birth weight (r=-0.44, p=0.01). Adiponectin correlated significantly with leptin (r=0.53, p=0.0023) and ghrelin (r=0.50, p=0.0045). Placental leptin gene expression and protein concentration showed the expected increase in the SGA group. Leptin was inversely correlated with birth weight. Positive correlation of adiponectin with leptin and ghrelin expression suggests an interaction between these hormones in the placenta. However, the unchanged expression of resistin, adiponectin, and ghrelin in SGA placentas and the absence of correlation with birth weight cast doubt whether these hormones produced in the placenta play a key role in fetal programming.

  10. High Gestational Folic Acid Supplementation Alters Expression of Imprinted and Candidate Autism Susceptibility Genes in a sex-Specific Manner in Mouse Offspring.

    Science.gov (United States)

    Barua, Subit; Kuizon, Salomon; Brown, W Ted; Junaid, Mohammed A

    2016-02-01

    Maternal nutrients play critical roles in modulating epigenetic events and exert long-term influences on the progeny's health. Folic acid (FA) supplementation during pregnancy has decreased the incidence of neural tube defects in newborns, but the influence of high doses of maternal FA supplementation on infants' brain development is unclear. The present study was aimed at investigating the effects of a high dose of gestational FA on the expression of genes in the cerebral hemispheres (CHs) of 1-day-old pups. One week prior to mating and throughout the entire period of gestation, female C57BL/6J mice were fed a diet, containing FA at either 2 mg/kg (control diet (CD)) or 20 mg/kg (high maternal folic acid (HMFA)). At postnatal day 1, pups from different dams were sacrificed and CH tissues were collected. Quantitative RT-PCR and Western blot analysis confirmed sex-specific alterations in the expression of several genes that modulate various cellular functions (P < 0.05) in pups from the HMFA group. Genomic DNA methylation analysis showed no difference in the level of overall methylation in pups from the HMFA group. These findings demonstrate that HMFA supplementation alters offsprings' CH gene expression in a sex-specific manner. These changes may influence infants' brain development.

  11. Pregnancy to postpartum transition of serum metabolites in women with gestational diabetes

    OpenAIRE

    Chorell, Elin; Hall, Ulrika Andersson; Gustavsson, Carolina; Berntorp, Kerstin; Puhkala, Jatta; Luoto, Riitta; Olsson, Tommy; Holmäng, Agneta

    2017-01-01

    Context Gestational diabetes is commonly linked to development of type 2 diabetes mellitus (T2DM). There is a need to characterize metabolic changes associated with gestational diabetes in order to find novel biomarkers for T2DM. Objective To find potential pathophysiological mechanisms and markers for progression from gestational diabetes mellitus to T2DM by studying the metabolic transition from pregnancy to postpartum. Design The metabolic transition profile from pregnancy to postpartum wa...

  12. Effect of radiation on gestation periods in dams of Segment III beagles

    International Nuclear Information System (INIS)

    Angleton, G.M.; Lee, A.C.

    1981-01-01

    The lengths of the gestation periods for bitches whose offspring were potentially assignable to Segment III of the Long-Term Study were not affected by radiation exposure (P = .998). Other factors were found to significantly correlate with the duration of the gestation periods, including the length of the first gestation period (P < .001), size of first litter (P = .175), the average environmental temperature during pregnancy (P = .055) and the size of the second litter

  13. Pre-prepregnancy body mass index and the risk of gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Rudić-Grujić Vesna

    2017-01-01

    Full Text Available Introduction/Objective. Not only do pre-pregnancy overweight or obesity increase the risk of adverse maternal and perinatal outcomes but they also lead to the development of gestational diabetes mellitus. The objective of this study was to estimate the prevalence of pre-pregnancy overweight and obesity in the Republic of Srpska and to investigate its association with hyperglycemia and risk of gestational diabetes mellitus. Methods. A cross-sectional study was carried out during the period from February to October 2012 among 555 pregnant women in gestational period from 24 to 28 weeks. The criterion for exclusion from the sample was previously diagnosed type 1 or type 2 diabetes. Results. Before pregnancy, 20.39% of participants had increased body mass index, while 4.04 % [95% confidence interval (CI; 2.62–6.13] were obese. Gestational diabetes mellitus was diagnosed in 10.91% (95% CI, 8.44–13.98 of them. The increase in body mass index by 1 increased the risk of gestational diabetes mellitus by 1.09 times [odds ratio (OR = 1.09; 95% CI; 1.02–1.16]. Pregnant women who were overweight had a 4.88 times greater risk (OR = 4.88; 95% CI, 1.23–29.41 of developing gestational diabetes. Conclusion. Every fifth pregnant woman in this study was overweight or obese before pregnancy. The increase in body mass index by 1 increased the risk of gestational diabetes by 1.09 times (OR = 1.09; 95% CI; 1.02–1.16. Counselling is necessary for overweight and obese women planning pregnancy.

