Validation of Raised Cord Blood Interleukin-16 in Perinatal Asphyxia and Neonatal Hypoxic-Ischaemic Encephalopathy in the BiHiVE2 Cohort

2018 ◽  
Vol 40 (3) ◽  
pp. 271-277
Author(s):  
Marc P. O’Sullivan ◽  
Klaudia M. Sikora ◽  
Caroline Ahearne ◽  
Deirdre M. Twomey ◽  
Mikael Finder ◽  
...  
Keyword(s):  
Cord Blood ◽  
Perinatal Asphyxia ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Levels ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Significant Difference ◽  
Elisa Technique ◽  
Umbilical Cord Blood Serum

The role of inflammation is an important factor in the progression of hypoxic-ischaemic encephalopathy (HIE). We have previously shown that interleukin-16 (IL-16) is increased in infants with moderate and severe HIE and relates to poor neurodevelopmental outcomes. We aimed to validate IL-16 as a cord blood-based biomarker for HIE and to examine its relationship to long-term outcomes. The study sample consisted of 105 full-term infants who experienced perinatal asphyxia (PA) (with and without an encephalopathy) along with healthy, gestational age-matched newborn controls. Umbilical cord blood serum was processed and biobanked at delivery. Infants were assigned a modified Sarnat score at 24 h. Analysis of IL-16 cytokine cord blood levels was performed using the sandwich-based enzyme-linked immunosorbent assay (ELISA) technique. Cord blood-based IL-16 was increased in infants with PA and HIE relative to controls (p = 0.025). IL-16 was also increased in the HIE group relative to controls (p = 0.042). There was no significant difference in IL-16 across grades of HIE or in those with abnormal outcomes at 2 years of age. This study validates findings that cord blood-based IL-16 levels are increased in infants with PA, including those who go on to develop HIE.

Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence

2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Control Group ◽  
Long Term Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Monochorionic Twin ◽  
Increased Risk ◽  
Study Population

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.

scholarly journals The Role of Ischemia-modified Albumin as a Biomarker in Preeclampsia

2020 ◽  
Vol 42 (03) ◽  
pp. 133-139
Author(s):  
Süleyman Serkan Karaşin ◽  
Tayfur Çift
Keyword(s):  
Pregnant Women ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Ischemia Modified Albumin ◽  
Significant Difference ◽  
Gestational Week ◽  
Severity Of The Disease

Abstract Objective Ischemia-modified albumin (IMA)is a modified type of albumin protein that is formed under oxidative stress. This study aims to compare the levels of serum IMA between normotensive and preeclamptic pregnancies and to evaluate the relationship between the severity of the disease. Methods A total of 90 pregnant women aged between 18 and 45 years participated in this cross-sectional study. The levels of serum IMA were measured by enzyme-linked immunosorbent assay in 30 preeclamptic pregnant women with the severe signs of the disease, 30 preeclamptic pregnant women, and 30 normotensive pregnant women.. The study was designed as a cross-sectional clinical study. Results When the demographic characteristics were examined, statistically significant differences were found between the groups in terms of age, gestational week at birth and blood pressure. Age was higher in the preeclampsia with signs of severity group than in the normotensive group (p = 0.033). Pregnancy week was significantly the lowest in the preeclampsia with the severity signs group (p = 0.004). In normotensive patients, IMA levels were lower than in the preeclampsia groups (p < 0.001) but there was no significant difference in terms of severity of disease (p = 0.191). According to laboratory data; only the creatinine level was significantly different between the groups. Conclusion The levels of serum IMA were higher in patients with preeclampsia than in healthy pregnancies. However, there was no significant correlation in terms of preeclampsia severity; more extensive, prospective and long-term studies are needed.

scholarly journals Study of cord blood nucleated RBC’s as a marker for fetal asphyxia

2017 ◽  
Vol 6 (2) ◽  
pp. 658
Author(s):  
Suvarna Jyothi Ganta ◽  
Sunanda R. Kulkarni
Keyword(s):  
Cord Blood ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Control Group ◽  
Apgar Scores ◽  
Hypoxic Episode ◽  
The Mean ◽  
Ischemic Encephalopathy ◽  
Control Study

