Mechanisms underlying the role of endoplasmic reticulum stress in the placental injury and fetal growth restriction in an ovine gestation model

Background Exposure to bisphenol A(BPA),an environmental pollutant known for its endocrine-disrupting properties,during gestation has been reported to increase the risk of fetal growth restriction(FGR)in an ovine model of pregnancy.We hypothesized that the FGR results from the BPA-induced insufficiency and barrier dysfunction of the placenta,oxidative stress,inflammatory responses,autophagy and endoplasmic reticulum stress(ERS).However,precise mechanisms underlying the BPA-induced placental dysfunction,and subsequently,FGR,as well as the potential involvement of placental ERS in these complications,remain to be investigated.Methods In vivo experiment,16 twin-pregnant(from d 40 to 130 of gestation)Hu ewes were randomly distributed into two groups(8 ewes each).One group served as a control and received corn oil once a day,whereas the other group received BPA(5 mg/kg/d as a subcutaneous injection).In vitro study,ovine trophoblast cells(OTCs)were exposed to 4 treatments,6 replicates each.The OTCs were treated with 400μmol/L BPA,400μmol/L BPA+0.5μg/m L tunicamycin(Tm;ERS activator),400μmol/L BPA+1μmol/L 4-phenyl butyric acid(4-PBA;ERS antagonist)and DMEM/F12 complete medium(control),for 24 h.Results In vivo experiments,pregnant Hu ewes receiving the BPA from 40 to 130 days of pregnancy experienced a decrease in placental efficiency,progesterone(P4)level and fetal weight,and an increase in placental estrogen(E2)level,together with barrier dysfunctions,OS,inflammatory responses,autophagy and ERS in type A cotyledons.In vitro experiment,the OTCs exposed to BPA for 24 h showed an increase in the E2 level and related protein and gene expressions of autophagy,ERS,pro-apoptosis and inflammatory response,and a decrease in the P4 level and the related protein and gene expressions of antioxidant,anti-apoptosis and barrier function.Moreover,treating the OTCs with Tm aggravated BPA-induced dysfunction of barrier and endocrine(the increased E2 level and decreased P4 level),OS,inflammatory responses,autophagy,and ERS.However,treating the OTCs with 4-PBA reversed the counteracted effects of Tm mentioned above.Conclusions In general,the results reveal that BPA exposure can cause ERS in the ovine placenta and OTCs,and ERS induction might aggravate BPA-induced dysfunction of the placental barrier and endocrine,OS,inflammatory responses,and autophagy.These data offer novel mechanistic insights into whether ERS is involved in BPA-mediated placental dysfunction and fetal development.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Antenatal taurine reduces cerebral cell apoptosis in fetal rats with intrauterine growth restriction

From pregnancy to parturition, Sprague-Dawley rats were daily administered a low protein diet to establish a model of intrauterine growth restriction. From the 12th day of pregnancy, 300 mg/kg taurine was daily added to food until spontaneous delivery occurred. Brain tissues from normal neonatal rats at 6 hours after delivery, neonatal rats with intrauterine growth restriction, and neo- natal rats with intrauterine growth restriction undergoing taurine supplement were obtained for fur- ther experiments. The terminal deoxyribonucleotidyl transferase （TdT）-mediated biotin-16-dUTP nick-end labeling assay revealed that the number of apoptotic cells in the brain tissue of neonatal rats with intrauterine growth restriction significantly increased. Taurine supplement in pregnant rats reduced cell apoptosis in brain tissue from neonatal rats with intrauterine growth restriction. Immu- nohistochemical staining revealed that taurine supplement increased glial cell line-derived neuro- trophic factor expression and decreased caspase-3 expression in the cerebral cortex of intrauterine growth-restricted fetal rats. These results indicate that taurine supplement reduces cell apoptosis through the glial cell line-derived neurotrophic factor-caspase-3 signaling pathway, resulting in a protective effect on the intrauterine growth-restricted fetal rat brain.

