Fetal microchimerism by mode of delivery: a prospective cohort study

Shree, Raj; Harrington, W.; Kanaan, SB; Forsyth, Alexandra M.; Cousin, Emma; López, Ana María Acevedo; Nelson, J. Lee; Gammill, HS

doi:10.1111/1471-0528.15432

Cited by 14 publications

(14 citation statements)

References 33 publications

(57 reference statements)

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“…We further conducted exploratory analyses of the relationship between obstetric outcomes of each participant's birth and MMc. Bivariate analyses tentatively support our hypothesis that MMc is decreased in preterm births compared to full term births (DRR 0.24, 95% CI 0.06–0.99, p = 0.049; Supporting Information, Table S4.1), and in contrast to fetal‐origin Mc (Shree et al, 2019), MMc is lower in cesarean section compared to vaginal delivery (DRR 0.20, 95% CI 0.06–0.61, p = 0.005; Supporting Information, Table S4.1). There is also a trend suggesting MMc is increased in complicated deliveries compared to uncomplicated deliveries (DRR 5.81, 95% CI 0.88–38.39, p = 0.068; Supporting Information, Table S4.1).…”

Section: Resultssupporting

confidence: 76%

“…Fetal origin Mc varies with obstetric outcomes of participant's birth, such as method of delivery (vaginal or cesarean) and complications of delivery (Shree et al, 2019). These obstetric outcomes could also affect the transfer of maternal cells.…”

Section: Methodsmentioning

confidence: 99%

“…We then transformed these telomere length measures to z-scores for statistical analysis. (Shree et al, 2019). These obstetric outcomes could also affect the transfer of maternal cells.…”

Section: Maternal Telomere Length Measurementmentioning

confidence: 99%

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Predictors of maternal‐origin microchimerism in young women in the Philippines

Pan

Kanaan

Lee

et al. 2020

American J Phys Anthropol

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Objectives: Microchimerism is the presence of a small quantity of cells or DNA from a genetically distinct individual. This phenomenon occurs with bidirectional maternalfetal exchange during pregnancy. Microchimerism can persist for decades after delivery and have long-term health implications. However, little is known about why microchimerism is detectable at varying levels in different individuals. We examine the variability and the following potential determinants of maternal-origin microchimerism (MMc) in young women in the Philippines: gestational duration (in utero exposure to MMc), history of being breastfed (postpartum exposure to MMc), maternal telomere length (maternal cells' ability to replicate and persist), and participant's pregnancies in young adulthood (effect of adding fetal-origin microchimerism to preexisting MMc). Materials and Methods: Data are from the Cebu Longitudinal Health and Nutrition Survey, a population-based study of infant feeding practices and long-term health outcomes. We quantified MMc using quantitative PCR (qPCR) in 89 female participants, ages 20-22, and analyzed these data using negative binomial regression. Results: In a multivariate model including all predictors, being breastfed substantially predicted decreased MMc (detection rate ratio = 0.15, p = 0.007), and there was a trend of decreasing MMc in participants who had experienced more pregnancies (detection rate ratio = 0.55, p = 0.057). Discussion: These results might be explained by breastfeeding having lasting impact on immune regulatory networks, thus reducing MMc persistence. MMc may also decrease in response to the introduction of fetal-origin microchimerism with pregnancies experienced in adulthood.

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Section: Resultssupporting

confidence: 76%

Section: Methodsmentioning

confidence: 99%

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Predictors of maternal‐origin microchimerism in young women in the Philippines

Pan

Kanaan

Lee

et al. 2020

American J Phys Anthropol

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“…This is because the judgment "disturbed" adds inconsistency to the diagnosis label. Most experts (60.40%) hence opted for the title "Risk for damaged maternal-fetal dyad", since the judgment "damaged" makes the label more understandable (13)(14)(15)(16) .…”

Section: Discussionmentioning

confidence: 99%

Content validation of the nursing diagnosis Risk for disturbed maternal-fetal dyad

Mendes

Frazão

Lacerda

et al. 2021

Rev. esc. enferm. USP

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Objective: To validate the content of the diagnosis Risk for disturbed maternal-fetal dyad in high-risk pregnant women. Method: Nursing diagnosis content analysis study in which 48 nurses evaluated agreement regarding title, definition, class, and domain of the studied nursing diagnosis, as well as the relevance of its antecedents. The items were considered relevant when the Confidence Interval of the Content Validity Index was 0.8 or higher. When lower, the item was modified or excluded according to the experts’ suggestions. Results: Out of 21 antecedents, 14 were considered relevant. The labels of five elements considered irrelevant were changed, and one item was excluded. The experts did not choose the title and definition proposed by NANDA-I, preferring instead the ones suggested in this study. The experts agreed with the class and domain proposed by the taxonomy. Conclusion: Ten risk factors, four populations at risk, and six associated conditions for this nursing diagnosis were maintained; these may provide a basis for nursing practice. The phase of clinical validation is suggested to be conducted to corroborate this study’s results.

