Browsing by Author "Mittal, Pooja"

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    A role for CXCL13 in the host response to intra-amniotic infection
    (2007) Nhan-Chang, Chia-Ling; Romero, Roberto; Kusanovic, Juan Pedro; Gotsch, Francesca; Edwin, Samuel S.; Erez, Offer; Mittal, Pooja; Espinoza, Jimmy; Friel, Lara; Vaisbuch, Edi; Than, Nandor Gabor; Mazaki-Tovi, Shali; Hassan, Sonia
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    Could alterations in maternal plasma visfatin concentration participate in the phenotype definition of preeclampsia and SGA?
    (TAYLOR & FRANCIS LTD, 2010) Mazaki Tovi, Shali; Romero, Roberto; Kim, Sun Kwon; Vaisbuch, Edi; Kusanovic, Juan Pedro; Erez, Offer; Chaiworapongsa, Tinnakorn; Gotsch, Francesca; Mittal, Pooja; Nhan Chang, Chia Ling; Than, Nandor Gabor; Gomez, Ricardo; Nien, Jyh Kae; Edwin, Samuel S.; Pacora, Percy; Yeo, Lami; Hassan, Sonia S.
    Objective. Women with preeclampsia and those who delivered a small-for-gestational-age (SGA) neonate share several mechanisms of disease, including chronic uteroplacental ischemia and failure of physiologic transformation of the spiral arteries. However, the clinical manifestation of these obstetrical syndromes is remarkably different. It has been proposed that an altered maternal metabolic state, as well as a unique circulating cytokines milieu, predispose women to develop either preeclampsia or SGA. Compelling evidence suggests that adipose tissue orchestrates both metabolic pathways and immunological responses via the production of adipokines. Visfatin is a novel adipocytokine with metabolic and immunomodulating properties. The objective of this study was to determine whether preeclampsia and SGA are associated with alterations in maternal circulating visfatin concentrations.
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    Does a perturbation in visfatin homeostasis participate in the phenotype definition of preeclampsia and SGA?
    (2009) Kim, Sun Kwon; Romero, Roberto; Mazaki-Tovi, Shali; Kusanovic, Juan Pedro; Vaisbuch, Edi; Erez, Offer; Than, Nandor; Gotsch, Francesca; Nhan-Chang, Chia-Ling; Chiaworapongsa, Tinnakorn; Gómez Mora, Ricardo Alberto; Mittal, Pooja; Hassan, Sonia; Pacora, Percy; Yeo, Lami
    Objective: Women with preeclampsia (PE) and those who delivered a small for gestational age (SGA) neonate share several mechanisms of disease including: chronic uteroplacental ischemia and failure of physiologic transformation of the spiral arteries. However, the clinical manifestation of these obstetrical syndromes is remarkably different. It has been proposed that an altered maternal metabolic state, as well as a unique circulating cytokines milieu, predispose women to develop either PE or SGA (Ness&Sibai AJOG 2006;195:40). Compelling evidence suggests that adipose tissue orchestrates both metabolic pathways and immunological responses via the production of adipokines. Visfatin is a novel adipocytokine with metabolic and immunomodulating properties. The objective of this study was to determine whether PE and SGA are associated with alterations in maternal circulating visfatin concentrations. Methods: This cross-sectional study included 255 pregnant women in the following groups: 1) normal pregnancy (n = 158); 2) patients with PE (n = 43) of which 32 had an AGA and 11 had an SGA neonate; and 3) patients who delivered an SGA neonate without PE (n = 54). Maternal plasma visfatin concentrations were measured by ELISA. Non-parametric tests and multiple linear regression analysis were used. Results: 1) Women who delivered an SGA neonate had higher median maternal plasma visfatin concentration than those with normal pregnancy (median: 20.0ng/ml, interquartile range: 17.2–24.6 vs. 15.2 ng/ml, 12.1–19.2, respectively; p. Conclusion: 1) Mothers with SGA, but not with PE, had a higher maternal plasma visfatin concentration than those with a normal pregnancy; 2) This finding suggests differential involvement of adipokines in SGA and PE; 3) We propose that perturbation of adipokine homeostasis may be implicated in the phenotypic definition and distinction of PE and SGA
