Growth Restriction: Etiology, Maternal and Neonatal Outcome. A Review

Kratak sadr`aj: Intrauterini zastoj u rastu ploda jedan je od vode}ih uzroka perinatalnog morbiditeta i mortaliteta. Kako kauzal na terapija ne postoji, predikcija intrauterinog zastoja u rastu je jedan od prioritetnih zadataka perinatalne za{tite. Cilj rada je bio da se na osnovu odre|ivanja nivoa serum skog feritina i ele menata crvene krvne loze kod trudnica izme|u 30. i 32. gestacijske nedelje izdvoji grupa trudnica kod kojih je mo gu }e o~ekivati nastanak zastoja u rastu ploda. Istra`ivanje je sprovedeno u vidu prospektivne studije me|u zdravim tru dni cama izme|u 30. i 32. gesta cijske nedelje. Svim trud nicama odre|ivane su vrednosti feritina. Posle poro|aja utvr|en je procenat beba malih za gesta cijsku dob; 8,1% rodilo je novoro|en~ad sa malom telesnom masom za gesta cijsku dob. Anemija nije utvr|ena ni kod jedne pacijen tkinje koja je rodila bebu male poro |ajne mase a bila je prisutna kod 47,44% pacijentkinja koje su rodile bebe normalne poro|ajne mase. Kod majki beba male poro|ajne mase, nivo serumskog feritina bio je u proseku za 6,42 mg/L vi{i nego kod majki koje su rodile bebe normalne poro|ajne mase (p<0,005). Uporednom analizom telesne mase novoro|en~adi i nivoa feritina iz krvi majke na|en je mali koeficijent korelacije, ali je ROC ana liza pokazala da nivo feritina u krvi ima dobru prediktivnu vrednost. Pri vrednostima feritina u krvi trudnice ve}im od 13,6 mg/L sa senzitivno{}u od 64,7% i specifi~no{}u od 91,7% mo`emo tvrditi da }e se razviti intrauterina retar da cija rasta ploda. Izostanak pada vrednosti serumskog feritina, eritrocita, hemoglobina i hematokrita u krvi zdrave trudnice u periodu izne|u 30. i 32. nedelje trudno}e mo`e ukazati sa velikom verovatno}om na razvoj intrauterine retar dacije rasta ploda.

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“…Similar results for the values of erythrocytes, he moglobin and ferritin were found in other studies (22)(23)(24)(25)(26).…”

Section: Discussionsupporting

confidence: 90%

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth Restriction

Visnjevac¹,

Segedi²,

Curcić³

et al. 2011

Journal of Medical Biochemistry

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“…Smoking exposure may reduce mean birth weight, and increase the risk of PTD and intrauterine growth restriction (Asmussen and Kjeldsen, 1975; Asmussen, 1977;, Nilsen et al, 1984; Ronco et al, 2005; Goldenberg and Culhane, 2007; Haram et al, 2007). Part of the effect of smoking on birth outcomes may be due to the metabolism of the tobacco compound PAH (polycyclic aromatic hydrocarbons) (Perera et al, 2005; Tsui et al, 2008; Wu et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Association of maternal CNVs in GSTT1/GSTT2 with smoking, preterm delivery, and low birth weight

