NSIDRC Journal Article Alert — December 18, 2009

Prepared by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center at Georgetown University.

These articles have been selected from PubMed, a service of the National Library of Medicine that includes over 19 million citations from MEDLINE and other life science journals for biomedical articles back to 1948. PubMed includes links to full text articles and other related resources.

Availability of full-text journal articles is often limited to subscribers or through inter-library loan. Please see your local library for copies of these articles, or view PubMed's How to Get the Journal Article for more details.

Past issues of Resource Center Journal Alerts

Miscarriage/Stillbirth/Prenatal Issues

1.Obesity and Pregnancy: Implications and Management Strategies for Providers
Shirazian T, Raghavan S
Mt Sinai J Med.;76(6):539-545. [Epub ahead of print]

Mount Sinai School of Medicine, New York, NY.

Obesity in pregnancy (pregravid body mass >/=30) has been linked to several adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, gestational diabetes, fetal macrosomia, cesarean delivery, and wound complications post-cesarean section. Intrapartum and postpartum management of obese gravidas requires multidisciplinary consultations between obstetricians, anesthesiologists, nurses, and pediatricians in order to improve the pregnancy outcomes of the mother and neonate. The American College of Obstetricians and Gynecologists currently supports risk-reducing strategies for obese pregnant patients, including limiting weight gain to 15 lb (standardized by the Institute of Medicine). Interventions to reduce gestational weight gain may be important modifiable risk factors for maternal and fetal perinatal complications. Interventions have targeted modifications of diet and exercise with educational methods such as radio broadcasts, pamphlets, and counseling. Interventions have also focused on motivational methods, such as individual and group classes, and have been implemented both before conception and immediately after birth. Effective interventions appear to be individualized in approach, but there is a lack of data to support any specific model. Prospective interventional studies are needed to demonstrate the benefits of weight limitation on pregnancy outcomes. Mt Sinai J Med 76:539-545, 2009. (c) 2009 Mount Sinai School of Medicine.

2. Adamczak JE, Wolf EJ
Maternal Blood Pressure Adaptation in the First Trimester of Pregnancy
Am J Perinatol [Epub ahead of print]

Division of Maternal Fetal Medicine, St. Barnabas Medical Center, Livingston, New Jersey.

Normal changes in blood pressure during pregnancy are well documented in the second and third trimesters. Little is known about first-trimester changes, particularly compared with preconceptional values. This knowledge might allow for early prediction of conditions such as preeclampsia or intrauterine growth restriction. Prior studies utilized a laboratory setting. We conducted this retrospective study to compare blood pressure readings in early pregnancy with preconceptional values in the clinical setting. The records of 44 healthy normotensive nonsmoking women with a body mass index <30 and an uncomplicated appropriately grown singleton term delivery were reviewed. Preconceptional blood pressures values were compared with values at five periods (weeks 1 to 8, 9 to 16, 17 to 23, 24 to 32, 33 to 40). There was no difference in blood pressure parameters when comparing preconceptional values with period 1. The mean and systolic arterial pressures decreased significantly in periods 2 and 3. We were unable to demonstrate significant change in any blood pressure parameter in the first 8 weeks of pregnancy. This work should be repeated in patients who subsequently develop preeclampsia, spontaneous abortion, or intrauterine growth restriction to determine if early changes might be evident in early pregnancy to identify patients destined to develop pregnancy complications. © Thieme Medical Publishers.

3. Ali YM, Kuriya B, Orozco C, Cush JJ, Keystone EC
Can Tumor Necrosis Factor Inhibitors Be Safely Used in Pregnancy?
J Rheumatol [Epub ahead of print]

From the Department of Clinical Immunology and Allergy, and Department of Rheumatology, University of Toronto, Toronto, Ontario; Presbyterian Hospital of Dallas; Rheumatology and Clinical Immunology Division, Arthritis Care and Research Center , Baylor University Medical Center , Baylor Research Institute, Dallas, Texas, USA; and The Rebecca MacDonald Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.

