Digital Commons Network^™

Maternal Immune Activation Alters Fetal Brain Development And Enhances Proliferation Of Neural Precursor Cells In Rats, Kelly J. Baines, Dendra M. Hillier, Faraj L. Haddad, Nagalingam Rajakumar, Susanne Schmid, Stephen J. Renaud

Brain and Mind Institute Researchers' Publications

Maternal immune activation (MIA) caused by exposure to pathogens or inflammation during critical periods of neurodevelopment is a major risk factor for behavioral deficits and psychiatric illness in offspring. A spectrum of behavioral abnormalities can be recapitulated in rodents by inducing MIA using the viral mimetic, PolyI:C. Many studies have focused on long-term changes in brain structure and behavioral outcomes in offspring following maternal PolyI:C exposure, but acute changes in prenatal development are not well-characterized. Using RNA-Sequencing, we profiled acute transcriptomic changes in rat conceptuses (decidua along with nascent embryo and placenta) after maternal PolyI:C exposure during early gestation, which …

Maternal Exposure To Δ9-Tetrahydrocannabinol Impairs Female Offspring Glucose Homeostasis And Endocrine Pancreatic Development In The Rat., Ryan Gillies, Kendrick Lee, Sebastian Vanin, Steven R Laviolette, Alison C Holloway, Edith Arany, Daniel B Hardy

Physiology and Pharmacology Publications

Recent reports indicate that 7% of pregnant mothers in North America use cannabis. This is concerning given that in utero exposure to Δ9-tetrahydrocannabinol (Δ9-THC), the main psychoactive component in cannabis, causes fetal growth restriction and may alter replication and survival of pancreatic β-cells in the offspring. Accordingly, we hypothesized that maternal exposure to Δ9-THC during pregnancy will impair postnatal glucometabolic health of offspring. To test this hypothesis, pregnant Wistar rats were treated with daily intraperitoneal injections of either 3 mg/kg Δ9-THC or vehicle from gestational day 6 to birth. Offspring were subsequently challenged with glucose and insulin at 5 months …

Development Of A Core Outcome Set For Studies On Cardiac Disease In Pregnancy (Coscarp): A Study Protocol, Rohan D'Souza, Chelsea Hall, Mathew Sermer, Samuel Siu, Candice Silversides

Paediatrics Publications

Background: Clinical studies looking at interventions to optimize pregnancy and long-term outcomes for women with cardiac disease and their babies are inconsistent in their reporting of clinical outcomes, making it difficult to compare results across studies and draw meaningful conclusions. The development of a core outcome set (COS) - a standardized, minimum set of outcomes that must be collected and reported in all studies - is a practical solution to this problem. Methods/design: We will follow a five-step process in developing a COS for studies on pregnant women with cardiac disease. First, a systematic literature review will identify all reported …

A Core Outcome Set For Studies Of Gestational Diabetes Mellitus Prevention And Treatment, Aoife M Egan, Delia Bogdanet, Tomás P Griffin, Oratile Kgosidialwa, Mila Cervar-Zivkovic, Eugene Dempsey, John Allotey, Fernanda Alvarado, Cheril Clarson, Shamil D Cooray, Harold W De Valk, Sander Galjaard, Mary R Loeken, Michael J A Maresh, Angela Napoli, Paula M O'Shea, Ewa Wender-Ozegowska, Mireille N M Van Poppel, Shakila Thangaratinam, Caroline Crowther, Linda M Biesty, Declan Devane, Fidelma P Dunne

Paediatrics Publications

AIMS/HYPOTHESIS: The aim of this systematic review was to develop core outcome sets (COSs) for trials evaluating interventions for the prevention or treatment of gestational diabetes mellitus (GDM).

METHODS: We identified previously reported outcomes through a systematic review of the literature. These outcomes were presented to key stakeholders (including patient representatives, researchers and clinicians) for prioritisation using a three-round, e-Delphi study. A priori consensus criteria informed which outcomes were brought forward for discussion at a face-to-face consensus meeting where the COS was finalised.

