Preterm Birth, Inflammation and Infection: New Alternative Strategies for their Prevention

Background:Worldwide, the progress in reducing neonatal mortality has been very slow. The rate of preterm birth has increased over the last 20 years in low-income and middle-income countries. Its association with increased mortality and morbidity is based on experimental studies and neonatal outcomes from countries with socioeconomic differences, which have considered implementing alternative healthcare strategies to prevent and reduce preterm births.Methods:Currently, there is no widely effective strategy to prevent preterm birth. Pharmacological therapies are directed at inhibiting myometrial contractions to prolong parturition. Some drugs, medicinal plants and microorganisms possess myorelaxant, anti-inflammatory and immunomodulatory properties that have proved useful in preventing preterm birth associated with inflammation and infection.Results:This review focuses on the existing literature regarding the use of different drugs, medicinal plants, and microorganisms that show promising benefits for the prevention of preterm birth associated with inflammation and infection. New alternative strategies involving the use of PDE-4 inhibitors, medicinal plants and probiotics could have a great impact on improving prenatal and neonatal outcomes and give babies the best start in life, ensuring lifelong health benefits.Conclusion:Despite promising results from well-documented cases, only a small number of these alternative strategies have been studied in clinical trials. The development of new drugs and the use of medicinal plants and probiotics for the treatment and/or prevention of preterm birth is an area of growing interest due to their potential therapeutic benefits in the field of gynecology and obstetrics.

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Determination of potential sources of drug development for menstrual disorders: A qualitative analysis of published literature of in-vitro rat uterus experimental studies

International Journal of Pharmaceutical Chemistry and Analysis ◽

10.18231/j.ijpca.2021.010 ◽

2021 ◽

Vol 8 (2) ◽

pp. 45-48

Author(s):

Paroma Arefin ◽

Md. Shehan Habib ◽

Aishawarya Arefin ◽

Md. Saidul Arefin

Keyword(s):

Medicinal Plants ◽

Drug Development ◽

Experimental Studies ◽

New Drugs ◽

Uterine Contractility ◽

Menstrual Disorders ◽

Rat Uterus ◽

Herbal Plants

Many herbal plants have been recorded in medicine for their usefulness in menstrual disorders, however, a few have been extensively examined for their pharmacological activities. These plants have been recorded to have usefulness in the management of painful menses, preventing miscarriages, prolonging birth, or inducing birth. Therefore, the effects of herbal plants on the contractility of the uterus will be investigated using the in-vitro experiment of the isolated rat uterus. The study aims to assess the most outstanding plants that are used to treat menstrual disorders, their uterine contractility properties, and adverse effects. The study will therefore acknowledge the importance of medicinal plants in the study of new drugs for regulating uterine contractility and propose suggestions for improving experiments involving medicinal plants on uterine contractility for drug development. The study will provide a direction as to whether the plant extract has drug development potential.

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Perinatal Outcomes and Factors Associated with Ethnic Group in cases of Preterm Birth: the Multicenter Study on Preterm Birth in Brazil

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1739492 ◽

2021 ◽

Vol 43 (11) ◽

pp. 811-819

Author(s):

