scholarly journals Enhanced Serum Levels of sFlt1: Impact on Materno–Fetal CMV Transmission

2020 ◽  
Vol 9 (5) ◽  
pp. 1258 ◽  
Author(s):  
Lukas Penka ◽  
Karl-Oliver Kagan ◽  
Klaus Hamprecht
Keyword(s):  
Primary Infection ◽  
Cytomegalovirus Infection ◽  
Predictive Biomarker ◽  
Serum Levels ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Time Interval ◽  
Study Cohort ◽  
Cmv Infection ◽  
Fetal Infection

Background: Antenatal Cytomegalovirus infection (CMV) can be associated with severe fetal symptoms and newborn outcome. The current prenatal diagnosis is based on amniocentesis (AC). No reliable biomarker for fetal infection is available. Methods: We measured Placenta-derived growth factor (PlGF), and soluble fms-like tyrosine kinase 1 (sFlt1), concentrations in maternal serum and amniotic fluid (AF) in context of maternal CMV primary infection. Blood sampling was carried out at the time of AC for detection of fetal CMV infection. The study cohort was divided into four subcohorts according to the presence or absence of fetal infection and preemptive hyperimmunoglobulin (HIG) treatment during the time interval between diagnosis of the CMV primary infection and AC. Results: The study cohort involved 114 pregnancies. In the non-transmitting subcohorts (NT) with and without prior HIG treatment, the median sFlt1 concentrations were 1.5 ng/mL (NT, HIG+) and 1.4 ng/mL (NT, HIG−), respectively. In the two transmitting groups (T) the concentrations were 1.3 ng/mL (T, HIG+) and 2.3 ng/mL (T, HIG−), respectively (NT, HIG− vs. T, HIG−, p < 0.001). The corresponding PlGF levels and the sFlt1/PlGF ratios showed no significant differences between the cohorts. The empirical cut-off values <1504 pg/mL sFlt1 and <307 pg/mL PlGF, were associated with the exclusion of CMV transmission (p < 0.001). Conclusion: sFlt1 concentration in the maternal blood could be a predictive biomarker for maternofetal CMV transmission.

Impact of the Israeli Ministry of Health Cytomegalovirus Guidelines on the Local Pregnancy Outcome

2020 ◽  
pp. 1-6
Author(s):  
Marina Pekar-Zlotin ◽  
Anat Alufi Naim ◽  
Perry Eliassi Revivo ◽  
Nadav Kugler ◽  
Yaakov Melcer ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Telephone Survey ◽  
Pregnancy Termination ◽  
Maternal Serum ◽  
Cmv Infection ◽  
Ministry Of Health ◽  
Newborn Outcomes ◽  
Fetal Infection ◽  
Postnatal Outcome

<b><i>Objective:</i></b> In 2011, the Israeli Ministry of Health (MOH) published standard guidelines for the follow-up of pregnant women infected by CMV, recommending that amniocentesis be performed in cases of maternal serum viral seroconversion or abnormal sonographic findings suggestive of CMV, in order to prove fetal infection before electing for pregnancy termination. <b><i>Methods:</i></b> A retrospective cohort study was performed, describing 448 pregnant women from 2006 to 2017. We collected data from all women that elected to continue their pregnancies after seroconversion and also of those who chose to undergo pregnancy termination. Subsequently, a telephone survey was then conducted to record outcomes of the newborns of women with CMV seroconversion during pregnancy. <b><i>Results:</i></b> 325 (73%) women chose to continue their pregnancy, while 123 (27%) opted for termination of pregnancy. We found that pregnancy termination due to CMV infection was reduced by 7%, from 72 cases (32%) to 51 cases (25%) after the implementation of the MOH guidelines in 2011. In addition, 182/305 (60%) of women responded to our telephone questionnaire regarding newborn outcomes. Of these women, 45/305 (14%) reported complications, and no correlation was found between the prenatal findings and postnatal outcome among those who have responded to our survey. <b><i>Conclusion:</i></b> Implementation of the new MOH guidelines has reduced the rate of pregnancy termination, without increasing the rate of neonatal complications in Israel with a similar outcome of complication rate as reported in the literature.

