RESUMO
Illicit drug use is a serious and complex public health problem, not only due to the severity of the health damage but also to the social implications, such as marginalization and drug trafficking. Currently, cocaine (COC) is among the most abused drugs worldwide with about 22 million users. Drug abuse has also been found in women during the pregnancy period, which has shed light on a new group for epidemiology. The diagnosis of COC use in these cases usually depends largely on the mother's reports, which in several cases omit or deny consumption. Therefore, considering physical-chemical methods of sample preparation and exposure biomarkers, the development of analytic toxicological methods can help to confirm drug use during pregnancy. Thus, the objective of the present work was to develop an analytical method based on dispersive liquid-liquid microextraction for the determination of COC analytes, using umbilical cord tissue as an alternative biological matrix, and detection by gas chromatography coupled to mass spectrometry. Therefore, after optimization, the dispersive liquid-liquid microextraction method was fully validated for quantification of COC, benzoylecgonine, cocaethylene, ecgonine, ecgonine methyl ester and norcocaine. The limits of detection were between 15 and 25 ng/g, the limits of quantification were 30 ng/g for ecgonine and 25 ng/g for the other analytes. Linearity ranged from the limits of quantification to 1,000 ng/g. Coefficients of variation for intra-assay precision were <18.5%, inter-assay was <8.75% and bias was <16.4% for all controls. The developed method was applied in 10 suspected positive samples, based on the mother's report and maternal urine screening and confirmation. COC, benzoylecgonine, ecgonine and ecgonine methyl ester were quantified in four umbilical cords with concentrations that ranged from 39.6 to 420.5 ng/g.
Assuntos
Cocaína , Cromatografia Gasosa-Espectrometria de Massas , Microextração em Fase Líquida , Troca Materno-Fetal , Detecção do Abuso de Substâncias , Cordão Umbilical , Humanos , Cocaína/análogos & derivados , Cocaína/análise , Feminino , Gravidez , Cordão Umbilical/química , Detecção do Abuso de Substâncias/métodos , Limite de Detecção , Reprodutibilidade dos Testes , Exposição MaternaRESUMO
Introducción: La placenta sintetiza y secreta varias hormonas que permiten la regulación del embarazo, el trabajo de parto y la adaptación metabólica materno-fetal. Su comportamiento asociado al tipo de parto puede dar información relevante sobre efectos epigenéticos. Objetivo: Describir el tipo de parto con los niveles de oxitocina, cortisol y hormonas tiroideas en plasma de cordón umbilical al nacer. Método: A 50 mujeres con embarazos principalmente normales se les cuantificaron los niveles neurohormonales en plasma de cordón umbilical, obtenido inmediatamente tras el periodo expulsivo. Los resultados se incorporaron a la base de datos clínicos de cada participante y se analizaron con Stata v.14.0. El protocolo fue aprobado por el comité de ética. Resultados: Hubo 33 partos vaginales (12 espontáneos, 13 acelerados y 8 inducidos) y 17 cesáreas (7 electivas y 10 de urgencia). Se observaron mayores niveles de cortisol en los partos vaginales acelerados; las cesáreas tuvieron menores niveles de cortisol y hormona estimulante de la tiroides. Las intervenciones clínicas, con altos o bajos niveles hormonales, están en directa relación con el tipo de parto. Conclusiones: El cortisol y la hormona estimulante de la tiroides medidos en plasma de cordón umbilical variaron según el tipo de parto. Esto es una primera cuantificación de hormonas en plasma de cordón umbilical y su posible regulación placentaria a propósito del tipo de parto.
Introduction: The placenta synthesizes and secretes several hormones allowing the regulation of pregnancy, labor and maternal-fetal metabolic adaptation. Their behavior associated with the type of delivery, may provide relevant information on epigenetic effects. Objective: To describe the type of delivery with the levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma at birth. Method: Neurohormonal levels from umbilical cord plasma obtained immediately post expulsion, were quantified in 50 women with mainly normal pregnancies. Results incorporated into the clinical database of each participant, statistically analyzed in Stata v.14.0. Protocol approved by ethics committee. Results: 33 were vaginal deliveries (12 spontaneous, 13 accelerated, 8 induced) and 17 cesarean sections (7 elective and 10 emergency). Higher cortisol levels were observed in accelerated vaginal deliveries, cesarean sections had lower cortisol and thyroid stimulating hormone levels. While clinical interventions, with high or low hormone levels, were related to the type of delivery. Conclusions: Cortisol and thyroid stimulating hormone measured in umbilical cord plasma varied according to the type of delivery. This is a first quantification of hormones in umbilical cord plasma and their possible placental regulation in relation to the type of delivery.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Hormônios Placentários/metabolismo , Parto Obstétrico , Sangue Fetal/química , Hormônios Tireóideos/análise , Cordão Umbilical/química , Hidrocortisona/análise , Ocitocina/análise , Cesárea , Estudos Transversais , Circulação PlacentáriaRESUMO
Introduction: Congenital hypothyroidism is a preventable cause of cognitive disability. Due to the absence of symptoms and signs in the newborn, it is necessary to perform screening tests. Its incidence ranges between 1:2,500 and 1:6,000. Objective: To describe the anthropometric and demographic characteristics, as well as the cord TSH levels, serum TSH, and serum T4L levels of the positive patients during screening and patients with confirmed congenital hypothyroidism. Materials and methods: We conducted a retrospective observational study for 17 years based on the review of clinical laboratory and medical records to describe the demographic and anthropometric characteristics of the patients at the time of diagnosis. Results: We analyzed 41,494 newborns in the 17 years of follow-up; 217 (0.52%) were positive in the screening test and the diagnosis was confirmed by serum tests (TSH and free T4) in 19 cases (8.76%) for an incidence of one for every 2,183 live births; 78.95% of the children with congenital hypothyroidism were born full-term and the average gestational age was 37.3 weeks, similar to that of those with no congenital hypothyroidism. There was no difference in the average weight and height at birth between the children with the condition and those who did not have it. TSH in the cord in the cases of congenital hypothyroidism was significantly higher than in the discarded cases. Conclusions: The incidence of congenital hypothyroidism was similar to that found in the literature. There were no relevant clinical differences between confirmed and ruled out cases reflecting the relevance of neonatal screening.
