Cord Blood Levels Research Articles

Incidence of vitamin D levels in cord blood of newborns and correlation with maternal vitamin D

Vitamin D deficiency is common in northern India but there are limited data in pregnant women and neonates. This study aimed to determine the prevalence of vitamin D levels in cord blood of newborns and the association with maternal vitamin D. A total of 50 pregnant women and their neonates were included. Clinical data and venous maternal blood for calcium,phosphate, albumin, alkaline phosphatase, magnesium, intact parathyroid hormone , and vitamin D were obtained on the day of labor. Cord blood was collected following delivery to evaluate vitamin D status of newborns. Mean serum maternal and cord blood 25 OHD levels were 25.42 ± 8.07 and 14.85 ± 5.13 ng/mL. The prevalence of vitamin D deficiency (25OHD < 12 ng/mL) and insufficiency (25OHD 12–20ng/mL) in cord blood of newborns were 20.2 and 69.1%,respectively. There was a significant correlation between maternal and cord blood vitamin D levels (P< 0.001). The factors associated with cord blood vitamin D deficiency were low maternal 25OHD level and no vitamin D supplement during pregnancy. Conclusion: There is a high prevalence of vitamin D deficiency among the neonates. Adequate prenatal vitamin D supplementation should be implemented as routine antenatal care.

Relationship between Twin-to-Twin Selective Intrauterine Growth Restriction with sFas/sFasL Level of Umbilical Cord Blood Using Doppler Ultrasound Fetal Heart Rhythm Detection Algorithm

The study focused on the application value of ultrasound Doppler fetal heart rate detection algorithm based on short-time Fourier transform (STFT) in the diagnosis of twin-to-twin selective intrauterine growth restriction (sIUGR) and the correlation between twin-to-twin sIUGR and sFas/sFasL levels of umbilical cord blood. The normalized method was introduced into the STFT algorithm to optimize it to detect the fetal instantaneous heart rate. 82 pregnant women with twin pregnancies were selected as the research subjects and they were divided into the restricted group (41 cases) and the control group (41 cases) according to whether the fetus had selective growth restriction. The two groups were compared for the differences in the fetal mortality, complication rate, and sFas/sFasL expression levels. The results showed that the STFT-based ultrasonic Doppler fetal heart rate detection algorithm could ensure the quality of the fetal heart rate signal and had high resolution at the 200–400 Hz characteristic frequency band and that the accuracy in distinguishing S1 and S2 was 5.8% higher than that of the traditional autocorrelation algorithm. The proportion of abnormal fetal heart rate in the restricted group was significantly higher than that in the control group ( P < 0.05 ), birth weight was significantly lower than that in the control group ( P < 0.05 ), and fetal mortality was significantly higher than that in the control group ( P < 0.05 ). There was no statistical difference in the incidence of complications between the two groups ( P > 0.05 ). In restricted group, the content of sFas in cord blood was (3326.54 ± 317.42) pg/mL and that in the control group was (2003.29 ± 196.45) pg/mL. The content of sFas in cord blood of the restricted group was significantly higher than that of the control group ( P < 0.01 ). In the restricted group, the content of sFasL in cord blood was (382.52 ± 36.17) pg/mL, and that in the control group was (180.84 ± 16.20) pg/mL. The content of sFasL in cord blood of the restricted group was significantly higher than that of the control group ( P < 0.001 ). It was concluded that the STFT-based ultrasound Doppler fetal heart rate monitoring is beneficial to early diagnosis and timely intervention of twin-to-twin sIUGR.

Umbilical Cord Procalcitonin to Detect Early-Onset Sepsis in Newborns: A Promising Biomarker.

Background: Up to 7% of neonates born in high-income countries receive antibiotics for suspected early-onset sepsis (EOS). Culture-proven neonatal sepsis has a prevalence of 0.2%, suggesting considerable overtreatment. We studied the diagnostic accuracy of umbilical cord blood and infant blood procalcitonin (PCT) in diagnosing EOS to improve antibiotic stewardship.Methods: Umbilical cord blood PCT was tested in newborns ≥ 32 weeks of gestation. Groups were defined as following: A) culture-proven or probable EOS (n = 25); B) Possible EOS, based on risk factors for which antibiotics were administered for <72 h (n = 49); C) Risk factor(s) for EOS without need for antibiotic treatment (n = 181); D) Healthy controls (n = 74). Additionally, venous or capillary blood PCT and C-reactive protein (CRP) were tested if blood drawing was necessary for standard care.Results: Between June 2019 and March 2021, 329 newborns were included. Umbilical cord blood PCT was significantly higher in group A than in group C and D. No difference between venous or arterial samples was found. Sensitivity and specificity for cord blood procalcitonin were 83 and 62%, respectively (cut-off 0.1 ng/mL). Antepartum maternal antibiotic administration was associated with decreased PCT levels in both cord blood and infant blood directly postpartum in all groups combined.Conclusion: Umbilical cord blood PCT levels are increased in newborns ≥32 weeks with a proven or probable EOS and low in newborns with risk factors for infection, but PCT seems not a reliable marker after maternal antibiotic treatment. PCT could be useful to distinguish infected from healthy newborns with or without EOS risk factors.

