ARDC Research Link Australia

Publication

Publisher: Elsevier

Date: 2012

DOI: 10.1016/B978-1-4377-2763-0.00011-1

Publication

THE REGULATION OF PLACENTAL INFLAMMATION BY GLUCOCORTICOID RECEPTOR ISOFORMS

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.PLACENTA.2019.06.034

Publication

Antioxidant-rich dietary intervention for improving asthma control in pregnancies complicated by asthma: study protocol for a randomized controlled trial

Publisher: Springer Science and Business Media LLC

Date: 04-04-2014

DOI: 10.1186/1745-6215-15-108

Abstract: Asthma is the most prevalent chronic disease to complicate pregnancies worldwide, affecting around 12% of pregnant women in Australia. Oxidative stress and inflammation manifest during pregnancy however asthma in pregnancies further intensifies oxidative stress. Consumption of antioxidant-rich foods has been shown to be beneficial for asthma control in non-pregnant asthmatic adults. It has not been investigated whether antioxidant-rich foods can improve the elevated oxidative stress that occurs with asthma in pregnancy, thereby improving asthma control. The primary aim of this study is to determine whether increased consumption of antioxidant-rich foods for 12 weeks will improve maternal asthma control, compared to standard dietary intake during pregnancy. A 12 week, parallel randomized controlled trial will be conducted. One hundred and sixty eight pregnant women with mild, moderate, or severe asthma, currently using inhaled corticosteroids, and with poor diet quality, will be recruited at approximately12 weeks gestation. Following a 4 week run-in period, women will be randomized to either a 12 week antioxidant intervention (increased consumption of antioxidant-rich foods (≥5 servings/day vegetables, ≥2 servings/day fruit, ≥8 ½ servings/day grains (mostly wholegrains), 3–4 serving/week lean meat) or standard pregnancy care. The primary outcome is asthma control score (decrease of 0.5, the minimally clinically significant change). Secondary outcomes include plasma antioxidants, markers of oxidative stress, and time to, and number of, exacerbations. With two-tailed t-tests at 80% power, a s le size of 52 completions per group is required. Allowing for a 78% retention including a 20% removal of women from the analysis due to non-compliance, we will recruit 168 women. It is expected that this 12 week study will improve asthma control. This is significant because asthma is the most prevalent condition to complicate pregnancies and contributes to poor maternal, neonatal and infant health outcomes. Our research will provide the first evidence to show that, in pregnancy, consumption of antioxidant-rich foods is a key modifier of clinical asthma status. This research is crucial for contributing to the evidence base to inform future guidelines given existing clinical and research gaps. ACTRN12613000301763

Publication

Publisher: Wiley

Date: 04-2022

DOI: 10.1111/AJO.13480

Publication

To Harold Fox - Our thanks

Publisher: Elsevier BV

Date: 06-2012

DOI: 10.1016/J.PLACENTA.2012.04.010

Publication

Placental glucocorticoid receptor isoforms in a sheep model of maternal allergic asthma

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.PLACENTA.2019.06.380

Abstract: Maternal asthma increases the risk of adverse pregnancy outcomes and may affect fetal growth and placental function by differential effects on the expression of glucocorticoid receptor (GR) isoforms, leading to altered glucocorticoid signalling. Our aim was to examine the effect of maternal asthma on placental GR profiles using a pregnant sheep model of asthma. Nine known GR isoforms were detected. There was a significant increase in the expression of placental GR isoforms that are known to have low trans-activational activity in other species including GR A, GR P and GRγ which may result in a pro-inflammatory environment in the presence of allergic asthma.

Publication

Publisher: Frontiers Media SA

Date: 13-10-2016

DOI: 10.3389/FGENE.2016.00183

Publication

Asthma self-management skills and the use of asthma education during pregnancy

Publisher: European Respiratory Society (ERS)

Date: 09-2005

DOI: 10.1183/09031936.05.00135604

Abstract: During pregnancy, patients with asthma are at risk of poor outcomes, particularly when asthma is poorly controlled. The aim of this study was to determine the level of asthma self-management skills and knowledge among pregnant subjects and describe the implementation of an asthma education programme delivered in an antenatal clinic setting. Pregnant subjects with asthma were assessed by an asthma educator at 20 (n = 211) and 33 weeks gestation (n = 149). Lung function, symptoms, medication use, adherence, knowledge and inhaler technique were assessed. They were asked whether they had a written asthma action plan, or performed peak flow monitoring. Asthma was classified as mild, moderate or severe. At the first visit with the asthma educator, 40% of females reported nonadherence to inhaled corticosteroids, inhaler technique was assessed as inadequate in 16% and 42% had inadequate medication knowledge. Peak flow monitoring was performed by 3% and 15% had a written action plan. There were significant improvements in all aspects of asthma self-management following education. In females with severe asthma, night symptoms and reliever medication use significantly decreased after education. In conclusion, during pregnancy, patients with asthma have poor asthma knowledge and skills, and may benefit from self-management education as part of their obstetric care.

Publication

Glucocorticoids and Their Receptor Isoforms: Roles in Female Reproduction, Pregnancy, and Foetal Development

Publisher: MDPI AG

Date: 09-08-2023

DOI: 10.3390/BIOLOGY12081104

Abstract: Alterations in the hypothalamic–pituitary–adrenal (HPA) axis and associated changes in circulating levels of glucocorticoids are integral to an organism’s response to stressful stimuli. Glucocorticoids acting via glucocorticoid receptors (GRs) play a role in fertility, reproduction, placental function, and foetal development. GRs are ubiquitously expressed throughout the female reproductive system and regulate normal reproductive function. Stress-induced glucocorticoids have been shown to inhibit reproduction and affect female gonadal function by suppressing the hypothalamic–pituitary–gonadal (HPG) axis at each level. Furthermore, during pregnancy, a mother’s exposure to prenatal stress or external glucocorticoids can result in long-lasting alterations to the foetal HPA and neuroendocrine function. Several GR isoforms generated via alternative splicing or translation initiation from the GR gene have been identified in the mammalian ovary and uterus. The GR isoforms identified include the splice variants, GRα and GRβ, and GRγ and GR-P. Glucocorticoids can exert both stimulatory and inhibitory effects and both pro- and anti-inflammatory functions in the ovary, in vitro. In the placenta, thirteen GR isoforms have been identified in humans, guinea pigs, sheep, rats, and mice, indicating they are conserved across species and may be important in mediating a differential response to stress. Distinctive responses to glucocorticoids, differential birth outcomes in pregnancy complications, and sex-based variations in the response to stress could all potentially be dependent on a particular GR expression pattern. This comprehensive review provides an overview of the structure and function of the GR in relation to female fertility and reproduction and discusses the changes in the GR and glucocorticoid signalling during pregnancy. To generate this overview, an extensive non-systematic literature search was conducted across multiple databases, including PubMed, Web of Science, and Google Scholar, with a focus on original research articles, meta-analyses, and previous review papers addressing the subject. This review integrates the current understanding of GR variants and their roles in glucocorticoid signalling, reproduction, placental function, and foetal growth.

Publication

A preferential switch between placental GR exon 1 promoter variants in the presence of maternal asthma or inflammation upregulates GRα D isoforms

Publisher: Elsevier BV

Date: 05-2021

DOI: 10.1016/J.PLACENTA.2021.03.013

Abstract: The human placenta expresses multiple glucocorticoid receptor (GR) isoforms that may be partially regulated by the untranslated 5' exon 1 GR gene promoter region which consists of 9 different promoters and 13 splice variants. The objective of this study was to determine which GR exon 1 variants are expressed in the human placenta and relate these findings to GR mRNA and protein expression. Placental extracts from pregnancies with or without the complication of maternal asthma and trophoblast cells exposed to an inflammatory challenge in vitro were examined using PCR and Western blot to measure GR exon 1 variants, GR splice variant mRNA and GR protein isoforms, respectively. All 9 GR exon 1 variants were detectable in the human placenta and included GR exons 1A, 1B, 1C, 1D, 1E, 1F, 1H, 1I and 1J. In the presence of maternal asthma and a male fetus there was preferential expression of GR exon 1B, 1C, IF and 1J (KW-ANOVA, P < 0.05) which were positively correlated with GRα D3 protein isoform. In female placentae from pregnancies complicated by asthma there was no upregulation of any exon 1 variant (KW-ANOVA, P < 0.05). Exposure of BeWo trophoblast cell line to an inflammatory challenge, lipopolysaccharide, in vitro, resulted in preferential expression of GR exon 1B, 1D, 1E and 1H and associated with GRα-D1 protein upregulation. The preferential expression of different GR exon 1 promoters drive the upregulation of GRα D isoforms and contribute to glucocorticoid resistance observed in male placentae of pregnancies complicated by asthma.

Publication

Perinatal outcomes following maternal asthma and cigarette smoking during pregnancy

Publisher: European Respiratory Society (ERS)

Date: 30-07-2013

DOI: 10.1183/09031936.00054913

Abstract: Does cigarette smoking in pregnancy explain the increased risk of adverse perinatal outcomes that occur with maternal asthma or does it compound the effect? Using population based birth records, a retrospective analysis was conducted of all singleton pregnancies in South Australia over 10 years (1999-2008 n=172 305), examining maternal asthma, cigarette smoking and quantity of smoking to estimate odds ratios. Compared with nonasthmatic females who did not smoke during pregnancy, both asthmatic females who smoked and those who did not smoke during pregnancy had a significantly increased risk of gestational diabetes, antepartum haemorrhage, polyhydramnios, premature rupture of membranes, emergency Caesarean section, and the child being small for gestational age and having congenital abnormalities. These associations suggest that asthma, independently of maternal smoking, increases the risk of these adverse perinatal outcomes. Maternal smoking was itself associated with an increased risk of a number of poor neonatal outcomes, with a dose-response relationship observed. Notably, maternal asthma combined with cigarette smoking significantly increased the risk of preterm birth and urinary tract infections to a greater degree than with either exposure alone. Maternal asthma and cigarette smoking during pregnancy are both independently associated with adverse perinatal outcomes and, combined, compound the risk of preterm birth and urinary tract infections.