Introducción. El hipotiroidismo congénito es una causa prevenible de discapacidad cognitiva. Dada la ausencia de signos y síntomas al nacer, es necesario hacer pruebas de tamización para detectarlo. Su incidencia oscila entre uno de cada 2.500 y uno de cada 6.000 nacidos vivos. Objetivo. Describir las características antropométricas y demográficas de los participantes, así como medir la concentración de tirotropina (TSH) en sangre de cordón umbilical y de TSH y tiroxina libre (T4 libre) en el suero de los recién nacidos positivos en la prueba de tamización y de aquellos con hipotiroidismo congénito confirmado. Materiales y métodos. Se hizo un estudio observacional retrospectivo de un periodo de 17 años mediante la revisión de los registros de laboratorio clínico y las historias para establecer las características demográficas y antropométricas en el momento del nacimiento. Resultados. Se analizaron 41.494 recién nacidos. Se encontraron 217 (0,52 %) recién nacidos con prueba positiva de tamización, 19 (8,76 %) de ellos con diagnóstico confirmado mediante pruebas séricas (TSH y T4 libre), para una incidencia de uno por cada 2.183 nacidos vivos. El 78,95 % de los casos de hipotiroidismo congénito correspondió a nacidos a término, el promedio de la edad gestacional fue de 37,3 semanas, similar al de quienes no lo presentaban. No hubo diferencia en el promedio de peso ni en la talla al nacer entre los afectados y los no afectados. La concentración de TSH en sangre de cordón umbilical fue significativamente mayor en los casos de hipotiroidismo congénito que en los recién nacidos sanos. Conclusiones. La incidencia de hipotiroidismo congénito fue similar a la encontrada en los estudios consultados. No hubo diferencias clínicas relevantes entre los casos confirmados y los descartados, lo que resalta la pertinencia de la tamización neonatal para el diagnóstico temprano y el tratamiento oportuno.
Assuntos
Hipotireoidismo Congênito/epidemiologia , Colômbia/epidemiologia , Hipotireoidismo Congênito/sangue , Hipotireoidismo Congênito/diagnóstico , Feminino , Idade Gestacional , Hospitais Universitários , Humanos , Incidência , Recém-Nascido , Masculino , Triagem Neonatal , Estudos Retrospectivos , Distribuição por Sexo , Tireotropina/sangue , Tiroxina/análise , Tiroxina/sangue , Fatores de Tempo , Cordão Umbilical/químicaRESUMO
Raltegravir (RAL) is a HIV-integrase inhibitor recommended for treatment of HIV type 1 infection during pregnancy. The elimination of RAL to RAL glucuronide (RAL GLU) is mediated primarily by UDP glucuronosyltransferase 1A1 (UGT1A1). The present study shows the development and validation of 4 different methods for the analysis of RAL and RAL GLU in plasma and in urine samples. The methods were applied to evaluate the maternal-fetal pharmacokinetics of RAL and RAL GLU in a HIV-infected pregnant woman receiving RAL 400â¯mg twice daily. The sample preparation for RAL and RAL GLU analysis in 25⯵L plasma and 100⯵L diluted urine (10-fold with water containing 0.1% formic acid) were carried out by protein precipitation procedure. RAL and RAL GLU generate similar product mass fragments and require separation in the chromatographic system, so a suitable resolution was achieved for unchanged RAL and RAL GLU employing Ascentis Express C18 (75â¯×â¯4.6â¯mm, 2.7⯵m) for both plasma and urine samples. The methods showed linearities at the ranges of 0.1-13.5⯵g/mL RAL and 0.15-19.5⯵g/mL RAL GLU in urine and 10-2000â¯ng/mL RAL and 2.5-800 RAL GLU in plasma. Precise and accurate evaluation showed coefficients of variation and relative errors ≤ 15%. The methods have been successfully applied in a maternal-fetal pharmacokinetic study.
