Plasma fatty acids of neonates born to mothers with and without gestational diabetes

Women with gestational diabetes mellitus (GDM) and their neonates have lower levels of arachidonic (AA) and docosahexaenoic (DHA) acids in red cell membranes. It is not clear if this abnormality is restricted to red cells or is a generalised problem. We have investigated plasma fatty acids of neonates (venous cord) of GDM (n=37), and non-diabetic (n=31) women. The GDMs had lower levels of dihomogamma-linolenic (20:3n-6, DHGLA) acid, summation operator n-6 metabolites, DHA and summation operator n-3 metabolites (p<0.05) in choline phosphoglycerides (CPG). They also had lower levels of AA (-4.5%), adrenic acid (22:4n-6, -13%), osbond acid (22:5n-6, -7%) and summation operator n-6 (-2.5%). There was a similar pattern in triglycerides (TG) and cholesterol esters (CE). Mead acid, a marker of generalised shortage of derived and parent essential fatty acids, was higher in CPG and TG of the GDM group by 73% and 76%. The adrenic/osbond acid (22:4n-6/22:5n-6) ratio, a biochemical marker of DHA insufficiency, was reduced in CPG (-4.5%), TG (-63%) and CE (-75%) of the GDM group. These findings, which are consistent with the previous red cell data, suggest that the neuro-visual and vascular development and function of the offspring of GDM women may be adversely affected if the levels of AA and DHA are compromised further by other factors, pre- or post-natally. Studies are required to elucidate the underlying mechanism for the reduction of the two fatty acids and to evaluate the developmental and health implications.     

Antibodies to poliomyelitis virus in cord blood of neonates born to from mothers in contact or not in contact with the wild virus

Neutralizing antibodies to polioviruses in cord blood of neonates born from 64 mothers under age 20 and in 53 mothers aged 30 years and over were investigated in order to know and compare the transfer to newborns of antibodies to polioviruses produced by live oral vaccine mainly and those antibodies induced by natural contact with wild poliovirus strains. Total immunity for the two groups was higher than 80% for the three types of polioviruses, with only virus 3 showing an immunity below 80% (77.4%) in mothers aged 30 years and over. Average geometric titers though relatively low may be considered satisfactory. However, there is a statistically significant difference in titers to poliovirus type 2 (24.9) in mothers over age 30 years as compared to those found in mothers below age 20 years (10.8), for which we have found no explanation. It is not deemed necessary for the time being to take special prophylactic measures with these children given the occurrent epidemiologic status quo.     

Essential fatty acid status of neonates born to Inuit mothers: comparison with Caucasian neonates and effect of diet.

Fatty acid compositions were determined of phospholipids isolated from venous cord plasma and from the walls of umbilical arteries and veins, collected from healthy, a terme, Inuit and Caucasian (Dutch) neonates. The Inuit fatty acid profiles were characterized by a lower essential fatty acid (EFA) status, with higher levels of monounsaturated fatty acids, of Mead acid [20:3(n-9)] and its direct elongation product, and with lower amounts of the longer chain (greater than or equal to 20 carbon atoms), highly unsaturated (greater than or equal to 4 double bonds) fatty acids of both the (n-3) and (n-6) families. Levels of linoleic- and dihomo-gamma-linolenic acids were higher in Inuit as compared to Caucasian neonates, which suggests a low activity of the delta-5-desaturase in the Inuit. Within the Inuit group, a higher intake of marine food was associated with a better neonatal (n-3) status. Although the differences between Inuit and Caucasian neonates may be of genetic rather than of dietary origin, the results imply that dietary long-chain (n-3) or (n-6) fatty acids may be particularly important during pregnancy in Inuit mothers. Further studies are indicated with respect to the EFA content of the habitual Inuit diet and levels of delta-5-desaturase activity in the Inuit.     

Cytokines in normal and abnormal parturition: elevated amniotic fluid interleukin-6 levels in women with premature rupture of membranes associated with intrauterine infection

The participation of interleukin-6 (IL-6) in the pathophysiology of normal and abnormal human parturition was evaluated by determining IL-6 concentrations in amniotic fluid (AF). Biologically active IL-6 was determined (in U/ml) using the B9 hybridoma growth factor assay, while the concentrations of immunoreactive IL-6 species (in pg/ml) were assessed using a monoclonal antibody (moAb)-based ELISA. Two hundred and twenty-seven AF samples from women in normal labor and from those presenting with a clinical diagnosis of premature rupture of membranes (PROM) were assayed. In selected instances, IL-6 levels were evaluated simultaneously in AF and in maternal and fetal plasma. Women with a normal pregnancy had low titers of biologically active IL-6 in AF both at midtrimester (group 1, n = 27; median IL-6 concentration = 16 U/ml) and at term (group 2, n = 33; median = 15 U/ml). There was an increase in the IL-6 bioactivity in AF from women in normal labor at term (group 3, n = 40; median = 74 U/ml; p less than 0.001). In order to distinguish between the relative contributions of parturition per se and of intrauterine infection to the elevation of biologically active IL-6 levels in AF, IL-6 titers were compared in four different groups of women with PROM.(ABSTRACT TRUNCATED AT 250 WORDS)     