  14. Gestational Weight Gain and Breastfeeding Outcomes in Group Prenatal Care.

    Science.gov (United States)

    Brumley, Jessica; Cain, M Ashley; Stern, Marilyn; Louis, Judette M

    2016-09-01

    This study sought to examine the differences in pregnancy outcomes with a focus on gestational weight gain for women attending group prenatal care compared to standard individual prenatal care. A matched case-control study was conducted including 65 women who chose group care and 130 women who chose standard individual care. Women were matched based on prepregnancy body mass index (BMI) category, eligibility for midwifery care, and age within 5 years. Women choosing group prenatal care and women choosing standard individual care had similar gestational weight gain, birth weight, gestational age at birth, and mode of birth. Women choosing group prenatal care did have a significantly higher rate of exclusive breastfeeding at 6 weeks postpartum (odds ratio [OR], 4.07; 95% confidence interval [CI], 1.81-9.15; P care. Group prenatal care participation resulted in equivalent gestational weight gain as well as pregnancy outcomes as compared to standard individual care. Breastfeeding rates were improved for women choosing group prenatal care. Randomized controlled trials are needed in order to eliminate selection bias. © 2016 by the American College of Nurse-Midwives.

  15. Reduction of Salmonella Shedding by Sows during Gestation in Relation to Its Fecal Microbiome

    Directory of Open Access Journals (Sweden)

    Guillaume Larivière-Gauthier

    2017-11-01

    Full Text Available Pork meat is estimated to be responsible for 10–20% of human salmonellosis cases in Europe. Control strategies at the farm could reduce contamination at the slaughterhouse. One of the targeted sectors of production is maternity, where sows could be Salmonella reservoirs. The aim of this study was to assess the dynamics of shedding of Salmonella in terms of variation in both shedding prevalence and strains excreted during gestation in Quebec’s maternity sector. The evolution of the fecal microbiota of these sows during gestation was also assessed to detect bacterial populations associated with these variations. A total of 73 sows both at the beginning and the end of the gestation were randomly selected and their fecal matter was analyzed. Salmonella detection was conducted using a method that includes two selective enrichment media (MSRV and TBG. Nine isolates per positive samples were collected. Among the 73 sows tested, 27 were shedding Salmonella. Sows in the first third of their gestation shed Salmonella significantly more frequently (21/27 than those in the last third (6/46 (χ2P < 0.05. The shedding status of 19 of the sows that were previously sampled in the first third of their gestation was followed, this time in the last third of their gestation, which confirmed reduction of shedding. Using 16S rRNA gene sequencing and qPCR, significant differences between the fecal flora of sows at the beginning and the end of the gestation, shedding Salmonella or not and with different parity number were detected. Using MaAsLin, multiple OTUs were found to be associated with the time of gestation, the status of Salmonella excretion and parity number. Some of the identified taxa could be linked to the reduction of the shedding of Salmonella at the end of gestation. In this study, we showed that the level of Salmonella shedding was variable during gestation with significantly higher shedding at the beginning rather than at the end of gestation. We

  16. Ovine placental steroid synthesis and metabolism in late gestation.

    Science.gov (United States)

    Reynolds, Lawrence P; Legacki, Erin L; Corbin, C Jo; Caton, Joel S; Vonnahme, Kimberly A; Stanley, Scott; Conley, Alan J

    2018-04-14

    Steroid synthesis is required for pregnancy maintenance and for parturition but comparatively little is known about the major metabolic routes that influence circulating concentrations. Dietary intake changes progesterone and estradiol concentrations in pregnant ewes but whether this reflects placental synthesis is unknown. Progesterone metabolism by 5alpha-reduction is a major metabolic route in other species and can influence the onset of parturition. Therefore, studies were conducted to 1) determine placental enzyme activity, progesterone and estradiol measured by immuno-assay in late gestation ewes on low, moderate and high nutritional planes, 2) to assess the significance of 5alpha-reduction of progesterone in determining progesterone concentrations in late gestation ewes (gestation day 145) given finasteride to inhibit 5alpha-reductase metabolism. In the second experiment, steroid profiles were examined comprehensively in blood and tissues by liquid chromatography tandem mass spectrometry for the first time in this species. Dietary intake altered progesterone and estradiol serum concentrations but without correlated changes in placental 3beta-hydroxysteroid dehydrogenase, 17alpha-hydroxylase/17,20-lyase cytochrome P450 or aromatase activity. 5alpha-reduced pregnane metabolites were identified in ewes at 145 days of gestation, but concentrations were lower than those of progesterone. Finasteride inhibited 5alpha-reduced progesterone metabolism but did not impact serum progesterone concentrations in these ewes. We conclude 1) that diet-induced changes in serum progesterone and estradiol concentrations are not likely a result of altered placental synthesis of sex steroid but most likely by their metabolism, and 2) metabolism by 5α-reduction is not a major determinant of systemic progesterone concentrations in late gestation ewes.