Assuntos
Infecções por HIV/tratamento farmacológico , Inibidores de Integrase de HIV/análise , Troca Materno-Fetal , Complicações Infecciosas na Gravidez/tratamento farmacológico , Raltegravir Potássico/análise , Brasil , Cromatografia Líquida de Alta Pressão/métodos , Feminino , Glucuronídeos/administração & dosagem , Glucuronídeos/sangue , Glucuronídeos/química , Infecções por HIV/sangue , Infecções por HIV/urina , Inibidores de Integrase de HIV/administração & dosagem , Inibidores de Integrase de HIV/química , Inibidores de Integrase de HIV/farmacocinética , Humanos , Recém-Nascido , Permeabilidade , Placenta/metabolismo , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/urina , Terceiro Trimestre da Gravidez/metabolismo , Raltegravir Potássico/administração & dosagem , Raltegravir Potássico/química , Raltegravir Potássico/farmacocinética , Espectrometria de Massas em Tandem/métodos , Cordão Umbilical/químicaRESUMO
OBJECTIVE: We measured the level of pH gases in premature infants at birth, and examined the relationship between brain ultrasonography on the third and seventh day after birth. A case-control study conducted at the Neonatal Intensive Care Unit (NICU) of Shahid Akbar Abadi Hospital, Iran, during the years 2016-2017. METHODS: All premature infants who were admitted to NICU were enrolled in the current study. At birth, a blood gas sample was taken from the umbilical cord of the infants. On the third and seventh day after birth, an ultrasound of the brain of each neonate was performed by a radiologist. The umbilical cord was evaluated for blood gases in 72 neonates (mostly boys). RESULTS: Sixty-six newborns had normal sonography, and 16.7% (12 cases) had anomalies. A total of 75% of the 8 infants with intravenous bleeding were girls, which were significantly different from those in the non-hemodynamic group (62.5% male) (P 0.049). However, the type of delivery, mean weight, height, head circumference, the circumference of the chest, and Apgar score did not differ between the two groups. Mean pH, HCO3- and PCO2 in umbilical cord blood gas samples were not significantly different between the two groups with or without intraventricular hemorrhage (IVH). Although it was not related to gender and type of delivery in newborns. CONCLUSION: Blood gases do not help in determining the occurrence of IVH in infants. Nevertheless, it is associated with immaturity and fetal age.
Assuntos
Hemorragia Cerebral Intraventricular/sangue , Concentração de Íons de Hidrogênio , Doenças do Prematuro/sangue , Recém-Nascido Prematuro/sangue , Cordão Umbilical/química , Distribuição por Idade , Índice de Apgar , Gasometria , Feminino , Sangue Fetal/química , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Estatísticas não ParamétricasRESUMO
SUMMARY OBJECTIVE: We measured the level of pH gases in premature infants at birth, and examined the relationship between brain ultrasonography on the third and seventh day after birth. A case-control study conducted at the Neonatal Intensive Care Unit (NICU) of Shahid Akbar Abadi Hospital, Iran, during the years 2016-2017. METHODS: All premature infants who were admitted to NICU were enrolled in the current study. At birth, a blood gas sample was taken from the umbilical cord of the infants. On the third and seventh day after birth, an ultrasound of the brain of each neonate was performed by a radiologist. The umbilical cord was evaluated for blood gases in 72 neonates (mostly boys). RESULTS: Sixty-six newborns had normal sonography, and 16.7% (12 cases) had anomalies. A total of 75% of the 8 infants with intravenous bleeding were girls, which were significantly different from those in the non-hemodynamic group (62.5% male) (P 0.049). However, the type of delivery, mean weight, height, head circumference, the circumference of the chest, and Apgar score did not differ between the two groups. Mean pH, HCO3- and PCO2 in umbilical cord blood gas samples were not significantly different between the two groups with or without intraventricular hemorrhage (IVH). Although it was not related to gender and type of delivery in newborns CONCLUSION: Blood gases do not help in determining the occurrence of IVH in infants. Nevertheless, it is associated with immaturity and fetal age.