RESULTS: Our review identified 74 GDM prevention and 116 GDM treatment outcomes, which were presented to stakeholders …

Labour Progression In Obese Women: Are Women With Increased Body Mass Index Having Unnecessary Cesarean Sections?, Caroline Shenouda, Aloka Wijesooriya, Amanda Toufeili, Michael R Miller, Debbie Penava, Barbra De Vrijer

Obstetrics & Gynaecology Publications

OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes.

METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m

RESULTS: Obese class II and III primiparous women required an additional 1.62 and 2.67 hours (P = 0.012), respectively, to reach a dilation of 10 cm compared with their normal weight counterparts; obese class II and III multiparous women required an …

Evidence Of Increased Hypoxia Signaling In Fetal Liver From Maternal Nutrient Restriction In Mice., Bethany N Radford, Victor K M Han

Paediatrics Publications

BACKGROUND: Intrauterine growth restriction (IUGR) is a pregnancy condition where fetal growth is reduced, and offspring from IUGR pregnancies are at increased risk for type II diabetes as adults. The liver is susceptible to fetal undernutrition experienced by IUGR infants and animal models of growth restriction. This study aimed to examine hepatic expression changes in a maternal nutrient restriction (MNR) mouse model of IUGR to understand fetal adaptations that influence adult metabolism.

METHODS: Liver samples of male offspring from MNR (70% of ad libitum starting at E6.5) or control pregnancies were obtained at E18.5 and differential expression was assessed by …

Placental Micrornas In Pregnancies With Early Onset Intrauterine Growth Restriction And Preeclampsia: Potential Impact On Gene Expression And Pathophysiology., Zain Awamleh, Gregory B Gloor, Victor K M Han

Paediatrics Publications

BACKGROUND:
A normally developed placenta is integral to a successful pregnancy. Preeclampsia (PE) and intrauterine growth restriction (IUGR) are two common pregnancy related complications that maybe a result of abnormal placental development. Placental microRNAs (miRNAs) have been investigated as potential biomarkers for these complications, as they may play a role in placental development and pathophysiology by influencing gene expression. The purpose of this study is to utilize next-generation sequencing to determine miRNA and gene expression in human placental (chorionic villous) samples from three distinct patient groups with early-onset (EO) PE, IUGR, or PE + IUGR.

METHODS:
Placental tissues were collected …

Novel Roles Of Mechanistic Target Of Rapamycin Signaling In Regulating Fetal Growth, Madhulika B. Gupta, Thomas Jansson

Paediatrics Publications

Mechanistic target of rapamycin (mTOR) signaling functions as a central regulator of cellular metabolism, growth, and survival in response to hormones, growth factors, nutrients, energy, and stress signals. Mechanistic TOR is therefore critical for the growth of most fetal organs, and global mTOR deletion is embryonic lethal. This review discusses emerging evidence suggesting that mTOR signaling also has a role as a critical hub in the overall homeostatic control of fetal growth, adjusting the fetal growth trajectory according to the ability of the maternal supply line to support fetal growth. In the fetus, liver mTOR governs the secretion and phosphorylation …

Effects Of Prenatal Exercise On Fetal Heart Rate, Umbilical And Uterine Blood Flow: A Systematic Review And Meta-Analysis, Rachel J. Skow, Margie H. Davenport, Michelle Mottola, Gregory A. Davies, Veronica J. Poitras, Casey E. Gray, Alejandra Jaramillo Garcia, Nick Barrowman, Victoria L. Meah, Linda G. Slater, Kristi B. Adamo, Ruben Barakat, Stephanie-May Ruchat

Anatomy and Cell Biology Publications

Objective To perform a systematic review and meta-analysis examining the influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and umbilical and uterine blood flow metrics.

Design Systematic review with random-effects meta-analysis and meta-regression.

Data sources Online databases were searched up to 6 January 2017.

