http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Sun, 02 Jun 2013 13:18:04 +0000 http://www.hindawi.com/journals/jp/2013/213193/ Objective. To assess the concentration of progesterone (PRs) and oestrogen (ORs) receptors of myometrium of full-term pregnant women in the myometrium of lower segment of the uterus in relationship with presence or absence of labour. Methods. This was a cross-sectional prospective study with 21 pregnant women, being 6 in labour (Group I) and 15 without labour (Group II). The biopsy of myometrium was realized during caesarian section, and the excised tissue was stained using immunohistochemical techniques for the quantification of the receptors, and with the aid of image-analysis software, the numbers of receptors for each hormone were determined spectrophotometrically. The Mann-Whitney test was used to compare the pregnant women in each study group with respect to the numbers of ORs and PRs. The Wilcoxon test was used to compare the concentration of ORs and PRs in each group separately. Results. The mean of gestational age was 39 weeks, (range, 37 to 41 weeks). The medians of PRs and ORs in pregnant women in labour (Group I) were 29.3 (range, 24.6–30.2) and 32.3 (range, 22.9–49.0), respectively. The medians of PRs and ORs in pregnant women without labour (Group II) were 43.6 (range, 23.6–70) and 43.9 (range, 18.3–62.6), respectively. We did not observe significant differences of the number of ORs and PRs in both groups ( and 0.37, resp.). The number of ORs was statistically more than that of PRs in Group II (Z calculated = 16.00). Conclusion. The concentrations of PRs and ORs were similar in the myometrium of the lower uterine segment of pregnant women during and without labour, but the concentration of ORs was more than that of PRs in the myometrium of the lower uterine segment of pregnant women without labour. Joana Soares de Arruda, Edward Araujo Júnior, Manuel de Jesus Simões, and Luiz Kulay Júnior Copyright © 2013 Joana Soares de Arruda et al. All rights reserved. Tue, 28 May 2013 11:08:37 +0000 http://www.hindawi.com/journals/jp/2013/537526/ Riitta Luoto, Michelle F. Mottola, and Leena Hilakivi-Clarke Copyright © 2013 Riitta Luoto et al. All rights reserved. Wed, 17 Apr 2013 17:45:33 +0000 http://www.hindawi.com/journals/jp/2013/320413/ Extrapolating from animal studies to human pregnancy, our studies showed that folate (FA) deficiency as well as one-time exposure to environmental factors in the first two to three weeks of human gestation can result in severe congenital heart defects (CHDs). Considering that approximately 49% of pregnancies are unplanned, this period of pregnancy can be considered high-risk for cardiac, as well as for neural, birth defects, as the woman usually is not aware of her pregnancy and may not yet be taking precautionary actions to protect the developing embryo. Using avian and mouse vertebrate models, we demonstrated that FA supplementation prevents CHD induced by alcohol, lithium, or elevation of the metabolite homocysteine, a marker for FA deficiency. All three factors affected the important Wnt signaling pathway by suppressing Wnt-mediated gene expression in the heart fields, resulting in a delay of cardiomyocyte migration, cardiomyogenesis, and CHD. Optimal protection of cardiogenesis was observed to occur with FA supplementation provided upon morning after conception and at higher doses than the presently available in prenatal vitamin supplementation. Our studies demonstrate pathways and cell processes that are involved with protection of one-carbon metabolism during heart development. Kersti K. Linask Copyright © 2013 Kersti K. Linask. All rights reserved. Sun, 07 Apr 2013 15:26:52 +0000 http://www.hindawi.com/journals/jp/2013/826045/ Objective. To describe the trends in incidence, characteristics, and outcomes of women with eclampsia. Methods. We reviewed and abstracted data from medical records of all women diagnosed with eclampsia in our institution from August 1998 to April 2011. In addition to overall characteristics and outcomes, the cases were stratified by onset: antenatal versus postnatal and early (<32 weeks of gestation) versus late antenatal cases (≥32 weeks of gestation). Comparisons were made using chi-square, Fisher's exact, Mann-Whitney U, and t-tests. A two-sided was considered statistically significant. Results. We identified 87 eclampsia cases out of 59,388 deliveries; 62 cases were diagnosed before delivery, and 25 had a postnatal onset. Among the 62 antenatal cases, 41 were diagnosed before 32 weeks and 21 at or after 32 weeks of gestation. Antenatal cases had higher systolic () and diastolic () blood pressures, more abnormal