Clinical and subclinical maternal hypothyroidism and their effects on neurodevelopment, behavior and cognition

ABSTRACT Clinical and subclinical hypothyroidism are the most common hormonal dysfunctions during pregnancy. Insufficient maternal thyroid hormones (THs) in the early stages of pregnancy can lead to severe impairments in the development of the central nervous system because THs are critical to central nervous system development. In the fetus and after birth, THs participate in neurogenic processes, cell differentiation, neuronal activation, axonal growth, dendritic arborization, synaptogenesis and myelination. Although treatment is simple and effective, approximately 30% of pregnant women in Brazil with access to prenatal care have their first consultation after the first trimester of pregnancy, and any delay in diagnosis and resulting treatment delay may lead to cognitive impairment in children. This review summarizes the effects of clinical and subclinical hypothyroidism on fetal neurodevelopment, behavior and cognition in humans and rodents. Arch Endocrinol Metab. 2020;64(1):89-95

The role of fetal-maternal microchimerism as a natural-born healer in integrity improvement of maternal damaged kidney

ABSTRACT Purpose: To identify the fetal stem cell (FSC) response to maternal renal injury with emphasis on renal integrity improvement and Y chromosome detection in damaged maternal kidney. Materials and Methods: Eight non-green fluorescent protein (GFP) transgenic Sprague-Dawley rats were mated with GFP-positive transgenic male rats. Renal damage was induced on the right kidney at gestational day 11. The same procedure was performed in eight non-pregnant rats as control group. Three months after delivery, right ne- phrectomy was performed in order to evaluate the injured kidney. The fresh perfused kidneys were stained with anti-GFP antibody. Polymerase chain reaction (PCR) assay was also performed for the Y chromosome detection. Cell culture was performed to detect the GFP-positive cells. Technetium-99m-DMSA renal scan and single-photon emission computed tomography (SPECT) were performed after renal damage induction and 3 months later to evaluate the improvement of renal integrity. Results: The presence of FSCs was confirmed by immune histochemical staining as well as immunofluorescent imaging of the damaged part. Gradient PCR of female rat purified DNA demonstrated the presence of Y-chromosome in the damaged maternal kidney. Moreover, the culture of kidney cells showed GPF- positive cells by immuno- fluorescence microscopy. The acute renal scar was repaired and the integrity of dam- aged kidney reached to near normal levels in experimental group as shown in DMSA scan. However, no significant improvement was observed in control group. Conclusion: FSC seems to be the main mechanism in repairing of the maternal renal injury during pregnancy as indicated by Y chromosome and GFP-positive cells in the sub-cultured medium.

Factores de riesgo maternos y neonatales asociados al retardo de la dentición temporal / Maternal and neonatal risk factors associated with the temporary teething delay

Se realizó un estudio analítico, observacional, de casos y controles, en niños de los círculos infantiles Pétalos de Rosa y La Espiguita, pertenecientes al área de salud del Policlínico Docente Armando García Aspurú de Santiago de Cuba, durante el período de febrero de 2015 a marzo de 2016, con vistas a determinar los factores maternos y neonatales asociados al retraso en la aparición de dientes temporales. La población quedó conformada por 150 niños de 2do a 4to años de vida, de los cuales se tomaron 2 controles (N=100) por cada caso (N=50). En la serie se obtuvo asociación estadísticamente significativa de las variables estado nutricional de la madre, ganancia de peso de la madre, enfermedades maternas, lactancia materna y peso del niño al nacer, con la alteración del brote dentario temporal en los niños. Se recomendó realizar intervenciones educativas en los círculos infantiles y las comunidades para apoyar el trabajo del médico de la familia

An analytic, observational, of cases and controls study, in children from Pétalos de Rosa and La Espiguita day care centers, belonging to the health area of Armando García Aspurú Teaching Polyclinic was carried out in Santiago de Cuba, during February, 2015 to March, 2016, aimed at determining the maternal and neonatal factors associated with the delay in the emergence of the temporary teeth. The population was conformed by 150 children from 2nd to 4th years of life, from whom 2 controls were taken (N=100) for each case (N=50). In the series a statistically significant association of the variables mother's nutritional state, mother's weight gain, maternal diseases, breast feeding and child birth weight was obtained, with the disorder of the temporary teething eruption in the children. It was suggested to carry out educational interventions in the day care centers and communities to support the family doctor's work

Ultrastructure of bovine placenta during all gestational period / Ultraestrutura de placenta bovina durante todo o período gestacional

