Stereologic examination of placentas from mothers who smoke during pregnancy

Larsen, Lise Grupe; Clausen, Helle V.; Jönsson, Lennart

doi:10.1067/mob.2002.120481

Cited by 116 publications

(67 citation statements)

References 22 publications

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“…On the other hand, the present study also showed obesity to be a protective factor, which may reflect the fact that obese women have a greater risk of developing hyperglycemic states or diabetes (gestational or type II), commonly associated with a greater gain in fetal weight. Smoking beyond the 4 th month of pregnancy was shown to be a risk factor irrespective of the number of cigarettes smoked per day, and this finding is in agreement with reports from previous studies [17][18][19][20] .…”

Section: Discussionsupporting

confidence: 82%

Factors associated with low birth weight in a historical series of deliveries in Campinas, Brazil

Coutinho¹,

Cecatti²,

Surita³

et al. 2009

Rev. Assoc. Med. Bras.

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SummaryObjective. To identify the risk factors associated with low birth weight (<2500 grams). MethOds. Unmatched case-control study performed in a tertiary maternity hospital in Campinas, Brazil, involving 43,499 liveborn infants delivered in the institution between 1986 and 2004. Analysis of the database containing information on deliveries of women who gave birth to infants with low (6,477 cases) and normal (37,467) birth weight were performed. Factors associated with low birth weight were identified according to the odds ratio (OR) and 95% confidence interval (95%CI) in the bivariate analysis and according to the adjusted OR in the multivariate analysis. Sociodemographic characteristics, reproductive history, previous morbidity and factors related to current prenatal care were studied. Results. Extremes of reproductive age, poor education, low maternal weight, smoking beyond the fourth month of pregnancy, previous cesarean section, interdelivery interval ≤24 months and ≥37 months, maternal history of hypertension, cardiopathy and premature delivery, few (≤5) prenatal visits and beginning prenatal care late in pregnancy (after the 3rd month), premature rupture of membranes, increased blood pressure, infectious diseases and hemorrhages during current pregnancy were all associated with low birth weight. Maternal obesity and being a primipara were found to be protective factors. cOnclusiOn. These results confirm the findings of previous studies. The detection and prenatal management of modifiable factors, counseling, pre-conception intervention, adequate prenatal care and the implementation of primary and secondary prevention of maternal morbidity should be a target for all obstetrician as a potential source for reducing the incidence of low birth weight.

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Section: Discussionsupporting

confidence: 82%

Factors associated with low birth weight in a historical series of deliveries in Campinas, Brazil

Coutinho¹,

Cecatti²,

Surita³

et al. 2009

Rev. Assoc. Med. Bras.

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“…Fibrinoid deposition during gestation occurs at sites of trophoblast discontinuity, it is nonrandom and influenced by the quality of vascular perfusion [16,45,46]. Smoking during pregnancy affects placental blood flow [47,48], therefore, the morphological findings in placentas of smoking mothers do not seem to be haphazard, but related to the effects of cigarette smoke.…”

Section: Discussionmentioning

confidence: 99%

Maternal Smoking, Intrauterine Growth Restriction, and Placental Apoptosis

et al. 2004

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Pregnant women who smoke are at greater risk of delivering a growth-restricted infant than nonsmoking mothers. We wanted to see if apoptosis could be involved in the mechanisms behind smoke-induced growth restriction, and our aim was to compare apoptosis in the placenta of smoking mothers giving birth to growth-restricted infants and nonsmoking mothers with infants of appropriate weight. The project was conducted at the Magee-Womens Hospital and Magee-Womens Research Institute, University of Pittsburgh, PA. Histological sections from 20 placentas were selected from smoking mothers who had given birth to small-forgestational-age infants (birth weight Յ 2 SD). The controls were gestational-age matched nonsmoking mothers with infants having appropriate-for-gestationalage weight. The TUNEL method was used to demonstrate DNA fragmentation in nuclei, and a monoclonal antibody M30, specific for a neo-epitope on cytokeratin 18, was used to identify apoptotic epithelial cells. The positive nuclei (TUNEL) and positive cells (M30-positive cytoplasm) were counted blindly both in villous tissue and in decidual/basal plate tissue. M30-positive cells in villous tissues were significantly increased in placentas from smoking mothers compared to nonsmoking mothers. When evaluated by the TUNEL method, the difference between the two groups of women was not significant. Our study shows that apoptosis was increased in the placentas of smoking mothers with growth-restricted infants. The difference between the two groups was mainly in the syncytiotrophoblast layer and in connection with perivillous fibrin deposition. Cigarette smoke with reduction in blood flow has previously been shown to increase apoptosis, and it is possible that this could be one of the mechanisms playing a role in the growth restriction.

