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1. Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol

Author

Neil Marlow, Luigi Raio, Roland Devlieger, Aris Papageorghiou, Rebecca Cannings-John, Christoph C Lees, Andrew Breeze, Andrew Sharp, Wessel Ganzevoort, Jim G Thornton, Julia Townson, Tanja Groten, Irene Cetin, Peter Lindgren, Federico Prefumo, Edward Mullins, Astrid Berger, Sofia Amylidi-Mohr, Cathrine Ebbing, Ladislav Krofta, Bianca Masturzo, Amarnath Bhide, Hans Wolf, Tiziana Frusca, Kurt Hecher, Tullio Ghi, Silvia Salvi, Wilfried Gyselaers, Raffaele Napolitano, MARK KILBY, Erich Cosmi, Claire Potter, Enrico Ferrazzi, Basky Thilaganathan, Dietmar Schlembach, Christine Morfeld, Bronacha Mylrea-Foley, Christina Ammari, Birgit Arabin, Eva Bergman, Caterina Bilardo, Julia Binder, Jana Brodszki, Pavel Calda, Andrej Černý, Elena Cesari, Andrea Dall'Asta, Anke Diemert, Torbjørn Eggebø, Ilaria Fantasia, Jenny Goodier, Patrick Greimel, Wassim Hassan, Constantin Von Kaisenberg, Alexey Kholin, Philipp Klaritsch, Silvia Lobmaier, Karel Marsal, Giuseppe M Maruotti, Federico Mecacci, Kirsti Myklestad, Eva Ostermayer, Jute Richter, Ragnar Kvie Sande, Ekkehard Schleußner, Tamara Stampalija, Herbert Valensise, Gerard HA Visser, Ling Wee, Andy Simm, Angela Ramoni, Barry Lloyd, Christopher Lloyd, Claudia Seidig, Danielle Thornton, Elena Mantovani, Emanuela Taricco, Emma Bertucci, Ferenc Macsali, Francesca Ferrari, Francesco D'Antonio, Giuseppe Cali, Giuseppe Rizzo, Ilaria Giuditta Ramezzana, Ioannis Kyvernitakis, Karen Melchiorre, Kristiina Rull, Laura Sarno, Liina Rajasalu, Louisa Jones, Makrina Savvidou, Maria Stefopoulou, Nicola Fratelli, Nishigandh Deole, Petra Pateisky, Pilar Palmrich, Ralf Schild, Sabina Ondrová, Sarah Gumpert, Serena Simeone, Silvia Visentin, Stefan Verlohren, Tatjana Radaelli, Tinne Mesens, Tiziana Fanelli, Yvonne Heiman, Zulfiya Khodzhaeva, Christoph Brezinka, Sanne Gordijn, Abin Thomas, and Ligita Jokubkiene

Subjects
Medicine
Abstract

Introduction Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area. We propose a randomised, controlled trial to establish the optimum method of timing delivery between 32 weeks and 36 weeks 6 days of gestation. We hypothesise that delivery on evidence of cerebral blood flow redistribution reduces a composite of perinatal poor outcome, death and short-term hypoxia-related morbidity, with no worsening of neurodevelopmental outcome at 2 years.Methods and analysis Women with non-anomalous singleton pregnancies 32+0 to 36+6 weeks of gestation in whom the estimated fetal weight or abdominal circumference is

Published
2022
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2. Symptom Burden and Factors Associated with Acute Respiratory Infections in the First Two Years of Life—Results from the LoewenKIDS Cohort

Author

Susan Langer, Johannes Horn, Cornelia Gottschick, Bianca Klee, Oliver Purschke, Mahrrouz Caputo, Evelyn Dorendorf, Kristin Maria Meyer-Schlinkmann, Heike Raupach-Rosin, André Karch, Nicole Rübsamen, Mustafa Aydogdu, Matthias Buhles, Frank Dressler, Wolfgang Eberl, Franz Edler von Koch, Torsten Frambach, Heiko Franz, Florian Guthmann, Carlos A. Guzman, Roland Haase, Gesine Hansen, Valerie Heselich, Johannes Hübner, Hans Georg Koch, Carsten Oberhoff, Peggy Riese, Ralf Schild, Sven Seeger, Michael Tchirikov, Stephanie Trittel, Constantin von Kaisenberg, and Rafael Mikolajczyk

Subjects
birth cohort, respiratory infection, newborn, children, symptom diary, longitudinal observation, Biology (General), QH301-705.5
Abstract

