Pregnancy Specific Adaptations in Leptin and Melanocortin Neuropeptides in Early Human Gestation

Abstract Introduction Pregnancy is characterized by increased appetitive drive beginning early in gestation, yet the central mechanisms underlying this adaptation are poorly understood in humans. To elucidate central mechanisms underlying appetite regulation in early pregnancy, we examine plasma and CSF leptin and AgRP as well as CSF POMC as surrogates for brain melanocortin activity. Methods Plasma leptin, Ob-Re, AgRP, and CSF leptin, POMC, and AgRP were collected from pregnant women prior to cerclage placement (16.6±1.1wks; N=24), scheduled cesarean section (39.2±0.2wks; N=24), and from non-pregnant controls (N=24), matched for age and BMI. Results Plasma leptin was 1.5 times higher in pregnancy vs. controls (P=0.01), but CSF leptin did not differ. CSF/plasma leptin percentage was lower in early pregnancy vs. controls (0.8±0.1 vs. 1.7±0.2; P<0.0001) and remained unchanged at term (0.9 ±0.1), supporting a decrease in leptin transport into CSF in pregnancy. Plasma AgRP, a peripheral biomarker of the orexigenic hypothalamic neuropeptide, was higher in early pregnancy vs. controls (95.0±7.8 vs. 67.5±5.3; P = 0.005). In early gestation, CSF AgRP did not differ from controls, but CSF POMC was 25% lower (P=0.006). In contrast, at term, CSF AgRP was 42% higher vs. controls (P=0.0001), but CSF POMC no longer differed. Overall, the CSF AgRP/POMC ratio was 1.5-fold higher in early pregnancy vs. controls, reflecting a decrease in melanocortin tone favoring appetitive drive. Conclusions Pregnancy-specific adaptions in the central regulation of energy balance occur early in human gestation and are consistent with decreased leptin transport into brain and resistance to the effects of leptin on target melanocortin neuropeptides.

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The erythrocyte incorporation of absorbed non-haem iron in pregnant women

British Journal Of Nutrition ◽

10.1079/bjn2001390 ◽

2001 ◽

Vol 86 (3) ◽

pp. 323-329 ◽

Cited By ~ 16

Author(s):

Paul G. Whittaker ◽

Jon F.R. Barrett ◽

Tom Lind

Keyword(s):

Pregnant Women ◽

Early Pregnancy ◽

Oral Absorption ◽

Late Pregnancy ◽

Late Gestation ◽

Stable Isotope Ratios ◽

Early Gestation ◽

Haem Iron ◽

In Pregnancy ◽

High Absorption

Studies of Fe absorption in pregnancy often make unfounded assumptions of erythrocyte incorporation. Therefore, we measured the absorption and utilisation of Fe during early and late pregnancy by the erythrocyte incorporation of two stable isotopes. 8·5 mg57Fe (oral) and 0·5 mg58Fe (intravenous) were given to five non-pregnant women, to five women in early gestation (12 weeks) and five women in late gestation (36 weeks). The stable isotope ratios in whole blood 14 d later were measured by MS. Together with estimation of body Fe mass, this enabled the calculation of Fe absorption and erythrocyte incorporation. In non-pregnant women, Fe absorption averaged 20·3 (range 10·2–34·3) %. It was not significantly different in early pregnancy (11·8 (range, 4·4–24·8) %), but during late pregnancy Fe absorption increased to 59·0 (range 38·2–77·2) %. All non-pregnant and early-pregnancy subjects had normal Fe status, but two women in late pregnancy had evidence of Fe insufficiency. During early and late pregnancy, mean erythrocyte incorporation was 63·4 (SD 12·1) % AND 71·0 (sd 10·4) % respectively, significantly reduced (P=0·003) compared with non-pregnant subjects (90·1 (sd 6·0) %). Decreased erythrocyte incorporation of absorbed Fe in early pregnancy is compatible with reduced Fe demand and low oral absorption. However, during late pregnancy decreased erythrocyte incorporation associated with high absorption and Fe insufficiency is different from the high erythrocyte incorporation which occurs in non-pregnant Fe-deficient women. This suggests that part of the aetiology of Fe deficiency during pregnancy may be the reduction of Fe utilisation.

