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Taiwanese Journal of Obstetrics &... Jan 2022Amniotic mesenchymal stromal cells (AMSCs) can be obtained from the mesoderm of human amniotic membrane. AMSCs derived from term baby show increased expression of genes...
OBJECTIVE
Amniotic mesenchymal stromal cells (AMSCs) can be obtained from the mesoderm of human amniotic membrane. AMSCs derived from term baby show increased expression of genes associated with apoptosis and senescence. The objective of this study was to examine gene expression profiles of AMSCs derived from preterm (preterm AMSCs) and term labors (term AMSCs) and analyze common and different mechanisms.
MATERIALS AND METHODS
We isolated and cultured AMSCs from 43 placentas: 27 from term labor and 16 from preterm labor. Microarray analysis and gene network analysis were performed to compare gene expression profile (GEP) of preterm (n = 6) with term AMSCs (n = 10). Senescence-associated gene (CDKN2A and CDKN2B) expression was also measured by reverse transcription quantitative PCR.
RESULTS
GEP demonstrated that preterm AMSCs showed upregulation of nicotinamide adenine dinucleotide biosynthetic process and downregulation of extracellular matrix, cholesterol import and transport, lipid storage, and maintenance of location. CDKN2A and CDKN2B genes showed similar expression levels between term and preterm AMSCs. CDKN2A gene expression was correlated with CDKN2B expression and population doubling time. Compared to term AMSCs, preterm AMSCs showed significantly different expression of genes associated with inflammatory response which could be one of the major players in labor events.
CONCLUSION
Increased CDKN2A expression in AMSCs is associated with placental membrane aging which participates in both preterm and term labor. To the best of our knowledge, this is the first report to demonstrate the association of AMSCs with labor.
Topics: Adult; Aging; Amnion; Cell Differentiation; Female; Gene Expression; Humans; Mesenchymal Stem Cells; Obstetric Labor, Premature; Placenta; Pregnancy
PubMed: 35181046
DOI: 10.1016/j.tjog.2021.10.005 -
Canadian Family Physician Medecin de... Jan 2018
Topics: Abruptio Placentae; Female; Humans; Obstetric Labor, Premature; Pregnancy
PubMed: 29358255
DOI: No ID Found -
BMC Medicine Jun 2016Preterm birth is now recognized as the primary cause of infant mortality worldwide. Interplay between hormonal and inflammatory signaling in the uterus modulates the...
BACKGROUND
Preterm birth is now recognized as the primary cause of infant mortality worldwide. Interplay between hormonal and inflammatory signaling in the uterus modulates the onset of contractions; however, the relative contribution of each remains unclear. In this study we aimed to characterize temporal transcriptome changes in the uterus preceding term labor and preterm labor (PTL) induced by progesterone withdrawal or inflammation in the mouse and compare these findings with human data.
METHODS
Myometrium was collected at multiple time points during gestation and labor from three murine models of parturition: (1) term gestation; (2) PTL induced by RU486; and (3) PTL induced by lipopolysaccharide (LPS). RNA was extracted and cDNA libraries were prepared and sequenced using the Illumina HiSeq 2000 system. Resulting RNA-Seq data were analyzed using multivariate modeling approaches as well as pathway and causal network analyses and compared against human myometrial transcriptome data.
RESULTS
We identified a core set of temporal myometrial gene changes associated with term labor and PTL in the mouse induced by either inflammation or progesterone withdrawal. Progesterone withdrawal initiated labor without inflammatory gene activation, yet LPS activation of uterine inflammation was sufficient to override the repressive effects of progesterone and induce a laboring phenotype. Comparison of human and mouse uterine transcriptomic datasets revealed that human labor more closely resembles inflammation-induced PTL in the mouse.
