Postpartum plasma metabolomic profile among women with preeclampsia and preterm delivery: implications for long-term health

Abstract Background Preeclampsia and preterm delivery (PTD) are believed to affect women’s long-term health including cardiovascular disease (CVD), but the biological underpinnings are largely unknown. We aimed to test whether maternal postpartum metabolomic profiles, especially CVD-related metabolites, varied according to PTD subtypes with and without preeclampsia, in a US urban, low-income multi-ethnic population. Methods This study, from the Boston Birth Cohort, included 980 women with term delivery, 79 with medically indicated PTD (mPTD) and preeclampsia, 52 with mPTD only, and 219 with spontaneous PTD (sPTD). Metabolomic profiling in postpartum plasma was conducted by liquid chromatography-mass spectrometry. Linear regression models were used to assess the associations of each metabolite with mPTD with preeclampsia, mPTD only, and sPTD, respectively, adjusting for pertinent covariates. Weighted gene coexpression network analysis was applied to investigate interconnected metabolites associated with the PTD/preeclampsia subgroups. Bonferroni correction was applied to account for multiple testing. Results A total of 380 known metabolites were analyzed. Compared to term controls, women with mPTD and preeclampsia showed a significant increase in 36 metabolites, mainly representing acylcarnitines and multiple classes of lipids (diacylglycerols, triacylglycerols, phosphocholines, and lysophosphocholines), as well as a decrease in 11 metabolites including nucleotides, steroids, and cholesteryl esters (CEs) (P < 1.3 × 10−4). Alterations of diacylglycerols, triacylglycerols, and CEs in women with mPTD and preeclampsia remained significant when compared to women with mPTD only. In contrast, the metabolite differences between women with mPTD only and term controls were only seen in phosphatidylethanolamine class. Women with sPTD had significantly different levels of 16 metabolites mainly in amino acid, nucleotide, and steroid classes compared to term controls, of which, anthranilic acid, bilirubin, and steroids also had shared associations in women with mPTD and preeclampsia. Conclusion In this sample of US high-risk women, PTD/preeclampsia subgroups each showed some unique and shared associations with maternal postpartum plasma metabolites, including those known to be predictors of future CVD. These findings, if validated, may provide new insight into metabolomic alterations underlying clinically observed PTD/preeclampsia subgroups and implications for women’s future cardiometabolic health.

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Influences on catch-up growth using relative versus absolute metrics: evidence from the MAL-ED cohort study

BMC Public Health ◽

10.1186/s12889-021-11120-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stephanie A. Richard ◽

Benjamin J. J. McCormick ◽

Laura E. Murray-Kolb ◽

Pascal Bessong ◽

Sanjaya K. Shrestha ◽

...

Keyword(s):