dipstick-test proteinuria (), and lower platelet counts () than postnatal cases. Early eclampsia cases were complicated more often with HELLP syndrome than late eclampsia cases (). Conclusion. The occurrence of eclampsia has decreased over time. The earlier the onset is, the worse the outcome appears to be. Mauro H. Schenone, Dorothy Miller, Jacques E. Samson, and Giancarlo Mari Copyright © 2013 Mauro H. Schenone et al. All rights reserved. Wed, 27 Mar 2013 13:43:08 +0000 http://www.hindawi.com/journals/jp/2013/619718/ Objective. We conducted the study to see the incidence of thyroid dysfunction in women with obstetrical high-risk factors. Methods. We retrospectively reviewed medical charts of high-risk pregnant women who had examination for thyroid function during pregnancy. Women were divided according to clinical presentation, symptoms of thyroid disease and those with a personal history of thyroid disease (thyroid disease, ), intrauterine growth restriction (IUGR, ), diabetes mellitus (diabetes, ), hypertension (), intrauterine fetal death (IUFD, ), and placental abruption (abruption, ). The incidence of thyroid dysfunctions including hyperthyroidism or hypothyroidism was compared. Results. The overall prevalence of thyroid dysfunction was 24.7%. The incidence of thyroid dysfunction in each group was as follows: 31% in thyroid disease, 25% in IUGR, 30% in diabetes, 27% in hypertension, 12% in IUFD, and 7% in abruption. Except IUFD, the incidence was not statistically significant from the group of thyroid disease (thyroid disease versus IUFD, by test). Thyroid disease represented for only 10% of all thyroid dysfunctions. Conclusion. Testing of women with a personal history or current symptoms of thyroid disease during pregnancy may be insufficient to detect women with thyroid dysfunction, who will become at high-risk pregnancy. Masanao Ohashi, Seishi Furukawa, Kaori Michikata, Katsuhide Kai, Hiroshi Sameshima, and Tsuyomu Ikenoue Copyright © 2013 Masanao Ohashi et al. All rights reserved. Wed, 20 Mar 2013 18:23:28 +0000 http://www.hindawi.com/journals/jp/2013/139049/ Background. Women with a history of gestational diabetes mellitus (GDM) are at increased risk for metabolic syndrome (MeS) after delivery. We studied the prevalence of MeS at one year postpartum among Finnish women who in early pregnancy were at increased risk of developing GDM. Methods. This follow-up study is a part of a GDM prevention trial. At one year postpartum, 150 women (mean age 33.1 years, BMI 27.2 kg/m2) were evaluated for MeS. Results. The prevalence of MeS was 18% according tothe International Diabetes Federation(IDF) criteria and 16% according toNational Cholestrol Education Program(NCEP) criteria. Of MeS components, 74% of participants had an increased waist circumference (≥80 cm). Twenty-seven percent had elevated fasting plasma glucose (≥5.6 mmol/L), and 29% had reduced HDL cholesterol (≤1.3 mmol/L). The odds ratio for the occurrence of MeS at one year postpartum was 3.0 (95% CI 1.0–9.2) in those who were overweight before pregnancy compared to normal weight women. Conclusions. Nearly one-fifth of the women with an increased risk of GDM in early pregnancy fulfilled the criteria of MeS at one year postpartum. The most important factor associated with MeS was prepregnancy overweight. Weight management before and during pregnancy is important for preventing MeS after delivery. Jatta Puhkala, Tarja I. Kinnunen, Tommi Vasankari, Katriina Kukkonen-Harjula, Jani Raitanen, and Riitta Luoto Copyright © 2013 Jatta Puhkala et al. All rights reserved. Thu, 07 Mar 2013 12:01:27 +0000 http://www.hindawi.com/journals/jp/2013/412831/ Preterm birth is a major cause of perinatal mortality and long-term morbidity. Chorioamnionitis is a common cause of preterm birth. Clinical chorioamnionitis, characterised by maternal fever, leukocytosis, tachycardia, uterine tenderness, and preterm rupture of membranes, is less common than subclinical/histologic chorioamnionitis, which is asymptomatic and defined by inflammation of the chorion, amnion, and placenta. Chorioamnionitis is often associated with a fetal inflammatory response. The fetal inflammatory response syndrome (FIRS) is defined by increased systemic inflammatory cytokine concentrations, funisitis, and fetal vasculitis. Clinical and epidemiological studies have demonstrated that FIRS leads to poor cardiorespiratory, neurological, and renal outcomes. These observations are further supported by experimental studies that have improved our understanding of the mechanisms responsible for these outcomes. This paper outlines clinical and experimental studies that have improved our current understanding of the mechanisms