Characterization of the Transient Deficiency of PKC Isozyme Levels in Immature Cord Blood T Cells and Its Connection to Anti-Allergic Cytokine Profiles of the Matured Cells.

Cord blood T cells (CBTC) from a proportion of newborns express low/deficient levels of some protein kinase C (PKC) isozymes, with low levels of PKCζ correlating with increased risk of developing allergy and associated decrease in interferon-gamma (IFN-γ) producing T cells. Interestingly, these lower levels of PKCζ were increased/normalized by supplementing women during pregnancy with n-3 polyunsaturated fatty acids. However, at present, we have little understanding of the transient nature of the deficiency in the neonate and how PKCζ relates to other PKC isozymes and whether their levels influence maturation into IFN-γ producing T cells. There is also no information on PKCζ isozyme levels in the T cell subpopulations, CD4+ and CD8+ cells. These issues were addressed in the present study using a classical culture model of neonatal T cell maturation, initiated with phytohaemagglutinin (PHA) and recombinant human interleukin-2 (rhIL-2). Of the isozymes evaluated, PKCζ, β2, δ, μ, ε, θ and λ/ι were low in CBTCs. The PKC isozyme deficiencies were also found in the CD4+ and CD8+ T cell subset levels of the PKC isozymes correlated between the two subpopulations. Examination of changes in the PKC isozymes in these deficient cells following addition of maturation signals showed a significant increase in expression within the first few hours for PKCζ, β2 and μ, and 1–2 days for PKCδ, ε, θ and λ/ι. Only CBTC PKCζ isozyme levels correlated with cytokine production, with a positive correlation with IFN-γ, interleukin (IL)-2 and tumour necrosis factor-alpha (TNF), and a negative association with IL-9 and IL-10. The findings reinforce the specificity in using CBTC PKCζ levels as a biomarker for risk of allergy development and identify a period in which this can be potentially ‘corrected’ after birth.

The association of maternal SARS-CoV-2 vaccination-to-delivery interval and the levels of maternal and cord blood antibodies.

ObjectiveTo evaluate the correlation of maternal and cord blood levels of SARS‐CoV‐2 antibodies in pregnant women immunized against COVID‐19.MethodsA prospective cohort study was performed of pregnant women who delivered at a single university affiliated tertiary medical center. Women who received the COVID‐19 vaccine (BNT162b2 Pfizer©) were approached. The correlation between levels of maternal sera and umbilical cord SARS‐CoV‐2 specific IgG was assessed.ResultsOverall, 58 women were included; of them, 19 had received a single dose and 39 received two doses of the COVID‐19 vaccine. Positive levels of umbilical cord IgG were found in 13/19 (68.4%) and 38/39 (97.4%) women after the administration of a single dose and two doses of the vaccine, respectively. The levels of SARS‐CoV‐2 IgG antibodies in the maternal sera of vaccinated women were positively correlated to their respective concentrations in cord blood sera (ρ = 0.857; R2 linear = 0.719; P < 0.001). Thirteen days after vaccination, the ratio of maternal‐to‐umbilical cord anti Spike IgG antibodies was approximately 1, indicating relatively similar levels in maternal and cord sera.ConclusionAfter the SARS‐CoV‐2 vaccine, levels of maternal and cord blood antibodies were positively correlated, especially when tested after 13 days following administration of the first dose of the vaccine.