The prediction of thyroid function in infants born to mothers with chronic thyroiditis

To elucidate the relationship between the mother's TSH-receptor antibody activities and the status of thyroid dysfunction in their offspring, blood was taken from 5 mothers with chronic thyroiditis with potent thyrotropin (TSH)-receptor blocking activity, and the potency of TBII and TSBAb activity was assayed more quantitatively. In those mothers whose infants suffered from neonatal hypothyroidism, the 50% inhibition of binding of labeled TSH to its receptors was obtained at more than 30 to 50-fold dilution, while in those mothers whose infants had transiently increased TSH or were euthyroid, the titers were of less than 30-fold dilution. Similarly, in those mother whose infants suffered from neonatal hypothyroidism, the 50% inhibition of TSH-induced cAMP accumulation was obtained at approximately 400 to 3000-fold dilution, while in those mothers whose infants had transiently increased TSH or were euthyroid, the titers were of less than 50-fold dilution. On the other hand TBII activity was much less potent in serum from patients with Graves' disease. These results suggested that the titration of serum with dilution to obtain 50% inhibition of labelled TSH binding to its receptor may be the simplest way to predict thyroid dysfunction of the newborn infants born to mothers with chronic thyroiditis.     

Exposure to moderate air pollution during late pregnancy and cord blood cytokine secretion in healthy neonates

Background/Objectives

Ambient air pollution can alter cytokine concentrations as shown in vitro and following short-term exposure to high air pollution levels in vivo. Exposure to pollution during late pregnancy has been shown to affect fetal lymphocytic immunophenotypes. However, effects of prenatal exposure to moderate levels of air pollutants on cytokine regulation in cord blood of healthy infants are unknown.

Methods

In a birth cohort of 265 healthy term-born neonates, we assessed maternal exposure to particles with an aerodynamic diameter of 10 µm or less (PM₁₀), as well as to indoor air pollution during the last trimester, specifically the last 21, 14, 7, 3 and 1 days of pregnancy. As a proxy for traffic-related air pollution, we determined the distance of mothers'' homes to major roads. We measured cytokine and chemokine levels (MCP-1, IL-6, IL-10, IL-1ß, TNF-α and GM-CSF) in cord blood serum using LUMINEX technology. Their association with pollution levels was assessed using regression analysis, adjusted for possible confounders.

Results

Mean (95%-CI) PM₁₀ exposure for the last 7 days of pregnancy was 18.3 (10.3–38.4 µg/m³). PM₁₀ exposure during the last 3 days of pregnancy was significantly associated with reduced IL-10 and during the last 3 months of pregnancy with increased IL-1ß levels in cord blood after adjustment for relevant confounders. Maternal smoking was associated with reduced IL-6 levels. For the other cytokines no association was found.

Conclusions

Our results suggest that even naturally occurring prenatal exposure to moderate amounts of indoor and outdoor air pollution may lead to changes in cord blood cytokine levels in a population based cohort.     