OBJECTIVE: We review available safety data for use of currently approved tumor necrosis factor (TNF) inhibitors during pregnancy and lactation and suggest guidelines for use of these agents among women of reproductive age. METHODS: Although regulatory agencies encourage the inclusion of pregnant women and those of child-bearing age in randomized controlled trials, pregnant and lactating women have universally been excluded from studies because of unknown or potential risks to the fetus. Thus, strong evidence-based treatment recommendations during pregnancy are usually lacking and safety information is derived from voluntary reports of adverse events during postmarketing surveillance or via uncontrolled, observational studies, reviewed here. RESULTS: Uncommon adverse pregnancy outcomes observed with TNF inhibitor therapy appear to approximate those seen in women not receiving such therapy and may include premature birth, miscarriage, low birthweight, hypertension, and preeclampsia. There are rare reports of fetal malformations or congenital anomalies in patients exposed to TNF inhibitors during conception or pregnancy. However, the incidence of these events appears to be far below the 3% rate of congenital anomalies in the general population. CONCLUSION: If the activity or disease severity precludes the cessation of a TNF inhibitor and/or DMARD, uncontrolled observations suggest that conception and early pregnancy are not adversely affected by use of TNF inhibitors. Nearly 70% of pregnant patients can discontinue their TNF inhibitor early in the pregnancy (or with determination of pregnancy) without augmenting maternal or fetal risks.

4. Hintz SR, Bann CM, Ambalavanan N, Cotten CM, Das A, Higgins RD; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Predicting Time to Hospital Discharge for Extremely Preterm Infants
Pediatrics [Epub ahead of print]

Division of Neonatology, Stanford University, Palo Alto, California;

Background: As extremely preterm infant mortality rates have decreased, concerns regarding resource use have intensified. Accurate models for predicting time to hospital discharge could aid in resource planning, family counseling, and stimulate quality-improvement initiatives. Objectives: To develop, validate, and compare several models for predicting the time to hospital discharge for infants <27 weeks' estimated gestational age, on the basis of time-dependent covariates as well as the presence of 5 key risk factors as predictors. Patients and Methods: We conducted a retrospective analysis of infants <27 weeks' estimated gestational age who were born between July 2002 and December 2005 and survived to discharge from a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network site. Time to discharge was modeled as continuous (postmenstrual age at discharge) and categorical (early and late discharge) variables. Three linear and logistic regression models with time-dependent covariate inclusion were developed (perinatal factors only, perinatal + early-neonatal factors, and perinatal + early-neonatal + later factors). Models for early and late discharge that used the cumulative presence of 5 key risk factors as predictors were also evaluated. Predictive capabilities were compared by using the coefficient of determination (R(2)) for the linear models and the area under the curve (AUC) of the receiver operating characteristic curve for the logistic models. Results: Data from 2254 infants were included. Prediction of postmenstrual age at discharge was poor. However, models that incorporated later clinical characteristics were more accurate in predicting early or late discharge (AUC: 0.76-0.83 [full models] vs 0.56-0.69 [perinatal factor models]). In simplified key-risk-factors models, the predicted probabilities for early and late discharge compared favorably with the observed rates. Furthermore, the AUC (0.75-0.77) was similar to those of the models that included the full factor set. Conclusions: Prediction of early or late discharge is poor if only perinatal factors are considered, but it improves substantially with knowledge of later-occurring morbidities. Predictive models that use a few key risk factors are comparable to the full models and may offer a clinically applicable strategy.

5. El-Zibdeh MY, Yousef LT
Dydrogesterone support in threatened miscarriage
Maturitas [Epub ahead of print]

Department of Obstetrics and Gynaecology, Islamic Hospital, Amman, Jordan.

INTRODUCTION: The aim of this study was to determine whether dydrogesterone helps to preserve pregnancy in women with threatened miscarriage. METHODS: 146 women who presented with mild or moderate vaginal bleeding during the first trimester of pregnancy were randomised to receive oral dydrogesterone (10mg b.i.d.) (n=86) or no treatment (n=60). Dydrogesterone was continued until 1 week after the bleeding had stopped. All women received standard supportive care. RESULTS: The incidence of miscarriage was significantly lower in the dydrogesterone group than in the untreated group (17.5% vs. 25%; p<0.05). There were no statistically significant differences between the groups with respect to pregnancy complications or congenital abnormalities. CONCLUSION: Dydrogesterone appears to have beneficial effects in women with threatened miscarriage.