Severe fetal anaemia caused by congenital cytomegalovirus infection

2021 ◽  
Vol 14 (10) ◽  
pp. e244585
Author(s):  
Claudia Salazar-Sanchez ◽  
Pedro Llancarí ◽  
Rommy H Novoa ◽  
Walter Ventura
Keyword(s):  
Pregnant Woman ◽  
Fetal Growth ◽  
Umbilical Cord Blood ◽  
Cytomegalovirus Infection ◽  
Peak Systolic Velocity ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Fetal Medicine ◽  
Fetal Infection

A 22-year-old pregnant woman was referred to our fetal medicine unit due to severe fetal growth restriction at 26 weeks of gestation. An extensive detailed ultrasound revealed signs of bilateral periventricular hyperechogenicity, suggesting fetal infection potentially due to cytomegalovirus (CMV). Doppler ultrasound showed a high peak systolic velocity in the middle cerebral artery. Percutaneous umbilical cord blood sampling confirmed fetal CMV infection and severe fetal anaemia. We present this case to highlight the importance of fetal anaemia, which can be fatal regardless of whether it is associated with generalised oedema or hydrops fetalis.

scholarly journals Serum Levels and Placental Expression of NGAL in Gestational Diabetes Mellitus

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiaoqian Yin ◽  
Yan Huo ◽  
Li Liu ◽  
Yixing Pan ◽  
Suxin Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Serum Levels ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Positive Correlation ◽  
Protein Levels

Objectives. The aim was to investigate neutrophil gelatinase-associated lipocalin (NGAL) levels in the serum and term placentas and its potential role in gestational diabetes mellitus (GDM). Methods. A total of 49 GDM subjects and 39 age-matched women with normal pregnancies were recruited. We examined serum concentrations of NGAL and tumor necrosis factor-α (TNF-α) in maternal blood and cord blood and their expression levels in the term placentas and umbilical cord. Results. Serum NGAL levels were significantly higher in GDM patients than in normal pregnant controls both in the maternal blood (4.80 ± 1.99 vs. 3.66 ± 1.13, P=0.001) and the cord blood (4.70 ± 2.08 vs. 3.85 ± 1.44, P=0.027). Moreover, serum NGAL levels exhibited a positive correlation with various parameters of insulin resistance. Maternal serum NGAL levels positively correlated with the NGAL levels found in the cord blood of the control (r = 0.399, P=0.012) and the GDM subjects (r = 0.349, P=0.014). Finally, the expression of NGAL protein levels in the placenta (1.22 ± 0.39 vs. 0.65 ± 0.23, P<0.001) and umbilical cord (0.65 ± 0.23 vs. 0.25 ± 0.10, P<0.001) were higher in GDM women than those noted in the control subjects. In the GDM group, maternal serum NGAL levels exhibited a positive correlation with placental NGAL mRNA and protein levels (r = 0.848, P=0.008; r = 0.636, P=0.011, respectively). Conclusions. NGAL may be an important adipokine involved in GDM and fetal development. The oversecretion of NGAL from the placenta may contribute to the elevated levels of serum NGAL in gestational diabetes mellitus.

Brief Report: Cytomegalovirus Infection in Pediatric House Officers: Susceptibility to and Rate of Primary Infection

1987 ◽  
Vol 8 (8) ◽  
pp. 329-332 ◽  
Author(s):  
Michael T. Brady ◽  
Gail J. Demmler ◽  
Donald C. Anderson
Keyword(s):  
Primary Infection ◽  
Cytomegalovirus Infection ◽  
Occupational Risk ◽  
Nursing Personnel ◽  
Patient Contact ◽  
Hospital Personnel ◽  
Cmv Infection ◽  
Pediatric Nursing ◽  
Child Bearing

Hospital personnel, especially women in their child-bearing years, continue to express concern about the risk of acquiring cytomegalovirus (CMV) infection as a result of their occupation. Previous investigations of occupational risk of CMV infection have focused primarily on pediatric nursing personnel. However, assessment of the rate of CMV infection by other hospital personnel who have different clinical responsibilities and levels of patient contact cannot rely solely on the rates obtained for nursing personnel.

scholarly journals Free threonine in human breast milk is related to infant intestinal microbiota composition

Amino Acids ◽  
2021 ◽  
Author(s):  
Monika Riederer ◽  
Natascha Schweighofer ◽  
Slave Trajanoski ◽  
Claudia Stelzer ◽  
Miriam Zehentner ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Intestinal Microbiota ◽  
Serum Levels ◽  
Protective Role ◽  
Maternal Serum ◽  
Study Cohort ◽  
Human Breast Milk ◽  
Microbiota Composition ◽  
Correlation Analyses