Prenatal exposure to bisphenols, immune responses in cord blood and infantile eczema: A nested prospective cohort study in China

Increasing evidence shows that human exposure to bisphenols can increase the risk of allergic disease, such as child asthma. However, the mechanism by which exposure to bisphenols causes allergic disease is unclear. In addition, the effects of exposure to bisphenols during pregnancy on infantile eczema have been poorly studied. The aim of our study was to investigate the effect of bisphenols (BPA, BPF and BPS) exposure during pregnancy on immune cells in cord blood, and on the occurrence of infantile eczema. 111 mother-child pairs with urine samples from pregnant women and cord blood were recruited from a birth cohort established in February 2019 in Shenyang, China. The levels of urinary bisphenols and Th1-, Th2-, Treg- and Th17-related genes, and cytokines in cord blood, as well as the incidence of infantile eczema at 6 and 12 months follow up were determined. Our results show that BPA, BPF and BPS were detected in 100%, 63.1% and 46.8% of the urine samples, respectively. The median concentration of urine specific gravity adjusted BPA (SG-BPA) was 7.46 ng/mL. High SG-BPA levels during pregnancy was independently associated with increased risk of infantile eczema (adjusted OR = 2.731, 95%CI: 1.064–7.012, P = 0.037). Higher levels of FOXP3 gene in cord blood had a significantly lower risk of developing eczema in infants (adjusted OR=0.430, 95%CI: 0.190–0.972, P = 0.042). However, BPS and BPF levels were not associated with infantile eczema. FOXP3 gene levels in cord blood mediated the relationship between SG-BPA levels during pregnancy and infantile eczema (indirect effect: β = 0.350 [CI:0.011,1.077]). Our findings indicate that high levels of BPA exposure during pregnancy increase the risk of infantile eczema, which may be associated with down-regulation of FOXP3 gene expression in cord blood.

Evaluation of pertussis antibody levels and related factors in maternal and cord blood, 2020

Abstract Background Pregnancy immunization is recommended to protect babies against pertussis, which has a high mortality and morbidity during infancy, but whooping cough vaccine is not given to pregnant women in Turkey. In this study, pertussis antibodies in maternal and cord blood were investigated. Methods The study group was one hundred and fifty-four mothers who gave birth at Hacettepe University Hospitals in Ankara, from July to October 2020. The information of the mothers was collected by questionnaire and sera were taken. In this descriptive epidemiological study, anti-PT and anti-FHA were investigated with ELISA (EUROIMMUN B. Pertussis toxin (PT) IgG, Filamentous Hemagglutinin (FHA) IgG) method in maternal and cord-paired sera, the limit value was accepted as 10 IU/ml. Anti-ACT was investigated in the sera of 79 mothers who were anti-PT or anti-FHA positive by Immunblot (EUROIMMUN Adenylate Cyclase Toxin (ACT) IgG) method. Correlation analysis of continuous numerical variables was performed. The difference between categorical variables was evaluated with the Chi-Square test. Results Mean (SD) maternal age, gestational age and birth weight were 30.1 (5.1) years, 38.5 (0.9) weeks, 3307 (441) g, respectively. Anti-PT and anti-FHA are at protective levels in 18.8% and 48.1% of the mothers, respectively. Anti-PT and anti-FHA are at the protective level in 38.3% and 55.8% of the cord, respectively. Anti-FHA positivity is 63.3% between the ages of 25 and under, 38.6% between the ages of 26-35, and 69.6% at the age of 36 and over (p = 0.005). 72.4% of mothers with anti-PT positive and 67.6% of mothers with anti-FHA positive were anti-ACT antibody positive. Anti-ACT positive mothers were immunized by having the disease, not by vaccine. Anti-PT and anti-FHA antibody levels in maternal and cord blood are highly correlated. Conclusions Protective level of pertussis antibodies in maternal and cord blood is low. Most mothers are immunized with pertussis infection, not vaccine. Key messages The amount of pertussis antibodies in maternal and cord blood is low in Turkey and maternal immunization is needed. The addition of pertussis-containing vaccines to pregnant immunization is important to protect babies from whooping cough disease, which remains a major public health problem.

Changes in MOTS-c Level in the Blood of Pregnant Women with Metabolic Disorders.

