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El objetivo del estudio fue comparar el índice de madurez placentaria y las alteraciones histopatológicas en placentas de recién nacidos/óbitos con y sin defecto congénito (DC). Se realizó un estudio tipo casos y controles. Se incluyeron n=25 casos yn=50 controles sin DC. Los casos se clasificaron de acuerdo a la presencia de DC aislado (n=17) omúltiple (n=8). Se incluyeron recién nacidos/óbitos (RN) con una edad gestacional (EG) > 20 semanas. Se excluyeron embarazos gemelares. Se recolectó información sobre las características clínicas del producto y de la madre, antropometría del RN y su evaluación de APGAR. Se examinó la placenta, macroscópica y microscópicamente, para determinar la presencia y extensión de alteraciones histopatológicas. Se determinó el índice de madurez placentaria (IMP), calculado dividiendo el número de membranas vásculo sinciciales en 1 mm2 entre el grosor de las mismas (µ). El IMP (media ±DE) fue de 27.77±14 en el grupo de controles, 30.31±12 en el grupo de casos aislados y 16.76± 1 en el grupo de DC múltiple (p<0.05).El resto de las variables evaluadas no mostraron diferencias significativas entre grupos. En conclusión este trabajo muestra una menor madurez placentaria asociada con la presencia de DC múltiple.

The objective of the study was to compare the placental maturity index (PMI) and pathohistological alterations of placentas from newborn/stillborns (NB) with or without congenital defects (CD). A case control study was carried out. N=25 CD cases and n=50 controls without CD were included. Cases were classified according to the presence of simple (n=17) or multiple (n=8) CD. Newborn/stillborns with gestational age >20 weeks were included. Twin pregnancies were excluded. We collected information on clinical characteristics of the NB and the mother, NB anthropometry and APGAR score. The placenta was macro and microscopically examined to determine the presence and extension of histological alterations. The PMI was obtained by dividing the number of vasculo-syncytial membranes in 1 mm2, by their thickness (µ). The PMI (Mean ± SD) was 27.77 ± 14 in the control group, 30.31 ± 12 in the group diagnosed with simple CD, and 16.76 ± 1 in the group diagnosed with multiple CD (p<0.05. The rest of the assessed variables did not show significant difference between groups. In conclusion, this work shows a lower placental maturity associated with the presence of multiple CD.

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El objetivo del trabajo fue realizar una evaluación morfológica externa de recién nacidos (RN) y lactantes con diagnóstico de defectos de tubo neural (DTN) y labio hendido c/s paladar hendido (LH c/s PH) para determinar el tipo de defecto, ubicación, extensión, clasificación y evaluar la proporción de RN con retardo del crecimiento intauterino (RCIU) y lactantes desnutridos. Estudio descriptivo. Se estudiaron 36 niños desde su nacimiento hasta los 12 meses de edad; 20 con DTN y 16 con LH c/s PH. El estudio se realizó en cinco hospitales de la ciudad de Chihuahua, México. Se hizo una evaluación morfológica externa y antropometría de los niños. Los DTN se clasificaron como lesiones abiertas y cerradas, como defectos altos o bajos, según el modelo de sitios múltiples y por la CIE-10. Los LH c/s PH se clasificaron como unilaterales o bilaterales, completos e incompletos y como aislados o múltiples. Se determinó RCIU en los RN y desnutrición en los lactantes. El análisis estadístico se realizó con el paquete STATA 8.0 para Windows. Se estudiaron 20 casos de DTN; 3 lactantes y 17 RN. De LH c/s PH fueron 8 lactantes y 8 RN. En cuanto a los DTN, 60 por ciento fueron mielomeningocele y correspondían a lesiones abiertas. El 85 por ciento se localizaron a nivel alto. En el modelo de cierres múltiples, el Z1 fue el 80 por ciento. Los LH c/s PH más frecuentes fueron aquellos con hendidura completa (50 por ciento). El 35 por ciento de los RN con DTN tuvieron RCIU y el 67 por ciento de los lactantes presentaron desnutrición. Es importante conocer los mecanismos del desarrollo de las anomalías congénitas ya que esto permite precisar el momento en que ocurrió la falla y permite estudiar los factores predisponentes, con lo cual se puede ofrecer asesoramiento genético para una posible prevención.