6. Pandian RU
Dydrogesterone in threatened miscarriage: A Malaysian experience
Maturitas.. [Epub ahead of print]

Department of Obstetrics & Gynaecology, Seberang Jaya Hospital, Tun Hussein Onn Road 34000, Seberang Jaya, Penang, Malaysia.

INTRODUCTION: Threatened miscarriage is a common problem during pregnancy. METHODS: The aim of this prospective, open, randomised study was to determine whether dydrogesterone was more effective than conservative management alone in preventing miscarriage in women with vaginal bleeding up to week 16 of pregnancy. Women were excluded if they had a history of recurrent miscarriage. A total of 191 women were randomised to dydrogesterone (40mg stat followed by 10mg twice daily) or conservative management (control group). The treatment was considered successful if the pregnancy continued beyond 20 weeks of gestation. RESULTS: The success rate in the dydrogesterone group was statistically significantly higher than that in the control group (87.5% vs. 71.6%; p<0.05). Miscarriage occurred in 12.5% of women in the dydrogesterone group compared with 28.4% in the control group (p<0.05). There were no differences between the groups with regard to the incidence of Caesarean section, placenta praevia, antepartum haemorrhage, preterm labour (weeks 28-36), pregnancy-induced hypertension or low birth weight (<2500g) babies. There were no intrauterine deaths or congenital abnormalities in either group. CONCLUSION: Compared with conservative management, dydrogesterone had beneficial effects on maintaining pregnancy in women with threatened miscarriage.

7. Wu K, Xu X, Liu J, Guo Y, Li Y, Huo X
Polybrominated Diphenyl Ethers in Umbilical Cord Blood and Relevant Factors in Neonates from Guiyu, China
Environ Sci Technol.. [Epub ahead of print]

Analytic Cytology Laboratory, Department of Preventive Medicine, and Department of Cell Biology, Shantou University Medical College, Shantou, China.

We aimed to evaluate the exposure of neonates to polybrominated diphenyl ethers (PBDEs) from a primitive e-waste (obsolete electrical and electronic devices) recycling area, in Guiyu, China, and a control area, Chaonan, China, through umbilical cord blood (UCB), the health effects, and relevant factors. Questionnaires were addressed, and UCB was collected shortly after birth from 153 pregnant women between May and July 2007. Blood samples were prepared by liquid-liquid extracting methods. PBDE concentration was determined by gas chromatography/mass spectrometry in the electron capture negative ionization mode. The total PBDE concentration was higher in UCB samples from Guiyu than in Chaonan samples (median 13.84, range 1.14-504.97 ng g(-1) lipid, vs 5.23, range 0.29-363.70 ng g(-1) lipid) (p < 0.05). BDE-209 was the dominant PBDE congener, followed by BDE-47, -153, and -99. Residence in Guiyu, which is a site for e-waste recycling, involvment in e-waste recycling, and the residence also being used as a family workshop were significant factors contributing to PBDE exposure. PBDE levels significantly differed in neonates by normal birth and adverse birth outcomes including stillbirth, low birth weight, and premature delivery (p < 0.05). The neonates from Guiyu are exposed to high levels of PBDEs. Prenatal exposure to PBDEs may affect neonates' health in Guiyu, which still needs to be evaluated in larger epidemiological studies.

8. Meeks KD, Sieve AN, Kolls JK, Ghilardi N, Berg RE
IL-23 Is Required for Protection against Systemic Infection with Listeria monocytogenes
J Immunol. 2009 Dec 15;183(12):8026-8034

Department of Molecular Biology and Immunology, University of North Texas Health Science Center, Fort Worth, TX 76107.

