RESUMO
El uso de bisfenol-A (BPA) a nivel de la industria global se ha venido incrementando en los ultimos anos, y fueron los mercados emergentes los impulsores de esta demanda creciente. Las aplicaciones de BPA en la industria de los alimentos y bebidas representan solo del 3 al 4% del consumo global de policarbonato, pero su uso esta siendo reexaminado debido a que se conocieron varios trabajos cientificos que indican la existencia de una relacion directa entre el BPA y los efectos adversos para la salud. La contaminacion de los alimentos y bebidas se produce por migracion del BPA desde los envases que los contienen (alimentos enlatados, vinos, etc.), y es la principal fuente de exposicion en el humano. Para evaluar dicha exposicion se desarrollo y valido un metodo analitico por cromatografia gaseosa acoplada a espectrometria de masa para la cuantificacion de BPA total en orina de mujeres embarazadas atendidas en el Hospital Italiano de Buenos Aires en el ano 2013, con un limite de cuantificacion de 2,0 ng/mL y un limite de deteccion de 0,8 ng/mL. De las 149 muestras de orina analizadas, el 66,4% fueron cuantificables, con la mediana de BPA total de 4,8 ng/mL (4,3 ng/mg de creatinina) y la media geometrica de 4,8 ng/mL (4,7 ng/mg de creatinina).
The use of bisphenol-A (BPA) at the level of the global industry has been increasing in recent years, with emerging markets being the drivers of this growing demand. BPA applications in the food and beverage industry represent only 3 to 4% of the global consumption of polycarbonate, but its use is being reexamined because several scientific works were reported indicating the existence of a direct relationship between BPA and adverse effects on health. The contamination of food and beverages is produced by the migration of BPA from the containers that hold them (canned foods, wines, etc.) and it is the main source of exposure in humans. To evaluate this exposure, an analytical method was developed by gas chromatography coupled to mass spectrometry for the quantification of total BPA in urine of pregnant women treated at the Hospital Italiano de Buenos Aires in 2013, with a limit of quantification of 2.0 ng/mL and of detection of 0.8 ng/mL. Of the 149 urine samples analyzed, 66.4% were quantifiable, with a median total BPA of 4.8 ng/mL (4.3 ng/mg creatinine) and a geometric mean of 4.8 ng/mL (4.7 ng/mg creatinine).
O uso de bisfenol-A (BPA) ao nivel da industria global foi aumentando nos ultimos anos, e foram os mercados emergentes que deram impulso a essa demanda crescente. As aplicacoes de BPA na industria de alimentos e bebidas representam apenas 3 a 4% do consumo global de policarbonato, mas seu uso esta sendo reexaminado visto que varios trabalhos cientificos indicando a existencia de uma relacao direta entre o BPA e os efeitos adversos na saude foram conhecidos. A contaminacao dos alimentos e bebidas e produzida pela migracao de BPA das embalagens que os contem (alimentos enlatados, vinhos, etc.) e e a principal fonte de exposicao em humanos. Para avaliar esta exposicao, foi desenvolvido e avaliado um metodo analitico por cromatografia gasosa acoplada a espectrometria de massas para a quantificacao do BPA total na urina de gestantes atendidas no Hospital Italiano de Buenos Aires em 2013, com um limite de quantificacao de 2,0 ng/mL e um limite de deteccao de 0,8 ng/mL. Das 149 amostras de urina analisadas, 66,4% foram quantificaveis, com uma mediana de BPA total de 4,8 ng/mL (4,3 ng/mg de creatinina) e a media geometrica de 4,8 ng/mL (4,7 ng/mg de creatinina).
Assuntos
Humanos , Feminino , Gravidez , Urina , Gravidez/urina , Disruptores Endócrinos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Espectrometria de Massas/métodos , Toxicologia/estatística & dados numéricos , Indústria Alimentícia , Saúde , Cromatografia Gasosa/métodos , Alimentos e Bebidas , Gestantes , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , AlimentosRESUMO
Abstract Objectives: to determine the prevalence of urinary incontinence (UI) during pregnancy, to identify and quantify the factors associated with gestational UI. Methods: a cross-sectional study carried out with women admitted for deliveries in all maternity wards in the city of Botucatu (São Paulo). Data were collected through a structured questionnaire, based on the literature, containing questions about the occurrence of UI, its types, risk factors and moments when urinary losses occurred. Associations between UI and the predictive variables were analyzed with logistic regression models. Results: 950 women were interviewed, out of which 472 complained of urinary losses during pregnancy, resulting in a prevalence of 49.68% (CI95%= 46.51 - 52.86). The majority (61.8%) were classified as mixed UI. Among the covariates investigated, smoking (OR= 4.56), illicit drugs use (OR= 25.14), stimulant foods (OR= 1.84), constipation (OR=1.99), hypertensive disorders during gestation (OR= 3.23), gestational diabetes mellitus (OR= 2.89), parity (OR= 1.52) and previous caesarean sections (OR= 2.56) increased the chance of urinary losses during pregnancy. Conclusions: there was a high prevalence of UI during pregnancy. This condition was strongly associated with lifestyle habits and gestational morbidities. Finally, it is worth high-lighting the fact that delivery via caesarean section increased the chance of UI in subsequent pregnancies.