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“…The presence of male cells in maternal circulation is indicative of microchimerism and has been well documented in women following pregnancy with a male fetus ( Lo et al , 1996 ; Murata et al , 1999 ; Mosca et al , 2003 ). The method of delivery, presence of placental complications and hypertensive disorders all can influence the amount of cell trafficking and therefore the exposure to microchimerism ( Gammill et al , 2013 ; Shree et al , 2019 ). Foetal loss in early pregnancy may also result in microchimerism ( Bianchi et al , 2001 ).…”

Section: Introductionmentioning

confidence: 99%

Male microchimerism in females: a quantitative study of twin pedigrees to investigate mechanisms

et al. 2021

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STUDY QUESTION Does having a male co-twin, older brothers, or sons lead to an increased probability of persistent male microchimerism in female members of twin pedigrees? SUMMARY ANSWER The presence of a male co-twin did not increase risk of male microchimerism and the prevalence of male microchimerism was not explained by having male offspring or by having an older brother. WHAT IS KNOWN ALREADY Microchimerism describes the presence of cells within an organism that originate from another zygote and is commonly described as resulting from pregnancy in placental mammals. It is associated with diseases with a female predilection including autoimmune diseases and pregnancy-related complications. However, microchimerism also occurs in nulliparous women; signifying gaps in the understanding of risk factors contributing to persistent microchimerism and the origin of the minor cell population. STUDY DESIGN, SIZE, DURATION This cross-sectional study composed of 446 adult female participants of the Netherlands Twin Register (NTR). PARTICIPANTS/MATERIALS, SETTING, METHODS Participants included in the study were female monozygotic (MZ) twins, female dizygotic same-sex twins and females of dizygotic opposite-sex twin pairs, along with the mothers and sisters of these twins. Peripheral blood samples collected from adult female participants underwent DNA extraction and were biobanked prior to the study. To detect the presence of male-origin microchimerism, DNA samples were tested for the relative quantity of male specific Y chromosome gene DYS14 compared to a common β-globin gene using a highly sensitive quantitative PCR assay. MAIN RESULTS AND THE ROLE OF CHANCE We observed a large number of women (26.9%) having detectable male microchimerism in their peripheral blood samples. The presence of a male co-twin did not increase risk of male microchimerism (odds ratio (OR) = 1.23: SE 0.40, P = 0.61) and the prevalence of male microchimerism was not explained by having male offspring (OR 0.90: SE 0.19, P = 0.63) or by having an older brother (OR = 1.46: SE 0.32, P = 0.09). The resemblance (correlation) for the presence of microchimerism was similar (P = 0.66) in MZ pairs (0.27; SE 0.37) and in first-degree relatives (0.091; SE 0.092). However, age had a positive relationship with the presence of male microchimerism (P = 0.02). LIMITATIONS, REASONS FOR CAUTION After stratifying for variables of interest, some participant groups resulted in a low numbers of subjects. We investigated microchimerism in peripheral blood due to the proposed mechanism of cell acquisition via transplacental blood exchange; however, this does not represent global chimerism in the individual and microchimerism may localize to numerous other tissues. WIDER IMPLICATIONS OF THE FINDINGS Immune regulation during pregnancy is known to mitigate allosensitization and support tolerance to non-inherited antigens found on donor cells. While unable to identify a specific source that promotes microchimerism prevalence within pedigrees, this study points to the underlying complexities of natural microchimerism in the general population. These findings support previous studies which have identified the presence of male microchimerism among women with no history of pregnancy, suggesting alternative sources of microchimerism. The association of detectable male microchimerism with age is suggestive of additional factors including time, molecular characteristics and environment playing a critical role in the prevalence of persistent microchimerism. The present study necessitates investigation into the molecular underpinnings of natural chimerism to provide insight into women’s health, transplant medicine and immunology. STUDY FUNDING/COMPETING INTEREST(S This work is funded by Royal Netherlands Academy of Science Professor Award (PAH/6635 to D.I.B.); The Netherlands Organisation for Health Research and Development (ZonMw)—Genotype/phenotype database for behavior genetic and genetic epidemiological studies (ZonMw 911-09-032); Biobanking and Biomolecular Research Infrastructure (BBMRI–NL, 184.021.007; 184.033.111); The Netherlands Organisation for Scientific Research (NWO)—Netherlands Twin Registry Repository (NWO-Groot 480-15-001/674); the National Institutes of Health—The Rutgers University Cell and DNA Repository cooperative agreement (NIMH U24 MH068457-06), Grand Opportunity grants Integration of genomics and transcriptomics in normal twins and major depression (NIMH 1RC2 MH089951-01), and Developmental trajectories of psychopathology (NIMH 1RC2 MH089995); and European Research Council—Genetics of Mental Illness (ERC 230374). C.B.L. declares a competing interest as editor-in-chief of Human Reproduction and his department receives unrestricted research grants from Ferring, Merck and Guerbet. All remaining authors have no conflict-of-interest to declare in regards to this work. TRIAL REGISTRATION NUMBER N/A.

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Fetal microchimerism by mode of delivery: a prospective cohort study

Abstract: Greater fetal microchimerism found in maternal blood following caesarean delivery compared with vaginal delivery.

Cited by 14 publications

References 33 publications

Predictors of maternal‐origin microchimerism in young women in the Philippines

Predictors of maternal‐origin microchimerism in young women in the Philippines

Content validation of the nursing diagnosis Risk for disturbed maternal-fetal dyad

Male microchimerism in females: a quantitative study of twin pedigrees to investigate mechanisms

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