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Selective enhancement of growth in twin foetuses by shearing ewes in early gestation

Animal Science ◽

10.1017/s1357729800016350 ◽

1997 ◽

Vol 65 (1) ◽

pp. 105-110 ◽

Cited By ~ 18

Author(s):

S. T. Morris ◽

S. N. McCutcheon

Keyword(s):

Birth Weight ◽

Early Pregnancy ◽

Live Weight ◽

Early Gestation ◽

Foetal Growth ◽

Grazed Pasture ◽

Birth Rank ◽

Selective Enhancement ◽

Selective Increase ◽

In Pregnancy

AbstractShearing ewes during pregnancy frequently increases the birth weight of lambs. In housed ewes, the birth weight responses are greatest when shearing occurs relatively early in pregnancy. This study examined the effects of the timing and method of shearing on foetal growth, as measured by birth weight, in ewes at pasture. Border Leicester × Romney ewes were allocated at day 50 of pregnancy to: four ‘time of shearing’ treatments — pregnancy day 70 (P70), P100, P130 (no. = 60 for each treatment) and unshorn (no. = 34); two methods of shearing (by standard comb or cover comb); and two levels of pregnancy/rearing rank All ewes had been mated over a 14-day period and grazed pasture together throughout the trial The mid-point of lambing was 17 August.At no time during pregnancy or lactation did ewe live weight differences between the groups exceed 4 kg. Ewes shorn by cover comb were heavier prior to lambing and during lactation than standard comb-shorn ewes. Time of shearing, method of shearing and ewe rearing rank had no effect on ewe annual greasy fleece production. There was a highly significant (P < 0·001) interaction between the effects of birth rank and time of shearing on lamb birth weight. Time of shearing did not affect birth weight of single-born lambs but birth weight of twin lambs increased with earlier maternal shearing to a maximum of 0·7 kg (per lamb) in those born to ewes shorn on P70. These results imply that shearing reduced the greater extent of maternal constraint which applies to the growth of twin v. single foetuses in utero. This selective increase in birth weights of twins achieved by early pregnancy shearing may have advantages in reducing lamb mortality.

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Association between maternal triglycerides and disturbed glucose metabolism in pregnancy

Acta Diabetologica ◽

10.1007/s00592-020-01644-z ◽

2021 ◽

Author(s):

Daniel Eppel ◽

Michael Feichtinger ◽

Tina Lindner ◽

Grammata Kotzaeridi ◽

Ingo Rosicky ◽

...

Keyword(s):

Insulin Resistance ◽

Glucose Metabolism ◽

Gestational Diabetes ◽

Pregnant Women ◽

Early Pregnancy ◽

Early Gestation ◽

Glucose Levels ◽

Increased Risk ◽

Mean Glucose ◽

In Pregnancy

Abstract Aims Dyslipidemia in pregnancy is associated with adverse pregnancy outcomes as elevated triglycerides might be considered as a risk factor for hyperglycemia and gestational diabetes. As only a few studies have addressed the association between maternal triglycerides and glucose metabolism, we aimed to explore the pathophysiologic associations of moderate hypertriglyceridemia and maternal glucose metabolism in pregnancy. Methods Sixty-seven pregnant women received a detailed metabolic characterization at 12+0–22+6 weeks of gestation by an extended 2h-75g OGTT (oral glucose tolerance test); with measurements of glucose, insulin and C-peptide at fasting and every 30 min after ingestion and assessment of triglycerides at fasting state. All examinations were repeated at 24+0–27+6 weeks of gestation. Results Elevated triglycerides in early gestation were associated with insulin resistance and β-cell dysfunction. Mean glucose concentrations during the OGTT in early pregnancy were already higher in women with hypertriglyceridemia as compared to women with triglycerides in the normal range. A higher degree of insulin resistance and increased OGTT glucose levels were also observed when metabolic assessments were repeated between 24 and 28 weeks of gestation. Of note, elevated triglycerides at early gestation were associated with development of gestational diabetes by logistic regression (odds ratio: 1.16, 95%CI: 1.03–1.34, p=0.022 for an increase of 10 mg/dl). Conclusions Hypertriglyceridemia at the start of pregnancy is closely related to impaired insulin action and β-cell function. Women with hypertriglyceridemia have higher mean glucose levels in early- and mid-gestation. Pregnant women with elevated triglycerides in early pregnancy are at increased risk of developing gestational diabetes.