Resumo Objetivos: estimar a prevalência de incontinência urinária (IU) na gestação, identificar e quantificar fatores associados à IU gestacional. Métodos: estudo transversal realizado com mulheres admitidas para o parto nas maternidades da cidade de Botucatu (São Paulo). Foi utilizado um questionário estruturado, baseado na literatura, contendo perguntas sobre a ocorrência de IU, seus tipos, fatores de riscos e momentos que ocorreram as perdas urinárias. Associações entre a ocorrência de IU e as variáveis preditoras foram analisadas por meio de modelos de regressão logística. Resultados: 950 mulheres foram entrevistadas, dessas 472 queixaram-se de perdas urinárias no período gestacional, resultando em uma prevalência de 49,68% (IC95%= 46,51 - 52,86), sendo a maioria (61,8%) classificada como IU mista. Entre as covariáveis investigadas, tabagismo (OR= 4,56), consumo drogas ilícitas (OR= 25,14), alimentos estimulantes (OR=1,84), constipação intestinal (OR= 1,99), distúrbios hipertensivos na gestação (OR=3,23), diabetes mellitus gestacional (OR= 2,89), paridade (OR=1,52) e parto cesárea (OR= 2,56) aumentaram a chance de perdas urinárias na gestação. Conclusões: houve uma alta prevalência de IU no período gestacional. Esta condição esteve fortemente associada à fatores como hábitos de vida e morbidades gestacionais. Por fim, merece destaque o achado que o parto via cesárea aumentou a chance de IU em gestação subsequente.
Assuntos
Humanos , Feminino , Gravidez , Complicações na Gravidez , Incontinência Urinária/etiologia , Incontinência Urinária/epidemiologia , Gravidez/urina , Gravidez/estatística & dados numéricos , Brasil , Estudos Transversais , Fatores de RiscoRESUMO
BACKGROUND: Preterm birth is a global public health issue and rates in Puerto Rico are consistently among the highest in the USA. Exposures to environmental contaminants might be a contributing factor. METHODS: In a preliminary analysis from the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort (nâ¯=â¯1090), we investigated the association between urinary phthalate metabolite concentrations measured at three study visits (targeted at 20, 24, and 28â¯weeks of gestation) individually and averaged over pregnancy with gestational age at delivery and preterm birth. We additionally assessed differences in associations by study visit and among preterm births with a spontaneous delivery. RESULTS: Compared to women in the general USA population, urinary concentrations of metabolites of di-n-butyl phthalate (DBP) and di-isobutyl phthalate (DiBP) were higher among pregnant women in Puerto Rico. Interquartile range (IQR) increases in pregnancy-averages of urinary metabolites of DBP and DiBP were associated with shorter duration of gestation and increased odds of preterm birth. An IQR increase in mono-n-butyl phthalate (MBP), a metabolite of DBP, was associated with 1.55â¯days shorter gestation (95% confidence interval [CI]â¯=â¯-2.68, -0.42) and an odds ratio (OR) of 1.42 (95% confidence interval [CI]: 1.07, 1.88) for preterm birth. An IQR increase in mono-isobutyl phthalate (MiBP), a metabolite of DiBP, was associated with 1.16â¯days shorter gestation (95% CIâ¯=â¯-2.25, -0.08) and an OR of 1.32 (95% CI: 1.02, 1.71) for preterm birth. Associations were greatest in magnitude for urinary concentrations measured at the second study visit (median 23â¯weeks gestation). DiBP metabolite associations were greatest in magnitude in models of spontaneous preterm birth. No associations were detected with other phthalate metabolites, including those of di-2-ethylhexyl phthalate. CONCLUSION: Among pregnant women in the PROTECT cohort, DBP and DiBP metabolites were associated with increased odds of preterm birth. These exposures may be contributing to elevated rates of preterm birth observed in Puerto Rico.
Assuntos
Poluentes Ambientais/urina , Ácidos Ftálicos/urina , Plastificantes/análise , Gravidez/urina , Nascimento Prematuro/epidemiologia , Adolescente , Adulto , Monitoramento Biológico , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Razão de Chances , Nascimento Prematuro/urina , Porto Rico/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Prenatal exposure to some phenols and parabens has been associated with adverse birth outcomes. Hormones may play an intermediate role between phenols and adverse outcomes. We examined the associations of phenol and paraben exposures with maternal reproductive and thyroid hormones in 602 pregnant women in Puerto Rico. Urinary triclocarban, phenol and paraben biomarkers, and serum hormones (estriol, progesterone, testosterone, sex-hormone-binding globulin (SHBG), corticotropin-releasing hormone (CRH), total triiodothyronine (T3), total thyroxine (T4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH)) were measured at two visits during pregnancy. METHODS: Linear mixed models with a random intercept were constructed to examine the associations between hormones and urinary biomarkers. Results were additionally stratified by study visit. Results were transformed to hormone percent changes for an inter-quartile-range difference in exposure biomarker concentrations (%Δ). RESULTS: Bisphenol-S was associated with a decrease in CRH [(%Δ -11.35; 95% CI: -18.71, - 3.33), and bisphenol-F was associated with an increase in FT4 (%Δ: 2.76; 95% CI: 0.29, 5.22). Butyl-, methyl- and propylparaben were associated with decreases in SHBG [(%Δ: -5.27; 95% CI: -9.4, - 1.14); (%Δ: -3.53; 95% CI: -7.37, 0.31); (%Δ: -3.74; 95% CI: -7.76, 0.27)]. Triclocarban was positively associated with T3 (%Δ: 4.08; 95% CI: 1.18, 6.98) and T3/T4 ratio (%Δ: 4.67; 95% CI: -1.37, 6.65), and suggestively negatively associated with TSH (%Δ: -10.12; 95% CI: -19.47, 0.32). There was evidence of susceptible windows of vulnerability for some associations. At 24-28 weeks gestation, there was a positive association between 2,4-dichlorophenol and CRH (%Δ: 9.66; 95% CI: 0.67, 19.45) and between triclosan and estriol (%Δ: 13.17; 95% CI: 2.34, 25.2); and a negative association between triclocarban and SHBG (%Δ: -9.71; 95% CI:-19.1, - 0.27) and between bisphenol A and testosterone (%Δ: -17.37; 95% CI: -26.7, - 6.87). CONCLUSION: Phenols and parabens are associated with hormone levels during pregnancy. Further studies are required to substantiate these findings.
