Deforestation and infant mortality: Evidence from Indonesia

Factors expected to change concurrently with forest loss—such as economic activity and air pollution—shape human health in different ways, making it difficult to ex ante predict the net impact of deforestation. This paper investigates the infant mortality effects of prenatal exposure to high biomass forest loss in Indonesia, a country with rich forest reserves increasingly being subjected to high levels of deforestation. Indonesia officially bans clearing in areas with high biomass natural forests (referred to henceforth as ‘protected forests’), yet these forests face illegal logging. The analysis uses a fixed effects approach, essentially tracking how mortality responds to protected forest cover changes over time within districts. Results suggest that protected forest loss favors survival among all infants. However, there is variation in the protected forest loss-infant mortality relationship by pregnancy order or gravidity—while children born from women’s higher order pregnancies are less likely to die when exposed to deforestation, children born from first pregnancies experience an increase in their risk of death. Potential mechanisms such as overall air pollution, economic activity and perinatal health care do not appear to explain the gravidity-specific effects of deforestation in protected areas. However, the observed pattern of results suggests that effects are being channeled through malaria—the disease, which is likely to increase with forest loss, tends to disproportionately infect women during their first pregnancy, thus causing greater harm to the children born from these pregnancies.     

Influence of season on corpus luteum structure and function and AI outcome in the Italian Mediterranean buffalo (Bubalus bubalis)

The aim was to ascertain whether relationships between corpus luteum (CL) vascularization, CL function, and pregnancy outcome in AI in buffaloes were consistent across the breeding season and transition period to the nonbreeding season in a Mediterranean environment. Stage of the estrous cycle in Italian Mediterranean buffaloes was synchronized using the Ovsynch with timed AI program and buffaloes were mated by AI in both the breeding season (N = 131) and transition period (N = 125). Detailed investigation of CL structure and function was undertaken in 39 buffaloes at each of the respective times using realtime B-mode/color-Doppler ultrasonography on Days 10 and 20 after AI. Progesterone (P4) concentrations were determined by RIA in all buffaloes. Pregnancy rate on Day 45 after AI was greater (P < 0.05) during the breeding season (58.0%) than the transitional period (45.6%) and this was primarily the result of a lower (P < 0.05) late embryonic mortality during the breeding season (7.3%) compared with the transition period (23%). Circulating concentrations of P4 on Days 10 and 20 after AI were greater (P < 0.01) during the breeding season (4.6 ± 0.3 and 3.4 ± 0.2, respectively) than during the transition period (1.6 ± 0.12 and 1.8 ± 0.2, respectively), and this was independent of reproductive status as there was no interaction between pregnancy and season. Corpus luteum time average medium velocity at Day 10 after AI was greater (P < 0.01) during the breeding season (19.3 ± 1.5) than in the transitional period (8.3 ± 0.7). There were positive correlations in pregnant buffaloes between CL time average medium velocity and P4 concentrations on Day 10 (r = 0.722; P < 0.01) and Day 20 (r = 0.446; P < 0.01) after AI. The findings were interpreted to indicate that relationships between CL vascularization, CL function, and pregnancy outcome in AI in buffaloes are consistent across the breeding season and transition period to the nonbreeding season. The distinction between the breeding season and the transition period is the relatively low proportion of buffaloes that have CL function and P4 concentrations required to establish a pregnancy during the transition period, which is manifested in a greater incidence of embryonic mortality.     

