Understanding the Maternal‐Fetal Environment and the Birth of Prenatal Pediatrics

Limperopoulos, Catherine; Wessel, David; Plessis, Adré J. du

doi:10.1161/jaha.121.023807

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…The lung pathology that underpins COPD - airway inflammation and remodelling, bronchiolitis, alveolar destruction, and pulmonary vascular damage - occurs firstly, because of factors that interfere with lung growth both before and after birth and across generations. An adverse fetal environment produces lung structural changes, altered immunology, low birthweight and prematurity, sensitization to later insults and premature aging (telomere shortening)(7) as well as increasing cardiovascular risk driving multimorbidity(8). The second main factor is exposures that accelerate lung function decline across the life course(9, 10).…”

Section: Model Developmentmentioning

confidence: 99%

Being responsible for COPD - lung disease as a manifestation of structural violence

Williams,

Buttery,

Laverty

et al. 2023

Preprint

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Lung health, the development of lung disease, and how well a person with lung disease is able to live, all depend on a wide range of societal factors. Considering COPD as a manifestation of structural violence, something that continues to be done to people, despite it being largely preventable, makes the causal processes more apparent and the responsibility to interrupt or alleviate these clearer. We developed a taxonomy to describe this, containing five domains. 1)Avoidable lung harms: (i)processes impacting on lung development (ii)processes which disadvantage lung health in particular groups across the life course. 2)Diagnostic Delay: (i)healthcare factors (ii)norms and attitudes that mean that COPD is not diagnosed in a timely way, denying people with COPD effective treatment. 3)Inadequate COPD Care: ways in which the provision of care for people with COPD falls short of what is needed to ensure that they are able to enjoy the best possible health, considered as (i)healthcare resource allocation (ii)norms and attitudes influencing clinical practice. 4)Low status of COPD: ways in which both COPD as a condition and people with COPD are held in less regard and considered less of a priority than other comparable health problems. 5)Lack of Support: factors that make living with COPD more difficult than it should be (i)socioenvironmental factors (ii)factors that promote social isolation. This model has relevance for policymakers, healthcare professionals and the public as an educational resource, to change clinical practices and priorities and to stimulate advocacy and activism with the goal of the elimination of COPD.

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Section: Model Developmentmentioning

confidence: 99%

Being responsible for COPD - lung disease as a manifestation of structural violence

Williams,

Buttery,

Laverty

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…There is also recent evidence of overall dysregulation of placental and fetal brain angiogenesis in CHD, suggesting that these fetuses may have an intrinsic placental angiogenic impairment that could contribute to impaired functional brain development [ 14 ]. There is, also, emerging evidence that CHD together with MRF is associated with impaired placental vasculature and substantially increased risk of mortality after cardiac surgery [ 15 , 16 , 17 , 18 ]. Taken together, these studies support the overarching hypothesis that MRFs and CHD would alter intrinsic placental and brain function.…”

Section: Introductionmentioning

confidence: 99%

Associations between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Rajagopalan

Schmithorst

El-Ali

et al. 2022

IJMS

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The relationship between maternal risk factors (MRFs) (particularly pre-gravid obesity, diabetes, and hypertension) and congenital heart disease (CHD) to placental and fetal brain outcomes is poorly understood. Here, we tested the hypothesis that MRF and CHD would be associated with reduced intrinsic placental and fetal brain function using a novel non-invasive technique. Pregnant participants with and without MRF and fetal CHD were prospectively recruited and underwent feto-placental MRI. Using intrinsic properties of blood oxygen level dependent imaging (BOLD) we quantified spatiotemporal variance of placenta and fetal brain. MRFs and CHD were correlated with functional characteristics of the placenta and fetal brain. Co-morbid MRF (hypertension, diabetes, and obesity) reduced spatiotemporal functional variance of placenta and fetal brain (p < 0.05). CHD predicted reduced fetal brain temporal variance compared to non-CHD (p < 0.05). The presence of both MRF and CHD was associated with reduced intrinsic pBOLD temporal variance (p = 0.047). There were no significant interactions of MRFs and CHD status on either temporal or spatial variance of intrinsic brain BOLD. MRF and CHD reduced functional characteristic of placenta and brain in fetuses. MRF modification and management during pregnancy may have the potential to not only provide additional risk stratification but may also improve neurodevelopmental outcomes.

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“…There is also recent evidence of overall dysregulation of placental and fetal brain angiogenesis in CHD, suggesting that these fetuses may have an intrinsic placental angiogenic impairment that could contribute to impaired functional brain development [14]. There is, also, emerging evidence that CHD together with MRF is associated with impaired placental vasculature and substantially increased risk of mortality after cardiac surgery [15-17]. Taken together, these studies support the overarching hypothesis that MRFs and CHD are with intrinsic placental and brain dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Rajagopalan

Schmithorst

El-Ali

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: The relationship between maternal risk factors (MRFs) (particularly pre-gravid obesity, diabetes, and hypertension) and congenital heart disease (CHD) to placental and fetal brain outcomes is poorly understood. Here, we tested the hypothesis that MRF and CHD would be associated with reduced intrinsic placental and fetal brain function using a novel non-invasive technique. Methods: Pregnant participants with and without MRF and fetal CHD were prospectively recruited and underwent feto-placental MRI. Using intrinsic properties of blood oxygen level dependent imaging (BOLD) we quantified spatiotemporal variance of placenta and fetal brain. MRFs and CHD were correlated with functional characteristics of the placenta and fetal brain. Results: Co- morbid MRF (hypertension, diabetes, and obesity) reduced spatiotemporal functional variance of placenta and fetal brain (p < 0.05). CHD predicted reduced fetal brain temporal variance compared to controls (p<0.05). Interaction of MRF and CHD status was associated with reduced intrinsic pBOLD temporal variance (p=0.047). There were no significant interactions of MRFs and CHD status on either temporal or spatial variance of intrinsic brain BOLD. Conclusion: MRF and CHD reduced functional characteristic of placenta and brain in fetuses. MRF modification and management during pregnancy may have the potential to not only provide additional risk stratification but may also improve neurodevelopmental outcomes.

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Understanding the Maternal‐Fetal Environment and the Birth of Prenatal Pediatrics

Cited by 6 publications

References 25 publications

Being responsible for COPD - lung disease as a manifestation of structural violence

Being responsible for COPD - lung disease as a manifestation of structural violence

Associations between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

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