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ObjectiveWe evaluated growth metrics in HIV unexposed African breastfed infants in the first 18 months of life in association with in-utero exposure to Tenofovir Diphosphate Fumarate (TDF) containing pre-exposure prophylaxis (PrEP).DesignWe conducted a secondary data analysis of a TDF-PrEP randomized control trial (CAP016 RCT). Pregnant women without HIV were randomized to initiating TDF-PrEP in pregnancy (Immediate-PrEP-IP) or deferred initiation of TDF-PrEP at cessation of breastfeeding (Deferred-PrEP-DP).MethodsInfant weight (W), length (L), and head circumference (HC) were measured at birth and 6, 26, 50, and 74 weeks of age. Stored dried blood spot samples from pregnant women randomized to the IP arm were used to measure tenofovir-diphosphate (TFV-DP) levels. Age-stratified mean weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and head circumference-for-age (HCAZ) Z-scores were compared between infants exposed to varying TFV-DP concentrations and infants in the DP arm.ResultsA total of 455 mother-infant pairs were included in the secondary analysis, 228 in the IP arm and 227 in the DP arm. WAZ, LAZ, WLZ, and HCAZ scores were comparable between infants in the Deferred-PrEP arm and Immediate-PrEP arm. In a mixed-effects linear regression model adjusting for maternal age, body mass index, socioeconomic and newborn characteristics, in-utero exposure to varying TFV-DP levels was not associated with WAZ (β = −0.52), LAZ (β = −0.46), WLZ (β = −0.43) and HCAZ (β = −0.11) scores over time.ConclusionThere was no evidence of an association between growth metrics in the first 18 months of life and in-utero exposure to TFV-DP among breastfed HIV unexposed infants.

Objective: We evaluated growth metrics in HIV unexposed African breastfed infants in the first 18 months of life in association with in-utero exposure to Tenofovir Diphosphate Fumarate (TDF) containing pre-exposure prophylaxis (PrEP)., Design: We conducted a secondary data analysis of a TDF-PrEP randomized control trial (CAP016 RCT). Pregnant women without HIV were randomized to initiating TDF-PrEP in pregnancy (Immediate-PrEP-IP) or deferred initiation of TDF-PrEP at cessation of breastfeeding (Deferred-PrEP-DP)., Methods: Infant weight (W), length (L), and head circumference (HC) were measured at birth and 6, 26, 50, and 74 weeks of age. Stored dried blood spot samples from pregnant women randomized to the IP arm were used to measure tenofovir-diphosphate (TFV-DP) levels. Age-stratified mean weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and head circumference-for-age (HCAZ) Z -scores were compared between infants exposed to varying TFV-DP concentrations and infants in the DP arm., Results: A total of 455 mother-infant pairs were included in the secondary analysis, 228 in the IP arm and 227 in the DP arm. WAZ, LAZ, WLZ, and HCAZ scores were comparable between infants in the Deferred-PrEP arm and Immediate-PrEP arm. In a mixed-effects linear regression model adjusting for maternal age, body mass index, socioeconomic and newborn characteristics, in-utero exposure to varying TFV-DP levels was not associated with WAZ ( β  = -0.52), LAZ ( β  = -0.46), WLZ ( β  = -0.43) and HCAZ ( β  = -0.11) scores over time., Conclusion: There was no evidence of an association between growth metrics in the first 18 months of life and in-utero exposure to TFV-DP among breastfed HIV unexposed infants., Competing Interests: JR and RC are employed by Gilead Sciences. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Naidoo, Naidoo, Lombard, Desmond, Clark, Rooney, Gray and Moodley.)

