Risk of blindness among premature babies with low levels of blood platelets

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Premature babies with low levels of platelets (thrombocytes) in their blood run a greatly increased risk of being afflicted with a severe variation of retinopathy of prematurity (ROP), an eye disease that can cause blindness, according to a study from Sweden and US published in the journal JCI Insight. In experiments on mice, injections of blood platelets reduce the pathological development of retinal vessels.

"I believe this paves the way for completely new therapeutic possibilities and also for new research domains for both pathological and normal vascular development," says Ann Hellström, professor of pediatric ophthalmology at Sahlgrenska Academy, University of Gothenburg, Sweden, and a chief physician at Sahlgrenska University Hospital.

Retinopathy of prematurity (ROP) mainly affects children born before 28 weeks of pregnancy whose retinal vessels have not finished growing at birth. The children run the risk of permanent vision impairment and in severe cases blindness due to retinal detachment.

Genetic variation in progesterone receptor tied to prematurity risk

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Humans have unexpectedly high genetic variation in the receptor for a key pregnancy-maintaining hormone, according to research led by scientists at the Stanford University School of Medicine. The finding may help explain why some populations of pregnant women have an elevated risk of premature birth.

A paper describing the work will be published June 21 in The American Journal of Human Genetics.

The researchers found that East Asian populations have one version of the progesterone receptor gene that appears to protect them against giving birth prematurely, whereas other populations with European or African ancestry have a higher prematurity risk and other versions of this gene. The discrepencies between the populations reflect relatively recent evolution.

Because progesterone and its receptor are so important for pregnancy, the results were unexpected. "People have thought everyone should have a similar version of the progesterone receptor. But our study showed that we have different versions -- that there is diversity between individuals and between populations," said Jingjing Li, PhD, an instructor of pediatrics at Stanford and the paper's lead author. "It really surprised us."

Does Premature Birth Αffect Child's Brain?

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"Researchers at the University of Helsinki and the Helsinki University Hospital have proven that premature birth has a significant and, at the same time, a very selective effect on the functional networks of a child's brain. The effects can primarily be seen in the frontal lobe, which is significant for cognitive functions.

Premature birth is globally the most important risk factor for life-time disorders and defects in neurocognitive functions. However, current methods have not shed much light on how premature birth affects the early activity of neurons in the frontal lobe, significant specifically to cognitive functions.

A study involving 46 infants exposed to very early prematurity and nearly 70 healthy and mature control infants was recently conducted at the University of Helsinki and the Helsinki University Hospital. Brain function in the infants was monitored and measured with the help of an EEG cap, developed earlier at the clinic, revealing new information on the subject.

"In this study, a new 'source analysis' method was used for the first time to measure functional networks in the infant brain: with the help of a computer model, the measured EEG signals were interpreted as activity in the infant cortex, which enabled the evaluation of the functional networking of neurons in a very versatile manner on the cortical level", says Sampsa Vanhatalo, a professor in clinical neurophysiology and the head of the study.

It was found that there are several overlapping functional neural networks in the cortex of a newborn. Another finding was that premature birth has a significant, but also a very selective effect on these networks. The clearest effect can be seen in the functional networks of the frontal lobe, especially significant to cognitive functions.

"We were able to demonstrate how the strength of synapses in the frontal lobe is linked with the neurological abilities of infants. This provides an extremely interesting opportunity to use the functional networking of the brain as an early indicator in, for example, clinical trials that compare the effects of different treatments on brain development. The selective changes found in the study also provide a potential explanation for attention deficit and other cognitive issues often found in children who are prematurely born."

Vanhatalo points out that functional MRI imaging does not show the functional coupling of an infant's neurons, even though the method is still widely used all over the world for studying this very phenomenon.

"Therefore, our EEG findings are the first results that actually provide information on cortical functional networks in preterm infants."

Source: https://www.news-medical.net/news/20180226/Premature-birth-has-selective-effect-on-functional-networks-of-a-childs-brain.aspx

For pregnant soldiers, recent deployment linked to higher risk of premature delivery

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"Female soldiers who give birth within six months of returning from military deployment face twice the risk of having a preterm baby as other active-duty servicewomen, a new study from the Stanford University School of Medicine has found.

The study, which examined 12,877 births to American soldiers from 2011-14, will be published online March 1 in the American Journal of Epidemiology. In total, 6.1 percent of births studied were premature, meaning the baby was born three or more weeks early. But among women who had recently returned from deployment, 11.7 percent of deliveries were premature. Women giving birth soon after deployment were, on average, younger than other military mothers, and with lower education and lower pay, the study found.

"What's important is the timing of deployment," said lead author Jonathan Shaw, MD, clinical assistant professor of medicine at Stanford. "Pregnancies that overlapped with deployment or the period of returning home were much more likely to end in preterm birth, which has impacts not only on the health of the infant, but also on the mother and family."

Premature birth can cause problems for the infant's vision, hearing, breathing and digestion, as well as lifelong developmental and learning disabilities. Families face financial and caregiving burdens associated with meeting the child's needs.

Shaw and his colleagues used the Stanford Military Data Repository, which contains de-identified medical and administrative data on United States Army soldiers. They identified pregnant servicewomen in the database for whom at least a year of medical data prior to the birth was available. The study examined only spontaneous premature birth, excluding early deliveries that were planned by physicians to preserve the health of the mother or infant.