Karayna Gil Fernandes ◽

Renato Teixeira Souza ◽

Renato Passini ◽

Ricardo Porto Tedesco ◽

José Guilherme Cecatti

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Low Income ◽

White Women ◽

Gestational Hypertension ◽

Mode Of Delivery ◽

Neonatal Outcomes ◽

Self Report ◽

Bivariate Analysis

Abstract Objective To investigate the characteristics of women who had preterm birth (PTB) and related outcomes according to ethnicity. Methods A secondary analysis of a multicenter cross-sectional study conducted in Brazil. Women who had PTB were classified by self-report as white and non-white. Clinical, pregnancy, and maternal data were collected through postpartum interviews and reviews of medical charts. The sociodemographic, obstetric and clinical characteristics of the women, as well as the mode of delivery and the neonatal outcomes among different ethnic groups were compared through a bivariate analysis. Results Of the 4,150 women who had PTB, 2,317 (55.8%) were non-white, who were more likely: to be younger than 19 years of age (prevalence ratio [PR]: 1.05; 95% confidence interval [95%CI]: 1.01–1.09); to be without a partner; to live on low income; to have lower levels of schooling; to have ≥ 2 children; to perform strenuous work; to be from the Northeastern region of Brazil rather than the from Southern region; to have a history of ≥ 3 deliveries; to have an interpregnancy interval < 12 months; to have pregnancy complications such as abortion, PTB, preterm premature rupture of membranes (pPROM), and low birth weight; to initiate antenatal care (ANC) visits in the second or third trimesters; to have have an inadequate number of ANC visits; to be under continuous overexertion; to smoke in the first and second or third trimesters; and to have anemia and gestational hypertension. The maternal and neonatal outcomes did not differ between the groups, except for the higher rate of low birth weight (73.7% versus 69.0%) in infants born to non-white women, and the higher rate of seizures (4.05% versus 6.29%) in infants born to white women. Conclusion Unfavorable conditions were more common in non-whites than in whites. Proper policies are required to decrease inequalities, especially in the context of prematurity, when women and their neonates have specific needs.

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Critical Analysis of Snuhi - Euphorbia Neriifolia (Upavisha- Poisonous Plant) and its Application as a Therapeutic Aid

AYUSHDHARA ◽

10.47070/ayushdhara.v8i5.807 ◽

2021 ◽

pp. 3498-3505

Author(s):

Sorab Gaind

Keyword(s):

Medicinal Plants ◽

Critical Analysis ◽

Experimental Studies ◽

Therapeutic Effects ◽

Poisonous Plant ◽

Poisonous Plants ◽

Cytogenetic Effect ◽

Traditional System ◽

Toxicity Studies ◽

Therapeutic Benefits

Traditional system of medicines has vast applications of poisonous plants; hence the knowledge about poisonous plant and its therapeutic effects becomes very essential to develop a new drug for the new diseases like Covid 19 and other diseases. Many research studies have showed that the poisonous medicinal plants are endowed with properties like Antidiabetic, Anticancer, Antibacterial, Antifungal, and Cytogenetic effect. This study focused on one such drug called Snuhi - Euphorbia Neriifolia, a Upavisha or a poisonous plant to evaluate its therapeutic effects, which would be helpful for the mankind after the proper Shodhana (purification), by conducting experimental studies, toxicity studies and thereby applied in various diseases for its therapeutic benefits and to relieve the sufferings of the patients.

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Phytotherapy for wound healing: The most important herbal plants in wound healing based on Iranian etnobotanical documents

Mini-Reviews in Medicinal Chemistry ◽

10.2174/1389557520666201119122608 ◽

2020 ◽

Vol 20 ◽

Cited By ~ 1

Author(s):

Kamal Solati ◽

Mehrdad Karimi ◽

Mahmoud Rafieian-Kopaei ◽

Naser Abbasi ◽

Saber Abbaszadeh ◽

...

Keyword(s):

Wound Healing ◽

Medicinal Plants ◽

Aloe Vera ◽

Datura Stramonium ◽

New Drugs ◽

Mentha Pulegium ◽

Accelerate Wound Healing ◽

Healing Tissue ◽

Herbal Plants ◽

Echium Amoenum

: Wound healing is a process which starts with inflammatory response after damage occurrence. This process happens by restoring the wound surface coating tissue, migrating fibroblasts to form the needed collagen, forming a healing tissue and finally contortion and extraction of the wound. Today, various drugs are used to heal the wound. However, the used drugs to repair wounds have some defects and side effects. In spite of all attempts to accelerate wound healing definitely, no safe drug has been introduced for this purpose. Therefore, the necessity of identifying herbal plants in ethnopharmacology and ethnobotany documents with healing effect is felt essential. In this article we tried to review and present Iranian effective medicinal plants and herbal compounds used for wound healing. Searching was performed on databases including ISI Web of Science, PubMed, PubMed Central, Scopus, ISC, SID, Magiran and some other databases. The keywords used included wound healing, skin treatment, medicinal plants, ethnobotany, and phytotherapy. In this regard, 139 effective medicinal plants on wound healing were identified based on ethnopharmacology and ethnobotanical sources of Iran. Medicinal plants such as Salvia officinalis, Echium amoenum, Verbascum spp., G1ycyrrhiza glabra, Medicago sativa, Mentha pulegium, Datura stramonium L., Alhagi spp., Aloe vera, Hypericum perforatum, Pistacia atlantica and Prosopis cineraria were the most important and effective medicinal plants on wound healing in Iran. These native Iranian medicinal plants are full of antioxidants and biological compounds and might be used for wound healing and preparation of new drugs.