Pesticide exposure may affect young children's neurodevelopment, but only few cohort studies have addressed possible effects of non-organophosphate pesticides. We evaluated associations between prenatal current-use pesticide exposure and neurodevelopmental outcomes among 1-year-old children from the Infants' Environmental Health (ISA) birth cohort. To determine prenatal pesticide exposure, we measured biomarkers of pyrimethanil, chlorpyrifos, synthetic pyrethroids, and 2,4-D in urine samples among 355 women, 1–3 times during pregnancy. One-year post-partum, we evaluated children's neurodevelopment with the Bayley Scales of Infant and Toddler Development 3rd edition (BSID-III). We assessed associations between exposures and neurodevelopmental outcomes (composite and z-scores) using single-chemical linear regression models adjusted for possible confounders (maternal education, parity, sex, gestational age at birth, child age, HOME-score, location of assessment, biomarkers of mancozeb), and studied effect-modification by sex. We evaluated non-linear associations of multiple pesticide exposures with Bayesian kernel machine regression (BKMR). We found higher prenatal urinary 2,4-D concentrations were associated with lower language (β per ten-fold increase = −2.0, 95 % confidence interval (CI) = −3.5, −0.5) and motor (β per ten-fold increase = −2.2, 95 %CI = −4.2, −0.1) composite scores among all children. Also, higher chlorpyrifos exposure [measured as urinary 3,5,6-trichloro-2-pyridinol (TCPy)] was associated with lower cognitive composite scores (β per ten-fold increase = −1.9, 95 %CI = −4.7, 0.8), and lower motor composite scores among boys (β per ten-fold increase = −3.8, 95 % CI = −7.7, 0.1) but not girls (β per ten-fold increase = 2.3, 95 %CI = −1.6, 6.3, pINT = 0.11). Finally, higher pyrimethanil was associated with lower language abilities among girls, but not boys. Pyrethroid metabolite concentrations did not explain variability in BSID-III composite scores. Associations were similar for BSID-III z-scores, and we found no evidence for non-linear associations or mixture effects. Prenatal exposure to common-use pesticides may affect children's neurodevelopment at 1-year of age, some effects may be sex-specific. • We repeatedly measured pyrimethanil, chlorpyrifos, pyrethroids, 2,4-D in urine of 355 pregnant women. • Prenatal 2,4-D and chlorpyrifos were associated with poorer child neurodevelopment at age 1. • Pyrimethanil was associated with decreased development among girls, but not boys. • Our results showed pesticides may affect infant's neurodevelopment at age 1. • Effects of some pesticides may differ between girls and boys. [ABSTRACT FROM AUTHOR]

Myelomeningocele (MMC) is recognized as the most prevalent neural tube defect (NTD) and the most complex congenital anomaly that is still consistent with life. In the era of folic acid fortification, its incidence has been observed at 3.4 per 10,000 live births. The observed decrease in incidence is attributed to a synergy of enhanced folate supplementation, along with advancements in prenatal diagnostics, and, in certain cases, the option of selective termination. Recently, innovative technology and growing expertise have sparked considerable excitement within the scientific community regarding fetal MMC repair. In this lecture, Dr. Elbabaa shares his surgical outcomes and provides an updated overview of the current state of the art in this surgical field. [ABSTRACT FROM AUTHOR]

The current study comprised four groups of pregnant animals viz; Control (CTR) received 10 ml/kg of normal saline, Al:10 mg/kg of AlCl 3 , Cd: 1.5 mg/Kg of CdCl 2 Al+Cd; 10 mg/kg of AlCl 3 and 1.5 mg/Kg of CdCl 2. Treatment was done from pregnancy days (PNT) 7–20. After delivery, male animals were weaned on PSD 21 and sacrificed on PSD 78. From the study significant increases on serum liver enzymes in the group exposed to Cd and that exposed to Al+Cd were observed. The study further showed altered serum and hepatic antioxidant balance for the Cd, Al and Al+Cd groups compared to control. Similarly, lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH) activities in the liver were elevated in Cd and Al+Cd groups while an altered liver histological feature in treated groups were also observed. it was concluded that in utero co-exposure to Al and Cd had the ability to alter hepatic functional indices. • Pregnant mice were co-exposed to aluminium (Al) and cadmium (Cd) from pregnancy day 7 to day 20. • The male offsprings were allowed to live to adulthood and sacrificed on postnatal day 78. • Co-exposure of both metals led to alteration in liver function, antioxidant and energy metabolic enzymes. • Co-exposure to Al and Cd potentiated hepatic features characterized by inflammation and hepatocyte degeneration. [ABSTRACT FROM AUTHOR]