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Opportunities for treating opportunistic vaginal infections during pregnancy

GYNECOLOGY ◽

10.26442/2079-5696_19.6.11-15 ◽

2017 ◽

Vol 19 (6) ◽

pp. 11-15 ◽

Cited By ~ 1

Author(s):

T E Karapetyan ◽

V V Muravieva ◽

A S Ankirskaya ◽

L A Lyubasovskaya ◽

T V Priputnevich

Keyword(s):

Positive Result ◽

Pregnant Women ◽

Early Pregnancy ◽

Premature Birth ◽

Local Treatment ◽

Vaginal Infections ◽

Aerobic Vaginitis ◽

Early Gestation ◽

Early Stages ◽

Intrauterine Infections

The aim of the study was to evaluate the effectiveness of treatment of women with opportunistic vaginal infections during pregnancy. Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed. Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections - in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.

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“The black box” of nonviable pregnancy in early gestation

10.21516/2413-1458-2017-16-2-151-156 ◽

2017 ◽

Author(s):

Å.S. Emelyanenko , A.Yu. Blinov , T.M. Volkovskaya

Keyword(s):

Early Pregnancy ◽

Ultrasound Examination ◽

Black Box ◽

Safety Regulation ◽

Intrauterine Pregnancy ◽

Early Gestation ◽

Prognostic Criteria

The modern sonographic approach to define miscarriage in early pregnancy was shown in the article. Ultrasound diagnostic and prognostic criteria of nonviable pregnancy in early gestation were introduced. Special attention was paid to the examination`s algorithm and repeatability of ultrasound scans with suspicion of intrauterine pregnancy of uncertain viability. Also the consequences of non-following the stringent ultrasound criteria, which lead to the abortions of potentially normal pregnancies were described. Furthermore, the authors highlighted the importance of safety regulation`s aspects in ultrasound examination in early gestation. The conclusion of the importance and need in following the uniform methodological criteria in diagnostics of nonviable pregnancy has been drawn according to the analysis of world experience.

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A case of minimal change disease during pregnancy – Benefits of early diagnosis and use of corticosteroids

Obstetric Medicine ◽

10.1177/1753495x21990214 ◽

2021 ◽

pp. 1753495X2199021

Author(s):

Priyanka S Sagar ◽

Eddy Fischer ◽

Muralikrishna Gangadharan Komala ◽

Bhadran Bose

Keyword(s):

Nephrotic Syndrome ◽

Early Diagnosis ◽

Renal Biopsy ◽

Early Pregnancy ◽

Minimal Change Disease ◽

Minimal Change ◽

Risk Of Bleeding ◽

Increased Risk ◽

Prompt Diagnosis ◽

In Pregnancy

Nephrotic syndrome presenting in pregnancy is rare and poses a diagnostic and therapeutic challenge. Timing of renal biopsy is important given the increased risk of bleeding and miscarriage, and the choice of immunosuppression is limited due to the teratogenicity profiles of standard drugs. We report and discuss a case of minimal change disease diagnosed by renal biopsy during early pregnancy and treated with corticosteroids throughout the pregnancy. Prompt diagnosis and treatment of glomerular disease in pregnancy are vital to prevent poor maternal and fetal outcomes.