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The Discovery and Development of Oxalamide and Pyrrole Small Molecule Inhibitors of gp120 and HIV Entry - A Review

Current Topics in Medicinal Chemistry ◽

10.2174/1568026619666190717163959 ◽

2019 ◽

Vol 19 (18) ◽

pp. 1650-1675 ◽

Cited By ~ 2

Author(s):

Damoder Reddy Motati ◽

Dilipkumar Uredi ◽

E. Blake Watkins

Keyword(s):

Small Molecule ◽

Viral Entry ◽

Biological Evaluation ◽

New Drugs ◽

Design Synthesis ◽

Mortality And Morbidity ◽

Glycoprotein Gp120 ◽

Hiv Entry ◽

Immunodeficiency Syndrome ◽

Hiv 1

Human immunodeficiency virus type-1 (HIV-1) is the causative agent responsible for the acquired immunodeficiency syndrome (AIDS) pandemic. More than 60 million infections and 25 million deaths have occurred since AIDS was first identified in the early 1980s. Advances in available therapeutics, in particular combination antiretroviral therapy, have significantly improved the treatment of HIV infection and have facilitated the shift from high mortality and morbidity to that of a manageable chronic disease. Unfortunately, none of the currently available drugs are curative of HIV. To deal with the rapid emergence of drug resistance, off-target effects, and the overall difficulty of eradicating the virus, an urgent need exists to develop new drugs, especially against targets critically important for the HIV-1 life cycle. Viral entry, which involves the interaction of the surface envelope glycoprotein, gp120, with the cellular receptor, CD4, is the first step of HIV-1 infection. Gp120 has been validated as an attractive target for anti-HIV-1 drug design or novel HIV detection tools. Several small molecule gp120 antagonists are currently under investigation as potential entry inhibitors. Pyrrole, piperazine, triazole, pyrazolinone, oxalamide, and piperidine derivatives, among others, have been investigated as gp120 antagonist candidates. Herein, we discuss the current state of research with respect to the design, synthesis and biological evaluation of oxalamide derivatives and five-membered heterocycles, namely, the pyrrole-containing small molecule as inhibitors of gp120 and HIV entry.

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Interleukin-6 and Malondialdehyde in Women with Preterm Birth

Current Immunology Reviews ◽

10.2174/1573395515666191026140006 ◽

2019 ◽

Vol 15 (2) ◽

pp. 207-212

Author(s):

Vinita Verma ◽

Hina Oza ◽

Riddhi Thaker ◽

Sunil Kumar

Keyword(s):