Abstract Introduction Prenatal exposure to some phenols and parabens has been associated with adverse birth outcomes. Hormones may play an intermediate role between phenols and adverse outcomes. We examined the associations of phenol and paraben exposures with maternal reproductive and thyroid hormones in 602 pregnant women in Puerto Rico. Urinary triclocarban, phenol and paraben biomarkers, and serum hormones (estriol, progesterone, testosterone, sex-hormone-binding globulin (SHBG), corticotropin-releasing hormone (CRH), total triiodothyronine (T3), total thyroxine (T4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH)) were measured at two visits during pregnancy. Methods Linear mixed models with a random intercept were constructed to examine the associations between hormones and urinary biomarkers. Results were additionally stratified by study visit. Results were transformed to hormone percent changes for an inter-quartile-range difference in exposure biomarker concentrations (%Δ). Results Bisphenol-S was associated with a decrease in CRH [(%Δ -11.35; 95% CI: -18.71, − 3.33), and bisphenol-F was associated with an increase in FT4 (%Δ: 2.76; 95% CI: 0.29, 5.22). Butyl-, methyl- and propylparaben were associated with decreases in SHBG [(%Δ: -5.27; 95% CI: -9.4, − 1.14); (%Δ: -3.53; 95% CI: -7.37, 0.31); (%Δ: -3.74; 95% CI: -7.76, 0.27)]. Triclocarban was positively associated with T3 (%Δ: 4.08; 95% CI: 1.18, 6.98) and T3/T4 ratio (%Δ: 4.67; 95% CI: -1.37, 6.65), and suggestively negatively associated with TSH (%Δ: -10.12; 95% CI: -19.47, 0.32). There was evidence of susceptible windows of vulnerability for some associations. At 24–28 weeks gestation, there was a positive association between 2,4-dichlorophenol and CRH (%Δ: 9.66; 95% CI: 0.67, 19.45) and between triclosan and estriol (%Δ: 13.17; 95% CI: 2.34, 25.2); and a negative association between triclocarban and SHBG (%Δ: -9.71; 95% CI:-19.1, − 0.27) and between bisphenol A and testosterone (%Δ: -17.37; 95% CI: -26.7, − 6.87). Conclusion Phenols and parabens are associated with hormone levels during pregnancy. Further studies are required to substantiate these findings.

Introduction: The World Health Organization estimates that about 25 million pregnant mothers are currently at risk for malaria, and that malaria accounts for over 10,000 maternal and 200,000 neonatal deaths per year. The current hypothesis of early life programming supports the premise that many developmental delay and disorders may have their origin In-utero. Therefore, the current study aimed at evaluating the possible impact of experimental malaria exposure In-utero on neurobehavioral profile in mice offspring. Methods: Pregnant mice were intraperitoneally infected on gestational day 13 with 1.02×105 infected red blood cells. Pregnant mice (both infected and uninfected) were allowed to deliver and the offspring were monitored up to postnatal day 42 when anxiety-like, Obsessive-Compulsive Disorder (OCD), and locomotor activity were evaluated using elevated plus maze, marble burying, and Open Field Test, respectively. Results: The current study showed that maternal infection with Plasmodium berghei resulted in an interesting behavior in offspring characterized by increased anxiety-like and OCD behaviors. Locomotor activity was however not affected. Conclusion: It may be concluded that In-utero exposure to experimental malaria in mice causes behavioral changes.

Normal human cells require a series of genetic alterations to undergo malignant transformation. Direct sequencing of human tumors has identified hundreds of mutations in tumors, but many of these are thought to be unnecessary and a result of, rather than a cause of, the tumor. The exact number of mutations to transform a normal human cell into a tumor cell is unknown. Here I show that male gonadal germ cell tumors, the most common form of testicular cancers, occur after four mutations. I infer this by constructing a mathematical model based upon the multi-hit hypothesis and comparing it to the age-specific incidence data. This result is consistent with the multi-hit hypothesis, and implies that these cancers are genetically or epigenetically predetermined at birth or an early age.

The impacts of late gestation heat stress on the dam and her subsequent lactation are well-recognized. However, more recent research has demonstrated the long-lasting and severe negative consequences on the in-utero heat-stressed progeny. Dairy calves born to late gestation heat-stressed dams weigh less at birth and up to one year of age and have compromised metabolism and immune function. In-utero programming of these offspring may coordinate alterations in thermoregulation, mammary development, and milk synthetic capacity at different developmental windows. Thus, prenatally heat-stressed dairy heifers will produce less milk across multiple lactations and have a lower herd survival rate, potentially negatively impacting the U.S. dairy economy. Dry period heat stress abatement strategies should be considered not only for the productivity and welfare of the pregnant dam but also for the developing calf. • Heat stress in late gestation negatively impacts calf health. • In utero heat stress alters the trajectory of mammary development. • In utero heat stress decreases productivity of the offspring. [ABSTRACT FROM AUTHOR]