Assuntos
Carbanilidas/urina , Poluentes Ambientais/urina , Hormônios/sangue , Parabenos/análise , Fenóis/urina , Gravidez/urina , Adulto , Biomarcadores/urina , Estudos de Coortes , Monitoramento Ambiental , Feminino , Humanos , Exposição Materna , Porto Rico , Adulto JovemRESUMO
BACKGROUND: Human exposure to phthalates and other non-persistent chemicals in developing countries is largely unknown. A preliminary analysis of urinary samples from pregnant Brazilian women revealed the presence of metabolites of Diisopentyl phthalate (DiPeP). OBJECTIVES: Reliably quantify DiPeP metabolites in human urine and investigate the potential antiandrogenic activity of this phthalate in rats. METHODS: We initiated a pilot pregnancy cohort in Curitiba, Brazil, to examine phthalate exposure in urine samples collected in early pregnancy (nâ¯=â¯50) or pooled samples from early, mid and late pregnancy (nâ¯=â¯44). Our well established phthalate method was modified to include the primary DiPeP metabolite, monoisopentyl phthalate (MiPeP), and two additional secondary oxidized metabolites, 3OH-MiPeP and 4OH-MiPeP. In a parallel approach, we orally exposed pregnant rats to DiPeP or Di-n-butyl phthalate (DnBP; reference phthalate) at 0, 125, 250, and 500â¯mg/kg/day from gestation day 14 to 18 and measured ex vivo fetal testis testosterone production. RESULTS: We were able to detect and quantify specific DiPeP metabolites in nearly all (98%) of the early pregnancy urine samples and in all gestational pool samples with a median concentration for MiPeP of 3.65 and 3.15⯵g/L, respectively, and for the two oxidized metabolites between 1.00 and 1.70⯵g/L. All three urinary DiPeP metabolites were strongly correlated (râ¯=â¯0.89 to 0.99). In the rat model, the effective dose (mg/kg/day) inhibiting fetal testosterone production by 50% (ED50 [95% confidence interval]) was 93.6 [62.9-139.3] for DiPeP which was significantly lower than for DnBP (220.3 [172.9-280.7]), highlighting the strong antiandrogenic potency of DiPeP within the spectrum of the phthalates. CONCLUSIONS: We unveiled and confirmed the exposure of pregnant Brazilian women to DiPeP via specific urinary metabolites. This unexpected and ubiquitous DiPeP exposure indicates to unique DiPeP exposure sources in Brazil. These exposures spark considerable concern because DiPeP is one of the most potent antiandrogenic phthalates.
Assuntos
Antagonistas de Androgênios/urina , Poluentes Ambientais/urina , Ácidos Ftálicos/urina , Gravidez/urina , Adulto , Antagonistas de Androgênios/toxicidade , Animais , Brasil , Monitoramento Ambiental , Poluentes Ambientais/toxicidade , Feminino , Feto/efeitos dos fármacos , Feto/metabolismo , Humanos , Masculino , Ácidos Ftálicos/toxicidade , Ratos Wistar , Testículo/efeitos dos fármacos , Testículo/metabolismo , Testosterona/metabolismoRESUMO
BACKGROUND: Dichlorodiphenyldichloroethene (p,p´-DDE), the main metabolite of dichlorodiphenyltrichloroethane (DDT), has been associated with changes in human thyroid hormone levels. Maternal thyroid hormones are essential for adequate fetal neurodevelopment during the first half of pregnancy. OBJECTIVE: To evaluate the association between maternal p,p´-DDE concentration and the maternal thyroid profile during the first half of pregnancy. MATERIALS AND METHODS: We analyzed the information of 430 pregnant women from a Mexican floriculture area, with a gestational age ≤16 weeks. By questionnaire, we obtained sociodemographic, reproductive, and life-style, information. Serum concentrations of thyroid stimulating hormone (TSH), and total and free T3 and T4 were determined by means of Enzyme-Linked ImmunoSorbent Assay (ELISA). p,p´-DDE was analyzed by Gas Chromatography. The association between p,p´-DDE and thyroid profile was assessed through linear and logistic regression models. RESULTS: Thirty eight percent of women had p,p´-DDE levels below the Limit of Detection and 12.3% below the Limit of Quantification. Within the quantifiable range, median was 53.03ng/g. TSH >2.5 mIU/L was present in 9.3% of women; 47.7% had isolated hypothyroxinemia; 3.5% had subclinical hypothyroidism, and 5.8% had overt hypothyroidism. We observed a significant positive association between quantifiable p,p´-DDE and total T3 serum levels in comparison with those with concentrations below the Limit of Detection (ß=0.19; 95% CI=0.06, 0.34). There were no significant associations with other hormones of the thyroid profile or with clinical diagnosis. CONCLUSIONS: Our findings suggest that p,p´-DDE exposure, even at low concentrations, could disrupt thyroid homeostasis during pregnancy.