Effect of Bushen Yiqi Huoxue Recipe on Placental Vasculature in Pregnant Rats with Fetal Growth Restriction Induced by Passive Smoking

Interactions of vascular endothelial growth factor （VEGF） with receptors VEGFR1/Fltl and VEGFR2/Flk1, and those of angiopoietins （Ang-1, Ang-2） with receptor Tie2 play important roles in placental angiogenesis. This study investigated vascular morphology and expression of these angiogenic factors in rat placenta on the day 15, 18, 21 of gestation （D 15, D 18 and D21）. The rats were randomly assigned into 3 groups： normal group, model group [fetal growth restriction （FGR） model], and Bushen Tqi Huoxue （BYHR） recipe treatment group （BYHR group, the pregnant rats with FGR were treated with BYHR recipe）. Morphological analysis indicated that during initial villous formation, fetal nucle- ated erythrocytes （FNEs） appeared in maternal blood sinus （MBS）. Subsequently, FNEs were sur- rounded by endothelial cells to form fetal capillary （FC） and then by trophoblast cells to form villi. As pregnancy proceeded, FC density increased progressively with increasing endothelial identification staining （EIS） in normal and BYHR groups. Whereas, villous formation was suppressed, normal in- crease in FC density was impaired and EIS was weakened in model group. Quantitative PCR analysis showed that VEGF and Flkl mRNA increased over gestation in all groups, indicating that VEGF might play a pivotal role in FC growth during late gestation. VEGF mRNA was increased on D15, while de- creased on D21 in model group as compared with normal group and BYHR group. Immunohistochemi- cally, Ang-2 protein was highly expressed in FNEs, gradually disappeared as villi matured, and decreased over gestation in all groups, indicating that Ang-2 might play a pivotal role in villous formation, which was further supported by decreased Ang-2 mRNA and protein expression in model group on D 15. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio increased from D15 to D18 in all groups as placenta matured. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio were decreased on D18 in model group as compared with normal and BYHR groups, indicating delayed maturity of FGR placenta. Alterations in angiogenic factors may result in altered placental vasculature and cause placental insufficiency. BYHR recipe could balance the angiogenic factors to promote the formation and maturation of FGR placental vasculature.

Expression of soluble vascular endothelial growth factor receptor-1 and placental growth factor in fetal growth restriction cases and intervention effect of tetramethylpyrazine

Objective:To investigate the expression of soluble vascular endothelial growth factor receptor-1(sFlt-1) and placental growth factor(PLGF) in the fetal growth restriction(FGR) cases and the intervention mechanism of tetramelhylpyrazine.Methods:A total of 60 fetal growth restriction cases that admitted lo our hospital were randomly divided into ligustrazine intervention group(group A) and nutritional support group(group B).A total of 50 healthy pregnant women were also enrolled as control group(group C).Expression level of maternal serum sFlt1,FLGF and fetal growth parameters including HC,AC,FL,BPD,EFW as well as placenta PLGF,sFlt-1 mRNA expression were recorded and compared among the three groups.A total of 15 SD rats were selected and were divided into lliree groups.TMP group,alcohol and tobacco group and blank control group.Three groups of rats were dissected on the twentieth day of gestation.Result:Expression level of sFlt-1 and PLGF in group A was not significantly different from that of group C(P>0.05):but significant difference in SFlt1 and PLGF expression level was observed between group C and group B(P<0.05).Before treatment.HC,AC,FL,BPD and EFW of group A and group B were significant lower than those of group C.hut after treatment,those parameters in group A were significantly improved(P<0.05).In the animal experiment there was no significant difference in sFlt-1 between treatment group and FGR group without treatment or control group(P>0.05).There was significant difference in PLGF between FGR group with treatment and FGR group without treatment or control group(P<0.01).Conclusions:PLGF level is decreased and sFlt-1 increased in patients suffered from fetal growth restriction,and FGR rats show increased sFlt-1 and decreased PLGF.thus they can be indicator of the fetal growth restriction.Ligustrazinc can effectively improve sFlt-1,PLGF expression level in fetal growth restriction cases,which can be used as treatment for FGR.

Long-term implications of fetal growth restriction

Fetal growth restriction(FGR),or intrauterine growth restriction(IUGR),is a complication of pregnancy where the fetus does not achieve its genetic growth potential.FGR is characterized by a pathological retardation of intrauterine growth velocity in the curve of intrauterine growth.However,the FGR definition is still debated,and there is a lack of a uniform definition in the literature.True IUGR,compared to constitutional smallness,is a pathological condition in which the placenta fails to deliver an adequate supply of oxygen and nutrients to the developing fetus.Infants with IUGR,compared to appropriately grown gestational age infants,have a significantly higher risk of mortality and neonatal complications with long-term consequences.Several studies have demonstrated how suboptimal fetal growth leads to long-lasting physiological alterations for the developing fetus as well as for the newborn and adult in the future.The long-term effects of fetal growth retardation may be adaptations to poor oxygen and nutrient supply that are effective in the fetal period but deleterious in the long term through structural or functional alterations.Epidemiologic studies showed that FGR could be a contributing factor for adult chronic diseases including cardiovascular disease,metabolic syndrome,diabetes,respiratory diseases and impaired lung function,and chronic kidney disease.In this review we discussed pathophysiologic mechanisms of FGR-related complications and potential preventive measures for FGR.

