| 1. |
- Beck, Astrid L, et al.
(author)
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Cotinine concentrations in maternal serum and amniotic fluid during pregnancy and risk of testicular germ cell cancer in the offspring : A prospective nested case-control study
- 2024
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In: International Journal of Cancer. - 0020-7136. ; 154:1, s. 71-80
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Journal article (peer-reviewed)abstract
- Maternal smoking in pregnancy may increase the risk of testicular germ cell cancer (TGCC) in offspring, but current evidence remains inconclusive. We performed a nested case-control study using cotinine measurements in maternal serum and amniotic fluid as a biomarker for tobacco exposure during pregnancy. A total of 654 males with maternal serum (n = 359, ncases/controls = 71/288) and/or amniotic fluid (n = 295, ncases/controls = 66/229) samples were included. Data on TGCC diagnoses and relevant covariates were derived from nationwide Danish health registries. Cotinine was quantified by liquid chromatography tandem mass spectrometry. An adapted cox regression model estimated the risk of TGCC considering active and inactive tobacco use defined according to cotinine concentrations of <, ≥15 ng/ml. Overall, the concentrations of cotinine were comparable in maternal serum and amniotic fluid (medianserum/amniotic fluid : 2.1/2.6 ng/ml). A strong statistically significant correlation was detected in 14 paired samples (Spearman rho: 0.85). Based on maternal serum cotinine concentrations, exposure to active tobacco use was not associated with risk of TGCC in offspring (HR 0.88, 95% CI 0.51; 1.52). Similarly, based on amniotic fluid cotinine concentrations, exposure to active tobacco use was not associated with risk of TGCC (HR 1.11, 95% CI 0.64; 1.95). However, different risks were observed for seminomas and nonseminomas in both matrices, but none were statistically significant. Our findings did not provide convincing evidence supporting that exposure to tobacco during pregnancy is associated with TGCC.
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| 2. |
- Hedengran, Katrine K., et al.
(author)
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Environmental tobacco smoke exposure during pregnancy has limited effect on infant birthweight and umbilical vein endothelial nitric oxide synthase
- 2018
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349. ; 97:11, s. 1309-1316
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Journal article (peer-reviewed)abstract
- Introduction: Women who smoke, deliver significantly smaller infants. These infants have reduced levels of the vasodilator endothelial nitric oxide synthase (eNOS) levels in the umbilical vessels, which may reduce fetal growth. Serum cotinine, the degradation product of nicotine, can be used to determine the level of tobacco exposure. Newborns of environmental smokers are suggested to be smaller and shorter in weight, length, and head circumference. eNOS levels have not yet been studied in these infants. We here investigated the existence of a relation between maternal environmental tobacco smoke exposure, eNOS activity, concentration, and birthweight. Material and methods: We included 263 healthy singleton pregnancies categorized into three groups according to measured cotinine levels: 175 nonsmokers, 38 smokers, and 50 environmental smokers. Cotinine was quantified by mass spectrometry with a detection limit of.2 ng/mL; eNOS activity and concentration were measured in endothelial cells (ECs) of the umbilical vein. Results: Infants born to environmental smokers had similar weights to infants born to nonsmokers (47 g heavier, P =.48). Cotinine concentrations were.06/.09/.12 ng/mL (quartiles) in infants born to nonsmokers,.27/.37/.81 ng/mL in infants born to women exposed to environmental tobacco smoke, and 43.0/63.8/108.1 ng/mL in infants born to smokers. The eNOS concentration was 1.65 ±.92 ng/106 ECs (mean ± SD) in nonsmokers and 1.71 ± 1.00 ng/106 ECs in environmental smokers. The eNOS activity was 52.0 ± 20.6 pmol l-citrulline/min/106 ECs in nonsmokers and 48.7 ± 19.8 pmol l-citrulline/min/106 ECs in environmental smokers. Conclusions: Infants born to environmental smokers, as judged by umbilical serum cotinine levels close to.2 ng/mL, are not associated with lower birthweight or reduced eNOS activity, or concentration in the fetal vascular bed.
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| 3. |
- Kruse, Anne R., et al.
(author)
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Breastfeeding among parous women offered home-visit by a midwife after early discharge following planned cesarean section : Secondary analysis of a randomized controlled trial
- 2023
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In: European Journal of Midwifery. - 2585-2906. ; 7:December
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Journal article (peer-reviewed)abstract
- INTRODUCTION Early discharge holds several advantages and seems safe after planned cesarean section among low-risk women. However, breastfeeding rates are lower after cesarean section. Thus, concern has been raised that early discharge among these women may affect breastfeeding even further. Therefore, we aimed to assess the effect of early discharge the day after planned cesarean section on breastfeeding, among parous women when a home-visit by a midwife was provided the day after discharge. METHODS We conducted a secondary analysis of a randomized trial. Parous women (n=143) planned for cesarean section were allocated to either discharge within 28 hours after planned cesarean section followed by a home visit the day after (early discharge) or discharge at least 48 hours after planned cesarean section (standard care). The participants filled in questionnaires approximately 2 weeks before delivery and 1 week, 4 weeks, and 6 months postpartum. RESULTS The proportions of women initiating breastfeeding were 84% versus 87% (early discharge vs standard care). After 6 months, 23% versus 21% were exclusively breastfeeding, while 29% versus 42% were partially breastfeeding. The mean duration of exclusive breastfeeding was 3.4 months (SD=2.3) in both groups. None of these differences was statistically significant. In both groups, the women’s breastfeeding selfefficacy score before cesarean section correlated with the duration of breastfeeding. After 4 weeks, low-score rates were 28% versus 30%. CONCLUSIONS Early discharge with follow-up home visits by a midwife after planned cesarean section in parous women is feasible without compromising breastfeeding.
