•Increase in the concentration of 8 proteins in the plasma of women with preeclampsia.•IFN-γ, IL-6, LIF, Hb-EGF, HGF, IP-10, leptin, PDGF-BB.•Significant decrease in the concentration of 3 proteins ...in the plasma of women with preeclampsia.•VEGF, PlGF and follistatin.
The aim of this study was to analyse a panel of 60 angiogenic factors (pro-angiogenic and antiangiogenic) in the plasma of women with mild preeclampsia.
We recruited 21 women between 25 and 40 weeks gestation with diagnosed mild preeclampsia into the study group and 27 healthy women with uncomplicated pregnancies of corresponding gestational age to that of the study to the control group. We used a quantitative protein macroarray method that allowed for analysis of 60 angiogenic proteins per sample simultaneously.
We showed a statistically significant increase in the concentration of 8 proteins, interferon gamma (IFN-γ), interleukin 6 (IL-6), leukaemia inhibitory factor (LIF), heparin-binding EGF-like growth factor (HB-EGF), hepatocyte growth factor (HGF), C-X-C motif chemokine 10 (IP-10), leptin and platelet-derived growth factor BB (PDGF-BB), as well as a significant decrease in the concentration of 3 proteins, vascular endothelial growth factor (VEGF), placental growth factor (PlGF) and follistatin, in the plasma of women with preeclampsia.
Based on our findings, it seems that protein factors may play an important role in the pathogenesis of preeclampsia, and there are many proteins that have not been studied in PE to date. There are no previous studies assessing the LIF, follistatin, HGF, HB-EGF and PDGF-BB concentrations in the plasma of women with PE; therefore, our obtained results indicate that these proteins are new factors that can play an important role in the pathomechanisms of PE.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The study was undertaken to analyze the course of pregnancy and delivery in women after previous cesarean section.
The study group consisted of 1272 pregnant women after one cesarean section, who ...delivered at the 1st Department of Gynecology and Obstetrics, Medical University of Lodz between 1st January 2007 and 31st December 2010.
Among patients after previous cesarean section, the most numerous group constituted women whose pregnancy was resolved with an elective repeat cesarean section, without the attempt to deliver vaginally - 58,96% whereas the remaining 41,04% of the women were qualified to make an attempt at vaginal delivery 48,28% of them succeeded to gave birth vaginally and 51,72% underwent repeat cesarean section.
Proper qualification of patients after previous caesarean section for a natural vaginal birth allows a successful vaginal delivery. A critical analysis of the indications for surgical delivery needs to be performed in order to lower the rate of cesarean sections.
Our previous study revealed that anti-inflammatory cytokine gene polymorphisms increase the risk of spontaneous preterm delivery (PD) in a population of Polish women. Different genetic background of ...PD due to preterm premature rupture of membranes (pPROM) than PD without pPROM has been suggested. The aim of this study was to examine the relationship between the maternal carriage of polymorphic alleles of the following genes: interleukin 1β(IL-1β +3953C>T), interleukin 6 promoter (IL-6 -174G>C), tumour necrosis factor promoter (TNF-α -308G>A) and interleukin 1 receptor antagonist (IL-1RN) and the risk of PD caused exclusively by pPROM in a population of Polish women.
A case-control study. 95 Caucasian women were examined including 32 cases and 63 controls. Case subjects experienced a delivery at less than 36 weeks and 6 days of gestation due exclusively to pPROM while control subjects gave birth at term. Polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP).
NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN POLYMORPHISMS OF EXAMINED GENES AND RISK OF PD DUE TO PPROM IN A POPULATION OF POLISH WOMEN WAS FOUND: OR = 0.84 (95% CI: 0.34-2.01) for IL-1β, OR = 0.77 (95% CI: 0.27-2.13) for IL-6, OR = 0.72 (95% CI: 0.26-1.90) for TNF-α and OR = 1.74 (95% CI: 0.66-4.64) for IL-1RN.
Maternal carriage of polymorphic alleles of IL-1β, IL-6 promoter, TNF-α promoter and IL-1RA seems to have no impact on the risk of PD due to pPROM in the population of Polish women.The genetic contribution and pathomechanism of PD related to pPROM seems to differ from those of spontaneous PD without pPROM.