Concentrations of Polybrominated Diphenyl Ethers in Maternal Blood,Placental Size,and Risk for Fetal Growth Restriction:A Nested Case-control Study

Objective To explore the effects of prenatal exposure to polybrominated diphenyl ethers(PBDEs)on placental size and birth outcomes.Methods Based on the perspective Wenzhou Birth Cohort,this nested case-control study included 101 fetal growth restriction(FGR)and 101 healthy newborns.Maternal serum samples were collected during the third trimester and measured for PBDEs by gas chromatography tandem mass spectrometry.The basic information of mother-newborn pairs was collected from questionnaires,whereas the placental size and birth outcomes of newborns were obtained from hospital records.Results A total of 19 brominated diphenyle ether(BDE)congeners were detected in maternal serum samples.Higher concentrations of BDE-207,-208,-209,and∑19PBDEs were detected in FGR cases than in controls.Increased BDE-207,-208,-209,and∑19PBDEs levels in maternal serum were related to decreased placental length,breadth,surface area,birth weight,birth length,gestational age,and Quetelet index of newborns.After adjusting for confounders,BDE-207 and∑19PBDE concentrations in maternal serum were significantly associated with an increased risk of FGR.Conclusion A negative association was found between PBDE levels in maternal serum and placental size and birth outcomes.Prenatal PBDE exposure may be associated with elevated risk of the incidence of FGR birth.

Effect of behavior training on learning and memory of young rats with fetal growth restriction

Objective: To investigate the effect of behavior training on the learning and memory of young rats with fetal growth restriction (FGR). Methods: The model of FGR was established by passive smoking method to pregnant rats. The new-born rats were divided into FGR group and normal group, and then randomly subdivided into trained and untrained group respectively. Morris water maze behavior training was performed on postnatal months 2 and 4, then learning and memory abilities of young rats were measured by dark-avoidance testing and step-down testing. Results: In the dark-avoidance and step-down testing, the young rats’ performance of FGR group was worse than that of control group, and the trained group was better than the untrained group significantly. Conclusion: FGR young rats have descended learning and memory abilities. Behavior training could improve the young rats’ learning and memory abilities, especially for the FGR young rats.

Impairments of spatial learning and memory in rat offspring with fetal growth restriction

Objective： Throughout the world, fetal growth restriction（FGR） is one of the most severe complications occurring during pregnancy. It is subsequently associated with neurologic abnormalities in chldren. Our aim was to investigate the spatial learning and memory ability of rat offspring born With FGR. Methods：A rat model of FGR was constructed using the method of passive smoking. Spatial learning and memory were studied in rat offspring born with FGR by assessing the animals＇ performance using the Morris water maze task. Results： At 1- and 2- months of age, both female and male offspring rats showed impairment of performance, while at 4 months of age, only female rats showed impaired performance. The FGR offspring spent a longer time swimming and used inefficient strategies（P〈 0.05, respectively）. However, there were no significant maze performance FGR effects in the 4 month old male rats. In all groups of FGR offspring, irrespective of age or sex, the time spent in the platform quadrant by the rat was significantly less than that in the control group（P〈 0.05）. Conclusion： The Morris water maze performance decreased in rat offspring born with FGR. It is suggested that FGR can cause impairments of spatial learning and memory in young animals.