Study eligibility criteria Studies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other …

Mediators Of Lifestyle Behaviour Changes In Obese Pregnant Women. Secondary Analyses From The Dali Lifestyle Randomised Controlled Trial, Mireille N.M. Van Poppel, Judith G.M. Jelsma, David Simmons, Roland Devlieger, Goele Jans, Sander Galjaard, Rosa Corcoy, Juan M. Adelantado, Fidelma Teh, Matt Firth, Takashi Ushiki, Christopher E. Andoniou, Mariapia A. Degli-Esposti, Phillip P. Sharp, Caroline E. Sanvitale, Giuseppe Infusini, Nicholas P.D. Liau, Edmond M. Linossi, Christopher J. Burns, Sebastian Carotta, Daniel H.D. Gray, Cyril Seillet, Dana S. Hutchinson, Gabrielle T. Belz, Andrew I. Webb, Warren S. Alexander

Paediatrics Publications

A better understanding of what drives behaviour change in obese pregnant overweight women is needed to improve the effectiveness of lifestyle interventions in this group at risk for gestational diabetes (GDM). Therefore, we assessed which factors mediated behaviour change in the Vitamin D and Lifestyle Intervention for GDM Prevention (DALI) Lifestyle Study. A total of 436 women, with pre-pregnancy body mass index ≥29 kg/m 2 , ≤19 + 6 weeks of gestation and without GDM, were randomised for counselling based on motivational interviewing (MI) on healthy eating and physical activity, healthy eating alone, physical activity alone, or to a usual …

Vitamin D And Gestational Diabetes Mellitus: Is There A Link?, Gianluca Rizzo, Simone Garzon, Michele Fichera, Marco Marzio Panella, Ursula Catena, Antonio Schiattarella, Pasquale De Franciscis, George Vilos, Jan Tesarik, Péter Török, Giuseppe Grosso

Paediatrics Publications

Gestational diabetes mellitus (GDM) is a very common condition among pregnant women worldwide with important metabolic implications on the mother and the offspring. Vitamin D status has been suggested to potentially play a role in GDM risk with no documented consequences for the offspring. The purpose of this article was to review currently available evidence on the relationship between vitamin D and GDM. Current evidence shows an association between vitamin D blood levels and risk of GDM, despite heterogeneity of results across studies limit the conclusions. Moreover, data from randomized controlled trials is scarce and resulting in null findings. Among …

A Mouse Model Of Gestational Glucose Intolerance Through Exposure To A Low Protein Diet During Fetal And Neonatal Development, Sandra K. Szlapinski, Renee T. King, Gabrielle Retta, Erica Yeo, Brenda J. Strutt, David J. Hill

Paediatrics Publications

Key points: Pancreatic β-cell dysfunction is hypothesized to be the significant determinant of gestational diabetes pathogenesis, however pancreatic samples from patients are scarce. This study reports a novel mouse model of gestational glucose intolerance in pregnancy, originating from previous nutrition restriction in utero, in which glucose intolerance was restricted to late gestation as is seen in human gestational diabetes. Glucose intolerance was attributed to reduced β-cell proliferation, leading to impaired gestational β-cell mass expansion in maternal endocrine pancreas, in addition to reduced glucose-stimulated insulin secretion. This model reproduces some of the features of gestational diabetes and is suitable for testing …

Guinea Pig Models For Translation Of The Developmental Origins Of Health And Disease Hypothesis Into The Clinic, Janna L. Morrison, Kimberley J. Botting, Jack R.T. Darby, Anna L. David, Rebecca M. Dyson, Kathryn L. Gatford, Clint Gray, Emilio A. Herrera, Jonathan J. Hirst, Bona Kim, Karen L. Kind, Bernardo J. Krause, Stephen G. Matthews, Hannah K. Palliser, Timothy R.H. Regnault, Bryan S. Richardson, Aya Sasaki, Loren P. Thompson, Mary J. Berry

Paediatrics Publications

Over 30 years ago Professor David Barker first proposed the theory that events in early life could explain an individual's risk of non-communicable disease in later life: the developmental origins of health and disease (DOHaD) hypothesis. During the 1990s the validity of the DOHaD hypothesis was extensively tested in a number of human populations and the mechanisms underpinning it characterised in a range of experimental animal models. Over the past decade, researchers have sought to use this mechanistic understanding of DOHaD to develop therapeutic interventions during pregnancy and early life to improve adult health. A variety of animal models have …