responsible for chorioamnionitis-induced preterm birth and explores the cellular and physiological mechanisms underlying poor cardiorespiratory, neural, retinal, and renal outcomes observed in preterm infants exposed to chorioamnionitis. Robert Galinsky, Graeme R. Polglase, Stuart B. Hooper, M. Jane Black, and Timothy J. M. Moss Copyright © 2013 Robert Galinsky et al. All rights reserved. Thu, 21 Feb 2013 09:51:06 +0000 http://www.hindawi.com/journals/jp/2013/654817/ This study was undertaken to assess the impact of obesity on fetal well-being in glucose-tolerant and nonhypertensive women. Medical charts of all patients admitted to the labor and delivery department at our institution between January, 2011 and July, 2011 were retrospectively reviewed. Patients with diabetes/impaired glucose tolerance or hypertension were excluded. A total of 100 women, 50 lean and 50 obese, were included. Umbilical artery blood gas parameters (BGPs) were compared in lean (<25 kg/m2) and obese (≥30 kg/m2) women. Obese and lean women were comparable with respect to all baseline characteristics. There was no difference in any of the BGP or Apgar scores between obese and lean patients. Pearson’s correlation coefficient found no significant correlation between BMI and BGP/Apgar scores. Maternal obesity does not seem to affect BGP and fetal well-being in glucose-tolerant and nonhypertensive women. Salam E. Chalouhi, Caroline Salafia, Magdy Mikhail, and Robert Hecht Copyright © 2013 Salam E. Chalouhi et al. All rights reserved. Wed, 20 Feb 2013 08:38:08 +0000 http://www.hindawi.com/journals/jp/2013/787032/ Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed 300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting “recommended weight gain advice” were 3 times more likely to meet total GWG recommendations (OR: 3.2, ; women who complied with weekly GWG goals minimized PPWR (OR: 4.2, . In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs. Tamara R. Cohen and Kristine G. Koski Copyright © 2013 Tamara R. Cohen and Kristine G. Koski. All rights reserved. Thu, 14 Feb 2013 16:47:30 +0000 http://www.hindawi.com/journals/jp/2013/368461/ Chronic diseases such as type 2 diabetes and cardiovascular disease are the leading cause of death and disability worldwide. Although the metabolic syndrome has been defined in various ways, the ultimate importance of recognizing this combination of disorders is that it helps identify individuals at high risk for both type 2 diabetes and cardiovascular disease. Evidence from observational and experimental studies links adverse exposures in early life, particularly relating to nutrition, to chronic disease susceptibility in adulthood. Such studies provide the foundation and framework for the relatively new field of developmental origins of health and disease (DOHaD). Although great strides have been made in identifying the putative concepts and mechanisms relating specific exposures in early life to the risk of developing chronic diseases in adulthood, a complete picture remains obscure. To date, the main focus of the field has been on perinatal undernutrition and specific nutrient deficiencies; however, the current global health crisis of overweight and obesity demands that perinatal overnutrition and specific nutrient excesses be examined. This paper assembles current thoughts on the concepts and mechanisms behind the DOHaD as they relate to maternal nutrition, and highlights specific contributions made by macro- and micronutrients. Bonnie Brenseke, M. Renee Prater, Javiera Bahamonde, and J. Claudio Gutierrez Copyright © 2013 Bonnie Brenseke et al. All rights reserved. Mon, 11 Feb 2013 11:51:30 +0000 http://www.hindawi.com/journals/jp/2013/327638/ Timothy R. H. Regnault, Mark J. Nijland, Helen Budge, and Janna L. Morrison Copyright © 2013 Timothy R. H. Regnault et al. All rights reserved. Tue, 05 Feb 2013 10:53:26 +0000 http://www.hindawi.com/journals/jp/2013/165617/ Multiple guidelines and definitions of physical activity (PA) have been used to study the benefits of activity during pregnancy. The different guidelines lead to a wide range of prevalence estimates and this has led to conflicting reports about activity patterns during pregnancy. A longitudinal study was conducted to assess PA using a pattern-recognition monitor for a 7-day period at week 18 () and week 35 () of pregnancy. The amount of activity performed and the number of women meeting six different PA guidelines were evaluated. Adherence to PA guidelines ranged from 5 to 100% and 9 to 100% at weeks 18 and 35, respectively. All women achieved the 500 MET-minute guideline and nearly all women accumulated ≥150 minutes of weekly moderate-vigorous