scholarly journals Analysing cord blood levels of TNF inhibitors to validate the EULAR points to consider for TNF inhibitor use during pregnancy

2021 ◽  
pp. annrheumdis-2021-221036
Author(s):  
Nafise Ghalandari ◽  
Erik Kemper ◽  
Ineke (Hubertina) Crijns ◽  
Gertjan Wolbink ◽  
Theo Rispens ◽  
...  
Keyword(s):  
Cord Blood ◽  
Concentration Ratio ◽  
Placental Transfer ◽  
Certolizumab Pegol ◽  
Maternal Blood ◽  
Blood Levels ◽  
Tnf Inhibitor ◽  
Blood Samples ◽  
Time Points ◽  
Median Concentration

BackgroundTo minimise placental transfer of tumour necrosis factor inhibitors (TNFi), the European League Against Rheumatism (EULAR) created points to consider (PtC) for the use of TNFi during pregnancy. We are the first to validate the EULAR-PtC by analysing TNFi concentrations in cord blood.MethodsPatients were derived from the Preconceptional Counselling in Active Rheumatoid Arthritis Study. TNFi was stopped at the time points recommended by the EULAR. Maternal blood and cord blood were collected and analysed for the concentration of TNFi.Results111 patients were eligible for the analysis. Median stop time points were gestational age (GA) 37.0 weeks for certolizumab pegol, GA 25.0 weeks for etanercept, GA 19.0 weeks for adalimumab and GA 18.4 weeks for infliximab. Certolizumab pegol (n=68) was detectable in 5.9% of cord blood samples, with a median concentration of 0.3 µg/mL (IQR: 0.2–1.3) and a median cord/maternal concentration ratio of 0.010. Etanercept (n=30) was not detected in any cord blood samples. Adalimumab (n=25) was detectable in 48.0% of cord blood samples, with a median concentration of 0.5 µg/mL (IQR: 0.2–0.7) and a median concentration ratio of 0.062 (IQR: 0.018–0.15). Infliximab (n=14) was detectable in 57.1% of cord blood samples, with a median concentration of 0.4 µg/mL (IQR: 0.1–1.2) and a median concentration ratio of 0.012 (IQR: 0.006–0.081).ConclusionCompliance with the EULAR-PtC results in absence or low levels of TNFi in cord blood.

Lessons From the E-Ferol Tragedy

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 503-506
Author(s):  
William F. Balistreri ◽  
Michael K. Farrell ◽  
Kevin E. Bove
Keyword(s):  
Vitamin E ◽  
Placental Transfer ◽  
Serum Vitamin ◽  
Maternal Blood ◽  
Blood Levels ◽  
Antioxidant Vitamin ◽  
Low Birth Weight Infants ◽  
Term Infants ◽  
Naturally Occurring ◽  
Supplemental Vitamin

"Those who cannot remember the past are condemned to repeat it."—G. Sabtatana Several factors combined to suggest that supplemental vitamin E should be administered to low birth weight infants. The persistent concern and controversy, the latter confounded by a paucity of data, have been discussed in recent editorials.1,2 At birh, tissue stores of the naturally occurring lipidsoluble antioxidant vitamin E (α-tocopherol) are low. The amount of total tocopherol in the tissue of premature infants is approximately one half that of full-term infants. 3 Maternal vitamin E supplementation seems to have minimal effect on serum vitamin E levels in the newborn because there is poor placental transfer; maternal blood levels are higher than cord levels.1-3

CAPACITY OF THYROXINE-BINDING GLOBULIN TO BIND TRIIODOTHYRONINE AND THYROXINE IN MATERNAL AND CORD BLOOD

PEDIATRICS ◽  
1962 ◽  
Vol 29 (3) ◽  
pp. 369-375
Author(s):  
William M. Michener ◽  
W. Newlon Tauxe ◽  
Alvin B. Hayles
Keyword(s):  
Cord Blood ◽  
Normal Values ◽  
Binding Capacity ◽  
Quantitative Difference ◽  
Maternal Blood ◽  
Blood Samples ◽  
Thyroxine Binding Globulin