Improving Pregnancy Outcomes In Humans Through Studies In Sheep, Janna L. Morrison, Mary J. Berry, Kimberley J. Botting, Jack R.T. Darby, Martin G. Frasch, Kathryn L. Gatford, Dino A. Giussani, Clint L. Gray, Richard Harding, Emilio A. Herrera, Matthew W. Kemp, Mitchell C. Lock, I. Caroline Mcmillen, Timothy J. Moss, Gabrielle C. Musk, Mark H. Oliver, Timothy R.H. Regnault, Claire T. Roberts, Jia Yin Soo, Ross L. Tellam

Paediatrics Publications

Experimental studies that are relevant to human pregnancy rely on the selection of appropriate animal models as an important element in experimental design. Consideration of the strengths and weaknesses of any animal model of human disease is fundamental to effective and meaningful translation of preclinical research. Studies in sheep have made significant contributions to our understanding of the normal and abnormal development of the fetus. As a model of human pregnancy, studies in sheep have enabled scientists and clinicians to answer questions about the etiology and treatment of poor maternal, placental, and fetal health and to provide an evidence base …

Association Between Gestational Weight Gain, Gestational Diabetes Risk, And Obstetric Outcomes: A Randomized Controlled Trial Post Hoc Analysis, David Simmons, Roland Devlieger, Andre Van Assche, Sander Galjaard, Rosa Corcoy, Juan M. Adelantado, Fidelma Dunne, Gernot Desoye, Alexandra Abenhaim, Jehier Afifi, Ruben Alvaro, James Andrews, Anthony Armson, Francois Audibert, Khalid Aziz, Marilyn Ballantyne, Jon Barrett, Marc Beltempo, Anick Berard, Valerie Bertelle, Lucie Blais, Alan Bocking, Jaya Bodani, Jason Burrows, Kimberly Butt, Roderick Canning

Paediatrics Publications

Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m2 <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24–28 weeks (4.66 ± 0.43 vs. 4.61 ± 0.40 mmol/L, p < 0.01), and a higher rate of caesarean section (38% vs. 27% p < 0.05). The GWG over the median at 35–37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0.05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or …

The Association Between Alcohol Outlet Accessibility And Adverse Birth Outcomes: A Retrospective Cohort Study, Jamie A. Seabrook, N Woods, Andrew F. Clark, Barbra De Vrijer, Debbie Penava, Jason A. Gilliland

Human Environments Analysis Lab (HEAL)

BACKGROUND:Alcohol outlet accessibility is positively associated with alcohol consumption, although this relationship has not been thoroughly examined in pregnant women. The present study examines the relationship between proximity and density of alcohol outlets and risk for low birth weight (LBW: <2,500 grams) and preterm birth (PTB: <37 weeks gestational age), and is the first Canadian study to investigate this association.

METHODS:Maternal accessibility to alcohol outlets was specified using a gravity-type measure of accessibility, which provides the amount of accessibility that a given household has to liquor stores within 30-minutes of their home. All singleton newborns without congenital anomalies that were born between February 2009 and February 2014 at London Health Sciences Centre in London, Ontario, were included in …

Correlates Of Poor Mental Health In Early Pregnancy In Obese European Women, Matteo C. Sattler, Judith G.M. Jelsma, Annick Bogaerts, David Simmons, Gernot Desoye, Rosa Corcoy, Juan M. Adelantado, Alexandra Kautzky-Willer

Paediatrics Publications

Background: Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. Methods: In this cross-sectional observational study, baseline data from early pregnancy (< 20 weeks) of the DALI (Vitamin D and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. Results.: A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25,.77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92,.98], social support, OR = .94, 95% CI [.90,.99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]). Conclusions: Mental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. Trial registration:ISRCTN70595832 , 02.12.2011.