Simple SummaryMetabolic relationships between mother and child are currently some of the most studied in the context of maternal imprinting. This is particularly important in the context of metabolic diseases as well as newly discovered peptides, proteins, and biologically active substances produced in the bodies of a mother and child. One of them is MOTS-c, which belongs to the group of mitochondria-derived peptides (MDP). The first reports show that it plays an important metabolic role in carbohydrate–lipid metabolism. We decided to investigate the concentration changes in MOTS-c levels in maternal and umbilical cord blood at delivery in healthy, obese, and hypothyroidism subjects. We found changes in MOTS-c levels depending on the metabolic condition of mothers.MOTS-c peptide is a member of the group of mitochondria-derived peptides (MDP). It is a product of the open reading frame in the 12S RNA gene. Due to its features and functions in the body, this peptide is classified as a hormone. The first publications indicated that this hormone improves insulin sensitivity and lowers body weight in obese animals. This suggests that it may be an important peptide in maintaining the body’s energy homeostasis. The aim of our work was to investigate the potential role of MOTS-c peptide during pregnancy, which is a condition prone to metabolic disorders. The research covered healthy, obese women and women with thyroid disorders. The obtained results indicated an increase in the concentration of MOTS-c in the blood of mothers and newborns in the obese group as compared to the healthy control group and a corresponding decrease in the concentration of this peptide in mothers and newborns in the group with hypothyroidism compared to the obese group. Moreover, we also observed a strong positive correlation between the concentration of MOTS-c in maternal blood and in umbilical cord blood. In summary, the MOTS-c peptide shows changes in blood concentration in various physiological states and may, in the future, become an important tool in the fight against metabolic diseases such as obesity or type 2 diabetes.

Lipoprotein(a) Levels at Birth and in Early Childhood: The COMPARE Study.

High lipoprotein(a) is a genetically determined causal risk factor for cardiovascular disease, and 20% of the adult population has high levels (ie, >42 mg/dL, >88 nmol/L). We investigated whether early life lipoprotein(a) levels measured in cord blood may serve as a proxy for neonatal venous blood levels, whether lipoprotein(a) birth levels (ie, cord or venous) predict levels later in life, and whether early life and parental levels correlate. The Compare study is a prospective cohort study of newborns (N = 450) from Copenhagen, Denmark, including blood sampling of parents. Plasma lipoprotein(a) was measured in cord blood (N = 402), neonatal venous blood (N = 356), and at 2 (N = 320) and 15 months follow-up (N = 148) of infants, and in parents (N = 705). Mean lipoprotein(a) levels were 2.2 (95% CI, 1.9-2.5), 2.4 (2.0-2.7), 4.1 (3.4-4.9), and 14.6 (11.4-17.9) mg/dL in cord, neonatal venous, and 2- and 15-month venous samples, respectively. Lipoprotein(a) levels in cord blood correlated strongly with neonatal venous blood levels (R2 = 0.95, P < 0.001) and neonatal levels correlated moderately with 2- and 15-month levels (R2 = 0.68 and 0.67, both P < 0.001). Birth levels ≥ 90th percentile predicted lipoprotein(a) > 42 mg/dL at 15 months with positive predictive values of 89% and 85% for neonatal venous and cord blood. Neonatal and infant levels correlated weakly with parental levels, most pronounced at 15 months (R2 = 0.22, P < 0.001). Lipoprotein(a) levels are low in early life, cord blood may serve as a proxy for neonatal venous blood, and birth levels ≥ 90th percentile can identify newborns at risk of developing high levels.

Influence of Dietary Behaviors on Dyslipidemia in Pregnant Women and Its Effects on Physical Development of Fetuses and Infants: A Bidirectional Cohort Study.

Background: Gestational diabetes can alter the trajectory of fetal development, but there are few studies on the effects of abnormal lipid metabolism on physical development of infants. We aimed to explore the prevalence of maternal dyslipidemia, its influencing factors and effects on the physical development of fetuses and infants, as well as the role of leptin in this process. Methods: Questionnaire surveys and main outcome measures were administered among 338 pairs of pregnant women and newborns. Results: The detection rate of maternal dyslipidemia was 31.5%. The median levels of TG (triglyceride) and TG/HDL (high-density lipoprotein) ratio were higher in large-for-gestational-age (LGA) newborns. Birth weight was positively related to infants’ height and weight at six months and one year old (p < 0.05). Leptin was positively related to TG levels of pregnant women and newborns’ birth weight (p < 0.05). Logistic regression analysis showed that having greater than or equal to four meals a day (OR = 6.552, 95%CI = 1.014–42.338) and liking to eat lightly flavored food during pregnancy (OR = 1.887, 95%CI = 1.048–3.395) were independent risk factors of maternal dyslipidemia. Conclusions: The prevalence of dyslipidemia was relatively high in pregnant women and was affected by dietary behaviors. Abnormal lipid levels during pregnancy could affect weight and length at birth, which might be associated with increasing leptin levels in cord blood, and then the weight of infants would be influenced by birth weight.

