Enhanced expression of IFI16 and RIG-I in human third-trimester placentas following HSV-1 infection.

The innate immune response in the placenta depends on the ability of maternal immune cells and fetal trophoblast cells to detect and eliminate invading pathogens through germline-encoded pattern recognition receptors (PRRs). In the present study, we analysed the transcripts and protein expression of interferon (IFN)-inducible protein (IFI)16, melanoma differentiation-associated protein 5 (MDA5), RIG-I-like receptor (RIG-I) and Toll-like receptor (TLR)-3 in third-trimester human placentas and investigated cytokine profiles generated during herpes simplex type 1 (HSV-1) infection. Decidual and chorionic villous biopsies (38-42 weeks of gestation) were obtained from healthy women immediately after a caesarean section. The expression of the DDX58 (RIG-I), IFIH1 (MDA5), IFI16 and TLR3 transcripts was measured using quantitative real-time polymerase chain reaction (qRT-PCR). Extracellular cytokine and PRRs levels were then quantified by enzyme-linked immunosorbent assays (ELISAs). All examined PRRs genes, including DDX58, IFIH1, IFI16 and TLR3, were expressed constitutively at the mRNA and protein levels in the placental biopsies. The concentration of the IFI16 protein was increased in HSV-1-infected decidual and chorionic villous explants compared to those of mock-infected tissues (P = 0·029). Higher protein expression levels of RIG-I in both the maternal and fetal parts of the placenta were found (P = 0·009 and P = 0·004, respectively). In addition, increased production of IFN-ß by HSV-1-infected tissues was noticed (P = 0·004 for decidua, P = 0·032 for chorionic villi). No significant differences in the IFN-α, interleukin (IL)-6 and IL-8 levels were found. These results showed that HSV-1 infection can enhance the expression of IFI16 and RIG-I proteins in the human term placenta.

Association between abnormal microbiological flora of the lower genital tract in early pregnancy and socio-economic, demographic and environmental risk factors.

BACKGROUND: The main aim of this study was to determine the socioeconomic, demographic and environmental factors which may be associated with the occurrence of pathological microflora of the lower genital tract in early pregnancy. MATERIAL AND METHODS: A group of 96 pregnant women was selected at random from the patients of 10 district maternity units in the Lodz region of Poland. Only singleton pregnancies below 24 weeks were qualified for inclusion in the survey. A standard questionnaire covering medical, socio-economic, demographic, constitutional, and environmental items was administered to every subject and checked against medical records. Based on microbiological results, two groups of pregnant women were distinguished: Group I, with normal cervicovaginal flora, predominantly Lactobacillus spp. with coagulase-negative staphylococci and viridans streptococci, and Group II, with abnormal flora. The latter included two subgroups: IIA, intermediate microbial flora, dominated by M. hominis, U. urealyticum, G. vaginalis, gram-negative anaerobic rods, Ch. trachomatis, and few Lactobacillus spp, and IIB, highly abnormal flora, containing similar microbial components as in IIB but without Lactobacillus spp. RESULTS: Based on the results of microbiological culturing, 18 (18.7%) of the 96 women examined were classified to Group I, and 78 (81.2%) to Group II: 32 (33.3%) in group IIA and 46 (47.9%) in IIB. Groups IIA and IIB were combined for further analysis. An excessive risk of abnormal vaginal flora was observed in connection with such socio-economic factors as marital status, unemployment, and smoking, Moreover, the first pregnancy was also found to be a potential risk factor for this pathology. The risk of developing abnormal vaginal flora, although exceeding unity for each of these factors, was not considered statistically significant. CONCLUSIONS: Socio-economic and environmental factors may influence the course and outcome of pregnancy. Pregnant women who present with risk factors for abnormal cervicovaginal microflora should be included in comprehensive prenatal surveillance, which enables early detection and treatment of this pathology.

Employment status of pregnant women in central Poland and the risk of preterm delivery and small-for-gestational-age infants.

