Search Results (148)

Background: Prematurely born newborns with low birth weight constitute a group of patients who require special care from the first days of life. Prematurity and low birth weight affect about 13.4 million infants. Risk factors include placental disorders but also factors related to the mother, such as smoking, alcohol drinking, drug use, malnutrition, or certain diseases. It is imperative to educate women of reproductive age (15–49) about the basic factors influencing embryonic development, such as oral health, diet, medicine intake, and harmful habits. Even though most women are aware of the negative impact of harmful habits on the fetus, still too little attention is paid to oral health in pregnant women. Poor oral health may influence the well-being of the future mother, as well as of the child. Therefore, women of reproductive age and those who are pregnant must have adequate knowledge on this subject. The aim of this study was to assess the knowledge of Polish women of reproductive age (15–49) regarding oral health during pregnancy, including the impact of dental treatment, oral hygiene, and maternal oral conditions on pregnancy outcomes and the health of the newborn. Materials and Methods: This was a cross-sectional study of 508 women, in the reproductive age, whose age ranged from 18 to 49 years old. The surveys were conducted from April 2020 to November 2020. The questionnaire was originally developed based on the available literature and consisted of seven sections: basic information, general health and habits, pregnancy status and dental care, knowledge of treatment options during pregnancy, oral health status and its association with the risk of preterm birth, prematurity and the child’s oral health, and breastfeeding and oral development. Results: After excluding incomplete questionnaires, a total of 499 questionnaires were included in the analysis. Women participating in the study had a fairly good understanding of the impact of oral health on the fetus and the role of breastfeeding in the development of the stomatognathic system (from 50% to 70% correct answers). However, even though most respondents had completed higher education (344/68.94%), their knowledge of oral health, preterm birth, and low birth weight was very limited (including the impact of inflammation on the intrauterine development of the child or bacteria and transfer across the placenta). In these sections, the percentage of correct answers ranged from less than 20% to 50%. When analyzing knowledge by age, education, number of births, and place of residence, the highest levels of knowledge were observed among respondents with higher education, particularly those aged 27–32. Conclusions: Respondents had a fairly good understanding of the general impact of oral health during pregnancy and recognition of the importance of breastfeeding for infants. However, their knowledge about the impact of bacteria and inflammation in the mother’s oral cavity on prematurity and low birth weight was limited. Therefore, educating women of reproductive age and pregnant women on this topic is essential, as it may help reduce the adverse consequences of prematurity. Full article

Gestational diabetes mellitus (GDM) occurs in approximately 9–25% of pregnancies and, if left undiagnosed or inadequately controlled, can lead to adverse outcomes for both the mother and the fetus, short and long term. GDM is characterized by glucose intolerance with onset or first recognition during pregnancy and is a multifactorial condition with a pathophysiology that remains incompletely understood. It is strongly associated with a chronic low-grade inflammatory state that contributes to insulin resistance, a hallmark of GDM pathogenesis. Among the fundamental pro-inflammatory cytokines implicated in this process, TNF-α and IL-6 play central roles. TNF-α is a cytokine primarily secreted by activated macrophages, as well as by adipocytes in the context of obesity. Many studies have shown that its levels are elevated in pregnant women with GDM compared to normoglycemic pregnant individuals. IL-6 is another pro-inflammatory cytokine secreted by immune cells, adipose tissue, and the placenta. It is found in higher concentrations in the maternal circulation during pregnancies complicated by GDM. Both TNF-α and IL-6 act synergistically to perpetuate a pro-inflammatory intrauterine environment. Their combined effects exacerbate insulin resistance and may impair pancreatic β-cell compensation during pregnancy, facilitating the onset of GDM in genetically or metabolically susceptible individuals. Recent research has identified various maternal serum biomarkers, such as TNF-α and IL-6, that may hold promise for the early detection of GDM. The aim of our study is to evaluate whether TNF-α and IL-6 can be used as diagnostic tools for the early diagnosis of GDM, allowing for timely intervention and reducing the risk of associated maternal and fetal complications. Full article

