The Difference of Lymphocyte Subsets Including Regulatory T-Cells in Umbilical Cord Blood between AGA Neonates and SGA Neonates

PURPOSE: This study aimed to compare the regulatory T cells in cord blood of appropriate for gestational age (AGA) neonates with those of small for gestational age (SGA) neonates. MATERIALS AND METHODS: Umbilical cord blood was collected upon labor in 108 healthy full-term (between 37 and 41 gestational weeks) neonates, who were born between November 2010 and April 2012. Among them, 77 samples were obtained from AGA neonates, and 31 samples were obtained from SGA neonates. Regulatory T cells and lymphocyte subsets were determined using a flow cytometer. Student's t-test for independent samples was used to compare differences between AGA and SGA neonates. RESULTS: Regulatory T cells in cord blood were increased in the SGA group compared with normal controls (p=0.041). However, cytotoxic T cells in cord blood were significantly decreased in the SGA group compared with normal controls (p=0.007). CONCLUSION: This is the first study to compare the distribution of lymphocyte subsets including regulatory T cells in cord blood between AGA neonates and SGA neonates.

Nitric oxide and antioxidant enzymes in venous and cord blood of late preterm and term Omani mothers

This study assessed the role of oxidative stress in parturition in Omani mothers following growing reports that late preterm neonates were at greater risk than term neonates of perinatal death. Venous blood samples were collected during labour, and cord [neonatal] blood samples were taken after childbirth in late preterm and term from women at Sultan Qaboos University Hospital, Oman. Plasma nitric oxide [NO] concentrations, erythrocyte catalase [CAT]. Erythrocyte glutathione peroxidase [GPx] activities were measured using spectrophotometric Methods. When compared with term mothers, late preterm mothers had markedly higher NO concentrations [micro mol/L] 17.1 +/- 3.3 versus 11.0 +/- 5.5 [P <0.0001], and lower GPx values [U/g Hb] 94.1 +/- 12.9 versus 110.4 +/- 12.3 [P <0.0001]. Late preterm mothers were significantly younger [P = 0.027] than term mothers and had neonates that weighed significantly less [P <0.0001] than term neonates. GPx activity was significantly reduced [P = 0.001] in late preterm neonates as compared to term neonates. CAT showed no change in activity in any comparison. Distinctly higher values of NO and lower GPx activity were found in late preterm mothers relative to term mothers; also, lower GPx in late preterm neonates relative to term neonates suggested a pro-oxidant-antioxidant imbalance due to the greater oxidative burden in late preterm parturition

Características morfológicas y morfométricas de la placenta de término, en recién nacidos pequeños para la edad gestacional (PEG) en la ciudad de Temuco-Chile / Morphometric and morphological characteristics of the placenta at term, in small for gestational age newborns (SGA) in the city of Temuco-Chile

El metabolismo placentario, el intercambio de sustancias y la producción de hormonas son funciones vitales de la placenta para mantener y promover el desarrollo normal del feto. Existen factores de riesgo que alteran este patrón en el caso del retardo del crecimiento intrauterino, cuyo resultado será un recién nacido (RN) pequeño para la edad gestacional (PEG) que presentará una mayor morbilidad, crecimiento físico e intelectual comprometido y una mayor probabilidad de desarrollar durante la vida adulta diferentes patologías. Los objetivos del presente trabajo son: 1. Reconocer las diferencias en los parámetros morfométricos, como el área de las vellosidades, el área de los vasos, el número de vasos y el área del sinciciotrofoblasto de las placentas de PEG en relación con placentas de recién nacidos AEG y 2. Relacionar el diagnóstico neonatal de PEG con las características morfométricas. Se utilizaron 25 placentas de término (37-42 semanas), 12 de recién nacidos adecuados a la edad gestacional (AEG), y 13 de recién nacidos pequeños para la edad gestacional (PEG). Las muestras fueron obtenidas de la maternidad del Hospital Hernán Henríquez Aravena de Temuco, IX Región Chile. De cada placenta se tomaron dos segmentos pericordonales, desde la placa subcorial hasta la placa basal y luego fueron fijadas en formalina tamponada al 10 por ciento. Las técnicas histológicas utilizadas fueron H-E azul de Alcián, Tricrómico de Masson, PAS-Hematoxilina y PAS-Diastasa. El área de las vellosidades mostraron diferencias significativas entre el grupo control (AEG) y el grupo PEG con p = 0,0194. En el grupo de PEG el área de los vasos fue significativamente mayor, con un valor de 234,05 i,m² en comparación con el grupo control cuyo promedio fue de 150.99 lm² (p = 0,0001). El número de vasos sanguíneos por vellosidad libre no mostró diferencias significativas. En relación con el área del sinciciotrofoblasto la diferencia no resultó ser significativamente ...

