This review summarizes many of the published reports about the production of melatonin and it’s role in regulation of carbohydrate metabolism, interrelationships between melatonin, insulin, glucagon and diurnal signaling the blood-glucose-regulating of the islet. The results of experimental and clinical investigations support that low melatonin levels and absence it’s circadian rhythm play the role in the development of gestational diabetes mellitus in womens with pathology of neuroimmunoendocrinology system and suggest the possibility of prognosis and prophylactic this complication of pregnancy.
The review presents the results of clinical and experimental studies that indicate a high frequency of neuropsychiatric diseases and mechanisms of adverse effects during intrauterine development, determining long-term effects in offspring of obese and / or diabetic mothers. Approaches to prevention in the planning stage and during pregnancy are also discussed in the review.
Neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) levels in umbilical cord blood in full-term newborns with asymmetrical intrauterine growth retardation resulted from chronic placental insufficiency have been studied. Not only a 2.0–2.5-fold increase in the blood NSE level, but also a reduction in BDNF levels were observed, indicating brain damage combined with the lack of adequate compensatory capabilities. With an increase in the duration of intrauterine fetal development under conditions of chronic hypoxia, the degree of damage to neuronal structures increases. This article discusses the mechanisms of the revealed changes, as well as the diagnostic and prognostic significance of the use of biochemical markers.
This review presents literature data on the role of melatonin in regulating the composition of the microbiota and on the variety of functions it performs that are synchronized with the circadian rhythm of vital activity of the body. During pregnancy, the restructuring of the intestinal, vaginal and placental microbiota is provided by a significant increase in the production of epiphyseal melatonin, which contributes to the creation of optimal conditions for the development of microflora in early ontogenesis. In the absence of circadian production of melatonin, a pregnant woman retains dysbiosis, which determines the transmission of altered intestinal microflora to the fetus and subsequent metabolic dysregulation in the childs body.
Noninvasive monitoring brain oxygenation with near-infrared spectroscopy (NIRS) is becoming a widely used in neonatology for determine the optimal target oxygen saturation during resuscitation of newborns, but its use in clinical practice for diagnostics and prognosis perinatal pathology is limited because intra and especially interpatient variability are too large for this aim. This study aimed to determine cerebral oximetry values during the sleep cycle and wakefulness in healthy full term newborns. 38 newborns (gestational age 38 weeks were included in this study (22 after normal birth I group and 16 after cesarean section). Near-infrared spectroscopy (CrSO2) from left fronto-parietal region was recorded in synchrony with polysomnography. Continuous cerebral CrSO2 were measured using near-infrared spectroscopy (Somanetic INVOS 5100C, USA). Fraction tissue oxygen extraction (FTOE) was calculated using SaO2 (pulse oximeter Radical Masimo) and CrSO2 (FTOE = (SаO2 CrSO2)/SаO2). CrSO2 and SаO2 were analyzed during 15 minutes polysomnography-defined quiet, active sleep and wakefulness (defined according to standard guidelines). The results: cerebral oxygen saturation varies with sleep-wake states: during active sleep (74,18 0,75%) was similar to the value in wakefulness (75,6 1,0%) and smaller than in quiet sleep (81,93 1,74%, р 0,001), but FTOE during active sleep was significantly higher (0,221 0,008% and 0,129 0,005%, p 0,001). There were no differences of rates between groups. The high oxygen consumption during REM sleep supports its role during postnatal brain functional development. The use of NIRS taking into account sleep structure will be new method for diagnostic and prognosis perinatal pathology CNS.
Relevance: The growth of neuropsychiatric diseases caused by perinatal pathology indicates the need to study the biochemical markers of brain damage in the newborn for the timely prevention of adverse consequences. Serotonin in early ontogenesis provides intensive development of neuronal structures and cortical networks involved in the mechanisms of formation of cyclic sleep organization a fine criterion of morphofunctional development of the brain. aim: The aim of the work is to study the content of serotonin in healthy full-term newborns in comparison with the quantitative and qualitative characteristics of the electropoligraphic sleep pattern. Material and methods: 84 healthy newborns were examined, which, depending on the gestational age, were divided into 3 groups: I 37 weeks (20 people), II 38 weeks (24 people), III 39-40 weeks (40 people). The content of serotonin in platelet-rich plasma of blood from the umbilical cord vein and in platelet suspension prepared from venous blood taken from mothers and children on the first day of life and again on day 5 was determined by high-performance liquid chromatography with electrochemical detection. A quantitative and qualitative analysis of the sleep electropoligram was performed 7-12 hours after birth. Results: The content of serotonin in platelet-rich plasma in umbilical cord blood in children does not depend on the method of birth, is 2 times lower than in the venous blood of mothers (0.379 0.116 microns/l, versus 0.756 0.200 microns/l, but there is a high correlation between the indicators (r = 0.8, p 0.05). At the gestational age of 39-40 weeks, the level of serotonin in platelet-rich plasma and in venous blood platelets is significantly higher than in those born at 37 weeks. In the latter, the increase in the content of serotonin in platelets continues after birth (at day 1, 0.539 0.149 nM/109 Tr, and on day 5 0.846 0.094 nM/109 Tr; p 0.05), whereas the indicators for those born at 39-40 weeks of pregnancy. They do not change (0.797 0.190 nM/109 Tr and 0.749 0.142 nM/109 Tr, respectively). A significant increase in the content of serotonin in the platelet-rich plasma and in the platelets of the child in the period from 37 to 39 weeks, both during intrauterine development and in the first days of life, correlates with an increase in the representation of the orthodox phase in the sleep cycle. Conclusion: The general pattern of changes in serotonin content and cyclic sleep organization in the early neonatal period in healthy newborns, depending on gestational age, indicates the possibility of using the obtained standard values of serotonin as a biochemical marker of functional brain development.
The review summarizes the literature data on the perinatal pathology of premature infants, the frequency of their development in the following months and years of life of neuropsychiatric and somatic diseases. The results of experimental and clinical studies are presented, revealing the general pathogenetic mechanism oxidative stress, underlying bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, periventricular leukomalacia, open ductus arteriosus and persistent pulmonary hypertension. The interrelation of the processes of inflammation and oxidative stress, which play a leading role in the brain damage of the fetus and newborn, is considered. The literature data on the possibility of preventing severe complications in the antenatal period of development with the timely use of surfactant, magnesium sulfate and acetylcysteine are presented, It is emphasized that the first hours of a premature baby's life are a critical period for an individual approach to resuscitation, the beginning and effectiveness of drug therapy aimed at suppressing oxidative stress and systemic inflammation, which is confirmed by modern trends in optimizing the care of premature babies using pentoxifylline, erythropoietin, cortexin and melatonin.
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