Normal values for the measurement of thyroidal function using the erythrocytic uptake of I131-labeled triiodothyronine and the thyroxine-binding capacity of the inter-alpha globulin were established. Paired maternal and cord blood samples collected at the time of delivery were studied with these methods. The erythrocytic uptake of labeled hormone was increased in cord blood as compared to maternal blood. Cord blood apparently binds exogenous triiodothyronine in a different manner than it does exogenous thyroxine. Whether this is a qualitative or quantitative difference was not shown in this study.

scholarly journals Formate concentrations in maternal plasma during pregnancy and in cord blood in a cohort of pregnant Canadian women: relations to genetic polymorphisms and plasma metabolites

2019 ◽  
Vol 110 (5) ◽  
pp. 1131-1137 ◽  
Author(s):  
John T Brosnan ◽  
Lesley Plumptre ◽  
Margaret E Brosnan ◽  
Theerawat Pongnopparat ◽  
Shannon P Masih ◽  
...  
Keyword(s):  
Cord Blood ◽  
Early Pregnancy ◽  
Carbon Metabolism ◽  
Critical Role ◽  
Plasma Concentrations ◽  
Maternal Blood ◽  
Plasma Metabolites ◽  
Blood Samples ◽  
One Carbon Metabolism ◽  
Thymidylate Synthesis

ABSTRACT Background One-carbon metabolism, responsible for purine and thymidylate synthesis and transmethylation reactions, plays a critical role in embryonic and fetal development. Formate is a key player in one-carbon metabolism. In contrast to other one-carbon metabolites, it is not linked to tetrahydrofolate, is present in plasma at appreciable concentrations, and may therefore be distributed to different tissues. Objective The study was designed to determine the concentration of formate in cord blood in comparison with maternal blood taken earlier in pregnancy and at delivery and to relate formate concentrations to potential precursors and key fetal genotypes. Methods Formate and amino acids were measured in plasma during early pregnancy (12–16 wk), at delivery (37–42 wk), and in cord blood samples from 215 mothers, of a prospective cohort study. Three fetal genetic variants in one-carbon metabolism were assessed for their association with cord plasma concentrations of formate. Results The formate concentration was ∼60% higher in the cord blood samples than in mothers’ plasma. The maternal formate concentrations did not differ between the early pregnancy samples and those taken at delivery. Plasma concentrations of 4 formate precursors (serine, glycine, tryptophan, and methionine) were increased in cord blood compared with the maternal samples. Cord blood formate was influenced by fetal genotype, being ∼12% higher in infants harboring the MTHFR A1298C (rs1801131) AC or CC genotypes and 10% lower in infants harboring the MTHFD1 G1958A (rs2236225) GA or AA genotypes. Conclusions The increased formate concentrations in cord blood may support the increased activity of one-carbon metabolism in infants. As such, it would support increased rates of purine and thymidylate synthesis and the provision of methionine for methylation reactions.

Total creatine kinase (CK) and CK-B activity in maternal blood and cord-blood samples after vaginal and cesarean births.

1988 ◽  
Vol 34 (7) ◽  
pp. 1498-1499 ◽  
Author(s):  
G Liras ◽  
V Diaz ◽  
C Alvarez ◽  
J Arenas ◽  
R Sanz ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Cord Blood ◽  
Venous Blood ◽  
Maternal Blood ◽  
Blood Samples ◽  
Cesarean Births ◽  
Total Creatine

Abstract We studied variations in the activity of total creatine kinase (CK; EC 2.7.3.2) and of CK-B in maternal and cord-blood samples, comparing data obtained for vaginal and cesarean births. CK-B activity was determined with an immunoinhibition assay. In all cases, there was a significant postpartum increase in total CK and in CK-B activity in maternal sera, whereas cord-blood samples showed no significant differences between activities in arterial and venous blood for either vaginal or cesarean births. Statistically significant differences were found in CK-B activity, but not in total CK, between cord-blood samples from vaginal births and those from cesareans.