Maternal-neonatal transfer of SARS-CoV-2 immunoglobulin G antibodies among parturient women treated with BNT162b2 messenger RNA vaccine during pregnancy

BACKGROUNDThe exclusion of pregnant women from initial COVID-19 messenger RNA vaccine trials raised hesitancy regarding the benefits of vaccination for pregnant women, hence little is known about vaccines’ efficacy in this population.OBJECTIVETo determine the maternal-neonatal transplacental transfer of SARS-CoV-2 antibodies among vaccinated parturient women. A control group of COVID-19-recovered patients was included to compare the immunoglobulin G levels between vaccinated and recovered patients.STUDY DESIGNThis is a prospective cohort study conducted in a single tertiary medical center in Israel between February and March 2021; parturient women vaccinated with the BNT162b2 messenger RNA vaccine during pregnancy were included and compared with COVID-19-recovered parturient women. SARS-CoV-2 immunoglobulin G antibodies were measured in maternal and cord sera, dried blood spot samples taken from newborns, and breast milk samples. The primary aim was to determine whether neonatal cord and dried blood spot samples were positive for SARS-CoV-2 antibodies and to evaluate the transfer ratio, defined as cord blood immunoglobulin G divided by maternal immunoglobulin G levels.RESULTSThe study included 64 vaccinated parturient women and 11 parturient women who had COVID-19 during pregnancy. All maternal blood sera samples and 98.3% of the cord blood sera samples were positive for SARS-Cov-2 immunoglobulin G with median concentrations of 26.1 (interquartile range, 22.0–39.7) and 20.2 (interquartile range, 12.7–29.0), respectively. Similarly, 96.4% of neonatal blood spot samples and all breast milk samples were positive for SARS-CoV-2 immunoglobulin G with median concentrations of 11.0 (interquartile range, 7.2–12.8) and 4.9 (interquartile range, 3.8–6.0), respectively. There was a significant positive correlation between maternal serum levels of SARS-CoV-2 immunoglobulin G and cord blood (r=0.483; P=.0001), neonatal blood spot (r=0.515; P=.004), and breast milk levels (r=0.396; P=.005) of SARS-CoV-2 immunoglobulin G. The median placental transfer ratio of SARS-COV-2 immunoglobulin G was 0.77. Comparison of vaccinated and recovered COVID-19 patients revealed significantly higher SARS-CoV-2 immunoglobulin G levels in maternal serum and cord blood among vaccinated women (P<.0001).CONCLUSIONOur study demonstrated the efficient transfer of SARS-CoV-2 immunoglobulin G across the placenta in women, vaccinated with the BNT162b2 messenger RNA vaccine during pregnancy, to their neonates, with a positive correlation between maternal serum and cord blood antibody concentrations. In addition to maternal protection against COVID-19, the vaccine may also provide neonatal humoral immunity.

Human epididymis protein 4 and fetal lung maturity.

To document the maternal and fetal cord blood levels of human epididymis protein 4 (HE-4) in term and preterm newborns in order to investigate the possible physiological role of HE-4 in fetal lung development. This cross-sectional study was conducted in a university-affiliated hospital between April 2018 and September 2018. The study population consisted of cesarean section (C-section) deliveries after 24weeks of pregnancy. Both maternal and umbilical cord HE-4 levels (mHE-4 and uHE-4, respectively) were measured using chemiluminescent microparticle immunoassay. Amniotic fluid was sampled from each case to determine the lamellar body count (LBC) as the gold standard test for lung maturation. All the parameters, including the uHE-4 levels, were compared between the term delivery (≥37weeks) (n=52) and preterm delivery (24-37thweeks) (n=30) groups. The best cut-off value of uHE-4 was calculated for fetal lung maturity. There were no statistically significant differences between the groups regarding the demographic data. The mHE-4 levels did not statistically significantly differ between the groups (p>0.05) whereas the uHE-4 level of the preterm newborns was significantly higher than that of the term newborns (p<0.05). There was a significant negative association between the uHE-4 level and LBC (r=-0.389; p<0.001). The uHE-4 level was the only statistically significant fetal parameter indicating fetal lung maturity confirmed by LBC. At a cut-off value of 281pmol/L, uHE-4 had 96.8% sensitivity, 45% specificity, 84.5% positive predictive value, and 81.8% negative predictive value for fetal lung maturity. Although the exact physiological role of HE-4 has not yet been elucidated, this preliminary study supports the idea that HE-4 plays a role in fetal lung maturation to some extent.

