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Medecine Sciences : M/S Oct 2013
Topics: Comorbidity; Female; Fetal Organ Maturity; France; Gestational Age; Humans; Infant, Newborn; Intensive Care, Neonatal; Labor, Induced; Pregnancy; Premature Birth; Terminology as Topic; United States
PubMed: 24148112
DOI: 10.1051/medsci/20132910001 -
Seminars in Immunopathology Aug 2020
Topics: Female; Humans; Infant, Newborn; Pregnancy; Premature Birth
PubMed: 32960305
DOI: 10.1007/s00281-020-00809-w -
Annals of Nutrition & Metabolism 2016Preterm birth accounts for more than 85% of all perinatal complications and deaths. There are many short- and long-term consequences of being born too soon. These... (Review)
Review
Preterm birth accounts for more than 85% of all perinatal complications and deaths. There are many short- and long-term consequences of being born too soon. These infants often require intensive care and are at increased risk of early morbidities often with life-long sequelae. Approximately 50% of all preterm births have unknown or unclear causes, and there are no effective primary prevention strategies in widespread clinical use. Epidemiological studies have observed an increased length of gestation in populations with high fish consumption. These findings have led to randomised controlled trials of omega-3 (n-3) long-chain polyunsaturated fatty acid (LCPUFA) supplementation which show that these dietary agents may delay the timing of birth and may have value as a prophylactic intervention in some women. This review presents the available evidence and discusses the relationship between prenatal n-3 LCPUFA supplementation during pregnancy and the incidence of preterm birth.
Topics: Adult; Dietary Supplements; Docosahexaenoic Acids; Fatty Acids, Omega-3; Female; Humans; Incidence; Infant, Newborn; Male; Pregnancy; Premature Birth; Prenatal Care; Prenatal Nutritional Physiological Phenomena; Randomized Controlled Trials as Topic
PubMed: 27842314
DOI: 10.1159/000448263 -
Environmental Health Perspectives Dec 2023Preterm birth (PTB), defined as birth before 37 wk gestation, is associated with hypertension, diabetes, inadequate prenatal care, unemployment or poverty, and metal...
BACKGROUND
Preterm birth (PTB), defined as birth before 37 wk gestation, is associated with hypertension, diabetes, inadequate prenatal care, unemployment or poverty, and metal exposure. Indigenous individuals are more likely to have maternal risk factors associated with PTB compared with other populations in the United States; however, the role of environmental metals on PTB among pregnant Indigenous women remains uncertain. Previous research identified associations between PTB and individual metals, but there is limited investigation on metal mixtures and this birth outcome.
OBJECTIVES
We used a mixtures analysis framework to investigate the association between metal mixtures and PTB among pregnant Indigenous women from the Navajo Birth Cohort Study (NBCS).
METHODS
Maternal urine and blood samples were collected at the time of study enrollment and analyzed for metals by inductively coupled plasma dynamic reaction cell mass spectrometry. Bayesian Profile Regression was used to identify subgroups (clusters) of individuals with similar patterns of coexposure and to model association with PTB.
RESULTS
Results indicated six subgroups of maternal participants with distinct exposure profiles, including one group with low exposure to all metals and one group with total arsenic, cadmium, lead, and uranium concentrations exceeding representative concentrations calculated from the National Health and Nutrition Examination Survey (NHANES). Compared with the reference group (i.e., the lowest exposure subgroup), the subgroup with the highest overall exposure had a relative risk of PTB of 2.9 times (95% credible interval: 1.1, 6.1). Exposures in this subgroup were also higher overall than NHANES median values for women 14-45 years of age.
DISCUSSION
Given the wide range of exposures and elevated PTB risk for the most exposed subgroups in a relatively small study, follow-up investigation is recommended to evaluate associations between metal mixture profiles and other birth outcomes and to test hypothesized mechanisms of action for PTB and oxidative stress caused by environmental metals. https://doi.org/10.1289/EHP10361.
Topics: Infant, Newborn; Humans; Female; Pregnancy; Pregnant Women; Nutrition Surveys; Bayes Theorem; Cohort Studies; Premature Birth; Uranium
PubMed: 38109118
DOI: 10.1289/EHP10361 -
Frontiers in Endocrinology 2020This article reviews evidence for maternal-fetal communication about the time of day. We explore the hypothesis that key maternal hormones synchronize daily rhythms in... (Review)
Review
This article reviews evidence for maternal-fetal communication about the time of day. We explore the hypothesis that key maternal hormones synchronize daily rhythms in the fetus to regulate gestation duration. These findings may help to predict and prevent preterm birth.
Topics: Animals; Circadian Rhythm; Female; Humans; Maternal-Fetal Exchange; Pregnancy; Premature Birth; Prognosis
PubMed: 32351448
DOI: 10.3389/fendo.2020.00198 -
American Journal of Obstetrics &... Jan 2023Preterm birth remains a major public health issue affecting 10% of all pregnancies and increases risks of neonatal morbidity and mortality. Approximately 50% to 60% of...
BACKGROUND
Preterm birth remains a major public health issue affecting 10% of all pregnancies and increases risks of neonatal morbidity and mortality. Approximately 50% to 60% of preterm births are spontaneous, resulting from preterm premature rupture of membranes or preterm labor. The pathogenesis of spontaneous preterm birth is incompletely understood, and prediction of preterm birth remains elusive. Accurate prediction of preterm birth would reduce infant morbidity and mortality through targeted patient referral to hospitals equipped to care for preterm infants. Two previous studies have analyzed cervical microRNAs in association with spontaneous preterm birth and the length of gestation, but the extent to which microRNAs serve as predictive biomarkers remains unknown.