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“…Smoking during pregnancy decreases trophoblast proliferation and reduces the length of villous capillaries in the placenta leading to diminished area for gas and nutrients exchange (39,40). Recently we have shown by immunohistochemical analysis that SP-D is synthesized in all villous and extravillous trophoblast sub-populations in the placenta (34).…”

mentioning

confidence: 99%

Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants. The Influence of Perinatal Factors

et al. 2006

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Surfactant protein D (SP-D) is a collectin that plays an important role in the innate immune system and takes part in the surfactant homeostasis by regulating the surfactant pool size. The aims of this study were to investigate the values of SP-D in umbilical cord blood and capillary blood of premature infants and to relate the levels to perinatal conditions. A total of 254 premature infants were enrolled in the present study. Umbilical cord blood was drawn at the time of birth and capillary blood at regular intervals throughout the admission. The concentration of SP-D in umbilical cord blood and capillary blood was measured using ELISA technique. The median concentration of SP-D in umbilical cord blood was twice as high as in mature infants, 769 ng/mL (range 140 -2,551), with lowest values in infants with intrauterine growth retardation (IUGR) and rupture of membranes (ROM). The median concentration of SP-D in capillary blood day 1 was 1,466 ng/mL (range 410 -5,051 ng/mL), with lowest values in infants born with ROM and delivered vaginally. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be more likely in infants in need for respiratory support or surfactant treatment and susceptibility to infections. We conclude that SP-D concentrations in umbilical cord blood and capillary blood in premature infants are twice as high as in mature infants and depend on several perinatal conditions. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be related to increased risk of RDS and infections. R espiratory distress syndrome (RDS) is a main contributor to increased mortality and morbidity among premature infants. RDS is caused by lack of pulmonary surfactant leading to atelectasis and ventilation-perfusion mismatch of the lungs (1). Biochemically, pulmonary surfactant is a mixture of phospholipids and associated proteins which are synthesized, stored, secreted and recycled by type II cells in the airways (2). This mixture forms a monolayer at the air-liquid interface which lowers the surface tension, stabilizes alveoli and terminal airways at low lung volume and prevents alveolar collapse at the end of the expiration. Treatment with synthetic or naturally developed surfactant has been associated with a decline in the mortality of RDS among premature infants (3,4).Four specific surfactant proteins have been identified, called surfactant protein (SP) A-D. SP-B and SP-C have been characterized as hydrophobic polypeptides that enhance the adsorption of lipid to the surface of the alveoli (5), while SP-A and SP-D are hydrophilic and participate in the innate host defense immune system. SP-D binds to macrophages and neutrophils and promotes phagocytosis and killing of bacteria, fungi, and viruses (6). Polymorphism in the amino acid residue 11 of the SPD gene has been found to increase severity of respiratory syncytial virus infection and susceptibility to tuberculosis (7,8).SP-A and SP-B are instrumental in surfactant storage in lamellar bodies and i...

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Stereologic examination of placentas from mothers who smoke during pregnancy

Cited by 116 publications

References 22 publications

Factors associated with low birth weight in a historical series of deliveries in Campinas, Brazil

Factors associated with low birth weight in a historical series of deliveries in Campinas, Brazil

Maternal Smoking, Intrauterine Growth Restriction, and Placental Apoptosis

Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants. The Influence of Perinatal Factors

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