Division of Pediatric Neurology, Department of Pediatrics, Fetal/Neonatal Neurology Program, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital/ MacDonald Hospital for Women, University Hospitals Cleveland Medical Center, 22315 Canterbury Lane, Shaker Heights, OH 44122, USA.
Clin Perinatol. 2024 Sep;51(3):535-550. doi: 10.1016/j.clp.2024.04.001. Epub 2024 May 16.
Reproductive, pregnancy, and placental exposomes influence the fetal neural exposome through toxic stressor interplay, impairing the maternal-placental-fetal (MPF) triad. Neonatal encephalopathy represents different clinical presentations based on complex time-dependent etiopathogenetic mechanisms including hypoxia-ischemia that challenge diagnosis and prognosis. Reproductive, pregnancy, and placental exposomes impair the fetal neural exposome through toxic stressor interplay within the MPF triad. Long intervals often separate disease onset from phenotype. Interdisciplinary fetal-neonatal neurology training, practice, and research closes this knowledge gap. Maintaining reproductive health preserves MPF triad health with life-course benefits.
生殖、妊娠和胎盘外显子组通过毒性应激因子的相互作用影响胎儿神经外显子组,损害母胎胎盘(MPF)三联体。新生儿脑病表现为不同的临床特征,基于包括缺氧缺血在内的复杂时变病因发病机制,对其诊断和预后构成挑战。生殖、妊娠和胎盘外显子组通过 MPF 三联体中的毒性应激因子相互作用损害胎儿神经外显子组。疾病发作与表型之间往往存在很长的时间间隔。胎儿-新生儿神经学科的跨学科培训、实践和研究可以缩小这一知识差距。保持生殖健康可以维持 MPF 三联体的健康,带来终生受益。