Oxidative Stress ◽

Preterm Birth ◽

Interleukin 6 ◽

Critical Role ◽

Serum Levels ◽

Maternal Serum ◽

Full Term ◽

Mortality And Morbidity ◽

Term Birth ◽

Weak Negative Correlation

Background: Preterm Birth (PTB) is one of the main causes of neonatal death and infant mortality and morbidity. The pro-inflammatory cytokine interleukin-6 (IL-6) is a major proinflammatory mediator of the host response to infection and malondialdehyde (MDA) is a marker of oxidative stress. Objective : To evaluate potential associations between IL-6 and MDA levels in women with preterm birth. Method: A total of 150 women (66 with full-term and 84 with PTB) were enrolled in this case-control study. Predesigned performas were filled through questionnaire interviews to collect data on personal, demographic, occupational, lifestyle and reproductive history. Blood samples were collected within 36 hours of delivery. Serum concentrations of IL-6 and MDA were determined in mothers with full-term and preterm birth. Results: The mean age was marginally higher; whereas BMI was slightly lower in cases (PTB) as compared to controls (full-term) subjects. Serum IL-6 and MDA levels were significantly higher in subjects with PTB than full-term birth. The data were further analyzed with respect to underweight, normal and overweight/obese BMI. In all the BMI categories, the levels of IL-6 and MDA were higher in PTB cases. Among the PTB categories, the levels of IL-6 and MDA were highest in moderate to late preterm birth. A significant positive correlation was found between IL-6 and MDA levels. There was a weak negative correlation between either IL-6 or MDA and the number of gestational weeks. Conclusion : Elevated maternal serum levels of Interleukin-6 and Malondialdehyde in preterm as compared to full-term birth might suggest that inflammation and oxidative stress play a critical role in PTB.

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Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

Current Women s Health Reviews ◽

10.2174/1573404816999201009160848 ◽

2020 ◽

Vol 16 ◽

Author(s):

Reza Omani-Samani ◽

Saman Maroufizadeh ◽

Nafise Saedi ◽

Nasim Shokouhi ◽

Arezoo Esmailzadeh ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Cesarean Section ◽

Pregnant Women ◽

Maternal Age ◽

Unwanted Pregnancy ◽

Advanced Maternal Age ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

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Predicting Risk of Antenatal Depression and Anxiety Using Multi-Layer Perceptrons and Support Vector Machines

Journal of Personalized Medicine ◽

10.3390/jpm11030199 ◽

2021 ◽

Vol 11 (3) ◽

pp. 199

Author(s):

Fajar Javed ◽

Syed Omer Gilani ◽

Seemab Latif ◽

Asim Waris ◽

Mohsin Jamil ◽

...

Keyword(s):

Low Income ◽

Operating Characteristic ◽

Mental Health Problems ◽

Characteristic Curve ◽

Antenatal Depression ◽

Low Income Countries ◽

Support Vector ◽

Depression And Anxiety ◽

Gynecology And Obstetrics ◽

Operating Characteristic Curve

Perinatal depression and anxiety are defined to be the mental health problems a woman faces during pregnancy, around childbirth, and after child delivery. While this often occurs in women and affects all family members including the infant, it can easily go undetected and underdiagnosed. The prevalence rates of antenatal depression and anxiety worldwide, especially in low-income countries, are extremely high. The wide majority suffers from mild to moderate depression with the risk of leading to impaired child–mother relationship and infant health, few women end up taking their own lives. Owing to high costs and non-availability of resources, it is almost impossible to diagnose every pregnant woman for depression/anxiety whereas under-detection can have a lasting impact on mother and child’s health. This work proposes a multi-layer perceptron based neural network (MLP-NN) classifier to predict the risk of depression and anxiety in pregnant women. We trained and evaluated our proposed system on a Pakistani dataset of 500 women in their antenatal period. ReliefF was used for feature selection before classifier training. Evaluation metrics such as accuracy, sensitivity, specificity, precision, F1 score, and area under the receiver operating characteristic curve were used to evaluate the performance of the trained model. Multilayer perceptron and support vector classifier achieved an area under the receiving operating characteristic curve of 88% and 80% for antenatal depression and 85% and 77% for antenatal anxiety, respectively. The system can be used as a facilitator for screening women during their routine visits in the hospital’s gynecology and obstetrics departments.

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Metabolic-endocrine disruption due to preterm birth impacts growth, body composition, and neonatal outcome

Pediatric Research ◽

10.1038/s41390-021-01566-8 ◽

2021 ◽

Author(s):

Lea Sophie Möllers ◽

Efrah I. Yousuf ◽

Constanze Hamatschek ◽

Katherine M. Morrison ◽

Michael Hermanussen ◽

...