  17. Risk of hearing loss in small for gestational age neonates

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    Melani Rakhmi Mantu

    2011-02-01

    Full Text Available Background Small for gestational age (SGA neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and neuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA infants. Objective To compare hearing loss in SGA and AGA neonates using otoocoustic emission (OAE tests and to study correlations between maternal risk factors and hearing loss in SGA neonates. Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this study. Statistical analysis was done by multivariable logistic-regression. Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE results in the SGA group compared to the AGA group (P<0.001, Z=13.247. For suhjects with OAE 'refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between  those with and without each of the four maternal risk factors studied (P< 0.001. By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR to he 4.34 (95% CI 2.52 to 7.49, P=0.001, meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group. Conclusion SGA neonates had a higher risk of hearing loss than AGA neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to

  18. Risk of hearing loss in small for gestational age neonates

    Directory of Open Access Journals (Sweden)

    Melani Rakhmi Mantu

    2011-01-01

    Full Text Available Background Small for gestational age (SGA neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and ncuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA infants. Objective To compare hearing loss in SGA and AGA neonates using otoacoustic emission (OAE tests and to study correlations between maternal risk factors and hearing loss in SGA neonates. Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this Study. Statistical analysis was done by multivariable logistic-regression. Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE results in the SGA group compared to the AGA group (P<0.001, Z=1.3.247. For subjects with OAE ,refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between those with and without each of the four maternal risk factors studied (P<0.001. By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR to be 4.34 (95% CI 2.52 to'7.49, P = 0.001, meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group. Conclusion SGA neonates had a higher risk of hearing loss than A(3A neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to

  19. The Nutrient Density of Snacks

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    Julie Hess BA

    2017-03-01

    Full Text Available Background: Although Americans receive almost a quarter of their daily energy from snacks, snacking remains a poorly defined and understood eating occasion. However, there is little dietary guidance about choosing snacks. Families, clinicians, and researchers need a comprehensive approach to assessing their nutritional value. Objective: To quantify and compare the nutrient density of commonly consumed snacks by their overall nutrient profiles using the Nutrient-Rich Foods (NRF Index 10.3. Methods: NRF Index scores were calculated for the top 3 selling products (based on 2014 market research data in different snack categories. These NRF scores were averaged to provide an overall nutrient-density score for each category. Results: Based on NRF scores, yogurt (55.3, milk (52.5, and fruit (30.1 emerged as the most nutrient-dense snacks. Ice cream (−4.4, pies and cakes (−11.1, and carbonated soft drinks (−17.2 emerged as the most nutrient-poor snacks. Conclusions: The NRF Index is a useful tool for assessing the overall nutritional value of snacks based on nutrients to limit and nutrients to encourage.

  20. The FL/AC ratio for prediction of shoulder dystocia in women with gestational diabetes.

    Science.gov (United States)

    Duryea, Elaine L; Casey, Brian M; McIntire, Donald D; Twickler, Diane M

    2017-10-01

    To determine if sonographic variables, including fetal femur length to abdominal circumference (FL/AC) ratio, are associated with shoulder dystocia in women with gestational diabetes. This was a retrospective cohort study of women with gestational diabetes who delivered singleton infants at Parkland Hospital from 1997 to 2015. Diagnosis and treatment of gestational diabetes were uniform including sonography at 32-36 weeks. Biometric calculations were evaluated for correlation with shoulder dystocia. During the study period, 6952 women with gestational diabetes underwent a sonogram at a mean gestation of 34.8 ± 1.8 weeks. Of 4183 vaginal deliveries, 66 experienced shoulder dystocia (16/1000). The FL/AC was associated with shoulder dystocia (p dystocia in women with gestational diabetes. Additionally, it is a simple ratio that is independent of the reference used and remains stable, unlike age-adjusted AC and HC/AC ratio.