早产儿肠道菌群检测及其与脑损伤的关系CSCD

目的 对早产儿肠道菌群进行检测,并分析肠道菌群与早产儿脑损伤的关系。方法 选取2018年1月至2020年1月本院产科分娩的174例早产儿(胎龄≤34周)为研究对象,所有早产儿均于纠正胎龄40周时行颅脑MRI和早产儿肠道菌群检测,根据早产儿是否发生脑损伤,分为无脑损伤组(136例)和脑损伤组(38例)。分析无脑损伤早产儿和脑损伤早产儿的肠道菌群相对丰度、菌群物种丰富度(Chao1指数)及菌群群落多样性(Shannon指数)的差异,采用Pearson秩相关性法分析早产儿的肠道菌群相对丰度、Chao1指数、Shannon指数与脑损伤程度相关性。结果 脑损伤组早产儿的脑组织TMS评分(13.42分±1.03分)低于无脑损伤组(17.91分±1.81分),差异有统计学意义(t=19.724,P=0.000 1)。脑损伤组早产儿的双歧杆菌属丰度比(23.63%±1.24%)、乳杆菌属丰度比(16.58%±0.94%)、乳球菌属丰度比(15.73%±0.89%)和拟杆菌属丰度比(8.78%±0.64%)均低于无脑损伤组早产儿(28.43%±1.34%,22.43%±1.27%,17.81%±1.10%,9.81%±0.69%),差异均有统计学意义(t=27.163、16.871、20.764、26.917,均P<0.000 1),脑损伤组早产儿的链球菌属丰度比(13.92%±0.84%)、沙门菌属丰度比(5.74%±0.51%)、瓦氏菌属丰度比(4.86%±0.29%)、梭菌属丰度比(6.74%±0.54%)和葡萄球菌属丰度比(8.52%±0.60%)均高于无脑损伤组早产儿(5.81%±0.37%,4.28%±0.32%,3.94%±0.22%,2.18%±0.19%,1.98%±0.16%),差异均有统计学意义(t=34.261、22.914、19.084、24.807、27.043,均P<0.000 1)。脑损伤组早产儿的肠道菌群Chao1指数(281.55±17.71)和Shannon指数(2.74±0.32)均低于无脑损伤组早产儿(397.43±21.58,3.98±0.49),差异均有统计学意义(t=36.812、17.949,均P<0.000 1)。脑组织TMS评分与双歧杆菌属丰度比(r=-0.843)、乳杆菌属丰度比(r=-0.782)、乳球菌属丰度比(r=-0.815)、拟杆菌属丰度比(r=-0.708)、肠道菌群Chao1指数(r=-0.742)和肠道菌群Shannon指数(r=-0.743)呈负相关,与链球菌属丰度比(r=0.871)、沙门菌属丰度比(r=0.903)、瓦氏菌属丰度比(r=0.791)、梭菌属丰度比(r=0.782)和葡萄球菌属丰度比(r=0.793)呈正相关。结论 早产儿的脑损伤发生率仍然较高,与早产儿肠道菌群相对丰度、菌群物种丰富度和菌群群落多样性均有密切的相关性。     

Elevated plasma levels of soluble TNF receptors are associated with morbidity and mortality in patients with acute lung injury

Ventilator-induced lung injury (VILI) is an inflammatory process that can be attenuated by lung protective ventilation strategies. Our objectives to further investigate the pathogenesis of ALI and VILI and the mechanism of lung protection in these syndromes were: 1) to determine if plasma measurements of soluble TNF receptor I (sTNFRI) and II (sTNFRII) would predict the development of ALI and mortality in a small single center trial; 2) to test the predictive value of these markers and of TNF-alpha in a larger, broader group of patients with ALI; 3) to test the hypothesis that low tidal volume ventilation (LTVV) would be associated with a decrease in plasma levels of TNF-alpha, sTNFRI, and sTNFRII. In the single center study, sTNFRI and II levels were higher in patients at risk for and with ALI, but they did not predict the development of the syndrome. In the multicenter trial sTNFRI and II were strongly associated with mortality (OR 5.76/1 log10 increment in receptor level; 95% CI 2.63-12.6 and OR 2.58; 95% CI 1.05-6.31, respectively) and morbidity measured as fewer nonpulmonary organ failure-free and ventilator-free days. The LTVV strategy was associated with an attenuation of plasma sTNFRI levels. In vitro, stimulated A549 cells release sTNFRI but not sTNRFII. In conclusion, plasma levels of sTNFRI and II can serve as biomarkers for morbidity and mortality in patients with ALI. Furthermore, LTVV is associated with a specific decrease in sTNFRI levels. This suggests that one beneficial effect of LTVV may be to attenuate alveolar epithelial injury.     

孕晚期胎膜早破孕妇产道无乳链球菌定植与新生儿感染的相关性分析

目的分析孕晚期胎膜早破妇女产道无乳链球菌(SA)定植与新生儿感染之间的相关性。方法筛选2014年1月-2017年3月我院产科收治的孕晚期胎膜早破孕妇589例作为观察组,无胎膜早破的正常孕晚期孕妇261例作为对照组,对两组孕妇宫颈拭子进行细菌培养,并对其分娩的新生儿咽拭子进行细菌培养,记录两组孕妇胎膜早破合并SA阳性结果孕妇数与新生儿感染人数。结果胎膜早破孕妇宫颈拭子SA阳性率为16.47%(97/589),无胎膜早破的正常妊娠晚期妇女SA阳性率为6.13%(16/261)(P0.01);观察组SA阳性孕妇新生儿感染发生率6.18%(6/97),显著高于本组SA阴性孕妇4.67%(23/492)(P0.05);观察组破膜时间≥24h孕妇其新生儿感染率为62.07%(18/29),高于本组破膜时间24h孕妇的新生儿感染率27.94%(19/68)(P0.01);观察组产程≥24h孕妇其新生儿感染率42.42%(14/33),高于本组破膜时间24h孕妇的新生儿感染率17.19%(11/64)(P0.05)。结论孕晚期孕妇产道SA感染导致胎膜早破风险增加,新生儿感染率升高,有必要对SA阳性孕妇及早干预治疗,尽量减少胎膜早破,缩短产程。     