The fact that ultrasound is generally perceived as a safe imaging modality due to its use of non-ionizing radiation encouraged its increasing use in the diagnosis of cyesis in Veterinary practice. Ultrasound heating during obstetric scans has the potential of increasing body temperature via absorption. The study was conducted to determine the effect of multiple prenatal ultrasounds scanning on haematological parameters of rabbit fetuses. The research involves in vivo experimental model using 16 pregnant does and exposing them to ultrasound for average of 5 minutes at day 7, 12, 15, 20, 25, 27 and 29 of gestation. They were divided into two groups as insonated and control, the restrain and scanning procedures were mimicked on the group of does that were not scanned (positive control). Upon parturition, blood samples were collected from the kits via jugular venesection into ethylene diamine tetra acetic acid containing tubes for haematology. There was a significant reduction (p < 0.05) of red blood cell count and haemoglobin concentration of insonated group. Values of packed cell volume and platelet were lower but not significant (p > 0.05) in insonated as against the control while a non-significant slight increase in total white blood cell count was seen in the control. Therefore, ultrasound heating from multiple in-utero exposure can possibly cause alterations in haematological values in Rabbits. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) is a recognized xenoestrogen, in that it possesses oestrogenic and anti-androgenic properties. These endocrine-disrupting effects of BPA at the estrogen receptor (ER) occur despite the very low affinity of BPA for the ERβ, which is 10,000 times lower than that of 17-β estradiol, and despite the European regulatory authorities stating that BPA is safe, at usual exposure concentrations, the use of BPA in baby drink bottles was banned in 2011. There exists conflicting evidence from human epidemiological studies as to its influence on adult male reproductive function, although animal data is more convincing. This mini-review will report on the limited epidemiological data from human studies relating early life exposure to BPA on adult male reproductive function. A long term follow-up study from Western Australia using a birth cohort, the Raine Study, demonstrated no adverse associations of antenatal exposure to BPA, and potentially a positive association with antenatal BPA exposure with sperm concentration and motility at 20 years of age, although recent scientific reports suggest traditional measures of BPA exposure may underestimate exposure levels, which makes data interpretation potentially flawed. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare short-term outcomes of neonatal opioid withdrawal syndrome (NOWS) treatment in infants exposed in-utero to opioids and selective serotonin reuptake inhibitors (SSRIs) or opioids alone. Methods: This was a retrospective cohort study of mother-infant dyads, 34 weeks or greater gestation, receiving opioids and/or SSRIs during pregnancy. Intravenous or oral methadone was administered according to a pre-existing protocol for NOWS treatment guided by withdrawal scores. Primary outcome was length of treatment (LOT). Secondary outcomes included length of stay (LOS), total methadone exposure, time to symptom control, need for a second agent, and NOWS medications at discharge. Results: Fifty-five mother-infant dyads were included in the study. LOT was longer in the infants in the SSRI plus opioid group but not significantly different [24 ± 23 days (SSRI plus opioid) vs 20 ± 14 days (opioid alone); P  = 0.78]. There was a trend towards shorter LOS (30 ± 22 day vs 27 ± 15 days; P  = 0.86), lower total methadone exposure (3.2 ± 4.3 mg/kg vs 2.7 ± 5.1 mg/kg; P  = 0.66), less time to control symptoms (1 ± 1.7 days vs 0.5 ± 0.36 days; P  = 0.31) and less need for a second agent (OR 2.65, 95% CI 0.69–10.5) in the opioid only group, although these observations also did not reach statistical significance. Conclusions: This study could not demonstrate a statistically significant difference in short-term NOWS outcome of LOT between the 2 groups. However, there was a trend towards longer LOT and LOS in the SSRI plus opioid group which could be clinically significant. A larger cohort may detect a true significant difference in these short-term outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization estimates that about 25 million pregnant mothers are currently at risk for malaria, and that malaria accounts for over 10,000 maternal and 200,000 neonatal deaths per year. The current hypothesis of early life programming supports the premise that many developmental delay and disorders may have their origin Inutero. Therefore, the current study aimed at evaluating the possible impact of experimental malaria exposure In-utero on neurobehavioral profile in mice offspring. Methods: Pregnant mice were intraperitoneally infected on gestational day 13 with 1.02×105 infected red blood cells. Pregnant mice (both infected and uninfected) were allowed to deliver and the offspring were monitored up to postnatal day 42 when anxiety-like, Obsessive- Compulsive Disorder (OCD), and locomotor activity were evaluated using elevated plus maze, marble burying, and Open Field Test, respectively. Results: The current study showed that maternal infection with Plasmodium berghei resulted in an interesting behavior in offspring characterized by increased anxiety-like and OCD behaviors. Locomotor activity was however not affected. Conclusion: It may be concluded that In-utero exposure to experimental malaria in mice causes behavioral changes. [ABSTRACT FROM AUTHOR]