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Insulin and central regulation of spontaneous fattening and weight loss

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1985.249.2.r203 ◽

1985 ◽

Vol 249 (2) ◽

pp. R203-R208

Author(s):

R. B. Melnyk ◽

J. M. Martin

Keyword(s):

Weight Loss ◽

Body Weight ◽

Weight Gain ◽

Energy Balance ◽

Binding Capacity ◽

Insulin Receptors ◽

Insulin Binding ◽

Strong Positive Correlation ◽

Central Regulation ◽

Isolated Pancreatic Islets

Insulin binding to receptors in a partially purified hypothalamic membrane preparation is altered by prolonged starvation. To define further the relationship between hypothalamic insulin binding and energy balance, we studied the Richardson's ground squirrel, a hibernator that exhibits spontaneous 6- to 8-mo body weight cycles when kept in constant conditions. Isolated pancreatic islets from squirrels killed during the weight gain phase had greater glucose-stimulated insulin secretion than those from weight loss phase animals, and adipocytes showed significantly greater glucose incorporation into total lipid in response to insulin. Differences in lipogenesis were not attributable to changes in insulin-binding capacity. Hypothalamic tissue from weight gain phase animals bound more insulin than that from weight loss phase animals. Maximal binding was correlated with pancreatic islet responsiveness and maximal insulin-stimulated lipogenesis. The strong positive correlation between peripheral metabolic events associated with spontaneous alterations in energy balance and the binding kinetics of hypothalamic insulin receptors suggests that insulin may play an important role in the central regulation of body weight.

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GAMMA GLOBULIN AGAINST RUBELLA IN PREGNANCY. II. MANIFEST MATERNAL RUBELLA IN EARLY PREGNANCY TREATED WITH CONVALESCENT GAMMA GLOBULIN

Obstetrical & Gynecological Survey ◽

10.1097/00006254-196202000-00021 ◽

1962 ◽

Vol 17 (1) ◽

pp. 70-71

Author(s):

ROLF LUNDSTRÖM ◽

CLAES THORÉN ◽

BERNT BLOMQUIST

Keyword(s):

Early Pregnancy ◽

Gamma Globulin ◽

In Pregnancy

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Vertebral malformation in the mouse foetus caused by X-radiation of the mother during pregnancy

Development ◽

10.1242/dev.12.4.841 ◽

1964 ◽

Vol 12 (4) ◽

pp. 841-850

Author(s):

Ujihiro Murakami ◽

Yoshiro Kameyama

Keyword(s):

Early Pregnancy ◽

Vertebral Column ◽

Strain Differences ◽

In Utero ◽

Oxygen Deprivation ◽

Experimental Animals ◽

Vertebral Malformation ◽

Pregnant Mice ◽

Maternal Hypoxia ◽

In Pregnancy

Maternal hypoxia in early pregnancy can result in malformations of the vertebrae of mouse foetuses, and there is a tendency for more posterior vertebrae to be affected the later in pregnancy the oxygen deprivation occurs (Murakami & Kameyama, 1963). Ingalls et al. (1957) and Degenhardt (1954, 1959) had earlier obtained similar results. We have also exposed pregnant mice to X-radiation and studied the consequent malformations. The effects on the extremities have already been described (Murakami, Kameyama & Nogami, 1963), and in the present paper we shall describe the effects on the vertebral column. Vertebral malformations in animals irradiated in utero have been described by Job, Leibold & Fitzmaurice (1935), Warkany and Schraffenberger (1947), Russell. (1950, 1954), and Russell & Russell (1954). In order to obtain results comparable with those of our experiments with hypoxia, no less than to detect inter-strain differences, we used mice of the ddN and CF1 strains originally supplied by the Central Laboratories for Experimental Animals, Tokyo (Zikkendobutsu Chuo Kenkyujo).

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