Publication

MICRORNAS REGULATING TOLL LIKE RECEPTOR INFLAMMATORY PATHWAYS IN PRETERM AND TERM PLACENTA AND CORD BLOOD

Publisher: Elsevier BV

Date: 09-2016

DOI: 10.1016/J.PLACENTA.2016.06.094

Publication

Publisher: Elsevier BV

Date: 04-2016

DOI: 10.1016/J.PLACENTA.2016.03.008

Publication

Asthma management during pregnancy: how long before we can all breathe a little easier?

Publisher: Informa UK Limited

Date: 16-09-2015

DOI: 10.3109/02770903.2015.1040494

Publication

Endocrine regulation of human fetal growth: The role of the mother, placenta, and fetus

Publisher: The Endocrine Society

Date: 04-2006

DOI: 10.1210/ER.2005-0011

Abstract: The environment in which the fetus develops is critical for its survival and long-term health. The regulation of normal human fetal growth involves many multidirectional interactions between the mother, placenta, and fetus. The mother supplies nutrients and oxygen to the fetus via the placenta. The fetus influences the provision of maternal nutrients via the placental production of hormones that regulate maternal metabolism. The placenta is the site of exchange between mother and fetus and regulates fetal growth via the production and metabolism of growth-regulating hormones such as IGFs and glucocorticoids. Adequate trophoblast invasion in early pregnancy and increased uteroplacental blood flow ensure sufficient growth of the uterus, placenta, and fetus. The placenta may respond to fetal endocrine signals to increase transport of maternal nutrients by growth of the placenta, by activation of transport systems, and by production of placental hormones to influence maternal physiology and even behavior. There are consequences of poor fetal growth both in the short term and long term, in the form of increased mortality and morbidity. Endocrine regulation of fetal growth involves interactions between the mother, placenta, and fetus, and these effects may program long-term physiology.

Publication

Publisher: Public Library of Science (PLoS)

Date: 07-01-2013

DOI: 10.1371/JOURNAL.PONE.0053384

Publication

Inflammatory mediator release in normal bronchial smooth muscle cells is altered by pregnant maternal and fetal plasma independent of asthma

Publisher: Elsevier BV

Date: 08-2006

DOI: 10.1016/J.PLACENTA.2005.08.007

Abstract: Studies have shown that pregnancy can alter the pathophysiology of a pre-existing maternal disease such as asthma. However, the mechanisms that alter maternal asthma during pregnancy are presently unknown. Previous work has demonstrated that human bronchial smooth muscle (BSM) cells produce inflammatory factors in response to nonpregnant, atopic plasma. The aim of this study was to determine whether circulating pregnancy-derived factors in maternal and fetal plasma can stimulate inflammatory mediator release in BSM cells in the presence and absence of maternal asthma. Cultured human BSM cells were exposed to maternal and fetal plasma from normal pregnancies and pregnancies complicated by asthma. Inflammatory mediator release was determined by enzyme-linked immunosorbent assay (ELISA). Both maternal and fetal plasma from asthmatic and nonasthmatic in iduals significantly increased production of interleukin (IL)-6 (ANOVA, P<0.001), regulated upon activation, normal T-cell expressed and secreted (RANTES) (ANOVA, P<0.01), and soluble intercellular cell-adhesion molecule-1 (sICAM-1) (ANOVA, P<0.01). There was no difference in inflammatory mediator release in response to asthma and nonasthmatic plasma. Eotaxin release was increased by pregnant asthmatic plasma (ANOVA, P<0.05). The results of this study suggest that circulating pregnancy-related factors can activate asthma-associated mediators in BSM cells. This change in BSM function may be one mechanism that contributes to increased asthma severity during pregnancy.

Publication

Publisher: MDPI AG

Date: 14-08-2013

DOI: 10.3390/NU5083212

Publication

Maternal creatine in pregnancy

Publisher: Wiley

Date: 23-08-2016

DOI: 10.1111/1471-0528.14237

Abstract: To estimate creatine concentrations in maternal plasma and urine, and establish relationships with maternal characteristics, diet and fetal growth. Retrospective cohort study. Lyell McEwin Hospital, Adelaide, Australia. A biobank of plasma and urine s les collected at 13, 18, 30 and 36 weeks' gestation from 287 pregnant women from a prospective cohort of asthmatic and non-asthmatic women. Creatine was measured by enzymatic analysis. Change in creatine over pregnancy was assessed using the Friedman test. Linear mixed models regression was used to determine associations between maternal factors and diet with creatine across pregnancy and between creatine with indices of fetal growth at birth. Maternal creatine concentrations, associations between maternal factors and creatine and between creatine and fetal growth parameters. Maternal smoking, body mass index, asthma and socio-economic status were positively and parity negatively associated with maternal plasma and/or urine creatine. Maternal urine creatine concentration was positively associated with birthweight centile and birth length. After adjustment, each μmol/l increase in maternal urinary creatine was associated with a 1.23 (95% CI 0.44-2.02) unit increase in birthweight centile and a 0.11-cm (95% CI 0.03-0.2) increase in birth length. Maternal factors and fetal growth measures are associated with maternal plasma and urine creatine concentrations. Maternal creatine is altered by pregnancy fetal growth measures are associated with maternal creatine concentrations.

Publication

Metabolism of synthetic steroids by the human placenta

Publisher: Elsevier BV

Date: 2007

DOI: 10.1016/J.PLACENTA.2005.12.010

Abstract: Pregnant women with asthma are frequently exposed to synthetic glucocorticoids and glucocorticoids are known to reduce fetal growth. The fetus is normally protected from the harmful effects of maternally derived glucocorticoids by the placental enzyme 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2). Whether 11beta-HSD2 inactivates the synthetic glucocorticoids used for asthma treatment during pregnancy (budesonide, beclomethasone dipropionate and fluticasone propionate) remains unknown. To investigate the relationship between steroid use during pregnancy and fetal growth and development, pregnant women with (n=119) and without asthma (n=84) were followed throughout pregnancy. Data on asthma medication use, neonatal size at birth, placental weight and cord blood cortisol and estriol were collected. Placental tissue s les were collected from non-asthmatic women (n=8) for metabolism studies. Placental 11beta-HSD2 activity was determined using beclomethasone dipropionate, budesonide, fluticasone propionate, prednisolone, dexamethasone and betamethasone as steroid substrates. Steroids and their oxidised metabolites were examined using thin layer chromatography and densitometry. Placental 11beta-HSD2 metabolised beclomethasone, prednisolone, dexamethasone and betamethasone, but not budesonide or fluticasone. No association between the use of inhaled steroids for asthma treatment during pregnancy and alterations in neonatal size, placental weight, gestational age at delivery, or umbilical vein estriol concentrations was demonstrated compared to non-asthmatic women. In conclusion, the use of inhaled steroids for asthma treatment does not affect fetal growth, despite differences in placental metabolism by 11beta-HSD2.

Publication

Localization and characterization of urocortin during human pregnancy

Publisher: Elsevier BV

Date: 11-2000

DOI: 10.1053/PLAC.2000.0570

Publication

Asthma during pregnancy: Mechanisms and treatment implications

Publisher: European Respiratory Society (ERS)

Date: 04-2005

DOI: 10.1183/09031936.05.00085704

Abstract: Asthma is becoming increasingly prevalent worldwide. Numerous historical and prospective cohort studies have investigated the effects of maternal asthma on pregnancy outcome however, the data has been conflicting and many studies have not used standard classifications for asthma severity. Overall, the literature suggests that asthmatic females are more at risk of low birth weight neonates, pre-term delivery and complications such as pre-ecl sia, especially in the absence of actively managed asthma treated with inhaled corticosteroids. Pregnancy with a female foetus may particularly increase the risk of these outcomes. In addition, pregnancy has an effect on the course of asthma. The risk of an exacerbation requiring medical intervention may be as high as 50% in females with severe asthma and this may further increase the risk of poor outcomes, particularly low birth weight and pre-term delivery. The mechanisms responsible for changes in asthma with pregnancy, or alterations in pregnancy outcomes due to asthma have not been thoroughly explored. Maternal inflammatory pathways may contribute to reduced foetal growth through alterations in placental function. Asthma treatment, by reducing maternal inflammation and preventing exacerbations, is safe for use in pregnant females and contributes to improved outcomes for both mother and foetus.

Publication

Publisher: Springer Science and Business Media LLC

Date: 07-08-2019

DOI: 10.1186/S12884-019-2441-1

Publication

Publisher: Public Library of Science (PLoS)

Date: 24-07-2017

DOI: 10.1371/JOURNAL.PONE.0181149

Publication

Neonatal death is a major concern for Indigenous women with asthma during pregnancy and could be prevented with better models of care

Publisher: Wiley

Date: 03-10-2021

DOI: 10.1111/AJO.13441

Abstract: Asthma is the most common respiratory illness in Aboriginal and Torres Strait Islander Australians. From the Mater Mothers routinely collected perinatal data in Brisbane we have identified that 24% of Indigenous and 17% of non‐Indigenous women have pregnancies complicated by asthma. Indigenous women with asthma are more likely to have poorer birth outcomes when compared to non‐Indigenous women with asthma, with neonatal death being doubled in asthmatic Indigenous women. These data indicate that asthma management during pregnancy is an unmet need for Indigenous women and essential if we are to avoid these devastating outcomes for Indigenous families.