Exposure to heat stress (HS) during the dry period not only exerts negative effects on the welfare of pregnant cows, but also impairs the development of the fetus in the utero. When dams are subjected to late-gestation HS, affectations to their placental function and blood placental flow occur, generating fetal hypoxia and growth retardation of their calves. Since on the last 60 d of gestation bovine fetuses undergo through a phase of accelerated growth where they accrue around 60% of their birth weight, the number of days that their dams become exposed to HS during this period could affect differently their body weight and oxygenation status at birth. Therefore, the objective of this study was to determine the effects of different late-gestation HS time-windows on the birth weight and oxygen saturation of newborn Holstein calves. The study was conducted at the Yaqui valley in northwest México, a semiarid zone where the temperature and humidity index (THI) exceeds the dairy cattle thermal threshold from mid-March to mid-October (~7 months). Under such environmental dynamic, all cows within this geographical zone experience HS at some point during their gestation; nonetheless, depending on the conception date of the cow, different late-gestation HS time-windows arise. To assess the influence of the number of days of intrauterine HS exposure during late gestation (e.g., days with an average THI > 72 units), three intrauterine heat-stressed groups of calves were formed: G1 = calves born to dams exposed to HS less than 20 d within the last 60 d of gestation (n = 30), G2 = calves born to dams exposed to HS between 21 and 40 d within the last 60 d of gestation (n = 20), and G3 = calves born to dams exposed to HS for more than 40 d within the last 60 d of gestation (n = 16). Upon calving, variables such as sex, birth weight (BW, kg) and oxygen saturation (SpO2, %) were recorded. A general linear model that included the effects of sex of the calf and intrauterine HS calves' group was implemented to analyze BW and SpO2. Harmonic means were compared via the Tukey-Kramer test. Harmonic means (±SE) for BW and SpO2 among groups were 42.42 ± 0.92, 40.84 ± 1.11, and 34.73 ± 1.24 kg, and 78.16 ± 2.71, 82.52 ± 3.28, and 82.29 ± 3.68 %, for G1, G2 and G3, respectively. Significant differences (P < 0.001) were found only for BW, with calves of G3 exhibiting the lowest BW in comparison to calves within G1 and G2, which were not statistically different among themselves (P > 0.05). Results of this study indicated that intrauterine HS exposures of >40 d strive deleterious effects on fetal growth and reduce the BW of newborn Holstein calves from northwest México. [ABSTRACT FROM AUTHOR]

Cannabinoids can cross the placenta, thus may interfere with fetal endocannabinoid signaling during neurodevelopment, causing long-lasting deficits. Despite increasing reports of cannabis consumption during pregnancy, the protracted consequences of prenatal cannabinoid exposure (PCE) remain incompletely understood. Here, we report sex-specific differences in behavioral and neuronal deficits in the adult progeny of rat dams exposed to low doses of cannabinoids during gestation. In males, PCE reduced social interaction, ablated endocannabinoid long-term depression (LTD) and heightened excitability of prefrontal cortex pyramidal neurons, while females were spared. Group 1 mGluR and endocannabinoid signaling regulate emotional behavior and synaptic plasticity. Notably, sex-differences following PCE included levels of mGluR1/5 and TRPV1R mRNA. Finally, positive allosteric modulation of mGlu5 and enhancement of anandamide levels restored LTD and social interaction in PCE adult males. Together, these results highlight marked sexual differences in the effects of PCE and introduce strategies for reversing detrimental effects of PCE.

Being exposed to cannabinoids in the womb has different consequences for male and female rats.