CONCLUSIONS
Labor in the mouse can be achieved through inflammatory gene activation yet these changes are not a requisite for labor itself. Human labor more closely resembles LPS-induced PTL in the mouse, supporting an essential role for inflammatory mediators in human "functional progesterone withdrawal." This improved understanding of inflammatory and progesterone influence on the uterine transcriptome has important implications for the development of PTL prevention strategies.
Topics: Animals; Female; Humans; Inflammation; Inflammation Mediators; Labor, Obstetric; Lipopolysaccharides; Mice; Models, Animal; Myometrium; Obstetric Labor, Premature; Parturition; Pregnancy; Progesterone; Transcriptome; Uterus
PubMed: 27291689
DOI: 10.1186/s12916-016-0632-4 -
Archives of Disease in Childhood. Fetal... Sep 2018Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal... (Review)
Review
Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal resuscitation guidelines, comprehensive recommendations are available on supporting pulmonary transition and delaying clamping of the cord in preterm infants. Recent experimental studies demonstrated that the pulmonary and haemodynamic transition are intimately linked, could influence each other and that the timing of umbilical cord clamping should be incorporated into the respiratory stabilisation. We reviewed the current knowledge on how to incorporate cord clamping into stabilisation of preterm infants and the physiological-based cord clamping (PBCC) approach, with the infant's transitional status as key determinant of timing of cord clamping. This approach could result in optimal timing of cord clamping and has the potential to reduce major morbidities and mortality in preterm infants.
Topics: Adaptation, Physiological; Constriction; Delivery, Obstetric; Female; Hemodynamics; Humans; Infant, Newborn; Infant, Premature; Obstetric Labor, Premature; Pregnancy; Time-to-Treatment; Umbilical Cord
PubMed: 29680790
DOI: 10.1136/archdischild-2018-314947 -
Scientific Reports Feb 2024The labor is a physiological event considered to have its own circadian (diurnal) rhythm, but some of the data remain conflicting, especially for preterm births. In this...
The labor is a physiological event considered to have its own circadian (diurnal) rhythm, but some of the data remain conflicting, especially for preterm births. In this retrospective study, we analyzed the circadian trends of labor onset times in the Slovenian birth cohort from 1990 to 2018 with over 550,000 cases of singleton births. The number of term and preterm labor onsets was calculated for each hour in a day and circadian trends were evaluated for each of the study groups by modeling with a generalized Poisson distribution linked with the cosinor regression model using logarithmic link function. The induced labors were taken as the control group since the timing of labor depends mostly on the working schedule of personnel and not on the intrinsic rhythmic characteristics. For induced labors, the main peak in the number of labor cases was observed in the late morning hours (around 10 AM) for all gestational ages. The prominence of this peak becomes smaller in spontaneous premature labors with gradually disrupting rhythmicity in very preterm and extremely preterm cases. Labors starting with spontaneous contractions peak between 6 and 7 AM and lose the rhythmicity at 35 weeks of gestation while labors starting with a spontaneous rupture of membranes peak at 1 AM and lose the rhythmicity at 31 weeks of gestation, suggesting differences in underlying mechanisms. According to our knowledge, this is the first study that shows differences of circadian trends between different types of spontaneous labors, i.e., labors initiated with contraction and labors initiated with a spontaneous rupture of membranes. Moreover, the obtained results represent evidence of gradual disruption of rhythmicity from mild to extreme prematurity.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Retrospective Studies; Rupture, Spontaneous; Obstetric Labor, Premature; Infant, Premature; Labor, Obstetric; Gestational Age; Premature Birth
PubMed: 38369585
DOI: 10.1038/s41598-024-54490-2 -
American Journal of Reproductive... Aug 2014Progress in our understanding of the role of the maternal immune system during healthy pregnancy will help us better understand the role of the immune system in adverse... (Review)
Review
Progress in our understanding of the role of the maternal immune system during healthy pregnancy will help us better understand the role of the immune system in adverse pregnancy outcomes. In this review, we discuss our present understanding of the 'immunity of pregnancy' in the context of the response to cervical and placental infections and how these responses affect both the mother and the fetus. We discuss novel and challenging concepts that help explain the immunological aspects of pregnancy and how the mother and fetus respond to infection.
