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- Abioye, Ajibola I., et al.
(author)
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Anemia of Inflammation during Human Pregnancy Does Not Affect Newborn Iron Endowment
- 2018
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In: Journal of Nutrition. - : AMER SOC NUTRITION-ASN. - 0022-3166 .- 1541-6100. ; 148:3, s. 427-436
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Journal article (peer-reviewed)abstract
- Background: To our knowledge, no studies have addressed whether maternal anemia of inflammation (AI) affects newborn iron status, and few have addressed risk factors for specific etiologies of maternal anemia. Objectives: The study aims were to evaluate 1) the contribution of AI and iron deficiency anemia (IDA) to newborn iron endowment, 2) hepcidin as a biomarker to distinguish AI from IDA among pregnant women, and 3) risk factors for specific etiologies of maternal anemia. Methods: We measured hematologic biomarkers in maternal blood at 12 and 32 wk of gestation and in cord blood from a randomized trial of praziquantel in 358 pregnant women with Schistosoma japonicum in The Philippines. IDA was defined as anemia with serum ferritin amp;lt; 30 ng/mL and non-IDA (NIDA), largely due to AI, as anemia with ferritin amp;gt;= 30 ng/mL. We identified cutoffs for biomarkers to distinguish IDA from NIDA by using area under the curve (AUC) analyses and examined the impact of different causes of anemia on newborn iron status (primary outcome) by using multivariate regression modeling. Results: Of the 358 mothers, 38% (n = 136) had IDA and 9% (n = 32) had NIDA at 32 wk of gestation. At 32 wk of gestation, serum hepcidin performed better than soluble transferrin receptor (sTfR) in identifying women with NIDA compared with the rest of the cohort (AUCs: 0.75 and 0.70, respectively) and in identifying women with NIDA among women with anemia (0.73 and 0.72, respectively). The cutoff that optimally distinguished women with NIDA from women with IDA in our cohort was 6.1 mu g/L. Maternal IDA, but not NIDA, was associated with significantly lower newborn ferritin (114.4 ng/mL compared with 148.4 mu g/L; P = 0.042). Conclusions: Hepcidin performed better than sTfR in identifying pregnant women with NIDA, but its cost may limit its use. Maternal IDA, but not NIDA, is associated with decreased newborn iron stores, emphasizing the need to identify this cause and provide iron therapy.
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| 2. |
- Abioye, Ajibola I., et al.
(author)
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Maternal, placental and cord blood cytokines and the risk of adverse birth outcomes among pregnant women infected with Schistosoma japonicum in the Philippines
- 2019
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In: PLoS Neglected Tropical Diseases. - : PUBLIC LIBRARY SCIENCE. - 1935-2727 .- 1935-2735. ; 13:6
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Journal article (peer-reviewed)abstract
- Background The objectives of this study were to 1) evaluate the influence of treatment with praziquantel on the inflammatory milieu in maternal, placental, and cord blood, 2) assess the extent to which proinflammatory signatures in placental and cord blood impacts birth outcomes, and 3) evaluate the impact of other helminths on the inflammatory micro environment. Methods/Findings This was a secondary analysis of samples from 369 mother-infant pairs participating in a randomized controlled trial of praziquantel given at 12-16 weeks gestation. We performed regression analysis to address our study objectives. In maternal peripheral blood, the concentrations of CXCL8, and TNF receptor I and II decreased from 12 to 32 weeks gestation, while IL-13 increased. Praziquantel treatment did not significantly alter the trajectory of the concentration of any of the cytokines examined. Hookworm infection was associated with elevated placental IL-1, CXCL8 and IFN-gamma. The risk of small-for-gestational age increased with elevated IL-6, IL-10, and CXCL8 in cord blood. The risk of prematurity was increased when cord blood sTNFRI and placental IL-5 were elevated. Conclusions Our study suggests that fetal cytokines, which may be related to infectious disease exposures, contribute to poor intrauterine growth. Additionally, hookworm infection influences cytokine concentrations at the maternal-fetal interface. Clinical Trial Registry number and website ClinicalTrials.gov (NCT00486863). Author summary Schistosomiasis is one of the most prevalent parasitic tropical diseases, and it is primarily treated with the drug praziquantel. This study examined the effects of praziquantel treatment for schistosomiasis and the presence of geohelminth infections during pregnancy on cytokines in maternal, placental, and cord blood, and examined the effects of pro-inflammatory signatures at the maternal-fetal interface on perinatal outcomes. We analyzed the data of 369 mother-infant pairs obtained from a randomized controlled trial of praziquantel given at 12-16 weeks gestation. Praziquantel treatment did not significantly alter the trajectory of the concentration of any of the cytokines examined. Elevated levels of both Th1 and Th2 cytokines were associated with the risk of adverse perinatal outcomes (small-for-gestational age and prematurity). Hookworm coinfection at 12 weeks gestation was, however, related to elevated levels of certain cytokines in the placenta (IL-1, IL-5, CXCL8 and IFN-gamma).