Exercise And Pregnancy In Recreational And Elite Athletes: 2016/17 Evidence Summary From The Ioc Expert Group Meeting, Lausanne. Part 3 - Exercise In The Postpartum Period, Kari Bø, Raul Artal, Ruben Barakat, Wendy J. Brown, Gregory A.L. Davies, Michael Dooley, Kelly R. Evenson, Lene A.H. Haakstad, Bengt Pusic, Don Mcconnell, Cheri Nijssen-Jordan, Norm Silver, Brett Taylor, Ian G. Stiell

Paediatrics Publications

This is Part 3 in the series of reviews from the IOC expert committee on exercise and pregnancy in recreational and elite athletes. Part 1 focused on the effects of training during pregnancy and on the management of common pregnancy-related complaints experienced by athletes1; Part 2 addressed maternal and fetal perinatal outcomes.2 In this part, we review the implications of pregnancy and childbirth on return to exercise and on common illnesses and complaints in the postpartum period. The postpartum period can be divided into hospital-based (during hospital stay), immediate postpartum (hospital discharge to 6 weeks postpartum) and later postpartum (6 …

Epidemiology Of Gestational Diabetes Mellitus According To Iadpsg/Who 2013 Criteria Among Obese Pregnant Women In Europe, Aoife M. Egan, Akke Vellinga, Jürgen Harreiter, David Simmons, Gernot Desoye, Rosa Corcoy, Juan M. Adelantado, Roland Devlieger, Andre Dahlben, Karl G. Helmer, Andrew M. Johnson, Jeffrey D. Holmes, Lorie A. Forwell, Elaine N. Skopelja, Martha E. Shenton, Paul S. Echlin, Inga K. Koerte

Paediatrics Publications

Aims/hypothesis: Accurate prevalence estimates for gestational diabetes mellitus (GDM) among pregnant women in Europe are lacking owing to the use of a multitude of diagnostic criteria and screening strategies in both high-risk women and the general pregnant population. Our aims were to report important risk factors for GDM development and calculate the prevalence of GDM in a cohort of women with BMI ≥29 kg/m2 across 11 centres in Europe using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG)/WHO 2013 diagnostic criteria. Methods: Pregnant women (n = 1023, 86.3% European ethnicity) with a BMI ≥29.0 kg/m2 enrolled into …

Is A Motivational Interviewing Based Lifestyle Intervention For Obese Pregnant Women Across Europe Implemented As Planned? Process Evaluation Of The Dali Study, Judith G.M. Jelsma, David Simmons, Nina Gobat, Stephen Rollnick, Kinga Blumska, Goele Jans, Sander Galjaard, Gernot Desoye

Paediatrics Publications

Background: Process evaluation is an essential part of designing and assessing complex interventions. The vitamin D and lifestyle intervention study (DALI) study is testing different strategies to prevent development of gestational diabetes mellitus among European obese pregnant women with a body mass index ≥29kg/m2. The intervention includes guidance on physical activity and/or healthy eating by a lifestyle coach trained in motivational interviewing (MI). The aim of this study was to assess the process elements: reach, dose delivered, fidelity and satisfaction and to investigate whether these process elements were associated with changes in gestational weight gain (GWG). Methods: Data on reach, …

Factors That Influence Excessive Gestational Weight Gain: Moving Beyond Assessment And Counselling, Emily E, Campbell, Paula D N Dworatzek, Debbie Penava, Barbra De Vrijer, Jason A. Gilliland, June I. Matthews, Jamie A Seabrook

Human Environments Analysis Lab (HEAL)

One in four Canadian adults is obese, and more women are entering pregnancy with a higher body mass index (BMI) than in the past. Pregnant women who are overweight or obese have a higher risk of pregnancy-related complications than women of normal weight. Gestational weight gain (GWG) is also associated with childhood obesity. Although the factors influencing weight gain during pregnancy are multifaceted, little is known about the social inequality of GWG. This review will address some of the socioeconomic factors and maternal characteristics influencing weight gain and the impact that excessive GWG has on health outcomes such as post-partum …

Maternal Cardiac Output And Fetal Doppler Predict Adverse Neonatal Outcomes In Pregnant Women With Heart Disease, Rachel M. Wald, Candice K. Silversides, John Kingdom, Ants Toi, Cathy S. Lau, Jennifer Mason, Jack M. Colman, Mathew Sermer, Samuel C. Siu