Cohort Study ◽

Low Income ◽

Cognitive Outcomes ◽

Absolute Difference ◽

Maternal Height ◽

Z Score ◽

Linear Regression Models ◽

Poor Growth ◽

Micronutrient Status

Abstract Background Poor growth in early childhood has been considered irreversible after 2–3 years of age and has been associated with morbidity and mortality over the short-term and with poor economic and cognitive outcomes over the long-term. The MAL-ED cohort study was performed in eight low-income settings with the goal of evaluating relationships between the child’s environment and experience (dietary, illness, and pathogen exposure, among others) and their growth and development. The goal of this analysis is to determine whether there are differences in the factors associated with growth from 24 to 60 months using two different metrics. Methods Across six MAL-ED sites, 942 children had anthropometry data at 24 and 60 months, as well as information about socioeconomic status, maternal height, gut permeability (lactulose-mannitol z-score (LMZ)), dietary intake from 9 to 24 months, and micronutrient status. Anthropometric changes were in height- or weight-for-age z-score (HAZ, WAZ), their absolute difference from the growth standard median (HAD (cm), WAD (kg)), as well as recovery from stunting/underweight. Outcomes were modeled using multivariate regression. Results At 24 months, almost half of the cohort was stunted (45%) and 21% were underweight. Among those who were stunted at 24 months (n = 426), 185 (43%) were no longer stunted at 60 months. Most children increased their HAZ from 24 to 60 months (81%), whereas fewer (33%) had positive changes in their HAD. Linear regression models indicate that girls improved less than boys from 24 to 60 months (HAZ: -0.21 (95% CI -0.27, -0.15); HAD: -0.75 (-1.07, -0.43)). Greater intestinal permeability (higher LMZ) at 0–24 months was associated with lower relative and absolute changes from 24 to 60 months (HAZ: -0.10 (-0.16, -0.04); HAD: -0.47 (-0.73, -0.21)). Maternal height (per 10 cm) was positively associated with changes (HAZ: 0.09 (0.03, 0.15); HAD: 0.45 (0.15, 0.75)). Similar relationships were identified for changes in WAZ and WAD. Conclusions The study children demonstrated improved growth from 24 to 60 months of age, but only a subset had positive changes in HAD and WAD. The same environmental factors were associated with growth from 24 to 60 months regardless of metric used (change in HAZ or HAD, or WAZ and WAD).

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Preterm delivery and long term mortality in women: national cohort and co-sibling study

BMJ ◽

10.1136/bmj.m2533 ◽

2020 ◽

pp. m2533 ◽

Cited By ~ 1

Author(s):

Casey Crump ◽

Jan Sundquist ◽

Kristina Sundquist

Keyword(s):

Environmental Factors ◽

Confidence Interval ◽

Preterm Delivery ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Term Delivery ◽

National Cohort ◽

Long Term Mortality

Abstract Objectives To examine the long term mortality associated with preterm delivery in a large population based cohort of women, and to assess for potential confounding by shared familial factors. Design National cohort study. Setting Sweden. Participants All 2 189 477 women with a singleton delivery in 1973-2015. Main outcome measures All cause and cause specific mortality up to 2016, identified from nationwide death records. Cox regression was used to calculate hazard ratios while adjusting for confounders, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and environmental) factors. Results In 50.7 million person years of follow-up, 76 535 (3.5%) women died (median age at death was 57.6). In the 10 years after delivery, the adjusted hazard ratio for all cause mortality associated with preterm delivery (<37 weeks) was 1.73 (95% confidence interval 1.61 to 1.87), and when further stratified was 2.20 (1.63 to 2.96) for extremely preterm delivery (22-27 weeks), 2.28 (2.01 to 2.58) for very preterm delivery (28-33 weeks), 1.52 (1.39 to 1.67) for late preterm delivery (34-36 weeks), and 1.19 (1.12 to 1.27) for early term delivery (37-38 weeks) compared with full term delivery (39-41 weeks). These risks declined but remained significantly raised after longer follow-up times: for preterm versus full term births, 10-19 years after delivery, the adjusted hazard ratio was 1.45 (95% confidence interval 1.37 to 1.53); 20-44 years after delivery, the adjusted hazard ratio was 1.37 (1.33 to 1.41). These findings did not seem to be attributable to shared genetic or environmental factors within families. Several causes were identified, including cardiovascular and respiratory disorders, diabetes, and cancer. Conclusions In this large national cohort of women, the findings suggested that preterm and early term delivery were independent risk factors for premature mortality from several major causes. These associations declined over time but remained raised up to 40 years later.

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Metabolome-Wide Association Study of the Relationship Between Habitual Physical Activity and Plasma Metabolite Levels

American Journal of Epidemiology ◽

10.1093/aje/kwz171 ◽

2019 ◽

Vol 188 (11) ◽

pp. 1932-1943 ◽

Cited By ~ 6

Author(s):

Ming Ding ◽

Oana A Zeleznik ◽

Marta Guasch-Ferre ◽

Jie Hu ◽

Jessica Lasky-Su ◽

...