physical activity (MVPA) at both time points. Only 22% and 26% participated in ≥3 sessions of MVPA lasting ≥30 minutes at both time points and this further declined to 5% and 9% when the guideline was increased to ≥5 sessions of 30 minutes. The amount of PA during pregnancy varied drastically depending on which guideline was used. Further research is warranted to clearly identify the patterns of activity that are associated with healthy pregnancy outcomes. Katie M. Smith and Christina G. Campbell Copyright © 2013 Katie M. Smith and Christina G. Campbell. All rights reserved. Mon, 04 Feb 2013 15:56:32 +0000 http://www.hindawi.com/journals/jp/2013/193170/ Background. The transtheoretical model (TTM) has been successful in promoting health behavioral change in the general population. However, there is a scant knowledge about physical activity in relation to the TTM during pregnancy. Hence, the aims of the present study were (1) to assess readiness to become or stay physically active according to the TTM and (2) to compare background and health variables across the TTM. Methods. Healthy pregnant women () were allocated to the study from Oslo University Hospital, Norway. The participants filled in a validated self-administered questionnaire, physical activity pregnancy questionnaire (PAPQ) in gestation, weeks 32–36. The questionnaire contained 53 questions with one particular question addressing the TTM and the five stages: (1) precontemplation stage, (2) contemplation stage, (3) preparation stage, (4) action stage, and (5) maintenance stage. Results. More than half of the participants (53%) were involved in regular exercise (stages 4-5); however, only six specified that they had recently started an exercise program (stage 4). About 33% reported engaging in some physical activity, but not regularly (stage 3). The results showed that receiving advice from health professionals to exercise during pregnancy increased the likeliness of being in stages 4-5, while higher age, multiparity, pregravid overweight, unhealthy eating habits, pelvic girdle pain, and urinary incontinence were more prevalent with low readiness to change exercise habits (stages 1–3). Conclusion. According to the TTM, more than half of the participants reported to be physically active. Moreover, most of the participants classified as inactive showed a high motivational readiness or intention to increase their physical activity level. Hence, pregnancy may be a window of opportunity for the establishment of long-term physical activity habits. Lene Annette Hagen Haakstad, Nanna Voldner, and Kari Bø Copyright © 2013 Lene Annette Hagen Haakstad et al. All rights reserved. Thu, 31 Jan 2013 08:38:46 +0000 http://www.hindawi.com/journals/jp/2013/718095/ The kinematic analysis of gait during pregnancy provides more information about the anatomical changes and contributes to exercise and rehabilitation prescription. The purposes were to quantify the lower limb kinematics of gait and to compare it between the second and third trimesters of pregnancy and with a control group. A three-dimensional analysis was performed in twenty-two pregnant women and twelve nonpregnant. Repeated Measures and Manova tests were performed for comparisons between trimesters and between pregnant and controls. The walking speed, stride width, right-/left-step time, cycle time and time of support, and flight phases remain unchanged between trimesters and between pregnant and controls. Stride and right-/left-step lengths decreased between trimesters. Double limb support time increased between trimesters, and it increased when compared with controls. Joint kinematics showed a significant decrease of right-hip extension and adduction during stance phase between trimesters and when compared with controls. Also, an increase in left-knee flexion and a decrease in right-ankle plantarflexion were found between trimesters. The results suggested that pregnant women need to maintain greater stability of body and to become more efficient in locomotion. Further data from the beginning of pregnancy anthropometric data may contribute to the analysis. Marco Branco, Rita Santos-Rocha, Liliana Aguiar, Filomena Vieira, and António Veloso Copyright © 2013 Marco Branco et al. All rights reserved. Tue, 29 Jan 2013 15:54:48 +0000 http://www.hindawi.com/journals/jp/2013/257546/ This paper applies a life-course perspective to the problem of early pregnancy and pregnancy-related mortality and morbidity in adolescents in developing countries. It describes the contribution that two categories of “pregnancy-focused” programmes make—firstly, the provision of effective care and support in the antenatal, childbirth, and postnatal