Paediatrics Publications

Background-The mechanistic basis of the proposed relationship between maternal cardiac output and neonatal complications in pregnant women with heart disease has not been well elucidated. Methods and Results-Pregnant women with cardiac disease and healthy pregnant women (controls) were prospectively followed with maternal echocardiography and obstetrical ultrasound scans at baseline, third trimester, and postpartum. Fetal/neonatal complications (death, small-for-gestational-age or low birthweight, prematurity, respiratory distress syndrome, or intraventricular hemorrhage) comprised the primary study outcome. One hundred and twenty-seven women with cardiac disease and 45 healthy controls were enrolled. Neonatal events occurred in 28 pregnancies and were more frequent in the heart disease …

Implantation Failure In Female Kiss1-/- Mice Is Independent Of Their Hypogonadic State And Can Be Partially Rescued By Leukemia Inhibitory Factor., Michele Calder, Yee-Ming Chan, Renju Raj, Macarena Pampillo, Adrienne Elbert, Michelle Noonan, Carolina Gillio-Meina, Claudia Caligioni, Nathalie G Bérubé, Moshmi Bhattacharya, Andrew J Watson, Stephanie B Seminara, Andy V Babwah

Obstetrics & Gynaecology Publications

The hypothalamic kisspeptin signaling system is a major positive regulator of the reproductive neuroendocrine axis, and loss of Kiss1 in the mouse results in infertility, a condition generally attributed to its hypogonadotropic hypogonadism. We demonstrate that in Kiss1(-/-) female mice, acute replacement of gonadotropins and estradiol restores ovulation, mating, and fertilization; however, these mice are still unable to achieve pregnancy because embryos fail to implant. Progesterone treatment did not overcome this defect. Kiss1(+/-) embryos transferred to a wild-type female mouse can successfully implant, demonstrating the defect is due to maternal factors. Kisspeptin and its receptor are expressed in the mouse …

Views Of Pregnant Women And Clinicians Regarding Discussion Of Exposure To Phthalate Plasticizers, Sapna Sharma, Justin M. Ashley, Alexandra Hodgson, Jeff Nisker

Paediatrics Publications

Objective. This study explores the views of pregnant women and clinicians regarding discussion of exposure to phthalate plasticizers during pregnancy, subsequent to the 2011 Health Canada ban of certain phthalates at a concentration greater than 1000 mg/kg in baby toys. This occurred with no regulation of products to which pregnant women are exposed, such as food packaging and cosmetics. Methods. Pregnant women, physicians and midwives were recruited through posters and pamphlets in prenatal clinics in Southwestern Ontario for a semi-structured interview. All interviews were audiotaped, transcribed, and subjected to rigorous qualitative analysis through a grounded theory approach, supported by NVIVO™ …

Maternal, Pregnancy And Fetal Outcomes In De Novo Anti-Glomerular Basement Membrane Antibody Disease In Pregnancy: A Systematic Review, Benjamin Thomson, Geena Joseph, William F. Clark, Michelle Hladunewich, Amit Patel, Peter Blake, Genevieve Eastabrook, Doreen Matsui, Ajay Sharma, Andrew House

Paediatrics Publications

Background Outside of pregnancy, anti-glomerular basement membrane (GBM) antibody disease is associated with significant morbidity and mortality. However, there is limited knowledge regarding de novo anti-GBM disease in pregnancy. Methods A systematic review was performed to identify maternal, pregnancy and fetal outcomes in de novo anti-GBM disease in pregnancy. Studies were selected from PubMed, EMBASE, Cochrane Library databases and conference proceedings, without language restriction. Results Data from eight patients were derived from seven case reports and one unpublished case. Most (6/8) patients presented after the first trimester. During pregnancy, acute kidney injury (5/8), anemia (5/8), hematuria (8/8) and proteinuria (8/8) …

The Effects Of Acute Exercise On Tobacco Cravings And Withdrawal Symptoms In Temporary Abstinent Pregnant Smokers, Harry Prapavessis, Stefanie De Jesus, Therese Harper, Anita Cramp, Lyndsay Fitzgeorge, Michelle F. Mottola, Michael Ussher, Guy Faulkner, Peter Selby

Paediatrics Publications

Introduction: Smoking during pregnancy is common, and quitting at any point during pregnancy can yield benefits to both the fetus and mother. Smoking cessation is typically followed by withdrawal symptoms and a strong desire to smoke, both of which are likely to contribute to relapse. Research has shown that a bout of exercise minimizes cravings and tobacco withdrawal symptoms (TWS) after temporary abstinence in smokers, but these findings have not been replicated in pregnant smokers. This study examined the effect of 20. min of exercise on cravings (primary outcome) and TWS (secondary outcomes) among temporary abstinent, inactive pregnant smokers. Methods: …

