Publications
465 results found
Li JK, Kim H, Johnson M, 2019, Investigating PKA and AKIP Mediated Regulation of NF-kB Transcriptional Activity in Primary Myometrial Cells., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 218A-219A, ISSN: 1933-7191
Nasri NM, Leiper J, Johnson M, 2019, Gender Dimorphism Following Sepsis Induction in a Mouse Model., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 214A-214A, ISSN: 1933-7191
Nasri NM, Leiper J, Johnson M, 2019, Neutrophils Infiltration Leads to Acute Lung Injury in CCR2 Deficiency Sepsis Mice Model., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 122A-122A, ISSN: 1933-7191
Varley A, Koschinski A, Jayarajan V, et al., 2019, Real-Time Visualisation of the cAMP Signalling Dynamics in Human Primary Myometrial Cells Using Targeted FRET Reporters., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 308A-308A, ISSN: 1933-7191
Varley A, Yulia A, Lei K, et al., 2019, Novel and Transformative Changes in the cAMP Effector Pathway in Three Distinct Types of Preterm Labour., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 219A-220A, ISSN: 1933-7191
West K, Kanu C, Maric T, et al., 2019, Maternal and neonatal metabolomic profile in pregnancies following bariatric surgery, Publisher: WILEY, Pages: 30-30, ISSN: 1470-0328
Cauldwell M, Steer PJ, Curtis S, et al., 2019, Maternal and fetal outcomes in pregnancies complicated by the inherited aortopathy Loeys-Dietz syndrome, BJOG: An International Journal of Obstetrics and Gynaecology, Vol: 126, Pages: 1025-1031, ISSN: 1470-0328
ObjectivePregnancies in women with Loeys–Dietz syndrome (LDS) are rare and are typically documented in case reports only. Early reports suggested high rates of maternal complications during pregnancy and the puerperium, including aortic dissection and uterine rupture, but information on fetal outcomes was very limited.DesignA retrospective cohort study.SettingEight specialist UK centres.SamplePregnant women with LDS.MethodsData was collated on cardiac, obstetric, and neonatal outcomes.Main outcome measuresMaternal and perinatal outcomes in pregnancies complicated by LDS.ResultsTwenty pregnancies in 13 women with LDS were identified. There was one miscarriage, one termination of pregnancy, and 18 livebirths. In eight women the diagnosis was known prior to pregnancy but only one woman had preconception counselling. In four women the diagnosis was made during pregnancy through positive genotyping, and the other was diagnosed following delivery. Five women had a family history of aortic dissection. There were no aortic dissections in our cohort during pregnancy or postpartum. Obstetric complications were common, including postpartum haemorrhage (33%) and preterm delivery (50%). In all, 14/18 (78%) of deliveries were by elective caesarean section, at a median gestational age at delivery of 37 weeks. Over half the infants (56%) were admitted to the neonatal unit following delivery.ConclusionWomen with LDS require multidisciplinary specialist management throughout pregnancy. Women should be referred for preconception counselling to make informed decisions around pregnancy risk and outcomes. Early elective preterm delivery needs to be balanced against a high infant admission rate to the neonatal unit.
Cauldwell M, Steer P, Sterrenburg M, et al., 2019, Birth weight in pregnancies complicated by maternal heart disease, Heart, Vol: 105, Pages: 391-398, ISSN: 1355-6037
Objective To assess median and percentile birthweight distribution in women with various groups of heart disease relative to a contemporaneous comparison group. Methods Data on birth weight and gestational age were collected from 1321 pregnancies ≥24 weeks' gestation in 1053 women with heart disease from seven UK maternity units. Women were assigned to one of 16 groups according to their cardiac lesion. In units where it was possible, data on two births, one delivering before and one after index cases, were collected, giving 2307 comparators. Birthweight percentiles (corrected for gestational age, sex and parity) were calculated using Aberdeen norms. We assessed the association of birth weight with cardiac lesion, maternal hypoxaemia (saturations <90%), systemic ventricular function and beta-blockers. Results 1321 pregnancies in women with heart disease and 2307 comparators were studied. Almost all groups with heart disease had lower median and percentile birth weights than comparators, significantly in 10 groups, the biggest effect seen in women with Fontan circulation, pulmonary hypertension, prosthetic heart valves, systemic right ventricle, Marfan syndrome, repaired tetralogy of Fallot and cardiomyopathy (in that order). In 307 pregnancies, women took beta-blockers; median birth weight adjusted for maternal age, parity and the effect of the cardiac lesion was 3116.7 g (IQR 790.4) when beta-blockers were used and 3354.3 g (IQR 634.1) when they were not (p<0.001). 17 women had saturations <90%, and median birth weight was significantly lower, 3105.4 g (IQR 1288.9) versus 3387.7 g (IQR 729.8) (p=0.006). Conclusion Our findings identify specific groups of women with heart disease at risk of having a small baby.