BACKGROUND: Unemployment is one of the consequences of the ongoing transformation of the Polish economy. The main objective of the present study was to investigate the relationship between women's employment status and preterm delivery (PD) and/or small-for-gestational-age (SGA) infants, in Central Poland during the socio-economic transition. METHODS: The study population comprised 8% random sample of 2,080 women from the Lodz macro region who gave birth to a child during a one-year period (1996-1997). Based on the employment status, three groups were distinguished: the employed (n = 1238), the unemployed (n = 128)--women who lost their job before pregnancy (at least 12 months prior to delivery) and were actively seeking employment, and the housewives (n = 714). Women with chronic medical problems diagnosed before pregnancy were excluded from the study. RESULTS: The rates of preterm delivery were found to be 6.3%, 11.7% and 4.9%, respectively for the employed, unemployed, and housewives. After adjustment for age, marital status, education, maternal height, smoking, own apartment, presence of cervical insufficiency and uterine irritability, an excess risk of PD was observed among the unemployed women (OR = 1.92, 95% CI: 1.01-3.64). Unemployment was associated, though not significantly, with higher rates of SGA births. CONCLUSION: In Central Poland, the unemployed pregnant women are characterised by an excess risk of preterm delivery. The impact of unemployment on the community's health, which seems to be underestimated, should be given more consideration in the national and local policies for public health.

[Influence of environmental smoke exposure during pregnancy on umbilical blood flow velocity]. / Wplyw srodowiskowej ekspozycji na dym tytoniowy kobiet ciezarnych na przeplyw krwi w tetnicy pepowinowej.

Influence of environmental smoke exposure during pregnancy on umbilical blood flow velocity and newborns birthweight was assessed in prospective study among 116 pregnant women between 20 and 24 week of pregnancy. The main aim was to search for a possible correlation between cotinine, an effective marker of smoke exposure, and umbilical blood flow as measured by S/D, RI and PI ratios. This study shows a significant increase of systolic/diastolic velocity ratio of the umbilical artery according with increased cotinine levels, either for active or passive smokers. Increase of S/D ratio > 3.0 in umbilical artery in 20-24 week of pregnancy was negatively correlated with newborns birthweight. The results of this study suggest that active and passive smoking by pregnant women causes a direct increase in the vascular resistance of the placenta and contribute to the decreased of the newborns birthweight associated with smoking.

[The effect of environmental tobacco smoke on birthweight: a prospective study employing biomarkers of exposure]. / Wplyw srodowiskowej ekspozycji kobiet ciezarnych na dym tytoniowy na mase urodzeniowa noworodka--badanie prospektywne z wykorzystaniem markerów ekspozycji.

The main goal of the project was to estimate the effect of environmental tobacco smoke (ETS) exposure on the birthweight. In a cohort of 196 pregnant women in 20-24 week of pregnancy the serum and urine cotinine levels were determined. The cohort included randomly selected pregnant patients of a maternity units in Lodz, Poland. To assess a 24 h exposure to ETS preceding the day of examination, both serum and urine cotinine measurements were applied. A statistically significant relationship was found between serum cotinine concentration and brithweight. The newborns of nonsmoking mothers whose serum cotinine levels were characteristic for passive smoking (2-25 ng/ml) had their birthweight lower by an average of 30 g, compared to those of women who were not exposed to ETS (serum cotinine below 2 ng/ml). It was concluded that more effective public health measures should be undertaken to ensure a tobacco smoke-free environment for pregnant women. Until this goal is achieved, pregnant women should be informed about health risks from ETS exposure so that they would avoid it both at home and workplace.

[Evaluation of the effectiveness of a low-dose aspirin in the treatment of intrauterine growth retardation (IUGR)]. / Ocena skutecznosci leczenia hipotrofii plodu przy uzyciu malych dawek kwasu acetylosalicylowego.

OBJECTIVE: To evaluate the benefits of IUGR treatment by low doses of acetylsalicylic acid (ASA) (1.5 mg/kg) compared to the standard method. The study was based on the reports that aspirin at low doses shifts prostacyclin/tromboxan A2 balance to the dominance of prostacyclin by inhibiting cyclooxygenase activity in platelets, which results in the improvement of the utero-placental circulation. MATERIAL AND METHOD: 31 pregnant women with diagnosed fetal IUGR were randomly assigned to two groups, receiving either low-dose ASA (n = 22) or the standard treatment (Sadamin, Partusisten, glucose i.v., amino acids i.v.) for 10 days. Ultrasound examination of the biometric parameters of the fetus (BPD, AC, FL) was performed and estimated fetal weight (EFW) calculated before and after treatment. The birthweight of infants in the two examined groups was compared. RESULTS: The mean increase in EFW was higher in the aspirin-treated group compared to that receiving standard treatment (478 g vs 246 g, p < 0.05). In all the biometric parameters under study a higher increase was noted in the group with aspirin treatment; however, the difference was not statistically significant. The mean birthweight was found to be higher in the ASA group as well (2856 g vs 2511 g). The frequency of small-for-gestational-age (SGA) infants (birth weight below 10th percentile) was lower in the ASA group than in the controls (27% vs 55%). The low-dose aspirin therapy did not produce any adverse side-effects either among mothers of infants. CONCLUSION: The treatment with low doses of aspirin reduces the proportion of SGA babies and increases birthweight in the case of a diagnosed fetal growth retardation. Since the number of subjects in this study was relatively small, further clinical trials are necessary to evaluate the effectiveness of IUGR treatment by low-dose aspirin.