Publication

Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study

Publisher: Wiley

Publisher: Wiley

Date: 21-10-2014

DOI: 10.1002/14651858.CD010660.PUB2

Publication

Maternal smoking during pregnancy and offspring overweight: is there a dose–response relationship? An individual patient data meta-analysis

Publisher: Springer Science and Business Media LLC

Date: 28-02-2018

DOI: 10.1038/S41366-018-0050-0

Publication

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.JRI.2010.06.008

Publication

Sex-specific differences in placental global gene expression in pregnancies complicated by asthma

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.1016/J.PLACENTA.2011.05.005

Abstract: Chronic maternal asthma is associated with reduced growth of the female fetus and normal growth of the male fetus. The mechanisms that control the differential effects of maternal asthma on the fetus have not been fully elucidated but alterations in placental function may play a role. In the current study we have used microarray platform to examine fetal sex-specific global changes in placental gene expression in pregnancies complicated by asthma as compared to non-asthmatic subjects. Placental RNA was extracted from 11 control subjects and 38 asthmatic subjects. Labeled cDNA was hybridized to an oligonucleotide chip with 1700 double spotted well-characterized human genes. Global gene expression data analysis and visualization were performed using the Binary Tree-Structured Vector Quantization (BTSVQ) software. Functional relationships of differentially expressed genes were assessed using protein-protein interaction database I2D, network analysis and visualization software NAViGaTOR and Ingenuity Pathway Analysis software. Overall, 65 genes were found to be altered in placentae of pregnancies complicated by asthma. Of these, only 6 genes were altered in male placentae. There were 59 gene changes in female placentae of asthmatic mothers relative to control placentae. Some of the sex-specific genes were associated with growth, inflammation and immune pathways. There are sex-specific alterations in placental gene expression in the presence of maternal asthma. Given that many of the identified genes in the female placentae were associated with or involved in cellular growth and tissue development, these may contribute to the sexually dimorphic difference in fetal growth in response to maternal asthma.

Publication

Publisher: Elsevier BV

Date: 09-2017

DOI: 10.1016/J.PLACENTA.2017.07.260

Publication

Evaluation of the Effects of 1,25 Vitamin D3 on Regulatory T Cells and T Helper 17 Cells in Vitamin D-deficient Women with Unexplained Recurrent Pregnancy Loss

Publisher: Bentham Science Publishers Ltd.

Date: 02-11-2020

DOI: 10.2174/1874467213666200303130153

Abstract: Vitamin D insufficiency and deficiency can be associated with adverse effects on pregnancy outcomes, which may include recurrent pregnancy loss through the mechanisms that are yet unknown. The aim of this study was to evaluate the effect of 1,25VitD3 on regulatory T cells (Tregs) and T helper17 (Th17) cell populations In vitro in unexplained recurrent pregnancy loss (URPL) patients and healthy women. S les from 20 non-pregnant women with a history of URPL were compared to 20 normal non-pregnant women. Peripheral blood mononuclear cells (PBMC) were ided into 3 wells for each subject: in the presence of 1, 25 VitD3 (50 nM, for 16 hours), PHA (positive control) (10μM), and without any treatment (as a baseline or negative control). The percentage of regulatory T cells and Th17 cells was measured by flow cytometry at baseline and then after cell culture experiments. Our study indicated that the percentage of Tregs in patients with URPL was significantly lower than the control group (2.42 ± 0.27 vs. 3.41 ± 0.29, P= 0.01). The percentage of Th17 cells was significantly greater in URPL patients compared to the control group (2.91 ± 0.33 vs. 1.18± 0.15, P=0.001). 1, 25VitD3 treatment significantly increased the percentage of Tregs from the baseline in the URPL group compared to that in the control group (1.23 ± 0.03 vs. 1.00 ± 0.03, P= 0.01). Vitamin D deficiency may be a contributor to recurrent pregnancy loss and suggests supplementation of women with Vit D pre-pregnancy may be protective against URPL.

Publication

The effects of exercise during pregnancy on placental composition: A systematic review and meta-analysis

Publisher: Elsevier BV

Date: 2022

DOI: 10.1016/J.PLACENTA.2021.10.008

Abstract: Morphological changes to the placenta occur as the demands of the foetus increase throughout gestation. Physical activity during pregnancy is known to benefit both the mother and infant, however the impact of antenatal exercise training on placental development is less known. The aim of this systematic review and meta-analysis was to investigate the effects of exercise training during pregnancy on measures of placental composition. Six electronic databases were searched from inception to June 2021 for studies comparing regular antenatal exercise with either usual maternal care or no exercise for its effect on measures of placental morphological composition. Meta-analyses were performed for placental weight and the placental weight to birthweight (PWBW) ratio. Seven randomised controlled trials and two cohort studies were included in the systematic review and meta-analysis (n = 9). There was no significant difference in placental weight (mean difference (MD) = -9.07g, p = 0.42) or the PWBW ratio (MD = 0.00, p = 0.32) between exercise and control groups. Parenchymal tissue volume was higher, represented by an increase in villous tissue, and non-parenchymal volume was lower in women who exercised regularly compared to those that were not exercising during pregnancy. Exercise training during pregnancy may not alter placental weight or the PWBW ratio. However, findings from this review indicate that antenatal exercise training can promote advantageous morphological changes to placental tissues.

Publication

Sex-specific associations between cortisol and birth weight in pregnancies complicated by asthma are not due to differential glucocorticoid receptor expression

Publisher: BMJ

Date: 13-07-2010

DOI: 10.1136/THX.2009.123091

Abstract: Fetal growth inhibition is a known sequelae of in utero glucocorticoid exposure and has long-term consequences for adult health. Sex-specific fetal growth patterns are observed in pregnancies with maternal asthma and may be due to differential sensitivity of the placenta to glucocorticoids. It is currently unknown whether expression of the placental glucocorticoid receptor (GR) becomes altered with asthma or the use of inhaled corticosteroids. Pregnant women with mild asthma (n=52), moderate-severe asthma (n=71) and without asthma (n=51) were recruited at John Hunter Hospital, Newcastle, Australia. At delivery, placentae and cord blood were collected, and fetal sex and birth weight were recorded. Placental GR heterogeneous nuclear RNA (hnRNA), mRNA and protein were measured and cord blood cortisol concentrations were assessed. Placental GR gene activity increased with cortisol exposure but decreased with inhaled corticosteroid treatment (p=0.05). With maternal asthma, female birth weight centiles were inversely associated with cortisol (r=-0.286, p=0.017) and, despite a decrease in placental GR mRNA (p=0.003), placental GRalpha protein levels were unchanged. In males, no change to cortisol, birth weight or placental GR were evident in pregnancies with asthma. Together, these results indicate that in pregnancies complicated by asthma, placental GR gene activity, but not mRNA expression or protein levels, is dependent on cortisol and inhaled corticosteroid treatment. The sex-specific associations between cortisol and birth weight observed in pregnancies with asthma are not due to altered GR expression however, they may be due to differential glucocorticoid sensitivity via preferential transcription of GR isoforms or post-translational modifications.

Publication

Publisher: Public Library of Science (PLoS)

Date: 16-05-2018

DOI: 10.1371/JOURNAL.PONE.0194337

Publication

Interleukin-1 signalling in cord blood from preterm neonates

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.JRI.2010.06.121

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Review: Alterations in placental glycogen deposition in complicated pregnancies: Current preclinical and clinical evidence

Publisher: Elsevier BV

Date: 06-2017

DOI: 10.1016/J.PLACENTA.2017.01.114

Abstract: Normal placental function is essential for optimal fetal growth. Transport of glucose from mother to fetus is critical for fetal nutrient demands and can be stored in the placenta as glycogen. However, the function of this glycogen deposition remains a matter of debate: It could be a source of fuel for the placenta itself or a storage reservoir for later use by the fetus in times of need. While the significance of placental glycogen remains elusive, mounting evidence indicates that altered glycogen metabolism and/or deposition accompanies many pregnancy complications that adversely affect fetal development. This review will summarize histological, biochemical and molecular evidence that glycogen accumulates in a) placentas from a variety of experimental rodent models of perturbed pregnancy, including maternal alcohol exposure, glucocorticoid exposure, dietary deficiencies and hypoxia and b) placentas from human pregnancies with complications including preecl sia, gestational diabetes mellitus and intrauterine growth restriction (IUGR). These pregnancies typically result in altered fetal growth, developmental abnormalities and/or disease outcomes in offspring. Collectively, this evidence suggests that changes in placental glycogen deposition is a common feature of pregnancy complications, particularly those associated with altered fetal growth.