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| 4. |
- Kruse, Anne R., et al.
(author)
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Effect of early discharge after planned cesarean section on recovery and parental sense of security. A randomized clinical trial
- 2021
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 100:5, s. 955-963
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Journal article (peer-reviewed)abstract
- Introduction: In some European countries, discharge the day after planned cesarean section has become an accepted procedure. However, little is known about the patients’ perception of early discharge. The aim of this study was to compare early discharge with standard care in relation to parental sense of security. Further, we evaluated postoperative pain, mobilization, and readmission. Material and methods: We performed a randomized clinical trial including parous, singleton pregnant women with a planned cesarean section at term. The women were allocated to either discharge within 28 hours (intervention group) or after 48 hours (standard care group) following the cesarean section. Women discharged within 28 hours after cesarean section were offered a home visit by a midwife the following day. The primary outcome was the postnatal sense of security, which was reported by the woman and her partner in the “Parents’ Postnatal Sense of Security” questionnaire 1 week postpartum. Secondary outcomes were pain score, use of analgesics, mobilization, readmission, and contacts with the healthcare system in the postoperative period. Results: We included 143 women, of whom 72 were allocated to the intervention group and 71 were allocated to the standard care group. There were no differences in baseline characteristics. The two groups did not differ concerning the postnatal sense of security for the women (P =.98) or the postnatal sense of security for the partners (P =.38). We found no difference in pain scores, step count, use of analgesics, or number of contacts with the health-care system between the groups. Conclusions: Parental postnatal sense of security is not compromised by discharge within 28 hours followed by a home visit compared with discharge after 48 hours after planned cesarean section among parous women.
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| 5. |
- Meinert, Mette, et al.
(author)
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Proteoglycans and hyaluronan in human fetal membranes
- 2001
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In: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 1097-6868 .- 0002-9378. ; 184:4, s. 679-685
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to describe the distributions of major extracellular matrix components, such as proteoglycans, collagen acid hyaluronan, in the fetal membranes at term. STUDY DESIGN: Fetal membranes were obtained from elective cesarean deliveries at term. Guanidinium extracts were analyzed for proteoglycans with alcian blue precipitation, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and Western blotting and for hyaluronan with a radioimmunoassay. Collagen was measured by estimating hydroxyproline content. Tissue sections were immunostained for decorin and biglycan and stained for hyaluronan with a biotin-labeled hyaluronan-binding protein. RESULTS: The fetal membranes contained predominantly smaller proteoglycans, such as biglycan and decorin. The amnion consisted of typical fibrous connective tissue with a high concentration of collagen. The amnion was dominated by decorin located in close connection with the collagen fibrils. The chorion was composed of a fibroblastic part containing collagen and decorin and a trophoblastic part mainly containing biglycan. In addition, large amounts of hyaluronan were found, especially in the amnion and in the decidual cell layers. CONCLUSION: The distributions of proteoglycans, collagen, and hyaluronan in human fetal membranes may explain the biomechanical properties of this tissue. We suggest that changes in the relative proportions of these extracellular molecules are crucial for the proposed maturation process in the fetal membranes during the last weeks of pregnancy.
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| 6. |
- Sorensen, Anne, et al.
(author)
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Changes in human fetal oxygenation during maternal hyperoxia as estimated by BOLD MRI
- 2013
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In: Prenatal Diagnosis. - : Wiley. - 1097-0223 .- 0197-3851. ; 33:2, s. 141-145
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Journal article (peer-reviewed)abstract
- Objective Changes in blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) signal are closely related to changes in fetal oxygenation. In this study, we aimed to investigate the changes in human fetal oxygenation during maternal hyperoxia by using the non-invasive BOLD MRI technique. Method Eight healthy pregnant women in gestational week 28 to 34 were included. With the use of a facial oxygen mask, we induced maternal hyperoxia and measured changes in the BOLD MRI signal of selected fetal organs. Results In a number of fetal organs, the BOLD MRI signal increased significantly (P<0.01) during maternal hyperoxia (mean change in %+/- SEM): liver (14.3 +/- 3.7%), spleen (15.2 +/- 3.5%) and kidney (6.2 +/- 1.8%) as well as the placenta (6.5 +/- 1.6%). In the fetal brain, however, the BOLD MRI signal remained constant (0.3 +/- 0.2%). Conclusion During maternal hyperoxia, we demonstrated an increased oxygenation in a number of human fetal organs by using the non-invasive BOLD technique. The oxygenation of the fetal brain remained constant, thus a reversed' brain sparing mechanism could be considered in healthy fetuses subjected to hyperoxia. (c) 2012 John Wiley & Sons, Ltd.
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