The prevalence, pathogenesis, and long-term consequences of hypertension differ significantly across the sexes, and pregnancy is a special physiological stress test that can reveal a woman’s underlying cardiovascular sensitivity. In addition to being direct risks to the health of the mother and fetus, hypertensive disorders of pregnancy (HDPs), especially preeclampsia, are also reliable indicators of future hypertension and cardiovascular disease in those who are afflicted. Fetal sex has a substantial impact on maternal vascular adaptation, according to new data from placental transcriptomics and epigenetics. This may be due to variations in the expression of angiogenic, immunomodulatory, and vasoactive genes. Sex-specific patterns of placental function, inflammation, and endothelium control are specifically influenced by X-linked gene dosage, escape from X-inactivation, and sex chromosomal composition. These biological variations highlight the placenta’s potential function as a mediator and indicator of maternal cardiovascular risk, and they may help to explain why the incidence and severity of hypertensive pregnancy challenges vary depending on the fetal sex. The purpose of this review is to summarize the state of the art regarding how placental genetics and fetal sex influence maternal hypertensive risk both during and after pregnancy. Additionally, it will investigate how these findings may influence sex-specific cardiovascular screening, prediction, and prevention methods. Full article

Background/Objectives: Prenatal hypoxia (PH) is a leading cause of nervous system disorders in early childhood and subsequently leads to a decline in the cognitive and mnemonic functions of the central nervous system (such as memory impairment, reduced learning ability, and information processing). It also increases anxiety and the risk of brain disorders in adulthood. Compensatory–adaptive mechanisms of the mother–placenta–fetus system, which enhance the fetus’s CNS resilience, are known, including the activation of endogenous neuroprotection in response to hypoxic brain injury through the pharmacological modulation of HSP₇₀. Methods: To evaluate the effect of HSP₇₀ modulators—Cerebrocurin, Angiolin, Tamoxifen, Glutaredoxin, Thiotriazoline, and HSF-1 (heat shock factor 1 protein), as well as Mildronate and Mexidol—on the motor skills, exploratory behaviors, psycho-emotional activities, learning, and memories of offspring after PH. Experimental PH was induced by daily intraperitoneal injections of sodium nitrite solution into pregnant female rats from the 16th to the 21st day of pregnancy at a dose of 50 mg/kg. The newborns received intraperitoneal injections of Angiolin (50 mg/kg), Thiotriazoline (50 mg/kg), Mexidol (100 mg/kg), Cerebrocurin (150 µL/kg), L-arginine (200 mg/kg), Glutaredoxin (200 µg/kg), HSF-1 (50 mg/kg), or Mildronate (50 mg/kg) for 30 days. At 1 month, the rats were tested in the open field test, and at 2 months, they were trained and tested for working and spatial memory in the radial maze. Results: Modeling PH led to persistent impairments in exploratory activity, psycho-emotional behavior, and a decrease in the cognitive–mnestic functions of the CNS. It was found that Angiolin and Cerebrocurin had the most pronounced effects on the indicators of exploratory activity and psycho-emotional status in 1-month-old animals after PH. They also exhibited the most significant cognitive-enhancing and memory-supporting effects during the training and evaluation of skill retention in the maze in 2-month-old offspring after PH. Conclusions: for the first time, we obtained experimental data on the effects of HSP₇₀ modulators on exploratory activity, psycho-emotional behavior, and cognitive–mnestic functions of the central nervous system in offspring following intrauterine hypoxia. Based on the results of this study, we identified the pharmacological agents Angiolin and Cerebrocurin as promising neuroprotective agents after perinatal hypoxia. Full article