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Differential cytokine profiles in arterial and venous cord blood in preterm infants

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.JRI.2010.06.122

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The impact of impact factors

Publisher: Elsevier BV

Date: 10-2012

DOI: 10.1016/J.PLACENTA.2012.07.006

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Prelabor screening at term using the cerebroplacental ratio and placental growth factor: a pragmatic randomized open-label phase 2 trial

Publisher: Elsevier BV

Date: 09-2020

DOI: 10.1016/J.AJOG.2020.02.034

Publication

Maternal asthma and placental morphometry: Effects of severity, treatment and fetal sex

Publisher: Elsevier BV

Date: 04-2008

DOI: 10.1016/J.PLACENTA.2008.01.011

Abstract: Asthma is the most common respiratory disease to complicate pregnancy. Although adverse effects on the fetus have been documented, there is a paucity of information regarding the effects of asthma, and its treatment, on placental morphology. The aim of this study was to test for volumetric differences in placental composition between non-asthmatic pregnancies and those associated with maternal asthma grouped according to asthma severity and glucocorticoid (GC) treatment. Each placenta was weighed and random s les of tissue were fixed in formalin-saline, embedded in wax and analysed by design-based stereology. Volume densities of parenchymal compartments (peripheral villi and maternal intervillous space) and residual non-parenchyma were estimated by test point counting and converted to absolute volumes by taking into account placental size. Relative and absolute lengths of villi and capillaries were also estimated and used to derive secondary quantities related to villous capillarization and maturation. Between-group comparisons were drawn by two-way analysis of variance with group and fetal sex as the principal factors. Compared to non-asthmatic controls, asthmatics had reduced absolute volumes of fetal capillaries which was most marked in those with moderate/severe asthma and those using low and high doses of inhaled GCs. Changes in the total length and mean cross-sectional area of capillaries and peripheral villi were also observed. Lengths were greater in mild asthmatics and lowest in those with high GC usage. Calibre areas were lower in mild asthmatics and villous calibres in the high GC group were greater than those in asthmatics not taking GCs. Those making greatest use of inhaled GCs also had villi which were hypovascularized in terms of capillary:villus length ratios. The findings suggest that the morphometric differences in fetoplacental vascularity are likely to be due to the effects of asthma and use of inhaled GCs rather than the effects of maternal or fetal hypoxic stress.

Publication

Pituitary autoantibodies in lymphocytic hypophysitis target both gamma- and alpha-Enolase - a link with pregnancy?

Maternal and cord plasma cytokine and chemokine profile in pregnancies complicated by asthma

Publisher: Elsevier BV

Date: 08-2008

DOI: 10.1016/J.CYTO.2008.05.008

Abstract: The mechanisms contributing to worsening of asthma during pregnancy have not been well characterized. Both asthma and pregnancy are conditions associated with a skewing of the immune response from T helper (Th) 1 toward a Th2 response. We hypothesise that worsening of asthma during pregnancy may be due to an enhanced production of circulating proinflammatory cytokines and chemokines and this may be modified by the use of inhaled glucocorticoid treatment. Peripheral blood was collected from asthmatic (n=35) and control non-asthmatic patients (n=13) in the third trimester (30-37 weeks) of pregnancy. Fetal blood was collected from the umbilical vein of the placenta after delivery from normal (n=24) and pregnancies complicated by asthma (n=24). Plasma s les were assayed for IL-6, -8, eotaxin and RANTES using conventional ELISA. In addition, a range of Th1 and Th2 cytokines measured using Luminex system. There were no significant differences in the levels of maternal IL-6, IL-8, eotaxin and RANTES between asthmatics and nonasthmatics. The results of this study suggest that the presence of asthma does not result in an enhanced circulation of Th2 related cytokines and chemokines during the third trimester of pregnancy. Furthermore peripheral blood cytokine concentrations appear unaffected by inhaled glucocorticoid treatment. Cord plasma eotaxin concentrations were increased in pregnancies complicated by asthma, compared with control. This is the first study to show increased eotaxin production in the feto-placental unit of asthmatic pregnancies and may be one mechanism by which allergy susceptibility is increased in the offspring of asthmatic women.

Publication

Intra-System Reliability Assessment of 2-Dimensional Shear Wave Elastography

Publisher: MDPI AG

Date: 26-03-2021

DOI: 10.3390/APP11072992

Abstract: The availability of 2-Dimensional Shear Wave Elastography (2D-SWE) technology on modern medical ultrasound systems is becoming increasingly common. The technology is now being used to investigate a range of soft tissues and related pathological conditions. This work investigated the reliability of a single commercial 2D-SWE system using a tissue-mimicking elastography phantom to understand the major causes of intra-system variability. Sources of shear wave velocity (SWV) measurement variability relates to imaging depth, target stiffness, s ling technique and the operator. Higher SWV measurement variability was evident with increasing depth and stiffness of the phantom targets. The influence of the operator was minimal, and variations in s ling technique had little impact on the SWV.

Publication

The social predictors of paternal antenatal mental health and their associations with maternal mental health in the Queensland Family Cohort prospective study

Publisher: Springer Science and Business Media LLC

Date: 19-08-2023

DOI: 10.1007/S00737-022-01257-1

Abstract: Antenatal depression (AND) affects 1 in 10 fathers, potentially negatively impacting maternal mental health and well-being during and after the transition to parenthood. However, few studies have assessed the social predictors of paternal AND or their possible associations with maternal mental health. We analysed data from 180 couples participating in the Queensland Family Cohort longitudinal study. Both parents completed surveys measuring mental health, relationship quality, social support, and sleep quality at 24 weeks of pregnancy. Mothers also completed the same surveys 6 weeks’ postpartum. Antenatal depression, stress, and anxiety were highest among fathers reporting lower social support and higher sleep impairment. Maternal AND, stress, and anxiety were higher among mothers reporting higher physical pain and poor sleep quality. Postnatally, mothers reporting lower social support also reported higher depression, anxiety, stress, and psycho-social well-being. While there were no significant associations between AND among fathers and maternal antenatal or postnatal depression, an exploratory analysis revealed that mothers whose partners reported lower antenatal social support also reported lower postnatal social support and higher postnatal depression. Our findings highlight the importance of including data among fathers to achieve a whole family approach to well-being during the transition to parenthood.

Publication

Corticotrophs and peptides.

Publisher: Informa UK Limited

Date: 2002

DOI: 10.1076/APAB.110.1.146.892

Abstract: Corticotrophs were long thought to be a static, homogeneous population of cells that respond positively to hypothalamic stimulation, are inhibited by glucocorticoid feedback and secrete a single biologically active peptide, ACTH(1-39). Our current understanding is that this is an oversimplification and corticotrophs are a dynamic and more complex group of cells. The biosynthetic precursors of ACTH and other cleavage products of proopiomelanocortin (POMC) have been found to be secreted by anterior pituitary cells, to circulate and to have biological activity. POMC and the biosynthetic intermediate, pro-ACTH, exert activity antagonistic to ACTH(1-39) on glucocorticoid secretion by adrenal cells, and other derivatives of POMC are mitogenic to adrenocortical cells. In terms of responses to hypothalamic and peripheral factors, corticotrophs are functionally heterogeneous. This is reflected in the sensitivity of in idual subtypes of corticotrophs to CRH, vasopressin and glucocorticoids. There is a functional plasticity amongst the various types of corticotrophs. During gestation, in fetal sheep, changes occur in the overall ACTH-secretory responses to CRH relative to vasopressin, the proportions of total corticotrophs that respond to the respective peptides and the average secretory response of in idual cells. Corticotrophs also respond to locally produced pituitary factors. Local actions of leukaemia inhibitory factor are demonstrated by the effects of immunoneutralization of the peptide in pituitary cells. Urocortin and preproTRH(178-199) are locally produced peptides with potent stimulatory and inhibitory actions on corticotrophs, respectively. The specific roles of these peptides are under investigation.

Publication

Do women of reproductive age presenting with pelvic floor dysfunction have undisclosed anal incontinence: A retrospective cohort study

Publisher: Elsevier BV

Date: 02-2017

DOI: 10.1016/J.WOMBI.2016.05.009

Abstract: Indirect and direct trauma following vaginal birth can negatively impact on the pelvic floor function increasing the risk of anal incontinence. It is often difficult for women to openly disclose that they have anal incontinence and there are limited data collection tools available for the identification of these women in a clinical setting. This study aims to describe the prevalence of undisclosed anal incontinence in antenatal and postnatal women with pelvic floor dysfunction. Retrospective cohort study of 230 antenatal and postnatal women referred to a Continence Nursing Service in a large tertiary hospital in South Australia, Australia, with pelvic floor dysfunction. A criteria list was utilised to access the primary reason for referral, anal incontinence assessments and attendance to an appointment. Anal incontinence was identified in 26% of women (n=59). Anal incontinence was the primary reason for referral amongst 8 women, with the remaining 51 women identified as having anal incontinence following clinical screening via phone consultation. Eighty six percent of women stated they had not previously disclosed anal incontinence to health professionals. Overall, 71% of symptomatic women (n=28 antenatal and n=14 postnatal women) attended appointments to a service specialising in pelvic floor dysfunction. Women presenting with urinary incontinence or other markers of pelvic floor dysfunction should be actively screened for anal incontinence as the prevalence of this condition is high amongst childbearing women.

Publication

Publisher: Elsevier BV

Date: 10-2011

DOI: 10.1016/J.JACI.2011.05.017

Publication

Publisher: Frontiers Media SA

Date: 08-09-2022

DOI: 10.3389/FIMMU.2022.998406

Publication

Microvascular effects of corticotropin-releasing hormone in human skin vary in relation to estrogen concentration during the menstrual cycle

Publisher: Bioscientifica

Date: 07-2005

DOI: 10.1677/JOE.1.06030

Abstract: Females have a significantly greater life expectancy than males, which in part may be due to the cardio-protective effects of the female sex hormone, estrogen, on vascular function. However, the sex-specific mechanisms contributing to these differences are complex and not fully understood. Previously we have reported that corticotropin-releasing hormone (CRH) has potent dilator effects in the female skin circulation via mast cell degranulation. Furthermore the dilator response to CRH was more enhanced in females than in age-matched males, suggesting that estrogens may be involved. In this study we examined whether CRH-induced dilation and endothelial cell-dependent dilation in the skin circulation of pre-menopausal females were associated with changes in estrogen during the menstrual cycle. CRH-induced dilation (1 nM) was enhanced in the presence of high circulating concentrations of estrogen and a positive correlation was identified between CRH-induced dilation and plasma estrogen concentrations. Endothelial cell-dependent dilation was examined using acetylcholine. Acetylcholine-induced dilation (1 nM) was not correlated with circulating concentrations of estrogen. These data suggest the variation in CRH-induced dilation in the skin microvasculature during the menstrual cycle may be due to estrogenic effects on mast cell function and not due to direct changes in endothelial cell function.

