Pregnancy Serum Levels Research Articles

Early pregnancy serum levels of folate and vitamin B12 in overweight and obese women in Khartoum, Sudan.

This study was conducted to assess serum levels of folate and vitamin B12 in overweight and obese pregnant women. A cross-sectional study was conducted at Saad Abualila Hospital, Sudan. Clinical data were collected through questionnaires and body mass index (BMI) was computed from weight and height. The serum folate and vitamin B12 levels were analyzed by immunofluorescence. Of 300 enrolled women, 44.7% were of normal weight, 32.3% were overweight and 3.0% were obese. The folate level was significantly lower in overweight women (median 4.79 ng/ml [IQR 2.70‒7.70]) than in normal-weight women (median 6.650 ng/ml [IQR 3.30‒10.55]; p=0.022). There was no significant difference in the prevalence of marginal and severe folate deficiencies in women in different BMI groups. Compared with normal-weight women (median 197.5 pg/ml [IQR 150.0‒263.0]), obese women (median 173.0 pg/ml [IQR 150.0‒213.0]; p=0.038) had significantly lower vitamin B12 levels and had a higher prevalence of vitamin B12 insufficiency. Fair negative correlations (p<0.01) were observed between folate and BMI (r = -0.157) and between vitamin B12 and BMI (r = -0.173). Overweight and obese pregnant Sudanese women had lower levels of serum folate and vitamin B12.

Prenatal Environmental Exposure to Persistent Organic Pollutants and Reproductive Hormone Profile and Pubertal Development in Dutch Adolescents.

Persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), may interfere with hormonal processes. Knowledge about the effects of prenatal exposure to PCBs and their hydroxylated metabolites (OH-PCBs) on pubertal development is limited. Therefore, the aim of the current study was to determine whether prenatal environmental PCB and OH-PCB exposure are associated with reproductive hormone levels and pubertal characteristics in 13- to 15-year-old children. In this Dutch observational cohort study, 194 mother–infant pairs were included (1998–2002). Maternal pregnancy serum levels of PCBs, OH-PCBs, and other POPs were measured. At follow-up (2014–2016), we measured serum or plasma levels of reproductive hormones in their children. We assessed Tanner stages and testicular volume (by clinician or standardized self-assessment), and participants completed questionnaires on pubertal onset. In total, 101 adolescents (14.4 ± 0.8 years; 53.7% of invited) participated, and 55 were boys. In boys, higher prenatal PCB levels were associated with higher testosterone levels, higher pubic hair stage, larger testicular volume, and younger age at onset of growth spurt and voice break. In girls, higher prenatal PCB levels were associated with higher stages for breast development. In conclusion, higher prenatal PCB exposure could be associated with more advanced pubertal development in 13- to 15-year-old children.

The Importance of Optimal Vitamin D Serum Levels in Pregnancy During the Covid-19 Pandemic

The Importance of Optimal Vitamin D Serum Levels in Pregnancy During the Covid-19 Pandemic

Prenatal Environmental Exposure to Persistent Organic Pollutants and Indices of Overweight and Cardiovascular Risk in Dutch Adolescents.

Persistent organic pollutants (POPs) may have obesogenic effects. Knowledge about the effects of prenatal exposure to POPs on anthropometric measurements and metabolic parameters into adolescence is limited. Therefore, the aim of the current study was to determine whether prenatal environmental exposure to several POPs is associated with indices of overweight and cardiovascular risk in 13–15-year-old children. In this Dutch observational cohort study, 194 mother–infant pairs were included (1998–2002). Maternal pregnancy serum levels of PCBs, OH-PCBs, PBDEs, and other POPs were measured. At follow-up (2014–2016), levels of cholesterol, HDL-C, LDL-C, triglycerides, fasting insulin, fasting glucose, leptin, and adiponectin were measured in their children. The children’s height, weight, waist circumference, hip circumference, and blood pressure were measured. In total, 101 adolescents (14.4 ± 0.8 years; 53.7% of invited) participated of which 55 were boys. Mean BMI was 19.1 ± 3.6 kg/m2 and mean BMI z-score 0.13 ± 1.14. Higher prenatal levels of PCBs were associated with lower levels of HDL-C and adiponectin in boys and higher levels of PBDEs with higher triglycerides in girls. We found significant differences by sex in the associations with OH-PCBs, with lower HDL-C and adiponectin, higher LDL-C/HDL-C ratio, fasting glucose, HOMA2-IR, height, and weight for boys. Our study indicates that higher prenatal exposure to PCBs, OH-PCBs, and PBDEs was associated with adolescent levels of some metabolic cardiovascular risk markers and hormones associated with the development of obesity and cardiovascular disease.