Vitamin D is an essential nutrient, involved in various biological processes including calcium homeostasis, bone health, immune function, and brain development. Vitamin D from the mother crosses the placenta during pregnancy, directly impacting the neurodevelopment of the fetus. Vitamin D insufficiency is a substantial global health problem, influencing almost 47.9% of individuals, with especially high predominance rates among pregnant women. Background/Objectives: Preclinical studies suggest that maternal vitamin D deficiency results in significant alterations in the development of the offspring’s brain. Nonetheless, randomized clinical trials in humans have produced conflicting results on the beneficial effect of high-dose vitamin D supplementation during pregnancy on neurodevelopmental outcomes. This review aims to evaluate the association of maternal prenatal vitamin D levels and vitamin D supplementation during pregnancy with offspring neurodevelopment. Methods: This study thoroughly reviewed the literature and searched throughout PubMed, ScienceDirect, Cochrane Library, and Google Scholar, adhering to PRISMA guidelines. Studies assessing maternal vitamin D levels, supplementation, and offspring neurodevelopmental outcomes were included based on predefined eligibility criteria. Results: Among 9686 screened studies, only 20 met the inclusion criteria, representing 18,283 mother–child pairs. A small, non-significant trend suggested a positive association between higher maternal vitamin D levels and offspring cognitive, language, motor, and social-emotional development. The strongest associations were observed in cognitive performance and language acquisition, though inconsistencies emerged across studies. Cord blood vitamin D levels showed no consistent effects on neurodevelopment. Maternal vitamin D supplementation during pregnancy demonstrated no reliable benefits for offspring neurodevelopment, with results varying by study design and participant characteristics. Conclusions: Large-scale, multicenter randomized trials, with standardized neurodevelopmental assessments at multiple ages are needed to define the effects of vitamin D deficiency and supplementation during pregnancy on offspring neurodevelopmental outcomes. Future research should investigate the confounding factors contributing to inconsistencies, including supplementation protocols, genetic variations, and assessment methodologies. Clarifying these aspects will enhance the understanding of maternal vitamin D’s role in fetal neurodevelopment and aid in refining prenatal supplementation guidelines. Full article

Background: The timing of delivery depends on the condition of the fetus and the mother’s body, which is reflected in both the incretion of enzymes in the pregnant woman’s body and their use by the developing fetus in the anabolic process. The aim: This work was aimed to analyze the activities of transaminases (aspartate aminotransferase (AST) and alanine aminotransferase (ALT)) and alkaline phosphatase (AlPh) in liquid media (blood serum, amniotic fluid, umbilical cord blood, and placental homogenate) in pregnant women in each trimester of pregnancy and in the postpartum period, considering the timing and type of delivery (term, premature or late delivery, or cesarean section). Methods: Data from studies in non-pregnant (n = 45) and pregnant (n = 193) women, including women in labor with different delivery timings (term, premature, and late) and types of delivery (natural birth or cesarean section), were analyzed. Amniotic fluid, umbilical cord blood, and the placental homogenate were collected during labor. The de Ritis coefficient (AST/ALT) was calculated. Alkaline phosphatase activity was determined using the standard constant-time method using Lahema diagnosticum biotests, and transaminase activity was determined using the colorimetric dinitrophenylhydrazine method, according to Reitman and Frenkel. Outcomes: The highest alkaline phosphatase activity was recorded in the placenta homogenate (6906.2 ± 208.1 U/mL) in pregnant women who gave birth at term. The highest transaminase activity was found in umbilical cord blood and, in particular, in the placenta in pregnant women with premature and late births. Conclusions: The significant role of transaminases and alkaline phosphatase in the transport functions of the histohematic barriers of the mother and fetus was established, which provides a mechanism for the constancy of enzyme levels in blood plasma. Full article

