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The effect of intrauterine growth restriction on circulating surfactant protein d concentrations in the perinatal period.
MedLine Citation:
PMID:  20360592     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
The aim of this study was to investigate possible alterations in circulating concentrations of surfactant protein D (SP-D)-an important component of the innate immune system that is upregulated in pulmonary diseases-in appropriate for gestational age (AGA) and intrauterine growth-restricted (IUGR) pregnancies, because the latter are characterized by structural lung immaturity, impaired immunocompetence, and increased risk of respiratory infections and chronic obstructive lung disease in later life. Serum SP-D concentrations were determined in 40 mothers and their 20 IUGR and 20 AGA full-term fetuses-neonates on postnatal day 1 (N1) and 4 (N4). Fetal SP-D concentrations were higher in the IUGR group (b = 18.16, 95% CI: 6.86-29.47, P = .002) and negatively correlated with infants' customized centiles and gestational age (r = -.326, P = .04, and r = -.446, P = .004, respectively). In both groups, fetal SP-D concentrations were lower than N1 and N4 ones (P <or= .015 in all cases). In the IUGR group, N1 SP-D concentrations were higher in vaginal deliveries (P = .032). Higher SP-D concentrations in IUGR fetuses may reflect structural lung immaturity, leading to increased alveolar-vascular permeability and protein leakage into the circulation. Alternatively, SP-D production may be increased due to intrauterine glucocorticoid exposure, leading to accelerated lung maturation. Surfactant protein D concentrations postnatally increase and are higher in neonates born vaginally, probably as a consequence of lung liquid reabsorption, concomitant with initiation of breathing and delivery stress. A progressive decrease in placental function may result in downregulated SP-D production, accounting for the negative correlation between fetal SP-D concentrations and gestational age.
Authors:
Despina D Briana; Dimitrios Gourgiotis; Stavroula Baka; Maria Boutsikou; Venetia-Maria Vraila; Theodora Boutsikou; Dimitrios Hassiakos; Ariadne Malamitsi-Puchner
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-01
Journal Detail:
Title:  Reproductive sciences (Thousand Oaks, Calif.)     Volume:  17     ISSN:  1933-7205     ISO Abbreviation:  Reprod Sci     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101291249     Medline TA:  Reprod Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  653-8     Citation Subset:  IM    
Affiliation:
Second Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece.
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