A Study of the Association of Early Pregnancy Serum Levels of Pregnancy-Associated Plasma Protein-A with Adverse Pregnancy Outcome

Background: Decreased levels of pregnancy-associated plasma protein-A (PAPP-A) in maternal serum can be a marker not only for some chromosomal disorders and anomalies in the fetus but also specific for adverse pregnancy outcomes too, such as preeclampsia, spontaneous preterm birth, gestational diabetes, and fetal growth restriction (FGR) and to the extent of stillbirth. Hence, measurement of early pregnancy PAPP-A levels may help identify the areas of intervention for reducing the adverse outcome in later gestations. Materials and Methods: This was a prospective observational study. A total of 250 antenatal cases fulfilling the inclusion criteria were taken in the study. Early pregnancy serum levels of PAPP-A were measured for antenatal cases visiting outpatient department of tertiary level teaching hospital between 10 and 14 weeks period of gestation, and these cases were followed up for development of adverse pregnancy outcome. Results: Two hundred and thirty-five patients had normal outcomes, among which 24 patients had PAPP-A values ≤0.4 multiples of the median (MoM) and 211 patients had PAPP-A level >0.4 MoM. Twenty-nine patients out of 250 in our study group had PAPP-A level <0.4 MoM, 1 patient developed preeclampsia (P = 0.211) but underwent normal vaginal delivery at term, and 1 had FGR (P = 0.513). Three patients had preterm delivery and the PAPP-A values in preterm group were lower as compared to term group, and this result was statistically significant (P = 0.005). Conclusion: The study concludes that the patients with low early pregnancy PAPP-A levels may be deemed to develop preterm labor subsequently and effective measures may be taken to prevent the same. However, it would be prudent to replicate the study in a wider and more representative sample over multiple centers to see if the results hold true.

THE DYNAMICS OF HUMAN TOTAL AND ACTIVATED ANTI-MULLERIAN HORMONE SERUM LEVELS IN DIFFERENT LIFE PERIODS

Here, changes in the serum level of total anti-mullerian hormone (AMH) and its activated form in children of both sexes and women with different reproductive status are investigated. This TGFβ superfamily cytokine is known to provide the formation of the male-type reproductive system in mammalian embryogenesis, and regulate folliculogenesis, spermatogenesis and the balance of sex hormones after birth. The biologically active form of the hormone (aAMH) is formed as a result of limited proteolysis of the AMH molecule; it is not reliably known in which tissues and under the action of which enzyme it occurs. The serum level of aAMH seems to be a more informative clinical indicator than the content of total AMH (tAMH), but there are no ELISA systems at the world market that provide direct quantitative detection of aAMH. In this work, quantitative detection of total hormone (tAMH) and its biologically active form (aAMH) in serum was performed using specially developed enzyme immunoassay systems. We showed that in girls, the total serum AMH level, as well as the concentration ratio aAMH / tAMH, practically does not change with age, whereas in boys, there is not only a significant decrease in the total serum AMH level previously described in the literature (Pearson correlation coefficient R = - 0.86, p <0.001), but also in the ratios of the aAMH / tAMH level (R = -0.531, p <0.001). It was also found that in pregnant women, the amount of total AMH and the proportion of aAMH in serum was significantly higher (p <0.01 and p <0.001, respectively) than in the control group women. The obtained results are in good agreement with the available data on the total and activated AMH content in the blood serum of people of different sex and age and indicate a change in the ratio of aAMH / tAMH serum levels in pregnancy. These data may be important both for deepening the understanding of AMH biology and for interpreting the results obtained using AMH detection based diagnostics.

