Anindita Dutta1, Galina Khramtsova2, Katherine Brito1, Donee Alexander3, Ariel Mueller4, Sireesha Chinthala5, Damilola Adu6, Tope Ibigbami6, John Olamijulo6, Abayomi Odetunde7, Kehinde Adigun8, Liese Pruitt9, Ian Hurley2, Olufunmilayo Olopade1, Oladosu Ojengbede10, Sarosh Rana5, Christopher O Olopade11. 1. Center for Global Health, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA; Center for Clinical Cancer Genetics, Department of Medicine, University of Chicago, IL 60637, USA. 2. Center for Clinical Cancer Genetics, Department of Medicine, University of Chicago, IL 60637, USA. 3. Center for Global Health, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA. 4. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA. 5. Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA. 6. Healthy Life for All Foundation, Ibadan, Nigeria. 7. Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria. 8. Department of Family Medicine, University College Hospital, Ibadan, Nigeria. 9. Department of Surgery, University of Utah, Salt Lake City, UT, USA. 10. Department of Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria; Centre for Population and Reproductive Health, College of Medicine/University College Hospital, University of Ibadan, Nigeria. 11. Center for Global Health, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA; Center for Clinical Cancer Genetics, Department of Medicine, University of Chicago, IL 60637, USA. Electronic address: solopade@bsd.uchicago.edu.
Abstract
BACKGROUND:Household air pollution (HAP) is associated with adverse pregnancy outcomes. OBJECTIVES: Investigate impact of in-utero HAP exposure on placental development and chronic hypoxia. METHODS: Markers of chronic placental hypoxia [Hofbauer cells (HBC), syncytial knots (SK), chorionic vascular density (cVD) and hypoxia-inducible factor (HIF)] were stained by hematoxylin-eosin and/or immunohistochemically in placenta samples collected from firewood-/kerosene-users (A,n=16), and ethanol-users (B,n=20) that participated in a randomized controlled intervention trial in Ibadan, Nigeria. A third group of non-smoking and presumed natural gas-using Chicago women (C,n=12) were included in this exploratory pilot to assess for possible differences in placenta histology between similar racial groups. All patients had uncomplicated pregnancies and delivered at term. RESULTS:HBC, SK and cVD were significantly increased among firewood-/kerosene-users compared to ethanol-users and natural gas-using Chicago women (HBC medians 5.5, 3.5, and 2.0, respectively; SK means 55.6, 41.8 and 30.1; cVD means 8.8, 6.2, and 5.2; all p<0.01). HIF expression was significantly higher in Group A compared to B and C (all p<0.001). CONCLUSIONS: In-utero exposure to HAP is associated with pathologic changes and HIF expression consistent with chronic hypoxia in placenta of firewood/kerosene-users compared to ethanol-users with less HAP exposure and Chicago women with no presumed HAP exposure. Presence of chronic hypoxic signature in placenta of women exposed to HAP has implications for adverse pregnancy complications and future growth and development of the young children. Future larger studies need to focus on HAP exposure and placental disorders like preeclampsia and long-term health impact of in-utero exposure to HAP.
RCT Entities:
BACKGROUND: Household air pollution (HAP) is associated with adverse pregnancy outcomes. OBJECTIVES: Investigate impact of in-utero HAP exposure on placental development and chronic hypoxia. METHODS: Markers of chronic placental hypoxia [Hofbauer cells (HBC), syncytial knots (SK), chorionic vascular density (cVD) and hypoxia-inducible factor (HIF)] were stained by hematoxylin-eosin and/or immunohistochemically in placenta samples collected from firewood-/kerosene-users (A,n=16), and ethanol-users (B,n=20) that participated in a randomized controlled intervention trial in Ibadan, Nigeria. A third group of non-smoking and presumed natural gas-using Chicago women (C,n=12) were included in this exploratory pilot to assess for possible differences in placenta histology between similar racial groups. All patients had uncomplicated pregnancies and delivered at term. RESULTS: HBC, SK and cVD were significantly increased among firewood-/kerosene-users compared to ethanol-users and natural gas-using Chicago women (HBC medians 5.5, 3.5, and 2.0, respectively; SK means 55.6, 41.8 and 30.1; cVD means 8.8, 6.2, and 5.2; all p<0.01). HIF expression was significantly higher in Group A compared to B and C (all p<0.001). CONCLUSIONS: In-utero exposure to HAP is associated with pathologic changes and HIF expression consistent with chronic hypoxia in placenta of firewood/kerosene-users compared to ethanol-users with less HAP exposure and Chicago women with no presumed HAP exposure. Presence of chronic hypoxic signature in placenta of women exposed to HAP has implications for adverse pregnancy complications and future growth and development of the young children. Future larger studies need to focus on HAP exposure and placental disorders like preeclampsia and long-term health impact of in-utero exposure to HAP.
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