The behaviour of the peripheral natural killer cells in the foetal growth restriction.

AIM: To study the behaviour of the peripheral lymphocyte subsets in foetuses affected by growth restriction. PATIENTS AND METHODS: Thirty consecutive pregnant women with an ultrasound diagnosis of foetal growth restriction were included in this study (group A) while 30 women with a physiologic pregnancy were recruited as control group (group B). The diagnosis was performed during the ultrasound of the third trimester and confirmed at birth. Blood samples were drawn after the ultrasound of the third trimester for all patients. The analyzed populations were: WBC, total lymphocytes, CD2+, CD3+, CD4+, CD5+, CD8+, CD19+, CD56+, HLA-DR+, CD45+, CD3+HLA-DR+, CD4+CD3+, CD3+CD8+, CD2+CD56+, CD19+CD5+, ratio (CD4+CD3+)/(CD3+CD8+). RESULTS: The percentage and absolute value of the NK cells was higher in the group A [(20.90 vs. 15.09)%, p = 0.0005; (419.55 vs. 341.40) UI/µl, p = 0.0005]. This trend was confirmed by the CD2+CD56+ natural killer (NK) subset [(18.84 vs. 13.42) UI/µl, p = 0.0005]. Instead, the CD4+ percentage value was lower in the group A [(41.15 vs. 44.84)%, p = 0.03] through the CD4+CD3+/CD3+CD8+ ratio was not significantly different. CONCLUSIONS: Our findings reinforce the concept of pregnancy as a controlled systemic inflammatory state that if altered can have adverse consequences for the mother and the foetus.

Low dose of betamethasone throughout the whole course of pregnancy and fetal growth: a clinical study.

AIM: To assess the eventual influence of low dose betamethasone throughout pregnancy on fetal growth. PATIENTS AND METHODS: 320 patients - admitted to the Section of Obstetrics and Gynecology of Ferrara University from January 2005 to December 2010 - were subdivided in two groups: 160 patients affected by recurrent spontaneous abortion (Group A), treated by low dose of betamethasone (0.5 mg/daily) throughout pregnancy for preventive purposes, 160 patients with physiological pregnancy as control group (Group B). Primary measured outcomes were neonatal biometric parameters such as birth weight, head circumference and neonatal length. Unpaired t-test was used to compare the neonatal biometric parameters. RESULTS: Birth weight, length and circumference head resulted significantly lower in groups treated by GCs. However, excluding bias as pregnancy complicated by diseases, which could affect fetal growth, biometric neonatal parameters were not different between two groups. Furthermore, analyzing the distribution of the value of birth weight we observed that in the group A there were 44 newborns with a weight even higher than fiftieth percentile. CONCLUSIONS: Betamethasone seems not to influence fetal growth. Our analysis demonstrates that fetal growth is influenced by several factors, therefore, homogeneous study population is essential to have convincing results.