Early pregnancy serum levels of perfluoroalkyl substances and risk of preeclampsia in Swedish women

Preeclampsia is a major cause of maternal and fetal morbidity. Emerging research shows an association with environmental exposures. The present aim was to investigate associations between early pregnancy serum levels of perfluoroalkyl substances (PFAS) and preeclampsia. Within the Swedish SELMA study, eight PFAS were measured at median 10 gestational weeks and cases of preeclampsia were postnatally identified from registers. Associations between individual PFAS and preeclampsia were assessed, adjusting for parity, age, weight and smoking. Out of 1,773 women in the study group, 64 (3.6%), developed preeclampsia. A doubling of PFOS and PFNA exposure, corresponding to an inter-quartile increase, was associated with an increased risk for preeclampsia of about 38–53% respectively. Serum PFOS within the highest quartile was associated with an odds ratio of 2.68 (CI 95%: 1.17–6.12), equal to the increased risk associated with nulliparity, when compared to exposure in the first quartile. The same associations were identified, although with higher risk estimates, in analyses restricted to nulliparous women. For other PFAS, there were no associations. In conclusion and consistent with limited previous research only on PFOS, increasing serum levels of PFOS and PFNA during early pregnancy were associated with a clinically relevant risk of preeclampsia, adjusting for established confounders.

Prenatal exposure to persistent organic pollutants and cognition and motor performance in adolescence

BackgroundPrenatal exposure to persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), was found to be associated with poorer neurological development in children. Knowledge about the effects on outcomes until adolescence is limited. ObjectivesTo determine whether prenatal exposure to POPs, particularly hydroxylated PCBs (OH-PCBs), is associated with cognitive and motor development in 13- to 15-year-old children. MethodsThis prospective observational cohort study is part of the Development at Adolescence and Chemical Exposure (DACE)-study, a follow-up of two Dutch birth cohorts. Maternal pregnancy serum levels of PCB-153 and three OH-PCBs were measured, in part of the cohort also nine other PCBs and three OH-PCBs, and in another part five polybrominated diphenyl ethers (PBDEs), dichloroethene (DDE), pentachlorophenol (PCP) and hexabroomcyclododecane (HBCDD). Of the 188 invited adolescents, 101 (53.7%) participated, 55 were boys. Cognition (intelligence, attention, verbal memory) and motor performance (fine motor, ball skills, balance) were assessed. Scores were classified into ‘normal’ (IQ > 85; scores > P15) and ‘(sub)clinical’ (IQ ≤ 85; scores ≤ P15). We used linear and logistic regression analyses, and adjusted for maternal education, maternal smoking, maternal alcohol use, breast feeding, and age at examination. ResultsSeveral OH-PCBs were associated with more optimal sustained attention and balance. PCB-183 was associated with lower total intelligence (OR: 1.29; 95%CI:0.99–1.68; P = .060), and HBCDD with lower performance intelligence (OR: 3.62; 95%CI:0.97–13.49; P = .056). PCBs, OH-PCBs and PBDEs were negatively associated with verbal memory. ConclusionsPrenatal background exposure to several POPs can influence neuropsychological outcomes in 13- to 15-year-old Dutch adolescents, although exposure to most compounds does not have clinically relevant consequences at adolescence.

SCD40 Ligand Determined in Maternal and Umbilical Cord Blood in Pregnancies Complicated by Pre-Eclampsia with and without Intrauterine Growth Retardation

Objective: The aim of this study was determination and comparative analysis of the maternal and umbilical cord sCD40L serum levels in pregnancies complicated by pre-eclampsia with and without intrauterine growth retardation (IUGR) and in normotensive pregnancies. Patients and Methods: The study was carried out on 16 patients with singleton pregnancies complicated by severe pre-eclampsia with appropriate-for-gestational-age weight infants and 14 pregnant patients with severe pre-eclampsia complicated by IUGR. The control group consisted of 13 healthy normotensive delivering patients. Five milliliters of blood were taken by venipuncture from each pre-eclamptic patient and from each woman from the control group before active phase of labor and 5 ml of umbilical vein blood were taken immediately after delivery and collected in sterile tubes. Maternal and umbilical serum sCD40L concentrations were estimated using a sandwich ELISA assay. Results and Conclusions: Our results reveal the higher levels of maternal and umbilical sCD40L serum levels in pregnancy complicated by pre-eclampsia with and without IUGR. The mean maternal values were 4.022 ± 2.399 ng/ml in group P, 3.914 ± 2.824 ng/ml in group PI and 0.885 ± 0.064 ng/ml in healthy controls. The mean umbilical values were 2.633 ± 1.984 ng/ml in group P, 2.703 ± 1.996 ng/ml in group PI and 1.112 ± 0.436 ng/ml in the control group. It seems that these higher concentrations of sCD40L protect maternal immune cells bearing CD40 receptor from Fas-mediated apoptosis. Our findings may suggest also enhanced platelet activation in pre-eclamptic patients. It may be one of the factors responsible for the enhanced procoagulatory and proinflammatory properties, and increased cytokine production, and endothelial cell dysfunction in pregnancies complicated by pre-eclampsia.