Objective: The aim of this study was to investigate the relationship between the concentration of selected proinflammatory cytokines (IL-1α, IL-1β, IL-6 and IL-8) in cervicovaginal fluid, as measured ...in midgestation, and the risk of early-onset neonatal infection (EONI). Method: Cervicovaginal fluids were obtained from a cohort of 114 pregnant women at 22 to 34 weeks' gestation. The samples were analyzed for the concentrations of selected proinflammatory cytokines using standard enzyme-linked immunosorbent assay technique (ELISA). Lower genital tract microbiology was diagnosed using Gram stain method according to Spiegel's criteria and by culture. Results: Mean gestational age at the time of sampling was 29.0 weeks. Mean time between sampling and delivery was 9.3 (SD 4.7) weeks. Bacterial vaginosis (BV) was diagnosed in 27.2% of subjects and M. hominis and U. urealyticum in 22.8% and 26.3%, respectively. Out of 114 women examined, 20 (17.5%) delivered newborns with EONI. Median cervicovaginal concentrations of IL-1α, IL-1β, IL-6 and IL-8 did not differ between women who delivered newborns with EONI as compared to women who delivered newborns without EONI. Women with pathological lower genital tract microflora and low IL-8 concentration (below 25th percentile) during pregnancy presented a significant risk of delivering newborns with EONI (OR=4.9; 95% CI, 1.1–22.8). Subjects with pathological lower genital tract microflora and a low concentration of more than one cytokine had the highest risk of delivering a newborn with EONI, OR=16.2, 95% CI, 1.1–234.0. Conclusions: Cytokine measurement in cervicovaginal fluid in early gestation could be useful for predicting subsequent EONI only among pregnant women with lower genital tract infection. Maternal genital tract immune hyporesponsiveness as represented by low concentrations of proinflammatory cytokines may create a permissive environment for ascending infection and may lead to subsequent EONI.
OBJECTIVES: Abnormal vaginal flora (AVF) is a result of excessive growth of some aerobic bacteria and fungi in relation to the scarce presence of Lactobacillus spp. It has been suggested that AVF is ...responsible for preterm birth and such neonatal conditions as infections or sepsis.The aim of the study was to assess the influence of excessive vaginal colonization with aerobic bacteria and fungi on the selected postnatal parameters of newborns, duration of pregnancy and length of hospitalisation of neonates. MATERIAL AND METHODS: Retrospective data of all 1057 patients who delivered between 01.2019 and 06.2019 in the Department of Perinatology of Medical University of Lodz was analyzed. Eight hundred nine patients were included in this retrospective study. The study group consisted of 396 patients with abundant growth of aerobic bacteria and fungi obtained between 26 and 42 weeks of gestation, while 413 patients with physiologic vaginal biocenosis constituted the control group. Two hundred forty-eight patients (23.46%) were excluded from the study due to incomplete data. RESULTS: Patients with abnormal vaginal flora (AVF) gave birth prematurely (9.09%) more often than patients with balanced microflora (5.31%), p = 0.038. Newborns of mothers with AVF obtained an Apgar score under four more frequently (1.21% vs 0%; p = 0.024). Eutrophic neonates were born less frequently in the study group (82.08% vs 88.65%; p = 0.025). Hospitalisation period was longer for children of mothers with AVF (mean of 6.30 ± 9.87 days) than those of mothers from the control group (mean of 5.06 ± 5.30), p = 0.025. Newborns of mothers with AVF developed perinatal infections more often (23.97% vs 15.94%; p = 0.004). Four infants died in the study group whereas no deaths were recorded in the control group (p = 0.045). The most prevalent pathogens were: Streptococcus agalactiae (GBS) 57.32%, Candida spp. 39.64%, Klebsiella spp. 9.85%, Staphylococcus aureus 7.32%. Signs of infection were more frequently recorded in newborns of mothers infected with Klebsiella spp. (35.90% vs 19.16%; p = 0.011). Premature birth was more prevalent in GBS carriers (11.81% vs 6.28%; p = 0.022). CONCLUSIONS: Abundant growth of aerobic bacteria in the 3rd trimester of gestation contributes to preterm birth, causes the development of infection signs in newborns, increases their mortality rate and prolongs hospitalisation period.
Regulatory T cells (Tregs) having CD4+ CD25+ Foxp3+ or CD4+ IL-10+ (Tr1) phenotype and capable of inducing anergy towards self- and alloantigens play an important role in autoimmunity, as well as in ...tolerance of allografts, pregnancy and cancer. Both thymus-derived T CD4+ CD25+ Foxp3+ natural cells and peripherally-induced T CD4+ CD25+ Foxp3+ cells prevent migration of effector immunocytes to target organs and inhibit their cooperation with antigen-presenting cells. The suppressive function of CD4+ CD25+ Foxp3+ Tregs depends on interactions between stimulatory (IL-2, CTLA-4) and inhibitory (GITR, CD28) signals, on stimulation of indoleamine 2,3-dioxygenase (IDO) activity in dendritic cells via CD80/CD86 molecules, and finally on cell-cell inhibition of effector cells by membrane-bound TGF-beta. Anergy of effector cells caused by Tregs could provoke them to secretion of IL-10/TGF-beta in mechanism of "bystander suppression". Tr1 cells constitute the distinctive Tregs population which originates from IL-10-primed naïve T cells or from T cells induced by tolerogenic IL-10/TGF-beta-expressing dendritic cells. The suppressive activity of Tr1 cells is based on local IL-10/TGF-beta secretion in the peripheral tissues. Tregs have a privileged place in the net of immunological interactions which makes them a possible common target for therapeutic interventions in different diseases.
to determine the relationship between the initial nucleated red blood cells (nRBC) count during the first 12 hours after birth and inborn infection in neonates.