Publication

Modulation of Placental Gene Expression in Small-for-Gestational-Age Infants

Publisher: MDPI AG

Date: 10-01-2020

DOI: 10.3390/GENES11010080

Abstract: Small-for-gestational-age (SGA) infants are fetuses that have not reached their genetically programmed growth potential. Low birth weight predisposes these infants to an increased risk of developing cardiovascular, metabolic and neurodevelopmental conditions in later life. However, our understanding of how this pathology occurs is currently incomplete. Previous research has focused on understanding the transcriptome, epigenome and bacterial signatures separately. However, we hypothesise that interactions between moderators of gene expression are critical to understanding fetal growth restriction. Through a review of the current literature, we identify that there is evidence of modulated expression/methylation of the placental genome and the presence of bacterial DNA in the placental tissue of SGA infants. We also identify that despite limited evidence of the interactions between the above results, there are promising suggestions of a relationship between bacterial signatures and placental function. This review aims to summarise the current literature concerning fetal growth from multiple avenues and propose a novel relationship between the placental transcriptome, methylome and bacterial signature that, if characterised, may be able to improve our current understanding of the placental response to stress and the aetiology of growth restriction.

Publication

An observational study of the impact of an antenatal asthma management service on asthma control during pregnancy

Publisher: Elsevier BV

Date: 02-2016

DOI: 10.1016/J.EJOGRB.2015.11.038

Abstract: We sought to investigate the impact of introducing an antenatal asthma management service (AMS) on asthma control during pregnancy and subsequent perinatal outcomes. Prospective, observational cohort study of pregnant asthmatic women attending a tertiary hospital antenatal clinic. Asthmatic women were recruited from the antenatal clinic and were followed prospectively with visits at 12, 20, 28 and 36 weeks gestation. A new nurse-led AMS was introduced offering asthma self-management education and support. Outcomes were compared between women recruited before and after the AMS was introduced (n=89 and 80, respectively) and included prevalence of exacerbations during pregnancy, asthma control throughout pregnancy and perinatal outcomes, including preterm birth and small-for-gestational-age (SGA). The relative risk for exacerbations (0.69 CI: 0.33-1.42), loss of control (0.67 CI 0.46-0.99) and persistent uncontrolled asthma (0.48 CI 0.26-0.9) were all reduced with attendance to AMS during pregnancy. AMS was associated with non-statistically significant reductions in asthma exacerbations (19.1-15.0% p=0.480) and uncontrolled asthma at ≥ 2 study visits (21.3-11.3% p=0.078). These findings demonstrate the potential impact of an AMS in improving asthma control during pregnancy, supporting the need for an adequately powered RCT to determine its clinical- and cost-effectiveness.

Publication

Whole transcriptome profiling of placental pathobiology in SARS-CoV-2 pregnancies identifies a preeclampsia-like gene signature

Publisher: Cold Spring Harbor Laboratory

Date: 21-01-2023

DOI: 10.1101/2023.01.20.524893

Abstract: In recent years, pregnant people infected with the SARS-CoV-2 virus have shown a higher incidence of “preecl sia-like syndrome”. Preecl sia is a systematic syndrome that affects 5-8 % of pregnant people worldwide and is the leading cause of maternal mortality and morbidity. It is unclear what causes preecl sia, and is characterised by placental dysfunction, leading to poor placental perfusion, maternal hypertension, proteinuria, thrombocytopenia, or neurological disturbances. In this study, we used whole-transcriptome, digital spatial profiling of placental tissues to analyse the expression of genes at the cellular level between placentae from pregnant participants who contracted SARS-CoV-2 in the third trimester of their pregnancy and those prior to the start of the pandemic. Our focused analysis of the trophoblast and villous core stromal cell populations revealed tissue-specific pathways enriched in the SARS-CoV-2 placentae that align with a pre-ecl sia signature. Most notably, we found enrichment of pathways involved in vascular tension, blood pressure, inflammation, and oxidative stress. This study illustrates how spatially resolved transcriptomic analysis of placental tissue can aid in understanding the underlying pathogenic mechanisms of SARS-CoV-2 in pregnancy that are thought to induce “preecl sia-like syndrome”. Moreover, our study highlights the benefits of using digital spatial profiling to map the crosstalk between trophoblast and villous core stromal cells linked to pathways involved in “preecl sia-like syndrome” presenting in pregnant people with SARS-CoV-2.

Publication

Acetonitrile, the polarity chameleon

Publisher: Springer Science and Business Media LLC

Date: 11-04-2010

DOI: 10.1007/S00216-010-3677-9

Publication

Regulatory effects of GR Exon 1 variants on differential placental glucocorticoid receptor protein isoform in pregnancies complicated with asthma

Publisher: Elsevier BV

Date: 09-2017

DOI: 10.1016/J.PLACENTA.2017.07.132

Publication

Neonatal respiratory infection and adult re-infection: Effect on glucocorticoid and mineralocorticoid receptors in the hippocampus in BALB/c mice

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.1016/J.BBI.2011.03.014

Abstract: Stressful events during the perinatal period in both humans and animals have long-term consequences for the development and function of physiological systems and susceptibility to disease in adulthood. One form of stress commonly experienced in the neonatal period is exposure to bacterial and viral infections. The current study investigated the effects of live Chlamydia muridarum bacterial infection at birth followed by re-infection in adulthood on hippoc al glucocorticoid receptors (GR) and mineralocorticoid receptors (MR) and stress response outcomes. Within 24 h of birth, neonatal mice were infected intranasally with C. muridarum (400 inclusion-forming units [ifu]) or vehicle. At 42 days, mice were re-infected (100 ifu) and euthanized 10 days later. In males, infection in adulthood alone had the most impact on the parameters measured with significant increases in GR protein compared to adult infection alone and significant increases MR protein and circulating corticosterone compared to other treatment groups. Neonatal infection alone induced the largest alterations in the females with results showing reciprocal patterns for GR protein and TH protein. Perinatal infection resulted in a blunted response following adult infection for both males and females across all parameters. The present study demonstrates for the first time that males and females respond differently to infection based on the timing of the initial insult and that there is considerable sex differences in the hippoc al phenotypes that emerge in adulthood after neonatal infection.

Publication

Publisher: Wiley

Date: 08-2008

DOI: 10.1111/J.1479-828X.2008.00863.X

Publication

Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital

Publisher: SAGE Publications

Date: 12-2016

DOI: 10.1177/0890334416678209

Abstract: Few studies have investigated breastfeeding outcomes among women exposed to antidepressants. This study aimed to evaluate the association between antidepressant use in late gestation and maternal psychiatric illness on breastfeeding rates at discharge from hospital. The authors conducted a retrospective cohort study of 32,662 women delivering live-born singletons between January 2001 and December 2008. Electronic hospital records were used to obtain data on antidepressant exposure during late gestation and whether mothers were breastfeeding at discharge from hospital following delivery. Five hundred seventy-five women received a dispensing for an antidepressant in late gestation (exposed), 1,552 did not receive a dispensing for an antidepressant but had a reported psychiatric illness (disease comparison), and 30,535 served as nonexposed controls. Exposed women were significantly less likely to be breastfeeding their infants at discharge from hospital compared with nonexposed women, adjusted odds ratio ( AOR) = 0.63, 95% confidence interval (CI) [0.50-0.80], but no statistically significant difference was observed when compared with women in the disease comparison group, AOR = 0.83, 95% CI [0.65-1.07]. In stratified analyses, compared with women in the disease comparison group, exposed women were significantly less likely to be breastfeeding their infants at discharge from hospital if their neonate was delivered at term, AOR = 0.73, 95% CI [0.55-0.98], but not preterm, AOR = 1.24, 95% CI [0.66-2.32]. While antidepressant use is associated with a reduction in breastfeeding rates, this association appears to be strongly influenced by factors such as underlying maternal psychiatric illness. Overall, these results highlight that these women may benefit from additional education and support to improve breastfeeding rates.

Publication

Modelling prenatal bacterial infection: Functional consequences of altered hypothalamic pituitary adrenal axis development

Publisher: Elsevier BV

Date: 03-2007

DOI: 10.1016/J.BBR.2006.12.008

Abstract: Prenatal exposure of animals to bacterial endotoxin is an experimental model of systemic maternal infection in the human pregnancy. Previous studies in the rat have demonstrated that such exposure is associated with long term alterations to hypothalamic pituitary adrenal (HPA) axis development. Typically, these animals display an elevated HPA response to stress in adulthood. As neural development is more similar in the human and the guinea pig than the rat, this study adopted a guinea pig model of pregnancy to explore the effects of endotoxin exposure on the HPA axis in the offspring. The offspring of dams exposed to endotoxin exhibited an attenuated cortisol response to the novel environment stress in the weaning period. The degree to which this cortisol response was both buffered by the mother's presence, and habituated to on repeated exposure, differed significantly between the prenatal treatment groups. In adulthood, a diminished cortisol response to the immune challenge was only evident in the female offspring, while both male and female offspring exhibited altered febrile responses. The results of the present study indicate that prenatal bacterial exposure in the guinea pig results in offspring with lower cortisol responses to stress in later life. These findings contrast past research that has used the rat to model pregnancy. As such, the use of the guinea pig to model infection may provide a useful alternative model of human pregnancy to explore programming effects.