Background: Perinatal asphyxia is a serious problem globally and is a common cause of neonatal mortality and long term morbidity. Various Parameters are being used as predictors for birth asphyxia but the correlation between clinical presentation and the biochemical results has been unsatisfactory. NRBC count of the cord blood is reported in literature as a possible marker of perinatal asphyxia. In-utero hypoxic episode may induce a haemopoetic response of exaggerated erythropoiesis leading to the presence of nucleated RBC's in fetal circulation. The aim of this study was to investigate whether NRBC count of the cord blood can be a useful parameter to determine perinatal asphyxia.Methods: This prospective case control study was conducted in Chinmaya Mission hospital, Bangalore, India between July 2015 to June 2016.we have studied the NRBC counts from the cord blood of 50 neonates with perinatal asphyxia and 50 healthy neonates, thus comparing the results.Results: The mean NRBC /100 WBC for cases with birth asphyxia was 11.6 and that of the control group was 5.6. NRBC count was found to be significantly higher in neonates with low Apgar scores. There was correlation between the Apgar scores at 1st and at 5 minutes, the degree of Hypoxic Ischemic Encephalopathy and the NRBC counts.Conclusions: Therefore NRBC counts of the cord blood can be used as an effective tool to confirm perinatal asphyxia. It is a simple, quick, accurate and clinically effective test to diagnose and initiate treatment to prevent long term sequel of perinatal asphyxia.

scholarly journals The Management and Outcome of Higher Order Multifetal Pregnancies: Obstetric, Neonatal and Follow-up Data

Twin Research ◽  
2001 ◽  
Vol 4 (1) ◽  
pp. 4-11
Author(s):  
Mark H. Yudin ◽  
Elizabeth V. Asztalos ◽  
Ann Jefferies ◽  
Jon F.R. Barrett
Keyword(s):  
Statistical Analysis ◽  
Motor Skills ◽  
Gestational Age ◽  
Neurodevelopmental Outcome ◽  
Higher Order ◽  
Neurodevelopmental Outcomes ◽  
Significant Difference ◽  
Before And After

AbstractThe objective of this study was to describe current obstetric, neonatal, and long-term neurodevelopmental outcomes of higher order multifetal gestations (≥ 3 fetuses) in the 1990s. We also intended to identify a target gestational age at which neonatal and neurodevelopmental morbidities are low. Records from all multifetal pregnancies (≥ 3 viable fetuses ≥ 20 weeks gestation) delivered at the two perinatal centers in Toronto, Ontario, Canada during the study period (January 1, 1990–December 31, 1996) were reviewed. Data were collected on obstetric, neonatal, and long-term neurodevelopmental outcomes. Follow up data were gathered regarding the presence of a severe deficit in four categories (vision, hearing, cognition, and motor skills). Statistical analysis was performed to determine a gestational age at which a significant decrease in deficit occurred. During the study period 165 multifetal pregnancies were delivered. This resulted in 511 fetuses, of which 496 were live births. Of these 496 infants, 453 survived to discharge. Follow up data were obtained on 332 (73.3 per cent) infants. Infant survival increased with gestational age, and was approximately 90 per cent or greater at 26 weeks or more. Of all infants followed, the proportion of those without deficit increased with increasing gestational age, such that the per cent without deficit was 96.9 at 31 weeks or greater. Of all infants followed, 301 (90.7 per cent) had no deficit. Statistical analysis revealed a significant difference in long-term neurodevelopmental outcome between infants born before and after 28 weeks gestation. The incidence of a major deficit was 44.1 per cent for those born earlier than and 5.4 per cent for those born later than this gestational age (p = 0.001). In our cohort, survival figures were high. Even in lower gestational groupings, survival was high, but not without serious concerns about severe morbidity. This information is useful when counseling parents of higher order multifetal pregnancies.

scholarly journals Creative Music Therapy and Neurodevelopmental Outcomes in Pre-term Infants at 2 Years: A Randomized Controlled Pilot Trial

2021 ◽  
Vol 9 ◽  
Author(s):  
Friederike Barbara Haslbeck ◽  
Hans Ulrich Bucher ◽  
Dirk Bassler ◽  
Cornelia Hagmann ◽  
Giancarlo Natalucci
Keyword(s):  
Music Therapy ◽  
Language Processing ◽  
Pilot Trial ◽  
Social Emotional Development ◽  
Long Term Effects ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Creative Music