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| 3. |
- Andolf, E., et al.
(author)
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Caesarean section and risk for endometriosis: a prospective cohort study of Swedish registries
- 2013
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 120:9, s. 1061-1065
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Journal article (peer-reviewed)abstract
- Objective To investigate the association between caesarean section and later endometriosis. Design A prospective cohort study. Setting The Swedish Patient Register (PAR) and the Swedish Medical Birth Registry (MBR). Sample Women who were delivered in Sweden between 1986 and 2004. Methods Women with the diagnosis of endometriosis, defined as codes 617 (International Classification of Diseases, ninth revision, ICD-9) or N80 (ICD-10), were retrieved from the PAR. Obstetric outcome was assessed through linkage with the MBR. Out of 709090 women, 3110 were treated as inpatients with a first diagnosis of endometriosis after their first delivery. Women with a diagnosis of endometriosis before their first delivery were excluded. Cox analyses were performed to obtain hazard ratios for endometriosis and adjusted for maternal age at first delivery, body mass index, maternal smoking, and years of involuntary childlessness at study entry. Kaplan-Meier estimates were performed to calculate the risk according to time elapsed. Main outcome In-hospital diagnosis of endometriosis. Results The Cox analyses yielded a hazard ratio of 1.8 (95%CI 1.7-1.9) for endometriosis in women who had had a previous caesarean section compared with women with vaginal deliveries only. The risk of endometriosis increased over time: one additional case of endometriosis was found for every 325 women undergoing caesarean section within 10years. No increase in risk could be seen after two caesarean deliveries. The risk of caesarean scar endometrioma was 0.1%. Conclusion In addition to the recognised risk of scar endometrioma, we found an association between caesarean section and general pelvic endometriosis. Further studies are needed to confirm our findings.
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| 7. |
- Jarvis, Nicholas
(author)
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A review of non-equilibrium water flow and solute transport in soil macropores: principles, controlling factors and consequences for water quality
- 2020
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In: European Journal of Soil Science. - : Wiley. - 1351-0754 .- 1365-2389. ; 71, s. 279-302
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Research review (peer-reviewed)abstract
- This review discusses the causes and consequences of 'non-equilibrium' water flow and solute transport in large structural pores or macropores (root and earthworm channels, fissures and interaggregate voids). The experimental evidence suggests that pores larger than c. 0.3 mm in equivalent cylindrical diameter allow rapid non-equilibrium flow. Apart from their large size and continuity, this is also due to the presence of impermeable linings and coatings that restrict lateral mass exchange. Macropores also represent microsites in soil that are more biologically active, and often more chemically reactive than the bulk soil. However, sorption retardation during transport through such pores is weaker than in the bulk soil, due to their small surface areas and significant kinetic effects, especially in larger macropores. The potential for non-equilibrium water flow and solute transport at any site depends on the nature of the macropore network, which is determined by the factors of structure formation and degradation, including the abundance and activity of soil biota such as earthworms, soil properties (e.g. clay content), site factors (e.g. slope position, drying intensity, vegetation) and management (e.g. cropping, tillage, traffic). A conceptual model is proposed that summarizes these effects of site factors on the inherent potential for non-equilibrium water flow and solute transport in macropores. Initial and boundary conditions determine the extent to which this potential is realized. High rain intensities clearly increase the strength of non-equilibrium flow in macropores, but the effects of initial water content seem complex, due to the confounding effects of soil shrinkage and water repellency. The impacts of macropore flow on water quality are most significant for relatively immobile solutes that are foreign to the soil and whose effects on ecosystem and human health are pronounced even at small leached fractions (e.g. pesticides). The review concludes with a discussion of topics where process understanding is still lacking, and also suggests some potential applications of the considerable knowledge that has accumulated in recent decades.
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