Heavy physical work during pregnancy--a risk factor for small-for-gestational-age babies in Poland.

BACKGROUND: Heavy physical work is still considered one of the most prevalent risk factors of negative pregnancy outcome. The present study was undertaken to evaluate the impact of heavy physical work during pregnancy, based on subjective assessment of workload, on the risk of delivering a small-for-gestational-age (SGA) baby. METHODS: Job characteristics were compiled for 1,064 working women from the Lódz region (8% population sample) based on questionnaire responses. Energy expenditure during daily work was estimated. SGA was diagnosed when the birth weight was below the 10th percentile of the standard curves for central Poland. The SGA group comprised 78 women who delivered SGA babies, while the non-SGA group consisted of 986 women with eutrophic newborns. RESULTS: An excessive risk of SGA was found in the group reporting heavy physical effort at work. The physical effort perceived as heavy by pregnant women appeared to be a better predictor of SGA manifestation than the estimated energy expenditure at work. CONCLUSIONS: The information obtained from a pregnant worker should constitute an essential decisive factor for determining the time of work cessation during pregnancy.

Passive smoking and pregnancy outcome in central Poland.

1. The present investigation was undertaken to evaluate the effect of environmental tobacco smoke (ETS) on the risk of preterm delivery (PD) and small-for-gestational age (SGA) infants in a female non-smoking population of central Poland. 2. The study group were 1751 women classified as non-smokers in the comprehensive project on 'Socio-economic and environmental risk factors of preterm delivery and small-for-gestationaI-age babies in central Poland' conducted on a randomly selected population of 2080 women who gave birth to a child between June 1, 1996 and May 31, 1997. The PD group comprised 95 non-smoking women who delivered before 37 weeks of pregnancy and the SGA group included 111 non-smoking mothers of babies with birthweight below the 10th percentile of the standard curves for central Poland. Passive exposure to tobacco smoke was determined based on a structured interview. 3. In the stepwise multiple logistic regression model maternal passive smoke exposure lasting 7 h or more was found to be a significant risk factor for preterm delivery. No significant effect of passive smoking on the risk of SGA was observed. 4. The information about the adverse effects of ETS exposure on pregnancy duration and outcome should be incorporated in the health promotion programmes for women.

Risk factors of intrauterine growth retardation: a study of an urban population in Poland.

The main objective of the study was to examine the role of selected socio-occupational factors on the development of intrauterine growth retardation (IUGR) in the urban population of Lódz, Poland. An epidemiological model of the case-control study was employed. Both the cases and controls were recruited from the female population covered by obstetric services in district hospitals during 1 January-30 June 1992. A group of cases included 92 females who delivered IUGR children, the control group-438 mothers of term born eutrophic babies. The presence of the relationship between IUGR manifestation and selected variables was initially assessed using the unadjusted odds ratio (OR). The variables described as significant were considered in the logistic regressions models, separately for all women and those with previous pregnancies. A comparison of the groups of cases and controls has revealed a significant excess of risk of delivering an IUGR child by mothers with the following characteristics: marital status-single, low educational level, low height (less than 1.60 m) low prepregnancy weight and low maternal weight gain. An elevated risk of delivering an IUGR child was found in the group of women who reported to have their first contact with the physician after 12 weeks of pregnancy. An adverse effect of prolonged vaginal bleeding was observed. Women who recently lost their job, compared to those employed continuously during pregnancy, were at an increased risk of IUGR. Cigarette smoking appeared to be the most important variable affecting the evaluated pregnancy outcome. For the women smoking 6-10 and more than 10 cigarettes a day, the risk of delivering an IUGR child was found to be almost 4 and 7 times, respectively, higher than for non-smokers. A logistic regression covering all the above mentioned maternal characteristics was employed. Only four of them proved to be significant: low maternal weight gain, prolonged vaginal bleeding, smoking and the marital status-single. The process of preventing IUGR and its consequences requires more effective activities aimed at increasing the level of health education and stimulating the development of appropriate, health-oriented behaviour.