periods (downstream programmes), and secondly, the provision of effective promotive, preventive, and curative care in the prepregnancy period (midstream programmes). It then makes the case for these pregnancy-focused programmes to be set within the context of a third type of programmes, upstream programmes, that is, the provision of promotive and preventive care that contributes to children and adolescents—both male and female—being well nourished, healthy, knowledgeable about their health, and motivated and empowered to protect their health. It provides examples of successful initiatives of all three types of programmes. Finally, it discusses some practical considerations in planning, implementing, and monitoring these three programmes in a coherent manner. Charlotte Sigurdson Christiansen, Susannah Gibbs, and Venkatraman Chandra-Mouli Copyright © 2013 Charlotte Sigurdson Christiansen et al. All rights reserved. Tue, 29 Jan 2013 11:28:36 +0000 http://www.hindawi.com/journals/jp/2013/780180/ Background. The objective was to examine the association between prepregnancy physical exercise and offspring birth weight and to assess the combined association of pre-pregnancy body mass index (BMI) and physical exercise on birth weight. Methods. The study included 2,026 women aged 20–39 years participating in the Norwegian HUNT study and linked with the Medical Birth Registry. We calculated mean differences in birth weight and odds ratios (ORs) for a macrosomic infant (i.e., birth weight  g) using linear and logistic regression analysis. Results. There was no clear association between leisure time physical exercise and mean birth weight. Women who reported no exercise had reduced risk of a macrosomic infant (OR, 0.6; 95% confidence interval (CI), 0.4–0.9) compared to women with a high exercise level. Overweight ( kg/m2) was associated with an OR of 1.9 (95% CI, 1.2–2.9) for a macrosomic infant among women who reported low exercise levels, whereas the OR was 1.2 (95% CI, 0.8–1.8) among women with higher exercise levels. Conclusion. There was some evidence that women who reported no exercise before pregnancy had lower risk for a macrosomic infant than women who exercised. Pre-pregnancy BMI was positively associated with birth weight and risk of macrosomia but only among the least active women. Silje Krogsgaard, Sigridur L. Gudmundsdottir, and Tom I. L. Nilsen Copyright © 2013 Silje Krogsgaard et al. All rights reserved. Mon, 14 Jan 2013 09:01:25 +0000 http://www.hindawi.com/journals/jp/2013/820892/ Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the data of two successful inductions as controls. Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position. Results. Between 1995 and 2010, labor was induced in 2548 parous women, of whom 80 had a cesarean delivery (3%). These 80 cases were compared to the data of 160 parous women with a successful induction of labor. In the multivariate analysis history of preterm delivery (odds ratio (OR) 5.3 (95% CI 1.1 to 25)), maternal height (OR 0.87 (95% CI 0.80 to 0.95)) and dilatation at the start of induction (OR 0.43 (95% CI 0.19 to 0.98)) were associated with failed induction. Conclusion. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction. Corine J. Verhoeven, Cedric T. van Uytrecht, Martina M. Porath, and Ben Willem J. Mol Copyright © 2013 Corine J. Verhoeven et al. All rights reserved. Mon, 31 Dec 2012 09:12:07 +0000 http://www.hindawi.com/journals/jp/2012/257597/ Background. To estimate the exposure to medicines with unknown fetal risk during pregnancy and to analyze the maternal characteristics associated with it. Methods. A questionnaire was administered to 4,189 mothers of children belonging to the 2004 Pelotas (Brazil) birth cohort study about use of any medicine during gestation. We evaluated the associations between use of medicines with unknown fetal risk and the independent variables through logistic regression models. Unknown fetal risk was defined as medicines in which studies in animals have revealed adverse effects on the fetus, and no controlled studies in women, or studies in women and animals, are available. Results. Out of the 4,189 women, 52.5% used at least one medicine from unknown fetal risk. Use of these medicines was associated with white skin color, high schooling, high income, six or more antenatal care consultations, hospital admission during pregnancy, and morbidity during gestation. Conclusion. The use of unknown fetal risk medicines is high, suggesting that their use must be addressed with caution with the aim of restricting their use to cases in which the benefits are greater than the potential risks. Andréa Dâmaso Bertoldi, Tatiane da Silva Dal