The placental metabolism, the exchange of substances and the production of hormones are vital functions of the placenta to maintain and promote the normal development of the fetus. There are risk factors that disrupt this pattern in the case of intrauterine growth retardation, whose outcome will be a small for gestational age (SGA) newborn having a higher morbidity, physical and intellectual growth pledged and greater probability of develop different pathologies during adulthood. The aims of this study are: 1 .-recognize the morphometric parameters differences as the area of the villi, the area of the vessel, the number of vessels and the area of placental syncytiotrophoblast SGA in connection with placentas of newborns AGA and 2.- relate the diagnosis of neonatal SGA with morphometric characteristics. We used 25 placenta at term (37-42 weeks), 12 newborns appropriate to the gestational age (AEG), and 13 small for gestational age infants (SGA). The samples were obtained from the Maternity Hospital Hernán Henriquez Aravena of Temuco, Chile IX Región. In each placenta two segments were taken from the subchorionic plate to the basal plate and then were fixed in 10 percent formalin buffered. The histological techniques used were H- E Alcián blue, Masson's Trichromic, Pas-hematoxylin Pas-diastase. The area of the villi showed significant differences between the control group (AEG) and the PEG group with p = 0.0194. In the group of PEG the area of vessels was significantly higher, with a value of 234.05 mm² compared with the control group whose average was 150.99 mm² (p = 0.0001). The number of blood vessels for free villi sampling not significant differences. Regarding the area of syncytiotrophoblast the difference was not significantly (p = 0.1410). In conclusion it was determined that PEG newborns placenta showed significant differences at the blood vessel area and free chorial villi area in relation to the AEG placenta.

Endothelin-1 and leptin as markers of intrauterine growth restriction

To explore the role of endothelin-1 [ET-1] and leptin in intrauterine growth restriction [IUGR] among preeclamptic and non-preeclamptic women. Forty patients with a pregnancy complicated by IUGR, 20 cases with severe pre-eclampsia and 20 cases non-preeclamptic were enrolled. Control group comprised 15 cases with uncomplicated pregnancy. Blood sample from umbilical artery and maternal venous blood were collected at the time of delivery for ET-1 and leptin levels. Mode of delivery, birth weight and Apgar score were recorded. The mean maternal and fetal ET-1 was significantly higher in pregnancies complicated by IUGR than in control group. The mean maternal leptin was significantly higher in preeclamptic patients when compared to nonpreeclamptic and control groups. Mean fetal leptin was significantly lower in patients than in control; however fetal leptin was corrected to fetal weight, it was insignificantly different in both groups. Maternal plasma ET-1 and leptin correlates with the degree of fetal growth restriction originating from deterioration of placental function. Maternal plasma leptin and ET-1 levels may reflect deterioration in fetal growth

Sensibilidad a IGF-I en niños pequeños para la edad gestacional / IGF-I sensitivity in small for gestational age children

Background: The lack of catch up growth (CUG) in small for gestational age (SGA) children may be related to a reduced sensitivity to insulin growth factor 1 (IGF-I). Aim: To assess the sensitivity to IGF-I in small for gestational age children, measuring basal and post IGF-I nocturnal profile of growth hormone (GH). Patients and methods: We studied 34 prepubertal SGA children aged 4 to 11 years. Twenty three had CUG and 11 did not have CUG. As an IGF-I sensitivity test, nocturnal GH levels were measured every 20 minutes from 23:00 h to 07:00 h, both under baseline conditions and after the administration of a subcutaneous bolus of 1 mg/kg/body weight of the IGF-I + IGFBP-3 complex (Somatokine®). Results: At the time of the study, the Z scores for height among children with and without CUG were -1.55 ± 0.22 and -3.24 ± 0.28, respectively (p <0.0001). There were no statistical differences between CUG + vs CUG- patients in mean basal GH (6.6 ± 0.5 and 5.6 ± 0.6 ng/ml, respectively). After Somatokine® administration, mean GH, and the mean GH area under the curve (AUC) decreased significantly in both groups. However, mean overnight GH AUC decreased in all SGA children with CUG, after Somatokine® administration, whereas 3 out of 11 SGA children without CUG had an increase in their mean GH AUC in response to Somatokine®. Conclusions: These findings suggest that pituitary sensitivity to IGF-I may be decreased in some SGA children without CUG.

