Preeclampsia is associated with over-activation of the innate immune system in the placenta,in which toll-like receptor 4（TLR4） plays an essential part.With their potent anti-inflammatory effects,statins have been s...Preeclampsia is associated with over-activation of the innate immune system in the placenta,in which toll-like receptor 4（TLR4） plays an essential part.With their potent anti-inflammatory effects,statins have been suggested as potential prevention or treatment of preeclampsia,although evidence remains inadequate.Herewith,we investigated whether pravastatin could ameliorate preeclampsia-like phenotypes in a previously established lipopolysaccharide（LPS）-induced rat preeclampsia model,through targeting the TLR4/NF-κB pathway.The results showed that pravastatin reduced the blood pressure [maximum decline on gestational day（GD） 12,（101.33±2.49） mmHg vs.（118.3±1.37） mmHg,P〈0.05] and urine protein level [maximum decline on GD9,（3,726.23± 1,572.86） μg vs.（1,991.03 ±609.37）μg,P〈 0.05],which were elevated following LPS administration.Pravastatin also significantly reduced the rate of fetal growth restriction in LPS-treated rats（34.10% vs.8.99%,P〈0.05）.Further pathological analyses suggested a restoration of normal spiral artery remodeling in preeclampsia rats by pravastatin treatment.These effects of pravastatin were associated with decreased TLR4/NF-κB protein levels in the placenta and IL-6/MCP-1 levels in serum.Additionally,no obvious abnormalities in fetal liver,brain,and kidney were found after administration of pravastatin.These results provide supportive evidence for use of pravastatin in preventing preeclampsia.展开更多
Amoxicillin,a widely used antibiotic in human and veterinary pharmaceuticals,is now considered as an“emerging contaminant”because it exists widespreadly in the environment and brings a series of adverse outcomes.Cur...Amoxicillin,a widely used antibiotic in human and veterinary pharmaceuticals,is now considered as an“emerging contaminant”because it exists widespreadly in the environment and brings a series of adverse outcomes.Currently,systematic studies about the developmental toxicity of amoxicillin are still lacking.We explored the potential effects of amoxicillin exposure on pregnancy outcomes,maternal/fetal serum phenotypes,and fetal multiple organ development in mice,at different doses(75,150,300 mg/(kg·day))during late-pregnancy,or at a dose of 300 mg/(kg·day)during different stages(mid-/latepregnancy)and courses(single-/multi-course).Results showed that prenatal amoxicillin exposure(PAmE)had no significant infuence on the body weights of dams,but it could inhibit the physical development and reduce the survival rate of fetuses,especially during the midpregnancy.Meanwhile,PAmE altered multiple maternal/fetal serum phenotypes,especially in fetuses.Fetal multi-organ function results showed that PAmE inhibited testicular/adrenal steroid synthesis,long bone/cartilage and hippocampal development,and enhanced ovarian steroid synthesis and hepatic glycogenesis/lipogenesis,and the order of severity might be gonad(testis,ovary)>liver>others.Further analysis found that PAmE-induced multiorgan developmental and functional alterations had differences in stages,courses and fetal gender,and the most obvious changes might be in high-dose,late-pregnancy and multicourse,but there was no typical rule of a dose-response relationship.In conclusion,this study confirmed that PAmE could cause abnormal development and multi-organ function alterations,which deepens our understanding of the risk of PAmE and provides an experimental basis for further exploration of the long-term harm.展开更多