Abstract Background Accumulating evidence indicates that free amino acids (FAA) might be bioactive compounds with potential immunomodulatory capabilities. However, the FAA composition in human milk is still poorly characterized with respect to its correlation to maternal serum levels and its physiological significance for the infant. Studies addressing the relation of human milk FAA to the infants' intestinal microbiota are still missing. Methods As part of a pilot study, maternal serum and breast milk FAA concentrations as well as infant intestinal microbiota (16S rRNA) were determined 2 months after birth. The study cohort consisted of 41 healthy mothers and their term delivered, healthy infants with normal birthweight. The relationship between maternal serum and milk FAA was determined by correlation analyses. Associations between (highly correlated) milk FAA and infant intestinal beta diversity were tested using PERMANOVA, LefSe and multivariate regression models adjusted for common confounders. Results Seven breast milk FAA correlated significantly with serum concentrations. One of these, threonine showed a negative association with abundance of members of the class Gammaproteobacteria (R2adj = 17.1%, p = 0.006; β= − 0.441). In addition, on the level of families and genera, threonine explained 23.2% of variation of the relative abundance of Enterobacteriaceae (R2adj; p = 0.001; β = − 0.504) and 11.1% of variability in the abundance of Escherichia/Shigella (R2adj, p = 0.025; β  = − 0.368), when adjusted for confounders. Conclusion Our study is the first to suggest potential interactions between breast milk FAA and infant gut microbiota composition during early lactation. The results might be indicative of a potential protective role of threonine against members of the Enterobacteriaceae family in breast-fed infants. Still, results are based on correlation analyses and larger cohorts are needed to support the findings and elucidate possible underlying mechanisms to assess the complex interplay between breast milk FAA and infant intestinal microbiota in detail.

scholarly journals Associations Between Maternal Tocopherol Levels and Pregnancy-Induced Blood Pressure Changes

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 987-987
Author(s):  
Alyssa Freeman ◽  
Corrine Hanson ◽  
Matthew Van Ormer ◽  
Maranda Thompson ◽  
Melissa Thoene ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Performance ◽  
Medical Center ◽  
Pearson Correlation ◽  
Inverse Correlation ◽  
Serum Levels ◽  
Maternal Blood ◽  
Maternal Serum ◽  
P Value ◽  
Cross Sectional

Abstract Objectives Vitamin E plays different roles in health based on its three isoforms: alpha (α)-tocopherol is anti-inflammatory, gamma (γ)-tocopherol is pro-inflammatory, delta (δ)-tocopherol remains unknown. As inflammation may promote hypertension, the objective of this study is to examine relationships between maternal serum tocopherol levels at time of delivery and pregnancy-related blood pressure (BP) changes. Hypothesis is that increased level of α-tocopherol has favorable effects and γ-tocopherol has adverse effects on maternal BP. Methods An IRB-approved cross-sectional study enrolled mother-infant dyads (n = 342) at time of delivery (Omaha, NE, USA) for collection of electronic health data and maternal blood. High-performance liquid chromatography analyzed serum tocopherol levels. Maternal BP values were collected from 1st and 3rd trimester clinic/hospital visits with changes calculated in systolic BP and mean arterial pressure (MAP = diastolic BP + 1/3(systolic BP – diastolic BP). Mothers were classified as hypertensive if: systolic BP ≥140, diastolic BP ≥ 90, or diagnosis of preeclampsia. Two-sample t-test and Pearson correlation coefficients compared relationships between serum tocopherol levels and BP data. P-value &lt; 0.05 was significant. Results Mean maternal age was 28.5 years, majority (61.4%) Caucasian, 10.4% (n = 29) with hypertension. Mean serum levels: α-tocopherol 15,229 + 5849 mcg/L, γ-tocopherol 1642 + 868 mcg/L, δ-tocopherol 226 + 164 mcg/L, with α: γ ratio 11.5 + 8.7. Mean serum α-tocopherol level was higher in normotensive vs. hypertensive mothers (15,751 vs. 13,819 mcg/L; P = 0.06). Ratio of α: γ demonstrated an inverse correlation with change in maternal systolic BP (r = −0.128; P = 0.03). No other relationships were significant. Conclusions Increasing maternal α-tocopherol and α: γ ratio has favorable association with maintaining normal BP during pregnancy. More research is needed to specifically identify serum thresholds and tocopherol isoform ratios for favorably reducing risk of pregnancy-related hypertension. Funding Sources Department of Pediatrics and the Child Health Research Institute at the University of Nebraska Medical Center and Children's Hospital & Medical Center (Omaha, NE).

scholarly journals Maternal Serum VEGF Predicts Abnormally Invasive Placenta Better than NT-proBNP: a Multicenter Case-Control Study