Laboring To Mother In The Context Of Past Trauma: The Transition To Motherhood, Berman Helene, Robin Mason, Jodi Hall, Susan Rodger, Catherine C. Classen, Marilyn K. Evans, Lori E. Ross, Gloria Alvernaz Mulcahy, Leonarda Carranza, Fatmeh Al-Zoubi

Journal Articles

The occurrence of interpersonal trauma is a reality for many women, with effects that often persist long after the traumatic events end. The purpose of this feminist grounded theory study was to examine how past trauma shaped the lives of women as they became new mothers. We recruited a purposive sample of 32 women from two Canadian communities and conducted semistructured, dialogic interviews during the second trimester of pregnancy. We analyzed data using thematic content analytic methods, including open coding whereby we read transcripts line by line and applied codes to portions of text that illustrated concepts or themes. The …

Low Birth Weight Male Guinea Pig Offspring Display Increased Visceral Adiposity In Early Adulthood., Ousseynou Sarr, Jennifer A Thompson, Lin Zhao, Ting-Yim Lee, Timothy Regnault

Paediatrics Publications

Uteroplacental insufficiency (UPI)-induced intrauterine growth restriction (IUGR) predisposes individuals to adult visceral obesity. We postulated that low birth weight (LBW) offspring, from UPI-induced IUGR pregnancies, would display a visceral adipose lipogenic molecular signature involving altered gene expression, phosphorylation status of proteins of the lipid synthesis pathway and microRNA (miR) expression profile, occurring in association with increased visceral adiposity. Normal birth weight (NBW) and LBW (obtained by uterine artery ablation) male guinea pig pups were fed a control diet from weaning to 145 days and sacrificed. Despite being lighter at birth, LBW pups displayed body weights similar to NBW offspring at …

Guidelines For Physical Activity During Pregnancy: Comparisons From Around The World, Kelly R. Evenson, Ruben Barakat, Wendy J. Brown, Patricia Dargent-Molina, Megumi Haruna, Ellen M. Mikkelsen, Michelle F. Mottola, Katrine M. Owe, Emily K. Kim, Bandar Al-Judaibi, Ute I. Schwarz, Alnoor Ramji, Edward Tam, Colin J. Ross, Bruce C. Carleton

Paediatrics Publications

Introduction. Women attain numerous benefits from physical activity during pregnancy. However, because of physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. Methods. We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most recent included. An abstraction form was used to extract key details and summarize. Results. In total, 11 guidelines were identified from 9 countries (Australia, Canada, Denmark, France, Japan, Norway, Spain, United Kingdom, United …

Stress-Inducible Phosphoprotein 1 Has Unique Cochaperone Activity During Development And Regulates Cellular Response To Ischemia Via The Prion Protein., Flavio H Beraldo, Iaci N Soares, Daniela F Goncalves, Jue Fan, Anu A Thomas, Tiago G Santos, Amro H Mohammad, Martin Roffé, Michele D Calder, Simona Nikolova, Glaucia N Hajj, Andre L Guimaraes, Andre R Massensini, Ian Welch, Dean H Betts, Robert Gros, Maria Drangova, Andrew J Watson, Robert Bartha, Vania F Prado, Vilma R Martins, Marco A M Prado

Obstetrics & Gynaecology Publications

Stress-inducible phosphoprotein 1 (STI1) is part of the chaperone machinery, but it also functions as an extracellular ligand for the prion protein. However, the physiological relevance of these STI1 activities in vivo is unknown. Here, we show that in the absence of embryonic STI1, several Hsp90 client proteins are decreased by 50%, although Hsp90 levels are unaffected. Mutant STI1 mice showed increased caspase-3 activation and 50% impairment in cellular proliferation. Moreover, placental disruption and lack of cellular viability were linked to embryonic death by E10.5 in STI1-mutant mice. Rescue of embryonic lethality in these mutants, by transgenic expression of the …