Maternal health during pregnancy has a direct impact on the risk and severity of neurodevelopmental disorders(NDDs)in the offspring,especially in the case of drug exposure.However,little progress has been made to asse...Maternal health during pregnancy has a direct impact on the risk and severity of neurodevelopmental disorders(NDDs)in the offspring,especially in the case of drug exposure.However,little progress has been made to assess the risk of drug exposure during pregnancy due to ethical constraints and drug use factors.We collected and manually curated sub-pathways and pathways(sub-/pathways)and drug information to propose an analytical framework for predicting drug candidates.This framework linked sub-/pathway activity and drug response scores derived from gene transcription data and was applied to human fetal brain development and six NDDs.Further,specific and pleiotropic sub-/pathways/drugs were identified using entropy,and sex bias was analyzed in conjunction with logistic regression and random forest models.We identified 19 disorder-associated and 256 regionally pleiotropic and specific candidate drugs that targeted risk sub-/pathways in NDDs,showing temporal or spatial changes across fetal development.Moreover,5443 differential drug-sub-/pathways exhibited sex-biased differences after filling in the gender labels.A user-friendly NDDP visualization website(https://ndd-lab.shinyapps.io/NDDP)was developed to allow researchers and clinicians to access and retrieve data easily.Our framework overcame data gaps and identified numerous pleiotropic and specific candidates across six disorders and fetal developmental trajectories.This could significantly contribute to drug discovery during pregnancy and can be applied to a wide range of traits.展开更多
<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal...<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. </span><b><span style="font-family:Verdana;">Methods:</span> </b><span style="font-family:Verdana;">A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. </span><b><span style="font-family:Verdana;">Results:</span> </b><span style="font-family:Verdana;">Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). </span><b><span style="font-family:Verdana;">Conclusion:</span> </b><span style="font-family:Verdana;">This study demonstrates that all children being considered for placement in foster care or residential should be screened for FASD.</span></span>展开更多
Nonalcoholic fatty liver disease(NAFLD)has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic.Evidence shows that prenatal and postnatal exposure to maternal...Nonalcoholic fatty liver disease(NAFLD)has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic.Evidence shows that prenatal and postnatal exposure to maternal abnormalities leads to a higher risk of pediatric NAFLD through persistent alterations in developmental programming.Gestational diabetes mellitus(GDM)is a hyperglycemic syndrome which has become the most prevalent complication in pregnant women.An increasing number of both epidemiologic investigations and animal model studies have validated adverse and long-term outcomes in offspring following GDM exposure in utero.Similarly,GDM is considered a crucial risk factor for pediatric NAFLD.This review aimed to summarize currently published studies concerning the inductive roles of GDM in offspring NAFLD de velopment during childhood and adolescence.Dysregulations in hepatic lipid metabolism and gut microbiota in offspring,as well as dysfunctions in the placenta are potential factors in the pathogenesis of GDM-associated pediatric NAFLD.In addition,potentially effective interventions for GDM-associated offspring NAFLD are also discussed in this review.However,most of these therapeutic approaches still require further clinical research for validation.展开更多