Inhibins and Activin A in hypertensive Disorders of Pregnancy and HELLP-Syndrome

Are serum concentrations of the ovarian glycoproteins inhibin A, inhibin B, pro-alpha-C and activin A different in normotensive, chronical hypertensive or pregancies complicated by preeclampsia or HELLP-syndrome? What are the clinical consequences? Serum concentrations of inhibin A, inhibin B, pro-alpha-C, and activin A of 99 women (37 normotensive patients, 23 patients with chronical hypertension, 25 women with preeclampsia and 14 patients with HELLP-syndrome) at different stages of pregnancy were determined by high specific ELISAS. During pregnancy serum levels of all parameters increased continually and fell rapidly within parturition. Activin A and inhibin B levels showed significant higher serum concentrations in patients with preeclampsia and - even more pronounced - in patients with HELLP-syndrome. Normotensive and chronically hypertensive patients were not different. Activin A and inhibin A appear to be viable candidates as laboratory parameters for detection of pregnancy induced hypertension. Maybe furthermore both parameters will allow the discrimination between chronic hypertension and hypertension induced by pregnancy.

Transforming growth factor-beta 1 serum levels in pregnancy and pre-eclampsia

Background. Isoforms of transforming growth factor-beta (TGF-β1) are thought to be involved in the pathogenesis of pre-eclampsia. Data with respect to TGF-β1 are controversial. We examined the correlation between TGF-β1 serum levels and the occurrence and severity of pre-eclampsia. Methods. Transforming growth factor-beta 1 serum levels were measured using a commercially available enzyme-linked immunosorbent assay in 44 women with pre-eclampsia and 44 healthy pregnant women. Results were correlated with clinical data. Results. No difference in TGF-β1 serum levels was assessed between women with pre-eclampsia and healthy pregnant women. Transforming growth factor-beta 1 serum levels were not associated with the severity of the disease and were not correlated with clinical maternal (blood pressure, proteinuria) and fetal (5-min APGAR score, umbilical cord pH values, birth weight) parameters. Conclusions. Our data support the assumption that in contrast to other isoforms, TGF-β1, as evidenced by serum TGF-β1 levels, does not seem to be involved in the pathogenesis of pre-eclampsia.

Capacity for hormone production of cultured trophoblast cells obtained from placentae at term and in early pregnancy.

