The route of maternal IgM transport to the rabbit fetus.

The route of IgM transport to the rabbit fetus was investigated by comparing its localization with that of IgG in the yolk sac splanchnopleure and uterine tissues using direct immunofluorescence and immunodiffusion analysis. IgM was first detected in fetal serum at 20 days of gestation but was present in uterine fluid at 18 days, the earliest stage tissues and fluids were examined. IgM was co-localized with IgG in the yolk sac endoderm basement membrane and in the vascular mesenchyme of the yolk sac splanchnopleure providing evidence of its transport to fetal blood; it was also present in vesicles in the yolk sac endoderm. IgM could not be detected in uterine fluid of nonpregnant uterine horns of rabbits unilaterally pregnant. Human IgM injected into the maternal circulation was readily transported to the uterine fluid and across the yolk sac splanchnopleure to fetal blood indicating that IgM secreting plasma cells, found to be present in the uterine stroma, contributed little towards IgM in the uterine fluid. Degenerating paraplacental decidual tissue, a feature of rabbit pregnancy, is suggested to be a major route for maternal immunoglobulin transport to the uterine fluid.     

Diurnal nonstress test variations in the human fetus at risk

Objective: To compare the results of the nonstress test (NST) performed at 9:00 PM and 9:00 AM on women with high-risk pregnancies. Method: The NST was performed 2 h after a meal, at 9:00 AM and 9:00 PM, in a quiet room exposed to daylight, on 80 women with high-risk singleton pregnancies. Each session lasted 20 min. If the NST was nonreactive, the entire biophysical profile was immediately performed. The women's blood pressure was measured before, 10 min within, and at the end of the NST. Women who smoked or had uterine contractions were excluded from the study. Results: Diurnal nonstress test variations were manifested by a higher incidence of reactive NSTs and an increased number of fetal heart accelerations after 9:00 PM (82.5%) than at 9:00 AM (68.8%) (p < 0.027 P < 0.001). Conclusions: Evening appointments for fetal assessments, except in emergency conditions, may eliminate the need for additional tests such as the entire biophysical profile because of the decreased incidence of nonreactive NSTs. Evening NSTs would save time and decrease maternal anxiety.     

Does father's unemployment put the fetus at risk?

Summary. Information concerning 15037 singleton deliveries in 1970 showed that among the 3.5% where the male head of the household was unemployed there was no significant excess of low birthweight or pre-term delivery, once social class had been taken into account. There were major differences, however, in maternal health behaviour. In order to ascertain whether the health behaviour might be a consequence of the unemployment, data were also analysed for the 658 pregnancies in women whose husbands, though employed at delivery, were subsequently unemployed. Almost identical patterns were found, implying that the association with health behaviour was not a time-related consequence of unemployment.     

Does father's unemployment put the fetus at risk?

Summary. Information concerning 15037 singleton deliveries in 1970 showed that among the 3.5% where the male head of the household was unemployed there was no significant excess of low birthweight or pre-term delivery, once social class had been taken into account. There were major differences, however, in maternal health behaviour. In order to ascertain whether the health behaviour might be a consequence of the unemployment, data were also analysed for the 658 pregnancies in women whose husbands, though employed at delivery, were subsequently unemployed. Almost identical patterns were found, implying that the association with health behaviour was not a time-related consequence of unemployment.     

Does father's unemployment put the fetus at risk?

Information concerning 15 037 singleton deliveries in 1970 showed that among the 3.5% where the male head of the household was unemployed there was no significant excess of low birthweight or preterm delivery, once social class had been taken into account. There were major differences, however, in maternal health behaviour. In order to ascertain whether the health behaviour might be a consequence of the unemployment, data were also analysed for the 658 pregnancies in women whose husbands, though employed at delivery, were subsequently unemployed. Almost identical patterns were found, implying that the association with health behaviour was not a time-related consequence of unemployment.     