RESUMO OBJETIVOS: Medimos o nível de gases de pH em bebês prematuros, no nascimento dos neonatos, e examinamos a relação entre a ecografia cerebral no terceiro e no sétimo dia após o nascimento. Um estudo de casos e controles realizados na Unidade de Cuidados Intensivos Neonatais (UCIN) do Hospital Shahid Akbar Abadi durante os anos de 2016-2017, Irã. MÉTODOS: Todos os recém-nascidos prematuros que deram entrada na UCIN foram inscritos no estudo atual. Ao nascer, foi retirada uma amostra de gás em sangue, do sangue do cordão umbilical dos bebês. No terceiro e sétimo dia após o nascimento, um radiologista realizou uma ecografia do cérebro de cada neonato. O cordão umbilical foi avaliado para detectar gases no sangue em 72 neonatos (em sua maioria do sexo masculino). RESULTADOS: Sessenta e seis recém-nascidos tinham ecografia normal e 16.7% (12 casos) tinham anomalias. 75% das 8 crianças com hemorragia intravenosa eram meninas, que foram significativamente diferentes das do grupo não hemodinâmico (62.5% homens) (P.0.049). Contudo, o tipo de parto, o peso médio, a altura, o perímetro cefálico, a circunferência do tórax e a pontuação de Apgar não foram diferentes entre os grupos. O pH médio, HCO3 e PCO2 nas amostras de gás no sangue do cordão umbilical não foram significativamente diferentes entre dois grupos com ou sem hemorragia intraventricular (Hiv). Apesar de não estar relacionado com o gênero e o tipo de parto em recém-nascidos. Conclusão: os gases sanguíneos não ajudam a determinar o aparecimento de Hiv nos bebês. Contudo, está associado com a imaturidade e idade fetal.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Cordão Umbilical/química , Recém-Nascido Prematuro/sangue , Hemorragia Cerebral Intraventricular/sangue , Concentração de Íons de Hidrogênio , Doenças do Prematuro/sangue , Índice de Apgar , Valores de Referência , Gasometria , Unidades de Terapia Intensiva Neonatal , Fatores Sexuais , Fatores de Risco , Distribuição por Sexo , Distribuição por Idade , Estatísticas não Paramétricas , Sangue Fetal/químicaRESUMO
OBJECTIVE: In neonates on total parenteral nutrition (TPN), amino acids may be a risk factor for developing total parenteral nutrition-associated cholestasis (TPNAC). We aimed, first, to compare methionine, cysteine, and taurine plasma levels between neonates on TPN who were receiving an intravenous amino acid solution based on a breast milk aminogram and those on an intravenous solution of pediatric amino acids based on an umbilical cord aminogram, and second, to determine the frequency of TPNAC. METHODS: A double-blind randomized controlled trial was conducted. Ninety-four neonates with a birthweight of 1000g or more and a gestational age of 30 wk or older were admitted and enrolled. Blood samples were obtained at 0, 7, and 14 d of TPN, and plasma amino acid concentrations were determined by ultra-high-resolution liquid chromatography. Continuous variables were compared using the Wilcoxon rank-sum test or Student's t test; categorical variables were compared using the Fisher exact test. RESULTS: Thirty-five neonates completed the study (Primene, nâ¯=â¯14; TrophAmine, nâ¯=â¯21). On day 14, methionine plasma concentrations were significantly lower in the Primene group than in the TrophAmine group (27 µmol/L versus 32.9 µmol/L, Pâ¯=â¯0.044); the taurine concentration was significantly higher in the same group (72.4 µmol/L versus 45.3 µmol/L, P < 0.0001). There were no differences in TPNAC incidence. CONCLUSIONS: Administering an intravenous solution of pediatric amino acids based on the umbilical cord aminogram yielded a higher taurine and lower methionine plasma concentration than did administering a similar solution based on the breast milk aminogram.
Assuntos
Aminoácidos/administração & dosagem , Colestase/epidemiologia , Cisteína/sangue , Metionina/sangue , Nutrição Parenteral/efeitos adversos , Taurina/sangue , Peso ao Nascer , Colestase/etiologia , Método Duplo-Cego , Eletrólitos/administração & dosagem , Feminino , Idade Gestacional , Glucose/administração & dosagem , Humanos , Incidência , Recém-Nascido , Masculino , Leite Humano/química , Soluções/administração & dosagem , Cordão Umbilical/químicaRESUMO
In a retrospective study of 501 neonates with potential in utero substance exposure, the drug detection performance of a commercially available umbilical cord tissue toxicology test was evaluated against a commercially available gold standard meconium toxicology test. Drugs detected in paired meconium and umbilical cord tissue samples were often discordant.
Assuntos
Drogas Ilícitas/análise , Troca Materno-Fetal/fisiologia , Mecônio/química , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Detecção do Abuso de Substâncias/métodos , Cordão Umbilical/química , Feminino , Seguimentos , Humanos , Drogas Ilícitas/toxicidade , Recém-Nascido , Masculino , Mecônio/citologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Estudos Retrospectivos , Cordão Umbilical/citologiaRESUMO
Vitamin E is important because of its antioxidant activity in situations of oxidative stress, especially postnatally. Hence, the objective was to verify whether maternal alpha-tocopherol level is associated with the alpha-tocopherol levels of the newborn and colostrum. This is a cross-sectional study of 58 women and their term newborns from a public hospital. Blood and colostrum were collected to measure alpha-tocopherol levels by high-performance liquid chromatography. Mothers with serum alpha-tocopherol levels <16.2 mmol L(-1) and newborns <11.6 mmol L(-1) were indicative of deficiency or low levels. Mothers were divided into two groups: <16.2 mmol L(-1) and those with levels ≥16.2 mmol L(-1) . The mean (95% confidence interval) serum alpha-tocopherol levels of mothers, umbilical cords and colostrum were 28 (24-32), 6 (5-8) and 39 mmol L(-1) (32-45), respectively (P < 0.001); 19% of the women and 90% of the newborns had low alpha-tocopherol levels. Maternal alpha-tocopherol level was associated with that of the umbilical cord. Newborns from mothers at risk of deficiency had low alpha-tocopherol levels (P < 0.001). Colostrum levels of vitamin E were not influenced by maternal serum. Maternal deficiency influenced the vitamin E level of the umbilical cord but does not in the colostrum, evidencing distinct transfer mechanisms via the mammary gland.
