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Anemia in Pregnancy: ACOG Practice Bulletin, Number 233.

Authors:

Obstet Gynecol 2021 Aug;138(2):e55-e64

Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Iron requirements increase during pregnancy, and a failure to maintain sufficient levels of iron may result in adverse maternal-fetal consequences. Read More

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Anemia in Pregnancy: ACOG Practice Bulletin Summary, Number 233.

Authors:

Obstet Gynecol 2021 Aug;138(2):317-319

Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Iron requirements increase during pregnancy, and a failure to maintain sufficient levels of iron may result in adverse maternal-fetal consequences. Read More

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Respiratory and glycemic control outcomes of late preterm infants after antenatal corticosteroid exposure.

J Perinatol 2021 Jul 21. Epub 2021 Jul 21.

Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Objective: To quantify changes in respiratory and glycemic control outcomes following antenatal corticosteroids (ANCS) exposure in late preterm neonates.

Design/methods: The study included 500 neonates born between 34 0/7 and 36 6/7 weeks of gestation. Study population was divided into two groups: an immature group (34 0/7-35 6/7 weeks) and a mature group (36 0/7-36 6/7 weeks). Read More

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The Serum Levels of Asymmetric Dimethylarginine, Vascular Endothelial Growth Factor, and Insulin-Like Growth Factor-1 in Preterms with Retinopathy of Prematurity.

Fetal Pediatr Pathol 2021 Jul 22:1-6. Epub 2021 Jul 22.

Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey.

Objective: To determine the serum levels of asymmetric dimethylarginine (ADMA), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1) in preterms with retinopathy of prematurity (ROP). We included 37 preterm infants. The first blood samples were obtained within the first 5 days of life and repeated at the time of the first ophthalmologic examination for ROP. Read More

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Fetal Thoracic Circumference and Lung Volume and Their Relation to Fetal Size and Pulmonary Artery Blood Flow.

J Ultrasound Med 2021 Jul 21. Epub 2021 Jul 21.

Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo.

Objective: Research on early origins of lung disease suggests the need for studying the relationships of thoracic and lung size with fetal size and pulmonary circulation. The primary aim of this study is therefore to explore the associations between fetal thoracic circumference, lung volume, and fetal size. We also aim to assess if lung volume and thoracic circumference are associated with fetal pulmonary artery blood flow velocity measures. Read More

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Altered serum soluble furin and prorenin receptor levels in pregnancies with pre-eclampsia and fetal growth restriction.

J Gynecol Obstet Hum Reprod 2021 Jul 18:102198. Epub 2021 Jul 18.

Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan.

Objective: The proprotein convertase furin is known to be involved in the processing of pro-B-type natriuretic peptide (proBNP) and prorenin receptor (PRR), suggesting that it has a potential function in blood pressure regulation. We investigated the role of furin in the etiology of pre-eclampsia and its related disorder, unexplained fetal growth restriction (FGR) without hypertension.

Methods: We evaluated serum and placental furin levels in pre-eclampsia, FGR and uncomplicated pregnancy. Read More

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Dietary fat intake during early pregnancy is associated with cord blood DNA methylation at IGF2 and H19 genes in newborns.

Environ Mol Mutagen 2021 Jul 21. Epub 2021 Jul 21.

Division of Environmental Health Sciences, University of California, Berkeley; Berkeley, CA, USA.

Maternal fat intake during pregnancy affects fetal growth, but mechanisms underlying these relations are unclear. We performed an exploratory study of the associations of fat consumption during pregnancy with cord blood DNA methylation of the Insulin-like Growth Factor 2 (IGF2) and H19 genes. We used data from 96 uncomplicated full-term pregnancies of mothers of whom majority had normal BMI (66%) in Project Viva, a prospective pre-birth cohort. Read More

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Exercise Capacity in Young Adults Born Small for Gestational Age.

JAMA Cardiol 2021 Jul 21. Epub 2021 Jul 21.

Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia Obstetricia i Neonatologia, Universitat de Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.

Importance: Being born small for gestational age (SGA), approximately 10% of all births, is associated with increased risk of cardiovascular mortality in adulthood, but mechanistic pathways are unclear. Cardiac remodeling and dysfunction occur in fetuses SGA and children born SGA, but it is uncertain whether and how these changes persist into adulthood.

Objective: To evaluate baseline cardiac function and structure and exercise capacity in young adults born SGA. Read More

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Anemic Hypoxemia Reduces Myoblast Proliferation and Muscle Growth in Late Gestation Fetal Sheep.