The retrospective study comprised of ...306 neonates born in the Department of Perinatology of the I Chair of Gynaecology and Obstetrics in Łódź, Poland, in the years 2002-2007, among whom the nucleated red blood cells count were calculated within the first 12 hours after birth. Two categories of nRBC count: the normal and the elevated value, were statistically elaborated by a Mann-Whitney test and a chi-square test with two clinical outcome categories: the presence and the absence of inborn infection in the analyzed neonates. Statistical significance was indicated by p value lower than 0,05.
Among 306 newborns, there were 127 mature neonates (41.5%) and 179 prematures (58.5%). The mean of the initial nRBC count in the analyzed newborn population was 40, 15. The mean of the nRBC count in the infected neonates was three times higher (52.56) than the mean of the nRBC count in newborns without inborn infection (16.76) - (p=0.00001). Inborn neonatal infection concerned a vast majority of cases with an elevated value of the nRBC count (86.4%), but in 13.6%, inborn infection was not observed. Among the cases with a normal nRBC count, the presence and the absence of inborn infection was diagnosed in about 50% of the analyzed babies (50.83% vs 49.17%). The elevated value of the nRBC count in infected neonates concerned mainly premature babies, rather than mature neonates, and similarly in neonates with a lower Apgar score than in babies born in good condition.
1. The positive association between elevated initial nucleated red blood cells count after birth and inborn infection in newborns has been revealed. 2. An elevated nucleated red blood cells count may be an auxiliary, early indicator for inborn infection in neonates. 3. Prematurity and perinatal asphyxia favour the elevation of a nucleated red blood cells count in cases with inborn infection.
While there are sufficient data regarding the negative effect of exposure to the constituents of tobacco smoke on newborn infants' birth weights, it is still unclear whether this effect may originate ...in early pregnancy. The aim of the present study was to evaluate the impact of exposure to tobacco smoke components in early pregnancy (20-24 weeks) on fetal biometry.
The study population comprised 183 women consecutively enrolled at 20-24 weeks of pregnancy at the two antenatal care units. Ultrasound biometric measurements of fetal bi-parietal diameter (BPD), abdominal circumference (AC) and femur length (FL) were performed at the time of enrollment. Serum cotinine concentration was determined at 20-24 weeks of gestation by gas chromatography with mass spectrometry detector (GC/MS) to assess environmental tobacco smoke (ETS) exposure during the previous evening and the morning of the same day (blood collection at 1200-1300 h). ETS exposure (passive smoking) was assumed to occur when the level of serum cotinine ranged from 2-10 ng/ml.
In a multiple regression model for bi-parietal diameter (BPD), after adjustment for pregnancy duration at the time of ultrasound examination, fetal gender, and maternal pre-pregnancy weight, a statistically significant negative association was found between the BPD and serum cotinine concentration. A similar association was identified for subjects with serum cotinine concentrations below 10 ng/ml (corresponding to passive smoking) (P=0.06). After controlling for pregnancy duration, maternal pre-pregnancy weight and infant's gender, we found that serum cotinine levels at 20-24 weeks of gestation was inversely associated with infant birth weight (P=0.004). For the subjects with serum cotinine levels below 10 ng/ml, a borderline association (P=0.09) with infant birth weight was found.
Maternal exposure to tobacco smoke in early pregnancy, as measured by serum cotinine concentrations at 20-24 weeks of gestation, adversely affects fetal BPD. Preventive measures need to be undertaken to encourage pregnant women to stop smoking and avoid passive exposure to tobacco smoke from the very beginning of pregnancy.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Rapid spread of severe acute respiratory syndrome coranovirus-2 virus (SARS-CoV-2) caused the pandemic of Coronavirus Disease 19 (COVID-19). Clinical course of the disease presents symptoms mainly ...from the respiratory system such as: cough, dyspnea and fever, and among some patients, can deteriorate even further to acute respiratory distress syndrome (ARDS), eventually leading to death. This outbreak, as well as previous ones (SARS, MERS) pose a significant challenge for health care managers, epidemiologists and physicians. Below we are presenting the clinical profile of the COVID-19 among special group of patients; pregnant women and newborns, who require special clinical management during hospitalization. In the summary of this manuscript, we present practical guidelines for managing pregnant women infected with SARS-CoV-2, labor and care of the newborn of a positive mother, as well as practical guidelines for COVID-19 vaccinations. It is important to stress, that this manuscript is based on information available as of December 2020.
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