Maternal Ca Research Articles

Second-trimester cancer antigen 125 and Down's syndrome.

This study explores if assay of cancer antigen 125 (CA 125) in maternal serum might aid the detection of Down's syndrome in the second trimester of pregnancy. CA 125 levels were determined retrospectively in stored maternal serum samples from ten Down's syndrome pregnancies and 78 controls matched for gestational and maternal age. In addition, second-trimester amniotic fluid samples from nine Down's syndrome and 109 unaffected pregnancies were analysed for CA 125. Maternal serum CA 125 values for Down's syndrome pregnancies were lower, with the median being 0.72 multiples of the unaffected population median. The medians for affected and unaffected pregnancies did not differ significantly and there was a considerable overlap in the range of values of cases and controls. The distribution of amniotic fluid CA 125 levels for Down's syndrome pregnancies resembled that for controls. From our present results, we could not find an association between Down's syndrome and second-trimester maternal serum or amniotic fluid CA 125 levels.

Maternal CA 125 seems to be depressed in Down??s syndrome

Maternal CA 125 seems to be depressed in Down??s syndrome

CA 125 levels in abruptio placentae

The diagnosis of abruptio placentae is frequently difficult despite ultrasonography; additional diagnostic parameters would be useful. Maternal serum CA 125, which is believed to derive from the decidua, is elevated in the first trimester and immediately after delivery when placental separation occurs, possibly because of decidual disruption. Serum CA 125 was measured in 27 patients beyond 20 weeks' gestation who were first seen with vaginal bleeding and in 17 control patients of similar gestational age and labor status. Mean (+/- SD) CA 125 levels were higher (p less than 0.01) among patients with abruptio placentae (105.9 +/- 115 U/ml) than among those with alternate sources of bleeding (13.7 +/- 10 U/ml) or control patients (18.2 +/- 11.7 U/ml). Mean (+/- SD) serum CA 125 levels in seven control patients within 6 hours post partum (194 +/- 80.5 U/ml) were higher than those among patients first seen with abruptio placentae (p less than 0.01). Sensitivity and specificity of CA 125 for abruptio placentae were 70% and 94%, respectively. Our data support a decidual source for CA 125 and may indicate utility of CA 125 as a marker for abruptio placentae.

The influence of gestational dietary calcium on serum 1, 25-dihydroxycholecalciferol in sows and their pigs.

Fifteen multiparous sows (three groups of five) were studied during one gestation-lactation cycle to measure the influence of dietary Ca (.5, .8[control], and 1.1%) on 1,25-dihydroxycholecalciferol (1, 25-(OH)2D3) in serum and colostrum of the sows and serum of their pigs. Concentrations of 1,25-(OH)2D3 and Ca, Mg, P, Cu, and Zn were determined on d 15 and 45 of gestation, at parturition, and at 3 wk postpartum in sow serum and at birth and d 10 and 21 in pig serum. Colostrum was assayed for 1,25-(OH)2D3. Serum 1,25-(OH)2D3 in sows was affected inversely (P less than .05) by dietary Ca within d 15 of gestation and was correlated (r = -.88) with serum Ca during gestation and lactation. Serum Ca was correlated (r = .52) with dietary Ca at d 15 and 45 of gestation and at farrowing. Sow serum Mg was inversely related (r = -.49) to serum Ca during gestation and early lactation. Serum 1,25-(OH)2D3 of the pigs at birth ranged from 38.7 to 44.2 pg/ml was decreased (P less than .05) by 1.1% maternal Ca intake. Sow colostrum 1,25-(OH)2D3 was related (P less than .05) inversely (r = -.40) to sow dietary Ca and directly (r = .90) to sow serum 1,25-(OH)2D3. Serum 1,25-(OH)2D3 of 10- and 21-d-old pigs was inversely related (P less than .05) to their dams' dietary Ca. These results indicate that 1,25-(OH)2D3 production in sows is quickly affected by modest changes in dietary Ca.(ABSTRACT TRUNCATED AT 250 WORDS)

Elevated calcium, phosphorus, and magnesium retention in pregnant rats prior to the onset of fetal skeletal mineralization.

Intestinal absorption and renal excretion rates of Ca, P, and Mg were compared in pregnant and control virgin rats fed a purified diet containing 0.55% Ca, 0.54% P, and 0.067% Mg. Four consecutive balance intervals of 5 days each were examined, beginning on day 1 of gestation. During days 6-10 of gestation, pregnant rats had elevated fractional intestinal absorptions of Ca (29.6 +/- 1.7 versus 20.6 +/- 1.5%), P (65.4 +/- 2.0 versus 59.9 +/- 0.9%), and Mg (54.3 +/- 1.5 versus 42.4 +/- 2.6%). Since urinary excretions of these elements did not change, the pregnant rats retained more Ca, P, and Mg than virgin rats. Fractional intestinal absorptions of these elements during pregnancy were similar to control values during days 1-5 and 11-15 of gestation and then rose for each element during days 16-20 of gestation. Presumably because of an increase in glomerular filtration rate, urinary excretions of Ca and Mg were elevated by 40 and 26% during days 16-20 of gestation. In contrast, urinary P excretion was decreased by 30% during days 11-20 of gestation. Analyses of uterine mineral contents indicated the increased maternal Ca and Mg retentions during pregnancy were balanced by the transfers of these elements to the fetuses. In contrast, pregnancy was associated with a net maternal retention of P. These data are consistent with previous observations of increased maternal skeletal mineralization during early pregnancy before the onset of fetal osteogenesis and subsequent enhanced maternal Ca intestinal absorption concurrent with fetal skeletal mineralization.