Assuntos
Diclorodifenil Dicloroetileno/sangue , Poluentes Ambientais/sangue , Gravidez/sangue , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adolescente , Adulto , Monitoramento Ambiental , Feminino , Humanos , Iodo/urina , México , Gravidez/urina , Adulto JovemRESUMO
Problema: a infecção do trato urinário é uma das principais afecções ocorridas no período gravídico, sendo causadora de importantes complicações materno-fetais que podem levar à morte. Objetivos: aplicar uma cartilha educativa sobre a prevenção da infecção urinária em um grupo de gestantes e analisar os problemas de enfermagem relacionados à ocorrência desse agravo. Método: estudo descritivo, qualitativo, realizado com 15 gestantes em uma unidade de Saúde da Família de Petrópolis/RJ, em abril de 2015. Os dados foram coletados por entrevistas individual e grupal e analisados por meio da técnica de triangulação dos dados. Resultado: a aplicação da cartilha evidenciou problemas de enfermagem relacionados à higiene, à alimentação, à ingestão hídrica, à eliminação intestinal e urinária, e ao coito. Conclusão: o uso da tecnologia impressa é uma importante ferramenta de discussão e aprendizado no processo de educação em saúde, e qualifica a prática assistencial do enfermeiro. (AU)
Problem: urinary tract infections are one of the main conditions that occur in the pregnancy period, causing important maternal-fetal complications that can lead to death. Aims: to implement an educational booklet on the prevention of urinary tract infections in a group of pregnant women and analyze the nursing problems related to the occurrence of this disease. Method: a descriptive, qualitative study with fifteen pregnant women at a Family Health Unit in Petrópolis, RJ, Brazil in April, 2015. Data was collected through interviews - individual and group - and was analyzed using the data triangulation technique. Results: the application of the booklet revealed nursing problems related to hygiene, food, water intake, intestinal and urinary elimination and coitus. Conclusion: the use of printed technology is an important tool for discussion and learning in the health education process, and it can be used to qualify the nurses' care practice. (AU)
Assuntos
Humanos , Feminino , Gravidez , Educação em Saúde , Infecções/urina , Enfermagem Materno-Infantil/educação , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações na Gravidez/enfermagem , Complicações na Gravidez/prevenção & controle , Infecções/enfermagem , Gravidez , Gravidez/urinaRESUMO
BACKGROUND: There is need to assess the developmental neurotoxicity of fluoride. Our knowledge of prenatal fluoride exposure is challenged as few population-based studies have been conducted and these generally date back several decades, provide incomplete data on sociodemographic variables, and have methodological limitations. OBJECTIVE: To measure urinary and plasma fluoride levels across three time points in pregnant mothers who were enrolled in the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) birth cohort study. METHODS: Fluoride levels were characterized in archived urine and plasma from 872 pregnant mothers sampled from the ELEMENT cohort. Various statistical methods were used to analyze the fluoride data with particular consideration for changes across three stages of pregnancy and against sociodemographic variables. RESULTS: All samples had detectable levels of fluoride. The mean urinary and plasma fluoride levels were 0.91 and 0.0221mg/L respectively, and these were not statistically different across three stages of pregnancy. Fluoride levels correlated across the stages of pregnancy studied, with stronger correlations between neighboring stages. Urinary fluoride changed as pregnancy progressed with levels increasing until ~23 weeks and then decreasing until the end of pregnancy. For plasma fluoride, there was a decreasing trend but this was not of statistical significance. Creatinine-adjusted urinary fluoride levels did not associate consistently with any of the sociodemographic variables studied. CONCLUSIONS: This study provides the most extensive characterization to date of fluoride exposure throughout pregnancy. These results provide the foundation to explore exposure-related health outcomes in the ELEMENT cohort and other studies.
Assuntos
Fluoretos/sangue , Fluoretos/urina , Gravidez/sangue , Gravidez/urina , Adulto , Estudos de Coortes , Monitoramento Ambiental , Feminino , Humanos , Recém-Nascido , Masculino , Exposição Materna , Troca Materno-Fetal , México , Adulto JovemRESUMO
STUDY QUESTION: How do women's first morning urinary cortisol levels, a marker of stress axis activity, vary during the peri-conceptional period (the 12 weeks around conception)? SUMMARY ANSWER: First morning urinary cortisol follows an overall increasing trajectory across the peri-conceptional period, interrupted by 2 week-long decreases during the week preceding conception and the fifth week following conception. WHAT IS KNOWN ALREADY: Later gestational stages (i.e. second and third trimesters) are characterized by increasing levels of circulating cortisol. This increase is hypothesized to constitute a response to the energy demands imposed by fetal growth, and the development of energy reserves in preparation for nursing and performing regular activities while carrying pregnancy's extra weight and volume. STUDY DESIGN, SIZE, DURATION: This study is based on a data set collected as part of a longitudinal, naturalistic investigation into the interactions between the stress (hypothalamic-pituitary-adrenal axis (HPAA)) and reproductive (hypothalamic-pituitary-gonadal axis (HPGA)) axes. Biomarkers of HPAA and HPGA function were quantified in first morning urinary specimens collected every other day from 22 healthy women who conceived a pregnancy during the study. We analyzed the longitudinal within- and between-individual variation in first morning urinary cortisol levels across the 12-week peri-conceptional period. