Perinatal-Related Pathology Volume II

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 10266

Special Issue Editors


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Guest Editor
Department of Neonatology, Medical University in Szczecin, Poland, Poland
Interests: early and late neonatal infection; microbiome; neonatal sepsis; breastfeeding
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Guest Editor
Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
Interests: early and late neonatal infection; microbiome; neonatal sepsis; breastfeeding
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

An increasing amount of data indicate that the majority of cases of the so-called great obstetrics syndrome are caused by dysfunction of the placenta, which is caused by its impaired development or too-early functional impairment. Today, a holistic approach to maternal-fetal medicine allows us to explore the causes and primary pathogenesis of subsequent clinical syndromes.

The proposed Special Issue aims to focus on the presentation of modern approaches to pathogenesis and diagnostic methods that take advantage of the primary trophoblast impairment and allow the detection of potential threats in advance.

Pregnant women with clinical symptoms of placental insufficiency are still doomed to iatrogenic premature termination of pregnancy, and the severity of the pathology is correlated with perinatal outcomes. Therefore, it is worth looking for genetic, biochemical, and biophysical methods that can be used to monitor the course of the disease, and in some situations prevent serious complications.

In recent years, attention has been paid to the role of the microbiome in the pathogenesis of many pathological conditions. There are also studies on the microbiome in the context of maternal-fetal medicine. A relationship is sought between the type of bacteria inhabiting the gastrointestinal tract of women and the occurrence of obesity, gestational diabetes, or premature birth, as well as hypoxia and intrauterine infection. Other metabolomes, such as maternal and newborn urine, amniotic fluid, human breast milk, and meconium of the newborn, are also tested. In research on the microbiome in the newborn, the relationship with civilization diseases, infections, and eating disorders is sought. Is it possible to get closer to personalized medicine by using metabolomics?

Prof. Dr. Agnieszka Kordek
Dr. Andrzej Torbé
Guest Editors

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Keywords

  • trophoblast markers
  • preeclampsia
  • maternal and perinatal consequences of placental insufficiency
  • fetal growth restriction
  • prediction and diagnostics
  • microbiome
  • metabolomics
  • neonatal sepsis
  • newborn of diabetic mother
  • congenital defects and prenatal diagnosis

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Published Papers (4 papers)