Delayed passage of meconium or constipation during the perinatal period is traditionally regarded as a signal to initiate further work up to evaluate for serious diagnoses such as Hirschsprung's disease (HD), meconium ileus due to Cystic Fibrosis, etc. The diagnosis of HD particularly warrants invasive testing to confirm the diagnosis, such as anorectal manometry or rectal suction biopsy. What if there was another etiology of perinatal constipation, that is far lesser known? Cow's milk protein allergy (CMPA) is often diagnosed in infants within the first few weeks of life, however, there are studies that show that the CMPA allergen can be passed from mother to an infant in-utero, therefore allowing symptoms to show as early as day one of life. The presentation is more atypical, with perinatal constipation rather than with bloody stools, diarrhea, and vomiting. The diagnosis and management would be avoidance of cow's milk protein within the diet, with results and symptom improvement in patients immediately. Therefore, we discuss whether an alternative pathway to address perinatal constipation should be further discussed and implemented to potentially avoid invasive techniques in patients. This entails first ruling out CMPA with safe, noninvasive techniques with diet modification, and if unsuccessful, then moving forward with further diagnostic modalities., Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: A number of phenols and parabens are added to consumer products for a variety of functions, and have been found at detectable levels in the majority of the U.S. population. Among other functions, thyroid hormones are essential in fetal neurodevelopment, and could be impacted by the endocrine disrupting effects of phenols and parabens. The present study investigated the association between ten maternal urinary phenol and paraben biomarkers (bisphenol S, triclosan, triclocarban, benzophenone-3, 2,4-dichlorophenol, 2,5-dichlorophenol, and ethyl, butyl, methyl and propyl paraben) and four plasma thyroid hormones in 439 pregnant women in a case–control sample nested within a cohort study based in Boston, MA. Methods: Urine and blood samples were collected from up to four visits during pregnancy (median weeks of gestation at each visit: Visit 1: 9.64, Visit 2: 17.9, Visit 3: 26.0, Visit 4: 35.1). Linear mixed models were constructed to take into account the repeated measures jointly, followed by multivariate linear regression models stratified by gestational age to explore potential windows of susceptibility. Results: We observed decreased total triiodothyronine (T3) in relation to an IQR increase in benzophenone-3 (percent change [%Δ] = −2.07; 95% confidence interval [CI] = −4.16, 0.01), butyl paraben (%Δ = −2.76; 95% CI = −5.25, −0.26) and triclosan (%Δ = −2.53; 95% CI = −4.75, −0.30), and triclocarban at levels above the LOD (%Δ = −5.71; 95% CI = −10.45, −0.97). A 2.41% increase in T3 was associated with an IQR increase in methyl paraben (95% CI = 0.58, 4.24). We also detected a negative association between free thyroxine (FT4) and propyl paraben (%Δ = −3.14; 95% CI = −6.12, −0.06), and a suggestive positive association between total thyroxine (T4) and methyl paraben (%Δ = 1.19; 95% CI = −0.10, 2.47). Gestational age-specific multivariate regression analyses showed that the magnitude and direction of some of the observed associations were dependent on the timing of exposure. Conclusion: Certain phenols and parabens were associated with altered thyroid hormone levels during pregnancy, and the timing of exposure influenced the association between phenol and paraben, and hormone concentrations. These changes may contribute to downstream maternal and fetal health outcomes. Additional research is required to replicate the associations, and determine the potential biological mechanisms underlying the observed associations. [ABSTRACT FROM AUTHOR]

Most sacrococcygeal teratomas present between the 22nd and the 34th week of gestation. The diagnosis of sacrococcygeal teratoma on routine antenatal sonograms is associated with a greater than expected incidence of prenatal and perinatal complications. We report a premature baby with intrauterine spontaneous rupture of giant sacrococcygeal teratoma which was managed successfully.