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were recruited from two rural, aboriginal, neighboring communities in Guatemala. Cortisol, estradiol and progesterone metabolites (estrone-3-glucuronide and pregnanediol glucuronide, respectively) and hCG levels were quantified in first morning urinary specimens using immunoassays to determine time of conception and confirm pregnancy maintenance. Linear mixed-effects models with regression splines were used to evaluate the magnitude and significance of changes in cortisol trajectories. MAIN RESULTS AND THE ROLE OF CHANCE: Overall, maternal first morning urinary cortisol increased from 6 weeks prior to conception (geometric mean ± SD = 58.14 ± 36.00 ng/ml) to 6 weeks post-conception (89.29 ± 46.76 ng/ml). The magnitude of the increase between the pre- and post-conception periods varied significantly between women (likelihood ratio test statistic = 8.0017, P = 0.005). The peri-conceptional period is characterized by an increasing cortisol trajectory (+1.36% per day; P = 0.007) interrupted by a week-long decline immediately prior to conception (-4.02% per day; P = 0.0013). After conception cortisol increased again (+1.73% per day; P = 0.0008) for 4 weeks, fell in the fifth week (-6.60% per day; P = 0.0002) and increased again in post-conceptional week 6 (+8.86% per day; P = 0.002). Maternal urinary cortisol levels varied with sex of the gestating embryo. During gestational week 2, mothers carrying female embryos (N = 10) had higher mean cortisol levels than those carrying male embryos (N = 9) (t(17) = 2.28, P = 0.04). LIMITATIONS, REASONS FOR CAUTION: Our results are based on a relatively small sample (n = 22) of women. However, our repeated-measures design with an average of 27 ± 8 (mean ± SD) data points per woman strengthens the precision of estimates resulting in high statistical power. Additionally, our study population's high degree of ethnic and cultural homogeneity reduces the effects of confounders compared with those found in industrialized populations. This higher level of homogeneity also increases our statistical power. However, since there may be small differences in absolute cortisol values among ethnic groups, the social and biological background of our sample may affect the generalizability of our results. General patterns of HPAA activity, however, are expected to be universal across women. Finally, as there is, to the best of our knowledge, no evidence to the contrary, we assumed that urinary cortisol levels reflect HPAA activity and that changes in gonadal steroids across the menstrual cycle do not affect the levels of free cortisol measured in urine. WIDER IMPLICATIONS OF THE FINDINGS: To our knowledge, this is the first longitudinal profile of basal maternal HPAA activity across the peri-conceptional period. A basic understanding of the normative (basal as opposed to stress-induced) changes in HPAA activity across this period is needed to accurately assess women's stress at this juncture. Importantly, changes in HPAA activity are likely to play a critical role in ovulation, fertilization, implantation, placentation and embryonic programing. Thus, this novel information should aid in the development of interventions aimed at preventing or moderating undesired effects of maternal physiological stress during the peri-conceptional period on reproductive outcomes as well as embryonic development. STUDY FUNDING/COMPETING INTERESTS: This research was funded by a CIHR IGH Open Operating grant (CIHR 106705) to P.A.N. and L.Z.; a Simon Fraser University (SFU) President's Start-up grant, a Community Trust Endowment Fund grant through SFU's Human Evolutionary Studies Program and a Michael Smith Foundation for Health Research Career Investigator Scholar Award to P.A.N.; an NSERC Discovery grant to L.Z.; a CIHR Post-Doctoral Fellowship to C.K.B. and an NSERC Undergraduate Student Research Award to H.M. and J.C.B. The funding agencies had no role in the design, analysis, interpretation or reporting of the findings. There are no competing interests. TRIAL REGISTRATION NUMBER: Not applicable.
Assuntos
Fertilização , Hidrocortisona/urina , Gravidez/urina , Progesterona/urina , Biomarcadores/urina , Gonadotropina Coriônica/urina , Estradiol/urina , Estrona/análogos & derivados , Estrona/urina , Feminino , Guatemala , Humanos , Modelos Lineares , Pregnanodiol/análogos & derivados , Pregnanodiol/urina , Progesterona/metabolismo , Análise de RegressãoRESUMO
BACKGROUND: Increasing scientific evidence suggests that exposure to phthalates during pregnancy may be associated with an elevated risk of adverse reproductive outcomes such as preterm birth. Maternal endocrine disruption across pregnancy may be one pathway mediating some of these relationships. We investigated whether urinary phthalate metabolites were associated with maternal serum thyroid (free thyroxine [FT4], free triiodothyronine [FT3], and thyroid-stimulating hormone [TSH]), and sex (estradiol, progesterone, and sex hormone-binding globulin [SHBG]) hormone levels at multiple time points during pregnancy. METHODS: Preliminary data (n = 106) were obtained from an ongoing prospective birth cohort in Northern Puerto Rico. We collected urine and serum sample at the first and third study visits that occurred at 18 +/- 2 and 26 +/- 2 weeks of gestation, respectively. To explore the longitudinal relationships between urinary phthalate metabolites and serum thyroid and sex hormone concentrations, we used linear mixed models (LMMs) adjusted for prepregnancy body mass index (BMI) and maternal age. An interaction term was added to each LMM to test whether the effect of urinary phthalate metabolites on serum thyroid and sex hormone levels varied by study visit. In cross-sectional analyses, we stratified BMI- and age-adjusted linear regression models by study visit. RESULTS: In adjusted LMMs, we observed significant inverse associations between mono-3-carboxypropyl phthalate (MCPP) and FT3 and between mono-ethyl phthalate (MEP) and progesterone. In cross-sectional analyses by study visit, we detected stronger and statistically significant inverse associations at the third study visit between FT3 and MCPP as well as mono-carboxyisooctyl phthalate (MCOP); also at the third study visit, significant inverse associations were observed between FT4 and metabolites of di-(2-ethylhexyl) phthalate (DEHP). The inverse association between MEP and progesterone was consistent across study visits. CONCLUSIONS: In this group of pregnant women, urinary phthalate metabolites may be associated with altered maternal serum thyroid and sex hormone levels, and the magnitude of these effects may depend on the timing of exposure during gestation.