Keyword(s):

Body Composition ◽

Preterm Birth ◽

Postnatal Development ◽

Endocrine Disruption ◽

Fat Mass ◽

Neonatal Morbidity ◽

Neonatal Outcomes ◽

Endocrine Function ◽

List Type ◽

Term Infants

Abstract Despite optimized nutrition, preterm-born infants grow slowly and tend to over-accrete body fat. We hypothesize that the premature dissociation of the maternal–placental–fetal unit disrupts the maintenance of physiological endocrine function in the fetus, which has severe consequences for postnatal development. This review highlights the endocrine interactions of the maternal–placental–fetal unit and the early perinatal period in both preterm and term infants. We report on hormonal levels (including tissue, thyroid, adrenal, pancreatic, pituitary, and placental hormones) and nutritional supply and their impact on infant body composition. The data suggest that the premature dissociation of the maternal–placental–fetal unit leads to a clinical picture similar to panhypopituitarism. Further, we describe how the premature withdrawal of the maternal–placental unit, neonatal morbidities, and perinatal stress can cause differences in the levels of growth-promoting hormones, particularly insulin-like growth factors (IGF). In combination with the endocrine disruption that occurs following dissociation of the maternal–placental–fetal unit, the premature adaptation to the extrauterine environment leads to early and fast accretion of fat mass in an immature body. In addition, we report on interventional studies that have aimed to compensate for hormonal deficiencies in infants born preterm through IGF therapy, resulting in improved neonatal morbidity and growth. Impact Preterm birth prematurely dissociates the maternal–placental–fetal unit and disrupts the metabolic-endocrine maintenance of the immature fetus with serious consequences for growth, body composition, and neonatal outcomes. The preterm metabolic-endocrine disruption induces symptoms resembling anterior pituitary failure (panhypopituitarism) with low levels of IGF-1, excessive postnatal fat mass accretion, poor longitudinal growth, and failure to thrive. Appropriate gestational age-adapted nutrition alone seems insufficient for the achievement of optimal growth of preterm infants. Preliminary results from interventional studies show promising effects of early IGF-1 supplementation on postnatal development and neonatal outcomes.

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Ethnomedicinal Plants Traditionally Used for the Treatment of Jaundice (Icterus) in Himachal Pradesh in Western Himalaya—A Review

Plants ◽

10.3390/plants10020232 ◽

2021 ◽

Vol 10 (2) ◽

pp. 232

Author(s):

Disha Raghuvanshi ◽

Rajni Dhalaria ◽

Anjali Sharma ◽

Dinesh Kumar ◽

Harsh Kumar ◽

...

Keyword(s):

Medicinal Plants ◽

Plant Species ◽

Ricinus Communis ◽

Western Himalaya ◽

Saccharum Officinarum ◽

Himachal Pradesh ◽

New Drugs ◽

Tinospora Cordifolia ◽

Ethnomedicinal Plants ◽

Pharmacological Significance

Ethnomedicinal plants have a significant role in the lives of people of rural and tribal areas. Thousands of medicinal plant species are used to treat various diseases, including jaundice, and are considered an important therapeutic resource to minimize these diseases. Jaundice (icterus) is a chronic disease that occurs when the amount of bilirubin in the blood increases. This review describes different ethnomedicinal plants used for curing jaundice by tribal and rural people of Himachal Pradesh. The study reveals 87 ethnomedicinal plant species belonging to 51 different families, which are used for treating jaundice in Himachal Pradesh. These plants are arranged in a systematic way, which includes a description of their common name, botanical name, along with its family, plant parts used, region, and mode of use in tabulated form. Some of the plant extracts have already been explored for their phytochemical and pharmacological significance and proved their potential in the preparation of new medicines or drugs against the treatment of jaundice. This review is an attempt to highlight the indigenous knowledge of medicinal plants, which are specifically used for the treatment of jaundice. The data mentioned in the present review is compiled from various sources like existing literature, books, Google Scholar, and Scopus publications. Among all the observed plant species, most used medicinal plants for the treatment of jaundice include Justicia adhatoda, Emblica officinalis, Ricinus communis, Saccharum officinarum, Terminalia chebula, Berberis aristata, Cuscuta reflexa, and Tinospora cordifolia. Plants that are mostly utilized for the treatment of jaundice need to be scientifically validated by pharmacological analysis and should be subsequently used for the preparation of new drugs, which may prove far more beneficial than the existing one.

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