先兆早产、胎膜早破、妊娠期糖尿病及正常妊娠女性阴道菌群分布的比较

目的:比较先兆早产、胎膜早破、妊娠期糖尿病及正常妊娠女性阴道菌群分布情况。方法:选择2016年6月至2018年6月在苏州大学附属第二医院妇产科住院的妊娠女性806例,其中先兆早产组206例,胎膜早破组234例,妊娠期糖尿病组156例,正常妊娠组210例。记录四组女性异常阴道菌群检出率及异常阴道菌群分布情况。结果:四组女性的年龄、孕周比较无统计学差异(P>0.05)。先兆早产组、胎膜早破组异常阴道菌群检出率高于妊娠期糖尿病组、正常妊娠组(P<0.05),而妊娠期糖尿病组、正常妊娠组异常阴道菌群检出率比较无统计学差异(P>0.05)。先兆早产组、妊娠期糖尿病组白色假丝酵母菌检出率高于胎膜早破组、正常妊娠组(P<0.05),先兆早产组、胎膜早破组阴道加德纳菌检出率高于妊娠期糖尿病组、正常妊娠组(P<0.05),先兆早产组无乳链球菌检出率高于胎膜早破组、妊娠期糖尿病组、正常妊娠组(P<0.05),胎膜早破组大肠埃希菌检出率高于先兆早产组、妊娠期糖尿病组、正常妊娠组(P<0.05)。结论:妊娠女性阴道感染以白色假丝酵母菌、大肠埃希菌、无乳链球菌、阴道加德纳菌为主,且先兆早产、胎膜早破女性阴道致病菌感染率较高,妊娠期糖尿病女性阴道白色假丝酵母菌的感染率较高。     

Effects of polyunsaturated fatty acid intake and status during pregnancy,lactation, and early childhood on cardiometabolic health: A systematic review

The importance of polyunsaturated fatty acid (PUFA) intake in fetal life and infancy has been widely studied in relation to child cognitive and visual development, but whether early life PUFA exposure is related to cardiometabolic risk factors is unclear. The focus of this systematic review was to evaluate the effects of PUFA dietary intake and blood levels during pregnancy, lactation, or early childhood (⩽5 y) on obesity, blood pressure, blood lipids, and insulin sensitivity. We identified 4302 abstracts in the databases Embase, Medline and Cochrane Central (April 2014), of which 56 articles, reporting on 45 unique studies, met all selection criteria. Many of the included studies focused on obesity as an outcome (33 studies), whereas studies on insulin sensitivity were relatively scarce (6 studies). Overall, results for obesity, blood pressure, and blood lipids were inconsistent, with a few studies reporting effects in opposite directions and other studies that did not observe any effects of PUFAs on these outcomes. Four studies suggested beneficial effects of PUFAs on insulin sensitivity. We conclude that there is insufficient evidence to support a beneficial effect of PUFAs in fetal life or early childhood on obesity, blood pressure, or blood lipids. More research is needed to investigate the potential favorable effects of PUFAs on insulin sensitivity, and to examine the role of specific fatty acids in early life on later cardiometabolic health.     

Sedentary behavior in obese pregnant women is associated with inflammatory markers and lipid profile but not with glucose metabolism

BackgroundSedentary behavior is an independent risk factor for the metabolic syndrome, but the role of sedentary behavior in the development of gestational diabetes is unclear.ObjectivesThis study tested the hypothesis that less sedentary behavior is related to better insulin sensitivity, lipid and cytokine profile in obese pregnant women.MethodsA longitudinal observational study with 46 overweight and obese pregnant women was conducted. Sedentary behavior was measured objectively using accelerometers at 15, 24 and 32 weeks of gestation, and at those time points fasting blood was taken as well. A 100 g oral glucose tolerance test was performed at 24 and 32 weeks. Levels of glucose, insulin, total cholesterol, HDL, LDL, triglycerides were measured, as well as cytokines. The relationship between sedentary behavior and metabolic outcomes was assessed using linear regression analysis.ResultsWomen spent almost 60% of their time sitting throughout pregnancy. In cross-sectional analyses, an association of sedentary time at 24 weeks was found with increased total cholesterol and HDL. More sedentary time was associated with lower IL-6 at 24 weeks and with higher IL-10, TNF-α and leptin levels at 32 weeks of pregnancy. Changes in sedentary time were not associated with changes in any of the metabolic outcomes.ConclusionsIn conclusion, time spent sedentary in pregnancy was associated with lipid and cytokine profile. Whether decreasing sedentary time beneficially influences lipid profile and influences cytokine profiles of overweight and obese women needs to be assessed in future intervention studies.     