Background: In recent decades, there has been a growing interest in the impact of insults during pregnancy on postnatal health and disease. It is known that changes in placental development can impact fetal growth and...Background: In recent decades, there has been a growing interest in the impact of insults during pregnancy on postnatal health and disease. It is known that changes in placental development can impact fetal growth and subsequent susceptibility to adult onset diseases;however, a method to collect sufficient placental tissues for both histological and gene expression analyses during gestation without compromising the pregnancy has not been described. The ewe is an established biomedical model for the study of fetal development. Due to its cotyledonary placental type, the sheep has potential for surgical removal of materno-fetal exchange tissues, i.e., placentomes. A novel surgical procedure was developed in well-fed control ewes to excise a single placentome at mid-gestation.Results: A follow-up study was performed in a cohort of nutrient-restricted ewes to investigate rapid placental changes in response to undernutrition. The surgery averaged 19 min, and there were no viability differences between control and sham ewes. Nutrient restricted fetuses were smaller than controls(4.7 ± 0.1 kg vs. 5.6 ± 0.2 kg;P < 0.05), with greater dam weight loss(-32.4 ± 1.3 kg vs. 14.2 ± 2.2 kg;P < 0.01), and smaller placentomes at necropsy(5.7 ± 0.3 g vs. 7.2 ± 0.9 g;P < 0.05). Weight of sampled placentomes and placentome numbers did not differ.Conclusions: With this technique, gestational studies in the sheep model will provide insight into the onset and complexity of changes in gene expression in placentomes resulting from undernutrition(as described in our study),overnutrition, alcohol or substance abuse, and environmental or disease factors of relevance and concern regarding the reproductive health and developmental origins of health and disease in humans and in animals.展开更多
To investigate the effect of placental isoferritin （PLF） on mouse embryo development in vitro, mice 2-cell embryos were co-cultured with human first trimester decidual cells at different concentrations of PLF in vit...To investigate the effect of placental isoferritin （PLF） on mouse embryo development in vitro, mice 2-cell embryos were co-cultured with human first trimester decidual cells at different concentrations of PLF in vitro. The following changes of the above system were observed under an invert microscope and the number of embryos were recorded and the embryos were classified. The results showed there was no significant difference in the percentage of embryos development to 4-cell 8-cell and morula （P〉0.05）. PLF at the doses of 10 and 100 U/mL significantly enhanced more embryos development to the blastocyst and hatching blastocyst （P〈0.05）. PLF at the dose of 1000 U/mL depressed more embryos development from 2-cell to hatching blastocyst, meanwhile such phenomena as cell degeneration and irregular cleavage were observed in part of embryos, but there was no significant difference in statistics （P〉0.05）. It was concluded that PLF at the concentration of 10-- 100 U/mL had no significant effects on the early development of mice embryos, however, PLF could promote the growth, differentiation, and hatching of preimplantion blastocysts.展开更多
There is consistent epidemiological evidence linking low birth weight, preterm birth and adverse fetal growth to an elevated risk of the metabolic syndrome (obesity, raised blood pressure, raised serum triglycerides, ...There is consistent epidemiological evidence linking low birth weight, preterm birth and adverse fetal growth to an elevated risk of the metabolic syndrome (obesity, raised blood pressure, raised serum triglycerides, lowered serum high-density lipoprotein cholesterol and impaired glucose tolerance or insulin resistance) and related disorders. This "fetal or developmental origins/programming of disease" concept is now well accepted but the "programming" mechanisms remain poorly understood. We reviewed the major evidence, implications and limitations of current hypotheses in interpreting developmental programming