Assuntos
Hormônios Esteroides Gonadais/sangue , Ácidos Ftálicos/urina , Gravidez/sangue , Gravidez/urina , Hormônios Tireóideos/sangue , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Mães , Ácidos Ftálicos/metabolismo , Projetos Piloto , Porto Rico , 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: There are potential adverse health risks to the mother and fetus from exposure to pesticides. Thus, studies of exposure to pesticides among pregnant women are of interest as they will assist with understanding the potential burden of exposure globally, identifying sources of exposure, and designing epidemiology studies. METHODS: We measured urinary concentrations of the insect repellent N-N-diethyl-meta-toluamide (DEET) and two of its metabolites [3-diethyl-carbamoyl benzoic acid (DCBA) and N,N-diethyl-3-hydroxymethylbenzamide (DHMB)], four pyrethroid insecticide metabolites [4-fluoro-3-phenoxybenzoic acid (4-F-3-PBA); 3-phenoxybenzoic acid (3-PBA); trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (trans-DCCA); and cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane carboxylic acid (cis-DBCA)], and two chlorophenoxy herbicides [2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)] in 54 pregnant women from Puerto Rico at three separate time points (20 ± 2 weeks, 24 ± 2 weeks, and 28 ± 2 weeks of gestation). We calculated the distributions of the biomarker concentrations and compared them to those of women of reproductive age from the general U.S. population where available, and estimated the within-subject temporal variability of these repeated measurements. We also collected questionnaire data on demographics, consumption of select fruits, vegetables, and legumes in the past 48-hr, and pest-related issues, and associations between these variables and biomarker concentrations were examined. RESULTS: We found that 95th percentile urinary concentrations of DEET, 3-PBA, trans-DCCA, and 2,4-D were lower than women of reproductive age on the U.S. mainland, whereas 95th percentile urinary concentrations of 4-F-3-PBA, cis-DBCA, and 2,4,5-T were similar. DCBA, the only urinary biomarker detected in >50% of the samples, showed fair to good reproducibility across pregnancy (intraclass correlation coefficient: 0.60). Women were more likely (p <0.05) to have greater urinary concentrations of pesticide biomarkers if they were less educated (DCBA and trans-DCCA), unemployed (DHMB), or married (2,4-D), had consumed collards or spinach in past 48-hr (2,4-D) or had been using insect repellent since becoming pregnant (DCBA), or were involved with residential applications of pesticides (trans-DCCA). CONCLUSIONS: We identified concentrations and predictors of several pesticides among pregnant women in Puerto Rico. Further research is needed to understand what aspects of the predictors identified lead to greater exposure, and whether exposure during pregnancy is associated with adverse health.
Assuntos
Poluentes Ambientais/urina , Herbicidas/urina , Repelentes de Insetos/urina , Inseticidas/urina , Gravidez/urina , Ácido 2,4,5-Triclorofenoxiacético/urina , Ácido 2,4-Diclorofenoxiacético/urina , Adolescente , Adulto , Biomarcadores/urina , DEET/análogos & derivados , DEET/urina , Monitoramento Ambiental , Feminino , Contaminação de Alimentos/análise , Humanos , Inquéritos Nutricionais , Porto Rico , Piretrinas/urina , Adulto JovemRESUMO
OBJECTIVE: To characterise the haemodynamic, renal-electrolyte and hormonal parameters in normal near-term pregnancy. DESIGN: Observational prospective case-series study. SETTING AND POPULATION: Eleven women with normal pregnancies at 35-39 weeks gestation. METHODS: Following baseline laboratory assessments and placement of a right-atrial catheter, serial measurements were obtained for 2 hours in the supine position (SP) followed by a change to the (LLP) and subsequent observations for 2 hours. MAIN OUTCOME MEASURES: Blood pressure (BP), central venous pressure (CVP), atrial natriuretic peptide (ANP), plasma renin activity (PRA), plasma aldosterone (ALDO), diuresis, creatinine clearance, sodium and potassium excretion. RESULTS: In the SP, the subjects' BP remained stable while their CVP decreased. In the LLP, the subjects' systolic and diastolic BP consistently decreased by about 15 mmHg and their CVP increased within the first 60 minutes. ANP levels doubled in the subjects while they rested in the LLP, whereas the subjects' PRA and ALDO levels decreased by half compared with when they rested in the SP. In the LLP, the subjects' creatinine clearance significantly increased by 12% and their sodium excretion and diuresis increased by 38% and 59% respectively. CONCLUSION: Rest in the LLP induces systemic and intra-renal haemodynamic and hormonal changes that may play a central physiological role in the renal excretory response to restore excessive sodium/water retention in late pregnancy.
Assuntos
Pressão Sanguínea/fisiologia , Rim/metabolismo , Gravidez/fisiologia , Adaptação Fisiológica , Adolescente , Adulto , Aldosterona/sangue , Fator Natriurético Atrial/sangue , Creatinina/urina , Diurese/fisiologia , Feminino , Humanos , Postura/fisiologia , Potássio/urina , Gravidez/sangue , Gravidez/urina , Terceiro Trimestre da Gravidez/sangue , Terceiro Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/urina , Renina/sangue , Sódio/urina , Decúbito Dorsal/fisiologia , Adulto JovemRESUMO
The Granada agar plate (GAP; Biomedics SL, Madrid, Spain) was evaluated for the detection of group B streptococci (GBS) in urine specimens from pregnant women submitted for testing for asymptomatic bacteriuria and was compared with blood agar (BA [Columbia agar with 5% sheep blood]; bioMérieux, Marcy l'Etoile, France). The GAP detected 103 out of 105 GBS, whereas BA detected only 50. Use of the GAP could be a good method for the detection of GBS in urine specimens from pregnant women.