The role of serum and urinary urea in the evaluation of enteral protein intake in adequate and small-for-gestational-age very low birth weight infants

INTRODUÇÃO E OBJETIVOS: Os recém-nascidos de muito baixo-peso (RNMBP) têm necessidades nutricionais especiais. Existe uma tendência atual de se individualizar a oferta protéica para essas crianças. O objetivo do trabalho é determinar a utilidade da uréia sérica e urinária como indicadores da oferta protéica em RNMBP adequados (AIG) e pequenos para a idade gestacional (PIG). TIPO DE ESTUDO E LOCAL: Estudo prospectivo realizado no Berçário Anexo à Maternidade Instituto da Criança "Prof. Pedro de Alcântara" do Hospital das Clínicas, Departamento de Pediatria da Faculdade de Medicina, Universidade de São Paulo, Brasil. MÉTODOS: Setenta e dois RNMBP (oferta protéica média = 3,7 g/kg/dia) foram incluídos, em um estudo de coorte prospectivo, em dois grupos: AIG (n = 34) e PIG (n = 38). Amostras de sangue, coletas de urina de seis horas (Ur6h) e em amostras isoladas (AIUr) foram obtidas para determinação de uréia e creatinina após a 3ª semana de vida e duas semanas após. Análise estatística: teste t de Student, correlação de Pearson e regressão linear (p < 0,05). RESULTADOS: Não houve diferença entre os grupos quanto aos níveis de uréia sérica, uréia Ur6h e uréia AIUr, bem como entre as duas avaliações dentro de cada grupo. A uréia sérica correlacionou-se à uréia Ur6h nos RNAIG e nos PIG, bem como à uréia AIUr nos RNPIG. A uréia Ur6h correlacionou-se à uréia AIUr nos RNAIG e nos RNPIG. Não houve correlação entre a oferta protéica e a uréia sérica ou urinária. CONCLUSÕES: A uréia sérica e a urinária não refletiram a oferta protéica quando foram utilizadas ofertas médias de 3,7 g/kg/dia. Uréia AIUr pode ser tão confiável quanto uréia da urina coletada por períodos mais longos.

Perfíl lipídico en recién nacidos con retardo del crecimiento intrauterino / Serum lipids in newborns with intrauterine growth retardation

Background: The X syndrome, related to coronary disease in adults, could be possibly programmed priory to delivery, in children with intrauterine growth retardation. Aim: To measure serum lipids in newborns with symmetrical or asymmetrical intrauterine growth retardation. Patients and methods: One hundred thirty five newborns with intrauterine growth retardation and 116 normal term newborns, with 38 to 41 gestational weeks, were studied. Total, HDL, and LDL cholesterol, triglycerides and apoproteins. A1 and B were measured in imbilical cord blood samples. Results: No differences in total, HDL, LDL cholesterol, apoproteins A1 and B were observed between the study groups. Triglycerides were higher in newborns with intrauterine growth retardation, compared to normal term newborns (45 ñ 27 and 36 ñ 19 mg/dl respectively, p<0,001). Differences in serum triglyceride levels respect to controls were observed in both male and female newborns with asymmetrical growth retardation. Likewise the differences respect to controls were observed in newborns with mild or severe but not with moderate growth retardation. Conclusions: Newborns with intrauterine growth retardation have higher triglyceride levels than normal term newborns

Hypoglycemia in small for gestational age babies.