and discuss future research directions. Major current hypotheses to interpret developmental programming include: (1)thrifty phenotype; (2) postnatal accelerated or catchup growth; (3) glucocorticoid effects; (4) epigenetic changes; (5) oxidative stress; (6) prenatal hypoxia; (7) placental dysfunction; and (8) reduced stem cell number. Some hypothetical mechanisms (2, 4 and 8) could be driven by other upstream "driver" mechanisms. There is a lack of animal studies addressing multiple mechanisms simultaneously and a lack of strong evidence linking clinical outcomes to biomarkers of the proposed programming mechanisms in humans. There are needs for (1) experimental studies addressing multiple hypothetical mechanisms simultaneously; and (2) prospective pregnancy cohort studies linking biomarkers of the proposed mechanisms to clinical outcomes or surrogate biomarker endpoints. A better understanding of the programming mechanisms is a prerequisite for developing early life interventions to arrest the increasing epidemic of the metabolic syndrome, type 2 diabetes and other related disorders.展开更多
Purpose: To investigate the relationship between preterm delivery and developmental outcomes in children born at 34 - 36 weeks of gestation (late preterm period). Methods: This study reviewed the cases of singleton la...Purpose: To investigate the relationship between preterm delivery and developmental outcomes in children born at 34 - 36 weeks of gestation (late preterm period). Methods: This study reviewed the cases of singleton late preterm children and full-term (38 - 40 weeks of gestation) children born at Showa University Hospital. The developmental outcomes at 3 years of age were assessed based on the results of questionnaires sent to the families by mail. In addition, the incidence of developmental delays was compared between the late preterm and full-term children. In the full-term control group, perinatal characteristics (neonatal gender, Apgar score, Cesarean delivery, birth weight < 10th percentile, birth weight < 3rd percentile) were matched with those of the late preterm cases. We compared categorical variables using Fisher’s exact test. For variables with a non-normal distribution, Welch’s t-test was applied. A p-value of <0.05 was considered to be statistically significant. Results: The rate of return of the questionnaires was 25.9% (121) among the cases and 25.8% (163) among the controls. The frequency of developmental delays was 6.6% among the cases, compared with 4.3% among the controls. Conclusions: Matching the perinatal characteristics of the subjects, the frequency of developmental delays was similar between the two groups.展开更多
Pregnancy in women with lupus,particularly those with lupus nephritis(LN),carries an increased risk of adverse outcomes.Women with active LN at the time of conception are at a high risk of poor maternal and fetal outc...Pregnancy in women with lupus,particularly those with lupus nephritis(LN),carries an increased risk of adverse outcomes.Women with active LN at the time of conception are at a high risk of poor maternal and fetal outcomes.Recent studies indicate that even in the presence of quiescent disease,factors such as hypertension and positive lupus anticoagulant are predictors of worse pregnancy outcomes.Consequently,pre-conception evaluation is essential to ensure that pursuing pregnancy is safe and timely,and to facilitate proper planning for optimizing medical regimens,discontinuing teratogenic agents,and treating active disease.Additionally,pre-existing LN is associated with higher rates of preeclampsia and hemolysis,elevated liver enzymes,and low platelet count syndrome.Women with lupus and prior LN can have successful pregnancies,but a multidisciplinary approach with close monitoring is essential for optimal outcomes.By systematically reviewing the available evidence,this narrative review aims to provide a comprehensive update on the complex interaction between LN and pregnancy,offering insights to guide clinical practice and future research in this field.展开更多