Keyword(s):

Physical Activity ◽

Multiple Testing ◽

Tail Probability ◽

Habitual Physical Activity ◽

Self Report ◽

Health Study ◽

Plasma Metabolites ◽

Cardiometabolic Health ◽

Physically Active ◽

Plasma Metabolite

Abstract We identified plasma metabolites associated with habitual physical activity among 5,197 US participants from the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHS II), and the Health Professionals Follow-up Study (HPFS). Physical activity was assessed every 2–4 years via self-report questionnaires. Blood was collected in the NHS in 1989–1990, in NHS II during 1996–1999, and in the HPFS during 1993–1995. Metabolic profiling was conducted by liquid chromatography–mass spectrometry. Our study included 337 known metabolites, with 256 of them classified as lipids. We corrected for multiple testing by controlling the tail probability of the proportion of false positives (TPPFP) and accounted for correlated tests using bootstrapping. Physical activity was significantly associated with 20 metabolites after correction for multiple testing (TPPFP < 0.05), and positive associations were found for most of the metabolites, including 2 amino acids (citrulline and glycine), 4 cholesteryl esters (C18:2, C18:1, C16:0, C18:3), 8 phosphocholines (PCs) (C36:4 PC-A, C34:3 PC plasmalogen, C36:3 PC plasmalogen, C34:2 PC plasmalogen, C36:2 PC) and lysophosphatidylcholines (C18:2, C20:5, C18:1), and 3 phosphatidylethanolamines (PEs) (C38:3 PE plasmalogen) and lysophosphatidylethanolamines (C18:2, C18:1). We independently replicated the 20 metabolites among 2,305 women in the Women’s Health Initiative using 1993 data, and half of the metabolites were replicated. Our study may help identify biomarkers of physical activity and provide insight into biological mechanisms underlying the beneficial effect of being physically active on cardiometabolic health.

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Comparison of Long-Term Outcomes for Medication and CBT With Low-Income Minority Women With Depression

PsycEXTRA Dataset ◽

10.1037/e525202013-005 ◽

2013 ◽

Author(s):

J. Siddique ◽

J. Y. Chung ◽

C. H. Brown ◽

J. Miranda

Keyword(s):

Low Income ◽

Minority Women ◽

Long Term Outcomes

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The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting

Thorax ◽

10.1136/thoraxjnl-2020-215338 ◽

2020 ◽

pp. thoraxjnl-2020-215338

Author(s):

Jamilah Meghji ◽

Stefanie Gregorius ◽

Jason Madan ◽

Fatima Chitimbe ◽

Rachael Thomson ◽

...

Keyword(s):

Low Income ◽

Disease Onset ◽

Treatment Completion ◽

Well Being ◽

Urban Setting ◽

Financial Strain ◽

First Episode ◽

Health Seeking ◽

Tb Treatment

BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), p<0.001), and more patients were living in poverty (earning <US$1.90/day: 57.7% (211/366) vs 41.6% (166/399), p<0.001) 1 year after TB-treatment completion compared with before TB-disease onset. Half of the participants (50.5%, 184/368) reported ongoing dissaving (use of savings, selling assets, borrowing money) and 9.5% (35/368) reported school interruptions in the year after TB-treatment completion. Twenty-one participants completed in-depth interviews. Reported barriers to economic recovery included financial insecurity, challenges rebuilding business relationships, residual physical morbidity and stigma.ConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.

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Limits of the current implementation of incremental housing

Architectural Research Quarterly ◽

10.1017/s135913552000041x ◽

2021 ◽

pp. 1-10

Author(s):

Goran Ivo Marinovic

Keyword(s):

Middle Class ◽

Housing Policy ◽

Low Income ◽

Bank Loans ◽

Housing Project ◽

Middle Income ◽

Specific Location ◽

Current Implementation ◽

Incremental Housing

In the case of conventional public housing, urban planners and policymakers design the layout of a housing project in a specific location and then estimate how many households can afford a home. This housing policy has been pursued as a legitimate solution for housing low- and middle-income households where the houses are individually financed by bank loans or mortgages raised by the occupants. John Turner criticised conventional housing solutions by affirming that ‘developing governments take the perspective of the elite and act as if the process of low-income houses were the same as in high-income countries and the same as for the small upper-middle class of their own countries’. Bruce Ferguson and Jesus Navarrete extend this argument with their critique of distributing finished houses to low-income populations and then requiring long-term payments, which are harmful to the beneficiaries. They note that ‘governments think of housing as complete units built by developers that households must purchase with a long-term loan rather than as a progressive process’.

