scholarly journals Fetal Toxicity of Immunosuppressive Drugs in Pregnancy

2018 ◽  
Vol 7 (12) ◽  
pp. 552 ◽  
Author(s):  
Claudio Ponticelli ◽  
Gabriella Moroni

Women affected by autoimmune diseases, organ transplantation, or neoplasia need to continue immunosuppressive treatment during pregnancy. In this setting, not only a careful planning of pregnancy, but also the choice of drugs is critical to preventing maternal complications and minimizing the fetal risks. Some immunosuppressive drugs are teratogenic and should be replaced even before the pregnancy, while other drugs need to be managed with caution to prevent fetal risks, including miscarriage, intrauterine growth restriction, prematurity, and low birth weight. In particular, the increasing use of biologic agents raises the question of their compatibility with reproduction. In this review we present data on the indication and safety in pregnancy of the most frequently used immunosuppressive drugs.

2019 ◽  
Vol 20 (7) ◽  
pp. 713-726 ◽  
Author(s):  
Shiyu Tao ◽  
Tianjiao Zhou ◽  
Perot Saelao ◽  
Ying Wang ◽  
Yuhua Zhu ◽  
...  

Intrauterine growth restriction (IUGR) remains a major problem in swine production since the associated low birth weight leads to high rates of pre-weaning morbidity and mortality, and permanent retardation of growth and development. The underlying regulatory mechanisms from the aspects of epigenetic modification has received widespread attention. Studies explore the changes in genome wide methylation in small intestine (SI), liver and longissimus dorsi muscle (LDM) between IUGR and normal birth weight (NBW) newborn piglets using a methylated DNA immunoprecipitation-sequencing (MeDIP-Seq) approach. The data demonstrated that methylated peaks were prominently distributed in distal intergenic regions and the quantities of peaks in IUGR piglets were more than that of NBW piglets. IUGR piglets had relatively high methylated level in promoters, introns and coding exons in all the three tissues. Through KEGG pathway analysis of differentially methylated genes found that 33, 54 and 5 differentially methylated genes in small intestine, liver and longissimus dorsi muscle between NBW and IUGR piglets, respectively, which are related to development and differentiation, carbohydrate and energy metabolism, lipid metabolism, protein turnover, immune response, detoxification, oxidative stress and apoptosis pathway. The objective of this review is to assess the impact of differentially methylation status on developmental delay, metabolic disorders and immune deficiency of IUGR piglets.


2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Olusola Funmilayo Sotunde ◽  
Silifat Ajoke Sanni ◽  
Oluseye Olusegun Onabanjo ◽  
Ibiyemi O. Olayiwola ◽  
Mure Agbonlahor

Our study assessed the health profile of neonates in relation to anemia in pregnancy and pregnancy induced hypertension (PIH). This was a retrospective study where a systematic random sampling technique was used to select a total of 1046 case records of pregnant women registered for ante-natal care at Lagos Island Maternity Hospital, Lagos, Nigeria, between 2005 and 2009. Socio-demographic characteristics of the mothers, prevalence of anemia and PIH, and neonatal health profile were obtained from the case records and were analyzed using both descriptive and inferential statistics. Pearson product moment correlation was used to show the relationship (P≤0.05) between maternal complications and neonatal health profile. Majority (68.8%) of the mothers had anemia and 6.7 % had PIH. Majority (97.12%) of the neonates were live births and 2.88% of the neonates were still births, 65.4% of the women with still birth pregnancy outcome had anemia, and 34.6% had PIH. Majority (74%) of the neonates had birth weight within normal range (2.5-4.0 kg) and majority (68%) had normal Apgar score at 5 min of birth (7- 10). A positive correlation existed between the packed cell volume of the mother and the birth weight of the neonates (r=0.740, P≤0.05). A negative correlation existed between the incidence of PIH and the birth weight of the neonates (r=


2010 ◽  
Vol 44 (1) ◽  
pp. 90-101 ◽  
Author(s):  
Monica Yuri Takito ◽  
Maria Helena D'Aquino Benício

OBJECTIVE: To investigate the relationship between physical activity during the second trimester pregnancy and low birth weight, preterm birth, and intrauterine growth restriction. METHODS: Case-control study including 273 low birth weight newborns and 546 controls carried out in the city of São Paulo, Southeastern Brazil, in 2005. Low birth weight cases were grouped into two subsamples: preterm birth (n=117) and intrauterine growth restriction (n=134), with their related controls. Information was collected by means of interviews with mothers shortly after birth and transcription of medical records. Data were analyzed using conditional multiple and hierarchical logistic regression. RESULTS: Light physical activity for over 7 hours per day was shown to be protective against low birth weight (adjusted OR=0.61; 95% CI 0.39-0.94) with a dose-response relationship (p-value for trend=0.026). A similar trend was found for intrauterine growth restriction (adjusted OR=0.51; 95% CI 0.26-0.97). Homemaking activities were associated as a protective factor for both low birth weight and preterm birth (p-value for trend=0.013 and 0.035, respectively). Leisure-time walking was found to be protective against preterm birth. CONCLUSIONS: Mild physical activity during the second trimester of pregnancy such as walking has an independent protective effect on low birth weight, preterm birth, and intrauterine growth restriction.