The objective of this study was to perform an external morphological evaluation of newborn (NB) and lactating children (LC) with diagnosis of neural tube defects (NTD) and cleft lip c/s palate (CL/s PH) to determine the type of defect, location, extent, classification and assess the proportion of infants with intrauterine growth retardation (IUGR) and malnourished infants. A descriptive study in 36 children from birth to 12 months of age , 20 with NTD and 16 with LH c / s PH was carried out. The study was conducted in five hospitals in the city of Chihuahua, Mexico. An external morphological assessment and anthropometry of children were performed. The DTN lesions were classified as open and closed, as defects high or low, depending on the model of multiple sites and ICD-10. The LH c / s PH were classified as unilateral or bilateral, complete or incomplete, and as isolated or multiple. IUGR was determined in the RN and malnutrition in infants. A statistic analysis was made with STATA 8.0 for Windows. We studied 20 cases of NTDs, 3 LCs and 17 RN. LH c/s PH were 8 LC and 8 RN. The DTN, 60 percent were myelomeningocele and corresponded to open lesions. Eighty five percent were located at high level. In the model of multiple closures, the Z1 was 80 percent. The LH c/s PH were more frequent with complete cleft (50 percent). The 35 percent of newborns with NTD had IUGR and 67 percent of LC had malnutrition. It is important to understand the mechanisms of development of congenital anomalies as this allows to specify the time the fault occurred and to study the underlying diseases to offer genetic counseling for possible prevention.

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Experimental studies have shown that prenatal exposure to lead (Pb) produces morphological changes related to extracellular matrix remodelling. To analyse whether the matrix metalloproteinases (MMPs), particularly MMP-2, MMP-9, and the tissue inhibitor of metalloproteinases-2 (TIMP-2), are associated with morphological alterations found in placentas, the expression of these enzymes was evaluated by immunohistochemical and image analyses in placentas of women with histories of environmental exposure to Pb. The median maternal concentration of Pb in blood was 4.68 µg/dL (x = 5.85 ± 6.48 µg/dL). Significant differences related to the exposure to Pb were not detected in newborn or placenta weight. MMP-2, MMP-9, and TIMP-2 were expressed in the syncytiotrophoblast layer of placental villi. A significant increase in both MMP-2 and MMP-9 was observed in placentas of women with concentrations of Pb in blood ≥4.68 µg/dL (p = 0.01 and 0.03 for MMP-2 and MMP-9, respectively) and decrease in TIMP-2 expression (p = 0.01) resulted in a significant increase in MMP-2/TIMP-2 ratio (p < 0.01). Increased expression of MMPs may be induced to aid in repairing placental tissue damaged by the exposure to Pb and that TIMP-2 decreases its expression to permit tissue repair. Increased expression of MMPs may be important to consider as a mechanism for generating placental abnormalities and in the induction of preterm delivery or abortion.

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El objetivo del trabajo fue determinar la asociación entre los niveles de ácido fólico, vitamina B (Vit B12) y homocisteína (Hci) maternos, con defectos del tubo neural (DTN) y labio hendido (LH) con y sin paladar hendido (c/s PH). Se realizó un estudio tipo casos y controles. Casos, con diagnóstico de DTN y LH c/s PH (n=36) y cuatro controles hospitalarios por caso (n=141). Se incluyeron recién nacidos (RN) y lactantes hasta 12 meses de edad. Las variables de pareamiento fueron: edad del RN o lactante, etnia y hospital. Un 23 por ciento de etnia Tarahumara y 77 por ciento mestizos. Se determinó ácido fólico intraeritrocitario (AFI), plasmático (AFP) y Vit B12 por radioinmunoensayo, la Hci por inmunoensayo de fluorescencia polarizada. Se consideró deficiencia si el AFI fue <160 ng/mL, AFP <3.5 ng/ mL y la Vit B12 <200 pg/mL e hiperhomocisteinemia, si Hci >15 J.mol/L. El análisis estadístico se realizó a través de regresión logística condicionada. Se identificó deficiencia de AFI en el 22 por ciento de las mujeres cuyos recién nacidos o lactantes presentaron algún tipo de defecto congénito y en el 12 por ciento de los controles. La relación entre AFI y DTN, LH c/s PH ajustada por edad materna, exposición a plaguicidas y zona de residencia fue RM 2,96 (IC 95 por ciento 0,92-9,46). No se encontraron diferencias en los niveles de Hci ni de Vit B12. Conclusiones: Nuestros resultados sugieren que RN cuyas madres cursan con una deficiencia de AFI tienen mayor riesgo de presentar DTN y LH c/s PH.

