Use of amniotic fluid for determining pregnancies at risk of preterm birth and for studying diseases of potential environmental etiology

Geer, Laura A.; Pycke, Benny F. G.; Sherer, David M.; Abulafia, Ovadia; Halden, Rolf U.

doi:10.1016/j.envres.2014.09.031

Cited by 16 publications

(12 citation statements)

References 122 publications

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“…At the inflammatory site, leukocytes (predominantly neutrophils and macrophages) are recruited into the gestational membranes and activated, and eventually secrete proinflammatory cytokines including IL-6 [45,46]. Neutrophil infiltration to the chorionic plate, choriodecidua, and umbilical cord can be measured through IL-6 concentrations of the amniotic fluid and cord blood [47]. The association between high IL-6 levels in the amniotic fluid and pregnancies complicated by premature rupture of membranes is especially strong when infection is present [48,49].…”

Section: Preterm Birth and Interleukin-6mentioning

confidence: 99%

Fetal and early neonatal interleukin-6 response

et al. 2015

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In 1998, a systemic fetal cytokine response, defined as a plasma interleukin-6 (IL-6) value above 11 pg/mL, was reported to be a major independent risk factor for the subsequent development of neonatal morbid events even after adjustments for gestational age and other confounders. Since then, the body of literature investigating the use of blood concentrations of IL-6 as a hallmark of the fetal inflammatory response syndrome (FIRS), a diagnostic marker of early-onset neonatal sepsis (EONS) and a risk predictor of white matter injury (WMI), has grown rapidly. In this article, we critically review: IL-6 biological functions; current evidence on the association between IL-6, preterm birth, FIRS and EONS; IL-6 reference intervals and dynamics in the early neonatal period; IL-6 response during the immediate postnatal period and perinatal confounders; accuracy and completeness of IL-6 diagnostic studies for EONS (according to the Standards for Reporting of Diagnostic Accuracy statement); and recent breakthroughs in the association between fetal blood IL-6, EONS, and WMI.

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Section: Preterm Birth and Interleukin-6mentioning

confidence: 99%

Fetal and early neonatal interleukin-6 response

et al. 2015

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“…Pregnant women are exposed to a multitude of diverse environmental contaminants through drinking water, food packaging, air pollution workplace exposures, and other sources (Mitro et al, 2015). Ubiquitous environmental contaminants such as lead, cadmium, PBDEs, bisphenol A, and phthalates have been detected in human FM (Miller et al, 2009;Kot et al, 2019) and amniotic fluid (Miller et al, 2012;Geer et al, 2015), demonstrating that contaminants can come into contact with the FM either through blood flow to the decidua or via the amniotic fluid. Numerous epidemiology studies have found associations between exposures to environmental toxicants and increased risk of pPROM.…”

Section: Fetal Membranes As a Target Of Environmental Toxicantsmentioning

confidence: 99%

Toxicant Disruption of Immune Defenses: Potential Implications for Fetal Membranes and Pregnancy

2020

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In addition to providing a physical compartment for gestation, the fetal membranes (FM) are an active immunological barrier that provides defense against pathogenic microorganisms that ascend the gravid reproductive tract. Pathogenic infection of the gestational tissues (FM and placenta) is a leading known cause of preterm birth (PTB). Some environmental toxicants decrease the capacity for organisms to mount an immune defense against pathogens. For example, the immunosuppressive effects of the widespread environmental contaminant trichloroethylene (TCE) are documented for lung infection with Streptococcus zooepidemicus. Group B Streptococcus (GBS; Streptococcus agalactiae) is a bacterial pathogen that is frequently found in the female reproductive tract and can colonize the FM in pregnant women. Work in our laboratory has demonstrated that a bioactive TCE metabolite, S-(1, 2-dichlorovinyl)-L-cysteine (DCVC), potently inhibits innate immune responses to GBS in human FM in culture. Despite these provocative findings, little is known about how DCVC and other toxicants modify the risk for pathogenic infection of FM. Infection of the gestational tissues (FM and placenta) is a leading known cause of PTB, therefore toxicant compromise of FM ability to fight off infectious microorganisms could significantly contribute to PTB risk. This Perspective provides the current status of understanding of toxicant-pathogen interactions in FM, highlighting knowledge gaps, challenges, and opportunities for research that can advance protections for maternal and fetal health.

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“…0.15 g/L), 21,22 a wide spectrum of hydrophilic and lipophilic xenobiotics has been detected in AF. 18,23−28…”

Section: Introductionmentioning

confidence: 99%

Method Development for Effect-Directed Analysis of Endocrine Disrupting Compounds in Human Amniotic Fluid

Dusza

Janssen

Kanda

et al. 2019

Environ. Sci. Technol.

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The developing fetus represents a highly sensitive period of exposure to endocrine disrupting compounds (EDCs). However, risk assessment of EDCs is hampered by the lack of data on direct in utero exposure. In this study, we developed a robust analytical methodology for the identification of a wide range of known and unknown EDCs in full-term amniotic fluid (AF). First, a method for extraction and fractionation of a broad range of polar and nonpolar EDCs was developed and validated. Maximal recoveries of reference compounds and minimal interference from the matrix were achieved with a combination of solid phase extraction and dispersive liquid/liquid extraction. Bioassay analysis using cell-based reporter gene assays revealed estrogenic, androgenic, and dioxin-like activity in AF extract corresponding to 1.4 nmol EEQ/L, 76.6 pmol DHT-EQ/L, and 10.1 pmol TEQ/L, respectively. Targeted analysis revealed 13 xenobiotics, phytoestrogens, and endogenous hormones in the AF extract that partly contributed to the bioassay activity. Separation of the complex mixture of chemicals in the AF extract with reversed-phase chromatographic fractionation and subsequent bioassay analysis revealed activity in fractions over a wide range of polarity, indicating diverse (unidentified) substances with potential ED activity. The method developed here represents the first methodological step in an effect-directed analysis approach to identify unknown biologically active compounds in the fetal environment.

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Use of amniotic fluid for determining pregnancies at risk of preterm birth and for studying diseases of potential environmental etiology

Cited by 16 publications

References 122 publications

Fetal and early neonatal interleukin-6 response

Fetal and early neonatal interleukin-6 response

Toxicant Disruption of Immune Defenses: Potential Implications for Fetal Membranes and Pregnancy

Method Development for Effect-Directed Analysis of Endocrine Disrupting Compounds in Human Amniotic Fluid

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