The negative correlation between prolactin and ionic calcium in cord blood of full term infants.

Total serum calcium (Ca), ionic calcium (Ca++), phosphorus, magnesium, total protein, immunoreactive parathyroid hormone (iPTH), calcitonin (iCT) and prolactin (iPRL) were measured in 30 paired samples of cord and maternal blood obtained at term delivery. In the cord blood, the concentrations of Ca, Ca++, phosphorus, magnesium, albumin, iCT and iPRL were all higher, and the concentrations of total protein and iPTH lower than in the maternal blood. The calcium binding capacity of albumin assessed with the equation (Ca-Ca++)/albumin, was similar at a given concentration of Ca in both the maternal and fetal circulations. There was a significant positive correlation between cord Ca++ and maternal Ca or Ca++, and a significant negative correlation between Ca++ and iPRL in cord blood. These data suggest that there is an active system transporting calcium from mother to fetus through the placenta, and PRL is the only one of the three hormones which was correlated with ionic calcium values in the fetus. The negative relationship between Ca++ and iPRL in the cord blood suggests an inhibitory effect of the relative hypercalcemia on PRL secretion in the fetus.

Evolution of serum calcium (Ca), phosphorus (P), magnesium (Mg), immunoreactive parathyroid hormone (iPTH) and calcitonin (iCT) levels in infants of diabetic mother (IDM) from 2 hours to 5 days of life

In order to study the pathogenesis of hypocalcemia in IDM, determinations of serum levels of Ca, P, Mg, iPTH and iCT were performed in 15 IDM (gestational age : 36.7 ± 1.3 weeks ; birth weight : 3755 ± 617 g) at 2, 24, 48 h and 5 days. Infants were infused with glucose and fed with human milk. Serum Ca (mg/dl, mean ± SD) decreased from 2 (8.6 ± 0.6) to 24 h (7.1 ± 1.2, p < 0.001) and remained low at 48 h and 5 days (7.5 ± 0.5). Serum Mg (mg/dl ; mean ± SD) decreased from 2 h (1.8 ± 0.2) to 24 h (1.6 ± 0.2, p <0.02) and returned to normal levels at 5 days. There was no significant change in serum P (6.3 ± 1.7 and 7.0 ± 1.2 mg/dl at 2 h and 5 days). Serum iPTH - undectable (<25 μlEq/ml) in 6 IDM and ranging from 27 to 160 μlEq/ml in 7 at 2 h (normal range in children : < 100) - showed a sustained increase until 5 days (184 ± 119 μlEq/ml, p<0.01). Serum iCT was undectable (<150 mg/ml) in 9 IDM and ranged from 150 to 180 pg/ml in 4 at 2 h ; it showed a marked increase at 24 h (536 ± 208 pg/ml, p<0.001) and by 5 days returned to mostly undectable values. Our findings indicate that hypocalcemia of IDM takes place during the first day of life ; in most IDM there is evidence for parathyroid responsiveness ; hypercalcitoninemia is present during the first 48 h. These data suggest that in IDM 1) Ca metabolism is similar to that of other premature infants and 2) hypocalcemia is mostly the consequence of the abrupt interruption of the large maternal Ca supply.

847 NEONATAL HYPOCALCEMIA ASSOCIATED WITH MATERNAL HYPERCALCEMIA

An infant born to a mother with hypercalcemia secondary to metastatic breast cancer developed severe hypocalcemia during the first week of life. Maternal calcium and phosphorous levels ranged from 14-17 mg/dl and 2-2.5 mg/dl, respectively, prior to delivery, and the infant's calcium level was 15.0 mg/dl at birth. During the first 9 days of life the infant's serum Ca level decreased to 4.8 mg/dl and P rose to 8.4 mg/dl. The serum Mg decreased to 0.7 mg/dl. Administration of MgSO4 intramuscularly raised the serum Mg to normal levels, but hypophosphaturia and hypocalcemia persisted. Administration of PTH was followed by return of Ca to normal levels and an apparent increase in P excretion. When PTH was stopped, serum Ca and Mg again decreased, but the phosphaturia persisted. Ca and Mg levels returned to normal spontaneously by the fourth week of life. The hypocalcemia of this infant supports the hypothesis of transient neonatal hypoparathyroidism resulting from exposure to relatively high levels of maternal Ca in utero and contradicts the theory that it is related to Mg deficiency and end-organ unresponsiveness to PTH.

Calcium metabolism in pregnant ewes.

1. A combination of balance and isotope techniques has been used to study calcium metabolism in ten sheep at different stages of pregnancy, and the results have been combined with earlier results obtained during lactation to show the variations in Ca metabolism which occur during the whole reproductive cycle.2. Transfer of Ca to the foetuses during pregnancy and to the milk after parturition rose rapidly from the 65th day of gestation and reached a maximum at parturition or shortly afterwards.3. Although the rate of absorption of Ca from the intestine increased steadily throughout pregnancy it was insufficient to meet the full requirements of late pregnancy and early lactation. During this period, the extra Ca was supplied by increased bone resorption.4. The maternal Ca balance became negative during pregnancy, the net daily loss of Ca reaching a maximum in early lactation.5. In late lactation the maternal Ca balance became positive enabling the animals to replenish their skeletal stores.6. There was no marked change in the demands for Ca at parturition and the connexion between this observation and the pathogenesis of milk fever is discussed.7. Rates of transfer of Ca to the foetus during pregnancy are compared with estimated values of other workers.