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    Low circulating maternal adiponectin in patients with pyelonephritis: adiponectin at the crossroads of pregnancy and infection
    (2010) Mazaki-Tovi, Shali; Romero, Roberto; Vaisbuch, Edi; Chaiworapongsa, Tinnakorn; Erez, Offer; Mittal, Pooja; Kwon Kim, Sun; Gotsch, Francesca; Lamont, Ronald; Ogge, Giovanna; Pacora, Percy; Goncalves, Luis; Jai Kim, Chong; Gómez Mora, Ricardo Alberto; Espinoza, Jimmy; Hassan, Sonia S.; Kusanovic, Juan Pedro
    Objective: An emerging theme in modern biology is that adipose tissue can respond to metabolic stress, and to inflammatory stimuli, by regulating the secretion of a complex network of soluble mediators, termed adipokines. Adiponectin, the most prevalent circulating adipokine in human, has profound insulin-sensitizing and anti-inflammatory properties. Indeed, the notion that adiponectin plays an important role in the interactions between the metabolic and the immune systems has been strongly suggested. Thus, the aim of this study was to determine if pyelonephritis during pregnancy is associated with changes in maternal serum adiponectin concentrations. Study design: This cross-sectional study included women in the following groups: 1) normal pregnant women (ns200); and 2) pregnant women with pyelonephritis (ns50). Maternal plasma adiponectin concentrations were determined by ELISA. Non-parametric statistics were used for analyses. Results: 1) The median maternal plasma adiponectin concentration was lower in patients with pyelonephritis than in those with a normal pregnancy (P-0.001); 2) among pregnant women with a normal weight, patients with pyelonephritis had a lower median plasma adiponectin concentration than those with a normal pregnancy (P-0.001); 3) similarly, among overweight/obese patients, those with pyelonephritis had a lower median plasma adiponectin concentration than those with a normal pregnancy (P-0.001); and 4) the presence of pyelonephritis was independently associated with maternal plasma adiponectin concentrations after adjustment for maternal age, smoking, gestational age at sampling, and pregestational body mass index (BMI). Conclusion: 1) The findings that acute pyelonephritis in pregnancy is characterized by low maternal plasma concentrations of adiponectin in both lean and overweight/obese patients are novel and concur with the antiinflammatory properties of adiponectin; and 2) the results of this study support the notion that adiponectin may play a role in the intricate interface between inflammation and metabolism during pregnancy
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    Maternal and neonatal circulating visfatin concentrations in patients with pre-eclampsia and a small-for-gestational age neonate
    (TAYLOR & FRANCIS LTD, 2010) Mazaki Tovi, Shali; Vaisbuch, Edi; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Nhan Chang, Chia Ling; Gomez, Ricardo; Savasan, Zeynep Alpay; Madan, Ichchha; Yoon, Bo Hyun; Yeo, Lami; Mittal, Pooja; Ogge, Giovanna; Gonzalez, Juan M.; Hassan, Sonia S.
    Objective. Maternal circulating visfatin concentrations are higher in patients with a small-for-gestational-age (SGA) neonate than in those who delivered an appropriate-for-gestational age (AGA) neonate or in those with pre-eclampsia. It has been proposed that enhanced transfer of visfatin from the foetal to maternal circulation may account for the high concentrations of maternal visfatin observed in patients with an SGA neonate. The aims of this study were: (1) to determine whether cord blood visfatin concentrations differ between normal neonates, SGA neonates and newborns of pre-eclamptic mothers; and (2) to assess the relationship between maternal and foetal circulating visfatin concentrations in patients with an SGA neonate and those with pre-eclampsia.
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    Maternal Plasma Concentration of the Pro-Inflammatory Adipokine Pre-B-Cell-Enhancing Factor (PBEF)/Visfatin Is Elevated In Pregnant Patients with Acute Pyelonephritis
    (WILEY, 2010) Mazaki Tovi, Shali; Vaisbuch, Edi; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Nhan Chang, Chia Ling; Gomez, Ricardo; Yoon, Bo H.; Yeo, Lami; Mittal, Pooja; Ogge, Giovanna; Gonzalez, Juan M.; Hassan, Sonia S.