Cauldwell M, Johnson M, Jahangiri M, et al., 2019, Cardiac interventions and cardiac surgery and pregnancy, International Journal of Cardiology, Vol: 276, Pages: 43-47, ISSN: 0167-5273
Both cardiac surgery and cardiac interventions are rare in pregnancy but are generally more common in the developing world. Women with known cardiac disease should receive contemporaneous preconception counselling to assess all risks associated with pregnancy including whether surgery or cardiac interventions may need to be considered prior to pregnancy. Some women may need to undergo emergency surgery or procedures during pregnancy and decisions regarding this should be multidisciplinary including cardiologists, cardiac surgeons, anaesthetists, obstetricians and neonatologists. In this review we discuss both conditions where surgery or percutaneous interventions may need to be considered and both the outcomes for the mother and her baby.
Zöllner J, Lambden S, Nasri NM, et al., 2019, Rapid onset of severe septic shock in the pregnant mouse†, Biology of Reproduction, Vol: 100, Pages: 505-513, ISSN: 1529-7268
AIMS: Globally, sepsis is a major cause of mortality through the combination of cardiovascular collapse and multiorgan dysfunction. Pregnancy appears to increase the risk of death in sepsis, but the exact reason for the greater severity is unclear. In this study, we used polymicrobial sepsis induced by cecal ligation and puncture (CLP) and high-dose intraperitoneal lipopolysaccharide (LPS; 10 or 40 mg, serotype 0111: B4) to test the hypotheses that pregnant mice are more susceptible to sepsis and that this susceptibility was mediated through an excessive innate response causing a more severe cardiovascular collapse rather than a reduction in microbe killing. METHODS AND RESULTS: Initial studies found that mortality rates were greater, and that death occurred sooner in pregnant mice exposed to CLP and LPS. In pregnant and nonpregnant CD1 mice monitored with radiotelemetry probes, cardiovascular collapse occurred sooner in pregnant mice, but once initiated, occurred over a similar timescale. In a separate study, tissue, serum, and peritoneal fluid (for protein, flow cytometry, nitric oxide, and bacterial load studies) were collected. At baseline, there was no apparent Th1/Th2 bias in pregnant mice. Post CLP, the circulating cytokine response was the same, but leukocyte infiltration in the lung was greater in pregnant mice, but only TNFα levels were greater in lung tissue. The bacterial load in blood and peritoneal fluid was similar in both groups. CONCLUSION: Sepsis-related mortality was markedly greater in pregnant mice. Cardiovascular collapse and organ dysfunction occurred sooner in pregnancy, but bacterial killing was similar. Circulating and tissue cytokine levels were similar, but immune cell extravasation into other organs was greater in pregnant mice. These data suggest that an excessive innate immune system response as shown by the exaggerated lung infiltration of leukocytes may be responsible for the greater mortality. Approaches that reduce off-site t
Sliwa K, Azibani F, Baard J, et al., 2018, Reducing late maternal death due to cardiovascular disease - A pragmatic pilot study, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 272, Pages: 70-76, ISSN: 0167-5273
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- Citations: 16
Bracewell-Milnes T, Saso S, Nikolaou D, et al., 2018, Investigating the effect of an abnormal cervico-vaginal and endometrial microbiome on assisted reproductive technologies: A systematic review, AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Vol: 80, ISSN: 1046-7408
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- Citations: 32
Ogundipe E, Tusor N, Wang Y, et al., 2018, Randomized controlled trial of brain specific fatty acid supplementation in pregnant women increases brain volumes on MRI scans of their newborn infants, PROSTAGLANDINS LEUKOTRIENES AND ESSENTIAL FATTY ACIDS, Vol: 138, Pages: 6-13, ISSN: 0952-3278
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- Citations: 21
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al., 2018, 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy, European Heart Journal, Vol: 39, Pages: 3165-3241, ISSN: 0195-668X
Azibani F, Libhaber E, Baard J, et al., 2018, Reducing late maternal death due to cardiovascular disease by targeted interventions, European-Society-of-Cardiology Congress, Publisher: OXFORD UNIV PRESS, Pages: 300-300, ISSN: 0195-668X
Shah NM, Imami N, Johnson MR, 2018, Progesterone Modulation of Pregnancy-Related Immune Responses, FRONTIERS IN IMMUNOLOGY, Vol: 9, ISSN: 1664-3224
Progesterone (P4) is an important steroid hormone for the establishment and maintenance of pregnancy and its functional withdrawal in reproductive tissue is linked with the onset of parturition. However, the effects of P4 on adaptive immune responses are poorly understood. In this study, we took a novel approach by comparing the effects of P4 supplementation longitudinally, with treatment using a P4 antagonist mifepristone (RU486) in mid-trimester pregnancies. Thus, we were able to demonstrate the immune-modulatory functions of P4. We show that, in pregnancy, the immune system is increasingly activated (CD38, CCR6) with greater antigen-specific cytotoxic T cell responses (granzyme B). Simultaneously, pregnancy promotes a tolerant immune environment (IL-10 and regulatory-T cells) that gradually reverses prior to the onset of labor. P4 suppresses and RU486 enhances antigen-specific CD4 and CD8 T cell inflammatory cytokine (IFN-γ) and cytotoxic molecule release (granzyme B). P4 and RU486 effectively modulate immune cell-mediated interactions, by regulating differentiated memory T cell subset sensitivity to antigen stimulation. Our results indicate that P4 and RU486, as immune modulators, share a reciprocal relationship. These data unveil key contributions of P4 to the modulation of the maternal immune system and suggests targets for future modulation of maternal immune function during pregnancy.
