CD68+ M1 MACROPHAGES IS ASSOCIATED WITH PLACENTAL INSUFFICIENCY UNDER FETAL GROWTH RESTRICTION

The aim: To elucidate the possible involvement of M1 and M2 macrophages in the placentas of women, whose pregnancies were complicated by fetal growth restriction (FGR) and resulted in term births after 37 weeks of gestation and preterm births up to 37 weeks of gestation. Materials and methods: CD68+ and CD163+ macrophages were studied by immunohistochemical method, placental morphology in the placentas of 16 women whose pregnancies were complicated by FGR and resulted in term births at a gestational age after 37 weeks (1-st group, n = 7) or resulted in preterm births at a gestational age up to 37 weeks (2-nd group, n = 9). The control group consisted of 10 placentas of women with physiological pregnancies and births. Results: Women 2-nd group showed significantly low weight of the placenta, a short gestation period at the time of delivery, and a prolonged labor period than women of the control group (p <0.001; p <0.001; p <0.05, respectively). The level of CD68+ and CD163+ macrophages in the placentas of women 2-nd group was significantly higher than in woman 1-st group (p <0.001, p <0.001, respectively). A significant correlation was found between the expression level of CD68+ monocytes in the intervillous space and the weight of a newborn (r = – 0.765; p = 0.016) in women 2-nd group. Conclusions: These studies suggest that in the placentas of women whose pregnancies were complicated by FGR and resulted in preterm births, the increased activation of CD68+ macrophages of the pro-inflammatory pool may be associated with disorders of the vascular and stromal component of the villous chorion with the development of involutive and dystrophic changes. In general, this fact probably determines the progress of chronic placental insufficiency and aggravates the development of fetal growth restriction.

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miR-16-5p, miR-103-3p, and miR-27b-3p as Early Peripheral Biomarkers of Fetal Growth Restriction

Frontiers in Pediatrics ◽

10.3389/fped.2021.611112 ◽

2021 ◽

Vol 9 ◽

Author(s):

Salvatore Tagliaferri ◽

Pasquale Cepparulo ◽

Antonio Vinciguerra ◽

Marta Campanile ◽

Giuseppina Esposito ◽

...

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Late Onset ◽

Maternal Blood ◽

Growth Restriction ◽

Therapeutic Interventions ◽

Control Group ◽

Fetal Hypoxia ◽

Blood Samples

Current tests available to diagnose fetal hypoxia in-utero lack sensitivity thus failing to identify many fetuses at risk. Emerging evidence suggests that microRNAs derived from the placenta circulate in the maternal blood during pregnancy and may be used as non-invasive biomarkers for pregnancy complications. With the intent to identify putative markers of fetal growth restriction (FGR) and new therapeutic druggable targets, we examined, in maternal blood samples, the expression of a group of microRNAs, known to be regulated by hypoxia. The expression of microRNAs was evaluated in maternal plasma samples collected from (1) women carrying a preterm FGR fetus (FGR group) or (2) women with an appropriately grown fetus matched at the same gestational age (Control group). To discriminate between early- and late-onset FGR, the study population was divided into two subgroups according to the gestational age at delivery. Four microRNAs were identified as possible candidates for the diagnosis of FGR: miR-16-5p, miR-103-3p, miR-107-3p, and miR-27b-3p. All four selected miRNAs, measured by RT-PCR, resulted upregulated in FGR blood samples before the 32nd week of gestation. By contrast, miRNA103-3p and miRNA107-3p, analyzed between the 32nd and 37th week of gestation, showed lower expression in the FGR group compared to aged matched controls. Our results showed that measurement of miRNAs in maternal blood may form the basis for a future diagnostic test to determine the degree of fetal hypoxia in FGR, thus allowing the start of appropriate therapeutic interventions to alleviate the burden of this disease.

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Morbilidade na Prematuridade Associada a Restrição do Crescimento Fetal e nos Prematuros Leves para a Idade Gestacional: Experiência de um Centro de Referência

Acta Médica Portuguesa ◽

10.20344/amp.9599 ◽

2018 ◽

Vol 31 (11) ◽

pp. 648

Author(s):

Noémia Rosado da Silva ◽

Joana Oliveira ◽

Alberto Berenguer ◽

André M. Graça ◽

Margarida Abrantes ◽

...

