Effect of maternal undernutrition on human foetal pancreas morphology in second trimester of pregnancy.

Background & objectives: Maternal undernutrition and hyperglycaemia during pregnancy, as well as foetal undernutrition affecting the development of foetal endocrine pancreas structure and function, especially that of β-cells is well known. This study was undertaken to look into the changes in pancreatic islets morphology of aborted normal human foetuses (16-20 wk old) of undernourished and adequately nourished mothers. Methods: Foetuses were collected over a 24 month period from medically terminated pregnancies of six undernourished mothers (BMI <18.5 kg/m2) and eight adequately nourished mothers (BMI >18.5 kg/m2). The sections were stained with haematoxylin & eosin as well as Masson trichrome for morphometric estimates such as islet count, area, volume, etc. and immunohistochemistry analysis of β-cells for insulin presence was done. Results: Significant correlations between maternal and foetal parameters were seen. However, there were no statistically significant differences in the number, size or density and beta cell counts of the pancreas among foetal pancreas of mothers with BMI <18.5 and >18.5 kg/m2. Interpretation & conclusions: Our findings indicate that nutritional status of the mother may not have profound influence on the morphology of beta cells of foetal pancreas in second trimester of pregnancy. Further studies need to be done to confirm these findings.

Maternal undernutrition and the offspring kidney: from fetal to adult life

Maternal dietary protein restriction during pregnancy is associated with low fetal birth weight and leads to renal morphological and physiological changes. Different mechanisms can contribute to this phenotype: exposure to fetal glucocorticoid, alterations in the components of the renin-angiotensin system, apoptosis, and DNA methylation. A low-protein diet during gestation decreases the activity of placental 11ß-hydroxysteroid dehydrogenase, exposing the fetus to glucocorticoids and resetting the hypothalamic-pituitary-adrenal axis in the offspring. The abnormal function/expression of type 1 (AT1R) or type 2 (AT2R) AngII receptors during any period of life may be the consequence or cause of renal adaptation. AT1R is up-regulated, compared with control, on the first day after birth of offspring born to low-protein diet mothers, but this protein appears to be down-regulated by 12 days of age and thereafter. In these offspring, AT2R expression differs from control at 1 day of age, but is also down-regulated thereafter, with low nephron numbers at all ages: from the fetal period, at the end of nephron formation, and during adulthood. However, during adulthood, the glomerular filtration rate is not altered, due to glomerulus and podocyte hypertrophy. Kidney tubule transporters are regulated by physiological mechanisms; Na+/K+-ATPase is inhibited by AngII and, in this model, the down-regulated AngII receptors fail to inhibit Na+/K+-ATPase, leading to increased Na+ reabsorption, contributing to the hypertensive status. We also considered the modulation of pro-apoptotic and anti-apoptotic factors during nephrogenesis, since organogenesis depends upon a tight balance between proliferation, differentiation and cell death.

Prevalencia de desnutrición materna y surelación con el bajo peso al nacer, Hospital Los Andes, gestión 2005 / Prevalence of maternal malnutrition and relation with low birth weight, the Hospital Andes, 2005 management

Objetivo: Determinar la prevalencia de desnutrición materna y su relación con el bajo peso al nacer en el Hospital Los Andes. Diseño: Corte transversal. Lugar Hospital Los Andes, segundo nivel, institucional. Participantes 204 mujeres embarazadas con trabajo de parto o para cesárea programada o de emergencia, con producto único vivo o muerto de cualquier edad gestacional; se excluyeron las pacientes con embarazo Múltiple, edema de cualquier etiología, Ruptura Prematura de Membranas y displasia de cadera. El muestreo fue no probabilístico de casos consecutivos. Intervenciones: Ninguna. Mediciones La variable independiente fue medida a través de la gráfica de índice de masa corporal de Atalah y la variable dependiente através de balanza digital, además se realizo antropometría neonatal. El personal que realizo las mediciones estaba estandarizado. Resultado La prevalencia de desnutrición materna es 7,4% y la frecuencia de bajo peso al nacer es 5,9%, la frecuencia de recién nacidos prematuros es 33,34% y con retraso de crecimiento uterino 58,33%. Los neonatos de madres desnutridas tienen en promedio peso 2940,67 gramos y talla 48,8 cm, y los neonatos de madres con estado nutricional normal tienen en promedio peso 3042,72 gramos y talla 48,93 cm. Conclusiones La prevalencia de desnutrición materna y la frecuencia de bajo peso al nacer son más bajas a las reportadas en otros estudios, las variables antropométricas neonatales en promedio se encuentran dentro de parámetros normales, sin embargo son menores en los neonatos de madres con desnutrición.

Objetivet o determinate maternal under nutrition prevalence and relation with low birth weight in Los Andes hospital. Design Cross sectional Location Los Andes hospital, second level, institutional. Participants 204 pregnant women with parturition or programmed or emergency cesarean, with only child alive or dead with any gestational age; the patients with multiple pregnancy, any etiological edema, membrane’s premature rupture and hip dysplasia were excluded. From consecutive cases the sampling wasn’t probabilistic. Intervention: none Measurements Independent variable was measuremented through Atalah ́s body mass index graphic and dependent variable through digital balance, moreover neonatal anthropometry was made. Personal who realized measurements was standardized. Results: The maternal undernutrition prevalence is 7,4% and low weight born frequency is 5,9%, premature neonate frequency is 33,34%, intrauterine growth retardation 58,33%. The neonates of undernutrition mothers have mean weight 2940,67 grams, height 48,8 cm and neonates of normal status nutritional have mean weigh 3042,72 grams and height 48,93 cm. Conclusion Maternal undernutrition prevalence and low birth weight frequency are lower than others studies, the mean neonatal anthropometry are in normal parameters, but they are smaller in undernutrition mother’s neonates.