Low cord blood levels of catecholamine from a newborn of a pheochromocytoma patient

1994 ◽  
Vol 130 (3) ◽  
pp. 217-219 ◽  
Author(s):  
Patricia LM Dahia ◽  
César Y Hayashida ◽  
Célia Strunz ◽  
Neusa Abelin ◽  
Sérgio PA Toledo
Keyword(s):  
Cord Blood ◽  
Good Control ◽  
Well Being ◽  
Maternal Blood ◽  
Protective Role ◽  
Fetal Mortality ◽  
Blood Levels ◽  
School Of Medicine ◽  
Degradative Enzymes ◽  
Hormone Inactivation

Dahia PLM, Hayashida CY, Strunz C, Abelin N, Toledo SPA. Low cord blood levels of catecholamine from a newborn of a pheochromocytoma patient. Eur J Endocrinol 1994;130:217–19. ISSN 0804–4643 Association of pheochromocytoma and pregnancy is rare and usually related to high maternal and fetal mortality rates. Maternal effects of the tumor have been studied extensively and the clinical outcome has markedly improved during the last decade. However, the role of excess catecholamines on fetal development has been discussed very little. We report here a case of pheochromocytoma during pregnancy, in which catecholamine levels from the cord blood were low despite simultaneous elevated maternal values (1.93 and 29.46 nmol/l norepinephrine, respectively), possibly owing to the high activity of the catecholamine degradative enzymes monoamine oxidase and COMT at the placental level. We suggest that in pregnancies complicated by pheochromocytoma, fetal well-being may be related mainly to good control of maternal blood pressure instead of to the amount of catecholamines in the fetal circulation, because the placenta performs a protective role through an effective process of hormone inactivation. Patricia LM Dahia, Endocrine Genetics Unit, University of ã Paulo School of Medicine, 455 Dr. Arnaldo Ave, 4th Floor, Room 50, 01246–913 São Paulo, Brazil

Distribution of relaxin between human maternal and fetal circulations and amniotic fluid

1992 ◽  
Vol 134 (2) ◽  
pp. 313-317 ◽  
Author(s):  
M. R. Johnson ◽  
A. Abbas ◽  
K. H. Nicolaides ◽  
S. L. Lightman
Keyword(s):  
Amniotic Fluid ◽  
Placental Transfer ◽  
Geometric Mean ◽  
Maternal Blood ◽  
Fetal Blood ◽  
Maternal Circulation ◽  
Blood Samples

ABSTRACT Relaxin was measured in maternal blood and amniotic fluid samples at 9–40 weeks and in fetal blood samples at 19–41 weeks of pregnancy. In amniotic fluid, concentrations of relaxin rose from 58 ng/1 (geometric mean) at 10 weeks to 142 ng/l at 14 weeks and declined subsequently to 55 ng/l at 22 weeks. In maternal blood, mean relaxin concentrations were ten times greater than in amniotic fluid, and concentrations decreased with gestation. Since there was no significant association between the relaxin concentrations in the two compartments, relaxin in the amniotic fluid may be derived from the decidualized endometrium rather than the maternal circulation, alternatively its metabolism may be different in the two compartments. The absence of detectable concentrations of relaxin in any of the fetal blood samples demonstrates that there is no significant placental transfer or fetal synthesis of this peptide. Journal of Endocrinology (1992) 134, 313–317

scholarly journals Study of correlation between maternal and cord blood vitamin D3 levels

2019 ◽  
Vol 7 (1) ◽  
pp. 20
Author(s):  
Sunil Rai ◽  
Saurav Das ◽  
Shankar Narayan
Keyword(s):  
Vitamin D ◽  
Cord Blood ◽  
Blood Sample ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Blood Levels ◽  
Cord Blood Sample ◽  
Vitamin D Levels