Impaired neurodevelopment is increasingly recognized as a major health issue in children born prematurely. Creative music therapy (CMT) intends to prevent and or reduce neurobehavioral deficits in pre-term infants using musical stimulation and socio-emotional co-regulation. We conducted a randomized, clinical pilot CMT trial to test feasibility and to examine long-term neurodevelopmental outcomes in pre-term infants (NCT02434224: https://clinicaltrials.gov/ct2/show/NCT02434224). Eighty-two pre-term infants were randomized either to CMT or standard care. A specially trained music therapist provided family-integrating CMT via infant-directed singing during hospitalization. Fifty-six infants underwent follow-up at 2 years of corrected age. No significant beneficial nor adverse effects of CMT were identified in routine clinical neurodevelopmental measures (Bayley-III Scales of Infant and Toddler Development and the standardized neurological examination). Longer term follow-up (5 years) and larger future studies are recommended to elucidate possible long-term effects of music in relation to more sensitive outcomes including executive function, detailed language processing and social-emotional development.

scholarly journals Effects of synergistic cytokine combinations, low oxygen, and irradiated stroma on the expansion of human cord blood progenitors

Blood ◽  
1992 ◽  
Vol 80 (2) ◽  
pp. 403-411
Author(s):  
MR Koller ◽  
JG Bender ◽  
ET Papoutsakis ◽  
WM Miller
Keyword(s):  
Cord Blood ◽  
Progenitor Cells ◽  
Enzyme Linked Immunosorbent Assay ◽  
Low Oxygen ◽  
Human Cord Blood ◽  
Cell Production ◽  
Endogenous Production ◽  
Mature Granulocyte ◽  
Marrow Stroma

Expansion of hematopoietic progenitor cells in the mononuclear cell (MNC) fraction of human cord blood was evaluated under atmospheres containing reduced (5%) and normal (20%) oxygen tensions. Cells were cultured with synergistic cytokine combinations in suspension (without stroma) and on irradiated bone marrow stroma. Addition of interleukin (IL)-3 and IL-6 (IL-3/IL-6) provided a greater expansion of both total and progenitor cells than IL-1 and IL-3 (IL-1/IL-3). IL-3/IL-6 maintained a higher level of progenitors throughout the 8-week culture period, whereas progenitors disappeared earlier from cultures with IL- 1/IL-3. This indicates that an earlier cell type was affected by IL- 3/IL-6, and/or that IL-3/IL-6 favored self-renewal while IL-1/IL-3 induced differentiation. Reduced oxygen tension enhanced the productivity of these long-term hematopoietic cultures (LTHC) under all conditions tested. In suspension cultures, reduced oxygen increased cumulative total cell production by 125% and 167%, and cumulative progenitor production by 68% and 21%, with IL-1/IL-3 and IL-3/IL-6, respectively. The presence of irradiated stroma increased cumulative progenitor cell production almost threefold in cultures without cytokines. In cultures with cytokines, the beneficial effect of stroma was less significant, but was greater under 20% O2 than 5% O2. Cultures under 5% O2 provided more progenitors and often maintained progenitors for 1 to 2 weeks longer than those under 20% O2. To quantitate more precisely the shift in cell populations induced by IL-3/IL-6 and stroma in cultures under 5% O2, flow cytometry analysis was used. By week 3, the addition of IL-3/IL-6 stimulated a 15-fold and 25-fold expansion of promyelocytes (CD15+CD11b-) in suspension and stromal cultures, respectively. Addition of IL-3/IL-6 also increased mature granulocyte (CD15hiCD11b+) and monocyte (CD15loCD11b+) numbers, while no effect was seen on T-(CD3+) or B- (CD19+) lymphocytes. Endogenous production of IL- 6 was significantly higher under 5% O2 in both suspension and stromal cultures, and IL-6 production was increased threefold by the addition of IL-1/IL-3. Very little IL-1 beta was produced in these cultures, and endogenous IL-3 and tumor necrosis factor (TNF)-alpha were undetectable by enzyme-linked immunosorbent assay (ELISA) analysis.

scholarly journals Perinatal outcomes of newborns born from young mothers with epidural analgesia

2021 ◽  
Vol 66 (3) ◽  
pp. 118-124
Author(s):  
R. T. Shakirov ◽  
S. V. Kinzhalova ◽  
R. A. Makarov ◽  
S. V. Bychkova ◽  
N. V. Putilova ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Cord Blood ◽  
Young Women ◽  
Neonatal Period ◽  
Young Mothers ◽  
Acid Base ◽  
Term Infants ◽  
Early Neonatal Period ◽  
Arterial Blood