Trophoblast-specific knockdown of CSPG4 expression causes pregnancy complications with poor placentation in mice

The multifunctional molecule chondroitin sulfate proteoglycan 4 (CSPG4/NG2) plays key roles in organogenesis and tumorigenesis. However, its roles in placentation remain unclear. In this study, CSPG4 expression in human and mouse placentas was investigated through immunohistochemistry (IHC), qPCR and western blotting. The theoretical structure and function of CSPG4 were assessed using bioinformatic tools, and the functions of CSPG4 in fetal and placental development were investigated using a mouse model established by trophoblast-specific CSPG4 knockdown and a trophoblast cell line with CSPG4 knockout by lentivirus infection. The results showed that CSPG4 was mainly located in trophoblasts in both human placentas and mouse placentas, with a higher level in preeclampsia (PE) placentas than in healthy control placentas. Furthermore, there was a trend of increasing expression in mouse placentas during pregnancy. The 3D structure of CSPG4 was visualized using an M model composed of two chains, and the structure implied that CSPG4 was a multifunctional molecule containing multiple pockets with multiligand binding sites and enzyme active sites. Trophoblast-specific CSPG4 knockdown caused frequent fetal loss, and viable fetal development was restricted by poor placentation, with mice placentas having reduced weight and width. The proliferation and invasion of CSPG4-knockout trophoblasts were significantly inhibited, and as such, the molecular signaling of AKT and ERK phosphorylation was inhibited, and the expression of MMP2 and MMP9 was reduced. In summary, CSPG4 deficiency inhibited trophoblast proliferation and invasion, which was associated with AKT, ERK and MMP signaling. CSPG4 deficiency also caused pregnancy complications with poor placentation in mice.     

Effects of adipokines and obesity on uterine contractility

Obesity is a major public health problem. The prevalence of obesity has significantly increased in developed countries, particularly in France with an overall increase of 76% over the last 15 years. In pregnant women, obesity is associated with alterations in the quality of labor, such as delayed onset of labor, a higher rate of prolonged pregnancies, prolonged labor, and higher oxytocin requirements. There is also an increased prevalence of Cesarean sections, particularly during the active phase of labor, and perinatal complications (postpartum hemorrhage).It seems that some of these functional changes and their consequences can be attributed to a disruption of hormonal balance encountered in obese women and involving adipokines (apelin, ghrelin, visfatin, leptin), but also to the interactions between adipose tissue and the “oxytocin (OT) – oxytocin receptor (OTR)”.In this review, we detailed mechanisms to understand the impact of specific metabolic alterations in obesity on uterine contractility.Better knowledge of the impact of obesity on labor and delivery pathophysiology should strengthen the prevention of obesity in women of childbearing age and provide a suitable and effective management. The beneficial effect of weight loss and exercise in non-pregnant women on the correction of metabolic disorders secondary to obesity should be studied in populations of overweight women to demonstrate its effectiveness.     

Place de la scintigraphie dans le diagnostic de l’embolie pulmonaire chez la femme enceinte – À propos de 17 cas

IntroductionPulmonary embolism in pregnant women is a deadly disease; its diagnosis is based on specific algorithms. The lung scan is one of the recommended diagnostic suspicion in further investigations.Material and methodsRetrospective study of a series of cases of pulmonary embolism in the period pre-partum and post-partum pregnant women collected during 3 years, from January 2010 to January 2013, at the reanimation department maternity Souissi in Rabat.ResultsSeventeen cases of pulmonary embolism pre- and post-partum. The age ranged between 21 and 37 years (mean age 30 years). Four EP post-partum were recorded with 13 cases of EP pre-partum whose mean gestational age was 30SA. Several risk factors were found: 7 cases obesity, 4 cases cesarean section, 3 cases of varicose veins, 2 cases of endometritis, 1 case of twin pregnancy, 1 case of gestational hypertension and 1 case of alitement. The first reason for consultation was respiratory distress (12 cases), followed by chest pain (9 cas) and palpitations (6 cas). Lung scintigraphy performed in 14 patients’ objective 9 cases of perfusion defect, 4 cases of normal scan and 1 case of massive PE. No deaths or recurrences have been reported.ConclusionPregnancy and the post-partum period are at high risk of thromboembolic events due to physiological changes. The diagnostic approach is now well codified with scores of clinical and paraclinical probability. The lung scintigraphy can be a method of choice. Hybrid imaging is a good alternative for diagnostic performance.