[Ovarian teratomas: some clinical and statistical factors based on 456 patients operated on in the Institute of Gynecology and Obstetrics Academy of Medicine in Lodz]. / Potworniaki jajników: niektóre wspólczynniki kliniczno-statystyczne w oparciu o dane u 456 chorych operowanych w Instytucie Ginekologii i Poloznictwa Akademii Medycznej w Lodzi.

In the years 1977-1994 456 cases of teratomas located in one ovary and 47 in two ovaries were diagnosed. 88,8% of patients were between 16 and 50 years old, with the peak of occurrence between 25 and 30 years. In 5% malignant teratomas were diagnosed.

[Tobacco smoking--a risk factor for intrauterine growth retardation, preterm delivery and low birth weight]. / Palenie tytoniu--czynnik ryzyka hipotrofii plodu, porodu przedwczesnego i malej masy urodzeniowej.

The risk of intrauterine growth retardation (IUGR) and preterm delivery, in the group of 551 females from the area of Lódz, was related to the amount of cigarettes smoked per day. In subjects smoking more than 20 cigarettes, the risk of IUGR and preterm delivery was five times as high as in the nonsmoking females. The average weight of the newborns was found to be 510 g lower in the group of the most heavy smokers as compared with the nonsmoking subjects. The study has not provided any clear evidence for the pre-pregnancy smoking and the passive smoking as the risk factors for the pathologies under study.

[The role of tobacco smoking as a risk factor for intrauterine growth retardation and preterm delivery]. / Rola palenia tytoniu jako cyznnika ryzyka hipotrofii plodu i porodu przedwczesnego.

The risk of intrauterine growth retardation (IUGR) and preterm delivery, in the group of 551 females from the area of Lódz, was related to the amount of cigarettes smoked per day. In subjects smoking 1-20 cigarettes a day, the risk of IUGR and preterm delivery was three times as high as in the nonsmoking females. The study has not provided any clear evidence for the prepregnancy smoking and the passive smoking as the risk factors for the pathologies under study.

[Social-occupational risk factors for fetal growth retardation and preterm birth. I. Role of occupational and non-occupational work]. / Spoleczno-zawodowe czynniki ryzyka hipotrofii plodu i porodu przedwczesnego. I. Rola pracy zawodowej i pozazawodowej.

Clinical and control examinations were performed in order to assess the effect of certain demographic, social and occupational factors on a relative risk for fetus hypotrophia and preterm birth. Two groups of cases were distinguished: mothers of hypotrophic children (72 women) and mothers of eutrophic premature babies (41 women). The control group was composed of women who had given birth to eutrophic babies (438 persons). An analysis of individual variables indicated the following risk factors for preterm birth: mother's age over 35 years, unmarried status of mothers, a low level of education; while unmarried status increased the risk for fetus hypotrophia. Only a half of women under study worked when pregnant, and no relationship between working during pregnancy and increased risk for the pathologies discussed, were found. An aggravated risk for preterm birth in women overloaded with housekeeping duties was noted. This observation applied, in particular, to women who had not been working occupationally during pregnancy. Bearing in mind a multifactorial etiology of fetus hypotrophia and preterm birth, in the authors' opinion it would be useful to analyse an unrelated effect of individual risk factors with concomitant control of confounding factors.

[Social-occupational risk factors for fetal growth retardation and preterm birth. II. An analysis of the independent effect of variables under study]. / Spoleczno-zawodowe czynniki ryzyka hipotrofii plodu i porodu przedwczesnego. II. Analiza niezaleznego wplywu analizowanych zmiennych.

In the study covering 551 female inhabitants of Lodz, a model for clinical and control examinations was used in order to identify risk factors (estimated by means of odds ratio) for fetus hypotrophia and preterm birth. Logistic regression was employed to determine independent variables and those contributing directly to the occurrence of both pathologies. The following risk factors for preterm birth and fetus hypotrophia were identified: smoking during pregnancy, bleeding in more than one trimester of pregnancy and low weight gain by mothers during pregnancy. Late reporting to a doctor, uterus cervical insufficiency, recent loss of the job, excessive responsibility for the management of household affairs and premature baby or a baby with low birth weight as an outcome of the previous pregnancy were proved to be specific risk factors responsible for preterm birth, while marital status, namely single young mothers, and short stature of mothers were responsible for fetus hypotrophia. The results obtained did not provide the basis for drawing a conclusion that work during pregnancy exerted an adverse effects and contributed to the magnitude of the analysed obstetric pathologies. Nevertheless, risk factors identified should be taken into account in the planning of mother and child care. The authors stress the need for taking further steps to eliminate, wherever possible, the aforesaid risk factors.