Listeria monocytogenes (LM) is a Gram-positive, intracellular bacterium that can induce spontaneous abortion, septicemia, and meningitis. Although it is known that neutrophils are required for elimination of the bacteria and for survival of the host, the mechanisms governing the recruitment of neutrophils to LM-infected tissues are not fully understood. We demonstrate here that IL-23 and the IL-17 receptor A (IL-17RA), which mediates both IL-17A and IL-17F signaling, are necessary for resistance against systemic LM infection. LM-infected IL-23p19 knockout (KO) mice have decreased production of IL-17A and IL-17F, while IFN-gamma production is not altered by the lack of IL-23. LM induces the production of IL-17A from gammadelta T cells, but not CD4, CD8, or NK cells. Furthermore, a lack of efficient neutrophil recruitment to the liver is evident in both IL-23p19 KO and IL-17RA KO mice during LM infection. Immunocytochemical analysis of infected livers revealed that neutrophils were able to localize with LM in IL-23p19 KO and IL-17RA KO mice, indicating that IL-23 and IL-17RA do not regulate the precise localization of neutrophils with LM. The importance of IL-23-induced IL-17A was demonstrated by injecting IL-23p19 KO mice with recombinant IL-17A. These mice had reduced LM bacterial burdens compared with IL-23p19 KO mice that did not receive IL-17A. These results indicate that during LM infection, IL-23 regulates the production of IL-17A and IL-17F from gammadelta T cells, resulting in optimal liver neutrophil recruitment and enhanced bacterial clearance.

Prepared by the
National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center
Georgetown University
2115 Wisconsin Avenue, N.W., Suite 601
Washington, DC 20007
(866) 866-7437 toll free
(202) 687-7466 local
(202) 784-9777 fax
info@sidscenter.org
http://www.sidscenter.org