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Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan

International Journal of Health Geographics ◽

10.1186/s12942-021-00271-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Amber L. Pearson ◽

Kimberly A. Clevenger ◽

Teresa H. Horton ◽

Joseph C. Gardiner ◽

Ventra Asana ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Low Income ◽

Spatial Data ◽

Vigorous Physical Activity ◽

Future Research ◽

Cardiometabolic Health ◽

Multilevel Regression ◽

Critical Pathway ◽

Perceived Safety

Abstract Introduction Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one’s neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health. Methods In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety. Results In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (β = − 2.34, p = 0.017), depression scores (β = − 4.22, p = 0.006), and BMI (β = − 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots. Conclusion Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity—via stress reduction and concomitant effects on cardiometabolic health.

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Trajectories of adolescent poly-substance use and their long-term social and economic outcomes for males from low-income backgrounds

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01810-w ◽

2021 ◽

Author(s):

Francis Vergunst ◽

Nicholas Chadi ◽

Massimiliano Orri ◽

Camille Brousseau-Paradis ◽

Natalie Castellanos-Ryan ◽

...

Keyword(s):

Substance Use ◽

Low Income ◽

Economic Outcomes

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Metabolomic profiles of plasma and uterine luminal fluids from healthy and repeat breeder Holstein cows

BMC Veterinary Research ◽

10.1186/s12917-021-02755-7 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Natsumi Funeshima ◽

Ryotaro Miura ◽

Taiga Katoh ◽

Hikari Yaginuma ◽

Takeshi Kitou ◽

...

Keyword(s):

Mononuclear Cells ◽

Plasma Metabolites ◽

Dependent Manner ◽

Interferon Tau ◽

Peripheral Blood Mononuclear ◽

Metabolomic Profiling ◽

Reproductive Disorder ◽

Uterine Fluid ◽

Reduced Rate ◽

Repeat Breeder

Abstract Background Repeat breeding is a critical reproductive disorder in cattle. The problem of repeat breeder cattle remains largely unmanageable due to a lack of informative biomarkers. Here, we utilized metabolomic profiling in an attempt to identify metabolites in the blood plasma and uterine luminal fluids. We collected blood and uterine fluid from repeat breeder and healthy cows on day 7 of the estrous cycle. Results Metabolomic analysis identified 17 plasma metabolites detected at concentrations that distinguished between the two groups, including decreased various bile acids among the repeat breeders. However, no metabolites that varied significantly were detected in the uterine luminal fluids between two groups. Among the plasma samples, kynurenine was identified as undergoing the most significant variation. Kynurenine is a metabolite produced from tryptophan via the actions of indoleamine 2,3-dioxygenase (IDO). As IDO is key for maternal immune tolerance and induced in response to interferon tau (IFNT, ruminant maternal recognition of pregnancy factor), we examined the responsiveness to IFNT on peripheral blood mononuclear cells (PBMC) isolated from healthy and repeat breeder cows. The mRNA expression of IFNT-response makers (ISG15 and MX2) were significantly increased by IFNT treatment in a dose-dependent manner in both groups. Although treatment with IFNT promoted the expression of IDO in PBMCs from both groups, it did so at a substantially reduced rate among the repeat breeder cows, suggesting that decreased levels of kynurenine may relate to the reduced IDO expression in repeat breeder cows. Conclusions These findings provide valuable information towards the identification of critical biomarkers for repeat breeding syndrome in cattle.

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