Pizzol, Aline Lins Camargo, Aluísio J. D. Barros, Alicia Matijasevich, and Iná S. Santos Copyright © 2012 Andréa Dâmaso Bertoldi et al. All rights reserved. Thu, 20 Dec 2012 17:34:19 +0000 http://www.hindawi.com/journals/jp/2012/945196/ The aim of the study was to examine the effects of tobacco smoking in pregnancy on children’s IQ at the age of 5. A prospective follow-up study was conducted on 1,782 women, and their offspring were sampled from the Danish National Birth Cohort. At 5 years of age, the children were tested with the Wechsler Preschool and Primary Scale of Intelligence-Revised. Parental education, maternal IQ, maternal alcohol consumption in pregnancy, the sex and age of the child, and tester were considered core confounders, but the full model also controlled for prenatal paternal smoking, maternal age and Bodymass Mass Index, parity, family/home environment, postnatal parental smoking, breast feeding, the child’s health status, and indicators for hearing and vision impairments. Unadjusted analyses showed a statistically significant decrement of 4 points on full-scale IQ (FSIQ) associated with smoking 10+ cigarettes per day compared to nonsmoking. After adjustment for potential confounders, no significant effects of prenatal exposure to tobacco smoking were found. Considering the indisputable teratogenic effects of tobacco smoking, these findings should be interpreted with caution. Still, the results may indicate that previous studies that failed to control for important confounders, particularly maternal intelligence, may be subject to substantial residual confounding. Hanne-Lise Falgreen Eriksen, Ulrik Schiøler Kesmodel, Theresa Wimberley, Mette Underbjerg, Tina Røndrup Kilburn, and Erik Lykke Mortensen Copyright © 2012 Hanne-Lise Falgreen Eriksen et al. All rights reserved. Mon, 17 Dec 2012 12:33:56 +0000 http://www.hindawi.com/journals/jp/2012/435090/ Preeclampsia (PE) affects around 2–5% of pregnant women. It is a major cause of maternal and perinatal morbidity and mortality. In an attempt to prevent preeclampsia, many strategies based on antenatal care, change in lifestyle, nutritional supplementation, and drugs have been studied. The aim of this paper is to review recent evidence about primary and secondary prevention of preeclampsia. Sammya Bezerra Maia e Holanda Moura, Laudelino Marques Lopes, Padma Murthi, and Fabricio da Silva Costa Copyright © 2012 Sammya Bezerra Maia e Holanda Moura et al. All rights reserved. Mon, 17 Dec 2012 08:56:10 +0000 http://www.hindawi.com/journals/jp/2012/470247/ Background. The period surrounding pregnancy has been identified as a risk period for overweight/obesity in both mother and child because of excessive gestational weight gain (GWG). The promotion of a healthy GWG is therefore of paramount importance in the context of the prevention of obesity in the current and next generations. Objective. To provide a comprehensive overview of the effect of prenatal physical activity interventions, alone or in combination with nutritional counselling, on GWG and to address whether preventing excessive GWG decreases the incidence of infant high birth weight and/or postpartum weight retention. Method. A search of the PubMed database was conducted to identify all relevant studies. Nineteen studies were included in this review: 13 interventions combining physical activity, nutrition, and GWG counselling and 6 interventions including physical activity alone. Results. Prenatal lifestyle interventions promoting healthy eating and physical activity habits appear to be the most effective approach to prevent excessive GWG. Achievement of appropriate GWG may also decrease the incidence of high infant birth weight and postpartum weight retention. Conclusion. Healthy eating habits during pregnancy, combined with an active lifestyle, may be important elements in the prevention of long-term risk of obesity for two generations. Stephanie-May Ruchat and Michelle F. Mottola Copyright © 2012 Stephanie-May Ruchat and Michelle F. Mottola. All rights reserved. Mon, 10 Dec 2012 08:55:09 +0000 http://www.hindawi.com/journals/jp/2012/179827/ Abnormal fetal growth, both growth restriction and overgrowth, is associated with perinatal complications and an increased risk of metabolic and cardiovascular disease later in life. Fetal growth is dependent on nutrient availability, which in turn is related to the capacity of the placenta to transport these nutrients. The activity of a range of nutrient transporters has been reported to be decreased in placentas of growth restricted fetuses, whereas at least some studies indicate that placental nutrient transport is upregulated in fetal overgrowth. These findings