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14 pages, 5122 KiB  
Article
Effect of Granzyme K, FasL and Interferon-γ Expression in Placentas with Preeclampsia
by Martina Vukoja, Marina Ćurlin, Katarina Vukojević, Nevenka Jelić-Knezović, Anita Kolobarić, Martina Orlović Vlaho and Violeta Šoljić
Biomedicines 2024, 12(4), 842; https://doi.org/10.3390/biomedicines12040842 - 11 Apr 2024
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Abstract
This study aimed to investigate the cytotoxic activity of decidual lymphocytes and the mRNA/protein expression of cytotoxic proteins in various cell types in the context of preeclampsia (PE) compared to those of healthy pregnancies. We analyzed fresh decidua basalis tissue and tissue embedded [...] Read more.
This study aimed to investigate the cytotoxic activity of decidual lymphocytes and the mRNA/protein expression of cytotoxic proteins in various cell types in the context of preeclampsia (PE) compared to those of healthy pregnancies. We analyzed fresh decidua basalis tissue and tissue embedded in paraffin (FFPE) from PE pregnancies (n = 15) and compared them with those of healthy pregnancies (n = 15) of the corresponding gestational age. Using double immunofluorescence staining, we observed differences in the intensity and distribution of staining for granzyme K (GZMK) and FasL in extravillous trophoblasts. RT-qPCR analysis of FFPE placental tissue showed that GZMK mRNA expression was statistically higher (p < 0.0001) in PE compared to that of healthy controls. On the contrary, there was a low expression (p < 0.001) of FasL mRNA in PE compared to controls, while there was no statistically significant difference for IFN-γ mRNA between PE and controls. Although the level of cytotoxic activity changed depending on the ratio of effector and target cells, there was no significant difference observed between PE and controls in this in vitro study. In conclusion, in PE, extravillous trophoblasts exhibited increased expression of GZMK and decreased expression of FasL. These changes may contribute to impaired trophoblast invasion. However, these alterations did not appear to affect the cytotoxic properties of decidual lymphocytes. Additionally, the possibility of cell sorter separation of decidual lymphocytes would greatly contribute to a better understanding of single cells’ genetic profiles. Full article
(This article belongs to the Special Issue Perinatal-Related Pathology Volume II)
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13 pages, 1673 KiB  
Article
Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
by Sylvie Pons, Sophie Trouillet-Assant, Fabien Subtil, Fatima Abbas-Chorfa, Elise Cornaton, Amélie Berthiot, Sonia Galletti, Aurélie Plat, Stephanie Rapin, Laurene Trapes, Laurence Generenaz, Karen Brengel-Pesce, Arnaud Callies, Franck Plaisant, Olivier Claris, Aurelie Portefaix, Cyril Flamant and Marine Butin
Biomedicines 2023, 11(6), 1703; https://doi.org/10.3390/biomedicines11061703 - 13 Jun 2023
Cited by 4 | Viewed by 1420
Abstract
Despite the high prevalence of late-onset sepsis (LOS) in neonatal intensive care units, a reliable diagnosis remains difficult. This prospective, multicenter cohort study aimed to identify biomarkers early to rule out the diagnosis of LOS in 230 neonates ≥7 days of life with [...] Read more.
Despite the high prevalence of late-onset sepsis (LOS) in neonatal intensive care units, a reliable diagnosis remains difficult. This prospective, multicenter cohort study aimed to identify biomarkers early to rule out the diagnosis of LOS in 230 neonates ≥7 days of life with signs of suspected LOS. Blood levels of eleven protein biomarkers (PCT, IL-10, IL-6, NGAL, IP-10, PTX3, CD14, LBP, IL-27, gelsolin, and calprotectin) were measured. Patients received standard of care blinded to biomarker results, and an independent adjudication committee blinded to biomarker results assigned each patient to either infected, not infected, or unclassified groups. Performances of biomarkers were assessed considering a sensitivity of at least 0.898. The adjudication committee classified 22% of patients as infected and all of these received antibiotics. A total of 27% of the not infected group also received antibiotics. The best biomarkers alone were IL-6, IL-10, and NGAL with an area under the curve (95% confidence interval) of 0.864 (0.798–0.929), 0.845 (0.777–0.914), and 0.829 (0.760–0.898), respectively. The best combinations of up to four biomarkers were PCT/IL-10, PTX3/NGAL, and PTX3/NGAL/gelsolin. The best models of biomarkers could have identified not infected patients early on and avoided up to 64% of unjustified antibiotics. At the onset of clinical suspicion of LOS, additional biomarkers could help the clinician in identifying non-infected patients. Full article
(This article belongs to the Special Issue Perinatal-Related Pathology Volume II)
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15 pages, 1390 KiB  
Systematic Review
Evidence of Placental Aging in Late SGA, Fetal Growth Restriction and Stillbirth—A Systematic Review
by Anna Kajdy, Dorota Sys, Jan Modzelewski, Joanna Bogusławska, Aneta Cymbaluk-Płoska, Ewa Kwiatkowska, Magdalena Bednarek-Jędrzejek, Dariusz Borowski, Katarzyna Stefańska, Michał Rabijewski, Arkadiusz Baran, Andrzej Torbe, Stepan Feduniw and Sebastian Kwiatkowski
Biomedicines 2023, 11(7), 1785; https://doi.org/10.3390/biomedicines11071785 - 21 Jun 2023
Cited by 6 | Viewed by 2916
Abstract
During pregnancy, the placenta undergoes a natural aging process, which is considered normal. However, it has been hypothesized that an abnormally accelerated and premature aging of the placenta may contribute to placenta-related health issues. Placental senescence has been linked to several obstetric complications, [...] Read more.
During pregnancy, the placenta undergoes a natural aging process, which is considered normal. However, it has been hypothesized that an abnormally accelerated and premature aging of the placenta may contribute to placenta-related health issues. Placental senescence has been linked to several obstetric complications, including abnormal fetal growth, preeclampsia, preterm birth, and stillbirth, with stillbirth being the most challenging. A systematic search was conducted on Pubmed, Embase, and Scopus databases. Twenty-two full-text articles were identified for the final synthesis. Of these, 15 presented original research and 7 presented narrative reviews. There is a paucity of evidence in the literature on the role of placental aging in late small for gestational age (SGA), fetal growth restriction (FGR), and stillbirth. For future research, guidelines for both planning and reporting research must be implemented. The inclusion criteria should include clear differentiation between early and late SGA and FGR. As for stillbirths, only those with no other known cause of stillbirth should be included in the studies. This means excluding stillbirths due to congenital defects, infections, placental abruption, and maternal conditions affecting feto-maternal hemodynamics. Full article
(This article belongs to the Special Issue Perinatal-Related Pathology Volume II)
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17 pages, 1705 KiB  
Systematic Review
Relationship between Abnormal Placenta and Obstetric Outcomes: A Meta-Analysis
by Shinya Matsuzaki, Yutaka Ueda, Satoko Matsuzaki, Hitomi Sakaguchi, Mamoru Kakuda, Misooja Lee, Yuki Takemoto, Harue Hayashida, Michihide Maeda, Reisa Kakubari, Tsuyoshi Hisa, Seiji Mabuchi and Shoji Kamiura
Biomedicines 2023, 11(6), 1522; https://doi.org/10.3390/biomedicines11061522 - 25 May 2023
Cited by 6 | Viewed by 4395
Abstract
The placenta has several crucial physiological functions that help maintain a normal pregnancy. Although approximately 2–4% of pregnancies are complicated by abnormal placentas, obstetric outcomes remain understudied. This study aimed to determine the outcomes and prevalence of patients with abnormal placentas by conducting [...] Read more.
The placenta has several crucial physiological functions that help maintain a normal pregnancy. Although approximately 2–4% of pregnancies are complicated by abnormal placentas, obstetric outcomes remain understudied. This study aimed to determine the outcomes and prevalence of patients with abnormal placentas by conducting a systematic review of 48 studies published between 1974 and 2022. The cumulative prevalence of circumvallate placenta, succenturiate placenta, multilobed placenta, and placenta membranacea were 1.2%, 1.0%, 0.2%, and 0.004%, respectively. Pregnancies with a circumvallate placenta were associated with an increased rate of emergent cesarean delivery, preterm birth (PTB), and placental abruption compared to those without a circumvallate placenta. The succenturiate lobe of the placenta was associated with a higher rate of emergent cesarean delivery, whereas comparative results were observed in terms of PTB, placental abruption, and placenta previa in comparison to those without a succenturiate lobe of the placenta. A comparator study that examined the outcomes of multilobed placentas found that this data is usually unavailable. Patient-level analysis (n = 15) showed high-rates of abortion (40%), placenta accreta spectrum (40%), and a low term delivery rate (13.3%) in women with placenta membranacea. Although the current evidence is insufficient to draw a robust conclusion, abnormal placentas should be recognized as a high-risk factor for adverse outcomes during pregnancy. Full article
(This article belongs to the Special Issue Perinatal-Related Pathology Volume II)
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