Assuntos
Gravidez/urina , Infecções Estreptocócicas/prevenção & controle , Streptococcus agalactiae/isolamento & purificação , Ágar , Técnicas Bacteriológicas , Bacteriúria , Meios de Cultura , Feminino , Humanos , Recém-Nascido , Infecções Estreptocócicas/diagnóstico , Urina/microbiologiaRESUMO
Pregnancy is a physiological condition characterized by a progressive increase of the different components of the renin-angiotensin system (RAS). The physiological consequences of the stimulated RAS in normal pregnancy are incompletely understood, and even less understood is the question of how this system may be altered and contribute to the hypertensive disorders of pregnancy. Findings from our group have provided novel insights into how the RAS may contribute to the physiological condition of pregnancy by showing that pregnancy increases the expression of both the vasodilator heptapeptide of the RAS, angiotensin-(1-7) [Ang-(1-7)], and of a newly cloned angiotensin converting enzyme (ACE) homolog, ACE2, that shows high catalytic efficiency for Ang II metabolism to Ang-(1-7). The discovery of ACE2 adds a new dimension to the complexity of the RAS by providing a new arm that may counter-regulate the activity of the vasoconstrictor component, while amplifying the vasodilator component. The studies reviewed in this article demonstrate that Ang-(1-7) increases in plasma and urine of normal pregnant women. In preeclamptic subjects we showed that plasma Ang-(1-7) was suppressed as compared to the levels found in normal pregnancy. In addition, kidney and urinary levels of Ang-(1-7) were increased in pregnant rats coinciding with the enhanced detection and expression of ACE2. These findings support the concept that in normal pregnancy enhanced ACE2 may counteract the elevation in tissue and circulating Ang II by increasing the rate of conversion to Ang-(1-7). These findings provide a basis for the physiological role of Ang-(1-7) and ACE2 during pregnancy.
Assuntos
Angiotensina I/metabolismo , Fragmentos de Peptídeos/metabolismo , Peptidil Dipeptidase A/metabolismo , Pré-Eclâmpsia/sangue , Gravidez/metabolismo , Sistema Renina-Angiotensina/fisiologia , Angiotensina I/sangue , Angiotensina I/urina , Animais , Biomarcadores , Feminino , Humanos , Fragmentos de Peptídeos/sangue , Fragmentos de Peptídeos/urina , Peptidil Dipeptidase A/sangue , Peptidil Dipeptidase A/urina , Gravidez/sangue , Gravidez/urina , RatosRESUMO
Chronic exposure to inorganic arsenic (In-As) from drinking water is associated with different health effects, including skin, lung, bladder, and kidney cancer as well as vascular and possibly reproductive effects. In-As is metabolized through the process of methylation, resulting in the production and excretion of methylated species, mainly monomethylarsenate (MMA) and dimethylarsenate (DMA). Because a large percentage of the dose is excreted in urine, the distribution of urinary In-As, MMA, and DMA is considered a useful indicator of methylation patterns in human populations. Several factors affect these patterns, including sex and exposure level. In this study, we investigated the profile of urinary In-As, MMA, and DMA of pregnant women. Periodic urine samples were collected from early to late pregnancy among 29 pregnant women living in Antofagasta, Chile, who drank tap water containing 40 micro g/L In-As. The total urinary arsenic across four sampling periods increased with increasing weeks of gestation, from an initial mean value of 36.1 to a final value of 54.3 micro g/L. This increase was mainly due to an increase in DMA, resulting in lower percentages of In-As and MMA and a higher percentage of DMA. Our findings indicate that among women exposed to moderate arsenic from drinking water during pregnancy, changes occur in the pattern of urinary arsenic excretion and metabolite distribution. The toxicologic significance of this is not clear, given recent evidence suggesting that intermediate methylated species may be highly toxic. Nevertheless, this study suggests that arsenic metabolism changes throughout the course of pregnancy, which in turn may have toxicologic effects on the developing fetus. Key words: arsenic, arsenic metabolism, arsenic methylation, Chile, pregnancy, urinary arsenic.
Assuntos
Arsênio/análise , Arsênio/urina , Monitoramento Ambiental/métodos , Gravidez/urina , Poluentes Químicos da Água/análise , Abastecimento de Água/análise , Adulto , Chile , Creatinina/urina , Feminino , Idade Gestacional , Humanos , Metilação , Gravidez/metabolismo , Complicações na Gravidez/urina , Trimestres da Gravidez/urina , Fumar/urinaRESUMO
One of the defenses against nephrolithiasis is provided by macromolecules that modulate the nucleation, growth, aggregation and retention of crystals in the kidneys. The aim of the present study was to determine the behavior of two of these proteins, Tamm-Horsfall and uromodulin, in calcium oxalate crystallization in vitro. We studied a group of 10 male stone formers who had formed at least one kidney stone composed of calcium oxalate. They were classified as having idiopathic nephrolithiasis and had no well-known metabolic risk factors involved in kidney stone pathogenesis. Ten normal men were used as controls, as was a group consisting of five normal women and another consisting of five pregnant women. Crystallization was induced by a fixed supersaturation of calcium oxalate and measured with a Coulter Counter. All findings were confirmed by light and scanning electron microscopy. The number of particulate material deposited from patients with Tamm-Horsfall protein was higher than that of the controls (P<0.001). However, Tamm-Horsfall protein decreased the particle diameter of the stone formers when analyzed by the mode of the volume distribution curve (P<0.002) (5.64 +/- 0.55 microm compared to 11.41 +/- 0.48 microm of uromodulin; 15.94 +/- 3.93 microm and 12.45 +/- 0.97 microm of normal men Tamm-Horsfall protein and uromodulin, respectively; 8.17 +/- 1.57 microm and 9.82 +/- 0.95 microm of normal women Tamm-Horsfall protein and uromodulin, respectively; 12.17 +/- 1.41 m and 12.99 +/- 0.51 microm of pregnant Tamm-Horsfall protein and uromodulin, respectively). Uromodulin produced fewer particles than Tamm-Horsfall protein in all groups. Nonetheless, the total volume of the crystals produced by uromodulin was higher than that produced by Tamm-Horsfall protein. Our results indicate a different effect of Tamm-Horsfall protein and uromodulin. This dual behavior suggests different functions. Tamm-Horsfall protein may act on nucleation and inhibit crystal aggregation, while uromodulin may promote aggregation of calcium oxalate crystals.