Prenatal exposure to endocrine disrupting chemicals is associated with altered DNA methylation in cord blood

ABSTRACT Prenatal exposure to endocrine disrupting chemicals can interfere with development, and has been associated with social-cognitive functioning and adverse health outcomes later in life. Exposure-associated changes of DNA methylation (DNAm) patterns have been suggested as a possible mediator of this relationship. This study investigated whether prenatal low-dose exposure to polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) is associated with altered DNAm patterns across the genome in a Western urban-industrial population. In 142 mother-infant pairs from the Duisburg Birth Cohort Study, PCBs and PCDD/Fs levels were quantified from maternal blood during late pregnancy and associated with DNAm levels in cord blood using the Illumina EPIC beadchip. The epigenome-wide association studies (EWAS) identified 32 significantly differentially methylated positions (DMPs) and eight differentially methylated regions (DMRs) associated with six congeners of PCB and PCDD in females or males (FDRs < 0.05). DMPs and DMRs mapped to genes involved in neurodevelopment, gene regulation, and immune functioning. Weighted gene correlation network analysis (WGCNA) showed 31 co-methylated modules (FDRs < 0.05) associated with one congener of PCDF levels in females. Results of both analytical strategies indicate that prenatal exposure to PCBs and PCDD/Fs is associated with altered DNAm of genes involved in neurodevelopment, gene expression and immune functioning. DNAm and gene expression levels of several of these genes were previously associated with EDC exposure in rodent models. Follow-up studies will clarify whether these epigenetic changes might contribute to the origin for adverse mental and health outcomes.

The newborn metabolome: associations with gestational diabetes, sex, gestation, birth mode, and birth weight.

Pathways towards many adult-onset conditions begin early in life, even in utero. Maternal health in pregnancy influences this process, but little is known how it affects neonatal metabolism. We investigated associations between pregnancy and birth factors and cord blood metabolomic profile in a large, population-derived cohort. Metabolites were measured using nuclear magnetic resonance in maternal (28 weeks gestation) and cord serum from 912 mother-child pairs in the Barwon Infant Study pre-birth cohort. Associations between maternal (metabolites, age, BMI, smoking), pregnancy (pre-eclampsia, gestational diabetes (GDM)), and birth characteristics (delivery mode, gestational age, weight, infant sex) with 72 cord blood metabolites were examined by linear regression. Delivery mode, sex, gestational age, and birth weight were associated with specific metabolite levels in cord blood, including amino acids, fatty acids, and cholesterols. GDM was associated with higher cord blood levels of acetoacetate and 3-hydroxybutyrate. Neonatal factors, particularly delivery mode, were associated with many cord blood metabolite differences, including those implicated in later risk of cardiometabolic disease. Associations between GDM and higher offspring ketone levels at birth are consistent with maternal ketosis in diabetic pregnancies. Further work is needed to determine whether these neonatal metabolome differences associate with later health outcomes. Variations in blood metabolomic profile have been linked to health status in adults and children, but corresponding data in neonates are scarce. We report evidence that pregnancy complications, mode of delivery, and offspring characteristics, including sex, are independently associated with a range of circulating metabolites at birth, including ketone bodies, amino acids, cholesterols, and inflammatory markers. Independent of birth weight, exposure to gestational diabetes is associated with higher cord blood ketone bodies and citrate. These findings suggest that pregnancy complications, mode of delivery, gestational age, and measures of growth influence metabolic pathways prior to birth, potentially impacting later health and development.

Temporal changes and control variables of growth differentiation factor 15 levels during the first week of life in hospitalised newborn infants

Serum growth differentiation factor 15 (GDF15) is a useful biomarker of mitochondrial diseases; its utility in newborns remains unknown. To investigate the temporal change in GDF15 within the first week of life, and to identify its potential control variables, blood samples were obtained from 18 newborns. The GDF15 levels declined to approximately 35% of the cord blood levels within the first week of life and were negatively correlated with postnatal age and Z-score of birth weight but were positively correlated with N-terminal pro-brain natriuretic peptide and lactate levels. GDF15 levels may reflect the progress of postnatal transition to aerobic metabolism.

Analysing cord blood levels of TNF inhibitors to validate the EULAR points to consider for TNF inhibitor use during pregnancy

BackgroundTo minimise placental transfer of tumour necrosis factor inhibitors (TNFi), the European League Against Rheumatism (EULAR) created points to consider (PtC) for the use of TNFi during pregnancy. We are...