suggest that changes in placental nutrient transport may directly contribute to the development of abnormal fetal growth. Detailed information on the mechanisms by which placental nutrient transporters are regulated will therefore help us to better understand how important pregnancy complications develop and may provide a foundation for designing novel intervention strategies. In this paper we will focus on recent studies of regulatory mechanisms that modulate placental transport of amino acids, fatty acids, and glucose. Susanne Lager and Theresa L. Powell Copyright © 2012 Susanne Lager and Theresa L. Powell. All rights reserved. Wed, 28 Nov 2012 08:25:47 +0000 http://www.hindawi.com/journals/jp/2012/134758/ Intrauterine growth restriction (IUGR) is strongly associated with obesity in adult life. The mechanisms contributing to the onset of IUGR-associated adult obesity have been studied in animal models and humans, where changes in fetal adipose tissue development, hormone levels and epigenome have been identified as principal areas of alteration leading to later life obesity. Following an adverse in utero development, IUGR fetuses display increased lipogenic and adipogenic capacity in adipocytes, hypoleptinemia, altered glucocorticoid signalling, and chromatin remodelling, which subsequently all contribute to an increased later life obesity risk. Data suggest that many of these changes result from an enhanced activity of the adipose master transcription factor regulator, peroxisome proliferator-activated receptor-γ (PPARγ) and its coregulators, increased lipogenic fatty acid synthase (FAS) expression and activity, and upregulation of glycolysis in fetal adipose tissue. Increased expression of fetal hypothalamic neuropeptide Y (NPY), altered hypothalamic leptin receptor expression and partitioning, reduced adipose noradrenergic sympathetic innervations, enhanced adipose glucocorticoid action, and modifications in methylation status in the promoter of hepatic and adipose adipogenic and lipogenic genes in the fetus also contribute to obesity following IUGR. Therefore, interventions that inhibit these fetal developmental changes will be beneficial for modulation of adult body fat accumulation. Ousseynou Sarr, Kaiping Yang, and Timothy R. H. Regnault Copyright © 2012 Ousseynou Sarr et al. All rights reserved. Thu, 22 Nov 2012 08:33:42 +0000 http://www.hindawi.com/journals/jp/2012/839656/ Glucocorticoids are administered to pregnant women at risk of preterm labour to promote fetal lung surfactant maturation. Intrauterine growth restriction (IUGR) is associated with an increased risk of preterm labour. Hence, IUGR babies may be exposed to antenatal glucocorticoids. The ability of the placenta or blood brain barrier to remove glucocorticoids from the fetal compartment or the brain is compromised in the IUGR fetus, which may have implications for lung, brain, and heart development. There is conflicting evidence on the effect of exogenous glucocorticoids on surfactant protein expression in different animal models of IUGR. Furthermore, the IUGR fetus undergoes significant cardiovascular adaptations, including altered blood pressure regulation, which is in conflict with glucocorticoid-induced alterations in blood pressure and flow. Hence, antenatal glucocorticoid therapy in the IUGR fetus may compromise regulation of cardiovascular development. The role of cortisol in cardiomyocyte development is not clear with conflicting evidence in different species and models of IUGR. Further studies are required to study the effects of antenatal glucocorticoids on lung, brain, and heart development in the IUGR fetus. Of specific interest are the aetiology of IUGR and the resultant degree, duration, and severity of hypoxemia. Janna L. Morrison, Kimberley J. Botting, Poh Seng Soo, Erin V. McGillick, Jennifer Hiscock, Song Zhang, I. Caroline McMillen, and Sandra Orgeig Copyright © 2012 Janna L. Morrison et al. All rights reserved. Mon, 22 Oct 2012 07:19:41 +0000 http://www.hindawi.com/journals/jp/2012/812094/ Constant maternal hyperglycemia limits, while pulsatile maternal hyperglycemia may enhance, fetal glucose-stimulated insulin secretion (GSIS) in sheep. However, the impact of such different patterns of hyperglycemia on the development of the fetal β-cell is unknown. We measured the impact of one week of chronic constant hyperglycemia (CHG, ) versus pulsatile hyperglycemia (PHG, ) versus controls () on the percentage of the fetal pancreas staining for insulin (β-cell area), mitotic and apoptotic indices and size of fetal β-cells, and fetal insulin secretion in sheep. Baseline insulin concentrations were higher in CHG fetuses () compared to controls