Consequences of Circadian Disruption on Pregnancy
The week 8 lectures comprises of the importance of the circadian rhythms at the time of pregnancy, clock molecular machinery and effect of pregnancy on the circadian rhythms, preterm babies and the circadian rhythms in the placenta of rat, spiny mouse and humans.
The most interesting points in the week 8 are the consequences of the circadian disruption that have a detrimental effect on the pregnancy. It is a matter of great concern as now a day; many women perform shift work that greatly affects their reproductive health during pregnancy (Haus and Smolensky 2013). Circadian disruption is the main factor for the preterm birth as there is disruption of sleep/wake rhythms in turn disrupting the pregnancy and parturition. There are complications in pregnancy that are caused by the disruptions in sleep or wake rhythms among the women shift workers (Smolensky et al. 2016).
Prior to this week lecture and material, I used to think that pregnancy is not much affected by the circadian rhythms and preterm birth is due to genetic factors or infections. I was unaware that circadian disruption is also a reason for preterm birth and predisposes the offsprings for the adult-onset diseases. During the class, questions arose that how the disruptions affect the pregnancy period and how placenta is a rhythmic organ. However, after the study lecture, I got my possible answers to the questions as it was very useful to know the key terms like circadian rhythms and disruptions, preterm birth fetal circadian rhythms and clock molecular machinery.
The week 8 lecture materials can be related to other weeks like week 11 that deals with the role of placenta that is associated with the developmental programming of the adult health and disease. Placenta acts as programming agent where the clock genes express themselves and disruption of the circadian compromises the function of the placenta in pregnancy (Qiu et al. 2015). The week 11 material is greatly linked with the week 8 material as the understanding of the placenta as the rhythm clock is well understood in the week 11 in detail.
This week material can be linked with the wider issues of the community as there are around 8% of preterm pregnancies in Australia before 37 weeks of gestation period. The preterm babies are given the light/dark treatment and are prone to many adult onset diseases due to preterm birth (Serón-Ferré et al. 2016). The work shift women suffer from consequences of circadian disruption that affects their pregnancy and leads to preterm pregnancy. Understanding the consequences of the circadian disruption, the community should work towards this issue of work shifts as it is affecting the rhythmic placenta.
Role of Placenta in Maintaining Circadian Rhythms
The week 9 deals with the topics of micro biome (microbial community) that are found on the multi cellular organisms including bacteria, viruses, protists, archaea and fungi. The micro biome is analyzed and the multiple factors that influence the maternal and infant gut micro biome that works independently but in symbiosis (Gomez-Arango et al. 2016). It also deals with the gestational diabetes mellitus that have long term consequences on the mother and the offspring.
The interesting point in the material is the interactions of the diet-micro biome-metabolism that modulates the physiology of the host through the production of the metabolites. It is derived from the food that we eat that has immune-modulatory properties (Aagaard et al. 2014). The material also showed that there are mechanisms that are linked with the obesity or diabetes with the gut micro biome.
Prior to this week material, I had questions regarding the C-section linked with the adverse health outcomes for the offsprings. However, the different studies that were performed are summarized in this material. This is helpful in knowing the underlying mechanism that C-section delivery is linked with obesity or diabetes in the offsprings.
Before the commencing of the topic, I had questions reading the mechanism of how the caesarian section (C-section) has long term health outcomes for the offsprings setting for the adult-onset diseases (Mueller et al. 2015). However, this material course helped me in understanding the mechanism along with the effects of the micro biome affecting the mother and the fetus health. The maternal and infant micro biome has an impact on the metabolic health and neurodevelopment. Furthermore, maternal nutrition during pregnancy and lactation also has an effect on the gut micro biome function and composition of the offspring (Jakobsson et al. 2014).
This week can be linked with the week 11 as it also deals with the developmental programming of the diseases like obesity or diabetes considered being the adult onset diseases. Neurodevelopment is affected due to the diet in the fetus and the adult offspring behavior. It is also linked with week 8 where the placenta is also considered to be as a diagnostic and circadian rhythm tool that have an effect on the development of the offspring and preterm birth.
This week material is also linked with the wider community issues that the maternal BMI and C-section affects the offspring’s chances of onset of adult diseases are obesity or diabetes. In obese women, the increased weight gain and diabetes is a risk factor for C-section delivery. In addition, the maternal gut micro biome is also altered in obese women with alterations in gut micro biome of the infant at the ages of 1 and 6 moths and also 2 years.
Impact of Gut Microbiome on Maternal and Fetal Health
This week material deals with the role and physiology of the placenta linked with adult disease. The size, thickness and phenotype of the placenta affects the normal functioning of the placenta and they onset of adult disease.
There are many topics that greatly interested me as how the placenta physiology is an important determining parameter in knowing the developmental of the adult disease where it acts as a diagnostic tool (Haider, Pollheimer and Knöfler, 2017). Another topic that interested me is the placenta specific therapy that helps to improve the baby health. The effect of the pravastatin is well-demonstrated that improves the physiology of the placenta. It also increases the placental blood flow and improves the heart function of the fetus.
