NSIDRC Journal Article Alert — June 11, 2010
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.
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Miscarriage/Stillbirth/Prenatal Issues
1. Vasudevan C, Renfrew M, McGuire W
Fetal and perinatal consequences of maternal obesity.
Arch Dis Child Fetal Neonatal Ed. 2010 Jun 7. [Epub ahead of
print]
Department of Child Health, University of Leeds, Leeds, UK.
In many industrialised countries, one in five women booking for antenatal care is obese. As well as affecting maternal health, maternal obesity may have important adverse consequences for fetal, neonatal and long-term health and well-being. Maternal obesity is associated with a higher risk of stillbirth, elective preterm birth and perinatal mortality. The incidence of severe birth defects, particularly neural tube and structural cardiac defects, appears to be higher in infants of obese mothers. Fetal macrosomia associated with maternal obesity and gestational diabetes predisposes infants to birth injuries, perinatal asphyxia and transitional problems such as neonatal respiratory distress and metabolic instability. Maternal obesity may also result in long-term health problems for offspring secondary to perinatal problems and to intrauterine and postnatal programming effects. Currently, the available interventions to prevent and treat maternal obesity are of limited proven utility and further research is needed to define the effects of maternal weight management interventions on fetal and neonatal outcomes.
2. Al Shobaili HA, Hamed HO, Al Robaee A, Alzolibani AA, Amin
AF, Ahmad SR
Obstetrical and fetal outcomes of a new management strategy
in patients with intra-hepatic cholestasis of pregnancy
Arch Gynecol Obstet. 2010 Jun 4. [Epub ahead of print]
Department of Dermatology, Qassim University, Qassim, Saudi Arabia.
PURPOSES: To determine the incidence, obstetrical, and fetal complication rates of intrahepatic cholestasis of pregnancy (ICP) in patients managed expectantly to 40-weeks gestation. METHODS: In a prospective cohort study conducted between February 2008 and January 2010, a total of 21,960 pregnant women in Qassim Region of Saudi Arabia were screened for ICP using specific criteria for diagnosis. The course of pregnancy was monitored to 40-weeks gestation or spontaneous onset of labor, whichever comes first. The measured outcomes were compared with a cross-matched group of healthy pregnant women. Continuous variables were analyzed with t test, while chi(2) test was used for comparing percentages. RESULTS: The incidence of ICP was 0.35% (76/21,960). There was no significant difference between groups in gestational age at delivery, preterm labor, intrauterine fetal death, cesarean section, or respiratory distress syndrome. There was significantly higher intrapartum non-reassuring fetal heart rate patterns and meconium-stained amniotic fluid in ICP group (P < 0.01 and <0.0001, respectively). CONCLUSIONS: The incidence of ICP in this region is low compared to worldwide range. Expectant management to 40-weeks gestation is associated with obstetrical and fetal outcomes comparable to normal pregnancy; however, intrapartum fetal asphyxia is more likely.
3. Vilarino FL, Christofolini DM, Rodrigues D, de Souza AM,
Christofolini J, Bianco B, Barbosa CP
Body mass index and fertility: is there a correlation with
human reproduction outcomes?
Gynecol Endocrinol. 2010 Jun 8. [Epub ahead of print]
Division of Pathological Gynecology and Human Reproduction, Department of Gynecology and Obstetrics, Faculdade de Medicina do ABC, Santo André, Brazil.
Considering the existing conflicts about how an elevated body mass index (BMI) affects fertility, this study had the objective of evaluating the impact of overweight and obesity on the results of IVF/ICSI (in-vitro fertilisation/intracytoplasmatic sperm injection) performed at the Human Reproduction Centre of Faculdade de Medicina do ABC. Retrospective data from 208 IVF cycles of 191 women, performed at our laboratory from February through June, 2008, were used to calculate their BMI. On the basis of the results, the patients were divided into two groups: Group 1: BMI <25 kg/m(2) and Group 2: BMI >/=25 kg/m(2). Of the 208 cycles, 137 were from patients with BMI <25 kg/m(2) and 71 cycles from patients with BMI >/=25 kg/m(2). Patients' ages and the number of cycles with gonadotrophin-releasing hormone agonist and antagonist were similar in both groups. The doses of follicle-stimulating hormone used for ovarian induction per cycle, the number of retrieved oocytes, fertilisation rate, embryo quality and number of transferred and frozen embryos, the hyperstimulation, pregnancy rates, miscarriage rate and live birth rates showed no statistically significant differences. BMI does not appear to be a good parameter for the definition of IVF success. The association with other methodologies may produce more consistent data about body composition and its impact on fertility.
4. Lopez MF, Kuppusamy R, Sarracino DA, Prakash A, Athanas
M, Krastins B, Rezai T, Sutton JN, Peterman S, Nicolaides K
Mass Spectrometric Discovery and Selective Reaction Monitoring
(SRM) of Putative Protein Biomarker Candidates in First Trimester
Trisomy 21 Maternal Serum
J Proteome Res. 2010 Jun 4. [Epub ahead of print]
ThermoFisher Scientific BRIMS, 790 Memorial Drive, Cambridge, Massachusetts 02139, VAST Scientific, 790 Memorial Drive, Cambridge, Massachusetts 02139, and Fetal Medicine Foundation, 137 Harley Street, London, United Kingdom W1G 6BG.
The accurate diagnosis of Trisomy 21 requires invasive procedures that carry a risk of miscarriage. The current state-of-the-art maternal serum screening tests measure levels of PAPP-A, free bhCG, AFP, and uE3 in various combinations with a maximum sensitivity of 60-75% and a false positive rate of 5%. There is currently an unmet need for noninvasive screening tests with high selectivity that can detect pregnancies at risk, preferably within the first trimester. The aim of this study was to apply proteomics and mass spectrometry techniques for the discovery of new putative biomarkers for Trisomy 21 in first trimester maternal serum coupled with the immediate development of quantitative selective reaction monitoring (SRM) assays. The results of the novel workflow were 2-fold: (1) we identified a list of differentially expressed proteins in Trisomy21 vs Normal samples, including PAPP-A, and (2) we developed a multiplexed, high-throughput SRM assay for verification of 12 new putative markers identified in the discovery experiments. To narrow down the initial large list of differentially expressed candidates resulting from the discovery experiments, we incorporated receiver operating characteristic (ROC) curve algorithms early in the data analysis process. We believe this approach provides a substantial advantage in sifting through the large and complex data typically obtained from discovery experiments. The workflow efficiently mined information derived from high-resolution LC-MS/MS discovery data for the seamless construction of rapid, targeted assays that were performed on unfractionated serum digests. The SRM assay lower limit of detection (LLOD) for the target peptides in a background of digested serum matrix was approximately 250-500 attomoles on column and the limit of accurate quantitation (LOQ) was approximately 1-5 femtomoles on column. The assay error as determined by coefficient of variation at LOQ and above ranged from 0 to 16%. The workflow developed in this study bridges the gap between proteomic biomarker discovery and translation into a clinical research environment. Specifically, for Trisomy 21, the described multiplexed SRM assay provides a vehicle for high-throughput verification of these, and potentially other, peptide candidates on larger sample cohorts.
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