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	Center Resources Bereavement Support Bibliographies Child Care and SIDS Definitions En Español First Responders For Families Infant Mortality Journal Alerts MCH Alert Multimedia Pregnancy Loss Professional Resources Safe Sleep Environment Statistics Training Toolkit Partner SIDS/ID Centers National SIDS & Infant Death Program Support Center / First Candle National SIDS & Infant Death Project IMPACT National Center for Cultural Competence SIDS/ID Project For more information on maternal and child health topics, visit the MCH Library	NSIDRC Journal Article Alert — December 18, 2009 Prepared by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center at Georgetown University. More about PubMed Copyright and Disclaimers These articles have been selected from PubMed, a service of the National Library of Medicine that includes over 19 million citations from MEDLINE and other life science journals for biomedical articles back to 1948. PubMed includes links to full text articles and other related resources. Availability of full-text journal articles is often limited to subscribers or through inter-library loan. Please see your local library for copies of these articles, or view PubMed's How to Get the Journal Article for more details. Past issues of Resource Center Journal Alerts Miscarriage/Stillbirth/Prenatal Issues 1.Obesity and Pregnancy: Implications and Management Strategies for Providers Shirazian T, Raghavan S Mt Sinai J Med.;76(6):539-545. [Epub ahead of print] Mount Sinai School of Medicine, New York, NY. Obesity in pregnancy (pregravid body mass >/=30) has been linked to several adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, gestational diabetes, fetal macrosomia, cesarean delivery, and wound complications post-cesarean section. Intrapartum and postpartum management of obese gravidas requires multidisciplinary consultations between obstetricians, anesthesiologists, nurses, and pediatricians in order to improve the pregnancy outcomes of the mother and neonate. The American College of Obstetricians and Gynecologists currently supports risk-reducing strategies for obese pregnant patients, including limiting weight gain to 15 lb (standardized by the Institute of Medicine). Interventions to reduce gestational weight gain may be important modifiable risk factors for maternal and fetal perinatal complications. Interventions have targeted modifications of diet and exercise with educational methods such as radio broadcasts, pamphlets, and counseling. Interventions have also focused on motivational methods, such as individual and group classes, and have been implemented both before conception and immediately after birth. Effective interventions appear to be individualized in approach, but there is a lack of data to support any specific model. Prospective interventional studies are needed to demonstrate the benefits of weight limitation on pregnancy outcomes. Mt Sinai J Med 76:539-545, 2009. (c) 2009 Mount Sinai School of Medicine. 2. Adamczak JE, Wolf EJ Maternal Blood Pressure Adaptation in the First Trimester of Pregnancy Am J Perinatol [Epub ahead of print] Division of Maternal Fetal Medicine, St. Barnabas Medical Center, Livingston, New Jersey. Normal changes in blood pressure during pregnancy are well documented in the second and third trimesters. Little is known about first-trimester changes, particularly compared with preconceptional values. This knowledge might allow for early prediction of conditions such as preeclampsia or intrauterine growth restriction. Prior studies utilized a laboratory setting. We conducted this retrospective study to compare blood pressure readings in early pregnancy with preconceptional values in the clinical setting. The records of 44 healthy normotensive nonsmoking women with a body mass index <30 and an uncomplicated appropriately grown singleton term delivery were reviewed. Preconceptional blood pressures values were compared with values at five periods (weeks 1 to 8, 9 to 16, 17 to 23, 24 to 32, 33 to 40). There was no difference in blood pressure parameters when comparing preconceptional values with period 1. The mean and systolic arterial pressures decreased significantly in periods 2 and 3. We were unable to demonstrate significant change in any blood pressure parameter in the first 8 weeks of pregnancy. This work should be repeated in patients who subsequently develop preeclampsia, spontaneous abortion, or intrauterine growth restriction to determine if early changes might be evident in early pregnancy to identify patients destined to develop pregnancy complications. © Thieme Medical Publishers. 