Fetal endocrinology

Kota, Sunil Kumar; Gayatri, Kotni; Jammula, Sruti; Meher, Lalit Kumar; Kota, Siva Krishna; Krishna, S V S; Modi, Kirtikumar D

doi:10.4103/2230-8210.113722

Cited by 26 publications

(17 citation statements)

References 76 publications

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“…Second, studies have been limited to the second half of gestation. Data from the first trimester is especially important because the fetal HPA axis is not functional until about mid gestation, meaning that the growth and development of the fetus in the first half of pregnancy is regulated primarily by exposure to maternal/placental cortisol (Kota et al, 2013). Furthermore, previous studies assessing pregnancy-related changes in HPA axis function have been limited to examining only half of pregnancy, and specifically the latter half during which the placenta plays an increasingly important role in regulating maternal HPA axis function (Mastorakos & Ilias, 2003).…”

mentioning

confidence: 99%

Adverse childhood experiences and HPA axis function in pregnant women

Thomas

Magel

Tomfohr‐Madsen

et al. 2018

Hormones and Behavior

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mentioning

confidence: 99%

Adverse childhood experiences and HPA axis function in pregnant women

Thomas

Magel

Tomfohr‐Madsen

et al. 2018

Hormones and Behavior

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“…This complex network allows communication of hypothalamic releasing factors to their respective pituitary somatotrophs, thyrotrophs, corticotrophs, and gonadotrophs, stimulating the release of anterior pituitary hormones. Unlike other hypothalamic releasing factor neurons, GnRH neurons migrate from the olfactory placode to the hypothalamus by 10–14 weeks [ 25 , 26 ]. It is reasonable to assume that an insult to the hypothalamic-pituitary axis prior to this time period may result in preserved GnRH function.…”

Section: Discussionmentioning

confidence: 99%

Endocrine and pubertal disturbances in optic nerve hypoplasia, from infancy to adolescence

Oatman

McClellan

Olson

et al. 2015

Int J Pediatr Endocrinol

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BackgroundEndocrinologic abnormalities are a common co-morbidity in patients with optic nerve hypoplasia (ONH), however the impact on puberty is unknown. The purpose of this study was to examine rates of endocrine dysfunction and pubertal disturbances in a pediatric population of ONH.MethodsA retrospective chart review was conducted on a cohort of children with ONH between January 2005 and March 2013. Endocrine dysfunction was determined based on laboratory evidence of hormone deficiency or hormone replacement. Pubertal disturbances were characterized based on presence of micropenis, tanner staging, menarche and hormone replacement. Pituitary abnormalities were classified using MRI findings. Descriptive statistics were used, and comparisons between groups were performed using the chi-square test.ResultsDuring the study period, 101 patients underwent an endocrine evaluation (median age: 2.3 years [0.76 – 6.5]). Hypopituitarism was present in 73% of patients with growth hormone deficiency (56%) and hypothyroidism (54%) being the most common. Pubertal disturbances (n = 19) were common; micropenis in 31% (13/42) of males and 2% with precocious puberty. Half of adolescents (n = 4/8) were diagnosed with gonadotropin deficiency. Patients with MRI pituitary abnormalities were more likely to have endocrine dysfunction than those without (p = 0.004). The sensitivity and specificity of MRI pituitary abnormalities for hypopituitarism was 54% and 92%, respectively.ConclusionsA significant proportion of children with ONH have endocrine dysfunction. The high frequency of pubertal disturbances in this study emphasizes the need for long-term monitoring of developing endocrinopathy. While pituitary gland abnormalities are a good predictor of endocrine dysfunction, a normal pituitary gland does not rule out endocrinopathy.

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“…In human fetal brain thyroid hormone receptors, TRα1 and TRβ1 isoforms and receptor binding are present by 8-10 weeks. TRα1 isoforms increase 8-10 fold by 16-18 weeks [5]. Studies suggest that, children of even marginally iodine deficient mothers show psychomotor and cognitive impairment Such data indicates sensitivity of the developing CNS to maternal thyroid metabolism in utero [6].…”

Section: Introductionmentioning

confidence: 98%

Maternal Outcome of Hypothyroidism in Pregnancy- a South Indian Perspect

Nirmala¹,

Chellamma²,

Rajasekharan³

et al. 2014

AJCMR

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Background: Hypothyroidism in pregnancy is increasing and is a major cause for concern because of its association with adverse maternal outcome if untreated. The literature related to the burden of adverse pregnancy outcomes associated with hypothyroid pregnant women on thyroxine replacement therapy is limited. Hence, this study was designed. Objective: The primary objective was to study the maternal outcome of hypothyroidism in pregnancy. Methodology: This study was conducted in the Department of Obstetrics & Gynecology in Govt. Medical College Trivandrum. This was a mixed method study that included retrospective patient data collection and a prospective matched case control study. Seventy-eight pregnant women were recruited as cases based on diagnosis of hypothyroidism prior to pregnancy from the medical department records. They were compared with 78 euthyroid pregnant women, approximately age matched. History and pregnancy outcome were assessed. Data was analyzed using SPSS statistical package. Results: Hypothyroidism was associated with 3.6 times higher risk of developing threatened abortion and 3.8 times higher risk of developing gestational hypertension (P=0.001). Rate of caesarian section (51.3%) and postpartum hemorrhage (12.8%) were higher among cases. Conclusions: Based on our study we conclude that hypothyroid mothers, in spite of thyroid replacement therapy, are at significantly higher risk of obstetric complications. A multidisciplinary team approach, where the services of an endocrinologist and an obstetrician experienced in high risk pregnancy care are used, and a tertiary level institution with good facilities for ante partum and intrapartum care, is essential to improve the outcomes.

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Fetal endocrinology

Cited by 26 publications

References 76 publications

Adverse childhood experiences and HPA axis function in pregnant women

Adverse childhood experiences and HPA axis function in pregnant women

Endocrine and pubertal disturbances in optic nerve hypoplasia, from infancy to adolescence

Maternal Outcome of Hypothyroidism in Pregnancy- a South Indian Perspect

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