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    Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods
    (WALTER DE GRUYTER GMBH, 2010) DiGiulio, Daniel B.; Gervasi, MariaTeresa; Romero, Roberto; Mazaki Tovi, Shali; Vaisbuch, Edi; Kusanovic, Juan Pedro; Seok, Kimberley S.; Gomez, Ricardo; Mittal, Pooja; Gotsch, Francesca; Chaiworapongsa, Tinnakorn; Oyarzun, Enrique; Kim, Chong Jai; Relman, David A.
    Objective: Infection has been implicated in the pathogenesis of preeclampsia, yet the association between microbial invasion of the amniotic cavity (MIAC) and preeclampsia has not been determined. The aim of this study was to determine the prevalence, and microbial diversity associated with MIAC, as well as the nature of the host response to MIAC in patients with preeclampsia.
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    Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses
    (WALTER DE GRUYTER GMBH, 2010) DiGiulio, Daniel B.; Gervasi, Maria Teresa; Romero, Roberto; Vaisbuch, Edi; Mazaki Tovi, Shali; Kusanovic, Juan Pedro; Seok, Kimberley S.; Gomez, Ricardo; Mittal, Pooja; Gotsch, Francesca; Chaiworapongsa, Tinnakorn; Oyarzun, Enrique; Kim, Chong Jai; Relman, David A.
    Objective: Microbial invasion of the amniotic cavity (MIAC) has been detected in women with preterm labor, preterm prelabor rupture of membranes (PROM), and in patients at term with PROM or in spontaneous labor. Intrauterine infection is recognized as a potential cause of fetal growth restriction; yet, the frequency of MIAC in pregnancies with small-for-gestational-age (SGA) fetuses is unknown. The aim of this study was to determine the frequency, diversity and relative abundance of microbes in amniotic fluid (AF) of women with an SGA neonate using a combination of culture and molecular methods.
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    Should Bilateral Uterine Artery Notching Be Used in the Risk Assessment for Preeclampsia, Small-for-Gestational-Age, and Gestational Hypertension?
    (WILEY, 2010) Espinoza, Jimmy; Kusanovic, Juan Pedro; Bahado Singh, Ray; Gervasi, Maria Teresa; Romero, Roberto; Lee, Wesley; Vaisbuch, Edi; Mazaki Tovi, Shali; Mittal, Pooja; Gotsch, Francesca; Erez, Offer; Gomez, Ricardo; Yeo, Lami; Hassan, Sonia S.
    Objective. The purpose of this study was to determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational-age (SGA) without preeclampsia. Methods. This prospective cohort study included 4190 singleton pregnancies that underwent ultrasound examination between 23 and 25 weeks' gestation. The 95th percentiles of the mean pulsatility index (PI) and resistive index (RI) of both uterine arteries were calculated. Multivariable logistic regression analyses were performed to determine if bilateral uterine artery notching is an independent explanatory variable for the occurrence of preeclampsia, early-onset preeclampsia (<= 34 weeks), late-onset preeclampsia (>34 weeks), gestational hypertension, and delivery of an SGA neonate without preeclampsia, while controlling for confounding factors. Results. (1) The prevalence of preeclampsia, early-onset preeclampsia, late-onset preeclampsia, SGA, and gestational hypertension were 3.4%, 0.5%, 2.9%, 10%, and 7.9%, respectively; (2) 7.2% of the study population had bilateral uterine artery notching; and (3) bilateral uterine artery notching was an independent explanatory variable for the development of preeclampsia (odds ratio [OR] 2.1; 95% confidence interval [CI], 1.28-3.36), early-onset preeclampsia (OR, 4.47; 95% CI, 1.50-13.35), and gestational hypertension (OR, 1.50; 95% CI, 1.02-2.26), but not for late-onset preeclampsia or SGA. Conclusions. Bilateral uterine notching between 23 and 25 weeks' gestation is an independent risk factor for the development of early-onset preeclampsia and gestational hypertension. Thus, bilateral uterine artery notching should be considered in the assessment of risk for the development of these pregnancy complications.