OBJECTIVE
This study aimed to examine associations between cervical microRNA expression and spontaneous preterm birth, with the specific goal of identifying a subset of microRNAs that predict spontaneous preterm birth.
STUDY DESIGN
We performed a prospective, nested, case-control study of 25 cases with spontaneous preterm birth and 49 term controls. Controls were matched to cases in a 2:1 ratio on the basis of age, parity, and self-identified race. Cervical swabs were collected at a mean gestational age of 17.1 (4.8) weeks of gestation, and microRNAs were analyzed using a quantitative polymerase chain reaction array. Normalized microRNA expression was compared between cases and controls, and a false discovery rate of 0.2 was applied to account for multiple comparisons. Histopathologic analysis of slides of cervical swab samples was performed to quantify leukocyte burden for adjustment in conditional regression models. We explored the use of Relief-based unsupervised identification of top microRNAs and support vector machines to predict spontaneous preterm birth. We performed microRNA enrichment analysis to explore potential biologic targets and pathways in which up-regulated microRNAs might be involved.
RESULTS
Of the 754 microRNAs on the polymerase chain reaction array, 346 were detected in ≥75% of participants' cervical swabs. Average cervical microRNA expression was significantly higher in cases of spontaneous preterm birth than in controls (P=.01). There were 95 significantly up-regulated individual microRNAs (>2-fold change) in cases of subsequent spontaneous preterm birth compared with term controls (P<.05; q<0.2). Notably, miR-143, miR-30e-3p, and miR-199b were all significantly up-regulated, which is consistent with the 1 previous study of cervical microRNA and spontaneous preterm birth. A Relief-based, novel variable (feature) selection machine learning approach had low-to-moderate prediction accuracy, with an area under the receiver operating curve of 0.71. Enrichment analysis revealed that identified microRNAs may modulate inflammatory cell signaling.
CONCLUSION
In this prospective nested case-control study of cervical microRNA expression and spontaneous preterm birth, we identified a global increase in microRNA expression and up-regulation of 95 distinct microRNAs in association with subsequent spontaneous preterm birth. Larger and more diverse studies are required to determine the ability of microRNAs to accurately predict spontaneous preterm birth, and mechanistic work to facilitate development of novel therapeutic interventions to prevent spontaneous preterm birth is warranted.
Topics: Pregnancy; Infant; Female; Infant, Newborn; Humans; Premature Birth; Case-Control Studies; Prospective Studies; Infant, Premature; MicroRNAs
PubMed: 36280145
DOI: 10.1016/j.ajogmf.2022.100783 -
JCI Insight Aug 2022Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. One of every 4 preterm neonates is born to a mother with intra-amniotic inflammation...
Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. One of every 4 preterm neonates is born to a mother with intra-amniotic inflammation driven by invading bacteria. However, the molecular mechanisms underlying this hostile immune response remain unclear. Here, we used a translationally relevant model of preterm birth in Nlrp3-deficient and -sufficient pregnant mice to identify what we believe is a previously unknown dual role for the NLRP3 pathway in the fetal and maternal signaling required for the premature onset of the labor cascade leading to fetal injury and neonatal death. Specifically, the NLRP3 sensor molecule and/or inflammasome is essential for triggering intra-amniotic and decidual inflammation, fetal membrane activation, uterine contractility, and cervical dilation. NLRP3 also regulates the functional status of neutrophils and macrophages in the uterus and decidua, without altering their influx, as well as maternal systemic inflammation. Finally, both embryo transfer experimentation and heterozygous mating systems provided mechanistic evidence showing that NLRP3 signaling in both the fetus and the mother is required for the premature activation of the labor cascade. These data provide insights into the mechanisms of fetal-maternal dialog in the syndrome of preterm labor and indicate that targeting the NLRP3 pathway could prevent adverse perinatal outcomes.
Topics: Animals; Female; Fetus; Humans; Infant, Newborn; Inflammation; Mice; NLR Family, Pyrin Domain-Containing 3 Protein; Obstetric Labor, Premature; Pregnancy; Premature Birth
PubMed: 35993366
DOI: 10.1172/jci.insight.158238 -
Clinics in Perinatology Dec 2020
Topics: Female; Fetofetal Transfusion; Healthcare Disparities; Humans; Hypertension, Pregnancy-Induced; Opioid-Related Disorders; Perinatology; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious; Premature Birth; Telemedicine
PubMed: 33153666
DOI: 10.1016/j.clp.2020.09.002 -
Ultrasound in Obstetrics & Gynecology :... Sep 2022
Topics: Cervical Length Measurement; Cervix Uteri; Female; Humans; Infant, Newborn; Pregnancy; Premature Birth; Ultrasonography
PubMed: 35904371
DOI: 10.1002/uog.26020 -
International Journal of Molecular... Dec 2015Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that... (Review)
Review
Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that there are no means to predict who is at risk when pregnancy begins or when women will actually deliver. Until these problems are addressed, there will be no interventions to reduce the risk because those who should be treated will not be known. Considerable evidence now exists that chronic life, generational or accumulated stress is a risk factor for preterm delivery in animal models and in women. This wear and tear on the body and mind is called allostatic load. This review explores the evidence that chronic stress contributes to preterm birth and other adverse pregnancy outcomes in animal and human studies. It explores how allostatic load can be used to, firstly, model stress and preterm birth in animal models and, secondly, how it can be used to develop a predictive model to assess relative risk among women in early pregnancy. Once care providers know who is in the highest risk group, interventions can be developed and applied to mitigate their risk.
Topics: Allostasis; Epigenesis, Genetic; Female; Humans; Inflammation; Models, Biological; Pregnancy; Premature Birth; Risk Factors
PubMed: 26694355
DOI: 10.3390/ijms161226209