and PHG. GSIS was lower in the CHG group () compared to controls and PHG. PHG β-cell area was increased 50% () compared to controls and CHG. CHG β-cell apoptosis was increased over 400% () compared to controls and PHG. These results indicate that late gestation constant maternal hyperglycemia leads to significant β-cell toxicity (increased apoptosis and decreased GSIS). Furthermore, pulsatile maternal hyperglycemia increases pancreatic β-cell area but did not increase GSIS, indicating decreased β-cell responsiveness. These findings demonstrate differential effects that the pattern of maternal hyperglycemia has on fetal pancreatic β-cell development, which might contribute to later life limitation in insulin secretion. Mackenzie S. Frost, Aqib H. Zehri, Sean W. Limesand, William W. Hay Jr., and Paul J. Rozance Copyright © 2012 Mackenzie S. Frost et al. All rights reserved. Wed, 03 Oct 2012 14:44:38 +0000 http://www.hindawi.com/journals/jp/2012/638476/ Placental insufficiency, maternal malnutrition, and other causes of intrauterine growth restriction (IUGR) can significantly affect short-term growth and long-term health. Following IUGR, there is an increased risk for cardiovascular disease and Type 2 Diabetes. The etiology of these diseases is beginning to be elucidated, and premature aging or cellular senescence through increased oxidative stress and DNA damage to telomeric ends may be initiators of these disease processes. This paper will explore the areas where telomere and telomerase biology can have significant effects on various tissues in the body in IUGR outcomes. Stephanie E. Hallows, Timothy R. H. Regnault, and Dean H. Betts Copyright © 2012 Stephanie E. Hallows et al. All rights reserved. Mon, 17 Sep 2012 10:09:29 +0000 http://www.hindawi.com/journals/jp/2012/482690/ Epidemiological studies have suggested that metabolic programming begins during fetal life and adverse events in utero are a critical factor in the etiology of chronic diseases and overall health. While the underlying molecular mechanisms linking impaired fetal development to these adult diseases are being elucidated, little is known about how we can intervene early in life to diminish the incidence and severity of these long-term diseases. This paper highlights the latest clinical and pharmaceutical studies addressing how dietary intervention in fetal and neonatal life may be able to prevent aspects of the metabolic syndrome associated with IUGR pregnancies. Noelle Ma and Daniel B. Hardy Copyright © 2012 Noelle Ma and Daniel B. Hardy. All rights reserved. Tue, 28 Aug 2012 07:43:32 +0000 http://www.hindawi.com/journals/jp/2012/241869/ Alexander Krafft, Laura Murray-Kolb, and Nils Milman Copyright © 2012 Alexander Krafft et al. All rights reserved. Thu, 16 Aug 2012 16:14:54 +0000 http://www.hindawi.com/journals/jp/2012/751694/ Fetuses at risk of premature delivery are now routinely exposed to maternal treatment with synthetic glucocorticoids. In randomized clinical trials, these substantially reduce acute neonatal systemic morbidity, and mortality, after premature birth and reduce intraventricular hemorrhage. However, the overall neurodevelopmental impact is surprisingly unclear; worryingly, postnatal glucocorticoids are consistently associated with impaired brain development. We review the clinical and experimental evidence on how glucocorticoids may affect the developing brain and highlight the need for systematic research. Laura Bennet, Joanne O. Davidson, Miriam Koome, and Alistair Jan Gunn Copyright © 2012 Laura Bennet et al. All rights reserved. Thu, 16 Aug 2012 10:09:37 +0000 http://www.hindawi.com/journals/jp/2012/792934/ Adverse uterine environments experienced during fetal development can alter the projected growth pattern of various organs and systems of the body, leaving the offspring at an increased risk of metabolic disease. The thrifty phenotype hypothesis has been demonstrated as an alteration to the growth trajectory to improve the survival and reproductive fitness of the individual. However, when the intrauterine environment does not match the extrauterine environment problems can arise. With the increase in metabolic diseases in both Westernized and developing countries, it is becoming apparent that there is an environmental disconnect with the extrauterine environment. Therefore, the focus of this paper will be to explore the effects of maternal malnutrition on the offspring’s susceptibility to metabolic disorders such as obesity, cardiovascular disease, and diabetes with emphasis on programming of the neuroendocrine-immune system. R. E. Fisher, M. Steele, and N. A. Karrow Copyright © 2012 R. E. Fisher et al. All rights reserved.