Keyword(s):

Intensive Care ◽

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Fetal Growth Restriction ◽

Neonatal Intensive Care ◽

Statistical Significance ◽

Growth Restriction ◽

Control Group ◽

Retrospective Case

Introduction: Prematurity and low birth weight have been associated with increased neonatal morbidity and mortality. This study aimed to evaluate possible risk factors for prematurity associated with fetal growth restriction and being small for gestational age and to determine the incidence of morbidity in these two groups of infants.Material and Methods: Retrospective case-control study of newborns with gestational age of less than 32 weeks, with obstetric diagnosis of fetal growth restriction and with the clinical diagnosis of small for gestational age, admitted to the Neonatal Intensive Care Unit of a tertiary hospital for a period of six years.Results: A total of 356 newborns were studied, with an incidence of 11% of fetal growth restriction and 18% of small for gestational age. Pre-eclampsia was the risk factor for gestation with higher statistical significance (47% vs 16%, p < 0.001) in small for gestational age newborns. There was also a higher incidence of mild bronchopulmonary dysplasia (66% vs 38%, p = 0.005), late sepsis (59% vs 37%, p = 0.003), retinopathy of prematurity (58% vs 26%, p = 0.003) and necrotizing enterocolitis (20% vs 9%, p = 0.005). Mortality was similar in all three groups.Discussion: There were fewer newborn males diagnosed with fetal growth restriction during pregnancy compared to women. Significant differences were observed in the group of these infants regarding the occurrence of chorioamnionitis and pre-eclampsia in comparison to the control group. Newborns with fetal growth restriction and small for age had higher scores on clinical risk indices compared to the control group. In general, small for gestational age newborns had a higher incidence of morbidity than infants with fetal growth restriction and the control group.Conclusion: Advances in neonatal intensive care decreased mortality in preterm infants. However, there are still significant differences in the incidence of morbidity in newborns with growth compromise. The collaboration between obstetricians and neonatologists provides the basis for a correct clinical evaluation, early signaling and global intervention on these newborns, with a significant impact on short and long-term prognosis.

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Correlation between Severity of Fetal Growth Restriction and Oxidative Stress in Severe Small-for-Gestational-Age Infants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010726 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10726

Author(s):

Mariko Ashina ◽

Takumi Kido ◽

Yuki Kyono ◽

Asumi Yoshida ◽

Shutaro Suga ◽

...

Keyword(s):

Oxidative Stress ◽

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Stress Index ◽

Control Group ◽

Z Score ◽

Significant Difference

Severe small-for-gestational-age (sSGA) infants exhibit increased mortality and morbidity. Oxidative stress is suggested to be involved in intrauterine growth restriction. This retrospective study aimed to evaluate the oxidative stress level at birth in an sSGA population. Sera of 28 sSGA (sSGA group) and 31 non-sSGA (control group) infants, born at our hospital between March 2017 and March 2020, were evaluated. Oxidative stress (derivative of reactive oxidative metabolites: d-ROM level), biological antioxidant potential (BAP) level, and the ratio of d-ROM/BAP level (oxidative stress index: OSI) were measured. The sSGA group had a significantly lower birth weight (BW), BW z-score, head circumference, and height than the control group (all p < 0.05). No significant difference was noted in the BAP level; sSGA infants exhibited a significantly higher d-ROM level than control infants. sSGA infants showed a significantly increased OSI compared with control infants, and the BW z-score was inversely correlated with d-ROM levels and OSI in sSGA infants (R2 = 0.300; p < 0.01 and R2 = 0.319; p = 0.02, respectively) but not in controls. In conclusion, sSGA infants, including preterm infants, exhibited higher oxidative stress at birth. The severity of fetal growth restriction was significantly correlated with oxidative stress levels at birth in sSGA infants.

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Comparison of fetal cardiac functions between small-for-gestational age fetuses and late-onset growth-restricted fetuses

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0206 ◽

2019 ◽

Vol 47 (8) ◽

pp. 879-884

Author(s):

Başak Kaya ◽

Ahmet Tayyar ◽

Deniz Kanber Açar ◽

Serdar Kaya

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Fetal Growth Restriction ◽

Late Onset ◽

Growth Restriction ◽

Doppler Imaging ◽

Control Group ◽

Ejection Time ◽

Cardiac Functions

Abstract Background This study aimed to investigate fetal cardiac functions by spectral tissue Doppler imaging (s-TDI) in pregnancies complicated with late-onset fetal growth restriction (LO-FGR) and small-for-gestational age (SGA). Methods Forty pregnancies complicated with late-onset FGR and 40 pregnancies complicated with SGA between the 34th and 37th weeks of gestation were enrolled in this study. Forty gestational age-matched pregnant women with no obstetrics complication were randomly selected as a control group. Small fetuses were classified as fetal growth restriction or SGA according to estimated fetal weight (EFW), umbilical artery pulsatility index (PI), cerebroplacental ratio (CPR) and uterine artery PI. s-TDI measurements were obtained at the right atrioventricular valve annulus. Results SGA and LO-FGR fetuses had significantly lower A′ and S′ values, and higher E′/A′ ratio than the control group (P < 0.001). In comparison to controls, significantly prolonged isovolumetric contraction time (ICT′) and isovolumetric relaxation time (IRT′) and, significantly shortened ejection time (ET′) were observed in fetuses with SGA and LO-FGR. Increased myocardial performance index (MPI′) values were also found in fetuses with SGA and LO-FGR compared to controls. Conclusion The signs of cardiac dysfunction were observed both in fetuses with SGA and LO-FGR. The fetal cardiac function assessment with s-TDI could be a valuable method in the diagnosis of true growth restricted fetuses and in the management of these fetuses.