Topics: Bacterial Infections; Female; Fetus; Humans; Immune System; Immune Tolerance; Maternal-Fetal Exchange; Obstetric Labor, Premature; Placenta; Pregnancy; Virus Diseases
PubMed: 24995526
DOI: 10.1111/aji.12289 -
International Journal of Infectious... Aug 2018The aim was to establish the incidence of adverse outcomes with brucellosis infection during pregnancy. (Review)
Review
BACKGROUND
The aim was to establish the incidence of adverse outcomes with brucellosis infection during pregnancy.
METHODS
Ovid Medline (1946-), Ovid Embase (1974-), and Web of Science (Clarivate Analytics) (1900-), the World Health Organization website and Google were searched September 27, 2017 for (i) outcomes with brucellosis diagnosed during pregnancy and (ii) studies with retrospective diagnosis of maternal brucellosis following adverse pregnancy outcomes.
RESULTS
Sixty studies met inclusion criteria. In 65 pregnancies from 28 case reports and 9 small case series (<10 women), there were 20 spontaneous abortions (SAs) (31%), 2 intra-uterine fetal deaths (IUFDs) (3%) and 11 cases of congenital brucellosis (17%). In 14 larger case series there were 181 SAs in 679 pregnancies (27%), 19 IUFDs in 458 pregnancies (4%), and 44 preterm infants (12%) plus 6 infants with congenital brucellosis (2%) in 362 pregnancies. SA, IUFD and preterm delivery incidence were increased with meta-analysis of the 5 case series with controls. Nine studies described brucellosis seroprevalence with adverse pregnancy outcomes with no increased seroprevalence in the two studies with controls.
CONCLUSIONS
Brucellosis almost certainly causes SA with increasing evidence that it also leads to IUFD and prematurity. Congenital brucellosis occurs in approximately 2% of infants exposed in-utero.
Topics: Abortion, Spontaneous; Brucellosis; Female; Fetal Death; Humans; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies
PubMed: 29885371
DOI: 10.1016/j.ijid.2018.05.023 -
Biology of Reproduction Nov 2018Preterm birth affects approximately 1 out of every 10 births in the United States, leading to high rates of mortality and long-term negative health consequences. To... (Review)
Review
Preterm birth affects approximately 1 out of every 10 births in the United States, leading to high rates of mortality and long-term negative health consequences. To investigate the mechanisms leading to preterm birth so as to develop prevention strategies, researchers have developed numerous mouse models of preterm birth. However, the lack of standard definitions for preterm birth in mice limits our field's ability to compare models and make inferences about preterm birth in humans. In this review, we discuss numerous mouse preterm birth models, propose guidelines for experiments and reporting, and suggest markers that can be used to assess whether pups are premature or mature. We argue that adoption of these recommendations will enhance the utility of mice as models for preterm birth.
Topics: Animals; Disease Models, Animal; Female; Humans; Mice; Obstetric Labor, Premature; Pregnancy
PubMed: 29733339
DOI: 10.1093/biolre/ioy109 -
Taiwanese Journal of Obstetrics &... Sep 2023To evaluate the safety and efficacy of atosiban and ritodrine in pregnant women who were hospitalized for threatened preterm labor (TPL).
A multicenter, retrospective comparison of pregnancy outcomes between groups of preterm labor nulliparous mothers treated with atosiban vs. ritodrine in singleton and multiple pregnancies.
OBJECTIVE
To evaluate the safety and efficacy of atosiban and ritodrine in pregnant women who were hospitalized for threatened preterm labor (TPL).