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    Spontaneous labor at term is characterized by specific differential expression of microRNAs: A novel mechanism for post-transcriptional gene expression regulation in human parturition
    (2006) Pineles, Beth L.; Romero, Roberto; Montenegro, Daniel; Kim, Jung-Sun; Tarca, Adi L.; Kusanovic, Juan Pedro; Mittal, Pooja; Hassan, Sonia; Espinoza, Jimmy; Kim, Chong Jai
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    The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age
    (TAYLOR & FRANCIS LTD, 2008) Erez, Offer; Romero, Roberto; Espinoza, Jimmy; Fu, Wenjiang; Todem, David; Kusanovic, Juan Pedro; Gotsch, Francesca; Edwin, Samuel; Nien, Jyh Kae; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Mazaki Tovi, Shali; Than, Nandor Gabor; Gomez, Ricardo; Hassan, Sonia S.
    Introduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate.
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    The clinical significance of eosinophils in the amniotic fluid in preterm labor
    (TAYLOR & FRANCIS LTD, 2010) Romero, Roberto; Kusanovic, Juan Pedro; Gomez, Ricardo; Lamont, Ronald; Bytautiene, Egle; Garfield, Robert E.; Mittal, Pooja; Hassan, Sonia S.; Yeo, Lami
    Methods. This retrospective case-control study included women who presented with preterm labor and intact membranes between 24 and 34 weeks of gestation. Patients underwent an amniocentesis shortly after admission for the assessment of the microbiologic status of the amniotic cavity and/or fetal lung maturity. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as genital mycoplasmas. Cytologic studies included amniotic fluid white blood cell count and differential, which was performed on cytocentrifuged specimens. Patients with microbial invasion of the amniotic cavity and/or an amniotic fluid white blood cell count > 20 cells/mm 20% of eosinophils. Controls were selected among women with an amniotic fluid eosinophil count < 20% and matched for gestational age at amniocentesis. The analysis was conducted with non-parametric statistics.
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    The pattern and magnitude of "in vivo thrombin generation" differ in women with preeclampsia and in those with SGA fetuses without preeclampsia
    (2018) Erez, Offer; Romero, Roberto; Vaisbuch, Edi; Pedro Kusanovic, Juan; Mazaki-Tovi, Shali; Chaiworapongsa, Tinnakorn; Gotsch, Francesca; Mittal, Pooja; Edwin, Samuel S.; Nhan-Chang, Chia-Ling; Than, Nandor Gabor; Kim, Chong Jai; Kim, Sun Kwon; Yeo, Lami; Mazor, Moshe; Hassan, Sonia S.
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    The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD)
    (WALTER DE GRUYTER GMBH, 2010) Kim, Sun Kwon; Romero, Roberto; Kusanovic, Juan Pedro; Erez, Offer; Vaisbuch, Edi; Mazaki Tovi, Shali; Gotsch, Francesca; Mittal, Pooja; Chaiworapongsa, Tinnakorn; Pacora, Percy; Ogge, Giovanna; Gomez, Ricardo; Yoon, Bo Hyun; Yeo, Lami; Lamont, Ronald F.; Hassan, Sonia S.
    Objective: Intrauterine devices (IUDs) are used for contraception worldwide; however, the management of pregnancies with an IUD poses a clinical challenge. The purpose of this study was to determine the outcome of pregnancy in patients with an IUD.
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    Tissue factor activity in women with preeclampsia or SGA: a potential explanation for the excessive thrombin generation in these syndromes
    (2018) Erez, Offer; Romero, Roberto; Vaisbuch, Edi; Than, Nandor Gabor; Pedro Kusanovic, Juan; Mazaki-Tovi, Shali; Gotsch, Francesca; Mittal, Pooja; Dong, Zhong; Chaiworapongsa, Tinnakorn; Kim, Chong Jai; Nhan-Chang, Chia-Ling; Kim, Sun Kwon; Yeo, L