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Changes of the sleep in pregnant women with intrauterine fetal growth restriction

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(1)-30 ◽

2018 ◽

Vol 22 (1) ◽

pp. 160-162

Author(s):

A.M. Berbets

Keyword(s):

Pregnant Women ◽

Sleep Disorders ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Intrauterine Growth Restriction ◽

Placental Insufficiency ◽

Growth Restriction ◽

Control Group ◽

Intrauterine Growth ◽

Intrauterine Fetal Growth Restriction

Objective – to study the reasons of appearance, terms of manifestation and types of the sleep disorders in pregnant women with intrauterine growth restriction of fetus. 80 pregnant women with placental insufficiency, manifesting as intrauterine fetal growth restriction (IUGR) of II–III degree in the 3rd pregnancy trimester (study group) and 30 women with normal clinical flow of pregnancy (control group) were questioned. They were asked about pregnancy term when the complains of the sleep disorders were firstly expressed, as well as about types of the sleep disorders and their frequency (in times per week). Questioning showed that pregnant women with IUGR in 86% cases experience the sleep disorders starting from pregnancy term 12–22 weeks (healthy pregnant women — mostly after 30 weeks, 57% cases), more commonly wake up 2 or more times per night (71% of positive answers, in control group – 23%), and 3 or more times per week (78% of positive answers, in control group – 17%). Thus, sleep disorders in pregnant women with IUGR appear earlier and seem to be more expressed then in pregnant women with normal fetal growth. Expression of the complains of insomnia, in our opinion, might be considered as an early diagnostic sign of forming of placental insufficiency, which is later realized as IUGR.

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Significance of pregnancy-associated plasma protein a (PAPP-a) concentration determination in the assessment of final outcome of pregnancy

Vojnosanitetski pregled ◽

10.2298/vsp110530023l ◽

2013 ◽

Vol 70 (1) ◽

pp. 46-50 ◽

Cited By ~ 3

Author(s):

Dragan Loncar ◽

Mirjana Varjacic ◽

Slobodan Arsenijevic

Keyword(s):

Pregnant Women ◽

Fetal Growth ◽

Plasma Protein ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Protein A ◽

Growth Restriction ◽

Control Group ◽

Group I ◽

Significant Difference

Background/Aim. Pregnancy-associated plasma protein A (PAPP-A) is high molecular matrix metalloproteinase originally isolated in the serum of pregnant women. The aim of this study was to analyze the values of concentration of PAPP-A in assessment of progress and outcome of pregnancy in pregnant women diagnosed with threatening preterm delivery, preeclampsia and fetal growth restriction in relation to physiological pregnancy of the same gestational age. Methods. The study included 60 pregnant women that were divided into three groups according to gestational age and the diagnosis of imminent premature birth upon reception, preeclampsia and fetal growth restriction as follows: the group I from 28 to 32 weeks of gestation, a total of 25 pregnant women, the group II from 33 to 36 weeks of gestation, a total of 23 pregnant women, and the group III from 37 to 41 weeks of gestation, a total of 12 pregnant women. The control group consisted of 60 pregnant women without complications of pregnancy that were identically divided into three groups according to gestational age as in the sample. We performed quantitative determination of PAPP-A from the venous blood of patients by using commercial tests of the company Diagnostics Product Corporation (DPC), Los Angeles, California, USA. Results. There was a statistically significant difference in PAPP-A values in the examined groups in all gestational ages (p < 0.01). The value of the PAPP-A concentration in different gestational ages with equal statistical significance indicated the possibility of complications, which was examined during pregnancy in relation to the control group of pregnant women with physiological pregnancies. This study confirmed that there was a statistically significant difference in fetal body weight at birth (p < 0.05), Apgar score in 5 min after birth (p < 0.05), and gestational age at birth (p < 0.05), as parameters of the outcome of pregnancy course, between the examined groups of pregnant women in relation to the value of PAPP-A concentration. The age of pregnant women was not statistically different in the examined groups (p > 0.05). Conclusion. Differences in PAPP-A concentration should point out to the obstetrician the need for more intensive antepartum fetal surveillance in order to increase the chances of favorable perinatal outcome, regardless gestational age.

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INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.25a ◽

2018 ◽

pp. 184-195

Author(s):

Minh Son Pham ◽

Vu Quoc Huy Nguyen ◽

Dinh Vinh Tran

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Growth Potential ◽

National Guidelines ◽

Intrauterine Growth ◽

No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

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