Placentas from pregnant cows with different gestation periods were used. Placental fragments of all groups were processed and evaluated by transmission electron microscopy. After fragment analysis, bovine placenta was observed to be epitheliochorial type in early pregnancy, becoming progressively sinepiteliocorial at the beginning of the second trimester. There are no ultrastructural evidences of inflammation in the region of caruncles throughout gestation, despite the invasion of caruncle proper lamina by trophoblast cells. However, throughout pregnancy and especially at the end, there were evident signs of cell degeneration in both trophoblast and the uterine epithelium. The active trophoblast cells intensely phagocytize cellular debris. There are complex interdigitations between the surface of the trophoblast and the uterine epithelium, which is related to the increase of the exchange surface between mother and fetus. At the end of pregnancy, interdigitations disappear, favoring the detachment and expulsion of the placenta after birth.(AU)

Foram utilizadas placentas de vacas abatidas em frigorífico com diversos tempos gestacionais. Fragmentos de placentomo de todos os grupos foram processados e avaliados em microscopia eletrônica de transmissão. Após análise dos fragmentos, observou-se que a placenta bovina é do tipo epiteliocorial no início da gestação, tornando-se sinepiteliocorial progressivamente a partir do início do segundo mês de gestação. Não existem evidências ultraestruturais de inflamação na região das carúnculas durante toda a gestação, apesar da invasão da lâmina própria caruncular por células trofoblásticas. No entanto, durante toda a gestação e em especial ao seu final, foram observados sinais evidentes de degeneração celular, tanto do trofoblasto como do epitélio uterino. As células trofoblásticas ativas fagocitam intensamente os debris celulares originados dessas degenerações. Existem complexas interdigitações entre a superfície do trofoblasto e do epitélio uterino, o que estaria relacionado com o aumento da superfície de troca entre mãe e feto. Ao final da gestação, praticamente desaparecem essas interdigitações, favorecendo o descolamento e a expulsão da placenta após o parto.(AU)

Morphology of Pêga jennies term placenta and its fetal-maternal interface / Morfologia da placenta a termo e da interface materno-fetal da jumenta Pêga

This study describes the placental morphology and fetal-maternal interface regarding macroscopic and microscopic aspects from Pêga Jennies at end of pregnancy. Eleven placentas were evaluated after delivery, and four fragments from each placenta were taken in duplicate corresponding to the pregnant uterine horn and non-pregnant horn. Fragments from fetal-maternal interface were obtained from one Jennie at C- section. All fragments were submitted to light microscopy and scanning electron microscopy. Regarding the macroscopic aspect of the placenta, microcotyledons were observed at the endometrial interface, characterized by the diffuse aspect of the placenta. Light microscopy revealed villous type chorion at the chorioallantoic membrane, which were organized in agglomeration villi, presenting a connective tissue stroma and trophoblastic cells. At the fetal-maternal interface, micro placentation, which were composed by inter digitations of agglomeration of villi, limited by maternal crypts, circled by arcades, composed by a fetal trophoblast and an internal portion. In addition, endometrial glands opening were observed. Scanning electron microscopy revealed that the chorioallantoic membranes were covered by villi agglomerations. At the top of those fetal villi we observed cell protrusions from trophoblast cells, which carried debris from maternal tissues. A transversal section from the fetal- maternal interface represented an intricate villi interdigitation with thin maternal caruncle structures, which consist in micro placentation. Macro and microscopic aspects of Jennies placenta, as well as the fetalmaternal interface presented similarities with the observed in mares.

O presente trabalho descreveu a morfologia placentária e a interface materno-fetal de jumentas da raça Pêga, quanto aos aspectos macroscópicos e microscópicos ao final da gestação. Foram avaliadas onze placentas, colhendo-se quatro fragmentos por placenta em duplicata, correspondentes ao corno uterino prenhe e ao corno uterino não prenhe. Fragmentos da interface materno-fetal, oriundos de uma jumenta com gestação a termo, foram obtidos durante o procedimento de cesariana. Os fragmentos foram examinados por microscopia de luz e microscopia eletrônica de varredura. Na macroscopia, foi observado microcotilédone na interface com o endométrio caracterizando placentação difusa. À microscopia de luz na membrana corioalantoide foi observado o córion do tipo viloso, com vilos organizados em tufos vilosos, estroma de tecido conjuntivo e células trofoblásticas. Na interface materno-fetal, microplacentônios, formados pela interdigitação dos tufos vilosos, limitados pelas criptas maternas, circundados pelas arcadas, compostos por uma parte fetal trofoblástica e uma parte interna, observando-se a abertura de glândulas endometriais. À microscopia eletrônica de varredura, foi constatado que a membrana corioalantoide se encontrava coberta por tufos vilosos. Nos ápices dos vilos fetais, foram observadas protrusões de células do trofoblasto, carreando debris de tecidos maternos. Em corte transversal da interface materno-fetal, foi verificada a intrincada interdigitação dos vilos com as finas estruturas das carúnculas maternas, formando os microplacentônios. Os aspectos macro e microscópicos da placenta da jumenta, assim como as descrições da interface materno-fetal apresentaram similaridades com os observados na égua.