Sliwa K, Petrie MC, Hilfiker-Kleiner D, et al., 2018, Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 20, Pages: 951-962, ISSN: 1388-9842
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- Citations: 72
Azibani FF, Baard J, Osman A, et al., 2018, Targeted interventions reducing late maternal death due to heart failure, Publisher: WILEY, Pages: 115-116, ISSN: 1388-9842
van Hagen IM, Baart S, Khioe RFS, et al., 2018, Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease, Heart, Vol: 104, Pages: 745-752, ISSN: 1355-6037
Objective Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.Methods The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient–centre–country).Results A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.Conclusion While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome.
Cauldwell M, Wallace S, Malin G, et al., 2018, Birthweight in pregnancies complicated by maternal heart disease: a UK multicentre retrospective cohort study, Publisher: WILEY, Pages: 64-65, ISSN: 1470-0328
Cauldwell M, Dos Santos F, Steer PJ, et al., 2018, Pregnancy in women with congenital heart disease, BMJ: British Medical Journal, Vol: 360, ISSN: 0959-8138
Cocker A, Sivarajasingam S, Dermont S, et al., 2018, Gestational immunological adaptations and anti-viral responses are disrupted in HIV-1+pregnancies, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Elsevier, Pages: 318A-319A, ISSN: 1933-7191
Lai PF, Young RC, Tribe RM, et al., 2018, The Efficacy of Aminophylline and Progesterone Co-Treatment to Suppress Human Myometrial Contractions during Prolonged Exposure., 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 104A-104A, ISSN: 1933-7191
Sassine AJ, Sivarajasingam SP, Cocker ATH, et al., 2018, Erythrocyte oleic acid is correlated with increasing natural killer cells in maternal blood, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Elsevier, Pages: 319A-319A, ISSN: 1933-7191
Shah NM, Sooranna G, Imami N, et al., 2018, Progesterone suppressed ex vivo pregnancy immune responses are reversed with the progesterone antagonist RU486, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Sage, Pages: 314A-314A, ISSN: 1933-7191
Shah NM, Edey L, Sooranna G, et al., 2018, Labour is associated with a decline in Treg function and their modulation of TLR-Ligand induced immune responses, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Sage Publications Inc., Pages: 314A-314A, ISSN: 1071-5576
Sivarajasingam SP, Cocker ATH, Sassine AJ, et al., 2018, Disrupted immunological equilibrium of decidual natural killer cells and regulatory T cells with onset of labour, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Elsevier, Pages: 177A-177A, ISSN: 1071-5576
Sassine AJ, Wang Y, Singh N, et al., 2018, Fatty Acid Composition in the Preterm and Term Human Placentae., 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 302A-302A, ISSN: 1933-7191
Cauldwell M, Steer PJ, Bonner S, et al., 2018, Retrospective UK multicentre study of the pregnancy outcomes of women with a Fontan repair, HEART, Vol: 104, Pages: 401-406, ISSN: 1355-6037
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- Citations: 23
Varley A, Koschinski A, Johnson M, et al., 2018, A Novel Method Using Fluorescence Resonance Energy Transfer (FRET) Imaging and Targeted FRET Reporters to Investigate cAMP Function in Human Myometrial Cells., 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 191A-191A, ISSN: 1933-7191
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