Hajnalka Orvos

Evaluation of oxidative stress markers in neonates with intra-uterine growth retardation

Abstract Intra-uterine growth retardation (IUGR) is an abnormality of pregnancy. Neonates with IUGR weigh less than the 10th percentile for gestational age. The objective of the study was to identify the relationship between IUGR and the antioxidant status. Cord blood of 157 neonates with normal weight (control group) and 29 neonates with IUGR were included. The following parameters were determined and compared in the two groups: lipid peroxidation in the plasma, red blood cells and erythrocyte ghosts; protein and DNA damage; antioxidant enzyme activities (superoxide dismutase, catalase, glutathione peroxidase); the level of reduced glutathione; and the ferric reducing ability of the plasma. The level of lipid peroxidation was significantly higher in the IUGR group. The antioxidant enzyme activities and the levels of antioxidants were significantly lower in the IUGR group. Damage of proteins and DNA was slightly, but non-significantly, higher in the IUGR group. Neonates with IUGR seem to have significant deficiencies in antioxidant defence. IUGR is correlated with significant oxidative stress.

Is adolescent pregnancy associated with adverse perinatal outcome

Abstract Background: The number of teenage pregnancies has increased throughout the world and these pregnancies are reported in association with a higher rate of maternal and fetal complications. Aim of the study: To evaluate the social surroundings; the results of ante-, intrapartum surveillance and perinatal outcome in adolescent pregnancies where mothers were below the age of 18. Methods: Between 1st January, 1991 and 31st December, 1996 there were 13 131 births at our department. During this period, 209 newborns were born of 207 adolescent mothers. We compared the data of adolescent mothers with the data of all mothers who delivered in Hungary during the study period. Results: 39 (18.6%) from 209 newborns were delivered before 37th week of gestation, and 34 (16.3%) newborns showed signs of intrauterine growth retardation (IUGR). The rate of primiparous adolescent mothers was 72.0%, 131 (63.3%) were primigravidae, and 136 (65.7%) received adequate prenatal care. Maternal complications (pregnancy induced hypertension, threatened preterm delivery, gestational diabetes and pretal eclampsia) and adverse perinatal outcome (higher rate of IUGR and perinatal mortality) were found more frequently in adolescent pregnancies. Conclusions: As young maternal age is associated with an increased risk of unfavourable fetal outcome, teenage mothers need improved prenatal care and increased observation during labour. In addition, improvement of the social environment of adolescents and the prevention of teenage pregnancies should be recommended.

Index Finger Movement Imitation by Human Neonates: Motivation, Learning, and Left-Hand Preference

Imitation of a fine motor movement, index finger protrusion, was examined in 39 neonates using an ethologically based objective coding system. Results confirmed that imitation of finger movements exists, and infants demonstrated “learning” as imitation developed through an incomplete imitation stage. Neonatal imitation was more frequently left-handed, an early sign of laterality in motivation to be investigated further. The existence of index finger imitation in human neonates indicates that volitional control of individuated finger movements develops much earlier than previously thought. The differential increase of index finger protrusion movements during the imitation periods suggests that this behavior is not an automatic response triggered by general arousal but instead is a true indicator of purposeful neonatal imitation.

Increased nuchal translucency and congenital heart defects in euploid fetuses: The Szeged experience

OBJECTIVE To determine the utility of the first-trimester fetal nuchal translucency (NT) thickness in the prediction of fetal cardiac malformations. DESIGN Retrospective study. SETTING Department of Obstetrics and Gynecology and Medical Genetics, University of Szeged. METHODS The pre- and postnatal course and outcome, and the relationship between the first-trimester fetal NT thickness and fetal congenital heart defects (CHDs) in 4309 pregnancies ended up with birth or therapeutic abortion between January 1998 and June 2000 were registered. Prenatal care included first- and second-trimester fetal sonography at weeks 10-13 and 18-20, respectively. RESULTS 4251 births and 58 first- and second-trimester therapeutic abortions due to lethal congenital malformations or chromosomal abnormalities were recorded. Altogether 209 (4.9%) congenital malformations were detected, 39 (18.7%) of which were heart defects with normal karyotype. At birth, 151 congenital malformations were diagnosed, 34 of them were known prenatally. The prevalence of CHDs was 9 per 1000 pregnancies. The measurement of fetal NT thickness was available in 35 of the 39 fetuses with heart defects: it was > or = 3 mm in 18 (51.4%) and <3 mm in 17 (48.6%). A sensitivity of 51.4% was found at a cutoff of 3mm. CONCLUSIONS An increased NT thickness in chromosomally normal fetuses was found to be highly associated with CHDs and identified in more than half of the affected cases. Furthermore, an increased NT of > or = 3 mm can be regarded a selection criterion for early second-trimester targeted fetal echocardiography and for increased fetal and neonatal surveillance.