Placental efficiency in the equine species: which factors may be related? / Eficiência placentária na espécie equina: quais fatores podem estar relacionados?

This review intends to show the main factors that may affect intrauterine growth and the placentals nutrients supply to the fetus, morphofunctional aspects placental efficiency, correlating them with performance indexes, such as breed, age and pluriparious. This study aims to discuss the interrelationships that determine greater placental efficiency, proposing a comparative parallel between various species in order to understand more about the placental efficiency in the equine species.

Esta revisão de literatura propõe levantar os principais fatores que podem influenciar o crescimento intrauterino e o suprimento de nutrientes placentários para o feto, abordando aspectos morfofuncionais relacionados à eficiência placentária, correlacionando-os com aspectos zootécnicos, como raça, pluriparidade e idade das fêmeas gestantes. O objetivo foi estabelecer as interrelações que determinem maior eficiência placentária, propondo um paralelo comparativo entre espécies a fim de ser entendida a eficiência placentária na espécie equina.

Effect of dietary phytoestrogens on human growth regulation: imprinting in health & disease.

This group has advocated a return to the notional Palæolithic diet with fruits, vegetables, roots, leaves, seeds, phytochemical antioxidants and proteins, etc. Phytoestrogens, viz. lignans, isoflavonoids and flavonoids are weak oestrogenic constituents of such a diet and may have a considerable impact on human health and disease. The aim of this paper was to conduct a preliminary overview of about 2000 research-led studies from the 1930s to the present time reported in the literature on flavonoids/isoflavonoids/lignans and to assemble evidence for a future strictly formal literature review on the health benefits and risks of flavonoids in a variety of diseases.

Trocas materno fetais da glicose, dos aminoácidos e das vitaminas / Glucose, amino acids and vitamins fetomaternal exchange

A descrição do transporte placentário envolve informações sobre mecanismos, propriedades e regulação genética das substâncias moleculares. As trocas materno-fetais se concretizam pelas células do sinciotrofoblasto (microvilosidades e camada basal da membrana plasmática) bem como o tecido conectivo e o endotélio capilar fetal. A transferência de glicose ocorre pelo mecanismo de difusão facilitada e já foram identificados na placenta humana aproximadamente 15 sistemas de transporte dos aminoácidos. A grande maioria das drogas é transportada pelo mecanismo de difusão, porém uma pequena parte depende de suas características fisicoquímicas.

Impact of gestational diabetes on lipid profiling and indices of oxidative stress in maternal and cord plasma

To study the effect of gestational diabetes mellitus [GDM] on indices of oxidative stress and lipid profiles in maternal and cord blood samples. Blood samples were collected from 40 normal pregnant women and 46 women with GDM during the period 1998 through to 1999 at the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia. The GDM patients were subdivided into 2 groups: patients receiving insulin treatment [GDM-I, N=19] and patients under control diet [GDM-D, N=27]. Plasma a- and y-tocopherols were estimated by high-performance liquid chromatography, whereas malondialdehyde [MDA] was analyzed by fluorometry. Serum lipids [low density lipoprotein, high density lipoprotein, total cholesterol, triglycerides, and total lipids] were determined by enzymatic colorimetry using automated clinical analyzer. The results of lipid profiles in maternal serum showed no significant difference between GDM patients and controls; however, all the lipid constituents except total cholesterol were significantly reduced in the cord blood of GDM patients as compared to control subjects. a-tocopherol levels in the maternal plasma were not significantly different among the 3 groups, whereas, cord plasma a-tocopherol was significantly decreased in both GDM-D and GDM-I. Maternal y-tocopherol was found to be significantly increased in GDM-D and only insignificantly increased in GDM-I, but the cord y-tocopherol showed no appreciable changes. The level of MDA was 3-fold higher in maternal plasma as compared to cord plasma. However, neither the maternal plasma nor cord plasma showed significant differences in MDA levels between GDM patients and normal pregnant women. A significant depletion of a-tocopherol in the cord blood of GDM patients is indicative of a possible oxidative stress in their fetuses. Further studies are warranted to examine a wider range of biochemical parameters to evaluate the potential risks of oxidative damage

Serum zinc and copper levels in the maternal blood and cord blood of neonates.