Assuntos
Colostro/química , Fenômenos Fisiológicos da Nutrição Materna , Vitamina E/sangue , alfa-Tocoferol/sangue , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Lactação , Mães , Estado Nutricional , Gravidez , Cordão Umbilical/química , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/diagnóstico , Adulto JovemRESUMO
Cigarette smoking during pregnancy has several impacts on fetal development, including teratogenic effects. The objective of this study was to assess whether the toxic substances (cotinine and polycyclic aromatic hydrocarbons) found in pregnant smokers are transmitted to their fetuses. The outcomes were analyzed measuring cotinine and 1-hydroxypyrene in the amniotic fluid and maternal urine, benzopyrene and cotinine in the umbilical cord blood. Through a controlled cross-sectional design, 125 pregnant women were selected and classified according to their smoking status: 37 current smokers, 25 passive smokers and 63 non-smokers (controls). We performed high-performance liquid chromatography to measure substances' concentrations. A post-hoc Tukey's test was used to analyze the differences between the groups. All variables were significantly different between controls and smokers. The mean ratios between the concentration of cotinine in smokers compared to controls were as follows: 5.9 [2.5-13.5], p<0.001 in the urine; 25 [11.9-52.9], p<0.001 in the amniotic fluid; and 2.6 [1.0-6.8], pâ=â0.044 in the umbilical cord blood. The mean ratios of 1-hydroxypyrene concentration between smokers and controls were 7.3 [1.6-29.6], pâ=â0.003 in the urine and 1.3 [1.0-1.7], pâ=â0.012 in the amniotic fluid, and of benzopyrene in umbilical cord blood was 2.9 [1.7-4.7], p<0.001. There were no significant differences between controls and passive smokers. When comparing the three groups together, there were statistical differences between all variables. Thus, the fetuses of pregnant smokers are exposed to toxic and carcinogens substances. To our knowledge, this is the first study to measure 1-hydroxypyrene in the amniotic fluid and benzopyrene in umbilical cord blood by high-performance liquid chromatography when considering pregnant women in relation to smoking exposure only.
Assuntos
Líquido Amniótico/química , Cotinina/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Gravidez/urina , Fumar/efeitos adversos , Cordão Umbilical/química , Adulto , Cromatografia Líquida , Cotinina/urina , Estudos Transversais , Feminino , Humanos , Exposição Materna/efeitos adversos , Hidrocarbonetos Policíclicos Aromáticos/urina , Fumar/urina , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/análise , Adulto JovemRESUMO
BACKGROUND: Lead exposure in adults is associated with hypertension. Altered prenatal nutrition is associated with subsequent risks of adult hypertension, but little is known about whether prenatal exposure to toxicants, such as lead, may also confer such risks. OBJECTIVES: We investigated the relationship of prenatal lead exposure and blood pressure (BP) in 7- to 15-year-old boys and girls. METHODS: We evaluated 457 mother-child pairs, originally recruited for an environmental birth cohort study between 1994 and 2003 in Mexico City, at a follow-up visit in 2008-2010. Prenatal lead exposure was assessed by measurement of maternal tibia and patella lead using in vivo K-shell X-ray fluorescence and cord blood lead using atomic absorption spectrometry. BP was measured by mercury sphygmomanometer with appropriate-size cuffs. RESULTS: Adjusting for relevant covariates, maternal tibia lead was significantly associated with increases in systolic BP (SBP) and diastolic BP (DBP) in girls but not in boys (p-interaction with sex = 0.025 and 0.007 for SBP and DBP, respectively). Among girls, an interquartile range increase in tibia lead (13 µg/g) was associated with 2.11-mmHg [95% confidence interval (CI): 0.69, 3.52] and 1.60-mmHg (95% CI: 0.28, 2.91) increases in SBP and DBP, respectively. Neither patella nor cord lead was associated with child BP. CONCLUSIONS: Maternal tibia lead, which reflects cumulative environmental lead exposure and a source of exposure to the fetus, is a predisposing factor to higher BP in girls but not boys. Sex-specific adaptive responses to lead toxicity during early-life development may explain these differences.
Assuntos
Pressão Sanguínea , Osso e Ossos/química , Poluentes Ambientais/toxicidade , Hipertensão/epidemiologia , Chumbo/toxicidade , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Cordão Umbilical/química , Adolescente , Criança , Estudos de Coortes , Feminino , Seguimentos , Humanos , Hipertensão/induzido quimicamente , Estudos Longitudinais , Masculino , México/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Estudos Prospectivos , Fatores SexuaisRESUMO
Foetal exposure to lead (Pb) during pregnancy is a major problem. However, no previous study has examined whether Pb concentrations in blood (Pb-B) and in serum (Pb-S) from pregnant women correlate with Pb-B and Pb-S in the foetuses. This hypothesis was tested in the present study. We measured Pb-B and Pb-S in 120 healthy pregnant women (more than 38 weeks of gestation) and their respective umbilical cord samples. The analyses were carried out with an inductively coupled plasma mass spectrometer. We found higher Pb-B levels in the women compared with their respective umbilical cord samples (1.736 ± 0.090 µg/dL and 1.194 ± 0.062 µg/dL, respectively; p < 0.05). In parallel, we found higher Pb-S levels in the women compared with their respective umbilical cord samples (0.042 ± 0.003 µg/dL and 0.032 ± 0.003 µg/dL, respectively; p < 0.05). However, similar %Pb-S/Pb-B ratios were found in the women compared with their respective umbilical cord samples (2.414 ± 0.210% and 2.740 ± 0.219%, respectively; p > 0.05). Interestingly, we found positive correlations between Pb-B in the umbilical cords and Pb-B in the respective pregnant women (rs = 0.5714; p < 0.0001), and between Pb-S in the umbilical cords and Pb-S in the respective pregnant women (rs = 0.3902; p < 0.0001) as well as between %Pb-B/Pb-S in the umbilical cords and %Pb-B/Pb-S in the respective pregnant women (rs = 0.3767; p < 0.0001). These results indicate that the assessment of Pb-B and Pb-S in pregnant women provides relevant indexes of foetal exposure to Pb. Moreover, the similar %Pb-S/Pb-B in pregnant women and in the umbilical cords shows that the foetuses are directly exposed to the rapidly exchangeable Pb fraction found in their mothers.