There is an increased doubt about the identity of isolated cytotrophoblast cells at term. Therefore, we compared pregnancy serum levels of three hormones [human placental lactogen (hPL), human chorionic gonadotropin (hCG), and leptin] with the capacity for hormone production of early placentae [EP; 8-13 weeks of gestation (WG)] and term placentae (TP; 38-42 WG). Serum levels of these hormones were determined in 15 paired maternal (7-41 WG) and fetal (37-41 WG) samples. Cytotrophoblast cells were isolated from term (TP; 38-42 weeks) and early (EP; 8-13 weeks) placentae by enzymatic digestion and subsequent purification on a Percoll gradient. These cells were cultured for 6 days. The production of the hormones hPL, hCG, and leptin was determined as release during culture + cell content after culture - cell content before culture. Serum levels (mean +/- SD; n = 15) at 7-12 and 37-41 WG were 89,652 +/- 21,431 and 13,620 +/- 5854 mIU/ml for hCG, 400 +/- 182 and 7088 +/- 2030 ng/ml for hPL, and 12,675 +/- 4266 and 32,236 +/- 10,961 pg/ml for leptin, respectively. For cultured cells from EP and TP, hCG and hPL showed different patterns of release during the first 2-3 days. While the release of these two hormones by EP cytotrophoblast cells continued during 6 days in culture, their concentrations reached a plateau for TP cytotrophoblasts between 4 and 6 days. Leptin was undetectable (< 15 pg/ml) in TP cell cultured media, while for EP all three hormones showed the same release profiles. Production calculated for 30,000 TP trophoblast cells cultured for 6 days (n = 8) was 2-31 mIU for hCG and 0.5-2 ng for hPL. For EP (n = 11), it was 50-1070 mIU for hCG, 15-323 ng for hPL, and 137-580 pg for leptin. Net synthesis of hCG and hPL for TP was > 10-fold and < 1-fold, respectively. In contrast, the production of all three hormones for EP was at least 100 times the initial cell content. These results demonstrate that trophoblasts from early pregnancy show much higher production rates of hCG, hPL, and leptin than at term. However, the in vitro findings are difficult to be reconciled with the different serum concentrations of the two hormones hPL and leptin observed during the course of pregnancy.

Vascular endothelial growth factor serum levels in pregnancy and preeclampsia

Vascular endothelial growth factor serum levels in pregnancy and preeclampsia

Vascular endothelial growth factor serum levels in pregnancy and preeclampsia

Vascular endothelial growth factor serum levels in pregnancy and preeclampsia

Adenomyosis:: Current Perspectives

Adenomyosis frequently involves gravid and nongravid uteri, remaining asymptomatic in up to one half of all cases. The symptoms of adenomyosis, particularly menorrhagia and dysmenorrhea, correlated with the depth of myometrial involvement, and consequently with the patient's age. Adenomyosis is most frequent in parous women in their middle to late forties. There is a high frequency of associated pathology, including leiomyomas, endometriosis, endometrial hyperplasia, and carcinoma. This relationship may suggest a common underlying disorder, such as hyperestrogenemia. Adenomyosis is a frequent finding in pregnancy, and obstetric or surgical complications are rare. Approximately 30 to 50 per cent of adenomyotic foci respond to progesterone, particularly to the high serum levels in pregnancy. The preoperative diagnosis of adenomyosis remains poor. Radiologic procedures and serum levels of CA-125 are of limited diagnostic value. Only a high degree of clinical suspicion will aid in the diagnosis of this histopathologic entity. Hysterectomy remains the mainstay of treatment and diagnosis.

SP-1 and beta-HCG in suspected ectopic pregnancy (author's transl)

Serum levels of SP-1 and beta HCG as Trophoblastic Markers were measured in 31 women operated on suspected ectopic pregnancy. In all 24 patients with tubal pregnancy SP-1 levels estimated by enzyme immunoassay Enzygnost were higher than 5 ng/ml, whereas SP-1 levels in 7 cases with benign ovarian cysts were less than 2 ng/ml. Beta-HCG in serum was analysed by radioimmunoassay (Serono-Biodata): in cases with ectopic pregnancy serum levels were between 113 mIU/ml and 1040 mIU/ml, in the 7 nonpregnant cases the highest concentration was 7 mIU/ml. There was no correlation between serum concentration of SP-1 and beta-HCG (r = 0,571). In view of clinical practice preference is given to estimation of SP-1 by enzyme immunoassay over estimation of beta-HCG by radioimmunoassay, the reasons are discussed.

Acute effects of human chorionic somatomammotropin on insulin and glucagon release in the isolated perfused pancreas.

Insulin and glucagon release from the isolated perfused pancreas of rats was measured following administration of human chorionic somatomammotropin (HCS). In the presence of low glucose levels there is a significant acute but short release of insulin and glucagon following HCS, which is not sustained despite continuous HCS infusion. The magnitude of HCS-induced insulin and glucagon release is closely related to the glucose concentration of the perfusion medium. At high glucose levels of 11 mM. there is no significant action on insulin or glucagon output by HCS. The short peaks of insulin and glucagon release are probably due to an HCS-induced membrane effect. The acute effects on α and β cells of the endocrine pancreas may indicate certain relationships between glycohomeostasis and HCS serum levels in pregnancy.