Am J Physiol Regul Integr Comp Physiol 2021 07 21. Epub 2021 Jul 21.

Perinatal Research Center, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.

Fetal skeletal muscle growth requires myoblast proliferation, differentiation, and fusion into myofibers in addition to protein accretion for fiber hypertrophy. Oxygen is an important regulator of this process. Therefore, we hypothesized that fetal anemic hypoxemia would inhibit skeletal muscle growth. Read More

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Gestational diabetes in rural central India: low prevalence but absence of typical risk factors.

Heliyon 2021 Jul 28;7(7):e07431. Epub 2021 Jun 28.

Jan Swasthya Sahyog, India.

Introduction: The reported prevalence of gestational diabetes mellitus (GDM) varies widely across India. Given the short-term, long-term, and multigenerational health impacts of GDM, understanding its frequency and risk factors is important for population screening strategies. We estimated the prevalence of GDM and determined associated risk factors in rural, central India, where data is sparse. Read More

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Classifying and Evaluating Fetuses With Ventriculomegaly in Genetic Etiologic Studies.

Front Genet 2021 2;12:682707. Epub 2021 Jul 2.

Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China.

The association between genetics and fetuses with ventriculomegaly (VM) is unknown. This study aimed to classify and evaluate abnormal copy number variations (CNVs) in fetuses with VM. From December 2016 to September 2020, amniotic fluid or umbilical cord blood from 293 pregnant women carrying fetuses with VM was extracted for single-nucleotide polymorphism microarray (SNP array). Read More

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Expression and significance of let-7a and tumor necrosis factor-alpha in placenta of severe preeclampsia.

J Matern Fetal Neonatal Med 2021 Jul 21:1-5. Epub 2021 Jul 21.

Department of Obstetrics, Lianyungang First People's Hospital, Lianyungang, China.

Objective: To investigate the expression and clinical significance of let-7a and tumor necrosis factor-alpha (TNF-α) in placental tissue of patients with severe preeclampsia (SPE).

Methods: From January 2018 to October 2019, 64 cases of puerperal delivery at the First People's Hospital of Lianyungang City, 44 cases of SPE (SPE group), and 20 cases of healthy pregnant women (NC group) were selected. QRT-PCR and Western-blot were used to detect the expression levels of let-7a, TNF-αmRNA, and protein in the two groups of placental tissues. Read More

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Morbidity associated with planned cesarean deliveries performed before the scheduled date: A cohort study.

Eur J Obstet Gynecol Reprod Biol 2021 Jun 29;264:83-87. Epub 2021 Jun 29.

Department of Obstetrics, Poissy-Saint-Germain-en-Laye Hospital Poissy, France; Research Unit EA 7285, Versailles St-Quentin University, Montigny-le-Bretonneux, France.

Objective: Women with planned cesareans can require delivery before the scheduled date. However, data describing the morbidity associated with planned cesarean deliveries performed before the originally scheduled date is lacking. The objective of this study was to compare the morbidity associated with planned cesarean delivery performed before compared with on the scheduled date. Read More

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Evaluation of the usefulness of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a context with increased resistance of Plasmodium falciparum in Kingasani Hospital, Kinshasa in the Democratic Republic of Congo.

Infect Genet Evol 2021 Jul 18;94:105009. Epub 2021 Jul 18.

Research Institute of Health and Society, Catholic University of Louvain, 1200 Brussels, Belgium.

Background: Increasing resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine (SP) threatens its usefulness for intermittent preventive treatment in pregnancy (IPTp-SP). The prophylactic effects of IPTp-SP on maternal malaria and adverse pregnancy outcomes were evaluated in Kingasani Hospital, Kinshasa in the Democratic Republic of Congo (DRC).

Methods: Laboring women (n = 844) and respective newborns were investigated. Read More

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Associations of single and multiple per- and polyfluoroalkyl substance (PFAS) exposure with vitamin D biomarkers in African American women during pregnancy.

Environ Res 2021 Jul 18;202:111713. Epub 2021 Jul 18.

Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address:

Vitamin D has been linked to various physiological functions in pregnant women and their fetuses. Previous studies have suggested that some per- and polyfluoroalkyl substances (PFAS) may alter serum vitamin D concentrations. However, no study has investigated the relationship between PFAS and vitamin D in pregnant women. Read More

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A polygenic score for acute vaso-occlusive pain in pediatric sickle cell disease.