MATERIALS AND METHODS
Diagnosis records of preterm labor and subsequent pregnancy-related records and medical records of newborns were extracted from the Clinical Data Warehouse of the Catholic Medical Center's affiliated hospital. Since 2009, cases of preterm labor diagnosed before 34 weeks of pregnancy for first-time mothers who delivered at any one of three hospitals and who received drug treatment for more than 2 days to delay delivery were included in the dataset. Based on characteristics of Korea's national health insurance system, the drug treatment after diagnosis of preterm labor could be classified into cases using only ritodrine (571 women), cases using only atosiban (244 women), and cases where ritodrine treatment was started and then changed to atosiban (275 women). Demographic factors, obstetric outcomes, neonatal outcomes of the two groups were analyzed.
RESULTS
The duration and maintenance of pregnancy were found to be similar between the two groups, although the initial cervical length was significantly shorter in the atosiban cohort (AC). Only in multifetal pregnancies, the maintenance of pregnancy was significantly longer in the AC. The total duration of pregnancy did not show any significant difference between the two groups regardless of singleton or multiple pregnancy. However, the distribution graph showed non-responders in the ritodrine cohort (RC). Our study showed a difference in neonatal birth weight of singleton between the two groups. The length of hospitalization and the NICU admission rate were also significantly higher in the RC for singleton. Although not significant, the proportion of numbers with an Apgar score less than 7 was higher in the RC. Neonatal death was more common in the RG (8 cases in AC and 18 cases in RC).
CONCLUSIONS
Using atosiban for TPL is more effective than using ritodrine for maintaining pregnancy in the case of a multifetal pregnancy. In singleton pregnancies, neonatal outcomes of the atosiban group were superior to those of the ritodrine group. There seems to be a non-responder group when using ritodrine for TPL. Further studies are needed to determine causes of non-responders of ritodrine and effects of ritodrine on the fetus.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Ritodrine; Mothers; Pregnancy Outcome; Retrospective Studies; Pregnancy, Multiple; Obstetric Labor, Premature
PubMed: 37678995
DOI: 10.1016/j.tjog.2023.07.009 -
Korean Journal of Women Health Nursing Sep 2023Preterm birth is increasing, and obstetric nurses should have the competency to provide timely care. Therefore, training is necessary in the maternal nursing practicum....
Does a preterm labor-assessment algorithm improve preterm labor-related knowledge, clinical practice confidence, and educational satisfaction?: a quasi-experimental study.
PURPOSE
Preterm birth is increasing, and obstetric nurses should have the competency to provide timely care. Therefore, training is necessary in the maternal nursing practicum. This study aimed to investigate the effects of practice education using a preterm-labor assessment algorithm on preterm labor-related knowledge and clinical practice confidence in senior nursing students.
METHODS
A pre-post quasi-experimental design with three groups was used for 61 students. The preterm-labor assessment algorithm was modified into three modules from the preterm-labor assessment algorithm by March of Dimes. We evaluated preterm labor-related knowledge, clinical practice confidence, and educational satisfaction. Data were analyzed with the paired t-test and repeated-measures analysis of variance.
RESULTS
The practice education using a preterm-labor assessment algorithm significantly improved both preterm labor-related knowledge and clinical practice confidence (paired t=-7.17, p<.001; paired t=-5.51, p<.001, respectively). The effects of the practice education using a preterm-labor assessment algorithm on knowledge lasted until 8 weeks but decreased significantly at 11 and 13 weeks after the program, while the clinical practice confidence significantly decreased at 8 weeks post-program.
CONCLUSION
The practice education using a preterm-labor assessment algorithm was effective in improving preterm labor-related knowledge and clinical practice confidence. The findings suggest that follow-up education should be conducted at 8 weeks, or as soon as possible thereafter, to maintain knowledge and clinical confidence, and the effects should be evaluated.
Topics: Pregnancy; Female; Humans; Infant, Newborn; Premature Birth; Obstetric Labor, Premature; Mental Processes; Personal Satisfaction; Algorithms
PubMed: 37813665
DOI: 10.4069/kjwhn.2023.08.17