Background: The impact of the SARS-CoV-2 viral infection during pregnancy on the fetus can be direct—transmitted through the placenta—and indirect—creating unfavorable conditions for the development of the fetus because of inflammation, micro-thrombosis, and hypercoagulation. Our study aimed to determine the types and frequency of pathohistological changes in placental tissue in SARS-CoV-2-positive pregnant women and to examine the possible role of oxidative stress in the prognosis of the delivery and its maternal and fetal complications. Methods: This prospective clinical study included 50 pregnant women divided into two groups, SARS-CoV-2 positive (COVID-19 group) and SARS-CoV-2 negative (control group), from who we collected demographic, clinical, obstetric, biochemical and pathologic data. Data about the newborn characteristics were also collected, which included anamnestic, clinical, and biochemical data. Results: The values of the superoxide anion radical and index of lipid peroxidation were significantly different in mothers concerning the presence of the SARS-CoV-2 infection, while the levels of the nitric oxide, index of lipid peroxidation, reduced glutathione, and superoxide dismutase were significantly different in the newborns depending on the SARS-CoV-2 infection. Newborn characteristics were similar between groups except for concentrations of IgM antibody. The incidence of pathohistological changes of the FVM type in the COVID-19 group of pregnant women was 46%, while in the control group, the incidence was 18%. Conclusions: This study confirmed the significant impact of the SARS-CoV-2 viral infection on maternal and fetal biochemical parameters and oxidative stress-mediated placental dysfunction. Future studies should be performed with more participants and follow-up neonatal development. Full article

Our ability to accurately predict the delivery date of term pregnancies is limited by shortcomings of modern-day clinical tools and due date estimation methods. The pregnancy clock is a series of coordinated and harmonized signals between mother, fetus, and placenta that regulate the length of gestation. Clock proteins are thought to be important mediators of these signals, yet few studies have investigated their potential utility as predictors of term delivery date. In this study, we performed a cross-sectional proteome analysis of 2648 serum samples collected between 18 and 28 weeks of gestation from mothers who delivered at term. The cohort included pregnancies both with and without complications. A total of 15 proteins of diverse functionalities were shown to have a direct association with time to birth (TTB), 11 of which have not been previously linked to gestational age. The protein A Distintegrin and Metalloproteinase 12 (ADA12) was one of the 15 proteins shown to have an association with TTB. Mothers who expressed the highest levels of ADA12 in the cohort (90th percentile) gave birth earlier than mothers who expressed the lowest levels of ADA12 (10th percentile) at a statistically significant rate (median gestational age at birth 39^0/7 weeks vs. 39^3/7 weeks, p < 0.001). Altogether, these findings suggest that ADA12, as well as potentially other clock proteins, have the potential to serve as clinical predictors of term delivery date in uncomplicated pregnancies and represent an important step towards characterizing the role(s) of clock proteins in mediating pregnancy length. Full article

Introduction: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a new member of the coronavirus family. While respiratory transmission is the main route, concerns have arisen regarding possible vertical transmission, which refers to the transmission of the virus from mother to fetus through the dissemination of viral particles in the amniotic fluid. Fetal viral infection via the placenta can affect the formation of the auditory system and lead to congenital hearing disorders. The aim of this research was to investigate the effects of vertical exposure to COVID-19 on the auditory system of newborns. Methodology: The study included a study group (SG) and a control group (CG). Selected during neonatal hearing screening, the SG consisted of 23 infants up to 1 year old whose mothers had been infected with SARS-CoV-2. The CG consisted of 15 infants whose mothers became pregnant after the end of the pandemic, had tested negative for COVID-19, and had no respiratory symptoms during pregnancy. The assessments for both groups were brainstem auditory evoked potentials (BAEPs), tympanometry, transient evoked otoacoustic emissions (TEOAEs), and distortion product otoacoustic emissions (DPOAEs). The research was divided into two studies, one cross-sectional and the other longitudinal. Results: All participants exhibited absolute latencies within the normal range for waves I, III, and V, although in the SG, there was a statistically significant increase in the latency of wave I in the left ear. In terms of OAEs, in the SG, there appeared to be a tendency for TEOAEs to be absent at high frequencies. Over several months, there was a general decrease in the amplitude of high-frequency responses in both TEOAEs and DPOAEs. Conclusion: No evidence was found that vertical exposure to COVID-19 causes hearing loss, although there were signs of possible deterioration in hair cell functioning. Full article