Objective: To determine the association between maternal folate deficiency, neural tube defects (NTDs), and cleft lip, with and without cleft palate (CL/P). Material and methods: A case/control study was conducted. The cases included subjects with diagnoses of NTD and CL/P (n=36) and four hospital controls per case (n=141); the study included newborns (NBs) and nursing babies up to 12monthsof age. The parameter variables were the following: the age of the NB or nursing baby, the ethnic group, and the hospital of origin. The Tarahumara ethnic group made up 23 percent of the cases, while 77 percent were mestizos. The red cell folate (RCF), the plasma folie acid (PFA), and the vitamin B12 levels were determined by radioimmunoassay and the homocysteine levels by polarized fluorescence immunoassay. A deficiency was considered to be present if the RCF were <160 ng/mL, the PFA <3.5 ng/mL and the vitamin B <200 pg/ mL; hyperhomocysteinemia was defined as HC >15 J,mol/L. The statistical analysis was carried out through of conditional logistic regression. Results: An RCF deficiency was identified in 22 percent of the women whose newborn or nursing babies presented with some type of congenital defect and in 12 percent of the controls. The correlation adjusted by maternal age, exposure to pesticides and zone of residence was OR 2.96 (CI 95 percent 0.92-9.46). There was no difference in vitamin B12 or homocysteine levels between groups. Conclusions: Our results suggest that newborns whose mothers present with an RCF deficiency have an increased risk of displaying NTD and CL/P.

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Placental transfer of methyl parathion (MP), an organophosphate pesticide, could involve effects on cholinergic system. To analyze whether placental cholinergic system is altered by prenatal exposure to MP, expression of muscarinic cholinergic receptors (M1 and M2 subtypes; mAChR) was determined in pregnant rats exposed to MP at 0.0, 1.0, 1.5, and 2.0 mg/kg. An immunohistochemical analysis for M1 and M2 mAChR was performed, and the density of the mAChR signal was measured by image analysis. M1 and M2 mAChR were found in the trophoblast present in the labyrinth, with an 18% predominance of M2 over M1 in the non-exposed group. The expression of M1 and M2 mAChR in placentas exposed to MP showed a decrease when compared with the non-exposed group (P < 0.05); a dose-response effect was not detected. These results demonstrate that prenatal exposure to MP causes changes in the placental expression of mAChR M1 and M2, suggesting that related placental cholinergic functions could be affected.

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BACKGROUND: Evidence from large studies suggests that low birthweight is a risk factor for cardiovascular disease and glucose metabolism disorders in adulthood, but the physiological mechanisms involved in intrauterine growth conditioning low birthweight are not completely understood. The objectives of this study were to determine whether placental immaturity (PI), defined as the lower quartile of placental maturity index (PMI), is associated to hyperinsulinaemia at birth and to identify the risk factors associated with PI. MATERIALS AND METHODS: Cross-sectional study conducted at medical research units of two Mexican general hospitals. A total of 272 full-term newborns with gestational age >/= 38 and < 41 weeks were allocated into the corresponding group according to the quartile distribution of PMI. Data from the lower (PMI < 13.3) and higher quartile (PMI >/= 24.3) were compared. The PMI was estimated by dividing the number of epithelial plates by the average thickness of the epithelial plate. Serum measures included cord glucose and insulin levels of the newborns at birth. RESULTS: A total of 74 (27.2%) children had hyperinsulinaemia at birth, of them 47 (63.5%) with PI. The adjusted multiple regression analysis showed a strong association between PI and hyperinsulinaemia at birth [odds ratio (OR) 2.6; CI 95% 1.3-4.3). Additional adjusted analysis showed that both mother's age