Acute respiratory infections (ARIs) are the most common childhood illnesses worldwide whereby the reported frequency varies widely, often depending on type of assessment. Symptom diaries are a powerful tool to counteract possible under-reporting, particularly of milder infections, and thus offer the possibility to assess the full burden of ARIs. The following analyses are based on symptom diaries from participants of the German birth cohort study LoewenKIDS. Primary analyses included frequencies of ARIs and specific symptoms. Factors, which might be associated with an increased number of ARIs, were identified using the Poisson regression. A subsample of two hundred eighty-eight participants were included. On average, 13.7 ARIs (SD: 5.2 median: 14.0 IQR: 10–17) were reported in the first two years of life with an average duration of 11 days per episode (SD: 5.8, median: 9.7, IQR: 7–14). The median age for the first ARI episode was 91 days (IQR: 57–128, mean: 107, SD: 84.5). Childcare attendance and having siblings were associated with an increased frequency of ARIs, while exclusive breastfeeding for the first three months was associated with less ARIs, compared to exclusive breastfeeding for a longer period. This study provides detailed insight into the symptom burden of ARIs in German infants.

Published
2022
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3. Incarceration of the Gravid Uterus – a Rare Condition not to be Missed

Author

Nadja Grosse, Sandy Liem, Elvira Miller, Gunnar Möller, Jürgen Weidemann, Christine A Morfeld, Ralf Schild, and Katrin Oehler-Rahman

Subjects
Maternity and Midwifery, Pediatrics, Perinatology and Child Health, Obstetrics and Gynecology
Abstract

Background Incarceration of a gravid uterus (IGU) is a rare manifestation in obstetrics that may be associated with serious complications. Case We report on a 29-year-old patient at 34+2 weeks’ gestation who presented with HELLP syndrome. IGU had been initially diagnosed in our department at 23+6 weeks’ gestation. Urgent cesarean section was performed taking into account the specific characteristics of IGU. A healthy premature child was born. With the prior knowledge of IGU no complications during delivery occurred and mother and child had favorable outcomes. Conclusion IGU is a rare condition in pregnancy that should not be overlooked. Early diagnosis and treatment of IGU can prevent serious complications to the mother and child during pregnancy and delivery. In this report, we discuss the specific peculiarities of an incarcerated uterus that need to be considered in this regard.

Published
2023
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4. 'A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening' – eine interdisziplinäre Stellungnahme

Author

Sandra Hummel, Katharina Laubner, Mellita Grieshop, Tanja Groten, Markus Schmidt, Ralf Schild, F Weschenfelder, Michael Abou-Dakn, Michael Hummel, Alexandra Kautzky-Willer, Maritta Kühnert, Jens H. Stupin, Ute Schäfer-Graf, and Heinke Adamczewski

Subjects
Gestational diabetes, Pediatrics, medicine.medical_specialty, Randomized controlled trial, business.industry, law, Endocrinology, Diabetes and Metabolism, medicine, medicine.disease, business, law.invention
Published
2021
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7. DNA methylation of the p66Shc promoter is decreased in placental tissue from women delivering intrauterine growth restricted neonates

Author

Anja, Tzschoppe, Helmuth, Doerr, Wolfgang, Rascher, Tamme, Goecke, Matthias, Beckmann, Ralf, Schild, Ellen, Struwe, Jürgen, Geisel, Heike, Jung, and Jörg, Dötsch

Subjects
Male, Fetal Growth Retardation, Src Homology 2 Domain-Containing, Transforming Protein 1, Placenta, Infant, Newborn, Down-Regulation, Gestational Age, DNA Methylation, Delivery, Obstetric, Real-Time Polymerase Chain Reaction, Long Interspersed Nucleotide Elements, Shc Signaling Adaptor Proteins, Pregnancy, Infant, Small for Gestational Age, Humans, Female, Promoter Regions, Genetic
Abstract

The adaptor protein p66Shc generates mitochondrial reactive oxygen species and translates oxidative signals into apoptosis. We aimed to analyze potential alterations in total methylation and in p66Shc activation in placental tissues from women delivering intrauterine growth restricted neonates (IUGR) versus appropriate for gestational age (AGA) and small for gestational age (SGA) neonates.DNA methylation of the p66Shc promoter and of long interspersed nuclear elements (LINE-1), as a marker for total methylation, was quantified by automatic pyrosequencing in 15 IUGR, 25 AGA and 15 SGA placentas. Placental gene expression of p66Shc was determined by TaqMan real-time polymerase chain reaction.No significant difference was found for LINE-1 methylation between IUGR, AGA and SGA newborns. DNA methylation of the p66Shc promoter was significantly decreased in the IUGR compared with the AGA group (p 0.0001) and the SGA group (p 0.0001). However, analysis of placental p66Shc gene expression did not show a significant difference between the three groups.It remains speculative if the decreased p66Shc promoter methylation might play a role in the pathophysiology of endothelial dysfunction and cardiovascular disease after IUGR.

Published
2013

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