One of the functions of placenta is to protect the fetus against harmful xenobiotics. Protective mechanisms of placenta are based on enzymes, e.g., antioxidant enzymes from the glutathione S-transferases group (GST) or human N-acetyltransferase 2 (NAT2). Many organic sunscreens are known to cross biological barriers—they are detected in mother’s milk, semen, umbilical cord blood or placental tissues. Some organic sunscreens are able to cross the placenta and to interfere with fetal development; they are known or suspected endocrine disruptors or neurotoxins. In this study, 16 organic sunscreens were investigated in the context of their placenta permeability and interactions with gluthatione S-transferase and human N-acetyltransferase 2 enzymes present in the human placenta. Binary permeability models based on discriminant analysis and artificial neural networks proved that the majority of studied compounds are likely to cross the placenta by passive diffusion. Molecular docking analysis suggested that some sunscreens show stronger affinity for glutathione S-transferase and human N-acetyltransferase 2 that native ligands (glutathione and Coenzyme A for GST and NAT2, respectively)—it is therefore possible that they are able to reduce the enzyme’s protective activity. It was established that sunscreens bind to the studied enzymes mainly by alkyl, hydrogen bonds, van der Waals, π-π, π-alkyl and π-sulfur interactions. To conclude, sunscreens may become stressors affecting humans by different mechanisms and at different stages of development. Full article

Background/Objectives: Respiratory syncytial virus (RSV) is the leading cause of severe respiratory disease in infants worldwide. Maternal immunization to protect younger infants is supported by evidence that virus-neutralizing antibodies, which are efficiently transferred across the placenta from mother to fetus, are a primary immune mediator of protection. In maternal RSV vaccine studies, estimates of correlates of protection are elusive because many factors of maternal–fetal immunobiology and disease characteristics must be considered for the estimates. Methods: We developed statistical models that aims to predict vaccine efficacy (VE) in infants following maternal immunization by including quantifiable covariates of the antibody titer distribution of the mother (pre- and post-immunization), the transplacental transfer ratio of IgG antibodies, the rate of antibody decay, and RSV disease incidence rate, all of which are season- and time-dependent and vary by infant age. Result: Our model shows that integrating the lower respiratory tract disease risk based on infant airway diameter and associated airway resistance is critical to appropriately model predicted infant VE. The VE predictions by our models, which preceded maternal RSV prefusion F vaccine efficacy trial primary readouts, closely align with the VE outcomes of these field studies. Conclusion: Our models successfully predicted VE of the RSV maternal vaccines and have potential use in modeling the clinical trial out-comes of other respiratory disease vaccines where maternal antibodies play a role in the protection of newborns. Full article

Background: Gestational diabetes mellitus (GDM) is one of the most prevalent complications associated with pregnancy, exhibiting a gradual rise in prevalence worldwide. Given the potential for numerous short- and long-term complications for both mother and child, patients diagnosed with GDM require individualised treatment to compensate for metabolic abnormalities and ultimately reduce the risk of the known adverse consequences of impaired glucose tolerance. Methods and results: The manuscript presents a summary of the current knowledge on changes in maternal metabolism during physiological pregnancy and pregnancy complicated by gestational diabetes. Furthermore, the article provides a synthesis of the findings from recent research examining the impacts of gestational diabetes and the therapeutic modalities employed on the nutritional status of the fetus and neonate. Additionally, the review elucidates the function of the placenta and placental hormones in fetal development, as well as the impact of hyperglycemia, insulin resistance and adipokines on fetal and neonatal nutritional programming and predisposition to metabolic complications in adulthood. Conclusions: The metabolic environment, resulting from abnormal glucose tolerance during pregnancy, exerts a particularly significant impact on fetal growth and, consequently, on the birth weight and fat mass of the newborn infants. This is a pivotal factor influencing the nutritional and metabolic programming of the developing fetus, predisposing the individual to the development of metabolic complications throughout their lifetime. Full article