2014 ◽  
Vol 5 (5) ◽  
pp. 370-373
Author(s):  
E. Dybjer ◽  
J. Linvik ◽  
P. M. Nilsson

Risk factors associated with intrauterine growth restriction (IUGR) have previously been identified, but few studies have described the relationship between IUGR and maternal stress caused by exposure to civil unrest. Here, we investigate this relationship during the Mount Elgon crisis in western Kenya between 2006 and 2008, following a period of violence. Birth weight data were compared between three hospitals in an exposed area, Mount Elgon (n=570), and one hospital in a control area, Kimilili (n=530). In a sub-analysis, the most stress exposed hospital, Bungoma West (n=211), was compared with the control hospital in Kimilili. Adjustments were made for offspring sex, gestational age and parity. The difference in mean birth weight between the most stress-exposed hospital (Bungoma West) and the control hospital (Kimilili) was 91 g after full adjustment (P=0.041). In conclusion, epidemiological data suggest a significant relationship between exposure to civil unrest and IUGR causing lower birth weight.


Author(s):  
MN Rashid ◽  
M Kari ◽  
R Rashid ◽  
MA Rana ◽  
A Amjad ◽  
...  

Preeclampsia and Intrauterine growth restriction (IUGR) remains as the important causes for the neonatal and maternal complications leading to even death in some cases. Uterine artery Doppler USG can be done transvaginally or trans abdominal and performed in the 1st or 2nd trimester of the pregnancy to detect these complications Doppler waveform suggested the high vascular resistance to blood flow. In our present study, we conclude uterine artery Doppler indices as prognostic procedure for the preeclampsia and intrauterine growth restriction. A cross-sectional survey design with convenient sampling technique was used. Mixture of standardized and self-modified structured questionnaire was undertaken to determine the indices of pre eclampsia and IUGR by uterine artery. The data was collected from Bahria International Hospital, Lahore during the period of 9 months. This study was included 162 pregnant females with identification of the main uterine artery on a longitudinal scan lateral to the uterus.  Initial diastolic notch of right and left side of the uterine artery waveforms was recorded. At every antenatal checkup, urine was tested for protein and blood pressure readings were taken to identify preeclampsia. Further analysis was done dividing patients as normotensive and those patients developing hypertension after 30 weeks of gestation. After delivery neonates observed for IUGR by head circumference and body weight. The study was concluded that from the total sample size of 162 pregnant females who undergoes uterine artery Doppler, 34% females shows diastolic notch and almost all of these later diagnosed with preeclampsia and 19.8% deliver babies with IUGR. So, based on the study, we have concluded that uterine artery Doppler is helpful to provide diagnosis of preeclampsia and IUGR in early pregnancy.


2021 ◽  
Vol 29 (1) ◽  
pp. 36
Author(s):  
Fita Maulina ◽  
M Adya F F Dilmy ◽  
Ali Sungkar

Objectives: To report maternal and perinatal outcomes of hyperthyroidsm in pregnancy.Case Report: There were 3622 cases of delivering pregnant women during the period of the study. From this number, the prevalence of pregnant women with hyperthyroid was 0.2 %. We reported 9 cases of hyperthyroid in pregnancy. The number of pregnancy complication and outcome on pregnant women with hyperthyroidism were preterm labor (44%) and preeclampsia (22%), both were found in group of mother who did taking antihyperthyroid therapy. In those who did not take antihyperthyroid therapy 11% had spontaneous abortion and 11% had preterm delivery. Fetal complications were intrauterine growth restriction (11%) and intrauterine fetal death (23%), both of these complication were on the group who did not take antihyperthyroid. On the contrary, 44% babies were born with normal birthweight in group who took antihyperthyroid.Conclusion: There were differences noted between the group that took adequate treatment and the group that did not take antihyperthyroid. The incidence of intrauterine growth restriction and intrauterine fetal death were high in group that did not took antihyperthyroid therapy but the incidence of preterm delivery as the maternal complication was high in group that did take the antihyperthyroid therapy.  


2007 ◽  
Vol 92 (7) ◽  
pp. 2758-2763 ◽  
Author(s):  
Rikke Beck Jensen ◽  
Signe Vielwerth ◽  
Torben Larsen ◽  
Gorm Greisen ◽  
Henrik Leffers ◽  
...  

Abstract Context: A common polymorphism in the GH receptor (GHR) gene has been linked to increased growth response in GH-treated patients. No former study has focused on the association to prenatal growth. Objective: The aim of the study was to evaluate the association between the d3-GHR isoforms and spontaneous pre- and postnatal growth. Design: A prospective study was conducted on third-trimester fetal growth velocity (FGV), birth weight, birth length, and postnatal growth. Setting: The study was conducted at Copenhagen University Hospital. Participants: A total of 115 healthy adolescents were divided into those born small for gestational age (SGA) and appropriate for gestational age with or without intrauterine growth restriction. Main Outcome Measures: FGV was measured by serial ultrasonography, birth weight, birth length, and adolescent height. Isoforms of the d3-GHR gene (fl/fl, d3/fl, and d3/d3) were determined. Results: The prevalence of the d3-GHR isoforms was 50% but differed among the groups (P = 0.006), with a high prevalence (88%) in the group born SGA with verified intrauterine growth restriction. The d3-GRH allele were associated with decreased third-trimester FGV (P = 0.05) in SGA subjects. In the entire cohort, carriers of the d3-GHR allele had a significantly increased height (−0.10 vs. 0.34 sd score; P = 0.017) and change in height from birth to adolescence compared with carriers of the full-length GHR allele (0.57 vs. −0.02 sd score; P = 0.005). Conclusions: This study showed an increased spontaneous postnatal growth velocity in the carriers of the d3-GHR allele. Interestingly, we found the opposite effect on prenatal growth in the SGA group, with a decreased FGV in carriers of the d3-GHR allele.


Sign in / Sign up

Export Citation Format

Share Document