3. Ali YM, Kuriya B, Orozco C, Cush JJ, Keystone EC Can Tumor Necrosis Factor Inhibitors Be Safely Used in Pregnancy? J Rheumatol [Epub ahead of print] From the Department of Clinical Immunology and Allergy, and Department of Rheumatology, University of Toronto, Toronto, Ontario; Presbyterian Hospital of Dallas; Rheumatology and Clinical Immunology Division, Arthritis Care and Research Center , Baylor University Medical Center , Baylor Research Institute, Dallas, Texas, USA; and The Rebecca MacDonald Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. OBJECTIVE: We review available safety data for use of currently approved tumor necrosis factor (TNF) inhibitors during pregnancy and lactation and suggest guidelines for use of these agents among women of reproductive age. METHODS: Although regulatory agencies encourage the inclusion of pregnant women and those of child-bearing age in randomized controlled trials, pregnant and lactating women have universally been excluded from studies because of unknown or potential risks to the fetus. Thus, strong evidence-based treatment recommendations during pregnancy are usually lacking and safety information is derived from voluntary reports of adverse events during postmarketing surveillance or via uncontrolled, observational studies, reviewed here. RESULTS: Uncommon adverse pregnancy outcomes observed with TNF inhibitor therapy appear to approximate those seen in women not receiving such therapy and may include premature birth, miscarriage, low birthweight, hypertension, and preeclampsia. There are rare reports of fetal malformations or congenital anomalies in patients exposed to TNF inhibitors during conception or pregnancy. However, the incidence of these events appears to be far below the 3% rate of congenital anomalies in the general population. CONCLUSION: If the activity or disease severity precludes the cessation of a TNF inhibitor and/or DMARD, uncontrolled observations suggest that conception and early pregnancy are not adversely affected by use of TNF inhibitors. Nearly 70% of pregnant patients can discontinue their TNF inhibitor early in the pregnancy (or with determination of pregnancy) without augmenting maternal or fetal risks. 4. Hintz SR, Bann CM, Ambalavanan N, Cotten CM, Das A, Higgins RD; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Predicting Time to Hospital Discharge for Extremely Preterm Infants Pediatrics [Epub ahead of print] Division of Neonatology, Stanford University, Palo Alto, California; Background: As extremely preterm infant mortality rates have decreased, concerns regarding resource use have intensified. Accurate models for predicting time to hospital discharge could aid in resource planning, family counseling, and stimulate quality-improvement initiatives. Objectives: To develop, validate, and compare several models for predicting the time to hospital discharge for infants <27 weeks' estimated gestational age, on the basis of time-dependent covariates as well as the presence of 5 key risk factors as predictors. Patients and Methods: We conducted a retrospective analysis of infants <27 weeks' estimated gestational age who were born between July 2002 and December 2005 and survived to discharge from a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network site. Time to discharge was modeled as continuous (postmenstrual age at discharge) and categorical (early and late discharge) variables. Three linear and logistic regression models with time-dependent covariate inclusion were developed (perinatal factors only, perinatal + early-neonatal factors, and perinatal + early-neonatal + later factors). Models for early and late discharge that used the cumulative presence of 5 key risk factors as predictors were also evaluated. Predictive capabilities were compared by using the coefficient of determination (R(2)) for the linear models and the area under the curve (AUC) of the receiver operating characteristic curve for the logistic models. Results: Data from 2254 infants were included. Prediction of postmenstrual age at discharge was poor. However, models that incorporated later clinical characteristics were more accurate in predicting early or late discharge (AUC: 0.76-0.83 [full models] vs 0.56-0.69 [perinatal factor models]). In simplified key-risk-factors models, the predicted probabilities for early and late discharge compared favorably with the observed rates. Furthermore, the AUC (0.75-0.77) was similar to those of the models that included the full factor set. Conclusions: Prediction of early or late discharge is poor if only perinatal factors are considered, but it improves substantially with knowledge of later-occurring morbidities. Predictive models that use a few key risk factors are comparable to the full models and may offer a clinically applicable strategy. 5. El-Zibdeh MY, Yousef LT Dydrogesterone support in threatened miscarriage Maturitas [Epub ahead of print] Department of Obstetrics and Gynaecology, Islamic Hospital, Amman, Jordan. INTRODUCTION: The aim of this study was to determine whether dydrogesterone helps to preserve pregnancy in women with threatened miscarriage. METHODS: 146 women who presented with mild or moderate vaginal bleeding during the first trimester of pregnancy were randomised to receive oral dydrogesterone (10mg b.i.d.) (n=86) or no treatment (n=60). Dydrogesterone was continued until 1 week after the bleeding had stopped. All women received standard supportive care. RESULTS: The incidence of miscarriage was significantly lower in the dydrogesterone group than in the untreated group (17.5% vs. 25%; p<0.05). There were no statistically significant differences between the groups with respect to pregnancy complications or congenital abnormalities. CONCLUSION: Dydrogesterone appears to have beneficial effects in women with threatened miscarriage. 