A total of 16 organic sunscreens and over 160 products of their degradation in biotic and abiotic conditions were investigated in the context of their safety during pregnancy. Drug-likeness and the ability of the studied compounds to be absorbed from the gastrointestinal tract and cross the human placenta were predicted in silico using the SwissADME software (for drug-likeness and oral absorption) and multiple linear regression and “ARKA” models (for placenta permeability expressed as fetus-to-mother blood concentration in the state of equilibrium), with the latter outperforming the MLR models. It was established that most of the studied compounds can be absorbed from the gastrointestinal tract. The drug-likeness of the studied compounds (expressed as a binary descriptor, Lipinski) is closely related to their ability to cross the placenta (most likely by a passive diffusion mechanism). The organic sunscreens and their degradation products are likely to cross the placenta, except for very bulky and highly lipophilic 1,3,5-triazine derivatives; an avobenzone degradation product, 1,2-bis(4-tert-butylphenyl)ethane-1,2-dione; diethylamino hydroxybenzoyl hexyl benzoate; and dimerization products of sunscreens from the 4-methoxycinnamate group. Full article

Fetal growth restriction (FGR) is a disorder defined as the failure of a fetus to achieve its full biological development potential due to decreased placental function, which can be attributed to a range of reasons. FGR is linked to negative health outcomes during the perinatal period, including increased morbidity and mortality. Long-term health problems, such as impaired neurological and cognitive development, as well as cardiovascular and endocrine diseases, have also been found in adulthood. Aspirin administered prophylactically to high-risk women can effectively prevent FGR. FGR pregnancy care comprises several steps, including the weekly assessment of several blood vessels using Doppler measurements, amniotic fluid index (AFI), estimated fetal weight (EFW), cardiotocography (CTG), as well as delivery by 37 weeks. Pregnancy is a complex condition characterized by metabolic adjustments that guarantee a consistent provision of vital metabolites allowing the fetus to grow and develop. The lipoprotein lipid physiology during pregnancy has significant consequences for both the fetus and baby, and for the mother. In the course of a typical pregnancy, cholesterol levels increase by roughly 50%, LDL-C (low-density lipoprotein cholesterol) levels by 30–40%, HDL-C by 25% (high-density lipoprotein cholesterol). Typically, there is also a 2- to 3-fold increase in triglycerides. Low maternal blood cholesterol levels during pregnancy are linked to a decrease in birth weight and an increased occurrence of microcephaly. FGR impacts the placenta during pregnancy, resulting in alterations in lipid metabolism. Research has been undertaken to distinguish variations in protein expression between normal placentas and those impacted by FGR. This can aid in comprehending the fundamental pathogenic mechanisms of FGR and perhaps pave the way for the creation of novel diagnostic and treatment methods. Commonly employed approaches for detecting and analyzing variations in placental proteomes include mass spectrometry, bioinformatic analysis, and various proteomic techniques. Full article

Vaccination in pregnancy is important to protect the mother and fetus from infectious diseases. The transfer of maternal antibodies across the placenta during pregnancy can continue to protect the neonate for several months after birth while the neonatal adaptive immune system develops. Several pathogens have been shown to impair the transplacental transfer of maternal antibodies, including human immunodeficiency virus, malaria, the severe acute respiratory syndrome coronavirus 2, and cytomegalovirus. This review discusses the mechanisms contributing to decreased transplacental antibody transfer in the setting of maternal infections, such as changes in antibody glycosylation profile, maternal hypergammaglobulinemia, and placental injury. The frequency of epidemics is increasing, and pregnant people are more likely to become exposed to novel pathogens now than they were in the past. Understanding the mechanisms by which infectious diseases impair maternal–fetal antibody transfer is important for pandemic preparedness to maximize the impact of maternal vaccination for child health. Full article