Blood Adv 2021 07;5(14):2839-2851

Department of Hematology.

Individuals with monogenic disorders can experience variable phenotypes that are influenced by genetic variation. To investigate this in sickle cell disease (SCD), we performed whole-genome sequencing (WGS) of 722 individuals with hemoglobin HbSS or HbSβ0-thalassemia from Baylor College of Medicine and from the St. Jude Children's Research Hospital Sickle Cell Clinical Research and Intervention Program (SCCRIP) longitudinal cohort study. Read More

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Prophylactic Intraoperative Uterine Artery Embolization During Cesarean Section or Cesarean Hysterectomy in Patients with Abnormal Placentation: A Systematic Review and Meta-Analysis.

Cardiovasc Intervent Radiol 2021 Jul 19. Epub 2021 Jul 19.

Department of Medical Imaging, Chi Mei Medical Center, NO. 901, Zhonghua Rd., Yongkang Dist., Tainan City, 710, Taiwan.

Purpose: To evaluate the effectiveness and safety of prophylactic intraoperative uterine artery embolization (UAE) performed immediately after fetal delivery during planned cesarean section or cesarean hysterectomy in patients with placenta accreta spectrum disorder or placenta previa.

Methods: A systematic search was conducted on Ovid MEDLINE and Embase, PubMed, Web of Science, and Cochrane databases. Studies were selected using the Population/Intervention/Comparison/Outcomes (PICO) strategy. Read More

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Distinction between the effects of parental and fetal genomes on fetal growth.

Nat Genet 2021 Jul 19. Epub 2021 Jul 19.

deCODE genetics/Amgen, Reykjavik, Iceland.

Birth weight is a common measure of fetal growth that is associated with a range of health outcomes. It is directly affected by the fetal genome and indirectly by the maternal genome. We performed genome-wide association studies on birth weight in the genomes of the child and parents and further analyzed birth length and ponderal index, yielding a total of 243 fetal growth variants. Read More

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Obstetric hemorrhage risk assessment tool predicts composite maternal morbidity.

Sci Rep 2021 Jul 19;11(1):14709. Epub 2021 Jul 19.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20037, USA.

Obstetric hemorrhage is one of the leading preventable causes of maternal mortality in the United States. Although hemorrhage risk-prediction models exist, there remains a gap in literature describing if these risk-prediction tools can identify composite maternal morbidity. We investigate how well an established obstetric hemorrhage risk-assessment tool predicts composite hemorrhage-associated morbidity. Read More

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Inflammation Markers in Infants of Mothers with Gestational Diabetes.

Fetal Pediatr Pathol 2021 Jul 19:1-11. Epub 2021 Jul 19.

Neonatal Intensive Care Unit, Health Sciences University, Istanbul Zeynep Kamil Maternity and Children's Hospital Research and Training Hospital, Üsküdar Istanbul, Turkey.

Aim: Pentraxin-3, high sensitive CRP (HsCRP) and adropin were investigated in cord blood of infants of mothers with gestational diabetes mellitus (IDM) to evaluate the exposure of fetus to inflammation and whether there is any correlation with clinical findings.

Methods: Forty IDM and forty three infants whose mother did not have diabetes were included in this prospective study. Adropin, pentraxin-3 and HsCRP levels were measured in the cord blood samples. Read More

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Development and validation of an LC-MS/MS assay for the quantification of allopregnanolone and its progesterone-derived isomers, precursors, and cortisol/cortisone in pregnancy.

Anal Bioanal Chem 2021 Jul 19. Epub 2021 Jul 19.

iC42 Clinical Research & Development, Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Bioscience 2, Suite 200, 12705 East Montview Blvd, Aurora, CO, 80045, USA.

Neuroactive steroids are potent neuromodulators that play a critical role in both maternal and fetal health during pregnancy. These stress-responsive compounds are reportedly low in women with perinatal depression and may be associated with poor pregnancy outcomes in animal models. Chronic stress is a risk factor for adverse birth outcomes. Read More

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A novel peptide promotes human trophoblast proliferation and migration through PI3K/Akt/mTOR signaling pathway.

Ann Transl Med 2021 Jun;9(12):981

Department of Obstetrics and Gynecology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China.

Background: Preeclampsia (PE) is a complex pregnancy-related disease that endangers the safety of maternal and fetal. The purpose of this study is to reveal the pathogenesis of preeclampsia and discover new predictors from the perspective of peptidomics. The umbilical cord blood of PE and control group was analyzed by peptidomics. Read More

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Assessment of dopperfluxometric indices of maternal-fetal structures in pregnant ewes.