6. Pandian RU Dydrogesterone in threatened miscarriage: A Malaysian experience Maturitas.. [Epub ahead of print] Department of Obstetrics & Gynaecology, Seberang Jaya Hospital, Tun Hussein Onn Road 34000, Seberang Jaya, Penang, Malaysia. INTRODUCTION: Threatened miscarriage is a common problem during pregnancy. METHODS: The aim of this prospective, open, randomised study was to determine whether dydrogesterone was more effective than conservative management alone in preventing miscarriage in women with vaginal bleeding up to week 16 of pregnancy. Women were excluded if they had a history of recurrent miscarriage. A total of 191 women were randomised to dydrogesterone (40mg stat followed by 10mg twice daily) or conservative management (control group). The treatment was considered successful if the pregnancy continued beyond 20 weeks of gestation. RESULTS: The success rate in the dydrogesterone group was statistically significantly higher than that in the control group (87.5% vs. 71.6%; p<0.05). Miscarriage occurred in 12.5% of women in the dydrogesterone group compared with 28.4% in the control group (p<0.05). There were no differences between the groups with regard to the incidence of Caesarean section, placenta praevia, antepartum haemorrhage, preterm labour (weeks 28-36), pregnancy-induced hypertension or low birth weight (<2500g) babies. There were no intrauterine deaths or congenital abnormalities in either group. CONCLUSION: Compared with conservative management, dydrogesterone had beneficial effects on maintaining pregnancy in women with threatened miscarriage. 7. Wu K, Xu X, Liu J, Guo Y, Li Y, Huo X Polybrominated Diphenyl Ethers in Umbilical Cord Blood and Relevant Factors in Neonates from Guiyu, China Environ Sci Technol.. [Epub ahead of print] Analytic Cytology Laboratory, Department of Preventive Medicine, and Department of Cell Biology, Shantou University Medical College, Shantou, China. We aimed to evaluate the exposure of neonates to polybrominated diphenyl ethers (PBDEs) from a primitive e-waste (obsolete electrical and electronic devices) recycling area, in Guiyu, China, and a control area, Chaonan, China, through umbilical cord blood (UCB), the health effects, and relevant factors. Questionnaires were addressed, and UCB was collected shortly after birth from 153 pregnant women between May and July 2007. Blood samples were prepared by liquid-liquid extracting methods. PBDE concentration was determined by gas chromatography/mass spectrometry in the electron capture negative ionization mode. The total PBDE concentration was higher in UCB samples from Guiyu than in Chaonan samples (median 13.84, range 1.14-504.97 ng g(-1) lipid, vs 5.23, range 0.29-363.70 ng g(-1) lipid) (p < 0.05). BDE-209 was the dominant PBDE congener, followed by BDE-47, -153, and -99. Residence in Guiyu, which is a site for e-waste recycling, involvment in e-waste recycling, and the residence also being used as a family workshop were significant factors contributing to PBDE exposure. PBDE levels significantly differed in neonates by normal birth and adverse birth outcomes including stillbirth, low birth weight, and premature delivery (p < 0.05). The neonates from Guiyu are exposed to high levels of PBDEs. Prenatal exposure to PBDEs may affect neonates' health in Guiyu, which still needs to be evaluated in larger epidemiological studies. 8. Meeks KD, Sieve AN, Kolls JK, Ghilardi N, Berg RE IL-23 Is Required for Protection against Systemic Infection with Listeria monocytogenes J Immunol. 2009 Dec 15;183(12):8026-8034 Department of Molecular Biology and Immunology, University of North Texas Health Science Center, Fort Worth, TX 76107. Listeria monocytogenes (LM) is a Gram-positive, intracellular bacterium that can induce spontaneous abortion, septicemia, and meningitis. Although it is known that neutrophils are required for elimination of the bacteria and for survival of the host, the mechanisms governing the recruitment of neutrophils to LM-infected tissues are not fully understood. We demonstrate here that IL-23 and the IL-17 receptor A (IL-17RA), which mediates both IL-17A and IL-17F signaling, are necessary for resistance against systemic LM infection. LM-infected IL-23p19 knockout (KO) mice have decreased production of IL-17A and IL-17F, while IFN-gamma production is not altered by the lack of IL-23. LM induces the production of IL-17A from gammadelta T cells, but not CD4, CD8, or NK cells. Furthermore, a lack of efficient neutrophil recruitment to the liver is evident in both IL-23p19 KO and IL-17RA KO mice during LM infection. Immunocytochemical analysis of infected livers revealed that neutrophils were able to localize with LM in IL-23p19 KO and IL-17RA KO mice, indicating that IL-23 and IL-17RA do not regulate the precise localization of neutrophils with LM. The importance of IL-23-induced IL-17A was demonstrated by injecting IL-23p19 KO mice with recombinant IL-17A. These mice had reduced LM bacterial burdens compared with IL-23p19 KO mice that did not receive IL-17A. These results indicate that during LM infection, IL-23 regulates the production of IL-17A and IL-17F from gammadelta T cells, resulting in optimal liver neutrophil recruitment and enhanced bacterial clearance. Prepared by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center Georgetown University 2115 Wisconsin Avenue, N.W., Suite 601 Washington, DC 20007 (866) 866-7437 toll free (202) 687-7466 local (202) 784-9777 fax info@sidscenter.org http://www.sidscenter.org
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For more information on maternal and child health topics, visit the MCH Library

NSIDRC Journal Article Alert — December 18, 2009

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