The main objectives of the study were to find the incidence and risk factors associated with development of hypoglycemia in small for gestational age (SGA) babies, to compare haemoglucotest strips (Boehringer Mannheim) with the standard laboratory method (glucose-hexokinase) for estimation of blood glucose, and to measure the insulin and cortisol responses of SGA babies. This was a prospective longitudinal study. The sample included SGA babies and over a period of six months, 127 consecutively born small for gestational age babies were investigated prospectively for development of hypoglycemia in first 48 hrs of life. Plasma samples were taken during episodes of hypoglycemia for insulin and cortisol estimation and compared with non-hypoglycemic controls. The overall incidence of hypoglycemia was 25.2% in SGA babies and 98% of the episodes occurred within first 24 hrs. Compared to non-hypoglycemics, mothers of hypoglycemic babies had higher incidence of receiving i.v. fluids (5% dextrose) during labour. The hypoglycemic babies were more likely to be sick and oral feeds had been initiated by one hour of life in only 37% of them compared to 63% of non-hypoglycemic babies. Plasma insulin/glucose ratio was significantly higher in hypoglycemic than non-hypoglycemic babies, whereas the cortisol levels were similar. Small for gestational age babies are highly prone to develop hypoglycemia in first 24 hrs of life.

Serum copper in newborns and their mothers.

Serum copper levels in the cord blood of 100 newborns and the respective maternal serum copper at the time of delivery was estimated by atomic absorption spectrophotometer. The cases were classified into term AGA, term SGA, term LGA, preterm AGA and preterm SGA. The mean maternal serum copper level 152.42 +/- 2.06 micrograms/dl) was significantly higher than the mean cord serum copper level (39.84 +/- 1.19 micrograms/dl). There was positive correlation between the maternal serum copper level and cord serum copper level. The mean serum copper level of term neonates was (44.42 +/- 1.26 micrograms/dl) significantly higher (p < 0.001) than that of preterm neonates (30.30 +/- 1.14 micrograms/dl). There was a positive correlation between cord serum cooper level and gestational age. The mean cord serum copper levels of term AGA, term SGA, preterm AGA and preterm SGA neonates was 45.42 +/- 1.44 ug/dl, 39.22 +/- 2.45 ug/dl, 31.00 +/- 2.11 ud/dl and 29.47 +/- 2.08 ug/dl respectively. There was no statistically significant difference in the mean serum copper level of AGA and SGA group of both term and preterm neonates. The difference amongst mean maternal serum copper level of various neonatal groups was not significant.

Hematocrit and whole blood viscosity in newborns: analysis of 100 cases.

Hematocrit (Hct) and whole blood viscosity was studied at a mean age of ten hours in 100 neonates. Group A (n = 25), were term normal newborns, Group B (n = 25) were preterms, Group C (n = 20) were term small for gestation (SGA) and Group D (n = 30) had perinatal hypoxia. Blood viscosity was estimated in all cases at shear rates 94.5, 51.2, 20.4 and 8.1 and intergroup variability in viscosity compared at shear rate 51.2. The mean hematocrit (Hct) (59.4%) and viscosity (8.2 cps) was higher in Group A as compared to other groups, but the difference was not significant (p greater than 0.05). The upper limit of viscosity in Group C (11.9 cps) was higher than in all other groups but this difference was also not significant (p greater than 0.05). With decrease in shear rates a reciprocal increase in viscosity was noted in all four groups. Seventeen neonates (17%) had polycythemia of which eight (47.5%) were SGA. Twelve per cent preterms were polycythemic. Only 3% of neonates had hyperviscosity. The mean Hct and viscosity of the 17 cases with polycythemia was 70.9 and 9.21 cps, respectively, which was significantly higher than mean Hct and viscosity of Group A (p less than 0.05). Partial exchange transfusions were done in five neonates with Hct greater than 75%, of which only one had hyperviscosity. Post-exchange viscosity was not estimated. Whereas, three neonates with polycythemia were symptomatic, none of these had hyperviscosity. A linear correlation between Hct and viscosity was observed (r = 0.67).

Cord blood lipid levels in low birth weight newborns.

Cord blood cholesterol, triglyceride and FFA levels were estimated in 73 newborns, subdivided into various gestation weight categories (FTAGA, PTAGA, FTSGA and PTSGA). Cholesterol levels were not influenced by birth weight and gestation. Prematurity and growth retardation caused a significant elevation in triglyceride values. FFA levels were not influenced by prematurity, but growth retardation produced a significant increase. Birth weight and gestational age should be taken into consideration before labelling the newborn as hyperlipidemic.