Obstetric and neonatal risk of pregnancies after assisted reproductive technology: a matched control study

Background.  The aim of the study was to evaluate the obstetric and neonatal outcome of pregnancies after assisted reproduction technology (ART) in comparison with matched controls from spontaneous pregnancies.

THE INCIDENCE OF MAJOR BIRTH DEFECTS FOLLOWING IN VITRO FERTILIZATION

AbstractPurpose: To evaluate the risk of congenital malformations in newborns delivered after IVF-ET in comparison with matched controls from spontaneous pregnancies. Methods: A total of 12,920 deliveries were subjected to retrospective analysis. A total of 301 neonates were evaluated. The incidence of major birth defects was compared with controls matched with regard to age, gravidity, parity, and previous obstetric outcome after spontaneous pregnancies. Results: The incidence of major congenital abnormalities was not significantly higher (p > 0.05

Gender-Related Heart Rate Differences in Human Neonates

) among the cases (1.90%) than among the controls (1.15%). Conclusions: The risk of major birth defects following IVF-ET is comparable with that of spontaneously conceived, matched pregnancies.

Breastfeeding duration and previous breastfeeding experience

The aim of the present study was to examine gender-related differences in heart rate of human neonates controlled for their behavior. Previous studies could not find any difference in male and female fetuses and newborns, although this gender-dependent difference clearly exists in children and adults. The heart rate of 99 newborns (47 girls and 52 boys) was measured with simultaneous video recording of their behavior. Results proved that alert newborns showed the same difference as adults: boys had a significantly lower baseline heart rate than girls. This suggests that heart rate is gender-dependent from birth onward.

Neonatal Blue Light Phototherapy and Melanocytic Nevi: A Twin Study

The aim of this study was to examine the effect of duration of earlier breastfeeding on the duration of breastfeeding with subsequent births. Medical records of 327 women who had had at least two deliveries were analysed; 89 of these women had had three deliveries. The average duration of breastfeeding increased from 6.01 mo to 6.85 mo with the second baby, but did not increase significantly with the third. A significant negative correlation was found between duration of first breastfeeding and change of breastfeeding duration at the second breastfeeding. Mothers who breastfed their first child for 0–7 mo significantly increased the duration of breastfeeding with the second child, whereas mothers who breastfed their firstborn for 8 mo or longer significantly reduced breastfeeding with the second baby.

Neonatal blue-light phototherapy could increase the risk of dysplastic nevus development.

BACKGROUND: Neonatal blue light phototherapy (NBLP) has been widely and successfully used for the treatment of neonatal jaundice to reduce the plasma concentration of bilirubin and, hence, to prevent kernicterus. Only a few and controversial data are available in the literature as to how NBLP influences melanocytic nevus development. OBJECTIVE: Our goal was to conduct a twin study with the aim of better understanding the role of NBLP in melanocytic nevus development. We also investigated the roles of other environmental and constitutional factors in nevus formation. METHODS: Fifty-nine monozygotic and dizygotic twins were included in this cross-sectional study. One of the twin members received NBLP, and the other did not. A whole-body skin examination was performed to determine the density of melanocytic skin lesions. The prevalence of benign pigmented uveal lesions was evaluated during a detailed ophthalmologic examination. A standardized questionnaire was used to assess data relating to constitutional, sun-exposure, and other variables. To search for possible gene-environmental interactions involved in the appearance of pigmented lesions, the melanocortin 1 receptor variants and the I439V polymorphism of histidine ammonia-lyase genes were also determined in the enrolled twins. RESULTS: NBLP was associated with a significantly higher prevalence of both cutaneous and uveal melanocytic lesions. No association was found between the examined gene polymorphisms and the number of pigmented alterations in the examined study group. CONCLUSIONS: Our data suggest that NBLP could well be a risk factor for melanocytic nevus development. Phototherapy with blue-light lamps is a standard and essential therapeutic modality in neonatal care; therefore, additional in vivo and in vitro studies are necessary to establish its potential long-term adverse effects.