Assuntos
Chumbo/sangue , Troca Materno-Fetal , Período Periparto , Cordão Umbilical/química , Feminino , Sangue Fetal/química , Feto , Humanos , Gravidez , Soro/química , Adulto JovemRESUMO
Umbilical veins (UV) and arteries (UA) of preeclamptic women in Curaçao harbor lower long-chain polyunsaturated fatty acids (LCP). The present aim was to test these findings in Mwanza (Tanzania), whose inhabitants have high LCPomega3 and LCPomega6 intakes from Lake Victoria fish. Women with preeclampsia (n=28) in Mwanza had lower PUFA and higher 20:0 in UV and UA, compared with normotensive/non-proteinuric controls (n=31). Their UV 22:6omega3, 22:4omega6, LCPomega6, omega6, and LCPomega3+omega6 were lower, while saturated FA, potentially de novo synthesized FA (Sigmade novo) and (Sigmade novo)/(LCPomega3+omega6) ratio were higher. Their UA had higher 16:1omega7, omega7, 18:0, and 16:1omega7/16:0. Umbilical vessels in Mwanza had higher 22:6omega3, LCPomega3, omega3, and 16:0, and lower 22:5omega6, 20:2omega6, 18:1omega9, and omega9, compared to those in Curaçao. Preeclampsia in both Mwanza and Curaçao is characterized by lower LCP and higher Sigmade novo. An explanation of this might be placental dysfunction, while the similarity of umbilical vessel FA-abnormalities in preeclamptic and diabetic pregnancies suggests insulin resistance as a common denominator.
Assuntos
Ácidos Graxos Ômega-3/análise , Ácidos Graxos Ômega-6/análise , Ácidos Graxos/análise , Produtos Pesqueiros , Pré-Eclâmpsia/metabolismo , Cordão Umbilical/química , Adolescente , Adulto , Gorduras Insaturadas na Dieta/metabolismo , Ácidos Graxos Insaturados/análise , Feminino , Humanos , Antilhas Holandesas , Gravidez , Tanzânia , Artérias Umbilicais/química , Veias Umbilicais/química , Adulto JovemRESUMO
This study assessed the effect of delayed (1 minute after delivery) clamping of the umbilical cord on hemoglobin and ferritin levels in infants at three months of age. Mothers and their infants born through vaginal delivery, at term, and without congenital anomalies (325 pairs) were recruited at a hospital in São Paulo, Brazil, in 2006 (164 in the delayed clamping subgroup and 161 in the early clamping subgroup). Maternal hemoglobin at delivery, umbilical cord hemoglobin, and ferritin were recorded. At three months follow-up, venous blood samples were drawn from 224 (69%) infants for hemoglobin and ferritin measurement. Socioeconomic, maternal reproductive, anthropometric, and infant feeding variables were studied. Multiple linear regression models were used to analyze the data. The effect of delayed clamping at birth, measured at three months, was only significant for ferritin (p = 0.040), and the concentration was higher (23.29ng/mL) in this subgroup as compared to the early clamping subgroup. Delayed umbilical cord clamping can serve as a strategy to improve infant iron status and prevent iron deficiency.
Assuntos
Anemia/etiologia , Ferritinas/sangue , Hemoglobinas/análise , Cordão Umbilical , Anemia/epidemiologia , Anemia/prevenção & controle , Anemia Ferropriva/prevenção & controle , Brasil/epidemiologia , Constrição , Humanos , Lactente , Parto Normal , Fatores Socioeconômicos , Fatores de Tempo , Cordão Umbilical/químicaRESUMO
OBJECTIVE: The aim was to identify exposure levels to dichlorodiphenyltrichloroethane (DDT) and to assess maternal factors as determinants of the serum dichlorodiphenyldichloroethylene (DDE) concentration in umbilical cord in newborns from the Mexican Pacific coastal area of Oaxaca State. MATERIALS AND METHODS: A cross-sectional study was conducted of 86 paired mothers and newborns from the Oaxaca community of Pochutla. Blood and umbilical cord blood samples were collected to determine DDT and DDE by GC. Information concerning possible determinant factors with regard to pesticide concentration was obtained by means of a questionnaire. RESULTS: A positive correlation between maternal and umbilical cord serum DDE concentration was observed (geometric mean of 7.69 microg g(-1) and 7.29, respectively). Multiple analyses showed that significant maternal factors related to umbilical cord serum DDE concentrations were: always having lived in the same community; low to high socioeconomic strata; accumulated breast-feeding time. CONCLUSIONS: The determinant factors observed in this study must be considered in future studies for the quantification of organochlorine concentration. In addition, these factors must be taken into account when preventive actions to minimize in utero exposure to these pesticides are carried out.