et al. 2013

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Preterm delivery (PTD) is an adverse birth outcome associated with increased infant mortality and negative lifelong health consequences. PTD may be the result of interactions between genetics and maternal/fetal environmental factors including smoking exposure (SMK). A common deletion in the GSTT1 gene was previously reported to affect birth outcomes in smokers. In this study, we dissect the associations among SMK, birth outcomes, and copy number variations (CNVs) in the GSTT1/GSTT2 region. A preterm birth case-control dataset of 1937 mothers was part of the GENEVA preterm birth study, which included genome-wide genotyping used to identify CNVs. We examined the association of SMK with birth outcomes, detected CNVs within the GSTT1/GSTT2 region using PennCNV, and examined associations of the identified CNVs with preterm birth and with birth weight (BW) in full term birth controls, including interactions with SMK. Finally, we tested the association of CNVs in GSTT1/GSTT2 with SMK. We confirmed the association of smoking with low BW and PTD. We identified 2 CNVs in GSTT2 (GSTT2a and GSTT2b), 1 CNV in GSTTP1 and 2 CNVs in GSTT1 (GSTT1a and GSTT1b). The GSTT2a deletion was associated with reduced BW (−284 g, p = 2.50E-7) in smokers, and was more common in smokers [odds ratio(OR) = 1.30, p = 0.04]. We found that the size of the reported common deletion CNV in GSTT1 was larger than previously shown. The GSTTP1 and GSTT1b null genotypes were in high linkage disequilibrium (LD) (D′ = 0.89) and less common in smokers (OR = 0.68, p = 0.019 and OR = 0.73, p = 0.055, respectively). These two deletions were in partial LD with GSTT2a and GSTT2b duplications. All 5 CNVs seem to be associated with increased risk of preterm birth before 35 completed weeks. CNVs in the GSTTT1/GSTT2 region appear associated with low BW and PTD outcomes, but LD complicated these CNVs in GSTT1/GSTT2. In genetic association studies of BW, multiple CNVs in this region need to be investigated instead of a single polymorphism.

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“…This well confirmed by a number of retrospective studies which have also demonstrated that the increase in serum ferritin level is associated with the higher risk of SGA in pregnancies with beta thalassemia intermedia (Gaspar, Ortega, & Moreiras, 1993;Origa et al, 2010;Uberos, 2000;Višnjevac, Segedi, Ćurčić, Višnjevac, & Stajić, 2011). Pregnancies complicated by IUGR have higher serum ferritin level due to decrease in ferritin and iron absorption by placenta (Bashiri, Burstein, Sheiner, & Mazor, 2003;Cogswell, Parvanta, Ickes, Yip, & Brittenham, 2003;Ćujić D, 2011;Haram, Svendsen, & Myking, 2007;Ronnenberg et al, 2004;Uberos, 2000).…”

Section: Discussionmentioning

confidence: 76%

The Effect of Hemoglobin Correction by Blood Transfusion on Pregnancy Outcomes in Minor and Intermedia Thalassemia Patients: A Single-Blind Controlled Randomized Clinical Trial

Najafian¹,

Ahmadzadeh²,

Barati³

et al. 2016

GJHS

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To the best of our knowledge, there is no prospective trial study assessing the management of β-thalassemia by blood transfusion in pregnancy. The aim of this study was to investigate the effect of blood transfusion on maternal and neonatal outcomes in pregnant patients with beta thalassemia minor and intermedia. We did this randomized, single -blind, controlled clinical trial on 36 pregnant women with β thalassemia minor and intermedia at two tertiary hospitals of Imam Khomeini and Shafa in Ahvaz, Iran from January 2016 to July 2016. Patients were randomly assigned to receive either packed cell or not (control group) during pregnancy (ratio 1:1). The main outcomes of interest transfusion times, abortion, preterm delivery, type of delivery (cesarean or vaginal), stillbirth, birth weight, low birth weight, very low birth weight, small for gestational age, low Apgar score (≤7) at 1 and 5 minutes, oligohydramnios, fetal anomalies , and NICU admission. The median of blood transfusion in intervention group during pregnancy was two blood units. The cesarean section rate did not significantly differ between the intervention and control groups (72.2% and 44.4%, respectively, P=0.2). Two infants in intervention group experienced with LBW, one with SGA, one with low Apgar score, two with oligohydramnios, and one with NICU admission, while none in control group experienced these complications. The mean birth weight of infants in intervention group was significantly lower than control group (P value 0.002). The comparison between two groups showed that the adverse maternal and neonatal outcomes, especially low birth weight and preterm delivery were higher in intervention group.

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Growth Restriction: Etiology, Maternal and Neonatal Outcome. A Review

Cited by 17 publications

References 213 publications

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth Restriction

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth Restriction

Association of maternal CNVs in GSTT1/GSTT2 with smoking, preterm delivery, and low birth weight

The Effect of Hemoglobin Correction by Blood Transfusion on Pregnancy Outcomes in Minor and Intermedia Thalassemia Patients: A Single-Blind Controlled Randomized Clinical Trial

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