Bertucci Micka C, Loose Jan M, Wallace Euan M, Jenkin Graham, Miller Suzanne L
Department of Physiology, Monash University, Clayton, Vic. 3168, Australia.
Reprod Fertil Dev. 2011;23(2):346-52. doi: 10.1071/RD10110.
Perinatal morbidity and mortality are significantly higher in pregnancies complicated by chronic hypoxia and intrauterine growth restriction (IUGR). Clinically, placental insufficiency and IUGR are strongly associated with a fetoplacental inflammatory response. To explore this further, hypoxia was induced in one fetus in twin-bearing pregnant sheep (n=9) by performing single umbilical artery ligation (SUAL) at 110 days gestation. Five ewes were administered the anti-inflammatory drug sulfasalazine (SSZ) daily, beginning 24h before surgery. Fetal blood gases and inflammatory markers were examined. In both SSZ- and placebo-treated ewes, SUAL fetuses were hypoxic and growth-restricted at 1 week (P<0.05). A fetoplacental inflammatory response was observed in SUAL pregnancies, with elevated pro-inflammatory cytokines, activin A and prostaglandin E(2). SSZ did not mitigate this inflammatory response. It is concluded that SUAL induces fetal hypoxia and a fetoplacental inflammatory response and that SSZ does not improve oxygenation or reduce inflammation. Further studies to explore whether alternative anti-inflammatory treatments may improve IUGR outcomes are warranted.
在合并慢性缺氧和宫内生长受限（IUGR）的妊娠中，围产期发病率和死亡率显著更高。临床上，胎盘功能不全和IUGR与胎儿-胎盘炎症反应密切相关。为了进一步探究这一问题，在妊娠110天时，通过对怀有双胎的孕羊（n = 9）中的一只胎儿进行单脐动脉结扎（SUAL）来诱导缺氧。五只母羊在手术前24小时开始每天服用抗炎药物柳氮磺胺吡啶（SSZ）。检测胎儿血气和炎症标志物。在接受SSZ治疗和安慰剂治疗的母羊中，SUAL胎儿在1周时均出现缺氧和生长受限（P<0.05）。在SUAL妊娠中观察到胎儿-胎盘炎症反应，促炎细胞因子、激活素A和前列腺素E（2）升高。SSZ并未减轻这种炎症反应。得出的结论是，SUAL会诱导胎儿缺氧和胎儿-胎盘炎症反应，且SSZ不能改善氧合或减轻炎症。有必要进行进一步研究，以探索替代抗炎治疗是否可能改善IUGR结局。