Anim Reprod 2021 5;18(2):e20210002. Epub 2021 Jul 5.

Departamento de Reprodução Animal, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista "Júlio de Mesquita Filho", Jaboticabal, SP, Brasil.

The aim of this study was to evaluate the blood flow of the uterine artery, fetal aorta and umbilical artery in the physiological pregnancy of sheep by means of pulsed Doppler throughout the gestational period. Thirty Santa Inês ewes weighing between 45.4±4. Read More

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Prenatal and Obstetric Parameters of Late Terminations: A Retrospective Analysis.

Geburtshilfe Frauenheilkd 2021 Jul 13;81(7):807-818. Epub 2021 Jul 13.

Universitätsklinikum Leipzig, Abteilung für Geburtsmedizin, Leipzig, Germany.

In Germany, the highly sensitive issue of late terminations of pregnancy and feticide is regulated in Sec. 218a para. 2 of the German Penal Code (medical indication). Read More

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Vascular Ageing in Youth: A Call to Action.

Heart Lung Circ 2021 Jul 15. Epub 2021 Jul 15.

Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France. Electronic address: https://twitter.com/rosam_bruno.

Extensive evidence shows that risk factors for cardiovascular disease (CVD) begin to develop early in life. Childhood obesity and elevated blood pressure (BP) have become overwhelmingly challenging, with 57% of today's children predicted to be obese by the age of 35 years, and global rates of hypertension in children and adolescents increasing by 75% from 2000 to 2015. Thus, there is an urgent need for tools that can assess early CVD risk in youth, which may lead to better risk stratification, preventative intervention, and personalised medicine. Read More

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Prenatal air pollution exposure to diesel exhaust induces cardiometabolic disorders in adulthood in a sex-specific manner.

Environ Res 2021 Jul 14:111690. Epub 2021 Jul 14.

Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France; MIMA2 Platform, INRAE, 78350, Jouy-en-Josas, France.

Background: Results from observational and experimental studies indicate that exposure to air pollutants during gestation reduces birth weight, whereas little is known on potential cardiometabolic consequences for the offspring at adulthood.

Objectives: Our aim was to evaluate the long-term effects of gestational exposure to diesel engine exhaust (DE) on adult offspring phenotype in a rabbit model.

Methods: The protocol was designed to mimic human exposure in large European cities. Read More

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The perinatal transition and early neonatal period in hypoplastic left heart syndrome is associated with reduced systemic and cerebral perfusion.

Can J Cardiol 2021 Jul 13. Epub 2021 Jul 13.

Cardiology Division, Stollery Children's Hospital and University of Alberta, Edmonton, Alberta. Electronic address:

Background: The impact of the striking perinatal circulatory changes on blood flow distribution have not to date been well-examined in hypoplastic left heart syndrome (HLHS). This study aims to document perinatal redistribution of cardiac output in HLHS compared to healthy controls, to further understand the impact of perinatal transition on cerebral and systemic blood flow.

Methods: Prospectively recruited HLHS cases (n=31) and healthy controls (n=19) underwent serial echocardiography from late fetal stages to 96 hours after birth. Read More

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Genotypic analysis of the female BPH/5 mouse, a model of superimposed preeclampsia.

PLoS One 2021 16;16(7):e0253453. Epub 2021 Jul 16.

Center for Immunity and Inflammation, Rutgers Biomedical and Health Sciences, Newark, NJ, United States of America.

Animal models that recapitulate human diseases and disorders are widely used to investigate etiology, diagnosis, and treatment of those conditions in people. Disorders during pregnancy are particularly difficult to explore as interventions in pregnant women are not easily performed. Therefore, models that allow for pre-conception investigations are advantageous for elucidating the mechanisms involved in adverse pregnancy outcomes that are responsible for both maternal and fetal morbidity, such as preeclampsia. Read More

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Perception of risk in massive transfusion as it relates to fetal outcomes: A survey of surgeons and nurses at one American trauma center.

Transfusion 2021 Jul;61 Suppl 1:S159-S166

Center for Injury Science and Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Background: The use of blood products early in the resuscitation of bleeding trauma patients is widely accepted, but made difficult by limited supplies of D- red blood cell (RBC)-containing products. Use of D+ RBC-containing products would alleviate this issue, but could lead to alloimmunization. Risk associated with transfusing D+ RBC in emergency bleeding situations is being reconsidered. Read More

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