Multiaxial mechanical behavior of human fetal membranes and its relationship to microstructure

This study was directed to the measurement of the mechanical response of fetal membranes to physiologically relevant loading conditions. Characteristic mechanical parameters were determined and their relation to the microstructural constituents collagen and elastin as well as to the pyridinium cross-link concentrations analyzed. 51 samples from twelve fetal membranes were tested on a custom-built inflation device, which allows mechanical characterization within a multiaxial state of stress. Methods of nonlinear continuum mechanics were used to extract representative mechanical parameters. Established biochemical assays were applied for the determination of the collagen and elastin content. Collagen cross-link concentrations were determined by high-performance liquid chromatography measurements. The results indicate a distinct correlation between the mechanical parameters of high stretch stiffness and membrane tension at rupture and the biochemical data of collagen content and pyridinoline as well as deoxypyridinoline concentrations. No correlation was observed between the mechanical parameters and the elastin content. Moreover, the low stretch stiffness is, with a value of 105 ± 31 × 10^?3 N/ mm much higher for a biaxial state of stress compared to a uniaxial stress configuration. Determination of constitutive model equations leads to better predictive capabilities for a reduced polynomial hyperelastic model with only terms related to the second invariant, I ₂, of the right Cauchy-Green deformation tensor. Relevant insights were obtained on the mechanical behavior of fetal membranes. Collagen and its cross-linking were shown to determine membrane’s stiffness and strength for multiaxial stress states. Their nonlinear deformation behavior characterizes the fetal membranes as I ₂ material.     

胎膜早破新生儿口腔分泌物细菌培养与药敏分析

【摘 要】 目的 分析胎膜早破新生儿口腔分泌物细菌的分布特点、耐药情况以及不同分娩方式的影响,为临床合理的预防性使用抗生素提供科学的指导。方法 对2011年1月至2012年12月广东省妇幼保健院新生儿科送检的116份胎膜早破新生儿口腔分泌物标本进行细菌培养,并以法国梅里埃的全自动细菌鉴定药敏系统(VITEK-2 compact)对分离出的纯菌株进行鉴定和药敏试验,统计不同分娩方式的阳性率。结果 116份口腔分泌物标本中,共分离出细菌33株/31例,总检出率为26.7%,其中G-菌28株,占84.8%,G+菌5株,占15.2%,检出率最高的病原菌是大肠埃希菌17株(51.5%),其除了对丁胺卡那霉素、头孢替坦和亚胺培南全部敏感以外,对其他的抗生素均有不同程度的耐药,两种分娩方式的细菌培养阳性率差异无统计学意义。结论 胎膜早破新生儿口腔分泌物培养以G-菌为主且耐药性较高,临床应根据药敏结果合理选用抗生素进行预防用药;在无医学指针的情况下,推荐阴道分娩。     

胎膜早破产妇羊水细菌培养及药敏结果分析

目的 分析胎膜早破(PROM)产妇羊水感染细菌的分布特点和耐药情况,以探讨PROM的病原学特征,并为围产期感染的用药提供科学的指导.方法 对2010年4月至2010年7月广东省妇幼保健院产科送检的199例PROM产妇羊水标本进行细菌培养,并以法国梅里埃的全自动细菌鉴定药敏系统(VITEK-2 compact)对分离出的...     

妊娠妇女阴道微生态和B族链球菌与胎膜早破及母婴结局的相关性

探讨妊娠妇女阴道微生态状况和B族链球菌（GBS）感染与妊娠晚期胎膜早破及母婴结局的相关性。

回顾性收集2021年1月至2022年12月我院114例临床确诊足月胎膜早破妊娠妇女为研究对象（胎膜早破组）,随机选取同期分娩的129例健康妊娠妇女为对照组。收集两组对象临床资料,比较两组对象阴道微生态变化、GBS感染及不良母婴结局发生情况。

两组妊娠妇女阴道假丝酵母菌菌体及孢子检出情况比较差异均无统计学意义（均P＞0.05）。胎膜早破组患者阴道pH≥4.5、细菌性阴道病、需氧菌性阴道炎的发生率及微生态失衡率高于对照组（均P＜0.05）。胎膜早破组妊娠妇女绒毛膜羊膜炎、产褥感染、胎儿窘迫及新生儿肺炎等不良母婴结局发生率高于对照组（均P＜0.05）。单因素分析结果显示,阴道pH≥4.5、有GBS感染、阴道微生态失调与不良母婴结局有关（均P＜0.05）。

妊娠晚期阴道微生态失衡、GBS感染与妊娠晚期胎膜早破的发生相关,同时会增加不良母婴结局的发生率。加强相关危险因素的干预可降低妊娠晚期女性胎膜早破发生率,改善不良母婴结局。