"This database allows us to explore the universal issue of healthy mothers and babies, and also the pragmatic issue of how scientific insights can support our servicewomen and contribute to military readiness," said Lianne Kurina, PhD, associate professor of medicine at Stanford and senior author of the study..."

Learn more:

https://medicalxpress.com/news/2018-03-pregnant-soldiers-deployment-linked-higher.html

Mother's cervical bacteria may be key to preventing premature birth

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"A team of researchers that has confirmed the presence of bacteria in a woman's vagina and cervix may either increase the risk of premature birth or have a protective effect against it, has won the March of Dimes Award for Best Abstract on Prematurity at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™. The findings will be presented Thursday, January 26, at 1:15 p.m. PST at Caesars Palace Augustus Ballroom in Las Vegas.

Michal Elovitz, M.D., and colleagues at the Perelman School of Medicine at the University of Pennsylvania and the University of Maryland studied 2,000 pregnant women, taking vaginal swabs at three distinct time points in pregnancy, and performed analyses on the specimens to determine the microbial colonies that were present. They found that the presence of many bacteria actually conferred a lower risk of spontaneous preterm birth while other bacteria were associated with a significant increased risk. The bacteria associated with spontaneous preterm birth, in conferring either protection or risk, were different between African-American and non-African-American women.

Premature birth (before 37 weeks of pregnancy) is the #1 killer of babies in the United States and the leading cause of death in children under age 5 around the world. Babies who survive an early birth often face serious and lifelong health problems, including breathing problems, jaundice, vision loss, cerebral palsy and intellectual delays. In addition to the human toll, preterm birth accounts for more than $26 billion annually in avoidable medical and societal costs, according to the National Academy of Medicine..." 

Learn more:

https://www.sciencedaily.com/releases/2017/01/170123151354.htm

Study confirms that breast is best for premature babies' hearts

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"Breastfeeding premature babies improves long-term heart structure and function, an Oxford University study has found.

The hearts of babies born early often develop abnormally. Dr Adam Lewandowski and colleagues at the Oxford Cardiovascular Clinical Research Facility, directed by Professor Paul Leeson, have previously shown that, in adult life, the hearts of people who were born very preterm have smaller chambers, thicker walls and reduced function.

The changes in the heart are thought to emerge in the first few months after birth and therefore the team wanted to explore whether the way the baby was fed during this time might be able to alter how the heart develops. Dr Lewandowski, who led the research, explained: 'We already had data on more than 900 individuals who were followed since birth as part of an earlier study, which started in 1982, on the effects of different feeding regimes in preterm infants. We invited individuals who had been followed up throughout life to come to Oxford for a detailed cardiovascular study and used this information to investigate how different feeding regimes could affect the development of the heart in the long term.'

From the original group, now in their early- to mid-twenties, 102 people were able to visit Oxford and take part in the study. A further 102 people of similar age who had not been born prematurely were also recruited.

The study published in Pediatrics showed that while those who had been born early had reduced heart volumes and function compared to those born at term, the reduction was considerably less in people who had been exclusively fed on breastmilk compared to those fed only on formula milk. Furthermore, in those fed a combination of breastmilk and formula, the more breastmilk consumed in the diet as babies the better their heart structure and function as adults..."

Learn more:

http://medicalxpress.com/news/2016-06-breast-premature-babies-hearts.html

Premature babies may grow up to have weaker bones

via medicaldaily.com

"Among the many important processes that happen during a woman's last few weeks of pregnancy is the transfer of calcium to the growing foetus to boost bone development. But what happens if this transfer is interrupted when a baby is born prematurely?

The answer, it seems, is lower peak bone mass as an adult, compared to adults who were born full term. Adults who were born full term but were small for their gestational age also had lower bone mass. These findings are important since peak bone mass is a major determinant of future osteoporosis.

"Few studies to date have addressed bone mass in adults who were born with low birth weight, and there are conflicting findings," said Chandima Balasuriya, the first author of the study. Balasuriya is a medical doctor and PhD candidate at the Norwegian University of Science and Technology (NTNU) and St Olavs University Hospital. "Our study shows that both those born prematurely with a very low birth weight and those who were born full term, but small for their gestational age, had lower bone mass than the control group, who were born full term with normal weights..."

Read more here:

http://medicalxpress.com/news/2016-05-premature-babies-weaker-bones.html

New Molecule Found to Prevent Premature Birth

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"Premature births are intimately linked with inflammation of the uterine tissue, that induces contractions and preterm labour. 

In their search for a mean to prevent this phenomenon and complications related to deliveries occurring before 37 weeks of gestation, researchers at CHU Sainte-Justine and University of Montreal discovered an agent that shows efficacy in inhibiting inflammation and preventing or delaying uterine contractions and premature delivery in murine models – without adversely affecting the foetus or the mother. 

This discovery is a giant step towards preventing prematurity, which is the world’s leading cause of infant death and the origin of potentially severe, long-lasting physical, intellectual or psychological impairment for the 10 per cent of infants born preterm worldwide.

While examining uterine tissues, the scientists found a messenger, called Interleukin 1, to be responsible for triggering and amplifying inflammation in the uterus, which led them to run preclinical trials in which they tested therapeutic agents known to target that messenger..."

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