2020 ◽  
Author(s):  
Alexander Schwickert ◽  
Frédéric Chantraine ◽  
Loreen Ehrlich ◽  
Wolfgang Henrich ◽  
Mustafa Zelal Muallem ◽  
...  
Keyword(s):  
Case Control Study ◽  
Predictive Biomarker ◽  
Serum Levels ◽  
Case Control ◽  
Maternal Serum ◽  
Control Group ◽  
Serum Samples ◽  
Invasive Placenta ◽  
Control Study ◽  
Abnormally Invasive Placenta

Abstract The aim of this study was to test if maternal serum vascular endothelial growth factor (VEGF) or N-terminal pro B-type natriuretic peptide (NT-proBNP) predicts abnormally invasive placenta (AIP) better. Secondary objective was to test whether the serum levels of VEGF and NT-proBNP can predict the degree of invasion. In a multicenter case–control study design, gestational age-matched serum samples from pregnant women with AIP (n = 44) and uncomplicated pregnancies (n = 55) who had been enrolled at Charité – Universitätsmedizin Berlin, Germany and Centre Hospitalier Régional de la Citadelle in Liège, Belgium were analyzed. Maternal blood serum VEGF and NT-proBNP levels were immunoassayed from samples taken immediately before delivery (GA median: 35 weeks). Biomarker levels were compared between AIP and control group. The correlation of biomarker levels with the clinical AIP degree was assessed. The predictive biomarker ability was characterized through a multivariate regression model and receiver operating characteristic curves. Women with AIP had significantly lower maternal serum VEGF levels (AIP mean 285 pg/ml, 95% CI 248–322, vs. control: 391 pg/ml, 95% CI 356–426, p < 0.01) and higher NT-proBNP levels (AIP median 329 pg/ml, IQR 287–385, vs. control 295 pg/ml, IQR 273–356, p = 0.03). Maternal serum VEGF levels were able to predict AIP better (AUC = 0.729, 0.622–0.836, p < 0.001; VEGF + number of previous cesarean deliveries: AUC = 0.915, 0.853–0.977, p < 0.001). Maternal serum VEGF levels correlated inversely with the clinical AIP degree (r = − 0.32, p < 0.01). In short, maternal serum VEGF, more than NT-proBNP, can help in predicting AIP and hints at the degree of invasion.

Congenital cytomegalovirus infection after maternal persistent immunoglobulin-M antibodies against cytomegalovirus prior to conception

2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka ◽  
Tatsuo Yamamoto
Keyword(s):  
Cytomegalovirus Infection ◽  
Congenital Infection ◽  
Maternal Serum ◽  
Immunoglobulin M ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Infant Girl ◽  
Congenital Cmv

AbstractWe describe a case of congenital cytomegalovirus (CMV) infection transmitted by an immunocompetent woman infected before conception with continuous hyper CMV-immunoglobulin M (IgM). A 33-year-old woman whose CMV-IgM levels were stable more than 8 months before conception was referred at 35 gestational weeks due to fetal unilateral cerebral ventriculomegaly. The maternal serum CMV-IgG was 61.7 U/mL, and the CMV-IgM was 3.89 U/mL. An infant girl weighing 2297 g was delivered transvaginally. The neonate was found to have congenital CMV infection. After delivery, the high maternal CMV-IgM level has continued for more than 2 years. In conclusion, although continuous hyper CMV-IgM is rare, the infants of infected women may develop congenital infection. It is our hope that the information provided in the present case will further aid clinicians in counseling patients who find themselves in this situation.

FEATURES OF THE CONGENITAL CMV INFECTION IN THE UNBORN AND NEWBORN INFANT

2007 ◽  
Vol 18 (3) ◽  
pp. 181-199 ◽  
Author(s):  
G BENOIST ◽  
Y VILLE
Keyword(s):  
Primary Infection ◽  
Transmission Rate ◽  
Sensorineural Deafness ◽  
Recurrent Infection ◽  
Maternal Infection ◽  
Cmv Infection ◽  
Live Births ◽  
Vertical Transmission Rate ◽  
Fetal Infection ◽  
Congenital Cmv Infection

Cytomegalovirus (CMV) is the most frequent cause of congenital viral infection,1with a prevalence of 0.5 to 1% of all live births, and the leading infectious cause of sensorineural deafness and mental retardation.1As otherHerpesviridae, CMV fetal infection can develop following both primary and recurrent maternal infection. Vertical transmission rate is around 30% following primary infection and 2 to 3% following recurrent infection.2Effects on the unborn as well as on the newborn are widely variable. It is estimated that only 5 to 10% of infected newborns have symptoms at birth, whereas around 90% of congenitally infected infants are asymptomatic although 5–15% of these infants will develop some degree of sensorineural hearing loss.3

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