Publication

Effect of inhaled glucocorticoid treatment on placental 11 beta-hydroxysteroid dehydrogenase type 2 activity and neonatal birthweight in pregnancies complicated by asthma

Publisher: Wiley

Date: 04-2006

DOI: 10.1111/J.1479-828X.2006.00543.X

Publication

Fatty acid profile of pregnant women with asthma

Publisher: Elsevier BV

Date: 04-2012

DOI: 10.1016/J.CLNME.2012.01.004

Publication

Changes in human placental 5α-reductase isoenzyme expression with advancing gestation: effects of fetal sex and glucocorticoid exposure

Publisher: CSIRO Publishing

Publisher: The Endocrine Society

Date: 10-1995

DOI: 10.1210/JCEM.80.10.7559870

Abstract: This study has used an in vitro perfusion method to investigate the mechanism by which CRH causes vasodilatation in the human fetal-placental circulation. In normal term placentas, vasodilatory responses to human CRH (24-7000 pmol/L) were examined during submaximal vasoconstriction (100-120 mm Hg) of the fetal-placental vasculature induced by prostaglandin F2 alpha (0.7-2 mumol/L), KCl (50-100 mmol/L), or the thromboxane A2 mimetic, U46619 (0.05-0.5 mumol/L). Infusion of CRH caused a concentration-dependent vasodilatation that was similar in the presence of each constrictor agent (P > 0.05). The CRH antagonist, alpha-helical CRH-(9-41) (200 pmol/L), and a polyclonal CRH antiserum significantly inhibited CRH-induced vasodilatation during constriction with prostaglandin F2 alpha (P < 0.05). Vasodilatory responses to CRH were attenuated by the nitric oxide synthase inhibitor, N omega-nitro-L-arginine (100 mumol/L P < 0.05), and the guanylate cyclase inhibitor, LY 83583 (1 mumol/L P 0.05). In placentas of women with increased fetal vascular resistance, as demonstrated by Doppler ultrasound waveforms in vivo, CRH-induced vasodilatation was significantly reduced (P < 0.05). These results indicate that in the human fetal-placental circulation, CRH causes a vasodilatory response via a nitric oxide-/cGMP-dependent pathway. CRH may play a role in the control of vascular resistance to blood flow in the normal human placenta, and there may be a deficiency in the CRH signaling pathway of placentas with increased fetal vascular resistance.

Publication

CORTICOTROPIN-RELEASING HORMONE-INDUCED VASODILATATION IN THE HUMAN FETAL-PLACENTAL CIRCULATION

Publisher: The Endocrine Society

Date: 08-1994

DOI: 10.1210/JC.79.2.666

Publication

Low-parachor solvents extraction and thermostated micro-thin-layer chromatography separation for fast screening and classification of spirulina from pharmaceutical formulations and food samples

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.1016/J.CHROMA.2011.06.065

Abstract: The goal of this paper is to demonstrate the separation and detection capability of eco-friendly micro-TLC technique for the classification of spirulina and selected herbs from pharmaceutical and food products. Target compounds were extracted using relatively low-parachor liquids. A number of the spirulina s les which originated from pharmaceutical formulations and food products, were isolated using a simple one step extraction with small volume of methanol, acetone or tetrahydrofuran. Herb s les rich in chlorophyll dyes were analyzed as reference materials. Quantitative data derived from micro-plates under visible light conditions and after iodine staining were explored using chemometrics tools including cluster analysis and principal components analysis. Using this method we could easily distinguish genuine spirulina and non-spirulina s les as well as fresh from expired commercial products and furthermore, we could identify some biodegradation peaks appearing on micro-TLC profiles. This methodology can be applied as a fast screening or fingerprinting tool for the classification of genuine spirulina and herb s les and in particular may be used commercially for the rapid quality control screening of products. Furthermore, this approach allows low-cost fractionation of target substances including cyanobacteria pigments in raw biological or environmental s les for preliminary chemotaxonomic investigations. Due to the low consumption of the mobile phase (usually less than 1 mL per run), this method can be considered as environmentally friendly analytical tool, which may be an alternative for fingerprinting protocols based on HPLC machines and simple separation systems involving planar micro-fluidic or micro-chip devices.

Publication

Publisher: Elsevier BV

Date: 09-2016

DOI: 10.1016/J.PLACENTA.2016.06.143

Publication

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.PLACENTA.2019.06.112

Publication

The Effects of COVID-19 on the Placenta During Pregnancy.

Publisher: Frontiers Media SA

Date: 15-09-2021

DOI: 10.3389/FIMMU.2021.743022

Abstract: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The virus primarily affects the lungs where it induces respiratory distress syndrome ranging from mild to acute, however, there is a growing body of evidence supporting its negative effects on other system organs that also carry the ACE2 receptor, such as the placenta. The majority of newborns delivered from SARS-CoV-2 positive mothers test negative following delivery, suggesting that there are protective mechanisms within the placenta. There appears to be a higher incidence of pregnancy-related complications in SARS-CoV-2 positive mothers, such as miscarriage, restricted fetal growth, or still-birth. In this review, we discuss the pathobiology of COVID-19 maternal infection and the potential adverse effects associated with viral infection, and the possibility of transplacental transmission.

Publication

Publisher: Wiley

Date: 20-06-2017

DOI: 10.1111/1471-0528.14606

Publication

Placental P-glycoprotein is unaffected by timing of antenatal glucocorticoid therapy but reduced in SGA preterm infants

Publisher: Elsevier BV

Date: 04-2013

DOI: 10.1016/J.PLACENTA.2013.01.013

Abstract: The beneficial effects of antenatal glucocorticoid therapy on fetal lung maturation require their passage across the placental glucocorticoid barrier, composed of glucocorticoid metabolising enzymes, such as 11 beta hydroxysteroid dehydrogenase (11βHSD), and proteins that efflux glucocorticoids, such as P-glycoprotein (P-gp). We have shown that 11βHSD2 activity is responsive to antenatal glucocorticoids, however the effect on placental P-gp remains unknown. Since antenatal glucocorticoids have a greater prophylactic effect in females compared to males, we also assessed whether this therapy induced sexually dimorphic effects on P-gp expression, as well as on placental inflammatory processes mediated by corticosteroids. Placentas were collected from 53 women presenting in threatened preterm labour, and processed to assess cytokine and P-gp mRNA expression, as well as P-gp localisation using immunohistochemistry. Placental cytokine, P-gp mRNA and protein expression were not altered by timing of antenatal glucocorticoids or fetal sex. However, both P-gp mRNA and protein expression were significantly reduced in placentas from infants born small for gestational age (SGA) compared to appropriately grown infants (p < 0.05), suggesting a role for P-gp in its pathogenesis via the provision of a net increase in fetal exposure to bioactive exogenous glucocorticoids. While this study identified no change in placental P-gp following antenatal glucocorticoids, it has provided evidence that P-gp plays an important role in cases of SGA. This supports the known mechanistic relationship between antenatal glucocorticoids, fetal development and the postnatal phenotype. Given that P-gp also confers fetal protection from a number of drugs, this finding warrants further investigation to improve clinical management of the SGA fetus.

Publication

Deciphering the Dichotomy: The Role of Glucocorticoid Receptor Isoforms in Cortisol’s Paradoxical Impact on Reproduction and Pregnancy

Publisher: MDPI AG

Date: 04-07-2023

DOI: 10.20944/PREPRINTS202306.2241.V1

Abstract: Alterations in the hypothalamic-pituitary-adrenal (HPA) axis and associated changes in circulating levels of glucocorticoids are integral to an organism's response to stressful stimuli. Glucocorticoids acting via glucocorticoid receptors (GR) play a role in fertility, reproduction, placental function, and fetal development. GRs are ubiquitously expressed throughout the female reproductive system and regulate normal reproductive function. Stress induced glucocorticoids have been shown to inhibit reproduction and affect female gonadal function by supressing the hypothalamic-pituitary-gonadal (HPG) axis at each level. Furthermore, during pregnancy, a mother's exposure to prenatal stress or external glucocorticoids can result in long-lasting alterations to the fetal HPA and neuroendocrine function. Several GR isoforms generated via alternative splicing or translation initiation from the GR gene have been identified in the mammalian ovary and uterus. The GR isoforms identified include the splice variants, GR& alpha and GR& beta , GR& gamma and GR-P. Glucocorticoids can exert both stimulatory and inhibitory effects and both pro- and anti-inflammatory functions in the ovary, in vitro. In the placenta, thirteen GR isoforms have been identified in human, guinea pig, sheep, rat and mouse indicating it is conserved across species and may be important in mediating a differential response to stress. Distinctive responses to glucocorticoids, differential birth outcomes in pregnancy complications, and sex-based variations in the response to stress could all potentially be dependent on a particular GR expression pattern. This review provides an overview of the structure and function of the GR in relation to female fertility and reproduction and discusses the changes in GR and glucocorticoid signalling during pregnancy. This review will delve into the existing understanding of GR isoforms and explore the possible roles that these distinct isoforms may have in regulating glucocorticoid signalling, along with their impact on gonadal activity, placental function, and fetal growth.

Publication

Publisher: Elsevier BV

Date: 11-2020

DOI: 10.1016/J.WOMBI.2020.09.005

Publication

Severe Asthma Exacerbations During Pregnancy

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-2021

DOI: 10.1097/01.AOG.0000185281.21716.02

Publication

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 31-03-2021

DOI: 10.11124/JBIES-20-00328

Publication

Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age

Publisher: Cambridge University Press (CUP)

Date: 05-10-2015

DOI: 10.1017/S2040174415007151

Abstract: The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women’s and Children’s Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 ( n =7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean ( s.d. ) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01–0.29) and 0.21 (0.13–0.29), respectively. A significant dose–response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score ( P .001). In conclusion, any maternal smoking in pregnancy, even if mothers quit, is associated with an increase in offspring BMI at 4 to 5 years of age.