超声监测结合BUN、UA水平预测PE并发FGR孕产妇不良结局价值

目的:探讨超声胎儿监测结合血尿素氮(BUN)和尿酸(UA)水平预测子痫前期(PE)并发胎儿生长受限(FGR)患者不良结局价值。方法:回顾性收集2020年1月-2023年5月本院就诊的PE患者,其中并发FGR 106例为观察组,未并发FGR患者106例为对照组,比较两组血BUN、UA水平,超声胎儿静脉导管收缩期峰值速度(PSV)、舒张期峰值速度(EDV)、平均时间最大血流速度(Vmax),统计新生儿及孕妇不良结局。结果:观察组血BUN(5.03±1.22mmol/L)、UA(435.54±52.13mmol/L)高于对照组(4.01±1.30 mmol/L、391.60±60.88 mmol/L),PSV(0.85±0.12cm/s)、EDV(0.78±0.11cm/s)、Vmax(0.81±0.13cm/s)低于对照组(0.89±0.11 cm/s、0.96±0.14 cm/s、0.98±0.12 cm/s),新生儿不良结局总发生率(67.9%)高于对照组(15.1%),孕妇不良妊娠结局总发生率(38.7%)高于对照组(20.8%);观察组发生新生儿不良结局患者血BUN、UA高于未发生新生儿不良结局患者,而超声胎儿静脉血流参数均低于未发生新生儿不良结局患者(均P<0.05)。血BUN、UA、PSV、EDV、Vmax及联合预测新生儿不良结局的曲线下面积分别为0.735、0.760、0.643、0.809、0.670和0.706,联合预测的灵敏性达到100.0%。结论:PE并发FGR患者BUN、UA水平异常升高,超声胎儿静脉血流参数异常降低,上述超声及血指标预测新生儿不良结局有一定临床指导价值。

Expression of Lung Surfactant Proteins SP-B and SP-C and Their Modulating Factors in Fetal Lung of FGR Rats

This study investigated the expression of lung surfactant proteins SP-B and SP-C, and their modulating factors TTF-1 and PLAGL2 in the fetal lung of rats with fetal growth restriction（FGR）. The rat FGR model was established by prenatal hypoxia in the first stage of pregnancy, 180 rats for experiment served as hypoxia group, and 197 healthy rats served as normal control group. The FGR incidence in hypoxia was compared with that in normal control group. The histological changes in the fetal lung were observed under the light microscope and electronic microscope in two groups. The SP-B, SP-C, TTF-1 and PLAGL2 proteins were determined in the fetal lung of two groups immunohistochemically. The expression levels of SP-B, SP-C, TTF-1 and PLAGL2 protein and m RNA in the fetal lung of two groups were detected by using Western blotting and RT-PCR respectively. The FGR rat model was successfully established by using hypoxia. Pathologically the fetal lung developed slowly, and the expression levels of SP-B, SP-C, TTF-1 and PLAGL2 protein and mR NA in the fetal lung were significantly reduced in hypoxia group as compared with those in normal control group. It was suggested that maternal hypoxia in the first stage of pregnancy could induce FGR, and reduce the expression of SP-B and SP-C, resulting in the disorder of fetal lung development and maturation.

Different Fetal and Neonatal Growth between Early- and Late-Onset Preeclampsia

Preeclampsia is a heterogeneous disease, and there are major differences in severity, fetal growth and poor placentation between early- and late-onset preeclampsia. Here, we examined the effect of onset period on fetal and neonatal growth in preeclampsia with a cross-sectional study including 102 pregnant women with preeclampsia visited Okayama University Hospital from 2009 to 2013. The subjects were retrospectively compared in terms of body mass index (BMI), weight gain during pregnancy, complications, weeks of delivery, neonatal body weight and BMI at birth, fetal growth restriction (FGR), small for gestational age (SGA), pathological findings in the placenta, and infant’s weight at 1 month after birth. Neonatal body weight and BMI at birth were significantly lower and the extent of FGR and the frequency of SGA were higher in early-onset group compared with late-onset group. Mean daily weight gain during the neonatal period was significantly lower in the early-onset group compared with the late-onset group, however the weight gain rate during the neonatal period in the early-onset group was higher than that in late-onset group. In conclusions, there are significant differences in fetal and neonatal growth between early- and late-onset preeclampsia and the catch up for growth might start during neonatal period.

