Reduced maternal serum concentrations of angiopoietin-2 in the first trimester precede intrauterine growth restriction associated with placental insufficiency

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

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Intrauterine Growth Restriction: Cytokine Profiles of Trophoblast Antigen-Stimulated Maternal Lymphocytes

Clinical and Developmental Immunology ◽

10.1155/2012/734865 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 33

Author(s):

Raj Raghupathy ◽

Majedah Al-Azemi ◽

Fawaz Azizieh

Keyword(s):

Inflammatory Cytokines ◽

Peripheral Blood ◽

Intrauterine Growth Restriction ◽

Mononuclear Cells ◽

Normal Pregnancy ◽

Placental Insufficiency ◽

Growth Restriction ◽

Intrauterine Growth ◽

Anti Inflammatory ◽

Ifnγ And Tnfα

Intrauterine growth restriction (IUGR) is an important perinatal syndrome that poses several serious short- and long-term effects. We studied cytokine production by maternal peripheral blood lymphocytes stimulated by trophoblast antigens. 36 women with a diagnosis of IUGR and 22 healthy women with normal fetal growth were inducted. Peripheral blood mononuclear cells were stimulated with trophoblast antigens and levels of the proinflammatory cytokines IL-6, IL-8, IL-12, IL-23, IFNγ, and TNFα and the anti-inflammatory cytokines IL-4, IL-10, and IL-13 were measured in culture supernatants by ELISA. IL-8 was produced at higher levels by blood cells of the IUGR group than normal pregnant women, while IL-13 was produced at lower levels. IL-8, IFNγ, and TNFα were higher in IUGR with placental insufficiency than in normal pregnancy. IL-12 levels were higher and IL-10 levels were lower in IUGR with placental insufficiency than in IUGR without placental insufficiency. We suggest that a stronger pro-inflammatory bias exists in IUGR as compared to normal pregnancy and in IUGR with placental insufficiency when compared to IUGR without placental insufficiency. Several ratios of proinflammatory to anti-inflammatory cytokines also support the existence of an inflammatory bias in IUGR.

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First trimester uterine artery Doppler and subsequent intrauterine growth restriction and preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.09.085 ◽

2004 ◽

Vol 191 (6) ◽

pp. S22

Author(s):

Lorraine Dugoff ◽

John Hobbins ◽

Vincent Faber ◽

Fergal Malone ◽

Michael Belfort ◽

...

Keyword(s):

Preterm Birth ◽

Intrauterine Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Intrauterine Growth

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Consequences in Infants That Were Intrauterine Growth Restricted

Journal of Pregnancy ◽

10.1155/2011/364381 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 44

Author(s):

Erich Cosmi ◽

Tiziana Fanelli ◽

Silvia Visentin ◽

Daniele Trevisanuto ◽

Vincenzo Zanardo

Keyword(s):

Intrauterine Growth Restriction ◽

Placental Insufficiency ◽

Growth Restriction ◽

Growth Potential ◽

Intrauterine Growth ◽

Cardiovascular Abnormalities ◽

Short And Long Term

Intrauterine growth restriction is a condition fetus does not reach its growth potential and associated with perinatal mobility and mortality. Intrauterine growth restriction is caused by placental insufficiency, which determines cardiovascular abnormalities in the fetus. This condition, moreover, should prompt intensive antenatal surveillance of the fetus as well as follow-up of infants that had intrauterine growth restriction as short and long-term sequele should be considered.

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Catecholamines Mediate Multiple Fetal Adaptations during Placental Insufficiency That Contribute to Intrauterine Growth Restriction: Lessons from Hyperthermic Sheep

Journal of Pregnancy ◽

10.1155/2011/740408 ◽

2011 ◽

Vol 2011 ◽

pp. 1-9 ◽

Cited By ~ 28

Author(s):

D. T. Yates ◽

A. S. Green ◽

S. W. Limesand

Keyword(s):