Introduction: Timely diagnosis is necessary to avert early death in HIV-infected neonates. Birth PCR testing may improve early identification and facilitate access to care. We implemented a birth HIV diagnosis programme in Johannesburg, South Africa and present successes and challenges of the first two and a half years of operation. Methods: Between June 2014 and December 2016, we sought to identify all HIV-exposed births and offer newborn HIV PCR testing before discharge after delivery. The programme identified newly delivered women who had tested positive during pregnancy and provided post-partum HIV antibody testing for women without recent negative results. HIV-positive women were required to consent for neonatal birth testing and asked to return a week later to obtain their results. Neonatal venous blood was sampled and tested at the national laboratory using Roche COBAS® TaqMan® HIV-1 Qualitative Test (Version 2.0). Non-negative results triggered active follow-up for confirmatory testing and appropriate treatment. Results: Of 30,591 women with live births, 6864 (22.4%) were known to be HIV positive and an additional 221 women (1.4% of those tested) were identified during maternal postnatal testing. Of 7085 HIV-positive women, 6372 (89.9%) were interviewed and agreed to data collection, 6358 (99.8%) consented to birth testing for 6467 neonates and a blood sample was collected for 6377 (98.6%). If tested, 6210 (97.4%) tested negative, 91 (1.4%) positive, 57 (0.9%) revealed errors and 19 (0.3%) were indeterminate. Seven of the 19 neonates with indeterminate results and one with initial error result were found to be infected on subsequent testing yielding an intrauterine transmission rate of 1.6% (95% CI: 1.3-1.9). Sixteen (16%) of 99 infected infants were born to women (n = 221) identified during postnatal testing. With active outreach, 95/99 (96%) infected infants were initiated on antiretroviral therapy. Of 6261 neonates with negative results, 3251 (52%) returned to receive their test results. Conclusion: Our programme successfully achieved high coverage and uptake of birth PCR testing and was able, with active tracking, to start almost all identified HIV-infected neonates on antiretroviral therapy. Implementation required additional staff for counselling, quality control and outreach. Return for negative results was low and neonates with indeterminate results required multiple repeat tests. [ABSTRACT FROM AUTHOR]

Background: Maternal-infant transmission of hepatitis B virus(HBV) occurs even after passive-active immunization. Some scholars speculate that in-utero infection may be the main cause of immunoprophylaxis failure. However, there is a lack of evidence about the possible occurrence periods of perinatal transmission.Methods: From 2008 to 2012, 428 pairs of HBsAg-positive mothers and neonates were enrolled and 385 infants aged 8-12 months were followed. HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, HBV-DNA) were performed on all subjects.Results: Of mothers who were positive for HBsAg, HBeAg, HBV-DNA, 35.1 %, 94.3 %, 12.7 % of their neonates were positive for those indices, respectively. Neonates' mean titers of those indices were significantly lower than their mothers'. There were no significant differences in rates of positivity and mean titers of anti-HBe and anti-HBc between neonates and mothers. Most of the positive indices turned negative during the follow-up period. Immunoprophylaxis failed in seventeen infants: four infants had HBV-DNA > 6 log 10copies/mL both at birth and in follow-up; in six infants, mean viral load was 3.72 ± 0.17 log 10copies/mLat birth and 7.62 ± 0.14 log 10copies/mL at follow-up; seven infants were HBV-DNA negative at birth but were found to have > 6 log 10copies/mL during follow-up. Infants that were immunoprophylaxis failures were all born to HBeAg-positive mothers with HBV-DNA > 6 log 10copies/mL.Conclusions: The placental barrier can partly prevent maternal HBsAg, HBeAg, HBV-DNA from passing through to fetus. Performing HBsAg, HBeAg, HBV-DNA once at birth can neither diagnose nor exclude maternal-infant transmission. The diagnosis of infection period depends on the dynamic changes in viral load from birth through the follow-up period but whether the infection occurred in utero, at delivery or during the neonatal period could not be determined. [ABSTRACT FROM AUTHOR]

There is accumulating evidence that methamphetamine (MA) is a widely abused drug popular among pregnant women. MA exposure is associated with changes in the function of neurotransmitter systems, namely the dopaminergic, serotonergic and glutamatergic systems. Since N-methyl- d-aspartate receptors (NMDA) are affected by MA-induced glutamate release, we assessed the expression of NMDAR subunits (NR1, NR2A, and NR2B) and postsynaptic density protein 95 (PSD-95), which is connected with NMDAR. We measured the expression of these proteins in adolescent (30 days old) and adult (60 days old) rat males exposed to MA during the entire prenatal period and compared them with the same parameters in age matched saline-exposed rats. There was a significant increase in the NR1 and NR2B subunits in the hippocampus of adult males, but not in adolescent males. We identified a significant change in adult MA-induced rats when compared to adult controls for NR2A and NR2B, while in adolescent MA rats this change was close to the boundary of significance. In summary, our study suggests that prenatal MA exposure is connected with changes in NMDAR subunit expression in adult rats but not in adolescent rats. [ABSTRACT FROM AUTHOR]