低分子肝素对子痫前期合并FGR孕妇HO-1及胎盘质量的影响

目的探讨低分子肝素对子痫前期合并胎儿生长受限孕妇血红素氧合酶-1(HO-1)表达及胎盘质量的影响。方法随机将120例子痫前期合并胎儿生长受限孕妇分成两组,每组60例。对照组给予硫酸镁冲击治疗控制血压及常规对症治疗,观察组则同时接受皮下注射4100 U低分子肝素,1次/d,治疗1 w。监测两组胎儿治疗后情况;分娩后,记录新生儿情况,并采用免疫组化检测胎盘HO-1表达情况。结果治疗1 w后,观察组胎儿各生长指标的增长幅度大于对照组(P<0.05),脐血流指标低于对照组(P<0.05);分娩后,观察组胎盘质量高于对照组(P<0.05);观察组新生儿出生体重、1分钟Apgar评分优于对照组(P<0.05);观察组胎盘HO-1表达的强阳性和中度阳性比例分别为53.4%和43.3%,明显高于对照组(P<0.05)。结论低分子肝素可上调胎盘HO-1的表达水平,纠正胎盘缺氧状态,增加胎盘质量,改善胎儿预后情况。

阻断子宫动脉建立FGR大鼠模型的研究

目的通过暂时阻断妊娠期大鼠子宫血供的方法建立子宫缺血引起胎儿生长受限的动物模型。方法根据大鼠子宫动脉是卵巢动脉的一个分支的解剖特点,于孕鼠妊娠第15天时施行手术暂时阻断卵巢动脉并于第21天行剖宫产术,术后称量新生胎仔体重及胎盘、脑、心、肝、肺、肾等重要脏器重量,对比各组间新生胎仔的预后的不同,并对照研究阻断血供10、20、30及40 min对胎仔的不同影响。结果妊娠晚期阻断孕鼠卵巢动脉20min可成功构建胎儿生长受限模型,这种方法与阻断动脉血流30或40 min相比,手术时间短,技术要求不高,胎仔死亡率与对照组差异无显著性(P>0.05)。各实验组较对照组新生胎仔体重及胎盘、各重要脏器重量均明显降低(P<0.05)。结论通过阻断卵巢动脉从而阻断子宫动脉血流,成功建立缺血缺氧性FGR孕鼠模型。该模型重复性好,操作简便,并可成功设立同体对照,为进行FGR相关的产科理论研究提供了一个有利的技术平台。

FGR的胎盘组织印记基因PEG10DNA甲基化水平及其意义

目的通过检测父方表达印记基因PEG10 DNA在胎儿生长受限(FGR)患者胎盘组织甲基化水平,探索FGR是否与其胎盘中印记基因的甲基化程度相关。方法采用前瞻性研究,收集2014年1月至2017年1月在上海市第一人民医院宝山分院妇产科住院分娩的FGR者56例(研究组)和同期正常单胎晚孕分娩者56例(对照组),采用亚硫酸氢盐测序法(BSP)检测研究组和对照组胎盘组织的PEG10 DNA甲基化水平,分析其甲基化水平与FGR的临床病理关系。结果 FGR胎盘组织印记基因PEG10表现为异常甲基化水平,与对照组相比,研究组胎盘组织印记基因PEG10 DNA甲基化水平在CPG岛1无明显差异,而在CPG岛2及CPG岛3明显高于对照组(t值分别为94.97,7.16,均P<0.05),尤其以CPG岛2最为明显(研究组表达为0.544±0.027,对照组表达为0.152±0.015)。结论胎盘组织父方表达的印记基因的DNA甲基化水平可能是导致FGR发病的原因之一。

FGR孕妇血清皮质醇浓度与胎盘11β-HSD2表达水平的关系

目的:探讨FGR孕妇及胎儿脐血清皮质醇浓度的改变与胎盘组织11β-HSD2表达水平间的关系。方法:用放射免疫法测定孕妇及脐血清皮质醇浓度;用免疫组织化学方法结合计算机多媒体彩色病理图像分析技术测定胎盘组织11β-HSD2表达水平;实验所的数据均经SPSS统计软件分析处理。结果:FGR组孕妇及胎儿脐带血清皮质醇浓度和胎盘组织11β-HSD2表达水平明显高于对照组(901.07±365.15vs602.96±237.24;552.75±205.02vs155.40±66.20;101.33±33.48vs135.13±29.951);孕妇血清皮质醇浓度与胎儿脐血清皮质醇浓度呈正相关(r=0.817,P<0.01);孕妇及胎儿脐血清皮质醇浓度与胎儿体重呈负相关(r=-0.388,P<0.05;r=-0.588,P<0.01);胎儿脐血清皮质醇浓度与胎盘组织11β-HSD2表达水平呈负相关(r=-0.385,P<0.05);胎盘组织11β-HSD2表达水平与胎儿体重呈正相关(r=0.649,P<0.01)。结论:母体孕期高浓度的血清皮质醇经胎盘灭活减少,使胎儿血清皮质醇浓度增高导致胎儿宫内发育迟缓。血清皮质醇浓度升高及胎盘组织11β-HSD2表达水平下降是导致FGR的病因之一。