Intrauterine Growth Restriction ◽

Somatic Growth ◽

Placental Insufficiency ◽

Growth Restriction ◽

Postnatal Life ◽

Adaptive Responses ◽

Hepatic Gluconeogenesis ◽

Intrauterine Growth ◽

Metabolic Adaptations ◽

Insulin Dependent

Placental insufficiency (PI) prevents adequate delivery of nutrients to the developing fetus and creates a chronic state of hypoxemia and hypoglycemia. In response, the malnourished fetus develops a series of stress hormone-mediated metabolic adaptations to preserve glucose for vital tissues at the expense of somatic growth. Catecholamines suppress insulin secretion to promote glucose sparing for insulin-independent tissues (brain, nerves) over insulin-dependent tissues (skeletal muscle, liver, and adipose). Likewise, premature induction of hepatic gluconeogenesis helps maintain fetal glucose and appears to be stimulated by both norepinephrine and glucagon. Reduced glucose oxidation rate in PI fetuses creates a surplus of glycolysis-derived lactate that serves as substrate for hepatic gluconeogenesis. These adrenergically influenced adaptive responses promotein uterosurvival but also cause asymmetric intrauterine growth restriction and small-for-gestational-age infants that are at greater risk for serious metabolic disorders throughout postnatal life, including obesity and type II diabetes.

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First trimester uterine artery Doppler abnormalities predict subsequent intrauterine growth restriction

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2005.06.054 ◽

2005 ◽

Vol 193 (3) ◽

pp. 1208-1212 ◽

Cited By ~ 67

Author(s):

Lorraine Dugoff ◽

Anne M. Lynch ◽

Darleen Cioffi-Ragan ◽

John C. Hobbins ◽

Lisa K. Schultz ◽

...

Keyword(s):

Intrauterine Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Intrauterine Growth

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Maternal Serum Endocan Concentration in Pregnancies Complicated by Intrauterine Growth Restriction

Reproductive Sciences ◽

10.1177/1933719118773480 ◽

2018 ◽

Vol 26 (3) ◽

pp. 370-376 ◽

Cited By ~ 1

Author(s):

Agata Szpera-Gozdziewicz ◽

Katarzyna Kosicka ◽

Tomasz Gozdziewicz ◽

Mariola Krzyscin ◽

Przemyslaw Wirstlein ◽

...

Keyword(s):

Intrauterine Growth Restriction ◽

Maternal Serum ◽

Growth Restriction ◽

Intrauterine Growth

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First trimester screening for pre-eclampsia and intrauterine growth restriction using three-dimensional Doppler angiography (SPIRIT): protocol for a multicentre prospective study in nulliparous pregnant women

BMJ Open ◽

10.1136/bmjopen-2020-037751 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037751

Author(s):

Charline Bertholdt ◽

Gabriela Hossu ◽

Claire Banasiak ◽

Marine Beaumont ◽

Olivier Morel

Keyword(s):

Pregnant Women ◽

Intrauterine Growth Restriction ◽

Power Doppler ◽

First Trimester ◽

Growth Restriction ◽

Flow Index ◽

Intrauterine Growth ◽

Uncomplicated Pregnancy ◽

Nulliparous Women ◽

Biomarker Analysis

IntroductionPre-eclampsia (PE) and intrauterine growth restriction (IUGR) are two major pregnancy complications, related to chronic uteroplacental hypoperfusion. Nowadays, there is no screening or diagnostic test for uteroplacental vascularisation deficiency in pregnant women. Since 2004, 3 three-imensional power Doppler (3DPD) angiography has been used for the evaluation of uteroplacental vascularisation and three vascular indices are usually calculated: Vascularisation Index (VI), Flow Index (FI) and vascularisation-FI (VFI). A high intraobserver and interobserver reproducibility and a potential interest for placental function study were reported by our team and others.The main objective of our study is to determine differences in 3DPD indices at first trimester between pregnancies defined at their outcome as uncomplicated pregnancy, PE (mild and severe) and IUGR in nulliparous women.Methods and analysisThis is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 2200 women in a period of 36 months. The nulliparous pregnant women will be recruited during their first trimester consultation (11–13+6 gestation week (GW)).The 3DPD and uterine artery Doppler acquisition will be included in the current routine 11–13+6 GW ultrasound. Also, additional blood samples will be taken for biomarker analysis (PAPP-A and P1GF) and biological collection. Uteroplacental VIs (FI and VFI) will be measured. For each subgroup (uncomplicated pregnancy, PE and IUGR), mean values in 3DPD indices will be computed and compared using a pairwise t test with a Bonferroni correction p value adjustment.Ethics and disseminationThe study was approved by the French Ethics Committee, the Comité de Protection des Personnes SUD MEDITERRANEE IV on 13 February 2018 with reference number 17 12 03. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences.Trial registration numberNCT03342014; Pre-results. PHRCN-16-0567.

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