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The objective of this work was to describe the anatomy of placentas from women who were at risk of exposure to parathion during their pregnancy, when examined with the light and scanning electron microscopes. Twenty term placentas were analyzed; 10 from women living in an agricultural area, who were at risk of exposure to parathion during their pregnancy, and 10 from women living in an urban area, not expressly exposed to pesticides. Each sample was examined with both light and scanning electron microscopes. Cholinesterase activity was significantly reduced in blood from women of the exposed group. In some placentas of women exposed to parathion, recent microinfarctions, microcalcifications and increased deposition of fibrinoid material were seen, along with a larger proportion of atypical characteristics of villi, such as bullous and balloon-like formations with nonhomogeneous surface, and other areas devoid of microvilli. These observations suggest that in chronic exposure to pesticides, the rate of atypical characteristics of placental villi increases, which could be related to changes in the fetus biology. In this study, one newborn from the exposed group showed intrauterine growth retardation and another one, some signs of hypoxia.

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Chorioangioma of the placenta is a benign vascular growth most frequently. Many small neoplasms are missed in routine examination of the placenta. The large tumors cause problems for the clinical outcome of the pregnancy or delivery or for the infant. We report a giant chorioangioma of the placenta of ten centimeters diagnosed in delivery by cesarean section in women with gestation third without complications. The benign vascular growth to fetal surface of the placenta. The histological variety was an angioblastic. In this case complication maternal or infant were not diagnosed.

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OBJECTIVE: To establish the relationship of normal, low, and moderate blood iron values in mothers and their newborns. MATERIAL AND METHODS: A cross-sectional study was conducted among 163 pregnant women and their newborns, users of Hospital de Ginecología y Obstetricia número 15, Instituto Mexicano del Seguro Social, from Chihuahua, Mexico. The mothers' clinical histories were collected and analyzed; hemoglobin, hematocrit, and ferritin serum levels were measured in maternal and umbilical cord samples. Iron maternal stores were determined by ferritin (microgram/l) values as follows: low: < or = 11; moderate: 12-20; and normal: > or = 20.1. The Kruskal-Wallis test was used to establish differences among group; the chi-squared test to determine differences of proportions; and Pearson's correlation coefficient for assessing the association between maternal and newborn iron stores. RESULTS: A weak correlation between maternal and neonatal ferritin was found (r = 0.14, p = 0.07). Geometric means of neonatal ferritin for low, moderate, and normal maternal iron stores were 4.77, 4.85, and 5.02 respectively (p = 0.12). The maternal iron stores changed after iron supplementation (p = 0.01). CONCLUSIONS: Iron stores in mothers and their newborns are closely related. Women who take iron supplements during pregnancy have significantly higher iron stores at the end of pregnancy.

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OBJECTIVES: Our purpose was to determine levels of acetyilcholinesterase (AchE) activity in total blood of women during pregnancy, and liverborns, and to analyze the correlation of the enzymatic activity between the capillary and venous sample. PATIENTS, MATERIAL, AND METHODS: We included 205 samples from pregnant (22), second (25), third trimester (36), full term pregnancy (65), non-pregnant women (28), and from Newborns (29). A bivaried analysis was used to analyse the AchE activity and its association with gestational age, body mass index, tobacco addiction, and use of pesticides at home, and hemoglobin concentration. RESULTS: Women at childbirth and at third trimester showed a significant increase in AcE levels by 5.75 + 1.15 U/mL and 4.98 +/- 0.87 U/mL respectively, respect to levels from non-pregnant women (4.59 +/- 0.79 U/mL). Activity in cord's blood was significatively minor (3.78 +/- 0.56 U/mL) compared with levels in non-pregnant women. There was no difference in AchE activity by tobacco addiction, hemoglobin levels, and use of insecticides at home. AchE activity by capillary and venous punction showed a correlation of 0.68 with p < 0.01 and IC 95% = 0.5171-0.8476. CONCLUSIONS: Enzymatic activity showed a normal distribution and could be considered like values from a non-exposure population. We determined that possible confounding factors like tobacco addiction and use of pesticides at home have no significant effects over AchE activity. Our results are important as reference values for studies about AchE activity in women from populations predominantly exposed to pesticides during gestation.

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