Duchenne型肌营养不良病高危胎儿的产前基因诊断

应用ＤＮＡ分子杂交和１８对引物的多重聚合酶链反应（ｍＰＣＲ）技术，对１０例Ｄｕｃｈｅｎｎｅ型肌营养不良病（ＤＭＤ）的高危胎儿进行产前基因诊断。结果：７例男性胎儿中有３例存在与先证者相同的基因缺失，诊断为ＤＭＤ患儿，均行人工流产术。另４例为正常男性胎儿。３例女性胎儿，１例为突变基因携带者，２例为正常胎儿。以上１０例均经出生后复检证实。提示：ｍＰＣＲ技术简单、快速、特异性高，是一种很好的基因缺失筛查方法。本研究还对ＤＭＤ高危胎儿产前诊断的步骤进行了探讨。     

Anti-annexin V IgM and IgG autoantibodies and the risk of idiopathic recurrent spontaneous miscarriage

Anti-annexin V antibodies have been identified as risk factors for recurrent spontaneous miscarriage (RSM) in some, but not all previous studies. We investigated the association between anti-annexin IgM and IgG in RSM cases and control women. Blood samples from 244 women with idiopathic RSM, and 283 multi-parous control women were tested for anti-annexin V antibodies by ELISA. A significant elevation in anti-annexin V IgM and IgG was seen in the RSM cases. An increased prevalence of elevated anti-annexin V IgM and to a lesser extent anti-annexin V IgG was seen in RSM patients. Receiver operating characteristic analysis indicated that the area under the curve for anti-annexin V IgM was 0.916, and for anti-annexin V IgG was 0.725. A systematic shift in anti-annexin V IgM and IgG distributions toward higher values occurred in RSM women, which was confirmed by percentile analysis. For each of the anti-annexin V isotypes, the adjusted odds ratio increased as the percentile value increased; the strongest risk was for anti-annexin V IgM, in which the 99th percentile (P99) was associated with a 165-fold higher risk than P50, and for anti-annexin V IgG where P99 was associated with a 38-fold higher risk than P50. In addition, a higher prevalence of elevated anti-annexin V IgM and anti-annexin V IgG was seen in RSM cases than in control women. We conclude that anti-annexin V IgM and IgG antibody positivity are independent risk factors for RSM.     

Renal and cerebral responses to hypoxemia in the ovine fetus

Mild to moderate hypoxemia without major changes in pH and pCO(2) does not reduce fetal renal blood flow and fetal urine production rate. Other factors such as acidemia, hypercapnia or changes in lung liquid production or fetal swallowing are candidates for the reduced amniotic fluid in the growth retarded fetus. Mild hypoxemia influences the fetal brain development in that the migration of PKC immunoreactive cells is delayed after a period of 48 h of hypoxemia. This could be due to the fact that under these circumstances the expected compensatory increase in fetal cerebral blood flow was only significant 1 h after the onset of hypoxemia. Further research on the final position of the hippocampal neurons in term lambs, subjected to fetal mild hypoxemia, can give more information on the effects of hypoxemia on the fetal brain.     

Leptin in relation to growth and developmental processes in the fetus

Leptin, a 16-kilodalton protein secreted by the adipose tissue in proportion to the amount of energy stored in adipose tissue, conveys to the hypothalamus information on energy homeostasis and regulates reproductive function. In addition, there is accumulating evidence that leptin produced by placental or fetal tissues acts through specific leptin receptors to regulate fetal growth and development. Although leptin levels are correlated with insulin and insulin-like growth factor (IGF)-1 levels, observational studies in humans indicate that its effects on fetal growth are independent of these axes and of adiposity. The extent to which leptin per se mediates the fetal growth and developmental abnormalities associated with disease states such as diabetes, hypoxia, or preeclampsia remains to be fully clarified by future studies in humans. It is hoped that clarification of these mechanisms may provide novel therapeutic approaches.