Before the commencement of this material, I had questions regarding the underlying mechanism of the placental vascularity and blood flow impact on the fetal development of heart and its functioning. However, after the week material, it was clear that glucocorticoid is responsible for the physiological changes in the placenta with decrease in size, vascularity, altered nutrient transport and sex differences. It is well demonstrated in the 11β-HSD2 knockout model (Cottrell et al. 2014). This greatly restricted the glucocorticoid access that in turn, alters the nutrient transport and placental physiology.
This week is also related with the other weeks 8. In week 8, it is explained that the preterm birth occurs when the circadian rhythm of the placenta is disrupted and the role of glucocorticoid in this mechanism. It is demonstrated that melatonin and glucocorticoid is responsible for the oscillations made in the maternal signals that affect the clock gene expression in the placenta and proper fetal circadian rhythms is responsible for the normal fetal growth and development. In week 11 also, placenta is also explained in the development of the adult onset diseases. In this also, glucocorticoid affects the physiology of the placenta that has a effect on the fetal growth and development. This shows that placenta is an important programming and diagnostic tool that would help to reduce the chances of onset of adult diseases in infants and proper growth and development (Al-Khan et al. 2014).
It can be linked with the wider issues of the community like the preeclampsia that is a pregnancy related disease leading to the abnormal placentation and is an issue of great public concern. There is also scope for the evaluation of the expressing genes that would help to control the preeclampsia as the circadian disruption is a presentation of the occupational risk factor leading to preterm birth via C-section leading to co-morbid conditions in mother and infants (Giardini et al. 2017).
References
Aagaard, K., Ma, J., Antony, K.M., Ganu, R., Petrosino, J. and Versalovic, J., 2014. The placenta harbors a unique microbiome. Science translational medicine, 6(237), pp.237ra65-237ra65.
Al-Khan, A., Gupta, V., Illsley, N.P., Mannion, C., Koenig, C., Bogomol, A., Alvarez, M. and Zamudio, S., 2014. Maternal and fetal outcomes in placenta accreta after institution of team-managed care. Reproductive Sciences, 21(6), pp.761-771.
Cottrell, E.C., Seckl, J.R., Holmes, M.C. and Wyrwoll, C.S., 2014. Foetal and placental 11β?HSD2: a hub for developmental programming. Acta Physiologica, 210(2), pp.288-295.
Giardini, V., Rovelli, R., Giunti, L., Algeri, P., Callegari, C., Lazzarin, S. and Vergani, P., 2017. Preeclampsia: Obstetric-neonatal risk stratification according to plasma placental growth factor levels. Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health, 7, pp.60-61.
Gomez-Arango, L.F., Barrett, H.L., McIntyre, H.D., Callaway, L.K., Morrison, M. and Nitert, M.D., 2016. Connections between the gut microbiome and metabolic hormones in early pregnancy in overweight and obese women. Diabetes, 65(8), pp.2214-2223.
Haider, S., Pollheimer, J. and Knöfler, M., 2017. Notch signalling in placental development and gestational diseases. Placenta.
Haus, E.L. and Smolensky, M.H., 2013. Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation. Sleep medicine reviews, 17(4), pp.273-284.
Jakobsson, H.E., Abrahamsson, T.R., Jenmalm, M.C., Harris, K., Quince, C., Jernberg, C., Björkstén, B., Engstrand, L. and Andersson, A.F., 2014. Decreased gut microbiota diversity, delayed Bacteroidetes colonisation and reduced Th1 responses in infants delivered by caesarean section. Gut, 63(4), pp.559-566.
Mueller, N.T., Whyatt, R., Hoepner, L., Oberfield, S., Dominguez-Bello, M.G., Widen, E.M., Hassoun, A., Perera, F. and Rundle, A., 2015. Prenatal exposure to antibiotics, cesarean section and risk of childhood obesity. International Journal of Obesity, 39(4), pp.665-670.
Qiu, C., Gelaye, B., Denis, M., Tadesse, M.G., Fernandez, M.A.L., Enquobahrie, D.A., Ananth, C.V., Sanchez, S.E. and Williams, M.A., 2015. Circadian clock-related genetic risk scores and risk of placental abruption. Placenta, 36(12), pp.1480-1486.
Serón-Ferré, M., Richter, H.G., Valenzuela, G.J. and Torres-Farfan, C., 2016. Circadian rhythms in the fetus and newborn: Significance of interactions with maternal physiology and the environment. Prenatal and Postnatal Determinants of Development, pp.147-165.
Smolensky, M.H., Hermida, R.C., Reinberg, A., Sackett-Lundeen, L. and Portaluppi, F., 2016. Circadian disruption: new clinical perspective of disease pathology and basis for chronotherapeutic intervention. Chronobiology international, 33(8), pp.1101-1119.
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