Assessing reference levels of nickel and chromium in cord blood, maternal blood and placenta specimens from Ankara, Turkey

Objective:Placenta is a temporary organ that connects the developing fetus and the mother. However, it cannot protect the embryo against chromium (Cr) and nickel (Ni) exposure. Quantification of Cr and Ni in biological and ecological subjects is challenging. Thus, the first goal of this study was to provide a validated Graphite Furnace Atomic Absorption Spectrometry (GFAAS) method to determine Cr and Ni in mother-newborn specimens. The second goal was to assess the reference Ni and Cr contents in cord blood, maternal blood, and placenta samples in a population from Ankara.Material and Methods:Biological samples were collected from 100 healthy mother-newborn pairs. Metal levels were quantified by GFAAS. Method validation of this toxicological analysis was performed by the use of certified reference materials, and assessed through accuracy, precision, specificity, range, quantitation, and detection limits.Results:Mean Cr levels of maternal blood, placentas, and cord blood were 0.337±0.222 μg/L, 0.221±0.160 μg/kg, 0.121±0.096 μg/L, respectively while mean Ni concentrations were 0.128±0.093 μg/L, 0.124±0.067 μg/kg, 0.099±0.067 μg/L, respectively. The method showed linearity with excellent correlation coefficients (r2) for Cr (0.9994) and Ni (0.9999). Satisfactory recovery and coefficient of variation for Cr and Ni were 102.85% and 102.35%; 1.75% and 2.91%, respectively. Relative error did not exceed 3%, demonstrating the accuracy of the method. Control charts were drawn to assess inter-day stability. The predicted reference ranges for Cr and Ni concentrations in maternal blood, placenta and cord blood were: Cr 0.033-0.75 μg/L; 0.032-0.526 μg/kg; 0.031-0.309 μg/L and for Ni were 0.011-0.308 μg/L; 0.024-0.251 μg/kg; 0.066-0.209 μg/L, respectively.Conclusion:The reported reference values of biological specimens in this paper will provide complementary aid to health professionals in terms of assessment of environmental and occupational exposure.

NEWBORNS OF WOMEN WITH POLYCYSTIC OVARY SYNDROME (PCOS) HAVE HIGHER ANTI-MULLERIAN HORMONE (AMH) LEVELS: A SYSTEMATIC REVIEW AND META-ANALYSIS

The first-degree female relatives of individuals with PCOS were more often diagnosed with PCOS in their sexual maturity, and they were further reported to exhibit higher levels of AMH during peripuberty, suggesting that the follicular alterations might happen early. AMH, as a reflection of increased stock of preantral and small antral follicles, was found significantly higher in pregnant PCOS women during the early trimester and at delivery. Animal studies also supported the hypothesis of exposure to excessive steroid or AMH during intrauterine life might develop PCOS-like phenotypes in the offspring. However, there was little human evidence substantiating a relationship between the exposure to maternal PCOS state and subsequent alteration of ovarian functions in neonates. By evaluating the AMH levels of newborns, the present meta-analysis was constructed to find potential evidence of influence by the intrauterine environment. A search of the literature was conducted in the PubMed, MEDLINE, EMBASE and Cochrane Library for articles assessing AMH levels in offspring of PCOS and non-PCOS mothers. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) scoring system. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were adopted to calculate the overall estimates with random-effects models. Subgroup analyses and meta-regression were performed to investigate the potential source of inconsistencies. Funnel plots and Egger’s test were used to assess the publication bias. Sensitivity analysis was performed to determine the robustness of the results. 6 high-quality studies involving 846 participants were included. The pooled analysis found an increased AMH level in the umbilical cord blood in newborns of PCOS mothers (SMD =0.62, 95% CI [0.28, 0.95]). Subgroup analyses revealed an elevation of AMH concentrations in female neonates (SMD = 0.64, 95%CI = [0.14, 1.14]), neonates born to American and Asian PCOS mothers (SMD = 0.81, 95%CI = [0.47, 1.16]; SMD = 1.12, 95%CI = [0.79, 1.46], respectively). In addition, higher AMH levels were also found in studies diagnosed by the National Institute of Health (NIH) criteria (SMD =0.97; 95%CI = [0.74, 1.21]), maternal clinical/biochemical hyperandrogenism (SMD =0.66; 95%CI = [0.21, 1.11]), or maternal body mass index (BMI) >30 kg/m2 (SMD =0.78; 95%CI = [0.39, 1.17]). Meta-regression analysis suggested that diagnostic criterion contributed mostly to the high heterogeneity (p＜0.01). There was no publication bias and our results remained constant after sensitivity analysis. In summary, the positive findings of this study suggested that AMH levels in neonates born to PCOS mothers were noticeably higher than those in neonates born to healthy controls. We found that AMH might play a potential part in the PCOS pathogenesis which inhibits folliculogenesis in the fetal stage.