目的探究分析婴幼儿发育性髋关节发育不良(DDH)的危险因素。方法回顾性分析本院在2022年1月至2024年3月收治的166例可疑DDH婴幼儿的病历资料,按不同月龄选择不同的影像学检查:即0~6月婴幼儿采取Graf法超声检查;≥7月婴幼儿采用X线检查...目的探究分析婴幼儿发育性髋关节发育不良(DDH)的危险因素。方法回顾性分析本院在2022年1月至2024年3月收治的166例可疑DDH婴幼儿的病历资料,按不同月龄选择不同的影像学检查:即0~6月婴幼儿采取Graf法超声检查;≥7月婴幼儿采用X线检查。根据影像学诊断结果,将研究对象分为髋关节发育不良阳性组与阴性组,其中阳性组73例,阴性组93例,收集2组资料,并采用多因素广义线性回归分析法(Logistic)分析婴幼儿DDH的危险因素。结果阳性组患儿的性别、家族遗传史、臀位、羊水量<300 mL、头胎、多胎、传统襁褓、首检月龄、髋关节弹响、肌性斜颈例数均多于阴性组,差异有统计学意义(P<0.05);多因素Logistic分析,女性、有家族遗传史、臀位、羊水量<300 m L、头胎、多胎、有传统襁褓史、首检月龄≥3个月、有髋关节弹响、有肌性斜颈情况是婴幼儿DDH的危险因素(P<0.05)。结论婴幼儿是女性、有家族遗传史、臀位、羊水量<300 mL、头胎、多胎、有传统襁褓史、首检月龄≥3个月以及检查合并有髋关节弹响、肌性斜颈情况可能会出现DDH,针对各影响因素为降低婴幼儿DDH发生提供参考。展开更多
基于生活环境、健康和疾病在分子水平上密切相关的核心理念,健康和疾病的发育起源(developmental origins of health and disease,DOHaD)理论为健康与疾病间的关联研究提供了全新视角。该理论通过多学科、多领域的知识互通,追溯不同的...基于生活环境、健康和疾病在分子水平上密切相关的核心理念,健康和疾病的发育起源(developmental origins of health and disease,DOHaD)理论为健康与疾病间的关联研究提供了全新视角。该理论通过多学科、多领域的知识互通,追溯不同的生活经历如何影响生命全过程中的健康和疾病风险。成人期疾病的敏感窗口期不再局限于妊娠前和妊娠期,分娩期至成年早期也成为暴露因素发挥作用的重要时段。母源性/父源性因素、环境因素、新生儿出生状况、儿童期代谢情况等能够通过影响表观遗传、代谢和免疫调控、氧化应激等,改变发育程序并对子代远期健康产生正向或负向影响。因此,为实现健康促进,需要同步推进早期生命阶段预防、后期随访及健康干预的关口前移,以期有效降低成年期疾病风险,提升生命全周期健康水平。综述DOHaD领域最新研究进展对阐明人类发展早期阶段发生的不良事件影响健康和疾病模式及发现有效干预措施具有积极意义。展开更多
目的评价新橙皮苷对大鼠胚胎-胎仔发育的毒性。方法妊娠大鼠根据妊娠第0天(gestation day 0,GD0)和体质量采用分层随机法分成5组:对照(0.5%羧甲基纤维素钠)组,环磷酰胺(12 mg·kg^(-1))组,新橙皮苷低、中、高(0.45,0.9,1.8g·kg...目的评价新橙皮苷对大鼠胚胎-胎仔发育的毒性。方法妊娠大鼠根据妊娠第0天(gestation day 0,GD0)和体质量采用分层随机法分成5组:对照(0.5%羧甲基纤维素钠)组,环磷酰胺(12 mg·kg^(-1))组,新橙皮苷低、中、高(0.45,0.9,1.8g·kg^(-1))3个剂量组。妊娠鼠于GD6开始给药至GD15。实验期间,每周至少测定2次体质量和1次摄食量。GD20处死妊娠鼠,对黄体、着床腺、胎仔、胎盘等情况进行检查。结果试验期间,各组动物临床症状观察均未见明显异常。与对照组相比,新橙皮苷各剂量组动物体质量未见明显改变,环磷酰胺组动物增重减缓;新橙皮苷各剂量组黄体、着床、活胎、吸收胎、死胎计数均未见明显改变,环磷酰胺组子宫重量下降;新橙皮苷高剂量组胎仔身长降低,环磷酰胺组身长、尾长、重量及胎盘重均降低;新橙皮苷各剂量组胎仔外观检查未见给药相关改变,环磷酰胺组主要可见全身浮肿、头、耳、面、肢、指趾等改变。胎仔内脏检查中,新橙皮苷各剂量组分别可见1例脑室改变,中、高剂量组分别可见2例和1例食管扩张;环磷酰胺组可见腭、脑室、食管、睾丸附睾等改变。骨骼检查中,新橙皮苷可延缓顶骨、胸骨的骨化,可能影响下颌骨、颈椎、腰椎、耻骨、枕骨和肋骨的骨化。环磷酰胺12mg·kg^(-1)对颅骨、脊椎骨、肋骨、胸骨、掌骨等的骨化均有所影响。结论新橙皮苷给药后,对母体未产生明显毒性反应,未观察到临床不良反应的剂量水平(NOAEL)为1.8 g·kg^(-1);对胚胎-胎仔的发育毒性主要表现为延缓骨骼如顶骨、胸骨等的骨化外,还可能影响脑部和食管的发育,NOAEL<0.45 g·kg^(-1)。展开更多
基金funded by the following Grants:National Natural Science Foundation of China,Grant/Award Number:81370724,81571463 and 81401225Innovative Research Program for Postgraduate in Higher Education Institutions of Jiangsu Province for the year 2016,Grant/Award Number:KYLX16_1111
文摘Preeclampsia is associated with over-activation of the innate immune system in the placenta,in which toll-like receptor 4（TLR4） plays an essential part.With their potent anti-inflammatory effects,statins have been suggested as potential prevention or treatment of preeclampsia,although evidence remains inadequate.Herewith,we investigated whether pravastatin could ameliorate preeclampsia-like phenotypes in a previously established lipopolysaccharide（LPS）-induced rat preeclampsia model,through targeting the TLR4/NF-κB pathway.The results showed that pravastatin reduced the blood pressure [maximum decline on gestational day（GD） 12,（101.33±2.49） mmHg vs.（118.3±1.37） mmHg,P〈0.05] and urine protein level [maximum decline on GD9,（3,726.23± 1,572.86） μg vs.（1,991.03 ±609.37）μg,P〈 0.05],which were elevated following LPS administration.Pravastatin also significantly reduced the rate of fetal growth restriction in LPS-treated rats（34.10% vs.8.99%,P〈0.05）.Further pathological analyses suggested a restoration of normal spiral artery remodeling in preeclampsia rats by pravastatin treatment.These effects of pravastatin were associated with decreased TLR4/NF-κB protein levels in the placenta and IL-6/MCP-1 levels in serum.Additionally,no obvious abnormalities in fetal liver,brain,and kidney were found after administration of pravastatin.These results provide supportive evidence for use of pravastatin in preventing preeclampsia.