Assuntos
Diclorodifenil Dicloroetileno/sangue , Poluentes Ambientais/sangue , Exposição Materna , Praguicidas/sangue , Cordão Umbilical/química , Adolescente , Adulto , DDT/sangue , Monitoramento Ambiental , Feminino , Humanos , Recém-Nascido , Lactação , Masculino , México , Gravidez , Fatores SocioeconômicosRESUMO
Este estudo verificou o efeito do clampeamento tardio (um minuto após o nascimento) do cordão umbilical sobre os níveis de hemoglobina e ferritina em crianças aos três meses de vida. Foram alocadas 325 mães e crianças, nascidas a termo, de parto vaginal e sem patologias (164 no grupo do clampeamento imediato e 161 no tardio) em um hospital do Município de São Paulo, Brasil, em 2006. Realizaram-se dosagens de hemoglobina da mãe no pré-parto e de hemoglobina e ferritina do cordão umbilical. As crianças (69 por cento) foram acompanhadas no ambulatório, após três meses, ocorrendo coleta de sangue venoso para dosagem de hemoglobina e ferritina. Variáveis sócio-econômicas, reprodutivas, antropométricas e de alimentação da criança foram estudadas. Utilizou-se a regressão linear múltipla para a análise dos dados. O efeito do clampeamento tardio do cordão umbilical foi significativo somente para os níveis de ferritina das crianças aos três meses de idade (p = 0,040), sendo superior em 23,29ng/mL quando comparado às crianças submetidas ao clampeamento imediato. O procedimento pode se constituir em uma estratégia para prevenir a deficiência de ferro em lactentes.
This study assessed the effect of delayed (1 minute after delivery) clamping of the umbilical cord on hemoglobin and ferritin levels in infants at three months of age. Mothers and their infants born through vaginal delivery, at term, and without congenital anomalies (325 pairs) were recruited at a hospital in São Paulo, Brazil, in 2006 (164 in the delayed clamping subgroup and 161 in the early clamping subgroup). Maternal hemoglobin at delivery, umbilical cord hemoglobin, and ferritin were recorded. At three months follow-up, venous blood samples were drawn from 224 (69 percent) infants for hemoglobin and ferritin measurement. Socioeconomic, maternal reproductive, anthropometric, and infant feeding variables were studied. Multiple linear regression models were used to analyze the data. The effect of delayed clamping at birth, measured at three months, was only significant for ferritin (p = 0.040), and the concentration was higher (23.29ng/mL) in this subgroup as compared to the early clamping subgroup. Delayed umbilical cord clamping can serve as a strategy to improve infant iron status and prevent iron deficiency.
Assuntos
Humanos , Lactente , Anemia/etiologia , Ferritinas/sangue , Hemoglobinas/análise , Cordão Umbilical , Anemia Ferropriva/prevenção & controle , Anemia/epidemiologia , Anemia/prevenção & controle , Brasil/epidemiologia , Constrição , Parto Normal , Fatores Socioeconômicos , Fatores de Tempo , Cordão Umbilical/químicaRESUMO
Fish is an important item in the diet of Amazonians, and per se is their best single source of essential nutrients. Rapid urbanization and migration are bringing changes in dietary habits of Amazonians. Exposure to fish-Hg during pregnancy and lactation were studied in 100 women and newborns from Porto Velho. Tissue-Hg concentrations and neurodevelopment (Gesell Developmental Schedules) were assessed at birth and at 6 months in exclusively breastfed infants. Maternal mean frequency of fish consumption was low (<2 meals/week; range 0->7 meals/week) compared to Amazonian standards. Women consuming <2 fish meals/week showed less median hair-Hg (3.5 microgg-1) than women that consumed 2 fish meals/week (5.7 microgg). Median total Hg in maternal hair (5.4 microgg-1) was higher than in newborns (1.6 microgg-1). Significant correlation was observed between maternal hair-Hg and infant hair-Hg at birth (r=0.353; p<0.01) and at six months (r=0.510; p<0.01). Placenta-Hg was also significantly correlated to maternal hair-Hg (r=0.321; p<0.01), newborn hair-Hg (r=0.219; p<0.05), maternal blood-Hg (r=0.250; p<0.01) and to umbilical cord-Hg (r=0.857; p<0.01). Most infants (74%) had normal Gesell Schedules but among the 26% showing neuro-motor development delays only six (7%) had multiple (motor, language, and adaptative) delays. The infants with multiple delays were born from mothers with range of hair-Hg comparable to mothers of normally developed infants. Coincidentally, mothers of infants with multiple delays also showed the lowest range of income and level of education. Fish consumption, income, and level of education varied greatly among these breastfeeding urban mothers. It seems that development delays of exclusively breastfed infants are a component of the health inequalities that accompanies socioeconomic disadvantages.