Vasopressin but Not Oxytocin Responds to Birth Stress in Infants.

ContextBirth triggers a large fetal neuroendocrine response, which is more pronounced in infants born vaginally than in those born by elective cesarean section (ECS). The two related peptides arginine vasopressin (AVP) and oxytocin (OT) play an essential role in peripheral and central stress adaptation and have a shared receptor mediating their function. Elevated cord blood levels of AVP and its surrogate marker copeptin, the C-terminal part of AVP prohormone, have been found after vaginal delivery (VD) as compared to ECS, while release of OT in response to birth is controversial. Moreover, AVP, copeptin and OT have not yet been measured simultaneously at birth.ObjectiveTo test the hypothesis that AVP but not OT levels are increased in infants arterial umbilical cord blood in response to birth stress and to characterize AVP secretion in direct comparison with plasma copeptin.MethodsIn a prospective single-center cross-sectional study, we recruited healthy women with a singleton pregnancy and more than 36 completed weeks of gestation delivering via VD or ECS (cesarean without prior uterine contractions or rupture of membranes). Arterial umbilical cord blood samples were collected directly after birth, centrifuged immediately and plasma samples were frozen. Concentrations of AVP and OT were determined by radioimmunoassay and that of copeptin by ultrasensitive immunofluorescence assay.ResultsA total of 53 arterial umbilical cord blood samples were collected, n = 29 from VD and n = 24 from ECS. Ten venous blood samples from pregnant women without stress were collected as controls. AVP and copeptin concentrations were significantly higher in the VD group than in the ECS group (both p < 0.001), median (range) AVP 4.78 (2.38–8.66) vs. 2.38 (1.79–3.88) (pmol/L), copeptin 1692 (72.1–4094) vs. 5.78 (3.14–17.97), respectively, (pmol/L). In contrast, there was no difference in OT concentrations (pmol/L) between VD and ECS, 6.00 (2.71–7.69) vs. 6.14 (4.26–9.93), respectively. AVP and copeptin concentrations were closely related (Rs = 0.700, p < 0.001) while OT did not show any correlation to either AVP or copeptin. In linear regression models, vaginal delivery and biochemical stress indicators, base deficit and pH, were independent predictors for both AVP and copeptin. OT was not linked to base deficit or pH.ConclusionVaginal birth causes a profound secretion of AVP and copeptin in infants. Whereas AVP indicates acute stress events, copeptin provides information on cumulative stress events over a longer period. In contrast, fetal OT is unaffected by birth stress. Thus, AVP signaling but not OT mediates birth stress response in infants. This unique hormonal activation in early life may impact neurobehavioral development in whole life.

Cord blood and peripheral nucleated red blood cells levels in term asphyxiated and non-asphyxiated new borns and neonatal outcome: a comparative study

Background: Perinatal asphyxia can cause severe hypoxic-ischemic damages in the organs and causes severe long-term consequences. It has recently been suggested that the increase in NRBC count in the umbilical vein of newborns can be considered a sign of birth asphyxia. The aim of the study was to evaluate the role of cord blood nucleated RBC count as a marker for presence and severity of birth asphyxia.Methods: This prospective observational comparative study was conducted among 30 asphyxiated (case) and 30 non-asphyxiated newborns (control) in Swami Dayanand Hospital. Number of nucleated red blood cells in cord blood and peripheral blood were counted per 100 leukocytes in smears in cases and control. Maternal parameters and neonate characteristics were recorded in a proforma.Results: NRBC count increased in cord blood during the first few hours of life in perinatal asphyxia (10.79±9.58) as compared with the healthy control subjects (4.03±2.87, p=0.002). Significant positive correlation of C-NRBC and P-NRBC with NICU stay (r=0.921, p&lt;0.0001 and r=0.698, p&lt;0.0001 respectively). Nucleated RBC count more than 18 can be used as predictor of abnormal neurological outcome with sensitivity 100% and specificity of 93.1%. The cord blood NRBC &gt;3/100 WBC has sensitivity of 92% and specificity of 77.8% in predicting birth asphyxia.Conclusions: Nucleated RBC count can be used as surrogate marker for birth asphyxia. It has significant positive correlation with severity of hypoxic ischemic encephalopathy, duration of NICU stay and duration of O2 requirement.