基金supported by the National Key Research and Development Program of China (No.2020YFA0803900)。
文摘Amoxicillin,a widely used antibiotic in human and veterinary pharmaceuticals,is now considered as an“emerging contaminant”because it exists widespreadly in the environment and brings a series of adverse outcomes.Currently,systematic studies about the developmental toxicity of amoxicillin are still lacking.We explored the potential effects of amoxicillin exposure on pregnancy outcomes,maternal/fetal serum phenotypes,and fetal multiple organ development in mice,at different doses(75,150,300 mg/(kg·day))during late-pregnancy,or at a dose of 300 mg/(kg·day)during different stages(mid-/latepregnancy)and courses(single-/multi-course).Results showed that prenatal amoxicillin exposure(PAmE)had no significant infuence on the body weights of dams,but it could inhibit the physical development and reduce the survival rate of fetuses,especially during the midpregnancy.Meanwhile,PAmE altered multiple maternal/fetal serum phenotypes,especially in fetuses.Fetal multi-organ function results showed that PAmE inhibited testicular/adrenal steroid synthesis,long bone/cartilage and hippocampal development,and enhanced ovarian steroid synthesis and hepatic glycogenesis/lipogenesis,and the order of severity might be gonad(testis,ovary)>liver>others.Further analysis found that PAmE-induced multiorgan developmental and functional alterations had differences in stages,courses and fetal gender,and the most obvious changes might be in high-dose,late-pregnancy and multicourse,but there was no typical rule of a dose-response relationship.In conclusion,this study confirmed that PAmE could cause abnormal development and multi-organ function alterations,which deepens our understanding of the risk of PAmE and provides an experimental basis for further exploration of the long-term harm.
基金supported by the National Natural Science Foundation of China[81701350 and 31671252]the Health Technology Plan of Zhejiang Province[2023RC205].
文摘Maternal health during pregnancy has a direct impact on the risk and severity of neurodevelopmental disorders(NDDs)in the offspring,especially in the case of drug exposure.However,little progress has been made to assess the risk of drug exposure during pregnancy due to ethical constraints and drug use factors.We collected and manually curated sub-pathways and pathways(sub-/pathways)and drug information to propose an analytical framework for predicting drug candidates.This framework linked sub-/pathway activity and drug response scores derived from gene transcription data and was applied to human fetal brain development and six NDDs.Further,specific and pleiotropic sub-/pathways/drugs were identified using entropy,and sex bias was analyzed in conjunction with logistic regression and random forest models.We identified 19 disorder-associated and 256 regionally pleiotropic and specific candidate drugs that targeted risk sub-/pathways in NDDs,showing temporal or spatial changes across fetal development.Moreover,5443 differential drug-sub-/pathways exhibited sex-biased differences after filling in the gender labels.A user-friendly NDDP visualization website(https://ndd-lab.shinyapps.io/NDDP)was developed to allow researchers and clinicians to access and retrieve data easily.Our framework overcame data gaps and identified numerous pleiotropic and specific candidates across six disorders and fetal developmental trajectories.This could significantly contribute to drug discovery during pregnancy and can be applied to a wide range of traits.
文摘<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. </span><b><span style="font-family:Verdana;">Methods:</span> </b><span style="font-family:Verdana;">A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. </span><b><span style="font-family:Verdana;">Results:</span> </b><span style="font-family:Verdana;">Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). </span><b><span style="font-family:Verdana;">Conclusion:</span> </b><span style="font-family:Verdana;">This study demonstrates that all children being considered for placement in foster care or residential should be screened for FASD.</span></span>
基金supported by grants from the National Nat-ural Science Foundation of China(82170593)National Key R&D Program of China(2021YFC2700802)Collaborative Innovation Program of Shanghai Municipal Health Commission(2020CXJQ01)。
文摘Nonalcoholic fatty liver disease(NAFLD)has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic.Evidence shows that prenatal and postnatal exposure to maternal abnormalities leads to a higher risk of pediatric NAFLD through persistent alterations in developmental programming.Gestational diabetes mellitus(GDM)is a hyperglycemic syndrome which has become the most prevalent complication in pregnant women.An increasing number of both epidemiologic investigations and animal model studies have validated adverse and long-term outcomes in offspring following GDM exposure in utero.Similarly,GDM is considered a crucial risk factor for pediatric NAFLD.This review aimed to summarize currently published studies concerning the inductive roles of GDM in offspring NAFLD de velopment during childhood and adolescence.Dysregulations in hepatic lipid metabolism and gut microbiota in offspring,as well as dysfunctions in the placenta are potential factors in the pathogenesis of GDM-associated pediatric NAFLD.In addition,potentially effective interventions for GDM-associated offspring NAFLD are also discussed in this review.However,most of these therapeutic approaches still require further clinical research for validation.