ICP、FGR及羊水过少患者血清中铜、锌、镁含量的变化

目的探讨妊娠期肝内胆汁淤积症(ICP)、胎儿生长受限(FGR)及羊水过少患者血清中铜、锌、镁含量的变化。方法以原子吸收分光光度法分别测定35名ICP患者、11例FGR患者、25例羊水过少患者及20例正常妊娠女性血清锌、铜、镁浓度。结果ICP患者血清锌较对照组明显降低(P<0.05),铜及镁较对照组无显著性差异(P>0.05);FGR组铜较对照组明显升高,锌、镁较对照组明显降低,均有显著性差异(P<0.05);羊水过少组铜含量较对照组无显著性差异,锌含量较对照组降低而镁含量较对照组升高,差异有显著性(P<0.05)。铜、锌、镁含量在ICP、FGR及羊水过少3组之间相比无显著性差异(P>0.05)。结论ICP、FGR及羊水过少患者血清铜、锌、镁含量较正常孕妇有所变化,针对这些变化进行饮食调整对孕期健康有重要意义。

FGR母体血及脐血中IGF-1水平与胎盘病理变化的关系

目的 了解胎儿生长受限（FGR）时母体血及脐血中胰岛素样生长因子-1（IGF-1）水平与胎盘病理变化的关系,以进一步探讨FGR的发病机制.方法 对40例妊娠合并胎儿生长受限组（FGR组）及40例正常孕妇组（对照组）,采取母体外周静脉血及脐血,测定其中IGF-1水平;光镜观察2组胎盘绒毛发育、末梢绒毛内毛细血管个数、血管占绒毛面积、绒毛面密度.结果 与对照组相比,FGR时母体血及脐血中IGF-1水平降低,差异有统计学意义（P〈0.05）; FGR组胎盘病理变化与对照组相比,差异有显著性（P〈0.05）.结论 FGR时,母血及脐血中IGF-1水平降低,导致胎盘微循环形成障碍,胎盘血流灌注减少,引起缺血缺氧,胎盘病理变化明显.

FGR的孕妇血清脂质过氧化物水平检测及意义

目的 探讨血清脂质过氧化物 (LPO)与胎儿宫内生长受限 (FGR )发生的相关性。 方法 抽取 5 0例胎儿生长受限的孕妇 (FGR组 )及 5 0例正常孕妇 (对照组 )肘血 ,采用改良的硫代巴比妥酸 (TBA)法测定血清脂质过氧化物水平。 结果 FGR组LPO水平明显增高。 结论 氧自由基与胎儿宫内生长受限的发生有关 ,检测孕妇血清LPO可作为胎儿生长受限诊断依据之一。

S100B蛋白与FGR胎儿脑损伤预后的相关性研究

目的探索胎儿生长受限(FGR)胎儿宫内脑损伤的有效预测指标。方法将2018年1月至2019年1月在湖南省妇幼保健院住院分娩的FGR孕妇380例作为研究组,并根据其胎儿出生后神经系统表现及影像学检查分为脑损伤组和非脑损伤组;另将同期且约同孕周、正常且无明显其他合并症孕妇400例作为对照组。抽取三组孕妇外周血及脐血,采用酶联免疫吸附试验(ELISA)法测定S100B蛋白水平。结果脑损伤组外周血及脐血中S100B蛋白水平明显高于非脑损伤组和对照组,差异均有统计学意义(P<0.05);脑损伤组孕妇外周血及脐血中S100B蛋白有相关性(P<0.05);脑损伤组孕妇脐血及外周血S100B蛋白水平与胎儿脑损伤有相关性(P<0.05);脑损伤组各月龄总平均发育商低于对照组和无脑损伤组,差异均有统计学意义(P<0.05)。结论S100B蛋白与FGR胎儿脑损伤之间有相关性。孕妇外周血S100B蛋白可作为产前评估胎儿有无脑损伤的量化指标,为分娩前更早地建立个性化的诊治方案奠定基础,做到早发现、早治疗。