Estimation of serum zinc and copper in the maternal blood and cord blood of neonates was carried out to correlate the trace metals in the neonates and their mothers in relation to gestational age and birth weight. Sixty-five healthy neonates, both term and preterm and their mothers were selected. This cross sectional study was done at Azimpur Maternity Centre, Dhaka Medical College Hospital and Chemistry Division, Atomic Energy Centre, Dhaka, Bangladesh from July 1997 to June 1998. The estimation of trace metals was carried out by Atomic Absorption Spectrophotometry (AAS). The mean serum zinc levels in the maternal blood and cord blood were 0.47 +/- 0.24 microgram/ml and 0.85 +/- 0.33 microgram/ml respectively and the mean copper levels in the maternal blood and cord blood were 1.37 +/- 0.62 micrograms/ml and 0.31 +/- 0.32 microgram/ml respectively. Cord blood zinc level was significantly higher and cord blood copper level was significantly lower than the corresponding maternal blood levels. There was no significant correlation between gestational age and serum zinc levels in the cord or maternal blood. But significant inverse correlation was found between gestational age and serum levels of copper in the maternal and cord blood.

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.

Revisión bibliográfica actualizada sobre cambios dentofaciales y malformaciones congéticas inducidas por deficiencia aguda de riboflavina / A current review of the literature on dentofacial changes and congenital malformations induced by acute riboflavin deficiency

La riboflavina no es sintetizada por animales superiores en cantidad suficiente como para cubrir las necesidades nutricionales, por lo cual debe ingerirse en los alimentos. La deficiencia aguda de riboflavina en edad embrionaria puede ocasionar malformaciones esqueléticas y alteraciones bucofaciales, siendo el esqueleto membranoso el primero en manifestar los signos de este sindrome. Entre las diferentes anomalías tenemos: braquignacia, fusión de las costillas superiores, ausencia de tibia, atresia del esófago, excenfalia, protrusión de la lengua, incisivos inferiores ausentes, paladar hendido, atrofia de los músculos milhoideo y masetero, sindactilia, abducción de las manos. Se acepta que el agentes causante de estas alteraciones es la hiporriboflavinosis, la cual afecta la multiplicación de células mesenquimatosas durante la vida intrauterina. Si bien estas anomalías no son exclusivas de la deficiencia de riboflavina, se puede afirmar que ciertas deficiencias nutricionales en madres durante el período de gestación pueden causar defectos congénitos en los descendientes.

Maternal hemoglobin and serum albumin and fetal growth.

Four hundred and eighty four pregnant women and their offsprings were studied to determine the relationship of maternal hemoglobin and serum protein levels on the birthweight of offspring. The correlation coefficient of maternal hemoglobin as well as serum albumin level (gamma = 0.1097 and 0.0936, respectively) with birthweight were not statistically significant. However, mean birthweight of neonates born to nonanemic mothers was significantly higher than of those born to anemic mothers. The prevalence of low birthweight babies was significantly higher among anemic mothers (p < 0.01); however, no such trend was observed in relation to maternal serum albumin (p > 0.05).

Doppler umbilical artery flow velocity waveforms in pregnancies complicated by major fetal malformations.

A pulse-wave Doppler ultrasound was used to identify fetal umbilical cord and to obtain flow-velocity waveforms. The umbilical artery Doppler indices were determined in 34 fetuses with major congenital malformations between 20 and 38 wks' gestation. Reference ranges of fetal umbilical artery systolic and diastolic (S/D) ratio, pulsatility index (PI) and resistance index (RI) with gestation were constructed from a cross-sectional study of 331 appropriate for gestation age fetuses of 16 to 41 wks' gestation. The records were reviewed to determine the changes associated with fetal malformation. Twenty five of 34 patients with major congenital anomalies showed high S/D ratio, PI and RI in waveforms taken from the umbilical artery. All fetuses with chromosomal aneuploidy (10 cases) had high umbilical artery S/D ratio, PI and RI. It appears that a fetal mechanism may determine the changes in the umbilical placental circulation resulting in an umbilical artery pattern of high flow resistance in fetuses with congenital anomalies.

Hepatitis B virus infection in pregnant mothers and its transmission to infants.

Screening for serological markers of hepatitis B virus infection was done on 500 pregnant mothers. HBsAg, AntiHBs and HBeAg were done. HBsAg was positive in 3.6%, AntiHBs in 17.4% and HBeAg in 0.4% cases. The infants born to the asymptomatic HBsAg carrier mothers were followed up to 6 months to determine the vertical transmission of HBV infection. Rate of transmission of infection from HBsAg positive mothers to infants were 16.66% irrespective of HBeAg status, whereas it was nearly 100% in case of HBeAg positive mothers. All of the HBsAg positive infants developed the antigenemia between 3-6 months of age, supporting the hypothesis that intrapartum transmission is the major mode of vertical transmission.