Objective. To evaluate the features of the course of the early neonatal period of newborns born from young women under conditions of epidural analgesia.Material and methods. The authors conducted a prospective, comparative, randomized, longitudinal, monocenter study. Patients of Group 1 (n=25) were anesthetized with a narcotic analgesic (2% Тrimeperedine 1,0 ml intramuscularly). Patients of Group 2 (n=30) received long-term epidural analgesia (EA) with 0,2% Ropivacaine (10,0 ml/hour). All patients delivered full-term infants. The course of labor, clinical and laboratory characteristics of newborns in the early neonatal period were evaluated.Results. There were no significant differences in the duration of labor, volume of blood loss, and other characteristics between the groups. There were no clinical differences between the groups of newborns. We did not find a negative effect of epidural analgesia on the Apgar score at the 1st (p=0,166) and 5th (p=0,217) minutes of life and the neuropsychiatric status of the newborn (p=0,322). At the same time, in the group of long-term epidural analgesia, there was a tendency to a higher incidence of moderate and mild asphyxia (19,2% versus 9,5%; p=0,436). When comparing the acid-base state of umbilical cord arterial blood, significant differences were found in the following indicators: lower pH (p=0,042) and pO2 level (p=0,007) and higher pCO2 level (p=0,031) in arterial cord blood.Conclusion. Epidural analgesia during labor in young women is accompanied by a lower level of pH and pO2 and a higher level of pCO2 in the arterial cord blood as compared to a Group of Тrimeperedine, which indicates a more pronounced shift in the acid-base state of the fetal blood. When analyzing neurological outcomes in newborns, there were no statistically significant differences. However, further follow-up is required for children born from young mothers who have received long-term epidural analgesia in labor.

GLYCOSYLATED FIBRONECTIN AND INHIBIN ARE LOWER AND ANTI-MÜLLERIAN HORMONE IS HIGHER IN UMBILICAL CORD BLOOD WHEN MOTHERS HAVE PREECLAMPSIA

2020 ◽  
Vol 26 (3) ◽  
pp. 318-327
Author(s):  
Bridget DiPrisco ◽  
Ajay Kumar ◽  
Bhanu Kalra ◽  
Gopal V. Savjani ◽  
Zoe Michael ◽  
...  
Keyword(s):  
Growth Factor ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Immunosorbent Assay ◽  
Plasma Protein ◽  
Umbilical Cord Blood ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Levels ◽  
Insulin Like Growth Factor ◽  
Tertiary Teaching

Objective: Preeclampsia is a common disorder of pregnancy, causing significant morbidity and mortality for mothers and infants. Several molecules, including glycosylated fibronectin (GlyFn), the inhibin-related proteins, anti-müllerian hormone (AMH), and the insulin-like growth factor axis, are altered in maternal plasma in the setting of preeclampsia; however, these molecules have not been previously measured in cord blood of infants born to mothers with preeclampsia, which may represent changes in fetal physiology. We evaluated potential biomarkers of preeclampsia in umbilical cord blood to fill the gap in knowledge. Methods: This is a case-control study of 196 neonates born at a tertiary teaching hospital in Boston from 2010–2017. Forty-nine neonates born to mothers with preeclampsia were matched 1:3 by gestational age, sex, and birth weight z-score with 147 controls. Eleven analytes were measured in cord blood by enzyme-linked immunosorbent assay. Binary logistic regression analyses were performed to evaluate associations between preeclampsia and analytes. Results: Mean cord blood levels of GlyFn and total inhibin were significantly lower in neonates born to mothers with preeclampsia compared to controls, and AMH levels were significantly higher in males born to mothers with preeclampsia than male controls. Associations remained significant after controlling for maternal and neonatal characteristics. Conclusion: Cord blood levels of GlyFn and inhibin are decreased and AMH (male) levels are increased in infants of preeclamptic mothers, which is opposite the pattern these biomarkers show in serum of mothers with preeclampsia. These molecules may be important in the pathophysiology and long-term effects of preeclampsia on the developing fetus. Abbreviations: AMH = anti-müllerian hormone; ELISA = enzyme-linked immunosorbent assay; GlyFn = glycosylated fibronectin; IGF = insulin-like growth factor; IGFBP5 = insulin-like growth factor binding protein 5; LOD = limit of detection; PAPP-A = pregnancy-associated plasma protein A; PAPP-A2 = pregnancy-associated plasma protein A2

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