文摘Background: In recent decades, there has been a growing interest in the impact of insults during pregnancy on postnatal health and disease. It is known that changes in placental development can impact fetal growth and subsequent susceptibility to adult onset diseases;however, a method to collect sufficient placental tissues for both histological and gene expression analyses during gestation without compromising the pregnancy has not been described. The ewe is an established biomedical model for the study of fetal development. Due to its cotyledonary placental type, the sheep has potential for surgical removal of materno-fetal exchange tissues, i.e., placentomes. A novel surgical procedure was developed in well-fed control ewes to excise a single placentome at mid-gestation.Results: A follow-up study was performed in a cohort of nutrient-restricted ewes to investigate rapid placental changes in response to undernutrition. The surgery averaged 19 min, and there were no viability differences between control and sham ewes. Nutrient restricted fetuses were smaller than controls(4.7 ± 0.1 kg vs. 5.6 ± 0.2 kg;P < 0.05), with greater dam weight loss(-32.4 ± 1.3 kg vs. 14.2 ± 2.2 kg;P < 0.01), and smaller placentomes at necropsy(5.7 ± 0.3 g vs. 7.2 ± 0.9 g;P < 0.05). Weight of sampled placentomes and placentome numbers did not differ.Conclusions: With this technique, gestational studies in the sheep model will provide insight into the onset and complexity of changes in gene expression in placentomes resulting from undernutrition(as described in our study),overnutrition, alcohol or substance abuse, and environmental or disease factors of relevance and concern regarding the reproductive health and developmental origins of health and disease in humans and in animals.
文摘To investigate the effect of placental isoferritin （PLF） on mouse embryo development in vitro, mice 2-cell embryos were co-cultured with human first trimester decidual cells at different concentrations of PLF in vitro. The following changes of the above system were observed under an invert microscope and the number of embryos were recorded and the embryos were classified. The results showed there was no significant difference in the percentage of embryos development to 4-cell 8-cell and morula （P〉0.05）. PLF at the doses of 10 and 100 U/mL significantly enhanced more embryos development to the blastocyst and hatching blastocyst （P〈0.05）. PLF at the dose of 1000 U/mL depressed more embryos development from 2-cell to hatching blastocyst, meanwhile such phenomena as cell degeneration and irregular cleavage were observed in part of embryos, but there was no significant difference in statistics （P〉0.05）. It was concluded that PLF at the concentration of 10-- 100 U/mL had no significant effects on the early development of mice embryos, however, PLF could promote the growth, differentiation, and hatching of preimplantion blastocysts.
基金Supported by a Research Grant from the Canadian Institutes of Health Research (CIHR), Institute of Nutrition, Metabolism and Diabetes (CIHR Grant # 79896 - Luo ZC)partly by a Clinical Epidemiology Junior Scholar Award from the Fonds de la Recherche en Santé du Québec (FRSQ) (Luo ZC)partly by a FRSQ Senior Scholar Award (Nuyt AM)
文摘There is consistent epidemiological evidence linking low birth weight, preterm birth and adverse fetal growth to an elevated risk of the metabolic syndrome (obesity, raised blood pressure, raised serum triglycerides, lowered serum high-density lipoprotein cholesterol and impaired glucose tolerance or insulin resistance) and related disorders. This "fetal or developmental origins/programming of disease" concept is now well accepted but the "programming" mechanisms remain poorly understood. We reviewed the major evidence, implications and limitations of current hypotheses in interpreting developmental programming and discuss future research directions. Major current hypotheses to interpret developmental programming include: (1)thrifty phenotype; (2) postnatal accelerated or catchup growth; (3) glucocorticoid effects; (4) epigenetic changes; (5) oxidative stress; (6) prenatal hypoxia; (7) placental dysfunction; and (8) reduced stem cell number. Some hypothetical mechanisms (2, 4 and 8) could be driven by other upstream "driver" mechanisms. There is a lack of animal studies addressing multiple mechanisms simultaneously and a lack of strong evidence linking clinical outcomes to biomarkers of the proposed programming mechanisms in humans. There are needs for (1) experimental studies addressing multiple hypothetical mechanisms simultaneously; and (2) prospective pregnancy cohort studies linking biomarkers of the proposed mechanisms to clinical outcomes or surrogate biomarker endpoints. A better understanding of the programming mechanisms is a prerequisite for developing early life interventions to arrest the increasing epidemic of the metabolic syndrome, type 2 diabetes and other related disorders.