Assuntos
Oxalato de Cálcio/química , Cálculos Renais/metabolismo , Mucoproteínas/fisiologia , Urina/química , Análise de Variância , Oxalato de Cálcio/urina , Estudos de Casos e Controles , Cristalização , Feminino , Humanos , Cálculos Renais/química , Cálculos Renais/ultraestrutura , Masculino , Gravidez/urina , UromodulinaRESUMO
Since normal human pregnancy is characterized by normotension in the face of an increased renin-angiotensin-aldosterone system (RAAS), we evaluated the temporal pattern of urinary excretion of a novel vasodilator within this system, angiotensin-(1-7) (Ang-[1-7]), during the menstrual cycle, pregnancy, and lactation. The urinary profiles of Ang I, Ang II, human chorionic gonadotropin, 17beta-estradiol, and progesterone were also determined. During the menstrual cycle, urinary Ang-(1-7) and Ang II remained stable (mean cycle value: 94.6 +/- 11.3 and 11.4 +/- 1.1 pmol/g of creatinine, respectively) in nine females. In 10 normal pregnant women, urinary Ang-(1-7) and Ang II increased throughout gestation, averaging 1499.8 +/- 310 and 224.4 +/- 58 pmol/g of creatinine, respectively (p < 0.05) at wk 35 and falling during lactation to 394.0 +/- 95 and 65.7 +/- 20 pmol/ g of creatinine (p < 0.05), respectively. The Ang-(1-7)/Ang II ratio was unchanged in the different reproductive periods. During the menstrual cycle, Ang II and Ang-(1-7) correlated with 17beta-estradiol and progesterone using multivariate analysis (r = 0.31, p < 0.001) and r = 0.28, p < 0.02, respectively). During gestation, 17beta-estradiol and progesterone correlated with urinary Ang-(1-7) (r = 0.48, p < 0.001 and r = 0.47, p < 0.001, respectively) and Ang II (r = 0.24, p < 0.03 and r = 0.25, p < 0.03, respectively); by multiple regression, only Ang-(1-7) correlated with both steroids (r = 0.49,p < 0.001). The progressive rise of Ang-(1-7) throughout gestation, probably modulated by estrogen and progesterone, suggests a physiologic counterregulation within the RAAS.
Assuntos
Angiotensinas/fisiologia , Lactação/urina , Ciclo Menstrual/urina , Gravidez/urina , Vasoconstrição/fisiologia , Vasodilatação/fisiologia , Adulto , Angiotensina I/fisiologia , Angiotensina I/urina , Angiotensina II/fisiologia , Angiotensina II/urina , Angiotensinas/urina , Feminino , Humanos , Fragmentos de Peptídeos/fisiologia , Fragmentos de Peptídeos/urinaRESUMO
Se estudió la frecuencia de producción de colicinas en 137 cepas provenientes de pacientes embarazadas con infección de vías urinarias (IVU), sintomática y asintomática. La frecuencia observada de cepas de E.coli uropatógenas, colicinogénicas aisladas en el primer grupo fue de 72.96 por ciento (n=96) mientras que en el segundo fue de 29.26 por ciento (n=41). Entre las cepas aisladas del grupo de pacientes sintomáticas, las colicinas encontradas con más frecuencia fueron: colicina V (23.9 por ciento), A (18.75 por ciento) y E1 (17.7 por ciento) y entre las cepas aisladas de población con infección asintomática, se identificaron con más frecuencia: colicina A (9.75 por ciento), E1 (17.0 por ciento) y V (2.4 por ciento). La frecuencia más elevada de colicina V en cepas provenientes de población sintomática con respecto a las aisladas en el grupo de pacientes asintomáticas, fue estadísticamente significativa (p = 0.025). Analizando la frecuencia de colicinas E1 y A, no se encontraron diferencias estadísticamente significativas. Entre las 137 cepas de E. coli estudiadas, se encontró que 37 por ciento de las mismas producen hemolisinas, observándose que 83.3 por ciento (n=24) de las cepas productoras de colicina V fueron hemolíticas mientras que 34 por ciento (n = 58) de cepas productoras de otras colicinas fueron hemolíticas y 12.7 por ciento (n=55) de las cepas hemolíticas no son colicinogénicas. Analizando los diferentes grupos productores de colicinas y hemolisinas se observa que estos resultados fueron estadísticamente significativos (p > 0.005). Los resultados presentados en este trabajo, sugieren que la producción de colicina entre cepas de Escherichia coli es un factor importante de patogenicidad, así como la asociación de hemolisina y colicina V, que puede favorecer que la infección de vías urinarias producida, se presente en forma de una infección sintomática.