Assuntos
Aleitamento Materno , Contaminação de Alimentos , Exposição Materna/efeitos adversos , Mercúrio/toxicidade , Poluentes Químicos da Água/toxicidade , Adolescente , Adulto , Animais , Brasil , Monitoramento Ambiental , Feminino , Peixes , Cabelo/química , Humanos , Lactente , Recém-Nascido , Desenvolvimento da Linguagem , Mercúrio/análise , Mercúrio/sangue , Destreza Motora/efeitos dos fármacos , Placenta/química , Gravidez , Cordão Umbilical/química , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/sangueRESUMO
The effect of prenatal lead acetate exposure was studied microscopically together with the concentration of lead and lipid fluorescent products (LFP) in the brain of rat fetuses. Wistar rats were intoxicated with a lead solution containing either 160 or 320 ppm of lead acetate solution during 21 days through drinking water. The control group (ten rats) received deionized water for the same period. The rats were killed on gestation day 21 and fetuses were obtained; the placenta, umbilical cord and parietal cortex (Cx), striatum (St), thalamus (Th) and cerebellum (Ce) were collected for measuring tissue lead concentration, LFP as an index of lipid peroxidation and histopathologic examination. Lead contents were increased in placenta, umbilical cord, St, Th and Cx in both lead-exposed groups. Lead exposure increased (LFP) in placenta and umbilical cord, St, Th and Ce as compared to the control group. Histopathological examination showed severe vascular congestion in placenta, the Cx, St, Th and Ce with hyperchromatic and shrunken cells. Interstitial oedema was found in all regions studied of both lead exposed groups. The morphometric evaluation of the studied brain regions showed an absolute decrease in total cell number and increased number of damaged cells and interstitial oedema. Our results show that morphological changes in rat brain are correlated with increased lipid peroxidation, and the lead levels of the umbilical cord, however it is not clear whether oxidative stress is the cause or the consequence of these neurotoxic effects of lead.
Assuntos
Encéfalo/efeitos dos fármacos , Encéfalo/embriologia , Peroxidação de Lipídeos/efeitos dos fármacos , Compostos Organometálicos/toxicidade , Efeitos Tardios da Exposição Pré-Natal , Lesões Pré-Natais/patologia , Animais , Encéfalo/metabolismo , Encéfalo/patologia , Química Encefálica/efeitos dos fármacos , Edema Encefálico/patologia , Cerebelo/química , Cerebelo/embriologia , Cerebelo/metabolismo , Cerebelo/patologia , Córtex Cerebral/química , Córtex Cerebral/embriologia , Córtex Cerebral/metabolismo , Córtex Cerebral/patologia , Corpo Estriado/química , Corpo Estriado/embriologia , Corpo Estriado/metabolismo , Corpo Estriado/patologia , Feminino , Histocitoquímica , Chumbo/análise , Chumbo/sangue , Lipídeos/análise , Placenta/química , Placenta/metabolismo , Placenta/patologia , Gravidez , Lesões Pré-Natais/induzido quimicamente , Lesões Pré-Natais/metabolismo , Ratos , Ratos Wistar , Tálamo/química , Tálamo/embriologia , Tálamo/metabolismo , Tálamo/patologia , Cordão Umbilical/química , Cordão Umbilical/metabolismo , Cordão Umbilical/patologiaRESUMO
The expression of purinergic P2Y receptors (P2YRs) along the cord, superficial chorionic vessels and cotyledons of the human placenta was analysed and functional assays were performed to determine their vasomotor activity. Immunoblots for the P2Y(1)R and P2Y(2)R revealed a 6- to 8-fold increase in receptor expression from the cord to the chorionic or cotyledon vessels. In the cord and chorionic vessels the receptor distribution was mainly in the smooth muscle, whereas in the cotyledon vessels these receptors were equally distributed between the endothelium and smooth muscle cells. An exception was the P2Y(2)R at the umbilical artery, which was distributed as in the cotyledon. mRNA coding for the P2Y(1)R and P2Y(2)R were detected by RT-PCR and the mRNA coding for the P2Y(4)R, P2Y(6)R and P2Y(11)R was also identified. Application of 2-MeSADP and uridine triphosphate (UTP), preferential P2Y(1)R and P2Y(2)R ligands, respectively, resulted in contraction of isolated rings from umbilical and chorionic vessels. The vasoconstriction was blocked in a concentration-dependent manner by 10-100 nm indomethacin or 10 nm GR32191, suggesting the involvement of thromboxane receptors. MRS 2179, a selective P2Y(1)R antagonist, reduced the 2-MeSADP- but not the UTP-evoked contractions. Perfusion of cotyledons with 2-MeSADP or UTP evoked concentration-dependent reductions in perfusion pressure mediated by the NO-cGMP pathway. Blockade of NO synthase abolished the vasodilatation and the rise in luminal NO elicited by either agonist. MRS 2179 antagonized the dilatation and rise in luminal NO evoked by 2-MeSADP but not by UTP. In summary, P2Y(1)R and P2Y(2)R are unevenly distributed along the human placental vascular tree; both receptors are coupled to different signalling pathways in the cord/chorionic vessels versus the cotyledon leading to opposing vasomotor responses.