文摘Purpose: To investigate the relationship between preterm delivery and developmental outcomes in children born at 34 - 36 weeks of gestation (late preterm period). Methods: This study reviewed the cases of singleton late preterm children and full-term (38 - 40 weeks of gestation) children born at Showa University Hospital. The developmental outcomes at 3 years of age were assessed based on the results of questionnaires sent to the families by mail. In addition, the incidence of developmental delays was compared between the late preterm and full-term children. In the full-term control group, perinatal characteristics (neonatal gender, Apgar score, Cesarean delivery, birth weight < 10th percentile, birth weight < 3rd percentile) were matched with those of the late preterm cases. We compared categorical variables using Fisher’s exact test. For variables with a non-normal distribution, Welch’s t-test was applied. A p-value of <0.05 was considered to be statistically significant. Results: The rate of return of the questionnaires was 25.9% (121) among the cases and 25.8% (163) among the controls. The frequency of developmental delays was 6.6% among the cases, compared with 4.3% among the controls. Conclusions: Matching the perinatal characteristics of the subjects, the frequency of developmental delays was similar between the two groups.
文摘Pregnancy in women with lupus,particularly those with lupus nephritis(LN),carries an increased risk of adverse outcomes.Women with active LN at the time of conception are at a high risk of poor maternal and fetal outcomes.Recent studies indicate that even in the presence of quiescent disease,factors such as hypertension and positive lupus anticoagulant are predictors of worse pregnancy outcomes.Consequently,pre-conception evaluation is essential to ensure that pursuing pregnancy is safe and timely,and to facilitate proper planning for optimizing medical regimens,discontinuing teratogenic agents,and treating active disease.Additionally,pre-existing LN is associated with higher rates of preeclampsia and hemolysis,elevated liver enzymes,and low platelet count syndrome.Women with lupus and prior LN can have successful pregnancies,but a multidisciplinary approach with close monitoring is essential for optimal outcomes.By systematically reviewing the available evidence,this narrative review aims to provide a comprehensive update on the complex interaction between LN and pregnancy,offering insights to guide clinical practice and future research in this field.
文摘目的探究分析婴幼儿发育性髋关节发育不良(DDH)的危险因素。方法回顾性分析本院在2022年1月至2024年3月收治的166例可疑DDH婴幼儿的病历资料,按不同月龄选择不同的影像学检查:即0~6月婴幼儿采取Graf法超声检查;≥7月婴幼儿采用X线检查。根据影像学诊断结果,将研究对象分为髋关节发育不良阳性组与阴性组,其中阳性组73例,阴性组93例,收集2组资料,并采用多因素广义线性回归分析法(Logistic)分析婴幼儿DDH的危险因素。结果阳性组患儿的性别、家族遗传史、臀位、羊水量<300 mL、头胎、多胎、传统襁褓、首检月龄、髋关节弹响、肌性斜颈例数均多于阴性组,差异有统计学意义(P<0.05);多因素Logistic分析,女性、有家族遗传史、臀位、羊水量<300 m L、头胎、多胎、有传统襁褓史、首检月龄≥3个月、有髋关节弹响、有肌性斜颈情况是婴幼儿DDH的危险因素(P<0.05)。结论婴幼儿是女性、有家族遗传史、臀位、羊水量<300 mL、头胎、多胎、有传统襁褓史、首检月龄≥3个月以及检查合并有髋关节弹响、肌性斜颈情况可能会出现DDH,针对各影响因素为降低婴幼儿DDH发生提供参考。
文摘基于生活环境、健康和疾病在分子水平上密切相关的核心理念,健康和疾病的发育起源(developmental origins of health and disease,DOHaD)理论为健康与疾病间的关联研究提供了全新视角。该理论通过多学科、多领域的知识互通,追溯不同的生活经历如何影响生命全过程中的健康和疾病风险。成人期疾病的敏感窗口期不再局限于妊娠前和妊娠期,分娩期至成年早期也成为暴露因素发挥作用的重要时段。母源性/父源性因素、环境因素、新生儿出生状况、儿童期代谢情况等能够通过影响表观遗传、代谢和免疫调控、氧化应激等,改变发育程序并对子代远期健康产生正向或负向影响。因此,为实现健康促进,需要同步推进早期生命阶段预防、后期随访及健康干预的关口前移,以期有效降低成年期疾病风险,提升生命全周期健康水平。综述DOHaD领域最新研究进展对阐明人类发展早期阶段发生的不良事件影响健康和疾病模式及发现有效干预措施具有积极意义。