Background: Vitamin D deficiency during pregnancy and in newborn period is common in this country. Vitamin D status of the mother is known to influence the vitamin D levels in the neonate, however how closely the maternal vitamin D level correlates with the cord blood Vitamin D is not clearly understood. To study the correlation between maternal and neonatal serum Vitamin D3 levels by as indicated by cord blood 25(OH)D levels and find out if there is a significant variation of cord blood 25(OH)D levels in Vitamin D sufficient and insufficient mothers.Methods: Healthy pregnant women between 18-45 years of age with no known history of chronic disease or long-term medication, consenting for the study were enrolled. Maternal blood sample was collected in peripartum period, cord blood sample was obtained after delivery from the umbilical cord after clamping. Vitamin D3 levels were measured by RIA and paired maternal and cord blood levels were statistically analyzed.Results: 569 paired samples of maternal and cord blood were analyzed. The mean maternal serum 25(OH)D level was 35.63ng/ml (sd 6.18, range 9.2-39.8) as compared to 13.52ng/ml (sd 3.79, range 7.9-27) for the neonates. 457 of the mothers were found to have sufficient, 101(18%) insufficient and 11(2%) deficient Vitamin D levels as per Endocrinological Society guidelines. In comparison, 535(94%) of the neonates had deficient levels, none of the neonates had sufficient Vitamin D levels, 34(5.99%) had insufficient levels. No significant correlation was found between maternal and neonatal serum vitamin 25(OH)D levels (r=0.007, P=0.85).Conclusions: Maternal and Cord blood serum Vitamin D3 levels were found to be poorly correlated in this study.

scholarly journals Prevalence of transmissible viral disease in maternal blood samples of autologous umbilical cord blood in a private cord blood bank

2013 ◽  
Vol 1 (1) ◽  
pp. 1 ◽  
Author(s):  
Juthatip Fongsarun ◽  
Maneerat Ekkapongpisit ◽  
Mantana Paisan ◽  
Siripen Chanthachorn ◽  
Konstantinos I Papadopoulos
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Viral Disease ◽  
Maternal Blood ◽  
Blood Bank ◽  
Blood Samples ◽  
Cord Blood Bank

scholarly journals Pharmacokinetics of Prophylactic Cefazolin in Parturients Undergoing Cesarean Delivery

2014 ◽  
Vol 58 (6) ◽  
pp. 3504-3513 ◽  
Author(s):  
Mohammed H. Elkomy ◽  
Pervez Sultan ◽  
David R. Drover ◽  
Ekaterina Epshtein ◽  
Jeffery L. Galinkin ◽  
...  
Keyword(s):  
Cord Blood ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Plasma Concentrations ◽  
Maternal Blood ◽  
Blood Samples ◽  
Elective Cesarean ◽  
Neonatal Blood ◽  
The Impact ◽  
Maternal Administration

ABSTRACTThe objectives of this work were (i) to characterize the pharmacokinetics of cefazolin in pregnant women undergoing elective cesarean delivery and in their neonates; (ii) to assess cefazolin transplacental transmission; (iii) to evaluate the dosing and timing of preoperative, prophylactic administration of cefazolin to pregnant women; and (iv) to investigate the impact of maternal dosing on therapeutic duration and exposure in newborns. Twenty women received 1 g of cefazolin preoperatively. Plasma concentrations of total cefazolin were analyzed from maternal blood samples taken before, during, and after delivery; umbilical cord blood samples obtained at delivery; and neonatal blood samples collected 24 h after birth. The distribution volume of cefazolin was 9.44 liters/h. The values for pre- and postdelivery clearance were 7.18 and 4.12 liters/h, respectively. Computer simulations revealed that the probability of maintaining free cefazolin concentrations in plasma above 8 mg/liter during scheduled caesarean surgery was <50% in the cord blood when cefazolin was administered in doses of <2 g or when it was administered <1 h before delivery. Therapeutic concentrations of cefazolin persisted in neonates >5 h after birth. Cefazolin clearance increases during pregnancy, and larger doses are recommended for surgical prophylaxis in pregnant women to obtain the same antibacterial effect as in nonpregnant patients. Cefazolin has a longer half-life in neonates than in adults. Maternal administration of up to 2 g of cefazolin is effective and produces exposure within clinically approved limits in neonates.

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