The studies outlined are directed at nutrient transport and its relationship to blood flow in pregnancies complicated by intrauterine growth retardation (IUGR). The transport of the 9 essential amino acids across the placenta will be studied using stable isotopes and determining the fetal/maternal enrichments and tracer concentration ratios in normal and IUGR pregnancies. IUGR pregnancies are classified by clinical severity based upon velocimetry findings and FHR data. These data on amino acid transport will be analyzed for the impact of variations in umbilical blood flow directly measured with power Doppler techniques. This will establish whether delivery of amino acids to the fetus in IUGR pregnancies is impacted by a reduction in umbilical blood flow and whether this relationship is nonlinear. The non-glucose carbohydrates including the polyols will be measured in normal and IUGR pregnancies. Specific attention is given to D-mannose and myoinositol which are studied with stable isotopes of each sugar and of D-glucose infused into the maternal circulation till steady state enrichments are established. At that time, the fetal/maternal enrichment ratios for both myoinositol and D-mannose are determined. The glucose carbon incorporation into both mannose and myoinositol will be compared in normal and IUGR pregnancies. The studies will establish which, if any, of these carbohydrates relies upon transplacental transport vs. synthesis within the fetal or placental tissues. It will determine if the transplacental gradient for some carbohydrates and polyols are increased in IUGR pregnancies as the gradient is for glucose. Finally, the impact upon the IUGR newborn of an enormous reduction in hepatic blood flow in utero will be assessed. The newborns with a marked reduction in hepatic blood flow can be detected in utero from the reduction in umbilical blood flow coupled with an increase in the ductus venosus shunt. Evidence of hepatocellular damage will be sought at delivery by analysis of cord blood for specific clotting factors and hepatic enzymes. In addition, functional disturbance in neonatal liver function will be assessed by D-galactose plasmal clearance in the newborn after a milk feeding. These studies will establish important links between blood flow changes in the fetus and nutrient delivery to the fetus.
| Jó?wik, Maciej; Jó?wik, Marcin; Teng, Cecilia et al. (2013) Human breast milk sugars and polyols over the first 10 puerperium days. Am J Hum Biol 25:198-204 |
| Staat, Barton C; Galan, Henry L; Harwood, Jeri E F et al. (2012) Transplacental supply of mannose and inositol in uncomplicated pregnancies using stable isotopes. J Clin Endocrinol Metab 97:2497-502 |
| Marconi, Anna Maria; Mariotti, Valentina; Teng, Cecilia et al. (2010) Effect of antenatal betamethasone on maternal and fetal amino acid concentration. Am J Obstet Gynecol 202:166.e1-6 |
| Galan, Henry L; Marconi, Anna Maria; Paolini, Cinzia L et al. (2009) The transplacental transport of essential amino acids in uncomplicated human pregnancies. Am J Obstet Gynecol 200:91.e1-7 |
| Arroyo, Juan A; Teng, Cecilia; Battaglia, Frederick C et al. (2009) Determination of the NFAT5/TonEBP transcription factor in the human and ovine placenta. Syst Biol Reprod Med 55:164-70 |
| Marconi, Anna Maria; Ronzoni, Stefania; Vailati, Simona et al. (2009) Neonatal morbidity and mortality in intrauterine growth restricted (IUGR) pregnancies is predicated upon prenatal diagnosis of clinical severity. Reprod Sci 16:373-9 |
| Marconi, Anna Maria; Ronzoni, Stefania; Bozzetti, Patrizia et al. (2008) Comparison of fetal and neonatal growth curves in detecting growth restriction. Obstet Gynecol 112:1227-34 |
| Brown, Laura D; Cavalli, Claudio; Harwood, Jeri E F et al. (2008) Plasma concentrations of carbohydrates and sugar alcohols in term newborns after milk feeding. Pediatr Res 64:189-93 |
| Pennati, Giancarlo; Socci, Laura; Rigano, Serena et al. (2008) Computational patient-specific models based on 3-D ultrasound data to quantify uterine arterial flow during pregnancy. IEEE Trans Med Imaging 27:1715-22 |
| Rigano, Serena; Bozzo, Maddalena; Padoan, Alessandra et al. (2008) Small size-specific umbilical vein diameter in severe growth restricted fetuses that die in utero. Prenat Diagn 28:908-13 |
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