Publication

Maternal asthma as a model for examining fetal sex-specific effects on maternal physiology and placental mechanisms that regulate human fetal growth

Publisher: Elsevier BV

Date: 04-2004

DOI: 10.1016/J.PLACENTA.2004.01.004

Publication

Factors Associated with Asthma Exacerbations During Pregnancy

Publisher: Elsevier BV

Date: 12-2021

DOI: 10.1016/J.JAIP.2021.07.055

Publication

Erratum: Localization and characterization of urocortin during human pregnancy (Placenta (2000) vol. 21 (782-788))

Publisher: Elsevier BV

Date: 02-2001

DOI: 10.1053/PLAC.2001.0632

Publication

Publisher: Wiley

Date: 10-2013

DOI: 10.1002/PDS.3512

Publication

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.JRI.2010.06.088

Publication

Column-based method to simultaneously extract DNA, RNA, and proteins from the same sample

Publisher: Future Science Ltd

Date: 12-2007

DOI: 10.2144/000112594

Abstract: We describe a procedure for the simultaneous extraction of proteins and nucleic acids from the same experimental s le allowing for direct correlations between genetic, genomic, and proteomic data. This approach, using commercially available column-based nucleic acid extraction kits, requires no hazardous chemicals and is a quick, reliable, and consistent method for concomitant protein extraction. Buffer choice is critical to completely solubilize all proteins in the s le. Proteins solubilized in radioimmunoprecipitation assay (RIPA) buffer did not represent the entire profile when compared with conventionally extracted proteins using the same buffer at the one-dimensional (1-D) sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) level, however, proteins extracted from the columns and solubilized in a two-dimensional (2-D) electrophoresis lysis buffer showed a similar profile to conventionally extracted proteins when analyzed at both the 1-D and the 2-D level. We further showed that proteins extracted using these methods were compatible with Western blot analysis. This technique provides a simple and effective way to analyze protein and nucleic acids simultaneously from the same s le without affecting yield and quality.

Publication

Impact of inter-pregnancy BMI change on perinatal outcomes: a retrospective cohort study

Publisher: Elsevier BV

Date: 10-2016

DOI: 10.1016/J.EJOGRB.2016.07.487

Abstract: To examine the patterns and predictors of inter-pregnancy body mass index (BMI) change and its impact on perinatal outcomes in the second pregnancy. Retrospective cohort study. Tertiary teaching hospital in Adelaide, Australia. Women with their first and second consecutive, singleton deliveries occurring between 2000 and 2012 (N=5371). Inter-pregnancy weight change calculated based on difference between BMI at respective antenatal booking visits. Association between inter-pregnancy weight change and perinatal outcomes investigated using multivariate generalised linear models, with stratification according to initial maternal BMI category in first pregnancy. Gestational diabetes (GDM) pregnancy induced hypertensive disorders small-for-gestational age (SGA) preterm birth large-for-gestational age (LGA) and macrosomia (>4500g). On average, women with a normal BMI gained 1kg/m(2) between first and second pregnancies, while women who were overweight or obese gained 1.37kg/m(2). Among women with a normal BMI in their first pregnancy, a BMI increase of ≥4kg/m(2) was associated with increased risk of developing GDM (aRR 1.97 95% CI 1.22-3.19), a macrosomic (aRR 4.06 95% CI 2.25-7.34) or LGA infant (aRR 1.31 0.96-1.78) in the second pregnancy, while a reduction in BMI (≤-2kg/m(2)) was associated with an increased risk of SGA (aRR 1.94 1.19-3.16). Among women who were overweight or obese in their first pregnancy, a BMI increase of ≥2-4 and ≥4kg/m(2) was associated with increased risks of developing GDM in the second pregnancy (aRR 1.39 95% CI 1.01-1.91 and aRR 1.64 95% CI 1.16-2.31 ptrend<0.001), while no associations were observed for a BMI increase and risk of a macrosomic, SGA, or LGA infant. In contrast, reduction in BMI (≤-2kg/m(2)) was associated with a reduced risk of GDM (aRR 0.58 95% CI 0.37-0.90) and SGA (aRR 0.47 95% CI 0.25-0.87). Increases in BMI between pregnancies is associated with an increased risk for perinatal complications, even in normal-weight women, while a reduction in BMI is associated with improved perinatal outcomes among women who are overweight/obese. Inter-pregnancy weight control is an important target to reduce the risk of an adverse perinatal outcome in a subsequent pregnancy.

Publication

Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial

Publisher: Elsevier BV

Date: 09-2011

DOI: 10.1016/S0140-6736(11)60971-9

Publication

The presence of maternal asthma during pregnancy suppresses the placental pro-inflammatory response to an immune challenge in vitro

Publisher: Elsevier BV

Date: 06-2011

DOI: 10.1016/J.PLACENTA.2011.03.004

Abstract: The mechanisms that contribute to adverse outcomes for the neonate in pregnancies complicated by asthma may be mediated via changes in placental immune function. This study was designed to determine whether the presence of maternal asthma during pregnancy alters the placental pro-inflammatory immune response in vitro. A prospective cohort study of women with asthma (n = 22) and control (n = 11) subjects had placentae collected immediately after delivery. Placental explants were exposed to an immune challenge, lipopolysaccharide, in the presence and absence of cortisol in vitro. Cytokines, glucocorticoid receptor α (GR α) and p38 MAPK protein were measured. Placentae of control pregnancies had an increase in pro-inflammatory cytokine production over a 24 h period. Placentae from pregnancies complicated by maternal asthma had a reduced pro-inflammatory cytokine response to an immune challenge relative to the controls especially in relation to the production of interleukin (IL)-1β and TNFα regardless of fetal sex. Cortisol inhibition of placental cytokine production was dependent on timing of exposure, fetal sex and presence and absence of asthma. GRα and p38 MAPK protein expression did not appear to contribute to differences in response to endotoxin or cortisol. Maternal asthma during pregnancy induces a hyposensitive inflammatory state in the placenta which is regulated by cortisol in a sexually dimorphic manner.

Publication

Fetal Glucocorticoid-regulated Pathways Are Not Affected by Inhaled Corticosteroid Use for Asthma during Pregnancy

Publisher: American Thoracic Society

Date: 15-03-2011

DOI: 10.1164/RCCM.201007-1188OC

Publication

Elemental Metabolomics for Prediction of Term Gestational Outcomes Utilising 18-Week Maternal Plasma and Urine Samples.

Publisher: Springer Science and Business Media LLC

Date: 04-2020

DOI: 10.1007/S12011-020-02127-6

Publication

Publisher: Springer Science and Business Media LLC

Date: 03-01-2017

DOI: 10.1186/S12864-016-3384-9

Publication

Sex and the Human Placenta: Mediating Differential Strategies of Fetal Growth and Survival

Publisher: Elsevier BV

Date: 03-2010

DOI: 10.1016/J.PLACENTA.2009.11.010

Abstract: There are known sex specific differences in fetal and neonatal morbidity and mortality. There are also known differences in birthweight centile with males generally being larger than females at birth. These differences are generally ignored when studying obstetric complications of pregnancy and the mechanisms that confer these differences between the sexes are unknown. Current evidence suggests sex specific adaptation of the placenta may be central to the differences in fetal growth and survival. Our research examining pregnancies complicated by asthma has reported sexually dimorphic differences in fetal growth and survival with males adapting placental function to allow for continued growth in an adverse maternal environment while females reduce growth in an attempt to survive further maternal insults. We have reported sex differences in placental cytokine expression, insulin-like growth factor pathways and the placental response to cortisol in relation to the complication of asthma during pregnancy. More recently we have identified sex specific alterations in placental function in pregnancies complicated by preterm delivery which were associated with neonatal outcome and survival. We propose the sexually dimorphic differences in growth and survival of the fetus are mediated by the sex specific function of the human placenta. This review will present evidence supporting this hypothesis and will argue that to ignore the sex of the placenta is no longer sound scientific practice.

Publication

Identification of placental androgen receptor isoforms in a sheep model of maternal allergic asthma

Publisher: Elsevier BV

Date: 11

DOI: 10.1016/J.PLACENTA.2021.01.003

Abstract: Maternal asthma is known to impact intrauterine growth outcomes, which may be mediated, in part, by altered androgen signalling. Our aim was to explore whether the sheep placenta expresses androgen receptor (AR) isoforms and determine if the differential expression of AR protein isoforms is altered by maternal asthma. Four known AR isoforms were detected (AR-FL, AR-v1, AR-v7, and AR-45), and their expression and subcellular distribution was altered in the presence of maternal allergic asthma. These findings underscore the importance for in vivo models of maternal asthma to delineate molecular patterns that may contribute to feto-placental growth and development.

Publication

Term histologic chorioamnionitis: a heterogeneous condition

Publisher: Elsevier BV

Date: 05-2015

DOI: 10.1016/J.EJOGRB.2015.02.034

Abstract: A histologic response of histologic chorioamnionitis (HCA) is defined as an intrauterine inflammatory condition characterized by acute granulocyte infiltration into the fetal-maternal or the fetal tissues. Prevalence of HCA is inversely correlated with gestational age, occurring in 50% of preterm birth and in up to 20% of deliveries at term. Regardless of these standard definitions, understanding HCA is challenging as it reflects a heterogeneous condition. A histologic response of HCA from term placentas often does not correspond to a clinical presentation in this context, the present review aims to analyze main characteristics of this condition, in particular focusing on mechanisms and birth outcomes.

Publication

Sex-Specific Differences in Peripheral Microvascular Blood Flow in Preterm Infants

Publisher: Springer Science and Business Media LLC

Date: 04-2008

DOI: 10.1203/01.PDR.0000304937.38669.63

Publication

Angiotensin Converting Enzyme 2 (ACE2) in Pregnancy: Preeclampsia and Small for Gestational Age

Publisher: Frontiers Media SA

Date: 30-09-2020

DOI: 10.3389/FPHYS.2020.590787

Publication

Human placental androgen receptor variants: Potential regulators of male fetal growth

Publisher: Elsevier BV

Date: 05-2019

DOI: 10.1016/J.PLACENTA.2019.03.012

Abstract: Numerous studies show that males have increased intrauterine growth compared to females, and that pregnancy complications may further these growth differences, but the regulatory mechanisms underlying these differences remain unknown. We propose that these growth outcomes may be due to sex-specific differences in androgen sensitivity - giving rise to altered growth signalling pathways - mediated by the differential expression of placental androgen receptor (AR) variants. Placental protein and mRNA were used to identify AR protein variant levels and AR-downstream target gene expression, and were then analysed against neonatal measurements. Dihydrotestosterone (DHT)-induced AR protein variant expression and downstream growth factors were examined in vitro. Four known AR variants (AR-FL, AR-V1, AR-V7, and AR-45), and three unknown proteins (120, 90 and 55 kDa) immunoreactive to the anti-AR antibody were identified in human placentae. Male placentae from controlled asthmatic pregnancies had increased AR-45 and decreased AR-V1 and AR-V7 nuclear expression. Increased nuclear AR-45 expression was associated with increased insulin-like growth factor 1 (IGF-1), IGF-1 receptor (IGF-1R), and IGF-binding protein 5 (IGFBP-5) mRNA expression and normal male growth. AR-45 mRNA and protein did not change in the presence of uncontrolled maternal asthma and associated with an increase in small for gestational (SGA) male fetuses. In vitro DHT stimulation increased AR-45 protein and IGF-1R and IGFBP-5 mRNA expression. Collectively, our data shows altered AR protein expression and downstream signalling targets may contribute to sex-specific fetal growth outcomes in response to an adverse environment, and that AR-45 appears central in mediating these changes.

Publication

Managing asthma in pregnancy: effects on future child health

Publisher: Elsevier BV

Date: 06-2019

DOI: 10.1016/S2213-2600(19)30149-3

Publication

Expression of eight glucocorticoid receptor isoforms in the human preterm placenta vary with fetal sex and birthweight

Publisher: Elsevier BV

Date: 07-2015

DOI: 10.1016/J.PLACENTA.2015.05.001

Vicki L. Clifton

Researcher

Research Topics

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Publications

A review of the impact of dietary intakes in human pregnancy on infant birthweight

Solving ‘wicked problems’ in the app co-design process

Prenatal alcohol consumption and placental outcomes: a systematic review and meta-analysis of clinical studies

IFPA Meeting 2009 Workshops Report

Assessment of the Microcirculation in the Neonate

THE REGULATION OF PLACENTAL INFLAMMATION BY GLUCOCORTICOID RECEPTOR ISOFORMS

Antioxidant-rich dietary intervention for improving asthma control in pregnancies complicated by asthma: study protocol for a randomized controlled trial

Identification of Candidate Genes in Human Placenta Involved in the Development of Childhood Allergy

Developmental Perturbation Induced by Maternal Asthma during Pregnancy: The Short- and Long-Term Impacts on Offspring

Impact of a history of maternal depression and anxiety on asthma control during pregnancy

The impact of iodine supplementation and bread fortification on urinary iodine concentrations in a mildly iodine deficient population of pregnant women in South Australia

IFPA Meeting 2010 Workshops Report II: Placental pathology; Trophoblast invasion; Fetal sex; Parasites and the placenta; Decidua and embryonic or fetal loss; Trophoblast differentiation and syncytiali

Corticotropin-releasing hormone-induced vasodilatation in the human fetal placental circulation

Early microvascular changes in the preterm neonate: a comparative study of the human and guinea pig

Expression of Glucocorticoid Receptor Messenger Ribonucleic Acid Transcripts in the Human Placenta at Term

Videomicroscopy as a tool for investigation of the microcirculation in the newborn.

Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life

Pre-birth origins of allergy and asthma

Response to Letter to the Editor ‘Adverse perinatal outcomes in the Australian Indigenous population, the role of asthma’

To Harold Fox - Our thanks

Placental glucocorticoid receptor isoforms in a sheep model of maternal allergic asthma

Special Issue from the Inaugural Meeting of the Queensland Perinatal Co Reviews of the latest advances in placental, fetal and neonatal biol Preface

Closed incision negative pressure wound therapy versus standard dressings in obese women undergoing caesarean section: Multicentre parallel group randomised controlled trial

Preconception Dietary Patterns in Human Pregnancies Are Associated with Preterm Delivery

Large Scale Gene Expression Meta-Analysis Reveals Tissue-Specific, Sex-Biased Gene Expression in Humans

Asthma self-management skills and the use of asthma education during pregnancy

Glucocorticoids and Their Receptor Isoforms: Roles in Female Reproduction, Pregnancy, and Foetal Development

A preferential switch between placental GR exon 1 promoter variants in the presence of maternal asthma or inflammation upregulates GRα D isoforms

Perinatal outcomes following maternal asthma and cigarette smoking during pregnancy

MICRORNAS REGULATING TOLL LIKE RECEPTOR INFLAMMATORY PATHWAYS IN PRETERM AND TERM PLACENTA AND CORD BLOOD

Steroid regulation of prostaglandin dehydrogenase activity and expression in human term placenta and chorio-decidua in relation to labor

Early Gut Microbiota Colonisation of Premature Infants Fed with Breastmilk or Formula with or without Probiotics: A Cohort Study

Relationship between placental elastography, maternal pre-pregnancy body mass index and gestational weight gain

Neonates Born to Mothers With Preeclampsia Exhibit Sex-Specific Alterations in Microvascular Function

Psychosocial Outcomes Are Related to Asthma Control and Quality of Life in Pregnant Women with Asthma

An ex vivo approach to understanding sex-specific differences in placental androgen signalling in the presence and absence of inflammation

The influence of sex and antenatal betamethasone exposure on vasoconstrictors and the preterm microvasculature

Placental cytokine expression covaries with maternal asthma severity and fetal sex

Increased anti-oxidant enzyme activity and biological oxidation in placentae of pregnancies complicated by maternal asthma

Editorial: ZIKA virus and placenta

Asthma management during pregnancy: how long before we can all breathe a little easier?

Endocrine regulation of human fetal growth: The role of the mother, placenta, and fetus

Asthma during pregnancy

Carbon Monoxide is a Significant Mediator of Cardiovascular Status Following Preterm Birth

Urocortin: a mechanism for the sustained activation of the HPA axis in the late-gestation ovine fetus?

Low Formalin Concentrations Induce Fine-Tuned Responses That Are Sex and Age-Dependent: A Developmental Study

Inflammatory mediator release in normal bronchial smooth muscle cells is altered by pregnant maternal and fetal plasma independent of asthma

Angiotensin Converting Enzyme 2 (ACE2) in Pregnancy: Preeclampsia and Small for Gestational Age (vol 11, 590787, 2020)

Review: The role of multiple placental glucocorticoid receptor isoforms in adapting to the maternal environment and regulating fetal growth

The endogenous retroviral envelope protein syncytin-1 inhibits LPS/PHA-stimulated cytokine responses in human blood and is sorted into placental exosomes

Improving Asthma during Pregnancy with Dietary Antioxidants: The Current Evidence

Maternal creatine in pregnancy

Metabolism of synthetic steroids by the human placenta

Localization and characterization of urocortin during human pregnancy

Asthma during pregnancy: Mechanisms and treatment implications

Altered Formalin-Induced Pain and Fos Induction in the Periaqueductal Grey of Preadolescent Rats following Neonatal LPS Exposure

IFPA Meeting 2013 Workshop Report I: Diabetes in pregnancy, maternal dyslipidemia in pregnancy, oxygen in placental development, stem cells and pregnancy pathology

Effect of maternal asthma, inhaled glucocorticoids and cigarette use during pregnancy on the newborn insulin-like growth factor axis

VARIATION IN GLUCOCORTICOID RECEPTOR ISOFORMS EXPRESSION AND FUNCTION: A POSSIBLE FORCE DRIVING GLUCOCORTICOID RESISTANCE AMONG MALE FETAL PLACENTAL UNIT IN PREGNANCIES COMPLICATED WITH ASTHMA

Prenatal endotoxin exposure alters behavioural pain responses to lipopolysaccharide in adult offspring

Maternal asthma during pregnancy and extremes of body mass index increase the risk of perinatal mortality: a retrospective cohort study

Childhood allergy susceptibility: The role of the immune system development in the in-utero period

The human placenta expresses multiple glucocorticoid receptor isoforms that are altered by fetal sex, growth restriction and maternal asthma

The effects of vigorous intensity exercise in the third trimester of pregnancy: a systematic review and meta-analysis

The regulation of human parturition

Innate immune dysfunction in the neonatal rat following prenatal endotoxin exposure

Alterations in human placental 11 beta-hydroxysteroid dehydrogenase type 1 and 2 with gestational age and labour

Trajectories of anxiety and health related quality of life during pregnancy

Neonatal death is a major concern for Indigenous women with asthma during pregnancy and could be prevented with better models of care

Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study

Regulation of 15-hydroxyprostaglandin dehydrogenase (PGDH) gene activity, messenger ribonucleic acid processing, and protein abundance in the human chorion in late gestation and labor

Differences in maternal smoking across successive pregnancies – dose‐dependent relation to BMI z‐score in the offspring: an individual patient data (IPD) meta‐analysis